Wednesday, November 11, 2009

Motor skills and autism

Categorized under "Things that make you say, 'Duh,' in the morning"--Autism is apparently linked to motor skills problems.


Really?

I guess now I can call the phys ed teacher at TH's school and tell him that. TH, who has notable upper-body weakness, hypotonia, all the things that parents of autistic kids know well, was "disqualified" from some fitness tests this week. Not the part that involves using the legs--his are strong and long--but the part that requires pushups and pullups. Couldn't do a single one. So, he told me, his phys ed teacher told him, "You're disqualified."

Add to that his fine motor issues, which include his persistence in using a fisted grasp with pencil. Add to that his hypermobility--women in Hollywood would pay millions to have his collagen--and you've got a kid who's all angles and awkwardness.

His writing almost halfway through third grade is almost completely illegible. I look at the writing sample pictured in the story and think, "Hmmph. That's nothing." I should send in some of TH's handiwork. It's become especially entertaining now that he's chosen to write backwards, a la Leonardo Da Vinci. I've included a sample of his forward writing from this week for illustrative purposes.

"These kids are going to get picked last for kickball," quoth one of the experts in the article. Not only that, but these kids are not going to be able to swing on their own even in third grade. They're going to wander around the playground alone at recess because they can't play basketball or football. "The motor component probably makes things worse," the expert further quoth.

Um, yep.

There's also this from the piece:

Other researchers say motor skills may offer a way to help spot children with autism as early as the first few months of life.

A study of babies who were later diagnosed as autistic were late reaching milestones such as sitting up, standing on their own and walking, says Dr. Sarah Spence, a pediatric neurologist at the National Institute of Mental Health who helped conduct the study.

TH did have these delays, but we ascribed it to his being an unusually large child with an unusually large head. Little Da had even more significant delays. His fine motor skills now are, however, relatively fantastic, right down to a near-tripod grasp of pencils and an ability to zip his own pants and put straws into individual milk boxes. Dubya has always been all tripod, all the way. He falls flat on his face all the time, we but think that's because he forgets to turn off his anti-gravity servos when he returns to Earth from Planet Dub.

So, for how many of you parents or autistic adults is the headline, "Writing Study Ties Autism to Motor-Skill Problems" a duh moment for you, too?

21 comments:

goodfountain said...

Duh!

Charlotte was late in all of her motor skill development. You may have heard me say it before but I have often joked the only things Charlotte did early were hair and teeth.

Actually reading this caused me to reflect back on her early gross motor skills (or lack thereof). I think I'll blog about it. Stay tuned.

kristenspina said...

Impaired motor skills and motor planning are huge issues for my son. He was on the tail end of every milestone there is, but always just this side of "normal" so our pediatrician simply thought he was a late-bloomer. But that's another story.

Today, at eight years old, he still scores low enough on physical tests to qualify for PT from the school district. So, yeah, I'd say there isn't anything in that headline or article that would surprise me.

lynnes said...

It's a huge Duh. G does reasonably well with gross motor tasks with the exception of riding a bike. His fine motor and writing skills are poor. His school is working to teach him keyboarding skills so he can type his work. Since writing triggers severe meltdowns and computers are a motivators, I can't wait for him to aquire typing skills! (but am trying not to push as this is counter-productive)

Ange said...

yep. I actually think dyspraxia is a much more concise dx for my youngest pdd-nos kiddo, but both boys have a lot of motor planning issues whatever diagnosis you wanna give them.

Aubrie said...

Hi Emily,

I'm an OT that reads your blog and other autism blogs just to keep up. I wanted to email and ask if you have had any experience with Interactive Metronome? (I'm not necessarily suggesting, just wondering if you have ever used/encountered it?)

I enjoy getting a mom's perspective and enjoy your stories about your family tremendously!

Emily said...

GF, KS, Lynnes...Yes, duh! They could have had a much larger N for that study if they'd just called us, right?

Lynnes...TH took a long time to learn the bike. It wasn't just one second he couldn't, the next he'd figured it out. We had weeks of practice that included remembering each step in the process and, I think, gaining and retaining the necessary motor memory, which he loses easily.

Ange...TH does, too. For example, he was able to start himself on a swing last year after much practice, but in the intervening months of no swinging, he's unable to plan that again.

Aubrie--thanks for posting! I've never heard of that; no one has ever mentioned it. But of course, I just googled it and will look at it more.

Aubrie said...

Just had an inservice on it and some of the research originally was done with kiddos on the autism spectrum so I'm just asking around to see who has experience with it!

Liz Ditz said...

Here's a link to Kevin McGrew, PhD's posts on Interactive Metronome. (He may have been involved with the development of IM).

http://ticktockbraintalk.blogspot.com/search/label/Interactive%20Metronome

Here's his 2007 keynote

http://www.slideshare.net/iapsych/brain-clock-im-keynote-brief-2007

I think there are some case studies.

Liz Ditz said...

My observation re motor skills & autism:

1. children of all neurotypes are introduced / expected to handwrite too soon
2. Many handwriting curricula are developmentally inappropriate and/or offer insufficient opportunities for correct practice
3. Teachers haven't a clue how to teach handwriting.

The kids with motor issues are just triple whammied.

VAB said...

Oh yeah. And do OT early if you can, because things like handwriting are harder to correct later on.

mama edge said...

If this is big news to the neurologist community, we are really in trouble.

Club 166 said...

I'm counting on the fact that other than signing one's name, that handwriting will not be a critical skill when one looks back on the 21st century.

Joe

Navi said...

heh. Tristan's Gross Motor is fine, if not advanced. Kid on hyperdrive, with the strength and ability to keep up.

Fine motor is inconsistent. he used to twirl pencils very similar to the way violin instructors teach their students to practice with a pencil to practice holding a bow. But he has trouble putting lids on. He can get them on, but not lined up, etc. I have no idea about his hand writing, as we're still working on lines and shapes.

Navi said...

Is bicycling really gross motor? I mean yes it's moving the entire leg, but it's a specific movement. might it be fine motor? I have no clue in that area, though... Is the OT still reading the comments?

Emily said...

Liz--thanks for that info. Yes, and there's also too much emphasis on handwriting, in my opinion. I've thought that since elementary school, when we received *letter grades* for it.

Mama...and I'm sure it's not the only thing.

Joe--we're counting on that, too. So much so that we ourselves have forgotten how to write by hand.

Navi...the cycling is more about motor planning issues, although he also had trouble with balance because of his trunk hypotonia...he would list considerably to one side or the other then torque his hips in the opposite direction to try to keep balance. The result? A header into somebody's shrubbery. He was a real trouper and just hopped back up and tried again.

The author said...

Handwriting is yet another example of a socially constructed skill set, that is not inherently natural nor linked to survival.

I have a lot of anger about it given that I was one of those kid's constantly penalised at school for my handwriting.

When I was 16 I learnt to type and never looked back. Why oh why could this not have been a solution earlier on? It has proved an advantageous skill in later life and more use than handwriting.

As an adult I consciously abandoned my illegible joined up writing and went back to print for clarity. It's good enough for the purpose and you often required to print in official forms anyway.

So just who is this victorian concept of copper plate handwriting for any more?

Emily said...

Author, I think it probably once distinguished people who had a "good" education from those who did not. I also was always penalized for my handwriting--in fact, it was my first and only "non-A" grade in elementary school. How stupid is that? I usually write in all caps if I must write at all.

Aubrie said...

Navi -- yes, I would consider cycling gross motor, not fine motor as fine motor skills are usually reserved for describing hand skills/functions. Emily is right, it is more of a motor planning issue to ride a bike versus a gross motor challenge because cycling involves so many praxic components.

I also hear the arguments about placing so much emphasis on handwriting and how that may be a disservice to our children, but as an OT I can't let go of it! So many other fine motor components are learned through and in conjunction with handwriting skills - even though our students may not rely on it as much as we once did, from a developmental standpoint it is still ever so important!

Navi said...

I'm young enough not to have received letter grades for handwriting. My 4th grade teacher allowed me to print and gave me extra time, 'supports' for a kid that didn't have an IEP. My 11th grade English teacher gave me an extra day to type drafts, as she knew I didn't have a computer at home, and had to use friends' computers or go to the lab at school, which didn't always mesh with watching my brothers. I'd give her the printed 'draft' on the day so she could scan over and see that it was done, and then I'd type a legible one and turn it in the next day. Again 'supports' for a kid sans IEP. Unfortunately not all teachers are so wonderful.

They actually stop requiring cursive after elementary school, except for when you fill out your SAT app (don't know if they still require a handwritten sentence for that, but they did when I took it in the late 90s)

My oldest, her cursive is actually a bit more legible than her print, oddly enough....

Do all of us with horrible handwriting have autistic kids?

xyz said...

“Since the implementation of the "Back to Sleep" campaign, therapists are seeing increasing numbers of kindergarten-aged children who are unable to hold a pencil.”
Susan Syron, Pediatric Physical Therapist

“There are indications of a rapidly growing population of infants who show developmental abnormalities as a result of prolonged exposure to the supine position.”
Dr. Ralph Pelligra regarding the impact of the Back to Sleep Campaign

As it turns out, when the primarily back and side sleeping ALSPAC babies were compared to the primarily stomach sleeping Colorado babies used to develop the DDST the researchers obtained these results: 68% of the ALSPAC infants had abnormal scores at 6 months of age compared to the stomach sleeping DDST Colorado infants and 57% of the ALSPAC infants had abnormal scores at 18 months compared to the original stomach sleeping DDST Colorado infants.
Summary of Alan Emond letter to BMJ in 2005 regarding ALSPAC data and a research project unrelated to Sudden Infant Death Syndrome.

Ali said...

My handwriting is and always has been variable. If I think about it long enough and really try, I can print quite neatly. Never got the hang of cursive (which got me in trouble in 3rd and 4th grade until, I think?, my mom talked to my teachers). My usual handwriting is a terrible scrawl and I get cramps very easily. I first wrote around 30 months old, though, and I doubt my grip style has changed much since then from a sort-of tripod. I can draw for hours, though, and quite well--I think I hold my pen/cil differently?

As for the physical fitness tests, I kick butt at the sit-and-reach (the flexibility test--like TH I'm hypermobile), but never passed because of the push/pull-ups. Frankly, it's a relief to know this is associated with the spectrum and isn't a personal failing!