Hi:
I am a frequent reader of this board, but seldom post. I just returned from a staffing on a preschooler I’ll have next year, and would appreciate input from anyone who might have further information. I don’t have his scores with me, but he was in the average range on the cognitive and portion of his testing. He is 5.8 years old, and has been in our early childhood program for a half year (his family moved from another area). The teachers report good socialization and adaptive skills, and his math is on level. The problem: he recognizes only the two first letters of his name, and cannot say the alphabet or any letter sounds in isolation. He cannot write any letters. His language is on track per the speech person. The other very interesting thing is that he does not cross the midline when copying designs. When the OT presented at the meeting, she showed us a copy of a design test she had given. In order to make an X, this boy made a diagonal mark from the top right to the middle, a diagonal mark from the top left to the middle, and same for bottom left and right, but did not cross over to make the X. The OT reports that he does a lot of squirming in his chair in order to avoid crossing this midline, too. He crosses the midline in gross motor activities, and neither the teachers nor the OT felt he had visual tracking problems. Any suggestions? Thanks.
Rosemary
Re: Midline Difficulty....long
My impression on reading this is to make sure he has regular OT in his IEP with specific goals stated. Whether or not he has visual tracking problems cannot be determined by the teachers and OT. He needs an evaluation by an ophthalmologist with expertise in this type of neurological problem. The parents could ask the pediatric neurologist for a referral on this. If he has never seen a ped neuro he should, and the OT report taken along at the time of the visit. This medical evaluation goes beyond what the school does but can be made as a suggestion to the parents.
Re: Midline Difficulty....long
I would suggest a CAPD evaluation by an audiologist specializing in pediatric CAPD. Auditory integration problems (a subset of of CAPD) include interhemispheric difficulties. The sound symbol problems are also characteristic of CAPD.
Not all audiologists will test a child that isn’t at least 6 though. OT is one standard treatment that could be started in the meantime.
My daughter has this same problem. She is in the intermediate grades, and also goes to great lengths to position her body to avoid crossing the midline. At the doctor’s office, she asked to throw darts at his dartboard. She would NOT face it straight on to throw. She had to move so it was on her right side when she threw the darts.
She had six months of private, clinical, OT in first grade. At her latest eval, the OT said martial arts would be good for crossing the midline as well as some sensory integration issues. He suggested a home program, and we have lots of OT equipment at home. She has developed some compensating skills, but it does affect her academic progress.
Although she reads on/above grade level, she does not choose to read grade level books. She apparently loses track when she gets to the middle of the page, and especially hates reading aloud because it is more obvious then. She loves being read to, and has a wonderful grasp of the deeper meanings of books (currently we are on a mission to read all the books about the Holocaust we can find; just finished Night by Elie Wiesel).
She has a learning disability for math, especially for calculation.
She is a talented artist, but cannot copy a design or picture. It makes her crazy! She almost always draws from the bottom up, or draws floating body parts (almost as if she is experimenting). Some people compare her work to Picasso in his Blue period. Hey, maybe Picasso didn’t cross the midline, either!!
There are many activites kids can do, and most are just plain fun. IE, squirt a balloon with a water pistol (with right hand, aiming across body to the left). The difficulty comes in making sure the child stays positioned on the midline. There’s also bouncing and catching a ball directly in front of you. And lying on a big therapy ball, reaching across with one hand or the other, to pick bean bags up from the floor and throw them into a basket. Just check with an OT at your school district or children’s hospital, or go to websites like www.henryot.com for ideas.