This winter, Precious was seen by a new occupational therapist (OT) after going almost 18 months without seeing one. She had four different OT’s during the first four years of life and they focused on self-care skills like teaching her to put on her shoes, do up her zippers, feed herself and use the toilet. The new therapist assigned to Precious at school assessed her on all of these ‘self-care’ criteria but also assessed her on her visual motor integration and visual perception. While Precious scored well on the self-care, which I fully expected, she scored very low on the other two. I was shocked when she got an overall score of the 0.1st percentile on the Movement Assessment Battery for Children and the 0.8 percentile on The Beery-Buktenica Developmental Test of VMI. I cried a little when I imagined that in an imaginary room of 1000 kids her age, she would be the lowest functioning one there.
The silver lining is that the new OT is working on things that no one has ever addressed before. We always felt that a piece of her care was missing. Her fine motor was advanced enough to make the letters, but she just didn’t seem to understand what the letters were and this is the ‘visual perception’. As for drawing pictures, Precious can draw a face with two eyes, a nose and a mouth. She can be prompted to make ears and hair and is starting to make arms and legs, with the arms coming out of the head right below the ears, and the legs coming out of the bottom of the face, but she can’t really draw anything else. Apparently this is ‘visual motor’.
We’re working on letter recognition and letter building. We have two matching sets of magnetic letters, both upper case and lower case, and we work on having three or four letters on the board, then Precious picks a letter out of the bag and matches it to the correct letter on the board. Then we name the letter and get her to repeat until all the letters have a match.
Now the OT has suggested that we build letters with straight and curved pieces. We’re breaking down the letters into their component parts. I’ve just ordered a set of wooden shapes with all the straight and curved pieces to make the alphabet, from an on-line functional toy store. I also bought 26 laminated 8 1/2″ X 11″ cards. The order for ‘drawing’ the letters is printed on the cards, and Precious will be able to lay the wooden pieces right on top of them to create each letter. As she gets better at this, she can move to the 8 1/2″ X 11″ foam mat that she can use as a base for her letters, using the laminated card as reminder, and eventually creating the letters on the mat without the card.
At school, we learn the alphabet one letter at a time, usually starting with A, but in this case, the OT suggested we start with F, H, E and L. She sent this home on a consult note so I can only guess that it’s because these letters have no curves in them. With her special needs worker on Friday, Precious started drawing these letters and naming them, and I’m sure it’s only a matter of time before it starts sinking in. I’m really excited about this new approach!