I find this a fascinating topic. Something I hadn't heard of until a behavioral optometrist tested DS2 for them and found some. I have since googled the heck out of it and found a lot of info.
Primitive & Postural Reflexes
As the infant brain develops during the first year of life connections to higher centres in the brain become stronger and increasingly take over the functions of primitive reflexes. As this occurs, early survival patterns are inhibited or controlled to allow more mature patterns of response (postural reflexes) to develop in their place.
The postural reflexes support control of balance, posture and movement in a gravity based environment. Postural reflex development is mirrored in the infant’s increasing ability to control its body, posture and movements.
Some children fail to gain this control fully in the first year of life and continue to grow up in a reflexive ‘no man’s land’, where traces of the primitive reflexes remain present and the postural reflexes do not develop fully. These children continue to experience difficulty with control of movement affecting coordination, balance, fine motor skills, motor development and associated aspects of learning such as reading, writing and physical education.
Retained primitive reflexes can also affect a child’s sensory perceptions, causing hypersensitivity in some areas and hyposensitivity in others.
Some sites with more info:
http://www.inpp.org.uk/
http://www.covd.org/
Sunday, September 26, 2010
DS2 - Details on his issues
I know this post is very long and boring for most of you, it's more for me to just get all this down in writing. I promise to try not to be so dull in the rest of my posts!
Thru the pediatrician we started the evaluation process (when we saw gross motor issues) back when he was 3. The hospital evaluation prompted us to get him evaluated by the school system where he first qualified for PT at age 4. Their follow up suggested he get tested for OT which he also qualified for and has been receiving since Kindergarten. They also suggested he be seen by a neurologist to rule out any physical spinal problems.
We saw a neurologist who suggested an MRI and FMAER/EEG/qEEG (I suggested the qEEG and he thought it was a good idea). The MRI was abnormal, he has a syrinx at T8 (space filled with fluid slightly larger than usual) and a thickened, fatty filum and possible tethered cord. We met with a neurosurgeon who thinks the syrinx is not a problem and was unsure if the fatty filum is an issue and contributing to his leg weakness (one more than the other). It can also cause pain, but he only occasionally complains of leg pain during the night which may or may not be related. Follow up testing to see if the nerves are being affected seemed to indicate they were not, so surgery should not be needed. (it would be a quick snip of the cord in the sacrum area and relatively minor)
The hospital did the FMAER and EEG, but not the qEEG which they didn't tell me until after the fact. The dr told me one thing and the testing dept told me another. It was a long story which I will spare you, but I was very upset and we switched neurologists. The 2 tests they did had some abnormal results.
From the EEG report: "There are two bursts of generalized slowing at 3 Hz with notched contours (left>right). This notching may represent admixed irregular spikes.
This EEG record is abnormal due to rare intermittent generalized slowing with notched contours."
From the FMAER report: "The 4 Hz steady state FMAER shows a very well developed left temporal-central response. However, there is a poor right central-temporal response with a clear 4 Hz following response noted just in the right posterior temporal (T6) region.
The borderline FMAER shows a poor right sided response in the face of an excellent left sided response.The relatively deficient, although present, right sided response may have other implications as regards subtle auditory processing deficiency or right temporal dysfunction in general."
We met the neurologist in August to review the results. After he realized that my son is left handed, he wondered if his brain is a mirror image of most people. He said about 50% of left handed people are right/left brain switched. If that is the case for my son then the report shows auditory processing issues.
In addition to these evaluations, we had his 504 Plan review meeting with his school in December of Kindergarten where I was a bit blind-sided by the many problems they told me he is having at school. Trouble with visual processing, attention, fine motor, motor planning and anxiety. Because of his fine motor trouble (his hands tremble a lot during tasks) he has trouble with cutting paper, coloring and writing. I think he sees how much his work differs from the other kids at his table and he gets anxious. He often says he can't do things and asks for help. His OT said it's like he has a block - once he perceives something as difficult he shuts down and says it's too hard or often tries to distract from the task by being funny or telling stories.
The school agreed to do CORE testing of visual perceptual skills, early academics, psychological and speech/language and he then qualified for an IEP. His tests show he is average to above average in intelligence, reading and math abilities. They all say he is a sweet boy with a great disposition, no behavioral problems. He loves the social aspect of school and has many friends.
The OT visual perceptual skills were problematic. He had difficulty tracking and scanning, crossing midline, converging/diverging, etc. This was news to me, I didn't realize.He also had a full evaluation with a private behavioral optometrist which showed a lot of issues. She noticed that he seems to have a pattern of overconvergence and his vision is tunneled down. His eyes work hard to keep things clear which causes fatigue over time. He has trouble getting his body to reproduce what his eyes see. He is delayed and still motor system dominant (as opposed to moving to visual system dominant) which is why he still constantly needs to touch everything.
She thinks he has trouble with primitive reflex integration. This is something I hadn’t heard of, but sounds like it might really help explain a lot of his issues. One fascinating example was when she asked him to stand next to her and copy what she was doing – put his heels together, point his toes out and take a few steps (walk like a duck). He struggled a lot and really wasn't able to do it. While concentrating on his feet, he didn't seem to realize that he was twisting his arms outward and moving them around a lot. She then asked him to try pointing his toes in (like a pigeon) and his arms turned in and his elbows went up to his shoulders (like a scarecrow).
Impression and Recommendations: "DS has not fully developed his visual tracking, focus flexibility and eye teaming stamina to support maximum academic achievement. In addition, he has not fully integrated primitive reflexes and struggles with visual motor integration and higher level processing of visual information. Less than optimal visual learning abilities will impact school, sports and play (social interaction). A success based vision therapy program will help him develop his visual efficiency and processing for maximum school and life success."
In addition to all this, around Xmas we discovered that he is color blind. He doesn't see red and green. He has trouble telling blue from purple for example. He sees colors and can often tell you if something is red or green, things just look differently to him. This is genetic from the mother and I learned that my mom's uncles were color blind, too. (My mother didn't even know this was in her family, but she and I must be carriers.)
In June 2010 we saw the new neurologist who specializes in behavioral neurology and learning disabilities and comes highly regarded. He said we would take a 'wait and see approach' and see him again in November once school is underway.
I wonder if he has adhd, but it could be that these other issues are the cause of his excessive talking and lack of attention. When his brother isn't around to get him riled up, he actually isn't nearly as difficult as his brother. Also, auditory processing problems can also be the cause of many of these issues, but he is too young to be evaluated for that yet (usually age 7-8).
I also wonder what life is like for him with all these issues. How different must things look and sound to him and how much does he have to muddle thru it all? I give him a lot of credit for doing as well as he is considering all this stuff he has to deal with. I just want to help my little guy succeed and feel good about himself.
Thru the pediatrician we started the evaluation process (when we saw gross motor issues) back when he was 3. The hospital evaluation prompted us to get him evaluated by the school system where he first qualified for PT at age 4. Their follow up suggested he get tested for OT which he also qualified for and has been receiving since Kindergarten. They also suggested he be seen by a neurologist to rule out any physical spinal problems.
We saw a neurologist who suggested an MRI and FMAER/EEG/qEEG (I suggested the qEEG and he thought it was a good idea). The MRI was abnormal, he has a syrinx at T8 (space filled with fluid slightly larger than usual) and a thickened, fatty filum and possible tethered cord. We met with a neurosurgeon who thinks the syrinx is not a problem and was unsure if the fatty filum is an issue and contributing to his leg weakness (one more than the other). It can also cause pain, but he only occasionally complains of leg pain during the night which may or may not be related. Follow up testing to see if the nerves are being affected seemed to indicate they were not, so surgery should not be needed. (it would be a quick snip of the cord in the sacrum area and relatively minor)
The hospital did the FMAER and EEG, but not the qEEG which they didn't tell me until after the fact. The dr told me one thing and the testing dept told me another. It was a long story which I will spare you, but I was very upset and we switched neurologists. The 2 tests they did had some abnormal results.
From the EEG report: "There are two bursts of generalized slowing at 3 Hz with notched contours (left>right). This notching may represent admixed irregular spikes.
This EEG record is abnormal due to rare intermittent generalized slowing with notched contours."
From the FMAER report: "The 4 Hz steady state FMAER shows a very well developed left temporal-central response. However, there is a poor right central-temporal response with a clear 4 Hz following response noted just in the right posterior temporal (T6) region.
The borderline FMAER shows a poor right sided response in the face of an excellent left sided response.The relatively deficient, although present, right sided response may have other implications as regards subtle auditory processing deficiency or right temporal dysfunction in general."
We met the neurologist in August to review the results. After he realized that my son is left handed, he wondered if his brain is a mirror image of most people. He said about 50% of left handed people are right/left brain switched. If that is the case for my son then the report shows auditory processing issues.
In addition to these evaluations, we had his 504 Plan review meeting with his school in December of Kindergarten where I was a bit blind-sided by the many problems they told me he is having at school. Trouble with visual processing, attention, fine motor, motor planning and anxiety. Because of his fine motor trouble (his hands tremble a lot during tasks) he has trouble with cutting paper, coloring and writing. I think he sees how much his work differs from the other kids at his table and he gets anxious. He often says he can't do things and asks for help. His OT said it's like he has a block - once he perceives something as difficult he shuts down and says it's too hard or often tries to distract from the task by being funny or telling stories.
The school agreed to do CORE testing of visual perceptual skills, early academics, psychological and speech/language and he then qualified for an IEP. His tests show he is average to above average in intelligence, reading and math abilities. They all say he is a sweet boy with a great disposition, no behavioral problems. He loves the social aspect of school and has many friends.
The OT visual perceptual skills were problematic. He had difficulty tracking and scanning, crossing midline, converging/diverging, etc. This was news to me, I didn't realize.He also had a full evaluation with a private behavioral optometrist which showed a lot of issues. She noticed that he seems to have a pattern of overconvergence and his vision is tunneled down. His eyes work hard to keep things clear which causes fatigue over time. He has trouble getting his body to reproduce what his eyes see. He is delayed and still motor system dominant (as opposed to moving to visual system dominant) which is why he still constantly needs to touch everything.
She thinks he has trouble with primitive reflex integration. This is something I hadn’t heard of, but sounds like it might really help explain a lot of his issues. One fascinating example was when she asked him to stand next to her and copy what she was doing – put his heels together, point his toes out and take a few steps (walk like a duck). He struggled a lot and really wasn't able to do it. While concentrating on his feet, he didn't seem to realize that he was twisting his arms outward and moving them around a lot. She then asked him to try pointing his toes in (like a pigeon) and his arms turned in and his elbows went up to his shoulders (like a scarecrow).
Impression and Recommendations: "DS has not fully developed his visual tracking, focus flexibility and eye teaming stamina to support maximum academic achievement. In addition, he has not fully integrated primitive reflexes and struggles with visual motor integration and higher level processing of visual information. Less than optimal visual learning abilities will impact school, sports and play (social interaction). A success based vision therapy program will help him develop his visual efficiency and processing for maximum school and life success."
In addition to all this, around Xmas we discovered that he is color blind. He doesn't see red and green. He has trouble telling blue from purple for example. He sees colors and can often tell you if something is red or green, things just look differently to him. This is genetic from the mother and I learned that my mom's uncles were color blind, too. (My mother didn't even know this was in her family, but she and I must be carriers.)
In June 2010 we saw the new neurologist who specializes in behavioral neurology and learning disabilities and comes highly regarded. He said we would take a 'wait and see approach' and see him again in November once school is underway.
I wonder if he has adhd, but it could be that these other issues are the cause of his excessive talking and lack of attention. When his brother isn't around to get him riled up, he actually isn't nearly as difficult as his brother. Also, auditory processing problems can also be the cause of many of these issues, but he is too young to be evaluated for that yet (usually age 7-8).
I also wonder what life is like for him with all these issues. How different must things look and sound to him and how much does he have to muddle thru it all? I give him a lot of credit for doing as well as he is considering all this stuff he has to deal with. I just want to help my little guy succeed and feel good about himself.
Summary of the issues
Son #1 has ADHD with anxiety, Dysgraphia (deficiency in the ability to write, regardless of the ability to read, not due to intellectual impairment) and is gifted. The term twice exceptional, often abbreviated as 2e, is commonly applied to high-ability children who have learning difficulties. It refers to the fact that these children are exceptional both because of their intellectual gifts and because of their special needs.
He is in 4th grade at the public elementary school and on a 504 plan, receiving OT twice a week for handwriting help.
Son #2 has Dyspraxia (motor learning difficulty that can affect planning of movements and co-ordination), also known as Developmental Coordination Disorder, along with visual processing problems. I also suspect auditory processing problems, but he is too young to be tested for that right now.
He is in the 1st grade at the public elementary school and just transitioned from a 504 plan to an IEP where he receives both OT and PT twice a week each, along with classroom accomodations.
He is in 4th grade at the public elementary school and on a 504 plan, receiving OT twice a week for handwriting help.
Son #2 has Dyspraxia (motor learning difficulty that can affect planning of movements and co-ordination), also known as Developmental Coordination Disorder, along with visual processing problems. I also suspect auditory processing problems, but he is too young to be tested for that right now.
He is in the 1st grade at the public elementary school and just transitioned from a 504 plan to an IEP where he receives both OT and PT twice a week each, along with classroom accomodations.
Subscribe to:
Posts (Atom)