Posts Tagged by Crossing the Midline

The Good, The Bad, and The Ugly

E’s first softball (t-ball) game was today.

The Good:

(Speech)

  • No issues.  She’s clear enough to give short answers and her sister is on the same team to translate if she says anything difficult for unfamiliar listeners to understand.

(Sensory)

  • She wore the uniform without any complaints.
  • She wore the pants that have two buttons and a zipper.  (She usually can only handle loose elastic pants.)  They were also 3/4 pants with elastic below the knee which she has never worn before.
  • She wore the socks which were probably pretty uncomfortable because when we took them off they had made huge marks all over her legs.
  • She wore her helmet (with a huge face guard).

(Socially)

  • She played with her teammates the entire time that we were waiting around during Opening Day.
  • Between waiting around for Opening Ceremonies and the game we were on the field for four and half hours.  E was as well-behaved as any of the other kids on the team.

(Motor)

  • E can throw the ball pretty well.  She could not throw anything six months ago.

The Bad:

(Speech)

  • Nothing.

(Sensory)

  • Nothing.

(Socially)

  • E played right field and spent most of the time with her back to the game or spinning.  Frustrating for me but most likely due in large part to her age and immaturity.  She is the youngest one on the team.

(Motor)

  • E cannot swing a bat worth squat - let alone make contact with the ball on the t.  We’ll have to work on the swinging motion first.

The Ugly:

(Speech)

  • Nothing.

(Sensory)

  • Nothing.

(Socially)

  • Nothing.

(Motor)

  • E did not want to (nor really understand how to) run the bases and only batted 1 1/2 times.

All and all, softball has been a good experience for her.  She has a lot to work on but she has come a long way.  She could not have handled all this sensory input even two months ago.  She’s growing, maturing, and improving every day.  Her favorite parts today were having everyone cheer for her at the end and getting juice and a snack after the game was over.  Of course, I was a big stress ball the entire game because I was worried about how she would handle everything and about how others would react to her.  She will earn a trophy at the end of the season but I think I deserve one too if I make it that long. ;)

And here’s the letter I sent off to her coaches tonight.  Hopefully, someday I won’t have to write these kinds of things anymore.

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E has Childhood Apraxia of Speech.  I wrote it on her registration forms but it is pretty rare and you’ve probably never heard of it before so I wanted to let you know a little about it.  CAS is a neurological motor speech disorder.  Her brain has a hard time controlling the muscles in her mouth.  Her motor problems are very similar to a stroke victim.  She has been in individual speech therapy two hours a week, eleven months a year, since she was twenty months old.  She has come a long way but her speech disorder is why her speech sounds different.  There are still quite a few sounds that she cannot say.  If you are struggling to understand her, S is usually pretty good at translating.

E also has some other motor difficulties, particularly with her arms and hands.  She just learned to throw in the last few months.  Right now swinging is pretty much impossible for her.  She has a hard time using her arms to cross her midline (moving her right arm to her left side and her left arm to her right side).  She will get it eventually but where other kids might take five times of practicing to understand the concept of swinging, it may literally take E a thousand times.  She has to build a muscle memory for each new motor movement she makes.  We’re working on with this at home too but I just wanted to let you know why she is having such a hard time.

E is very aware of her disabilities and when things get too difficult for her she will shut down and say she doesn’t want to do it.  We let her take breaks but we want her to keep working at it too.  There is nothing the matter with her cognitive functioning and because she is so aware of her disabilities, we try not to talk about them in front of her.  I haven’t had a chance to talk to you alone so I figured I would just email you instead.

She (and S) had a great time today.  Thank you for coaching and managing the team.  I’m sure all of the girls will have a great time this season.

Thanks,

Laura

W Sitters of the World Unite

E is a W-sitter.  I had heard this phrase before and had seen children who sit like this but I didn’t realize how much of a problem it can be.  W-sitting does not relate to Childhood Apraxia of Speech per say but it can certainly be co-occurring.  Many, many children with CAS have weak fine motor skills and W-sitting can certainly contribute to diminished skills in this area.

I am not an occupational therapist – just a mom.  I will, however, tell you why W-sitting has become such a problem for E and why you should look out for it and correct it in your child too.  If anyone has further information, or would like to correct me on something, please feel free to do so in the comments.

Most children W-sit at one time or another.  It is a normal stage of development.  Children sit this way because it gives them more trunk (core) support.  Doctors may tell you that the danger in w-sitting is undue pressure on the knees and hips.  In my experience, however, the more important danger in continuing to W-sit is that children do not need to cross the midline while playing in this position.  If a child sits in this position, he or she may only do things on the right side of the body with his/her right hand and vice versa with the left.  It is important for children to learn to cross the midline easily (do things on the left hand side with their right hand or things on the right hand side with their left).  When a child does not learn to cross the midline often, he/she may not develop handedness.  Naturally, human beings are supposed to develop one dominant hand and one supportive hand.  When a child W-sits and does not cross the midline, neither hand becomes dominant.  In a sense, E might be considered ambidextrous except that neither hand is strong (dominant).  Instead, she is left with some extremely weak fine motor skills (drawing, writing, cutting, etc.)

E points with both hands.  If she’s pointing to something on the right, she points with her right hand, and vice versa with the left.  They same goes for eating, drawing, or cutting.  She cannot play a game like Patty Cake because she has difficulty moving either arm across the midline.  On standardized tests, E falls in the 1st percentile for fine motor control.  In a room of one hundred same aged kids, she has the worst fine motor control of the bunch.

I’ve known that this was a problem for E for two years but all the experts kept telling me she’d grow out of it.  I wish that I has listened to my gut and pursued it earlier because fine motor skills are very important now that E is in pre-kindergarten.  Her deficits in this area are really holding her back.  Furthermore, her lack of practice in crossing the midline is also holding back her bilateral coordination skills like pedaling and catching a ball.

In our case, we are having difficulty getting services for E in this area but I came across a fantastic website by a mom who is also an OT.  Here is a link to a page she created giving ideas about how to help children learn to cross the midline. We are working on these activities at home with E in order to help her motor skills.

If your child W sits, rather than freaking out, pay attention to see if he/she is crossing the midline.  If he/she is, then it is probably not something to worry about too much.  However, if he/she is not, try to encourage cross-legged sitting or sitting on the heels and especially try some of these activities at home to help your child’s motor skills.