Hi Robynne!

My middle son was just evaluated by an OT after being referred for his horrific fine motor problems at school. It turns out we have a lot of problems and I am a bit surprised by it all. Much of it is goobledeegook to me, so I shall be likely to ask you a lot of questions once I get this report figured out a bit more. ;)

One thing that is surprising me is that he is a toe-walker. I mean, I have seen him do it, but really did not think much of it. :oops: He is 5 years old and turns 6 at the end of November. He has always been a tremendous spaz when it comes to many gross motor planning skills, but to see it in print is a bit surprising. :oops:

This is what is in the report for the toe-walking:



Goal 5: To provide programming and strategies to parents and school staff to encourage development of bilateral coordination, balance and motor planning.

Present performance:

-difficulty with the timing of jumping jacks
-walks on toes, and bumps into things

Expected outcome:

-Curran's functional balance, bilateral coordination skills and motor planning will improve

Action plan:

-Curran will participate in activities from the Postural stability and Balance sheet
-Curran will participate in activities from the Bilateral coordination activity sheet
-provide consultation and activity suggestions



The tests used for assessment were:

The Bruininks-Oseretsky Test of Motor Proficiency (fine motor and gross motor subtests)
The Beery-Buktenica Developmental Test of Visual Motor Integration
The VMI developmental Test of Visual Perception

**just an aside here, but WHO ON EARTH names these tests?! Egad. They are impossible to spell, let alone remember! :smt036 **

Anyway, she is going to see him about twice a month (maximum 11 visits) until spring (March) and then he is likely to be cut loose from the program. He has a LOT of issues and the way this works is that he is likely to be graduated from the program even if he has not achieved all the goals. Is this enough time to get this kid on the path to correcting this? Is toe walking a big deal at age 6? Should I be worried about this? As I said, he was referred for his fine motor issues, but it seems he has plenty of gross motor problems, too.

She lists his summary of skills as:

Areas of strength:

Friendly, cooperative (she missed out on saying he is exceptionally communicative!)
Upper-limb speed and dexterity

Developing areas:

Visual perception
Visual motor integration
cutting skills
bilateral coordination
ADL's

Areas of difficulty:

Visual motor control
printing skills
pencil grasp

Again, the report is much bigger than what I am posting here, but I am most curious about the toe walking. I can post the entire report, if you would like in case it would be of use in this particular question. Besides, I am likely to ask you all about the rest of it, too. ;) I am not able to get to see this OT for quite awhile due to work and to committments with Iain's therapies right now.

Thanks, Robynne. I appreciate your input.

Hi Leigh:

I am going to do a big blurb of sorts on toe walking. It is an anterior mid-line deficit related to visual-motor problems. I happen to see that your OT is going to address a few visual-motor skills in the IEP. I am going to talk with a neuro optometrist tomorrow and went to a fascinating visual motor conference in November. Consultation with a neuro optometrist is quickly becoming a new way of treating visual-motor and sensory integration issues. I look forward to sharing my visit with Dr. Shidlofsky with the website. He is a specialist in this area and is also seeing my Drew! Drew has the opposite problem. He has a posterior mid-line deficit...his heels of his shoes are worn through the sole. He also has many of the sensory issues and has difficulty motor planning for gross motor skills. Most importantly, his vision is so poor, he has extreme gravitational insecurity. In other words, he screams bloody murder when his feet are off the ground. Bike riding is a scream...literally:favorites21:

Robynne