Motor planning skills reminder

Motor planning skills is one of things I never really thought about until I had kids diagnosed with autism. At first I didn't realise our eldest son's motor skills were anything different to other kids, then when I noticed, I thought it had something to do with his autism. Of course I discovered that his difficulties with motor planning skills is a comorbid condition than can have a diagnosis in itself, referred to as Dyspraxia.

Anthony had difficulty with a range of fine motor skills which are small movements like:

• picking up a pencil 
• doing up buttons or zips

And difficulty with gross motor skills which are larger movements like:

• running, skipping
• jumping with his feet together
• using alternate feet to go down stairs.  

Anthony found all these things difficult and his pencil use is still terrible.

It was only when I had other kids that I spotted how they intuitively knew how to move their body to do things in a way that Anthony never really did, or possible still does.

I was pulling Anthony's little sister Jane along on Anthony's scooter this morning as we headed back to our home from school. I carefully pulled her along and she casually tapped her left foot along the floor, mimicking her older brother's movements.  I remember how we had to physically place Anthony's feet where they needed to go on his scooter when we first got it, and when had to hold and move his feet for him until he understood what his body needed to do to get the scooter moving.

Jane of course was oblivious to the effort Anthony had to put in.  She seamlessly switched feet and began to tap her right foot on the floor instead.  I said something like, "You might get confused my switching feet." as I have to really think about it when I switch feet on a scooter or skateboard.  In fact, I'm pretty sure I can only skateboard with my left foot forward on the board.  I have tried it the other way but my body doesn't seem to know what's doing and I had to think about what I was doing with the individual parts of my body. 

A bit like when I drive an automatic car in the USA. I know how to drive but it takes a while to think about the gear console being on the other side and I have to think about what I'm doing with my left foot because there isn't a clutch. Goodness knows the mess I make if I try to write with my left hand despite knowing the shapes of the letters etc. And then I thought.. maybe that's the feeling Anthony had all the time.  It must have been so mentally tiring for him every time he had to do something.  At times it had felt frustrating when he was holding up the family because putting on a pair of socks took 10 minutes.  But it must have been far more frustrating for him.

Of course, Jane was just fine and I don't think it will be too long before she is on a smaller scooter by herself. As she switched feet again I wondered if in fact she was comfortable with both, maybe she'll turn out to be ambidextrous like my brother? 

Links
Our blog - Mess free motor skills fun activity
Our blog - Disastrous at decision making - comorbid conditions

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Art Neuro?

It's been well over six months since I raised the question with our various health professionals. We know our son Anthony has autism but does he also have Attention Deficit Hyperactivity Disorder (ADHD)? So how come it was only today I came across the term neuro-disability.

Anthony has been diagnosed with autism, or autistic spectrum disorder (ASD), since he was three years old.  This confirmed his difficulties in lots of areas such as language, social interaction and also sensory processing.  Both Anthony and his younger brother are sensory seekers and demonstrate sensory seeking behaviours.  They move their bodies an effort to 'feel' right.  Constant spinning, flapping, and in Anthony's case jumping to settle their sensory system. 

At school Anthony leaves his classroom several times a day for movement breaks and as he has grown I've wondered whether his constant moving and lack of interaction could partly be due to also having ADHD.  Many kids with ASD  have comorbid conditions, one's that are likely to co-occur and having both ASD and ADHD is quite common indeed.  Practically if this meant Anthony should be getting different support to help him function at school then I knew I should seek further advice and a diagnosis if needed.

Our appointment with the Neuro Development team was today and could be described as dull at best.  I spent an hour answering the many questions that I've answered before and Anthony sat, tapping, tutting and eventually ended up on the floor. Despite me trying to involve him the conversation, the consultant hardly ever asked Anthony a question about himself.  Anthony was paying absolutely no attention anyway, yet another pointer to his potential ADHD. 

At the end of the appointment the neuro consultant talked a bit about 'neuro stimulus' and Anthony's obvious hyperactivity and said he'd be in touch again in a few days after talking to Anthony's school.  We started on our one hour journey home and after 15 minutes went back past a grand building called the Royal Hospital for Neuro Disability.  It suddenly occurred to me - have our kids had neuro-disabilities this whole time and I've never realised it? 

I don't know why but it doesn't feel like this is the right term to describe them.  NHS England defines Neurodisability is an umbrella term for conditions associated with impairment involving the nervous system.  The basic element of the nervous system is the nerve cell, or neuron.  There are billions of neurons in the brain and this along with the spinal cord forms the two main structures of the nervous system.

NHS England goes on to say that this includes conditions such as cerebral palsy, autism and epilepsy.  Other organisations seem to list different conditions.  I've not been able to find a definite list, but NHS England would say our son's have neuro-disabilities. I've always described Jane their younger sister as neuro-typical and  I've always been happy to describe my boys as having a disability but it seems weird somehow to say they have a 'brain' disability. Clinically, I guess it's true, their brains function differently. 

Obviously I'm not a neuro expert and I think I'll probably not be able to stop myself investigating this more. Most recently I came across the term neurodiversity from Steve Silberman's book 'Neurotribes'. Neurodiversity is an approach to learning and disability that suggests that diverse neurological conditions appear as a result of normal variations in the human genome and presents the idea that neurological differences should be recognised and respected as a social category on a par with gender, ethnicity and sexual orientation. Perhaps it is because I heard the term neurodiversity first that I find neuro-disability strange.  

Whether officially my boys are neuro-disabled or neuro-diverse, I guess all that matters is that my son's get the support they need.  That they are given the opportunity to reach their full potential and to lead their lives in the way they wish.  And so I'll wait to hear from the neuro development team as to whether Anthony needs an ADHD diagnosis and what we can do to continue to support him.  

Links
Our Blog - Hyper what else? (Co-morbid conditions)

External Links
NAS - Sensory
Neurotribes - Steve Silberman's website

Disastrous at decision making

A report released today by the Kings Fund reports that mental health patients are at risk due to budget cuts. I've been listening to Radio 5 Live about it. It occurs to me that many people may not know that quite a few mental health conditions are comorbid with autism - that is that they are common occurring conditions.

The hope I see in the kind acts of children

Performance has always been difficult for Anthony.  The pressure of a spectacle, the potential of failure and the large number of people are a lot to cope with.  We've always been very proud of Anthony's effort to participate in his class performances but I've noted that it's not only his increased ability to cope with summer concerts and Christmas plays that gives me hope for his future.  It's the actions of the other children too.

Read the updated version and rest of this post here.

External Links
NAS - Routines and resistance to change
NAS - The sensory world of autism

Hyper-what else?

Anthony has been tip-toe walking for as long as I can remember.  Whether it's running, jumping, climbing or walking, and whether it's at school, home or in the garden, Anthony does it on his toes.  We buy the toughest school boots available.  He bends them all and goes through the ball of them by the end of each term.  Anthony is very sensory seeking and it's long been thought that he enjoys the feeling of pressure this puts on his feet.  In the summer we took him to a trial trampolining class and noticed he wasn't able to point his toes up when they were stretching - in fact it didn't look like he could do it at all.