When my son reached Grade 2 he started getting tummy aches and was reluctant to go to school. The aches persisted so I spoke to his teacher who said that my son – a chatty and confident boy at home – was anxious and quiet at school. She put this down to his probably being frustrated by his inability to translate his thoughts onto the page, which she suggested might be knocking his self-esteem. He could tell a story with ease, but writing it down was harder. At first I thought he was dyslexic, but now I realise that he might have been struggling with dysgraphia.
If you haven’t heard of dysgraphia don’t be surprised. It’s a medical term describing difficulties with drawing, copying and writing. Occupational Therapists (OTs) in South Africa generally don’t use the term much. They prefer to talk about Visual Motor Integration, which is the combination of spatial perception, planning skills and pencil control. A developmental delay in the acquisition of motor skills is associated with dysgraphia, but there is no single cause.
Signs may include reversal and bunching of letters, excessive pencil pressure, slowness to complete work and untidiness, or difficulty with planning. On referral, an OT assesses a range of things, from gross motor function (including postural control) to bilateral coordination (the coordination of both sides of the body) to crossing the midline and motor planning. Lindy Kennedy, an OT based at Micklefield School in Cape Town, says that, while every child is different, there are standardised norms for specific ages.
“We look at pencil grip,” says Lindy, “which can relate to slowness of writing. If the grip is incorrect it adds extra tension to the wrist so the child writes slowly and often presses too hard. We can’t always change the grip, but the earlier we pick up the problem the greater the chance to encourage a better grip. What we can do is work on other areas that would slow that child down later.”
Lindy likens it to an aerobics class. “Not everyone finds aerobics easy because it requires motor planning, but with practice you can be as good as the average. If your child is experiencing difficulty with drawing or writing there are lots of things you can do at home to help them.”
For starters, check their pencil grip and teach them their left and right, as well as the sounds, symbols and letter names of the alphabet. “Many children don’t know where to start on the page,” says Lindy, “so give them a step-by-step structure. Get some lined A5 paper so that they can learn to write between the lines, then use dot and finger spacing and teach them where to start when writing a letter: at 2 o’clock, for example.”
Good sitting posture is crucial, so strengthen stomach and back muscles as well as wrists. Your child should hold down the paper with a flat hand when working and her feet should be placed firmly on the floor. Colouring against a vertical surface, and exercises like netball, basketball, and volleyball, where hands are above the heart, work well for this. Swimming lengths is also a great way to strengthen muscles.
“You can teach your child and have fun,” says Lindy. “Star jumps on the trampoline and painting lazy eights in shaving cream on a mirror will help. Encourage your children to do 100-piece puzzles and use the opportunity to write words when playing games.”
10 Exercises to Help Your Child Develop Stronger Motor Control
· You stand with your legs apart – these are the goalposts. Your child lies about a metre from you, flat on the floor on his stomach with his arms and legs outstretched and slightly raised off the floor. You roll the ball to him and he uses both hands to push it back through your legs. You block the ball occasionally with your hands. This strengthens the child’s neck, back and shoulders.
· You’ll need a Pilates ball for this one. Ask your child to lie on the ball, on her stomach with her hands on the floor. She then walks forward until her knees are on the ball. With her arms kept straight she must move her legs up towards her chest and back again. This strengthens the stomach muscles.
· Ask your child to lie on his back on the floor with his knees drawn up towards his chest. Then throw a lightweight ball to him so that he can use both feet to kick it back to you. He must keep both feet off the ground. This strengthens the stomach and neck muscles.
· Ask your child to kneel on her left knee. As you throw the ball to her call out “right” and she must move onto her right knee while hitting the ball with her left hand. Alternate left and right. This helps with motor planning, right-left discrimination and postural control.
· Draw circles with both hands simultaneously to work on bilateral integration (the simultaneous coordination of both sides of the body).
· Ask your child to lie on his back, holding the ball firmly above his head. Both arms should be outstretched. Then you tap the ball and try to dislodge it while he holds it tight. This helps with shoulder strengthening.
· Other ways to strengthen the shoulders include weight-bearing exercises like handstands with feet on a wall, crawling tummy-side up with a beanbag on the tummy and wheelbarrow walking.
· To help a child “cross the midline”, ask her to draw a lazy eight (a horizontal eight) on a whiteboard, or on a wall in water with a paintbrush. She must move the right hand right across her midline without moving her head from side to side. Then do it with the left hand, and then draw two lazy eights simultaneously with both hands.
· Encourage your child to cut and to draw patterns everyday. Start with cutting straight lines before going on to curvy lines. This develops good bilateral integration.
· To help children with spatial problems and visual closure, photocopy a picture from a colouring-in book. Tippex out parts of the outline and selected detail. Photocopy your altered picture and then get your child to complete it by referring to the original. You could also photocopy half a symmetrical design (like a heart, mushroom, house or a tree) and ask your child to complete the picture by copying the existing half.