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Standing at the Crossroads of OT Support

I recently evaluated a boy who will be in kindergarten next year. His hand grasp is not fully developed and he seemed to need OT support to move his grasp development along. At evaluation, his middle finger would wrap around the pencil and that is how he would drive the pencil. OTs work on encouraging and facilitating the use of the tripod grasp (the use of the thumb and two fingers adding 3 points of pressure to the pencil), because it is most efficient and it allows for more minute movement with less effort. Mainly, it helps with writing speed and endurance, so a student will be able to handle the greater amounts of writing they will perform in later school years.

I approached his father and brought up the subject. The dad told me his daughter also has a unique grasp. He shared that she is an amazing, successful artist who travels the world being invited to share her art. She can draw, sketch and make beautiful minute marks of detail on paper. The crazy thing is, she happens to have a “funky” grasp too.

I love how life brings me to these situations. This is the tough meat I chew on as a therapist. Do I attempt to strengthen this boy’s hand and fingers in an attempt to “fix” him? The fact is, he is able to move the pencil where he wants with function and control. However, I am taught as an OT that the tripod grasp is the most conventional way to help children understand proper pencil grasp. Then his sister comes in with her funky grasp and that grasp hasn’t held her back in life. Frankly, just the opposite. She has thrived and continues to develop her artistic work without the use of the tripod grasp.

This is really a profound crossroad. Should I support his different and unique grasp and let him see his sister in all her glory as akin to him and his ways? Should I support him being different, and knowing he is fully capable, and that he can rock his “funky” grasp? If I try to correct his grasp, will I be put into the pool of all the other people in his life journey, who will try to correct every angle of him? If I try to change his very functional but “funky” grasp, will it plant seeds in him that he is different in a “bad” way? Will I fertilize a self-consciousness that lasts throughout his school experience? He seems to be just fine with how he writes and his father doesn’t seem to mind either. His father is giving me the full choice of what to do in this situation. He appreciates my OT experience and my philosophies, however, his support doesn’t defeat my consciousness. I’m still thinking about how I will handle this task in front of me.

Have you ever experienced a situation where there wasn’t one right choice of action? How did you handle the pressure of your conscious and what ultimately lead you to your final decision? I’m curious to know your story. Feel free to share them with me in the comment section below.

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