Challenges with Fine Motor Skills

Probably the 2 most challenging things for Taylor these days are her fine motor skills and her sight.  Her fine motor skills are still developing but not yet back to the point where she can type or text.  She has the new iPhone, which has accessibilities (voice-over) for sight impaired people and Siri to tell it commands, so that she can start to check her messages and make phone calls on her own.  Her biggest frustration is dressing herself.  She still requires moderate assistance to get dressed, and it is frustrating for her that she cannot do this herself.  Of course, her imperfect sight contributes to her not being able to learn this faster.  She cannot see exactly where the arm hole is in the t-shirt where her arms need to go or where the leg-hole is in her shorts where her leg needs to go, for example. With her sight, she can now read short sentences on flash cards.  However, she cannot see the whole sentence at once, like you or I can.  She has to read one word, remember it as she scans for the next word, and then eventually put the whole sentence together.

As I said, her motor skills are improving.  Recently, she has been practicing her writing at CNS.  I saw her write her name for the first time since her accident, and I was over joyed!

On another note, the paper that Taylor co-authored (May 21 post) has been published in hard copy.  The paper made the cover of that journal’s issue. Taylor’s former graduate student mentor (James, now a PhD – congratulations James!) sent her a framed, author signed copy of the cover, which now hangs in her room.

There are days when the frustration leads to tears, but as a friend said to me, we should be worried if Taylor is not frustrated. That she is frustrated means she wants to improve; and that’s a good thing.

How Taylor Is Now (Fall 2014)

This is an update on Taylor’s current condition to let everyone know how she is doing in a technical sense.

In all things Taylor continues to improve. Her determination, perseverance, and good attitude continue to inspire and amaze me.

Mental Skills
Taylor is back to her old self mentally. So much so that it feels inappropriate for me to comment on it. She can do this for herself at some future time.

Motor Skills
What is perplexing about Taylor is that her memory of all kinds of facts and ideas are intact but her memory of motor skills seems completely lost. In each task she tackles she has to break down the task and examine exactly how to do it given her current abilities. Because most of our everyday simple tasks are actually highly coordinated movements involving momentum and precise timing she has to come up with simpler ways to get them done. For instance when opening a heavy self closing door she grabs the handle with her right hand and walks backward to open the door wide, then she puts her left hand behind the door, then she puts her right hand behind the door, then she moves her body around to the back side of the door, finally she backs into the doorway. Each of these steps she can do one motion at a time which minimizes the need for coordinated movement. Over time she will develop more sophisticated methods of opening the door as in each of these carefully thought out tasks she constantly improves and improvises.

As I pick her up each day from therapy she methodically goes about each task in her routine. Some she is still learning, like zipping and unzipping her backpack, others she is refining like opening a car door and sitting in the car. Each is a process and a therapy in itself. As she continues to improve it is easy to imagine her completing her goal of returning to school in fall 2015.

Physically her left arm is not as coordinated as her right and she relies on her right arm a great deal. To a lesser degree her left leg is not as agile as her right. When walking it is challenging for her to relax her left arm and let it swing.

Taylor’s vision is improving, but is still her greatest challenge to a full recovery. She got some new glasses with prisms designed to open up her tunnel vision but they did not help as much as we had hoped. They did make objects appear sharper which is a big help in correcting the mechanical half of the challenge. The other half of the challenge is her ability to mentally recognize what she sees. The other day I sat in on an occupational therapy session where Taylor was locating letters randomly placed on a wall. Each letter was about 4 inches tall and she was unable to see all the features of any one letter. Like a detective she explained how she identified each feature and how that allowed her to deduce which letter she was looking at. For instance the presence of a curve rules out letters with only straight lines like E and A, the presence of straight lines and curves could mean letters like D and B. Using these methods, along with the knowledge of the location of other letters she found and the process of elimination, she was able to find all the letters but took longer than a normally sighted person would. Like with motor skills Taylor has to break down the task of visually identifying an object into more thought out rudimentary steps. Perhaps the two are linked? Like her motor skills her vision improves everyday and she is building her methods of discerning the visual information she needs to get her tasks done.

Attitude and Motivation
Taylor continues to be praised by her therapists for being a hard worker, highly motivated, serious and thoughtful as she goes about her therapy sessions. She has a great attitude and is usually joking about everything when we are together.