We've never quite gotten a straight answer as to whether L has what the doctors/therapists refer to as "Global Apraxia." We've been told he has apraxia of speech, as well as oral apraxia, but he also struggles with gross and fine motor planning, and at one point had hypotonia (low muscle tone) on the list, but even the pediatric neurologist was hesitant to label his challenges as Global Apraxia, although I never felt I received an answer as to how this was officially diagnosed. Or perhaps the issue is that it's not a "true diagnosis" and just kind of a term for kiddos who struggle with all motor planning, and not just oral or speech. Who knows. I've kind of given up caring at this point what the exact diagnoses are, as long as I know we are treating his current challenges to the best of our ability.
So, we currently take L for occupational therapy once a week for an hour. Because his therapist is over an hour away from us (but she is THAT GOOD, and it's totally worth the drive) and because we homeschool, so we have the ability to work therapy homework into our daily school life, we ask for more home assignments than probably the average family (so I've been told). I'm going to start adding some of our favorite, or most helpful assignments, and give suggestions as to how we made them fun and integrated them into our daily lives.
I'm going to call this one the Fine Motor Challenge, just because that's what we call it in our household. We all participate and make it into a fun dinner time game. Being a "Type A" personality, but also someone with ADD, I love finding ways to hold myself (as the "responsible adult") accountable for accomplishing our homeschool and therapy homework tasks. One of the things I find challenging is being able to SEE progress as it occurs. I know it happens, and I can look back and see how far we've come, but it's extremely validating being able to watch the progress in the short-term and not just over the long-term.
You can find a template for the Fine Motor Challenge on my products page, but it's pretty simple to make your own as well on even just a piece of paper.
1) Take 3 fine motor tasks you want to work on, write each one on their own chart.
2) Figure out how to count the repetitions of each task in a given time period
3) Chart by day, for one month - You'll love to see the improvement
Here is one of our examples:
Time: 15 second for each task
Task #1 - Opposition (tap thumb to each finger in order, then start at the beginning)
Task #2 - Open & Close (open and close the dominant hand, all the way open wide, tight fist closed)
Task #3 - Finger Tapping (make a number 1 with dominant hand, rest hand on the table and tap the
pointer finger on the table)
Now, there are two options here; You can either just track successful attempts at the tasks, or you can track both correct and incorrect attempts at the tasks. We just tracked correct attempts, and ignored the incorrect. (If he made too many incorrect attempts in a row, we would stop, go through the demonstration again and correct his movements, practice a bit, and then get back to it. No one needs to be practicing motor skills incorrectly, especially a child with apraxia).
We watched L go from not even making it through one round of the opposition task to four full rounds by the end of the month. When he started the open and close task, he could only accomplish this five times in the 15 seconds, and could only manage 27 fingers taps. Now he can do 22 open and closes, and as many as 42 fingers taps in the 15 seconds. Now why is this really important you may ask. It's not that any of these tasks is essential to his daily activities on its own, but the more individual small movements you can build motor plans for, then the easier large scope movements involving these individual plans become. For instance, catching a ball (open and closing his hands), pencil grip (pressing his pointer finger and thumb together), and typing would involve moving each finger independently of the others.
While certainly not the only homework we worked on, this gives an example of a homework assignment that we made into a game, and L found fun! When L was first diagnosed with Suspected Childhood Apraxia of Speech, his fine motor skills were such a challenge that we couldn't use sign language as a communication tool because his hands were not dexterous to manage much signing. And because of games and homework such as this, we have seen incredible improvement in his overall fine motor coordination.