Pointer Skills...One area we've been working really hard with Wesley on are his pointer skills. One of the first questions the neurologist and all our development evaluations always ask is does he point to things that he wants. No, actually, he doesn't. He never has. The next question then is, well how does he tell you what he wants? Well, honestly he's not a very demanding kid and he's extremely easy going, so a lot of the time he just moves on. If he wants something or can't get what he wants he whines (no talking yet) until I figure it out for him, or if I'm close enough he'll grab my hand and move it to what he wants or needs. That's obviously not an answer they want to hear and twice now I've been told that could mean he's on the Autism Spectrum. This was extremely upsetting to me, not so much because I care about the actual diagnosis, just add it to the list... but because I feel like he's being labeled based on a behavior that can be explained by a dozen other characteristics he has or deals with (easy going personality, delayed motor skills, no talking, etc).
I think it makes doctors and specialists feel better when they can throw a label on the kid to define their behavior... what I can't understand is how they can possibly think that a simple checklist with yes/no questions can tell them whether a kid has Autism for example. Wesley had a severe brain injury at birth, how can anyone possibly say that his behaviors are the result of Autism and not the consequence of his injured brain? Even more frustrating is that they ask these questions without explaining what behavior they're looking for or what that means. When they ask me whether Wesley points to things he wants, I think about it for a second and say "no, not really." What I don't get an opportunity to explain are the ways he does tell me what he wants/needs. It's only afterward, when I'm home replaying the conversation/appointment in my head, that I get upset for not saying what he is able to do instead of pointing.
Regardless of what it does/doesn't mean, pointing is still a skill Wes needs to learn and we're working working working on it. He can use his pointer finger to do things like hit buttons, light switches, iPad activities, and he's just now starting to use it to point to what he wants when I present him with options. What he can't do is point to something across the room or when he throws something under the couch, for example, he can't point at it to tell me that's what he wants. So, this skill is still a work in progress...
Learning the BasicsObviously, Wes can only use his good hand to point to things since he has no real control over his fingers with his weak side. One of the first toys/tools we used to get him to use that pointer finger were toys with buttons of course. Toy phones, piano toys, anything with music buttons, etc. He started with the whole hand and slowly got better and better with narrowing down the pointer finger. One toy in particular that has helped with this is his Rainforest Music box that we keep in his crib. As I've said before, Wes is a major music lover and this toy is a major source of comfort for him while sleeping. Once he figured out that he could control the music and lights by hitting the bird button, his pointer finger skills got real good real quick! I highly recommend something like this in the crib if possible since Wes, for example, spends a lot of time in bed either going to sleep or waking up and ends up playing with the box the whole time!!
Another game we play that helps with Wesley's pointer skills is identifying body parts, particularly on the face. He learned the nose and eyes first just with repeated asking and modeling with hand over hand pointing, then he picked up ears, hair, and mouth. We make different buzzing sounds every time he touches his or our nose, which he thinks is a game, so he points back and forth between our noses to get the buzz effect. Unfortunately he's gotten a little bored with this game lately but it was good while it lasted and taught him not only to point, but what each part of the face is... win win.
We've also been working on Wesley pointing to objects in a book to identify things. He's still a little hit and miss, but with certain books (ones we've specifically worked on) he is able to point out the animals on each page. Eric Carle's Brown Bear and Polar Bear books are ones we always read and we've taught Wes that he can't turn the page until he points to the animal first. We also have a lot of those baby's first words, baby's first animals, baby's first sounds, etc books and we use those to practice pointing to different objects that Wes knows or needs to learn. He's temperamental when it comes to participating, it all depends on his mood that day, but we always try!
iPad and Pointing SkillsThe real difference maker in the pointer skill department, though, has been the iPad. I never used to let Wes do anything with the iPad except watch a story book when he was younger, but my brother talked me into (demanded really) buying an iPad case so Wes could actually touch and play with it. Let me tell you... BEST PURCHASE EVER! It was $35, (for a CASE, ugh), but worth every penny! Here's the one we got and it's been a life-changer: Once I put the iPad in that case it became indestructible, LITERALLY!
There are 100 reasons why the iPad has been an amazing tool for Wesley's development, but I'll stick to the pointer skills for now. When he first started playing with the iPad, it was really him watching the screen, not a lot of interaction. So, we had to show him that there was a cause/effect relationship. When you touch the iPad, something happens. Fisher Price Storybook apps are the BEST for this. Actually ALL Fisher Price toddler apps are amazing and free, I recommend downloading every one you can find (I've scour the app store looking for all things Fisher Price). The great thing about the Storybook apps is they sing/read a nursery rhyme one page at a time. So on one of the app's settings, all Wes has to do is hit the screen anywhere and the page turns. PERFECT for cause/effect and teaching him that touching the screen causes something to happen.
Once Wes figured that out, he started to realize that if he touched in certain places, different things would happen. Again with the Storybook apps, they have another setting that allows you to play with the pictures on the screen and you can't turn the page unless you hit the arrow button. All of the Fisher Price apps have similar settings with arrows, characters, and buttons that you can play with and these features have literally taught Wes that he has to use a pointer finger (not the whole hand method) if he wants to do more things with the app. Now, that's not to say he doesn't slap the iPad with his whole hand still... he's a boy and he always tries the easiest method first :) SO, I have to constantly remind him to "use your finger" and many times I still guide his hand and help him point his finger to target certain buttons/areas.
At the end of the day, one of the lessons I've learned about pointer finger and other fine motor skills with Wesley is practice practice practice. Even if he doesn't seem to be getting it, learning, trying, or even paying attention, as long as we try even just once a day, over time it will become a routine and he WILL learn it. Patience always pays off!