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[quote=Anonymous][quote=Anonymous]Little private school. 12 kids in class. Compared to everyone else, his writing and artwork are probably the least accomplished. He always meets standards in school and I always see progress from quarter to quarter, year to year.

He was evaluated by an OT at age 4 and within the range of normal although they said he works really hard to be stay in that range. And didn't advise therapy. I don't need him to be the best, but I don't want him to struggle. At some point does physical difficulty writing end up hindering the learning process? If he's only getting one page of a story down while his peers can write two, is this detrimental? I'm just wondering if I need to do something. Another evaluation, or something else?  He complains sometimes his hand gets tired. But he's doing the work. I don't want to be the parent who pushes too hard but I also don't want to be the parent who neglects to help when help is warranted. Anyone else face something similar?[/quote]

I can tell you this.  If there is even a 1% chance an OT thinks a kid needs OT, they are all over that.  It is their bread and butter.  If an OT said no therapy at the time, I would trust that.  It is not to say he does not need it right now though.  My daughter is 5 and we went back and forth with 2 OT's who thought two different things.  In the end, her fine motor skills were okay.  It was her core and upper body strength that was the problem. She also has mild SPD (Sensory processing disorder) So we are working on gross muscles in the upper body, core exercises, along with some fine motor and hand strengthening.

Some suggestions to determine if he is weak in upper body/core (and exercises to help if he does have an issue)

Can he sit still for periods of time or shifts around like he looks uncomfortable
Can he do monkey bars
Can he do a push up
Can he stand on one leg for 15 seconds 
Does he reposition on the coach all the time while watching tv - sometimes lying, sitting sideways etc... just never sits up
Does he have trouble sitting still at a movie theater
Can you put paper underneath a kids table and see if he can color on his back for at least a few minutes, without difficulty. 
Can we hand walk across a room while you hold his legs (think wheelbarrow race)
Get window markers and see if he can color up real high on sliding glass door or window

If he is struggling, upper body/core could be the problem.  Start gymnastics, agility, tennis, basketball.  Think upper body strength sports/exercises.  
Here is a link that has exercise too
http://www.ot-mom-learning-activities.com/shoulder-exercises-for-kids.html

and this toy is also great for upper body:
http://www.amazon.com/Sliding-Family-Slider-Assorted-Colors/dp/B005DS7ICC/ref=pd_sim_t_4?ie=UTF8&refRID=129D1DZABGTD48SWN5BS

this is great for core
http://www.amazon.com/ALEX®-Toys-Active-Monkey-Balance/dp/B000N40SDC/ref=pd_sim_t_7?ie=UTF8&refRID=0XZJCR9YY7J5WBC3BQQE

Now for hand muscles/fine motor

Can he tie his shoes, zipper, snap, button without difficulty
Can you weave pieces of paper in and out (like a basket)
Can he color within the lines without difficulty/stress
Can he pick up pieces of rice/pony beads with tweezers and place them in a cup. 
Can he trace letters without his hand shaking
Can he string pony beads onto a pipe cleaner or yarn without a problem
Can he squeeze a chip-clip open and closed 50 times
Does he avoid play-doh, art, legos, sidewalk chalk
Can he cut in straight and curved lines on the dot or is too hard, takes too long.

All these note some fine motor issues.  
If so practice the above type items, plus get perler bead sets like this  http://www.amazon.com/Perler-Beads-Dragons-Knights-Fused/dp/B00B1BSF2M/ref=sr_1_3?s=toys-and-games&ie=UTF8&qid=1411188593&sr=1-3&keywords=perler+boy and do lots of other strengthening that doesn't seem to be work.  Get Gak, moon sand, play doh, modeling clay, squeeze balls, lacing patterns, etc.   A great game my kids love is wok n roll  http://www.amazon.com/Perler-Beads-Dragons-Knights-Fused/dp/B00B1BSF2M/ref=sr_1_3?s=toys-and-games&ie=UTF8&qid=1411188593&sr=1-3&keywords=perler+boy

Also, make sure his vision is REALLY checked.  By a professional.  And you can always get your primary to send you to a development-behavioral pediatrician to be sure.  I would go there before an OT again.

Good luck! 
[/quote]

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