We have a 12 year old girl with a diagnosis of William's Syndrome who receives OT as a consult service this year after receiving 60 minutes a week direct service since preschool. She functions very well in the school setting. This child has been involved in many additional activities, Scouts, gymastics, junior high track at the moment.and will soon start swimming. She holds her left arm in a position that would suggest high tone-shoulder elevated, elbow and wrist flexed with ulnar deviation. When cued she can completely extend this and move it appropriately.
Tone appears normal.
In addition wrist and hand strength are less than expected although in the G- range with hyperextension at the MCPs. We try to look at functional activities to support the child's educational program. This seems to be a more medically based issue. We have recommended accommodations to make her more functional in the school setting including peer note takers, keyboard for longer written assignments, dictating answers at times, key lock rather than combination in gym etc. 30 or so minutes per week is not going to change this unless home program etc. is in place and these are not school issues.