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View Full Version : Clenched Fists vs. Waving & Clapping?



lovin2shop
01-20-2009, 12:00 PM
My DS who just turned one seems to want to keep his hands clenched most of the time. He has waved before, but doesn't do it very often. He has never clapped. I brought this up at our 1 year visit and my Ped was mildly concerned, but said that we would just keep an eye on it for now. Other than this issue, he seems to be on target with the other developmental milestone. He feeds himself well and eats enthusiatically. He is very interactive, makes eye contact, smiles, babbles a lot, says "hi", "mamma" and "dada". He also uses his hands well to play with his toys, push buttons, etc. Our Ped said that he put him at 10mos on the development scale due to this issue. Would you be comfortable just watching this to see if he catches up, or do you think that I should be doing something further? If there are any PT's reading, I'm wondering if the clenched hands is a sign of a specific problem or just an overall delay? TIA for any advice, I'm a worrier by nature, so I have a hard time relaxing about things like this and I've had a hard time sleeping the last couple of nights!

mamaoftwins
01-20-2009, 12:56 PM
I would be fine with waiting and watching a bit longer. Both of my boys didn't start clapping until around 13.5mos and really waving until right at 14mos (I also thought there might be something wrong!). There is such a varying time frame for these milestones.

Are you having a 15mo checkup? I'd watch until then and bring it up again.

Sorry, these comments aren't the most helpful. Maybe someone else can chime in.

brittone2
01-20-2009, 01:03 PM
It is one of those things that is impossible to tell without seeing him. The fact that he can use his hands to feed himself and play with toys is a good sign.

If it were me, I'd schedule an EI eval...because I'd want more info. IT may take a while to even get an eval, and by that point, he may demonstrate clapping and a more open-handed posture. If not, you can proceed with the eval. My concern is that a lot of fine motor stuff really comes into play by 1 year...if it takes a while to monitor, and then a while to get in for an EI eval, that could be valuable time lost *if* there is a concern.

Not waving at a year would be less of a concern IMO if you weren't also seeing a closed-fist posture most of the time. The two together makes me think it is worth at least having someone (PT or OT through EI) take a look. Not waving or not clapping, I'd say watch and monitor for other signs, but if you are also noticing a fisted posture in conjunction with not waving/not clapping, worth having someone take a peek IMO. They should evaluate range of motion, tone, etc. and then they'll be able to get a better idea of whether this is truly a problem.

I'm not trying to worry you...it is just one of those things that is hard to judge over the web. I'd talk tot he folks at EI and see what kind of timeframe you are looking at for an eval (you can usually self-refer). You can always cancel if he shows some changes in the next few weeks (it usually takes several weeks at least to get the eval team out).
:hug:

lovin2shop
01-20-2009, 02:26 PM
Thanks for the info, mamaoftwins and brittone. We do have a 15 month appt scheduled, so I'm hoping that this will be a forgotten issue by then. I think I might go ahead and request the EI evaluation just to make sure that I've covered every base, plus I worry less when I have a plan that I can put into action. I had a good experience with EI in the past. Drew had eating issues that we did some therapy for and they were scheduled through EI. Amazing how kids can be so different, Drew was very far ahead on every milestone, but wouldn't eat anything. Ethan couldn't be a better eater!

One more question for Brittone, as for fine motor skills, is this an indicator of a certain development problem or type of delay? Our ped referred to the waving and clapping as a language skill, but this seems to me to be more of a physical issue than a communication issue? Just wondering, if there is a problem, what it would lead to in terms of therapy and future diagnosis? I know I'm getting ahead of myself here and you probably can't tell me much from my limited description, but I have to ask anyway!

brittone2
01-20-2009, 03:16 PM
Thanks for the info, mamaoftwins and brittone. We do have a 15 month appt scheduled, so I'm hoping that this will be a forgotten issue by then. I think I might go ahead and request the EI evaluation just to make sure that I've covered every base, plus I worry less when I have a plan that I can put into action. I had a good experience with EI in the past. Drew had eating issues that we did some therapy for and they were scheduled through EI. Amazing how kids can be so different, Drew was very far ahead on every milestone, but wouldn't eat anything. Ethan couldn't be a better eater!

One more question for Brittone, as for fine motor skills, is this an indicator of a certain development problem or type of delay? Our ped referred to the waving and clapping as a language skill, but this seems to me to be more of a physical issue than a communication issue? Just wondering, if there is a problem, what it would lead to in terms of therapy and future diagnosis? I know I'm getting ahead of myself here and you probably can't tell me much from my limited description, but I have to ask anyway!
nak w/ sleeping babe in arms...
Unfortunately, it is impossible to say what it could mean. I wish I could tell you more :hug: It could be absolutely nothing, or it could be something where therapy would be very helpful. Waving and clapping are certainly a communication/language skill, but the clenched fists are what push into the category of worth looking into more, IMHO. It doesn't mean there is anything wrong, but I would recommend having a PT/OT look at range of motion, muscle tone, strength of hand/wrist muscles, etc. to see if there's anything physical underlying the fist clenching (and they will look at those things).

I remember being mildly concerned when DS didn't wave or point at 12 months (he did it a few weeks later and was actually really verbal as a toddler). The fact that your DC is saying 3 words at his age is a great sign for his communication skills :) I personally would probably pursue the EI eval...as I said, you can always cancel. YOu can always say that you don't want/need services even if he qualifies. But for me, the combo of not clapping, not waving, *and* the clenched fists would tip me toward having an eval done. With his verbal/speech skills, the not clapping, not waving at 12 months by itself would probably make me lean toward watch and wait with the ped. But in combo with the fisted hands, I'd have someone take a look. It could be nothing at all, but IMO it is worth looking at. I wish I could give you more info but it is one of those things that is impossible to tell without seeing him first hand.

Hopefully the eval will give you some reassurance and/or some answers and ideas. And maybe you won't need it at all. I just would personally hesitate to wait until a 15 month visit, and then have to wait for an eval, etc....that's like 4 months or possibly longer (depending on how backed up EI is) that could elapse if there is a problem.

brittone2
01-20-2009, 03:35 PM
still nak
the other thing a PT/OT would look at would be what is called bilateral integration...using two hands together at midline.

You could try taking two blocks and see if you can get him to bang them together (or two of anything he likes that will make a fun noise when banged together...two pot lids, etc. Obviously watch out for smooshed fingers). It isn't a sub for real services but it certainly won't hurt anything and can encourage him to use both hands together at midline. Oh, If he likes bubbles you could see if you can get him to clap to burst them.. .one parent could blow the bubbles and the other parent could sit behind him and "help" him hand over hand to clap at the bubbles to pop them. That said, I'd still let someone look at him for tone, strength, range of motion, etc.

do they get clenched tighter if he gets more excited? eta: can he/does he open them when he crawls? If so, you could also play some chase games and crawl around on the floor together to encourage opening his hands.

lovin2shop
01-20-2009, 04:42 PM
Thank you so much for the additional information. I'm going to try out some of these activities when I get home tonight. I don't think that I actually mentioned the clenched fists part to my ped, so I'm glad that I asked here!

brittone2
01-20-2009, 05:13 PM
Thank you so much for the additional information. I'm going to try out some of these activities when I get home tonight. I don't think that I actually mentioned the clenched fists part to my ped, so I'm glad that I asked here!
You might also want to call and mention the clenched fists along w/ the not waving/pointing to your doc prior to the EI eval (if you go that route).

mommatj
03-29-2009, 04:13 PM
lovin2shop: I originally happened upon this thread when I was searching the internet for information about my daughter. This sounds almost exactly like my daughter who just turned one. Would you mind if I asked if you have obtained any more information in the past few months?

lovin2shop
03-30-2009, 12:11 PM
Mommatj, I only have a little bit of information to update at this point. After posting, I called EI and scheduled and evaluation. Of course, within a couple of days of scheduling, he started waving enthusiastically, so I canceled the appointment. However, I'm starting to get a little bit concerned again about his fine motor skills. He is not clenching as much and does still wave actively. However, he still doesn't point at all and seems kind of clumsy with his hands for his age. I've also noticed that he curls up his toes quite a bit, and he's not walking yet although I think he is just on cusp of it. So, long story short, we have his 15 month appointment in another week, so I'm going to discuss further with our Ped. I kind of regret canceling the evaluation, so if you have these same concerns, I think that it couldn't hurt to schedule an appointment.

Also, to brittone, just wanted to say thank you again for all the information. I meant to update the post, but never did get around to it. I'll post again after our dr's appointment.

nenenka
03-18-2011, 08:55 PM
Hi love2shop, I know your posts are from a while ago but I came across this link when trying to find info about my son's condition. He also clenches both fists on and off and doesn't wave or clap at 12 months. he doesn't crawl or walk. Can sit unsupported and stands leaning against an ottoman. How is your son doing? Did he eventually catch up or was there any other issue? Hope you find time to answer my questions. Thanks!

lovin2shop
03-21-2011, 04:52 PM
Hi nenenka,
Happy to update that he has definitely caught up on major milestones, but I would say that he may still have a slight fine motor skill delay. Our pediatrician isn't very concerned at this point, and he is ahead in gross motor skills. He starts preschool soon, and I agreed with the Ped's suggestion to see how he does in a classroom setting. Part of our problem is that he just isn't interested in the activities that would help him improve like coloring, playdough, etc. He's just much more of a rough and tumble kind of kid. If he struggles with the preschool craft type activities, then our Ped said that we could call our school district and have him evaluated. I also was lucky enough to find a Preschool that has a special session especially for fine motor and handwriting development starting at age 4. So, I would say that it is still a minor worry, but nowhere near as concerning as it was back when he was a baby. He did start to both walk and wave at about 14 months. We also had a big problem with scratching around that age through his 2's. Not sure if it had anything to do with the clenched fists, but it just seemed like he had to get all his frustration out through scratching. We finally taught him to scratch things other than people! Eventually, with talking, the frustration subsided and scratching is no longer a problem. So again, not sure if it was related, but I sometimes muttered under my breath that we should have him declawed!