Help me understand fine motor skills delay - Mothering Forums
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#1 of 19 Old 12-16-2007, 12:18 AM - Thread Starter
 
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The other day I took DS (4 1/2) to the pediatrician for his annual checkup. She said that everything looked fine, but that she felt that he had fine motor skills delay. She based this on the fact that he can't pedal a bike, doesn't draw any distinguishable figures, cannot work buttons, and holds a pen/fork/etc whole fisted. She recommended that we see an OT, and I have made an appointment for next month.

Now here is where I am confused. Although he cannot do the things mentioned above (and in addition he has great difficulty with pouring liquids, drinking from a regular glass, properly using eating utensils, brushing his teeth, and using scissors in a way other than cutting random strips), he can do other things like thread small beads, complete up to 48 pc puzzles, and recently started writing letters (though he seems slower picking this up than his friends).

So I am wondering how can he be delayed in some areas but not others. If he has a delay wouldn't he be unable to any fine motor things? I'd love any insight that anyone has on this.
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#2 of 19 Old 12-16-2007, 12:24 AM
 
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Hmmm... I await answers too!:

I did think that pedaling a tricycle was a gross motor skill and not a fine one though? Or perhaps I'm just really tired tonight.

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#3 of 19 Old 12-16-2007, 12:30 AM
 
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Peddling is a gross motor skill, yep.

Fine motor is tricky. My 6 yo has some minor fine motor delays. There are so many muscles and so many little things that those muscles are trying to do that it's very possible for him to have a good enough pencil grip to start to form letters but still have trouble with a toothbrush. Being able to do a few fine motor things with ocasional competency doesn't rule out a general fine motor delay. Does that make sense?

FWIW, my 6 yo still can't use scissors well, has the wackiest pencil grip I have ever seen and still has trouble pulling the pegs out of the Battleship board. I've been working with him for 2 years, and he's now caught up enough that his 1st grade teacher tells me he comes across as disinterested in fine motor activites now as opposed to unable to perform.
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#4 of 19 Old 12-16-2007, 12:41 AM
 
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My ds is going to be 8 in Feb and has a terrible time writing. I bought all the workbooks, hand manipulation games and tools, play doug, ect. He can cut with scissors now, he can button his clothes, and tie his shoes. He couldn't do a lot of things until last year. I think that it is more than the muscles in his hands needing to develop but also the perceptual maturity to plan out how to do fine motor skills. Bdavis your son sounds like mine in a way. He doesn't like art class at all. His drawings are very raw compared to his peers and I feel like art class is an area he feels like his efforts are displayed along his peers and compared. I just tell him everyone can't be perfect at everything because I don;'t know what else to tell him.
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#5 of 19 Old 12-16-2007, 12:45 AM
 
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my boy loves art, but he's just not "good" at it. he's come up with a really minimalist way of drawing and representing things - in his latest story he wrote about receiving his yellow belt in tae kwon do, and he had to illustrate each page. He used scribbles of color to represent the other students in his class, each color of course for the color of that student's belt. His instructor was a black upright rectangle, and each page was bordered with a wide yellow band. I loved it, and thought it was very creative and very fun. He had to work so hard on the penmanship he just didn't have anything left for the artwork!
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#6 of 19 Old 12-16-2007, 01:00 AM
 
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Originally Posted by bdavis337 View Post
Peddling is a gross motor skill, yep.
whew! I got something right today! Its been one of those days...

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#7 of 19 Old 12-16-2007, 01:02 AM
 
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Ha! I was just thinking "I bet peddling really IS fine motor in some ways, b/c of the complicated nature of what it involves, and how it's so much more than just doing one thing at a time"..........
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#8 of 19 Old 12-16-2007, 01:03 AM
 
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Ha! I was just thinking "I bet peddling really IS fine motor in some ways, b/c of the complicated nature of what it involves, and how it's so much more than just doing one thing at a time"..........
Shhhhh! don't spoil it! I was just starting to feel good tonight!

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#9 of 19 Old 12-16-2007, 01:13 AM
 
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Well, I've got a very similar kiddo. He's really good at fine motor manipulation (the beads and puzzles involve that in your child). But his fine motor skills fall apart in strength areas--he's weak muscularly. While I don't know that that is the issue with your child weakness is evidenced by gripping with the whole fist (more power/control than fingers) and cutting issues (open/close/squeeze). Either of those could also be about other things too of course. The pedaling when they are looking OT wise they are looking for the coordination of both sides of the body. It could be a coordination issue with your child. If not, weakness can make pedaling hard even if the coordination is there. However most buttons are more manipulation that strength but using both sides of the body maybe at midline might be indicated by that.

I'm babbling. But the point is that it doesn't surprise me that he might have some fine motor strengths and other weaknesses. It sounds like he does need some work fine motor wise as he does have some significant delays in that area. That said, lots of kids (especially boys) do.

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#10 of 19 Old 12-16-2007, 01:53 AM - Thread Starter
 
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The coordination thing sounds like it might be him. When he cuts with scissors he gets frustrated and a lot of times has to hold one side of the scissors with one hand and the other with his other hand and cuts two handed. He writes with his right hand but paints with both (not sure if there is any relevance there. And when he's on a bike he seems to know what to do but just can't get it together.

What is really difficult is that my younger ds (2) is the complete opposite and is actually physically gifted. His motor skills, both fine and gross, are at the level of most 5 year olds, and I think ds1 gets frustrated because the "baby" can do things that he can't, such as drinking out of a regular glass or pouring his own drink.
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#11 of 19 Old 12-16-2007, 03:05 AM
 
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I think it's a coordination, possibly even visual-motor integration kind of issue. Our ds has (or had) fine motor delay and couldn't pedal a trike. His OT diagnosed (among other things) difficulties with bilateral coordination - he just couldn't get his body to work together (fine or large motor) and for fine motor, it was also motor planning and strength. Even now his pencil grasp is a bit weird, and his writing sucks. In fact, I'm going to have a conference with his teachers on Monday about getting them to cut him some slack on the handwriting stuff.

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#12 of 19 Old 12-16-2007, 07:42 AM
 
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I'm kind of confused about the same thing, so I'm glad to read that it's not uncommon.

My dd has fine motor delays only in certain areas, too. Writing and drawing are awful. She has lots of trouble with buttons, zippers, tying. Yet, she had an early and very effective pincher grasp, her gross motor skills are advanced, she does beading and puzzles. For a long time I didn't realize she had fine motor problems because she did so many fine motor things well. The best explanation I can get for her delays is that there are certain things where the message from her brain doesn't quite get to her hands. Her OT says it's a form of dyspraxia. Others have alternately suggested that because she is slow to grow she hasn't matured enough to do these things. When you stop to think about it there are so many different skills coming together to do some of those task especially things like writing. It's more than just using the hand -- like I tend to first think when I think fine motor.
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#13 of 19 Old 12-16-2007, 10:22 AM
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DS is scattered in fine motor skills as well, and always has been. For example, he could eat with a fork before he could eat with a spoon--like months and months before.

Right now (at 4.5) he can write his first name (and it's a long one and he's been able to do it for 6 months), just learned to put the two pieces together to zip, can draw a circle and a square, can cut a straight line and circle with scissors, but he cannot button or unbutton. No one has really figured out his pattern. DH thinks it's finger strength (but DS holds a pencil perfectly), I think it might be motor planning (but he's good at that in more gross motor skills type settings), our OTs have never speculated. . . . .
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#14 of 19 Old 12-16-2007, 11:00 AM
 
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Hmmm... now you've got me thinking. OT hasn't tested 4.5 yo dd yet with anything, but by observation my dd cannot pedal a trike, steer a trike, unbutton buttons, put together zippers to zip, tie shoes (this one I didn't think mattered much. I was nearly 8 before I learned myself) she recently learned how to cut with scissors better.

She can, write her first name though sometimes its IYV and IYYYY, etc. she can draw a circle, and sort of a square. She draws pictures that are more than just a head now but this is very recent. She can put her own clothes on, though has a hard time with socks, buttons, snaps, tights, and putting things on so they aren't on inside out. This is also something very new as usually she prefers being naked. She has a hard time using a fork or spoon, preferring to use her fingers. She can drink from a cup, but she always manages to spill it a million times somehow. She can do simple puzzles now, but this is recent too. She holds her pencil with all her fingers. Not in a fist, but more like just all of them touching. Coincidentally I also hold my pencil incorrectly it seems.

As a baby she had a late pincher grasp, and was late to do things like stack blocks and Duplos. (not until she was 3) Late to color and draw (around 3, not recognizable as anything until very recently) And the trike we've been working on for a few years now and she just cannot get it down. She tries, its like she knows what to do, but she can't coordinate to alternate feet AND push, AND steer. Otherwise, she runs, climbs, jumps, kicks a ball, etc. but she is very clumsy and falls all the time. Stairs she takes deliberately, and has to pay attention or she'll fall. She still doesn't always alternate feet on the stairs, and usually holds onto the railing with both hands.

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#15 of 19 Old 12-16-2007, 11:16 AM
 
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DS is 4 and recently had an OT evaluation for fine motor. He also has a mix of weak and strong areas. He can cut with scissors and string beads just fine. However he has a hard time with buttons and with any kind of writing/drawing. The therapist described it as muscular weakness. I guess there are two components to fine motor skills, dexterity and strength. He's got the dexterity, like the ability to manipulate things with his fingers, he just doesn't have the strength to put with it. We are going ot have a few more sessions with the therapist where she shows us activities to do with him to help him strengthen his muscles. It's not a huge major problem but I want him to be prepared for going into kindergarten next fall.
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#16 of 19 Old 12-16-2007, 01:32 PM
 
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Chiming in to say, yeah, us too! dd2 has a killer pincher grasp, always has, and that (for me) really masked the limb apraxia problems she has. She can't sign well at all, because she can't coordinate her fingers. She can't do the Peace sign, for example. She won't be able to do buttons anytime soon!

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#17 of 19 Old 12-17-2007, 12:10 AM
 
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DS is 4 and recently had an OT evaluation for fine motor. He also has a mix of weak and strong areas. He can cut with scissors and string beads just fine. However he has a hard time with buttons and with any kind of writing/drawing. The therapist described it as muscular weakness. I guess there are two components to fine motor skills, dexterity and strength. He's got the dexterity, like the ability to manipulate things with his fingers, he just doesn't have the strength to put with it. We are going ot have a few more sessions with the therapist where she shows us activities to do with him to help him strengthen his muscles. It's not a huge major problem but I want him to be prepared for going into kindergarten next fall.
This is our DS exactly. He is 4 this week and is in OT. Definitely has vestibular dysfunction, "floppiness" and lack of strength in his hands. I was very confused as well.
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#18 of 19 Old 12-17-2007, 04:15 AM
 
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It doesn't sound like fine motor delay, it sounds like motor planning. Two different issues.

Motor planning is sort of like bad coordination. It is more than that, but that is an easier to understand way to put it.

For people with motor planning delays, they aren't always able to pick up a lot of the motor planning that most kids pick up just from watching something. You have to break it down into more steps and practice it. Sometimes you use hand over hand to show their muscles how to move to accomplish a task. Once they have it, they are able to do it well, but learning it is more challenging.

That is why some kids are able to do some things that require motor planning with ease, but other, sometimes simpler, things are difficult. My ds can type pretty decently, and has specific motor planning things that are above age level even, but a lot of other things have to be taught meticulously step by step and take a LOT of effort.

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#19 of 19 Old 12-17-2007, 11:07 AM
 
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Jake, my middle kid, the one who's supposed the be "normal," is starting OT for some pretty severe fine and gross motor delays. I've suspected he's had them since he was a baby and didn't crawl till about 10-11 mos and didn't walk till 16, but I've listened to my ped all these years telling me he's fine, just on the late end of normal. Um, no, he's well below the late end of normal. He is fine with things like pouring and drinking from a cup, but he can't hold a pencil, he still holds it in his fist, and he can't really draw ANYTHING recognizable, even a simple shape. He can't pedal and steer at the same time, and he's really clumsy. He also has a lot of sensory issues, which may compound his motor delays.

Sort of off topic here, but during his evaluation, his OT pointed out to me that he has a lot of anxiety and his social skills actually aren't that hot, even though he can have conversations and is extremely friendly and talkative. My friend who has a son w/ AS and a daughter who has a lot of the signs, but is only 3, has been telling me for a while she really thought all 3 of my kids have AS, but I insisted Jake was normal, even though I agree the other 2 definitely do. Might have to rethink that. I still think Jake is not on the spectrum. He's just really really close to that line. His social skills are "off," but they're not impaired enough to be considered autistic. KWIM?
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