Stepping In To Help:
I Am Concerned About My Child's Physical Development - What Should I Do?
From the time of a baby's birth, we eagerly wait for the day when our child will start to roll over, crawl and then walk. Unlike speech and language development, these milestones are at first glance easily determined. Yet, what many parents do not know is that within the field of physical development there are separate areas of development and within those areas the manner in which a child is able to accomplish a certain task, can make a big difference in his life.
The area of physical development can be divided into two main areas:
There are also two areas, which can affect a child's ability to learn and may contribute to difficulty with physical tasks. These are:
Here is an explanation of each of these basic terms:
This is the area of physical development that most parents think of first - the child's general ability to move around and use the various parts of his body. Activities like rolling over; crawling, walking, running and jumping are gross motor skills. These skills usually involve using the entire body or several parts of the body at one time.
Some of the areas that are considered when evaluating the area of gross motor development are:
Muscle Tone: How tightly or loosely a person's body is put together? If a child's body is too tight (high tone) then his movements might be jerky or disconnected. If a child's body is too loose (low tone) then her movements might be slow and lack strength. Some technical terms that are associated with these areas are Hypertonic (someone who has high tone) and Hypotonic (associated with low tone). These are professional terms and do not apply to every child whose tone happens to be either a bit tight or a bit loose. Only a professional can decide if a child's skills fit these criteria.
Muscle strength: How much strength does a child have? How much pressure can she apply with her hands and legs? How much pressure can her body withstand?
Quality of movements: Are a child's movement's smooth or does she seem to jerk her limbs? Does she seem to move either particularly slow or fast? Does it take effort for her to move around?
Range of movement: An important area in physical development is a child's ability to make movements that span the entire length of her body. A significant milestone is the ability to make movements that go from one side of the body to the other, referred to as "crossing the midline." This skill is necessary for a child to do tasks such throwing a ball or passing an object from one hand to another. This concept is also important for the area of fine motor development.
This term refers to skills that require smaller movements and more intricate capabilities. A generalization that is often made is that fine motor activities are skills that a child does with his hands. While this is not totally accurate, it is true that most fine motor activities involve a child's ability to use his hands properly. Overall, when we say that a child has appropriate fine motor skills, it means that he can use his hands appropriately for a child of his age.
Here are terms that are used to describe specific fine motor skills.
- Visual Motor Skills
These skills require coordination between the child's ability to see (visual skills) and his hands. In early childhood, this includes activities such as putting together puzzles and building with construction toys. (blocks, leggos)
- Grapho-Motor Skills
Any task that involves using a writing tool is considered a grapho-motor skill. These tasks include drawing, coloring, and using a pencil. (Grapho-Motor skills are also visual motor skills.)
An important term related to these areas and fine motor development in general, is eye-hand coordination. This refers to a person's ability to coordinate the information that she sees with her eyes in order to tell her hands what to do.
- Motor Planning
Professionals use the term motor planing to describe a child's ability to interact successfully with his physical environment; which means to plan, organize and carry out unfamiliar motor actions. When a child sees a new puzzle for the first time, it is not enough to have the physical ability to move the pieces around and fit them together. He also needs to know how to organize the activity so that he will be successful. (i.e. start with the ends, put the ones of the same color together, etc…). If a child has difficulty with a task, it is important to consider if he is unable to physically complete the task or if he is unable to figure out how to go about doing so.
While you can evaluate a child's fine motor skills from a very young age, until age two, the line between fine and gross motor skills is often very difficult to ascertain. The skills most closely associated with fine motor skills (drawing, puzzles, building, etc…) generally start to develop in children from ages two and up. Up until age two, a young child is not able to use her hands in a more intricate way. Among infants, babies and toddlers, therefore, physical development difficulties are not always clearly defined as gross motor or fine motor difficulties. By age three, however, the difference between these two areas is more obvious and the tasks that the child has difficulty with are defined as falling into either only one or both of these areas.
When considering a child's motor skills the following factors need to be taken into consideration:
Another area that can contribute significantly to a child's ability to perform physical tasks is his attention span. In the last few years, a condition called Attention Deficit Disorder has become very well known and commonly diagnosed among both pre-school and school age children. While this condition can not be properly explained in a few lines, the main point is that a child's attention span can affect his ability to complete activities. It is important to point out that when a child is having difficulty learning to perform physical tasks, it is essential to consider if his abilities are affected by his ability to pay attention to what he is doing. Is he truly unable to build a tower of ten blocks -- Or is he simply too easily distracted by the child next to him who is coloring with markers?
While many parents have heard of attention deficit disorder, few parents are aware of how their child's relationship to his senses, can affect his physical development. All children and adults, in one way or another have sensory sensitivities. There will always be certain smells that make one person feel sick and do not bother someone else, or a certain sound that makes a person's skin crawl while it does not affect someone else. But what many parents and professionals do not realize, is that there are children for whom this sensitivity keeps them from learning in a classroom or at home.
In fact, in addition to the five senses of touch, taste, smell, hearing and sight, there are two more senses that are also essential to a child's development: the movement sense (vestibular) and position in space (propriception).
All seven of these senses need to properly take in information from the environment and organize them in a way that our bodies can use. This is called sensory integration. Sometimes there are imbalances in this system that can lead to over or under sensitivity in one or several of these areas.
Being either over or under sensitive in one or several of these seven areas can affect a child's ability to perform physical tasks.
Here are some examples:
- Touch - A child might be sensitive to the feel of objects against his skin. He might hate activities such as dress up, pretend play with makeup, or arts and craft activities that involve working with playdough or clay. A child who is overly sensitive to touch may overeact when touched even lightly on the shoulder by a teach or a friend. A child who is underly sensitive may have no reaction if he falls or hurts himself.
- Smell - A child might react strongly to unusual or strong smells or not seem to notice even unusual smells such as food burning or gas leaking.
- Taste - Some children are particularly sensitive to the taste of different foods.
- Sight - Strong lights or certain types of colors may bother a child.
- Hearing - A child may be disturbed by sudden or loud noises.
- Position in Space - Some children have difficulty evaluating how much space is needed to reach a certain item. This would include putting a pegboard down on the table without tipping it over, judging if there is room for a child to crawl underneath a jungle gym and sitting down on the center of the chair. A child who seems to eternally "miss the chair" when sitting down may be having difficulty in this area.
- Movement - an overly sensitive child may fear climbing on a jungle gym, and have difficulty with gross motor activities. An underly sensitive child may be fidgety, jump on the couch all afternoon, and have difficulty sitting down to do table activities such as a puzzle.
These are but a few examples of how a child's ability to use the information he receives from his environment is critical to his ability to perform physical tasks.
When a child is having difficulty in the area of physical development, it is essential for parents and professionals that treat a child to consider how his sensory environment affects his development. In this way a parent can determine if a child really "can't" put together that puzzle or if the lights or other sounds in the room are just so disturbing to him that he is unable to do so.
It is also important for parents to understand that sensory integration is a real issue and not just a child being "picky" or "fussy." While to some children a strong smell or bright lights might be annoying, to others, the experience can be unbearable.
Evaluating Contributing Factors:
How can a parent or professional know if a child's problem is a purely physical one or if it is being affected by contributing factors such as sensory integration or attention skills? Often, making this discrimination is the hardest task of all. The first tip off that a contributing factor is affecting a child's development, is if a child can perform a task in some situations, but not in others. If a child can sit and put together 20 piece puzzles at home, but in pre-school he just moves around the pieces, then clearly the problem is not just physical. Instead, a parent and professional should consider if the child's difficulty in school is in the area of attention (too much is going on) or if he has trouble with the sensory stimuli in school (i.e. the lights are too bright, the noise of the children is too loud.)
While it is often easy to determine if a child can or cannot do a particular physical skill it can be difficult to decide if this is an exclusively physical problem or if there are other factors contributing to the child's difficulty. The key for a parent and a professional is to determine how a child's physical skills are developing. Then, if there are any difficulties, it is essential to determine if this is purely a physical difficulty or if other factors may be affecting the child's development.
This checklist was developed by Ziva Schapiro, OTR
Below is a tool to help you check up on how your child is doing. If you don't know which of these tasks your child can complete, just print out the form and keep it handy while working with your child. This tool does not replace consulting with a qualified professional if you are concerned about your child's development.
I will point out which area of physical development the task is connected to by using the following abbreviations:
G= Gross Motor Development
F= Fine Motor Development
If there are tasks that your child has difficulty with, note if they belong primarily to a specific area of physical development. Then also consider if any of the contributing factors that I mentioned about (sensory integration orattention skills) may be affecting his performance in these areas. Try some of the tasks again, in different situations and see if there are things he can do in one situation and not in another. This will help you know what areas to work on with him and may be relevant information to pass on to professionals, if you feel a professional consultation will be necessary.
If your child does not have all of these at the appropriate age - do not worry, children develop at different paces.
If your child has not developed many of these skills or most of the skills in a certain category, then - still do not worry - but you may want to check his development with the relevant professionals.
" Emotional Problems"
Children are precious; As parents we worry about their health. When our children have issues and crises, these issues and crises affect us just as much, if not more, than it affects them. We fear that which might bring them fear; we hurt when we see them hurt; and sometimes, we cry just seeing them cry. Writer Elizabeth Stone once said "Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body." So, when it seems like something is not quite right with your children - perhaps they seem more afraid than other kids, or they seem to get a lot angrier than their playmates do over certain things - this odd or "off" behavior can be experienced as terrifying. In fact, a child's difficulty can be just the starting point for your parental worry and concern. You might not know what to do to help your child, or where to go for help. Possibly, you may worry because you don't even know if your child's problem is something you should be concerned about in the first place.
We've created this survey of childhood mental and emotional disorders to help worried parents better understand the various ways that mental illness can effect children; what it looks like and how it can be helped. Children's mental and emotional disorders are problems that affect not only their behavior, emotions, moods, or thoughts, but can also affect the entire family as well. These problems are often similar to other types of health problems that your child might have, and can generally be treated with medications or psychotherapy (or a combination of both).
Many childhood disorders are often labeled as developmental disorders or learning disorders, so you may have heard those terms as well. Generally, when we speak about childhood disorders, we are referring to mental and emotional problems that most often occur and are diagnosed when children are school aged or younger. Usually, symptoms start during infancy or in early childhood, although some of the disorders may develop throughout adolescence.
The diagnostic criteria for the childhood disorders specifically require that symptoms first appear at some point during childhood. Adults may find themselves relating to some of the symptoms characteristic of one or more childhood disorders, but unless those adults first experienced their symptoms as children themselves, whatever it is that they may have will not be a childhood disorder, but instead, some other adult diagnosis.
Though by definition, no disorder discussed in this document may begin in adulthood, it is possible for a childhood disorder to begin at a young age but continue to be problematic on into adulthood. Conversely, some childhood disorders tend to resolve by the time children enter adulthood. Or, prior to adulthood, children may developed a set of coping skills that allow them to compensate for their disorder(s) so that they can go on to lead a happy and productive life. This latter outcome is especially likely when the right type of professional intervention has been obtained (and followed consistently) from an early age.
Introduction and Nature of Mental Retardation
(Intellectual Disabilities)
For Starters, a Terminology Note:
The term "Mental Retardation" (MR) is going out of favor as it has been judged to have acquired a negative and prejudicial meaning. It will likely be replaced with something along the lines of "Intellectually Disabled" or "Intellectual Disabilities" in the near future if that substitution has not (informally) happened already. This shedding of terms to describe the underlying phenomena associated with MR has happened before, and in all likelihood will probably one day happen again. No matter what the phenomena is called, some cruel people inevitably seem to find whatever terms are used to describe the phenomena useful as insults and taunts. We want to acknowledge the ongoing shift in the favored terms used to describe MR upfront. However, as our discussion is intimately linked with terms formally defined in the DSM (e.g., Diagnostic and Statistical Manual of Mental Disorders, currently in the 4th text-revised edition), our plan is to continue to use the term Mental Retardation until such time as the term changes with the publication of the upcoming DSM-V (5). At this time, Mental Retardation remains the formal and proper diagnostic term.
Nature of Mental Retardation
Mental Retardation is a diagnostic classification denoting significantly low intellectual functioning or other brain functioning problems. It is not a disease in of itself.
Classification of mental retardation indicates that developmental immaturities are present in the form of intellectual deficits, and often emotional deficits as well. This immaturity interferes with an individual's ability to function at age-appropriate levels and makes independent living a challenging proposition. A mentally retarded individual's cognitive abilities are impaired. This means that they acquire new information slowly and have difficulty understanding complex concept.
Popular thinking often paints an unflattering picture of only children, portraying them as self-centered, attention-seeking, dependent, and temperamental. Despite these negative stereotypes, smaller families in general -- and the one-child option -- are growing in popularity.
The Shy Child
Shyness is a common but little understood emotion. Everyone has felt ambivalent or self-conscious in new social situations. However, at times shyness may interfere with optimal social development and restrict children's learning. This digest (1) describes types and manifestations of shyness, (2) reviews research on genetic, temperamental, and environmental influences on shyness, (3) distinguishes between normal and problematic shyness, and (4) suggests ways to help the shy child.
Loneliness is a significant problem that can predispose young children to immediate and long-term negative consequences. However, only recently have research and intervention in educational settings focused on young children who are lonely. This digest presents an overview of loneliness with suggestions for practitioners on how they can apply the research in early childhood settings.
Children's Peer Relationships
Children who are unable to form close or satisfying relationships with peers should be of concern to parents and teachers alike. For one thing, these children miss out on opportunities to learn social skills, skills needed to initiate and maintain social relationships and to resolve social conflicts, including communication, compromise, and tact.
Traditionally, many adults have viewed conflicts between children as undesirable and have tried to prevent them or to intervene. Recent theory and research, however, suggest that peer conflict contributes to children's development and represents an important form of social interaction.
- Bullying
- Bullying can take many forms; racial discrimination and sexual harassment are examples of abuse students can face. Childrearing influences, the characteristics of the child, and factors of the environment are cited as possible reasons why children bully. Most bullying occurs in the school environment so how schools respond to such interactions impacts the school climate.
- Preventing Student Sexual Harassment
- This digest reviews effective strategies currently used by schools to combat sexual harassment. Sexual harassment is considered any unwelcome behavior of a sexual nature that interferes with the life of the target individual. Experts agree that sexual harassment is about power, not sex. A serious effort to keep a school free of sexual harassment involves the commitment of the whole school, school district, and community to a multidimensional approach and long-term educational strategies. Student education about harassment needs to be age and grade appropriate.
- Aggression and Cooperation
- Helping Young Children Develop Constructive Strategies
- Aggression and cooperation represent two critical features in the child's social domain. What do they have in common? Both emerge from the child's strong developmental push to initiate and maintain relationships with other children, beginning at a very early age. Peer relationships provide critical opportunities for children to learn to manage conflict and work towards establishing intimacy. Aggression and cooperation are two possible strategies for dealing with the normal conflicts of early peer interactions. Both have important roots in early family interactions, both are responsive to adult expectations and values, and both can be responsive to environmental factors.
- Helping Young Children Develop Constructive Strategies
Early Childhood Moral Development
During early childhood, children also grow in their ability to tell the difference between moral rules, social norms, and personal choices. By around age 5, children see that moral rules are intended to prevent "really wrong" behavior that could potentially hurt or take away from others. In contrast, social norms are rules about socially-defined behaviors that are wrong or right; however, violating these rules will not hurt other people. For example, Kayla knows that hitting Darin is morally wrong, because it will hurt him and make him cry. In contrast, Kayla knows that playing in the mud in a new dress is wrong because it will probably make Grandma mad, but it's not something that her peers will get upset or angry about. Kayla will also be able to identify different personal choices. She'll realize that even though she doesn't like to put ketchup in her macaroni and cheese, it's okay for Frankie to eat this concoction if he likes that taste.
By ages 6 and 7, the ability to differentiate between moral rules, social norms, and personal choices matures, and children can take more circumstances and possibilities into account when thinking about the ramifications of different behavior. For example, Becky knows that it is not okay to copy her friend's homework, even if she didn't have time to complete her math problems because she was at soccer practice (e.g., a moral rule). She also knows that even though it won't hurt anyone, giggling with and tickling her sister during a religious service is inappropriate (e.g., a social norm). Finally, she can think about the consequences of going outside on a chilly day without a jacket, and choose to do so (against her father's advice) anyway (e.g., a personal choice).
During the Preoperational stage, young children also start to understand that they have a choice between "right" and "wrong" in a tempting situation. For example, Sarah realizes that when Mom says "no cookies before dinner" and there's a plate of cookies on the table, she can choose whether to grab one or not. Children's ability to understand that they can make right or wrong choices leads to more self-control. Most children will be able to start delaying self-gratification (i.e. hold off doing things that will feel good in the moment) in order to make good choices. This new moral ability can be cultivated through positive discipline. Parents can be sure to highlight children's "good choices" and "bad choices" without labeling the children themselves as "bad" or "good." More information about positive parenting styles can be found in our article on Alternative Discipline (This article is not yet complete.).
While most facets of child development have both internal factors (temperament, genetics, and characteristics) and external factors (environment and social influences), morality is largely developed through external factors. Children's environments exert influence on their moral development in many different ways. Adult and peer modeling, family and societal values, religious values and beliefs, and parenting practices can all play a part in shaping morality.
Some moral behaviors are passed on by way of verbal stories or structured lessons, such as religious parables or classroom teaching activities. However, more commonly, moral behavior is learned through direct observation and imitation. Children carefully watch the behavior of their caretakers, other adults, and older children. If they see Uncle Dan being helpful to strangers, they'll be more likely to be helpful to others as well.
Parenting practices and daily discipline have a huge effect on a child's developing sense of morality. Children who receive fair consequences every time they break a rule will learn to connect their choices with consequences. For example, if Daisy gets in trouble only periodically for taking change out of Mommy's coin jar, Daisy may learn that stealing is sometimes okay. However, if Daisy learns that she will get fair consequences every time she takes money from Mom's coin jar, she will understand that stealing is never okay. Furthermore, she will learn a lesson (hopefully) that she will carry forward as she matures into a responsible and moral young woman.
