Q&A: Child with Possible Fine Motor Delay

CME WebsitesChild Development

blockquote_bgI teach a child with possible fine motor delays and maybe some sensory issues. He’s almost 3. He cannot put on even simple shoes with straps; he cannot cut at all with scissors; he doesn’t really draw any recognizable shapes, doesn’t eat well with a spoon, can’t peel up stickers, or properly work a soap pump. The thing that concerns me the most is that I can’t get him to stiffen his hands to do things – like rolling a pin over play-doh. He keeps his hands sort of limp. He also has some issues with being touched in the face, and is very active – bouncy all the time. I am looking for something I can use to do a basic evaluation of him before talking the plunge and telling his parents that he should be referred to ECSE. Any advice?

There are a variety of quick assessment tools that may help this teacher. Informally there are numerous developmental checklists available for free on the Internet, from reputable sources. Two sites to recommend are www.cdc.gov and www.aap.org. For more formal testing, depending on what this teacher has available to her, the fine motor sections of the Peabody Developmental Scales would work, or portions of the Batelle Developmental Inventory 2. For assessment of his visual motor skills, she could use the Beery Developmental Test of Visual Motor Integration but the Peabody has a visual motor component so that it would not be necessary to do both. Regarding the muscle tone in his hands, I would recommend the teacher focus on what this child can and cannot do functionally, and refer back to the pediatrician to look at underlying physiological issues. Sensory processing skills are easily assessed with either the long or short version of the Sensory Profile, and the teacher could probably complete this even without Mom’s help depending on how well she knows the child. One of my favorite comprehensive assessments of overall function is the Pediatric Evaluation of Disability Inventory but not everyone has access to that.

The CDC has some printable worksheets/lists that describe developmental skills including fine motor skills that a child should have by various ages. (I assume that she doesn’t have access to something like the HELP aka Hawaii Early Learning Profile). Then you just select an age and you can print the appropriate sheet. That could give a teacher a basic “screen” for what the child should be doing that she could review with the parent.
It seems that she was most concerned with the motor issues, but also mentioned sensory, so here is another checklist to check out for that.