Background
Liam is a two year, eight month old who weighs approximately forty one pounds and thirty eight inches tall, within the average range for a child his age (Cools, Martelaer, Samaey, Andries, 2009). He is a very active child who moved constantly around the room, climbed on furniture, rolled on the floor, threw toys, and had difficulty following instructions. Liam was interacting with other children throughout this observation and appeared to be having some problems with age appropriate socialization. Liam is the only child of a young mother who explained that she has worries about her son because he is so rough in his play.
At one point during the observation, Liam attempted to engage his mother in some physical play. He began crawling behind her legs as she sat on a sofa, attempting to crawl through as if her were in a tunnel. He was unable to move through smoothly. When he could not maneuver, he would lie on the floor and kick his feet to gain momentum. This play quickly degenerated into more roughness in which he kicked at his mother, jumped on the couch beside her, falling frequently and kicking wildly whenever he fell. While his walking appeared to be normal, he moved aimlessly making it difficult to assess his balance, control, and refinement of his gross motor abilities.
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Skills Assessed
The Gross motor skills observed during this session were running, jumping, walking & balance. In order to better understand this child’s development, an interview was conducted with the mother to explore his development overtime. Mother indicated that her son held up his head around two months. He was able to sit up independently by six months. His mother explained that her son did not crawl but rolled to move from place to place. He began walking around nine months by holding onto objects. He was walking independently without holding on by twelve months, according to his mother’s report. Her report indicated that Liam’s gross motor development through the first year was on track.
Liam’s mother indicated that her son has a tricycle at home and enjoys riding it. However, he prefers running to riding. Liam was able to hop on one foot for two hops before needing to put his other foot down. His balance was difficult to assess as there was nothing in the room that required him to balance. However, he appeared awkward in his movements and the roughness of his play suggested some difficulty in controlling his movements, the application of strength, and the amount of force required to complete the action. While these factors did not appear to affect his ability to perform in the activities that he engaged in during the observation period, his mother’s report about his performance in his school setting indicated that he is frequently having difficulty with playing too roughly with other children.
Liam also threw toys during this observation period. His fine motor skills appeared to be behind as he was still using a prehensil grasp. His throws were unaimed and seemed to be motivated by some frustration with the object and his inability to get it to do what he wanted. While these issues are not the result of gross motor deficits, they add to the impression of awkwardness and may also be related to his over-reliance on big movements rather than more fine-tuned movements.
He had some difficulty walking on tiptoe but it was difficult to assess if he was unable to balance or if he was acting silly. Liam appeared to be overstimulated in the room with other children and was not listening to instructions or following rules. He walked up and down steps holding the rail and bringing both feet on the step rather than alternating feet, appropriate for a child two years six months.
Summary
Liam’s motor skills overall appear to be within the two year six month and three year range. He displayed no evidence of developmental delays in motor areas earlier on. Liam will be three years old in four months. His balance and motor control is adequate but his awkwardness indicates that his abilities in these areas may be beginning to be inadequate to allow him to pursue the activities of his interest. Liam’s mother is concerned about his behaviors and his roughness. At Liam’s age, it is difficult to determine whether or not his behaviors are age appropriate or the result of discipline or parenting issues. At this time, his motor development would be described as being within normal limits but there are indicators of some developmental delays in his fine motor and social development. Liam should continue to be monitored for functional issues that may emerge as he moves forward in his school career.
- Cools, W.; Martelaer, KD.; Samaey, C.; Andries, C. (2009). “Movement Skill Assessment of Typically Developing Preschool Children: A Review of Seven Movement Skill Assessment Tools.”. Journal of Sports Science Medicine, 8 (2): 154–168
