Coordination

Is your child clumsy?

Is your child:

  • Having challenges running?
  • Moving awkwardly?
  • Running into things or people?
  • Tripping or falling down a lot?
  • Struggling to participate in P.E. or sports for fear of getting hurt?
  • Feeling embarrassed about a lack of athletic ability?
  • Unable to use both sides of their body effectively during a task?
  • Having difficulty stringing beads, tying shoes or buttoning?

LET'S TALK ABOUT IT

Some children have trouble running or walking. They may bump into the walls while running down the hall. They may hit their heads when entering a play tunnel. Children with these challenges generally do not enjoy hopscotch or the monkey bars.

Sometimes they accidentally crash into people at school while in circle time. They might have trouble with walking in a single-file line or with other motor activities in which they are in close proximity to peers. They may not understand personal space.

Children who struggle with this skill may be described as ‘bulls in a china shop.’ They may move loudly and clumsily and may fall down frequently. Clumsy children are often getting hurt; bumps, bruises, and even more serious injuries may happen more frequently than in children with better coordination.

Sometimes, you may notice these children behave impulsively, that is, not thinking before acting. It may be that you notice your child simply looks funny or awkward when running at the park. He may appear ‘wobbly’ or ‘floppy.’

You may notice that your child doesn’t seem to understand how far away things are and may run into the screen door or fall off of playground equipment. Within a developmental context, difficulty running smoothly is normal through the toddler years. However, if your child is 4 years old or older, he or she should be able to walk like an adult and be starting to run naturally [2].

CLINICAL DESCRIPTION

Clinically, clumsiness is referred to as a deficit in gross motor skills. The term ‘gross motor’ refers to large muscle groups such as those used for walking and running. The term ‘motor planning’ refers to coordination of movement. A child who is very coordinated and smooth when walking, running, kicking a ball, or playing sports, likely has good gross motor abilities.

Within gross motor, low muscle tone and poor coordination may impact walking and running. Difficulties with walking swiftly and smoothly may also be referred to as ‘awkward gait.’ This term means that the walking movements are jerky and awkward, rather than fluid, straight and coordinated.

A child who struggles with gross motor control has difficulty sending signals from the brain to the limbs in order to execute effective, fluid movement. In the brain, the parietal lobe and the basal ganglia regulate gross motor movement. Some children have trouble running smoothly but eventually grow out of it.

Typical development is as follows:

36 Months (3 years): Children who are 36 months of age should be able to walk naturally while rotating the upper body and swinging arms at sides [2].

48 months (4 years): By 48 months, children should be able to walk like an adult and to run smoothly.

66 months (5.5 years): By the age of 66 months, children should have a mature running pattern and may enjoy racing peers to show off their skills [2].

Some children may have ‘comorbid concerns,’ which means that the motor challenges are related to problems in other areas. Examples of comorbid concerns are as follows: reading or writing, solving puzzles, and understanding nonverbal social cues.

Some children who are clumsy may also be very active and impulsive, not thinking before they leap. These children may get hurt more frequently and can even be more prone to have a concussion, which can cause further difficulty by damaging the brain.

Children who have fine motor coordination issues often have trouble with writing, puzzles, tying their shoes, and any activity requiring them to manipulate small objects and pieces, such as buttons, zippers, cutting, and beads. Finally, children with poor coordination or body-awareness may fail to assess and pay attention to social cues.

For example, children may back away if your child gets too close, and that social ‘hint’ may go unnoticed. Because those cues are not regarded and adhered to, your child may be left out of social interactions. In many cases, these children who lack social boundaries also get in trouble at school for hurting other children accidentally, for violating personal space, or for being off-task during group activities.

If your child is experiencing these challenges, it is important to seek the help of a professional. An Occupational Therapist or Physical Therapist can help with the motor skills; a Psychologist or ABA Therapist can help with the social awareness and pro-social behaviors.

WHAT TO DO IF YOUR CHILD IS CLUMSY

Physical therapy and Occupational therapy may be available to your child in school or privately through insurance.

Physical therapy addresses gross motor movements, which are big movements like walking and running.

Occupational therapy addresses fine motor coordination and control as well as sensory differences and needs. Sensory differences refer to being less or more sensitive to sensory stimuli like light, sound, touch, taste, smell, and movement.

Encourage activities such as: martial arts, yoga, dance, swim, or gymnastics. These sports might best be initiated at a beginner level with lots of individual support. Just as you can strengthen your core doing exercise, your child can too. He or she may not be a stellar athlete but can build more confidence and strength.

Keep in mind that some children will not care as much about athletics, and this preference is okay. It may be that your child simply dislikes P.E. class and prefers to stay away from baseball. If he or she is finding a sense of belonging in academics, chess club, card clubs, or student council, the child may not need to worry about sports as much. In this case, it will be important to ensure that your child is healthy physically and has a good self-esteem.

Other activities to promote your child’s coordination

  • Lacing cards
  • Ball activities (playing catch, throwing a ball up and catching, tossing against a wall and catching, standing in a line with multiple people and passing it over/ under)
  • Obstacle courses
  • Shuffling and passing out cards
  • Placing noodles or beads on a string
  • Playing Twister

SIMILAR SYMPTOMS

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

  • Motor Planning (Moving & Sensing): the ability to plan and execute gross motor movements
  • Depth Perception: judging the distance in space between the child and other objects in the visual field
  • Visual-Spatial: seeing how objects fit together

POTENTIAL DISABILITIES

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

  • Motor Apraxia: challenges with gross motor movement
  • Developmental Coordination Disorder: challenges with fine motor, likely including poor handwriting
  • Autism Spectrum Disorder: deficits in social communication and restricted interests or behaviors
  • ADHD: challenges with hyperactivity, inattention and impulsivity that could result in clumsy behavior
  • Specific Learning Disability in reading / Dyslexia (Educationally Identified Disabilities: may be diagnosed clinically as well, challenges with reading that have underlying visual processing deficits
  • Specific Learning Disability in writing / Dysgraphia (Educationally Identified Disabilities: may be diagnosed clinically as well, challenges with writing due to visual or motor processing deficits
  • Specific Learning Disability in math / Dyscalculia (Educationally Identified Disabilities: may be diagnosed clinically as well, challenges with mathematics may relate to visual-spatial deficits

WHERE TO GO FOR HELP

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

  • CLEAR Child Psychology: to have a ‘live’ consultation with a psychologist or to obtain a customized profile of your concerns for your child
  • Physical Therapist: to assess and treat gross motor coordination; to help with large muscle groups and movement
  • Occupational Therapist: to assess and treat fine motor skills and sensory integration needs
  • Psychologist or Neuropsychologist: to consider symptoms in mental health context

These professionals may recommend or administer the following tests for this symptom:

  • MVPT-4: test of visual perception (Neuropsychological evaluation)
  • WISC-V: test of intelligence. Subtests related to block design, picture memory, coding, symbol search and cancellation can provide information on your child’s coordination and motor planning skills (Psychological or School Psychological evaluation)
  • Beery VMI sequence: test of visual-motor integration, visual perception and motor coordination (Neuropsychological evaluation or Occupational Therapy evaluation)
  • ADOS-2: test of social communication for related concerns indicating an autism diagnosis should be considered
  • TOVA, Conner’s-3: tests of attention, impulsivity and hyperactivity
  • WIAT-III: academic tests for related concerns in reading, writing, or math

LEARN MORE

[1] Barton, Erin. Educating Young Children with Autism Spectrum Disorders.

NASP: http://www.nasponline.org/books-and-products/products/books/titles/educating-young-children-with-autism

[2] Linder Ed.D., Toni & Petersen-Smith Ph.D., Ann (2008) Administration Guide for TPBA2 & TPBI2 (Play-Based Tpba, Tpbi, Tpbc). Paul H. Brookes, Inc.

Amazon: https://www.amazon.com/Administration-Guide-TPBA2-TPBI2-Play-Based/dp/1557668736/

[3] Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

[4] Trawick-Smith, Jeffrey (2013). Early childhood development: A multicultural perspective.

Amazon: https://www.amazon.com/Early-Childhood-Development-Multicultural-Perspective/dp/0132868598/ref=dp_ob_title_bk

Image Credit:
Description: Preschool girl with inline roller skates on, falling down
Stock Photo ID: #47519923 (Big Stock)
By: Anatols
Why-is-my-child-so-clumsy
Previously Licensed on: May 13, 2017
Stylized by Katie Harwood exclusively for CLEAR Child Psychology

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