Following a brain injury, students often have difficulties with various areas of their motor skills. The term ‘Motor Skills’ refers to a range of physical skills affecting gross motor and fine motor skills. These are assessed by a Physiotherapist and Occupational Therapist, and will often be discussed in reports.
Motor skills are a complex mixture of stability and mobility. For example, to be able to walk efficiently, your head and trunk need to be stable while your arms and legs are moving. The performance of motor skills can be affected by many different factors including muscle tone, balance and coordination, strength, attention and concentration and motivation.
How do I know if my student is having difficulties with their gross motor skills?
Gross Motor Skills are the larger movements we make from day to day, often involving our whole body (running, jumping, catching, sitting down, rolling over and kneeling). These skills are particularly important to enable students to participate in play, sports and recreational activities. There are a number of causes of gross motor difficulties and it can be complex trying to determine the exact cause. The student’s physiotherapist can help you to determine the basis of the problem and develop appropriate strategies.
Reasons behind gross motor difficulties
- Reduced strength or co-ordination of the muscles in the trunk, legs and ankles.
- Increased tone (muscle tension) in the legs and ankle.
- Decreased strength in the core (tummy) muscles.
- Have a hemiplegia (one side of the body is weak/paralysed) resulting in poor balance, appearing asymmetrical when walking or may trip over their weaker side.
- Poor sensation in legs and feet.
- Reduced proprioception (the ability to sense where your legs/feet are and what they are doing without looking).
- Poor stability in the joints especially the knee and ankle.
- Difficulty planning how to complete a task eg. Stepping over an obstacle.
Signs of gross motor difficulties
- Poor push off when jumping or hopping.
- May appear clumsy or awkward.
- Unable to perform activities quickly or smoothly.
- Unable to stand still or constantly bumping into other students in line.
- Avoiding participation in PE or other activities involving running or ball skills, or reduced ability to participate in these skills.
- Needing more practice than other children to complete a physical task such as walking along a plank.
- Only being able to do one part of an activity at one time (not able to jump & catch a ball) especially if the task has a cognitive component as well as a physical one.
Strategies to assist students with gross motor difficulties
- Reduce number of distractions when student is performing tasks especially with new or difficult tasks. Break down the tasks where possible.
- Use a combination of verbal cues (instructions) and visual cues (demonstration) when teaching a new physical skill.
- Continue to encourage their participation in activities as they should improve with practice.
- Encourage the student walking on smooth walking surfaces.
- Specific activities may be given by the student’s therapist to assist with some underlying difficulties. These can be incorporated as a warm up session with the entire class prior to physical activities.
- Encourage the use of AFO’s/splints if recommended by the students physiotherapist.
How do I know if my student is having difficulties with their fine motor skills?
Fine motor skills are the smaller movement of the hands and include the ability to grasp (picking up objects), release (letting go of objects), manipulate objects in the hand and to use tools (scissors, pencils, hammer and utensils).
Reasons behind fine motor difficulties
- Reduced strength or co-ordination of the small muscles in the hand.
- Increased tone (muscle tension) in the arm, hand and/or fingers.
- Have a hemiplegia resulting in neglecting to use their affected arm especially with two handed activities.
- Poor sensation in hands and fingers.
- Reduced proprioception (the ability to sense where your hand/fingers are and what they are doing without looking).
- Reduced stereognosis (the ability to perceive the shape of an object by feeling).
- Poor stability in the joints of their fingers.
- Poor stability around the shoulder (difficulty holding upper arm still while using hand and fingers).
- Difficulty planning how to do a fine motor task (how to move the pencil to form the letter “A”).
Signs of fine motor difficulties
Students find it difficult to:
- perform individual finger movements eg. To poke, point, use individual fingers for typing or playing a piano
- hold and manipulate a pencil to write/draw
- hold and manipulate paper while using scissors
- manipulate objects in their hand e.g. Take a handful of change out of their pocket to feed into a piggy bank.
- do up shoe laces, zips or buttons
- participate in craft activities such as weaving, threading, cutting, sewing.
Strategies to assist students with fine motor difficulties
- Always ensure the student is seated appropriately for fine motor activities (i.e. hips bent to 90̊, feet balanced and flat on the floor, forearms supported on desk). Sitting on the floor for fine motor tasks might not provide adequate positioning and support for the student to perform these activities optionally.
- Specific activities may be given by the student’s therapist to assist with some underlying difficulties. These can be incorporated as a warm up session with the entire class prior to specific fine motor tasks such as writing and may only take a few minutes to do.
- Simple modifications to craft activities may assist with success eg. Wrapping sticky tape around the end of wool used for threading or using non-slip matting to help stabilise the craft activity.
- Encourage the student to wear splints as recommended by the student’s occupational therapist.
- The student’s parents and therapists can assist with ongoing problem solving of any specific difficulties the student is facing.
- Students with hemiplegia (when able), encourage the use of their affected hand to be the stabilising hand for two handed tasks. e.g. Cutting paper – paper to be held by the affected arm, on table top with scissors in the other hand.
Queensland Paediatric Rehabilitation Service
Lady Cilento Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.