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What is it?

"Gross motor skills" is the phrase we use to refer to the movements we do with the large muscle groups of our body, such as rolling, hopping, balancing, running, playing sports etc

Gross motor skills are linked to the body's proprioceptive skills (which is where our muscles and joints give us body awareness or the  ability to recognise where the body is in space) and vestibular skills (based in the inner ear) which is linked to the ability to retain balance with our eyes closed.

Why is it a problem?

Gross motor skills and strength are needed for every activity children do, including being able to: get dressed whilst weight bearing on one leg; sit at a desk or sit on the floor in the classroom. When children have poor muscle strength or joint instability, we have poor balance and cannot do simple activities easily- such as putting on pants or sitting still. 

Children with a suboptimal vestibular system can have gravitational insecurity (they are unsure where their body/balance is in space). They may cause them to be fearful or reluctant to participate in everyday activities such as going on a swing or climbing stairs. Problems with our vestibular system can also mean the child  has trouble with balance, dizziness and eye control, which can affect every area of their lives.

Some children presenting with poor gross motor skills may have dyspraxia, which is a motor planning disorder. We need praxis to: understand what we need to do; plan how to do it and execute that task. Children with praxis difficulties may be very avoidant of everyday activities as they don’t know how to do them or they may prefer to withdraw to an online or internal world that does not require any motor skills from them. 

What can OT do?

First the child is assessed to see what the underlying deficits are caused by e.g. hypotonia, hyper-flexibility, developmental coordination disorder (DCD), poor core strength, poor proprioception or vestibular function, poor motor planning, poor hand-eye coordination etc

​OT can work on the vestibular system, gross motor strength, related motor planning or proprioceptive difficulties, crossing the mid line and any related difficulties with sensory processing or visual perception. We may work in conjunction with a Paedeatric physiotherapist to build endurance  through exercises as well as provide adaptive equipment where the child is struggling to maintain attention in school due to body fatigue.

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