Gross motor skills
Gross motor skills are the abilities required in order to control the large muscles of the body for walking, running, sitting, crawling , and other activities.
Motor skills are actions that involve the movement of muscles in the body. They are divided into two groups: gross motor skills, which are the larger movements of arms, legs, feet, or the entire body (crawling, running, and jumping); and fine motor skills , which are smaller actions, such as grasping an object between the thumb and a finger or using the lips and tongue to taste objects. Motor skills usually develop together since many activities depend on the coordination of gross and fine motor skills. Gross motor skills develop over a relatively short period of time. Most development occurs during childhood. However, soldiers, some athletes, and others who engage in activities requiring high degrees of endurance may spend years improving their level of muscle and body coordination and gross motor skills.
Gross motor skills development is governed by two principles that also control physical growth. Head to toe development refers to the way the upper parts of the body develop, beginning with the head, before the lower ones. The second principle of development is trunk to extremities. Head control is gained first, followed by the shoulders, upper arms, and hands. Upper body control is developed next, followed by the hips, pelvis, and legs.
Encouraging gross motor skills requires a safe, open play space, peers to interact with, and some adult supervision. Promoting the development of gross motor abilities is considerably less complicated than developing fine motor skills. Helping a child succeed in gross motor tasks requires patience and opportunities for a child to practice desired skills. Parents and other persons must understand the child's level of development before helping him or her master gross motor skills. Children reach developmental milestones at different rates. Pushing a child to perform a task that is impossible due to development status promotes frustration and disappointment. Children should be allowed to acquire motor skills at their own paces.
There are a number of activities parents can have children do to help develop gross motor skills. These include:
- playing hopscotch and jumping rope; activities that help children learn balance
- hitting, catching, kicking, or throwing a ball, such as a baseball, football, or soccer ball; activities that help develop hand-eye or foot-eye coordination
- kangaroo hop, in which children hold something, such as a small ball or orange, between their knees and then jump with their feet together frontward, backwards, and sideways
- playing wheelbarrow, in which someone holds the children's legs while they walk on their hands along a specific route
- walking on a narrow bar or curb, while holding a bulky object in one hand, then the other hand, and then repeating the activity walking backwards and sideways
- toss and catch, in which children toss an object, such as a baseball, in the air and then catch it, while sitting or lying down and also while using alternate hands
The first gross motor skill infants learn usually is to lift their heads and shoulders before they can sit up, which, in turn, precedes standing and walking. Lifting the head is usually followed by head control. Although they are born with virtually no head or neck control, most infants can lift their heads to a 45-degree angle by the age of four to six weeks, and they can lift both their head and chest at an average age of eight weeks. Most infants can turn their heads to both sides within 16 to 20 weeks and lift their heads while lying on their backs within 24 to 28 weeks. By about nine to 10 months, most infants can sit up unassisted for substantial periods of time with both hands free for playing.
One of the major tasks in gross motor development is locomotion, the ability to move from one place to another. Infants progress gradually from rolling (eight to 10 weeks) to creeping on their stomachs and dragging their legs behind them (six to nine months) to actual crawling (seven to 12 months). While infants are learning these temporary means of locomotion, they are gradually becoming able to support increasing amounts of weight while in a standing position. In the second half-year of life, babies begin pulling themselves up on furniture and other stationary objects. By the ages of 28 to 54 weeks, on average, they begin navigating a room in an upright position by holding on to the furniture to keep their balance. Eventually, they are able to walk while holding on to an adult with both hands and then with only one. They usually take their first uncertain steps alone between the ages of 36 and 64 weeks and are competent walkers by the ages of 12 to 18 months.
Toddlers are usually very active physically. By the age of two years, children have begun to develop a variety of gross motor skills. They can run fairly well and negotiate stairs holding on to a banister with one hand and putting both feet on each step before going on to the next one. Most infants this age climb (some very actively) and have a rudimentary ability to kick and throw a ball. By the age of three, children walk with good posture and without watching their feet. They can also walk backwards and run with enough control for sudden stops or changes of direction. They can hop, stand on one foot, and negotiate the rungs of a jungle gym. They can walk up stairs alternating feet but usually still walk down putting both feet on each step. Other achievements include riding a tricycle and throwing a ball, although they have trouble catching it because they hold their arms out in front of their bodies no matter what direction the ball comes from.
Four-year-olds can typically balance or hop on one foot, jump forward and backward over objects, and climb and descend stairs alternating feet. They can bounce and catch balls and throw accurately. Some four-year-olds can also skip. Children this age have gained an increased degree of self-consciousness about their motor activities that leads to increased feelings of pride and success when they master a new skill. However, it can also create feelings of inadequacy when they think they have failed. This concern with success can also lead them to try daring activities beyond their abilities, so they need to be monitored especially carefully.
School-age children, who are not going through the rapid, unsettling growth spurts of early childhood or adolescence , are quite skilled at controlling their bodies and are generally good at a wide variety of physical activities, although the ability varies according to the level of maturation and the physique of a child. Motor skills are mostly equal in boys and girls at this stage, except that boys have more forearm strength and girls have greater flexibility. Five-year-olds can skip, jump rope, catch a bounced ball, walk on their tiptoes, balance on one foot for over eight seconds, and engage in beginning acrobatics. Many can even ride a small two-wheel bicycle. Eight- and nine-year-olds typically can ride a bicycle, swim, roller skate, ice skate, jump rope, scale fences, use a saw, hammer, and garden tools, and play a variety of sports . However, many of the sports prized by adults, often scaled down for play by children, require higher levels of distance judgment and hand-eye coordination , as well as quicker reaction times, than are reasonable for middle childhood. Games that are well suited to the motor skills of elementary school-age children include kick ball, dodge ball, and team relay races.
In adolescence, children develop increasing coordination and motor ability. They also gain greater physical strength and prolonged endurance. Adolescents are able to develop better distance judgment and hand-eye coordination than their younger counterparts. With practice, they can master the skills necessary for adult sports.
There are a range of diseases and disorders that affect gross motor skill development and skills. Among young persons, developmental problems such as genetic disorders, muscular dystrophy , cerebral palsy , and some neurological conditions adversely impact gross motor skill development.
Gross motor skills can become impaired in a variety of ways, including injury, illness, stroke , and congenital deformities. Developmental coordination disorder affects motor skills. A person with this disorder has a hard time with skills such as riding a bike, holding a
|SOURCE : Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, 5th ed. and Child Development Institute, http://www.childdevelopmentinfo.com.|
|One month||May hold up head momentarily.|
|Two months||Lifts head when placed on stomach. Holds up head briefly when held in a seated or standing position.|
|Three months||Holds head and shoulders up when placed on stomach. Puts weight on forearms.|
|Four months||Holds head up well in sitting position. Can lift head to a 90-degree angle when placed stomach. May start to roll over.|
|Five months||Has full head control. When pulled by hands to a sitting position, the head stays in line with body.|
|Six months||Rolls over (front to back first). Bears a large. percentage of body weight when held in a standing position.|
|Seven months||Can stand with support. May sit without support for short periods. Pushes upper part of body up while on stomach.|
|Eight months||Stands while holding onto furniture. Sits well unsupported. Gets up on hands and knees; may start to crawl backwards.|
|Nine months||Crawls first by pulling body forward with hands. May move around a room by rolling.|
|Ten months||Pulls up to standing. Is very steady while sitting; moves from sitting to crawling position and back. Crawls well.|
|Eleven months||"Cruises," walking while hanging onto furniture. Walks with two hands held.|
|Twelve months||Walks with one hand held. May walk with hands and feet. Stands unsupported for longer periods of time.|
|Fifteen months||Walks without help. Crawls up stairs. Gets into a standing position without support.|
|Eighteen months||Seldom falls while walking. Can walk and pull toy. Runs. Climbs stairs holding railing. May walk backward.|
|Two years||Kicks a ball. Walks up and down stairs, two feet per step.|
|Two and a half years||Jumps with both feet. Jumps off step. Can walk on tiptoe.|
|Three years||Goes upstairs one foot per step. Stands on one foot briefly. Rides tricycle. Runs well.|
|Four years||Skips on one foot. Throws ball well overhand. Jumps a short distance from standing position.|
|Five years||Hops and skips. Good balance. Can skate or ride scooter.|
pencil, and throwing a ball. People with this disorder are often called clumsy. Their movements are slow and awkward. People with developmental coordination disorder may also have a hard time completing tasks that involve movement of muscle groups in sequence. For example, such a person might be unable to do the following in order: open a closet door, get out a jacket, and put it on. It is thought that up to 6 percent of children may have developmental coordination disorder, according to the 2002 issue of the annual journal Clinical Reference Systems . The symptoms usually go unnoticed until the early years of elementary school; the disorder is usually diagnosed in children who are between five and 11 years old.
Children with any one or combination of developmental coordination disorder symptoms should be seen by a pediatrician who specializes in motor skills development delays. There are many ways to address gross motor skills impairment, such as physical therapy. This type of therapy can include treating the underlying cause, strengthening muscles, and teaching ways to compensate for impaired movements.
Parents, teachers, and primary caregivers need to have a clear understanding of how young children develop gross motor skills and the timetable for development of the skills. The Lincoln-Oseretsky Motor Development Scale is an individually administered test that assesses the development of motor skills in children and adults. Areas covered include fine and gross motor skills, finger dexterity and speed, and hand-eye coordination. The test consists of 36 tasks arranged in order of increasing difficulty. These include walking backwards, standing on one foot, touching one's nose, jumping over a rope, throwing and catching a ball, putting coins in a box, jumping and clapping, balancing on tiptoe while opening and closing one's hands, and balancing a rod vertically. Norms have been established for each part of the test for children aged six to 14.
When to call the doctor
Parents, who suspect that their child has a delay in developments should follow their instincts in having that child evaluated. The earliest intervention possible offers the highest response and success rate among children with special needs. Parents should call the doctor any time they have a concern about their child's motor skill development. Parents should keep in mind that children develop at different rates and try to focus on the skills their children have mastered instead of those they may have yet to master. Still, there are certain signs that may point to a problem, and these should be discussed with a pediatrician or physician. These signs include not walking by 15 months of age, not walking maturely (heel to toe) after walking for several months, walking only on the toes, and not being able to push a toy on wheels by age two. Toddlers may begin to prefer one hand to the other, the first sign of right- or left-handedness, or to use both hands equally. This preference should be allowed to develop naturally. Parents should call a doctor if the child does not seem to use one hand at all or has a strong hand preference before he or she is one year old.
Cerebral palsy —A nonprogressive movement disability caused by abnormal development of or damage to motor control centers of the brain.
Congenital malformation —A deformity present at birth.
Developmental coordination disorder —A disorder of motor skills.
Fine motor skill —The abilities required to control the smaller muscles of the body for writing, playing an instrument, artistic expression and craft work. The muscles required to perform fine motor skills are generally found in the hands, feet and head.
Lincoln-Oseretsky Motor Development Scale —A test that assesses the development of motor skills.
Locomotion —The ability to move from one place to another.
Muscular dystrophy —A group of inherited diseases characterized by progressive wasting of the muscles.
See also Fine motor skills .
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Ken R. Wells