My case study student is a 4 1/2 year old girl named Sally. She has some interesting motor delays. Her Preschool Multidisciplinary Assessment reported that her gross motor skills were at "average skill acquisition for her age level." Even though she has "average" gross motor skills, she is unbalanced and walks with a clumsy gait. She walks on her toes. She stumbles often, especially on uneven terrain. Her fine motor skills were rated at 70 on a scale of 100 = average. This puts her in the significantly delayed range. She needs help establishing a tripod grip on a marker, getting her fingers in the scissors and cutting along a line, and fastening zippers, buttons and snaps on her clothing. Her IEP fine motor goals include imitating prewriting strokes (vertical line, horizontal line, circle), using scissors in the "thumbs up" position to make 10 snips along the edge of the paper and then cut along a 3-4 inch piece of paper, using a functional grasp on a writing utensil to color in 80% of a shape, and manipulating preschool materials. Everyday after hanging her coat and backpack in her cubby, Sally signs-in. We help her grip her marker appropriately and trace the letters of her name. Everyday she puts on her own coat to go outside and we help her fasten the zipper. During table-top activities, Sally uses a variety of preschool materials such as: scissors, crayons, play dough, puzzles, beads, pegs, lacing cards, shape sorter, tongs and paintbrush. She holds a small cup to drink her milk or water. She uses a spoon and fork to eat her food. She holds the toothbrush while I help her brush in and out, up and down. Sally is able to pull her pants up and down when using the toilet. She washes her own hands adequately. She needs help getting her socks on, but she is able to put on her own shoes. We tie the laces. Sally enjoys jumping on a mini trampoline, pushing a baby buggy, and riding a tricycle (she pushes the ground with her feet, does not use the pedals). She likes to run in the grass, but she stumbles and falls often.
When assessing Sally using the Creative Curriculum Developmental Continuum, I found her to be at the "Foundational 2 or 3" level for all gross motor skills, and at "Level 1" for all fine motor skills. I find it interesting that she scored higher for fine motor skills considering her rating of "average" for gross motor and significant delay for fine motor.
Sally does not yet show a preference for using her left or right hand. According to Cook, Klein, Tessier (2008), a preference for handedness is not expected until 6 years. old.
According to Cook, Klein, Tessier (2008), a child at 36 - 48 months should be able to pour from a small pitcher, spread soft butter, button large buttons, and blow her nose when reminded. Sally is 53 months old and is unable to do these things. At 36 - 48 months she should be able to walk on a line, balance on one foot, hop on one foot, pedal a tricycle, jump over a 6 inch high object and catch a bounced ball. She is unable to do these things.
Sally has definite delays in both gross and fine motor skills. These motor delays effect her self-help skills. Motor and self-help skills are very interconnected.
Resources:
Creative Curriculum for Preschool. 2001. Teaching Strategies, Inc. Printed in the United States.
Cook, Ruth E., Klein, Diane M., Tessier, Annette. Adapting Early Childhood Curricula for Children with Special Needs. (7th ed.). Upper Saddle River, New Jersey, Columbus, Ohio: Pearson Merrill Prentice Hall, 2008.
I think that your assessments will help to guide you in the development and refinement of various activities for Sally. Children's center of gravity changes as they grow and they require ongoing practice to adjust for changes. It sounds like you plan play materials that support fine-motor control and self help skills, so hopefully with your supportive environment and encouragement, she will make progress.
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