Gross Motor Coordination

Gross Motor skills refer to large motor movements of the body. Fine Motor skills refer to the small precise movements required for tasks such as sewing, snapping, or even whistling.  Fine Motor skills do not have to be performed with the fingers, they can be performed with your lips or even your toes.  Gross Motor skills use the muscles in the arms, legs, torso and feet.

Gross Motor skills involve the large muscles of the body that enable such functions as walking, kicking, sitting upright, lifting, and throwing a ball. A person’s gross motor skills depend on both muscle tone and strength. Low muscle tone, or hypotonia, is a characteristic of several disabling conditions such as Down syndrome, genetic or muscle disorders, or central nervous system disorders.  High tone, also known as hypertonia, often accompanies cerebral palsy.  With Low tone, muscles are described as loose or floppy. With High tone, they are usually stiff and rigid.

The most important thing that people should know is that gross motor and fine motor skills are connected.  I often tell parents to picture a pyramid in their minds.  The bottom of the pyramid is gross motor skills.  Gross motor skills are the foundation that a child will build new skills upon.  It’s very simple if you think about it.  A child has to learn to roll before he can learn to crawl.  He learns to pull himself up before he learns to walk.  He has to learn how to control his shoulders and arms purposefully before he can learn to draw shapes.

I have had parent ask me, “but you are my child’s OT. Why are you working on gross motor skills?”  Many people think that PT and OT divide the child in half – PT gets the bottom to work on jumping, running, balance, etc. And OT gets the top – hands and fingers only.

This is untrue. A good therapist has to look at the whole child.  Simply put, if the child doesn’t have the strength or trunk control to hold their bodies up, they aren’t going to get the most out of a handwriting lesson.  That doesn’t mean that I won’t still work on handwriting or fine motor strength, but I need to address the foundational problem of weak trunk and upper body strength, too.

You can think about gross and fine motor development like this.  Development happens from inside to the outside.  It starts at the trunk (abs and back) for postural control, and then starts to develop outward.  A child develops shoulder stability and control before they develop wrist stability. Then finally, they develop the very fine and precise movements in the hand.

Stability is a word that often needs more explanation.  Shoulder stability is a really important part of childhood development.  Stability refers to being able to keep certain parts of the body stable, while moving other parts.  When a child has developed good shoulder stability, he is able to keep his scapula and shoulder still when he moves his hand to write.  Later on, the child develops wrist stability; the ability to keep the wrist still while moving the fingers to color or write.  This is the ultimate goal.  Most children are still developing shoulder stability in kindergarten.  By the end of kindergarten, most children should be able to sit up in their chair, rest their arm on the table and use only their fingers to write.

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