Gifted Issues Discussion homepage Forums Parenting and Advocacy update:Core strength/fine motor & TOEFL for a 4yo?

So first, core strength/fine motor:
Our DD (4 in December) seems to have trouble sitting and she is getting extremely tired when doing so. When they have to sit in a circle at school she bends over, twists, lays down ect. She pays attention and said she is really really trying to sit but she gets so so tired. Her fine motor is also really struggling (says her school). Are these related. Does anyone have experience with this? What did you do?

TOEFL:
Apparently DD's fine motor is preventing a grade skip so they are saying she is not in either grade because she doesn't really fit in either grade (montessori so it doesn't really matter anyway). But they asked if they could give her a TOEFL reading test to help them gage where she is reading-level wise because they were having a hard time figuring it out. I said ok, but just curious, what is this test? How do they test the 4yo's using this?

Thank you!!! Any suggestions/knowledge would help!

We're had a lot of experience with the core strength/fine motor issue at that age, and yes they were related. First, I would recommend getting a full evaluation to see the extent of the issue. If you can, I would start with a pediatric orthopedist and a private OT. If that is not financially doable, the public schools are required to do a PT/OT eval for a child that age if you believe that it would "impact her success in kindergarten". They will be vastly different evils (we actually did both) but give you a good indication about the extent of the problem. All that said, the "normal range" for PT/OT that age is rather large so even though you may see issues, he may not be declared out of range. In the meantime, while trying to sort out the levels, fighting with the school, insurance etc., the best two things we found to do were structured swimming lessons (either with a teacher or with you in the pool--anything that gets her feet off the bottom of the pool and engages her core muscles for 30-60 minutes at a time) and coloring with crayons or colored pencils (not markers) inside the lines with proper pencil grip (you can buy grip helpers if she can't do it). Both will develop the muscle tone and not interfere with anything the OT/PT may eventually do. In hindsight, we should have done more of this than we did b/c growth spurts over the years have made these problem reoccur (though not at the same level). Good luck!

DS has had ongoing issues with both gross and fine motor and he has hypotonia and hypermobile joints (they go together). Look up hypotonia in Wikipedia.
He also has Developmental Coordination Disorder.
He does not have any obvious issues like sitting up in school. You can really see it when he is asked to do things like hop or jump. If she is 4, she should be able to hop up and down, jump forward easily with both feet together, jump off something like a couch without falling on her face or her legs collapsing on impact, hang from a bar with her hands, etc.

If she has hypotonia, it would also be hard for her to do things like hold a pencil properly. If she writes, she may not press down on the paper very hard.

In your shoes, I would ask the pediatrician for a referral for a physical and occupational therapy assessment (they will probably be done by 2 people in two different days). She may qualify for private therapy, or you can use the results to get the school district to do an evaluation. Depending on how low she scores, she could qualify for an IEP with the school district and get therapy free.

Gymnastics, dance and swim are all very very good for core. We did gymnastics and swim lessons and then switched over competitive swim for his core and those two things were the best investment.

He did OT and one of the best things also in addition to the therapy was to get homework activities each week. I kept all of them and then once he was dismissed asked what activities we should continue to revisit. And then around eleven, twelve it became pretty much a non issue. He does type as much as he possibly can.

You've received wonderful advice above already. I don't have anything really different to add, but fwiw my older dd had low muscle tone in her trunk when she was young, and she also had trouble sitting, loved to ben over, twist, lay down etc when she was supposed to be sitting (in circle) or was always jumping up and moving off her chair at the table (when she wasn't falling out of the chair). She went through physical therapy, and had "homework" of swinging for at least 20 minutes a day or whenever she could (we also had her swing when she became anxious). She loved to swing, and it really helped with the trunk muscle weakness. Having her sit on a ball rather than a chair, or on one of the knobby-looking sensory cushion that has air in it also really helped her stay on her chair.

Re the fine motor - our dd didn't really have fine motor issues but had what *looked* like fine motor issues - her handwriting was so sloppy that it rivaled our dysgraphic's handwriting in early elementary and she was just generally very klutzy with fine-motor (as well as gross-motor) activities. In her case, that all turned out to be related to an undiagnosed vision issue, as well as a good portion of the falling off her chair and not wanting to sit still etc. She really did have low muscle tone in her trunk, but she also had vision issues playing into it. Same thing happened with another young child we knew who was slow to develop gross motor skills... turns out it was due to vision. So... just thought if you hadn't considered vision that might be something else you'd want to look into.


I'm wondering if you have the correct test acronym? The "TOEFL" I've heard of is "Test of English as a Foreign Language" (or something like that) and is a test for adults. There is a test that is commonly given to young children to assess writing skills called the "TOWL" (Test of Written Language) and I *think* there is a similar test for reading - but can't remember the exact acronym for it.

No matter what the acronym, you can always ask the school staff for details on the test, what type of questions there are, what it assesses, and how to interpret your dd's results. Let us know how it goes!

polarbear

Thank you for the responses! DD has an OT/PT eval set up in a few weeks. Thank you for the suggestions. Another thing that came up in the OT/PT eval forms was her over-excitabilities. I had no idea that she could even be evaluated/helped on that front. The OT I talked to actually even made that the focus!

As far as TOFEL I am quite sure that there is no way I have that acronym correct . My husband chuckled when I relayed that to him too. I sent out an email to her teacher asking the name.

Thank you again for the help!!

That's great if the OT is experienced and willing to consider over excitabilities during in her/his determination. DS3.11 is low tone with hypermobile joints according to OT, struggles with vestibular sensory issues according to the OT and PCP, and over excitabilities according to the educational consultant. Thank goodness some of the therapy suggestions accommodate each. Gymnastics has been great as well as varying physical and movement activities at home, and he is sometimes receptive to using his hand strengthening balls. We've had less luck with the brushing and vest, but he sometimes asks for these things too. He's made progress with his fine motor development, though sitting still (and yes too not falling off chairs or walking into things) continues to be more of a challenge. We too are in the middle of trying to figure out what to do about school for next year. Good luck with both the school and clinical assessments! I hope all falls into place for you and DD!

I never heard of giving TOEFL to a little kid, but the acronym is correct. Foreign students often take the TOEFL as part of admissions to US colleges - it is the Test of English as a Foreign Language as mentioned above. I think you can take it over the Internet now, so maybe they could use it to easily evaluate your child's level of understanding (evaluates up to college level of understanding).

I wrote a bunch of stuff about Developmental Coordination Disorder and sensory issues, but then I deleted it. I recognize that people would just rip me for my opinions on this, and how we resolved these issues with our kids (I'm sure that they would have been diagnosed with DCD), but it did not involve any therapy.

One piece of advice on the gross motor skills area - teach your kid to ride a bike while she is young. We clearly failed to spend enough time on this, so now middle kid can drive a car but still can't ride a bike.

NotSoGifted- would have been interested in what you were going to say about DCD. Also, good suggestion about the bike. DD was so insanely determined to learn to ride a 2 wheeler last summer - so could ride a 2 wheeler at 3 1/2, despite me thinking that she is not overly coordinated. It has been a very long, very cold, & very snowy winter here though so months & months without practice. Hopefully when we pull the bike out in a month or so she can still ride it!

I will fill everyone in on OT/PT but I'm sure it will be several weeks as eval is the 5th then probably some time before they determine what/if she needs any help. Thanks to everyone for encouraging the eval.

update:
Fine motor: We scheduled the OT/PT then realized it was $1600 for the entire evaluation. So, we decided to just to the handwriting portion ($100). They evaluated her yesterday as they had an opening and suggested twice/week handwriting. I am still going to keep the OT/PT evaluation in mind as they reiterated the need to address other issues (gross motor, sensory integration, ect.) to fully tackle the handwriting. But we are going to start with this.

Reading eval: Still not sure what rubric they used but they said that she was a level "E" despite her being able to read a "J" or beyond. Their reasoning was that while she answered the post-reading questions correctly, she used one word to answer them and the teacher wanted more explanation. On one hand I totally understand this, on the other, she completely understands what she reads at a level J too (and would probably answer questions with one word) so I guess I am wondering what is the difference? Couldn't they just as easily work from there?