Gross Motor Skill Development

Gross motor skills are defined as the movements of the large muscles of the body. Gross motor development is often better than fine motor development in boys with fragile X syndrome. Overall, gross motor development is in keeping with cognitive level. Infants and toddlers usually acquire the same skills in the same order as their non-affected peers. However, there may be delays in the acquisition of early milestones, such as sitting, crawling, and walking. Many infants achieve these milestones at the same times as their non-affected peers, and most boys with fragile X walk by the age of 2.

Some problems with low muscle tone and balance may affect the gross motor development of boys with fragile X. Flat feet and hyperextensible joints can cause awkwardness in motor movements. Poor motor planning may lead to difficulties in learning certain skills, such as throwing and catching a ball. With some of the sensory defensiveness seen in children with fragile X (see Sensory Integration Characteristics), motor movements may be inhibited by a reluctance to catch a ball, focus on a target, or other sports related skills. Balance problems may cause riding a two-wheel bike to be more difficult, but many boys do achieve this ability.

Some boys with fragile X syndrome may require either physical therapy or adapted physical education. Physical therapists (PT) may be part of an early intervention team or a school-based team, or they may be in private practice or clinics, such as Easter Seals. Physical therapists may work with occupational therapists to design exercises, posture strategies, and balance activities. Physical therapy can be a part of the Individual Family Service Plan (IFSP) or Individualized Education Plan (IEP) for a child with many gross motor needs, but not all children with fragile X require physical therapy goals.

Adapted physical education may be designed to help a child with fragile X to learn the games and skills of the regular physical education curriculum. Boys with fragile X may not have particular gross motor problems, but may need to have the skills broken down and sequenced into steps. They may not understand complex rules and may require explanations coupled with demonstrations. Adapted physical education can be included on a child's Individualized Education Plan (IEP).

Many children with fragile X simply need more opportunity for participation in sports and games. Physical play at home and in the yard provides ways to develop physical strength and skills and to calm overstimulation. Special education recreation departments often provide year-round opportunities for a variety of sports and games. They are geared with a teaching focus, such that every child or adult involved learns new skills. Special Olympics provide an outlet for children with special needs to compete in a variety of sports. Both special recreation and Special Olympics provide opportunities for socialization in addition to gross motor skills.

Gail Harris-Schmidt, Ph.D., CCC-SLP
Saint Xavier University
Chicago, Illinois