Performance Areas

Performance Areas

* Fine Motor Skills

Fine motor skills include the many actions of the torso, shoulders, arms, wrists, hands and fingers (i.e. dexterity, coordination and strength). Fine motor skills include the ability to hold and use objects in a coordinated and purposeful fashion. 

To control fine motor movements, children must be able to activate stabilizing muscles closer to the trunk of the body (e.g. core muscles, shoulders, arms) in order to more effectively use the more distal muscles (i.e. wrists, hands, fingers) in a precise way. 

Fine motor skills include many daily functional tasks that a child needs to perform in the course of a school day, e.g. cutting with scissors, handling tools (staplers, hole-punchers, tape dispensers), self-help (buttons, zippers, buckles, opening food containers, etc), playing board games, using computers, and - of course - the crucial skills of handwriting.

Handwriting: Handwriting includes a surprisingly complex combination of factors:

  • Upper body strength (shoulders, arms, wrists, hands, fingers)
  • Postural muscles (including core muscles)
  • Manual dexterity
  • Bilateral  coordination (using both sides of the body)
  • Visual perception
  • Visual motor integration (eye-hand coordination)
  • Sensory processing (ability to sense touch and force)

*Visual Perception Skills
These skills can be broken down into two somewhat interwoven categories:

1. Visual Perception – the ability to see, process, and understand visual information. This includes skills such as:
> Form Constancy – the ability to identify a form even if it is presented in a different size, position, color or background (e.g. "that small blue one is a square too").
> Figure Ground – the ability to identify a shape/figure in a (possibly complicated) surrounding background (e.g. Where's Waldo)
> Spatial Relations/Position in Space – the ability to understand the position of objects in relation to each other and to one’s self.
> Visual Discrimination – the ability to see and register the differences and similarities in shapes/figures.
> Visual Closure – the ability to identify and mentally supply missing part(s) of a form even if part of it is not visible.
> Visual Memory – the ability to remember what one sees.

2. Visual-motor Integration – the ability to take in information with the eyes and translate it into a physical response, e.g. copy a geometric design, cutting with scissors

Visual-motor skills develop in a roughly sequential fashion:
1. Imitation: First of all, children learn to watch and imitate an adult's demonstration of how to draw/write a shape/letter.
2. Copying: Once a child can imitate a shape or letter, he/she can learn how to copy it - to draw or write a shape or letter from a model.
3. Independent: With practice, children can learn to draw/write a shape/letter independently from memory. 

Activities of Daily Living (ADLs)
ADLs may include the self-care tasks a student  performs during the school day:
     Dressing/undressing for recess, bathroom use, arrive/leave school.
     Ability to independently access and feed self for lunch, snack, etc.
     Hygiene, mobility, manage personal belongings, etc.

Sensory Processing
Sensory processing involves the ability to receive true and accurate sensory information, to process it, and to use it to guide responses and behaviors. Sensory information includes oral, auditory, tactile (touch, temperature, pain), olfactory (smell), visual, vestibular (motion and balance), and proprioceptive (body position - from muscles and joints).             
Sensory processing issues arise when an individual has an interruption in the process of one or more of the following steps: 
1. Receiving sensory input: Information received by the body - sight, sound, touch, taste, smell, movement, position. 2. Processing sensory input: Information is quickly sorted (perceived or ignored) and organized (e.g. new or familiar, pleasant or unpleasant, safe or dangerous). 3. Response to the sensory information: Responses can be Actions (reflex or purposeful),  Feelings, and/or Thoughts.
4. Feedback: Responses provide more sensory input.
These steps form a continuous loop of input-processing-response-feedback input.

The Sensory Processing Spectrum: The more one learns about sensory processing, the more one begins to spot “sensory issues” in ourselves and everyone we know. One realizes that the sound of a vacuum cleaner or heavy perfume can make you feel or react with “unreasonable” emotion or one hears a friend remarking that they “can’t eat yogurt because of the texture”. These are sensory sensitivities, but not necessarily sensory issues. Issues begin when sensory preferences and/or aversions interfere with daily function, when reactions cannot be understood as "reasonable" and/or controlled. Sensory processing issues can disrupt a child’s attention, social life and performance at school. Often these issues can be addressed by strategies that work to integrate, desensitize, or compensate for sensitivities.

Sensory issues become sensory disorders when an individual’s reactions (internal or external) are extreme, regularly affect daily life, and require regular and focused methods to address.

  • A child may exhibit over-responsive and/or under-responsive behaviors to sensory stimuli.
  • Over-responsive behavior may manifest itself as over-sensitivity and/or an avoidance of touch, movement, tastes, smells, sights, or sounds.
  • Under-responsive behavior may manifest as a lack of response or a tendency to seek touch, movement, tastes, smells, sights, or sounds.

Sensory issues and sensory disorders often accompany a specific diagnosis (e.g. autism, ADD/ADHD, learning disability). However, more and more we are seeing children who are missing crucial sensory development due to a lack of physical experience. The sensory system requires experience to develop and grow. As a species, we are meant to explore and experience our environment. In modern times, this means to run and hang on monkey bars, ride bikes and crawl through the underbrush, push and pull objects, and get our hands dirty. Really! Without these experiences to learn how to use and coordinate both sides of our bodies and to learn how to process sensory information, we can lack the proper information and training to put all the pieces of our nervous system and brain together properly.
The same crucial elements that may make up a sensory diet for children with sensory issues…are the same crucial elements all people need to grow and develop their sensory, physical and emotional well-being:
i.e. heavy work, physical activity, muscle exertion, bilateral and weight-bearing activities, and firm comforting touch.
Children (and adults!) benefit from MORE. We can all use existing opportunities to be MORE physical: walk, run, bend, stretch, lift, carry, push, pull, crawl, hug!