Is your preschool child beginning to establish hand dominance?<\/strong><\/p>\nOnce a child starts drawing pictures and writing her ABC\u2019s (4-5 years), it is important that one hand emerges as a preferred hand to better fine tune pencil grasp and develop the hand dexterity needed for handwriting.<\/p>\n
Generally, when parents report that their child is \u201cambidextrous\u201d (uses both hands equally well), there are actually delays in fine motor skills for both hands.<\/p>\n
In addition, if your child is truly competent in fine motor skills for both hands, it is still important to pick a single hand for writing\/cutting tasks in order for the child to begin to fine tune these complex fine motor skills.<\/p>\n
Does your child cross midline when reaching for items? <\/strong><\/p>\nAt least by 6 months of age, you should notice your child watching and reaching for items that move from one side of her body to the other. If your child only grabs items on the left side with her left hand and only grabs items on the right side of her body with her right hand, then she won\u2019t develop diagonal movements required for more complicated gross motor patterns.<\/p>\n
In addition, when children rarely cross midline, they tend to also not develop handedness in a timely manner, causing the pre-academic skills such as writing and cutting to also be delayed.<\/p>\n
Is your preschool child able to complete different actions with each hand at the same time? <\/strong><\/p>\nAs children begin to develop those pre-academic skills, watch to make sure they are able to stabilize items with their non-dominant hand while completing tasks with their dominant hand, such as holding a bottle to twist open the cap, or stabilizing the paper during coloring\/writing tasks.<\/p>\n
Social-Emotional Developmental Milestones<\/strong><\/h3>\n\n- Begins to smile at people\/faces \u2013 2 months<\/span><\/li>\n
- Calms when spoken to, picked up, sucking, or looking \u2013 4 months<\/span><\/li>\n
- Responds to name \u2013 6 months<\/span><\/li>\n
- Smiles to initiate engagement with others \u2013 6 months<\/span><\/li>\n
- Is fearful of strangers \u2013 7 to 9 months<\/span><\/li>\n
- Understands \u201cno\u201d \u2013 9 months<\/span><\/li>\n
- Demonstrates \u201cjoint attention\u201d (gives or shows by extending item to another person in order to \u201ccomment\u201d non-verbally) \u2013 12 months<\/span><\/li>\n
- Pretends to feed a doll or stuffed animal \u2013 18 months<\/span><\/li>\n
- Imitates peers \u2013 18 months<\/span><\/li>\n
- Enjoys the company of other children \u2013 2 years<\/span><\/li>\n
- Shows defiant behavior and seeks more independence \u2013 2 years<\/span><\/li>\n
- Shows concern for a crying friend \u2013 3 years<\/span><\/li>\n
- Takes turns \u2013 3 years<\/span><\/li>\n
- Separates easily from parents \u2013 3 years<\/span><\/li>\n
- Enjoys make-believe play \u2013 4 years<\/span><\/li>\n
- Begins to have preferred friends \u2013 4 years<\/span><\/li>\n
- Wants to be like friends and make friends happy \u2013 5 years<\/span><\/li>\n<\/ul>\n
Additional Questions about Social-Emotional Development<\/strong><\/h3>\nDoes your child generally seek out and enjoy the company of other adults and children?<\/strong><\/p>\nEven from infancy, you should notice your child watching faces of familiar adults and siblings, and then curiously watching other children at the park, etc. As your child\u2019s gross motor skills and social skills mature, she should seek out simple engagements with other children, developing into more cooperative and imaginative play.<\/p>\n
Is your child able to self-soothe?<\/strong><\/p>\nEven from infancy, children should be able to find ways to self-soothe such as sucking on their hand, or reaching for a toy. As a child grows, she should begin to be able to use words to ask others for help and gain access to what she wants (e.g., \u201cI am hungry,\u201d or \u201cI want that\u201d).<\/span><\/p>\n<\/span><\/p>\nThe ages of 2 to 4 years are particularly difficult times for behavior and tantrums, as children assert their independence and this is very much normal. However, when structure and consistency is provided by parents and the environment, take note if your child is unable to calm down and recover from tantrums, or if tantrums last several hours. These can be signs of difficulty with self-regulation. \u00a0<\/span><\/p>\nDaily Living Developmental Milestones<\/strong><\/h3>\n\n- Removes socks \u2013 12 months<\/span><\/li>\n
- Finger feeds entire snack\/meal \u2013 1\u00bd years<\/span><\/li>\n
- Uses spoon to eat (but messy) \u2013 1\u00bd to 2 years<\/span><\/li>\n
- Uses spoon and fork well \u2013 3 years<\/span><\/li>\n
- Drinks from open cup \u2013 3 years <\/span><\/li>\n
- Undresses self completely including socks\/shoes \u2013 3 years<\/span><\/li>\n
- Dresses self with simple pull-on clothing \u2013 3\u00bd to 4 years<\/span><\/li>\n
- Buttons\/unbuttons simple buttons \u2013 4\u00bd years<\/span><\/li>\n
- Washes and dries hands thoroughly \u2013 5 years<\/span><\/li>\n<\/ul>\n
Additional Questions about Daily Living Skills<\/strong><\/h3>\nIs your child consistently seeking out assistance for self-care tasks that you feel like she should be able to do by herself? <\/strong><\/p>\nAll children want the \u201ceasy way out\u201d sometimes. And, all parents need to take the \u201ceasy way out\u201d sometimes and just help the child with self-care tasks in order to get out the door in the morning on time!<\/p>\n
If your child consistently refuses to perform or requests help with self-care activities, it may be important to assess if difficulties with coordination could be to blame or if behavior modification techniques may be needed to help foster independence.<\/p>\n
If parents have significant concerns about their child\u2019s development in a specific area, what should they do? <\/strong><\/h3>\nFirst, as always, parents should discuss their concerns with their child\u2019s pediatrician. The pediatrician can help guide families to the therapist who will best evaluate and potentially treat the child if a significant deficit is in fact present. In general, physical therapists address gross motor concerns, occupational therapists address fine motor concerns, and speech therapists address speech\/language concerns. <\/span><\/p>\nMany disciplines overlap. For example, if a child is clumsy and the parents\u2019 primary concern is prewriting skills, the pediatric occupational therapist might address both gross motor skills as well as the fine motor and visual motor skills required for handwriting. <\/span><\/p>\nIf a child is a severe picky eater, the occupational therapist and the speech therapist might work together to assess if the cause is more oral motor in nature (addressed by ST), or sensory\/taste\/smell related (addressed by OT).<\/p>\n
If a child is having significant behavior difficulties, the OT and ST might work together again to determine if inappropriate behaviors are due to frustrations with language expression and comprehension (ST), or due to difficulties with sensory and emotional regulation skills (OT). Once again, your child\u2019s pediatrician can help guide a child to the most appropriate pediatric therapist.\u00a0\u00a0<\/span><\/p>\nOther Medical Concerns<\/strong><\/h3>\nYes, it is important to discuss all developmental concerns with your child\u2019s pediatrician in order to obtain a referral to the correct therapy, but it is also important to discuss these concerns with the pediatrician to help rule out any medical causes for your concerns. <\/span><\/p>\n