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Ask David L. Hill, MD, FAAP Your Own Ques...
David L. Hill, MD, FAAP
David L. Hill, MD, FAAP, Doctor
Category: Pediatrics
Satisfied Customers: 416
Experience:  Adjunct Assistant Professor of Pediatrics, UNC Medical School. Vice President, Cape Fear Pediatrics.
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My 8 year old son has gross and fine motor skills difficulties

Resolved Question:

My 8 year old son has gross and fine motor skills difficulties - he lacks coordination, spacial control, movement organisation, speed...still, thanks to our insistence and hard work he has improved a lot in everyday tasks and some sports. Is it worth going on insisting on sports (swimming, judo ,cycling and basketball)? He is extremely tall - 158cm, so I wonder if this symptoms of dyspraxia can be caused by his height? If so, can they be overcome by time and practice?
Submitted: 6 years ago.
Category: Pediatrics
Expert:  David L. Hill, MD, FAAP replied 6 years ago.
Hi, Dr. Hill here.
First, it sounds like your son is absolutely wonderful in every way, a boy any parent would be proud of. Second, I assume in terms of his height someone has considered whether he has Marfan syndrome and ruled out this diagnosis based on appropriate clinical criteria. Third, since you have already seen a neurologist I assume your son has had somewhat extensive evaluation of these perceived motor deficits. If you have not already worked with a phycial or occupational therapist you might find these professionals to be very helpful in assessing what skills need work and which exercises would best develop these skills. I would encourage you to seek out such resources and let them guide you on how to best help your son. Most importantly, I would take some time to find out what it is your son wants to do/be and make sure you're meeting his needs and not your own. All of us as parents have dreams and goals for our children, but sometimes we find they do the very best when they ignore our dreams and pursue their own. In practical terms a family counselor can help mediate such a conversation and provide some objectivity in assessing the situation. Enjoy this wonderful boy, and best of luck to you.
Customer: replied 6 years ago.

He underwent a genetic study which ruled out Sotos syndrome - the shape of his had , apart from his tallness and dyspraxia made his pediatrician suspicious. . There are no deformities perceiveble in his skelleton, skin or eyes or in any organic function- his body is actually quite proportional, and beautifull, just so surprising for such a young boy. Given these circumstances, o you thing we should do further tests for MArfan or any other syndrome/disorder related with his hight - in my family there are lots of tall people (my brother is 194cm) but it seems he may be much taller in the end.

On the other hand, in his father's family they are all quite short, but grow very quickly first - and stop when they are 12 or 13. Can my son just be tall -like my people - but follow his father's pattern of growth, or his unusual tallness already does mean he will be well over 2m?

He does love his activities, (basket, judo, swimming, regardless his slow progress). so I am willing to insisit if it is worth our while - that is ,back to the first quiestion, according to the statistics, can insistence on sport activities be helpful in the long run for children with dyspraxia, and can it be that he simply overceomes his clumsiness when his body is mature enough to deal with his tallness...

As I said, where I live it is not easy to find a reliable occupational therapist (southern Spain ), this is why we are trying to get informed and help the best we can

Thank you a lot for your attention, best regards


Expert:  David L. Hill, MD, FAAP replied 6 years ago.
Thank you for the additional information. First, it sounds like he has been evaluated quite thoroughly for genetic issues like Marfan syndrome, so I would not add any further studies. Second, involvement in athletics certainly can improve coordination, and as long as your son himself seems to be happy with the activities I would pursue them to the extent they bring him joy. Third, it certainly is possible he is growing quickly to begin with and may level out at some point. The best way to assess his growth is to look at the growth curve, a plot of all his known heights and weights against a statistical standard. His primary care physician should have this information. Fourth, our brains learn to control our bodies through practice. Periods of rapid growth make yesterday's practice out-of-date for today's body. So I would expect his coordination to improve as his growth slows.
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