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Neurodiversity Hub Wirral

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Physical Challenges

Children and young people may face physical challenges that affect daily activities. These can involve: 

  • Gross motor skills (whole-body movements) 

  • Fine motor skills (hand and finger movements) 

  • Or a mix of both 

Common signs include: 

  • Delay or difficulty with skills like riding a bike, catching a ball, getting dressed, using fastenings, and handwriting 

  • Awkward or clumsy movement, such as bumping into things or spilling drinks 

  • Trouble with tasks that have multiple steps or need sequencing 

  • Strong intellectual or language skills but weaker motor skills 

  • Difficulty learning new motor skills; some may improve while others stay challenging 

  • Struggles with activities that need quick changes in body position or adapting to the environment (like team sports) 

  • Difficulty using both sides of the body together (e.g. cutting with scissors or doing star jumps) 

  • Poor balance and trouble with tasks that need postural control (e.g. climbing stairs, standing while dressing, or riding a bike)

  • Supporting a Child with Motor Skill Difficulties

    At Home

    • Encourage physical activities the child enjoys. Focus on fun, not competition. 

    • Introduce new sports or playgrounds one-on-one before joining a group. 

    • Support the child in activities they enjoy and do well in (e.g. drama, music, choir). 

    • Help them practice planning and sequencing tasks like laying the table, packing a school bag, or making lunch. Use picture strips or ask guiding questions like “What do you need to do first?” 

    • Choose school clothes that are easy to put on and take off (e.g. loose-fitting items, elastic waistbands, hook-and-loop fastenings [Velcro]).

    Dressing Skills – Using the MATCH Strategy

    You can use this method to support your child with other motor skill challenges too. 

    Modify the Task

    • Choose clothes with fewer fastenings to reduce frustration. 

    • Use larger buttons and buttonholes, hook-and-loop fasteners (Velcro), large zip tabs, and loose-fitting clothes with wide neck and armholes. 

    • For hooded coats or cardigans, teach the child to put the hood on first. This helps the sleeves hang in a way that makes them easier to find. 

    • Add visual cues. For example: 

    • Use a coloured mark to show the back of clothing. 

    • Place arrows inside shoes—when side by side, the arrows should point toward each other. 

    Alter Your Expectations

    • Give plenty of time to practice. Try new skills on weekends instead of busy school mornings. 

    • Lay out clothes in the correct order and direction to help the child get started.

  • At School

    Communication

    • Keep communication open between home and school. This helps ensure the child’s needs are understood and supported in both places. 

    In the Classroom

    • Check that chair and table heights are correct. Feet should rest flat on the floor, and the table should be at elbow height so forearms rest comfortably. 

    • Allow posture breaks. Let the child lean against a wall or furniture during carpet time. 

    • Provide helpful tools: 

    • Rulers with handles 

    • Writing slopes to improve paper position and wrist posture 

    • A variety of pencils and pens (e.g. triangular, thick barrels, non-slip grips) 

    • Give extra time for fine motor tasks like handwriting. 

    • Use “fill in the blank” worksheets when handwriting isn’t the focus. 

    • Introduce laptops or tablets early to build keyboard skills. These can help when written work increases or neat presentation is needed. 

    • Match paper to the child’s handwriting needs: 

    • Wide lines for large writing 

    • Graph paper for spacing and number alignment 

    • Offer different ways to show learning: 

    • Oral presentations 

    • Voice recordings 

    • Typed stories 

    • Drawings or photos 

    • Focus on the lesson’s goal: 

    • If creativity is the goal, accept messy presentation. 

    • If layout is the goal (e.g. in maths), allow extra time or accept that the problem may not be solved. 

    • Make sure special access arrangements are in place for tests that require lots of writing. 

    In Physical Education

    • Break activities into small, manageable steps. Add new steps gradually. 

    • Choose tasks where the child can succeed at least half the time. 

    • Focus on participation, not competition. Reward effort, not skill. 

    • Help children aim to improve their personal best rather than compete with others. 

    • Modify equipment. For example, use larger balls to help with catching and throwing. 

    • Use hand-over-hand guidance to help the child feel the movement. 

    • Explain rules when the child is not focused on movement. This helps them plan better. 

    • Demonstrate clearly and highlight key parts of the movement. For example, “Keep your feet wide to help balance.” 

      Emotional and Behavioural Challenges

      Children may: 

      • Avoid physical activities that feel hard or tiring 

      • Feel frustrated, anxious, or have low self-esteem due to repeated struggles 

      • Stay away from playground games or prefer playing with younger children 

      • Resist changes in routine or environment, especially if tasks need planning and sequencing 

      Other Common Challenges

      Children may: 

      • Struggle to balance speed and accuracy (e.g. neat handwriting may be very slow) 

      • Find it hard to lay out work neatly on a page (e.g. maths or spelling tasks) 

      • Have difficulty with self-organisation and keeping track of belongings 

  • Teaching Strategies

    • Use a consistent step-by-step method to teach dressing. 

    • Provide a pictorial sequence to follow. 

    • Try backward chaining: teach the last step first. Once the child masters it, teach the step before. Keep adding earlier steps until they can do the whole task. This helps them feel successful each time. 

    • Teach the idea of a “helper hand” and a “doer hand.” For example, when zipping a coat, the helper hand holds the bottom while the doer hand pulls the zip. 

    • Demonstrate each step clearly and use verbal cues like “labels at the back.” 

    Change the Environment

    • Let the child sit on the floor with their back against a wall or use a low chair for stability. 

    • Make sure there’s enough space to move comfortably. 

    Help by Understanding

    • Work with the child to find strategies that suit them. 

    • Encourage an “I can do it” attitude by celebrating effort and progress toward independence.

In the Community

Supporting Physical Activity

  • Encourage physical activities for fun, fitness, and participation. 

  • Help coaches, sports instructors, and activity leaders understand the child’s strengths and challenges. A One Page Profile can be a useful tool for this. 

  • Some children may need extra support or one-on-one lessons to learn a sport or physical activity. 

  • Use protective gear when needed, such as helmets and knee or elbow pads. 

  • Promote social activities the child enjoys and finds less physically demanding, like drama, music, or clubs. 

Teaching a Cognitive Approach to Motor Skill Development

Using a strategy like Goal, Plan, Do, Check helps children learn new motor skills by thinking through each step. 

GOAL: What do I want to do?

Start with a small part of the task and build up gradually. 

Examples: 

  • Skipping – Goal: Jump over a rope lying still on the floor. 

  • Riding a bike – Goal: Walk beside the bike and stop it using the brakes at a marked line. 

  • Tying laces – Goal: Make the loop to form a bow. 

PLAN: How am I going to do it?

The child should make the plan, with support if needed. Plans may include: 

  • Body position – “I will sit with my back ‘glued’ to the chair.” 

  • Focus – “I will keep my eyes on the ball.” 

  • Task modification – “I will stand on the tape when drawing on the board.” 

  • Feeling the movement – “I will feel the bumps in the letter B when I draw it in the air.” 

  • Verbal motor mnemonic – “I need to use my Alligator grip.” Or “1, 2, 3, 4 – are my feet on the floor; 5, 6, 7, 8 – am I sitting up straight?” 

  • Verbal rote script – Use a pattern of words to guide movement: “Dribble, dribble, shoot” or “Push, glide, push, glide.” 

DO: Carry out the plan

Let the child try the task using their plan. 

CHECK: How well did my plan work?

Reflect on the plan. Adjust it if needed for next time. 

Tips to Support the Process

  • Change one thing at a time. 

  • Ask the child questions instead of giving instructions. 

  • Demonstrate the task and highlight the key parts. 

Reference:The Cognitive Orientation to Occupational Performance by Polatajko et al. (2001)