Gross Motor Skills in Children with Down Syndrome: A Guide for Parents and Professionals.

Gross Motor Skills In Children With Down Syndrome: A Guide for Parents and Professionals

Winders PC. Bethesda, MD 20817, Woodbine House Inc, 1997, paperback, 236 pp, $16.95.

This text on motor development in children with Down syndrome is an excellent guide for parents and professionals who are looking for ways to foster motor development in this population. In addition to providing useful background information on typical development, this book also provides readers with descriptions of the component movements for a variety of skills, detailed instructions for activities, and practical guidelines for performing the activities.

In the introduction, the author provides a useful overview of the typical obstacles to gross motor development in children with Down syndrome. This clearly written introduction should help parents and nonmedical professionals understand the implications of problems such as hypotonia, weakness, and medical complications. Physical therapists and other medical professionals reading this section, however, would benefit from more advanced information than it provides. In addition, the introduction presents general guidelines for practicing gross motor skills. A particular strength of this book is the information that the author provides about the impact of temperament on the development of motor skills. This concept is presented in the introduction and is explored throughout the various sections of the book.

The remainder of the book is organized into 2 parts: motor development from birth to walking and postambulatory skills. Each of the 5 chapters in part I addresses a particular stage in motor development, starting with the development of midline control and ending with standing, cruising, and walking. The 10 chapters that comprise part II span walking on uneven surfaces to riding a tricycle. The final chapter encourages parents to go beyond teaching their child these basic skills to find recreational sports and activities that their child may find enjoyable.

Each chapter includes an overview of the motor skills to be targeted in that particular stage of development, numerous well-defined activities, and a motor milestone checklist that can be used to determine whether a child is ready to move on to the next stage of development. Accompanying photos make the activities easy to follow and add visual appeal to the text.

In the appendix, the author presents her data on the gross motor development of children with Down syndrome to give parents a better idea of what constitutes "normal" motor development in a child with Down syndrome. Without the details concerning sample selection and data collection and analysis, it is difficult to assess the validity of this section; however, the author clearly explains the limitations of her data and clarifies concepts such as "standard deviation" and "normal distribution" using understandable terms. Because developmental "norms" such as gross motor development milestones are not readily available for this population, this appendix will undoubtedly be of interest to parents and professionals alike. The final section of the book lists resources, including organizations and Internet sites, that can be accessed for additional information.

Several factors help make this book a valuable reference as well as enjoyable to read. Hirst, this author's great affection for children and their families is evident in her writing style. She demonstrates a great respect for individual differences among children, and, despite the fact that she could be viewed as using a "cookbook" approach to teaching gross motor skills, she makes frequent allowances for possible variations. Second, the author encourages the use of practical items and toys that can be found in the home or easily purchased in the community. Parents will be encouraged by her optimistic attitude and positive outlook on the potential of children with Down syndrome.

This text could serve as a valuable resource to many groups of individuals. Parents, early intervention teachers, and adaptive physical education teachers are just a few examples of individuals who would benefit from having this book on their shelf. In addition, experienced and novice physical therapists can use this test as a guide for developing the plan of care, goal setting, and providing home activity programs to parents. Finally, it should be mentioned that the activities presented in this book are not limited to children with Down syndrome. These activities could most certainly be used with children who have gross motor delay due to other conditions as well.

Michelle Brodersen Broggi, PT Quinnipiac College Hamden, Conn

Ms Broggi is Assistant Professor in the physical therapy program and has experience in pediatric and adult neurological rehabilitation.