There is a 4-year-old in my class who seems to have poor muscle control. She unintentionally knocks things off shelves and intrudes into other children's space. The children find her aggressive during outdoor play because of the way she runs toward them. Her lack of control is having a negative effect on her social development. How can I help her?

First, we need to get a picture of the extent of the child's difficulties with large-muscle control. Some children, for example, have a hard time with balance. If they're in an area that requires walking a narrow line, they may bang into a desk. They need a wide area in which to navigate. Other children will have difficulty with balance when they're climbing and may feel very insecure when they're off the ground on a slide or a swing. Still others are skillful at balancing and climbing but have trouble throwing and catching.

Difficulties Related to Motor Skills

Problems with large-motor coordination are often accompanied by difficulties with fine-motor skills. Children may have trouble holding a crayon or printing letters. These motor-coordination problems become evident in all areas of children's lives-not just in outdoor play and writing but in simple activities such as brushing teeth, climbing stairs, and getting up from and sitting down at the table.

As you observed, these coordination problems have an impact on a child's social development. A child who bangs into people is often labeled a "bad" child. He becomes frustrated and anxious and may even become careless and less cautious over time. Because he's frustrated and angry, he may bump into people more often, starting a vicious cycle.

Motor Planning and Sequencing

Another factor affecting motor coordination is motor planning and sequencing. This is the ability to carry out actions that require five or six steps. For example, many children can take off their coats, hang them in their cubbies, walk back to a table, sit at the table, and get ready for an activity. A child with coordination problems is likely to have a harder time with this series of movements. This leads to difficulty following instructions and participating in many different kinds of learning tasks.

Even more problematic is how poor motor planning and sequencing impacts social skills. For example, a child who's trying to figure out which group of children on the playground wants to play with him needs to look for cues. These cues may include smiles and inviting head nods that encourage him to join the group, or head shakes and turning away that signal "leave us alone." This requires the ability to read nonverbal cues and a massive amount of planning and sequencing. If you watch a socially successful child in the middle of an outdoor play space, he appears to manage all of this effortlessly. The same is true for the adult who smoothly moves from one group to another at a party, first talking to this one and then to that one. In both cases, the child and adult have good planning and sequencing skills. But the child who has difficulty with these skills may withdraw socially or become aggressive, or simply appear to behave inappropriately by misreading cues and doing the wrong things at the wrong times.

Goals for Improvement

You'll need to work in concert with the child's parents to achieve some of the following important, interrelated goals.

Help the child improve his motor functioning and coordination. There's no better way to improve those things than to practice the skills that are difficult for the child (such as throwing, catching, and climbing). While this may seem to be a simple recommendation, it is hard to implement because children, by their nature, shy away from things that are difficult for them. You can inspire interest by making practice activities fun and interesting. For example, you might offer a big, bright orange foam ball to a child who has trouble throwing and engage him in a game of "hit the silly monster face" (a makeshift target) with the ball.

Apply the same principle to practice fine-motor skills. You might ask the child to scribble on the page and then show him how he can make something interesting from the scribble. The idea is to make the practice activities as much fun for the child as you can to override any negative feelings.

Have children follow a series of directions to improve skill in planning and sequencing. For instance, if a child wants to go outdoors, you might say: "First you need to put your toy in your cubby, then put on your jacket, and then put on your hat."

Play modulation games. Invite the child to sing, dance, or play the drums to music. The child must pick up or slow down the tempo based on what he hears. Another modulation exercise is to ask the child to run fast, then slowly, then very slowly, then fast again. Both of these exercises help the child learn to modulate a variety of motor activities.

Work in partnership with parents. Help the child acknowledge feelings of incompetence that prevent him from participating in activities. Saying: "Gee, I know that's hard for you. How does it feel when something is hard?" can make the child feel better. Just empathizing and sharing a little anecdote of something that's hard for you can be very, very helpful.

Support and encourage the child in areas where he can find success. Underscore the child's competency in drawing or singing or whatever area he is skillful in by joining him in these activities and showing the pride you feel in his abilities.

Floor Time

It's important for teachers to use "floor time" with children who have motor challenges. Find some time for working with the child alone or in a small group. Follow the child's lead in pretend play or conversations and help him elaborate on the play. The child who has motor problems is likely to have some difficulties with aggressive feelings. Sometimes the child who can't flex his real muscles is also afraid to flex his emotional muscles, yet this is part of what the child needs to master. Create opportunities for pretend play and challenge the child to engage in some of these muscle-flexing activities.