Monday, January 21, 2013

When Low Tone Meets Low Motivation

I hear a lot from parents of kids with Down syndrome, telling the world how very hard their child works to reach milestones and accomplish things that come easily to the typical population.  How their child works tirelessly, pressing forward, eager to achieve, never giving up. 

And then I wonder:  why doesn't my child seem to have this pressing drive that so many other parents see?

In my reading on raising a child with Ds, I read that often children with Ds will find shortcuts and take "the easy way".  This isn't just due to laziness.  It's often because low muscle tone and hyper-mobile joints with loose connective tissue make it difficult to use muscles easily.  Muscles with low tone are not always ready to do work like typical muscles are, so extra signals need to be sent to make any movements.

So a movement that comes easily to a typical child may be very difficult for a child like Cora.  Case in point:  getting onto her hands and knees to crawl, bearing weight by standing, climbing up stairs, moving to a seated position.  A child with low tone actually needs to be stronger to do the same movements someone else will do, because greater strength is needed to stabilize loose joints and more work is required for even simple movements.

Reading more about low tone this weekend clarified to me why Cora does many of the things in the way that she does.  It helped me understand a little better what low tone means to her and why it is so hard for her to do certain things.

And it makes sense that if someone, even you or I, could adapt our movements to make certain things easier, we certainly would, wouldn't we?  

Well so does Cora.  And that's why she butt-scoots instead of crawls, and is just now learning to do things that very young babies often master well over a year before she was even willing to try.  The fact that she hasn't had much practice doing these things makes it that much harder for her to do them.  Her muscles haven't figured it out.  Her muscles haven't strengthened in the ways needed for her to do these movements.

But the difficulty alone doesn't exactly explain her lack of motivation.  I see pictures and stories of children Cora's age with Ds who are walking, taking steps and moving all over the place, low-tone and all.  Their parents constantly applaud their fierce determination.  

Cora just isn't doing that.  This is largely because it's just not her priority and it's not in her personality.  Children are often said to be either "motor driven" or "observers."  It is clear that Cora is an observer.  That she would rather read, and sing, play and communicate than try to walk or crawl. 

And, like her mother, she seems to not want to do things when they are too difficult.  I admit it.  When things don't come easily to me I am reluctant to expend the energy.  And it seems that Cora is following suit.  If there's an easier way to do something she'll likely find it.  Or she simply won't do it all until she's darn good and ready.

Happily, she has been making progress in gross motor recently.  On her birthday, she began to pull to stand regularly.  In the past she could do it, but seldom did.  Especially if anyone was looking.  But she seems to have figured out how to use her legs to get up, and is now pulling up all over the place.  Last week, cruising on the couch finally "clicked."  Although she could do it months ago, she just didn't.  But now she's learned that she can do it, and she's finally found the internal motivation. 

We still need to work on independent standing, bending her knees more (especially when sitting down), using a push toy and increasing her overall stability to move her toward walking.  It may take a while yet.  And with Cora it is so hard to say.

I've learned that it's really all about waiting until she's ready.  Trying to wait patiently and not get too frustrated seeing 6 month old babies doing things she's just now doing at 2.   Pushing her to do movements that she doesn't want to do doesn't work.  When she wants to, she'll figure it out.  And she's doing it; albeit very slowly.

For the record:  this is pretty much just my thoughts on Cora's gross motor skills.  I am fully aware of her strengths in other areas: signing, social skills and interaction, and extreme cuteness, to name just a few. 


  1. It's funny you write about this today because I just had a conversation about this very topic with another Ds mom on the phone. We were lamenting the fact that our boys (who are only 2 months apart) are so motor driven. We'd both love to hear them talk, but those boys don't care about that--they just want to climb, run, jump instead. I completely agree with your observations and the fact that our kids will do it when they are ready. They truly have their own time tables and it's us parents who simply have to wait. It's nice to hear that Cora is taking some interest in gross motor stuff. I am of the opinion that once a kiddo has a good handle on one area, he/she pops over to a weaker one for a bit. Keep it up, Cora!

  2. Well if we merge Hailey and Cora, we have a very well-rounded child, don't we??1? It definitely is all a matter of what they want to do and when they want to do it. Drives this momma mad some days :-) I love the pic of Cora standing...such a cutie! I have several younger neices and nephews that are surpassing Hailey in a lot of areas....that is when it stings. I am glad to see Cora is taking an interest in gross motor. Love this post!

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  4. I hear you Leah! I could write a similar post about Ben's communication. He's just not motivated! I think we both know that Cora and Ben will do it in their own time but the wait can be frustrating!

  5. Cora sounds a lot like Kamdyn. She did t pull to stand or cruise until after she turned 2 if I remember right. I thought she would be 3 before she walked, but she surprised me and kind of did it out of the blue. Kamdyn is an observer too. There are advantages to that, like you said.

  6. Levi is the opposite in one way - he is intensely motor-driven (one of the biggest reasons for his lack of progress in communication)... but he is definitely the same in that he CAN do so many things before he WILL do them! He's so close to walking but he needs more practice. What will get him willing to walk more? Very little. He's so good at his crawl/scoot that he doesn't ever really "practice" walking unless Mom makes him. Since I have more to do than break my back all day making him walk everywhere - it's a sloooow process. *sigh* At least the one benefit in this whole long, drawn-out process is that I'm forced to learn to be a little more patient. That's finding the silver lining, right? :-) Motivation is KEY in any child's success and personally, I think our kiddos are often very sneaky about hiding their motivations, forcing us to get creative and learn patience. Always teaching us while we teach them.

  7. Sounds like Cora is up to some good stuff these days. Her gross motor skills might just explode out of the blue and sooner than you think! I know Russell seemed to lack motivation for forever...It was just his personality though. Easy going, laid back kids are more content to just be, they don't see the rush to get moving. Sounds like Cora is starting to kick things up a notch though. The waiting is hard, I hear ya there...But she is on the move now, things are just going to click into place from here on out.

  8. Yep..completely girl is an observer whereas Jono (nearly 3 and not walking) but still ever so active, scooting about on all fours because crawling on hands and knees is too slow, and climbing everything OMG! So different from my daughter. (Jono is our no 2 with Ds, we adopted him)
    However, my girl was walking by 2 but here we have a highly motivated nearly 3yo boy not yet walking. No rhyme or reason to the low tone conundrum as far as I am concerned.
    But sounds like your girl is doing just fine, and she is ever so cute! Love the leggings and stripey top!

  9. It's so hard to be patient for those milestones! I think medical issues, like Cora's heart surgery and Anthony's NICU stay, really add to motor delays more than we realize.

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