Journal of Developmental & Behavioral Pediatrics:
Division of Child Development and Rehabilitation; Children’s Hospital of Philadelphia; Philadelphia, PA
Fine Motor Skills for Children with Down Syndrome: A Guide for Parents and Professionals, Second ed.
Maryanne Bruni, BScOT, Bethesda, MD, Woodbine House, 2006, 241 pp, $19.95, softcover.
From her experience as both an occupational therapist and a parent of a child with Down syndrome, Maryanne Bruni seeks to share ideas for home—and school—based activities to promote the development of fine motor skills for children with Down syndrome from birth to 12 years of age. Her extensive book successfully communicates these ideas to her target audience of parents, teachers, and professionals.
The opening chapter describes Bruni’s analogy of fine motor skills as a “house,” of which the fundamental blocks are stability, bilateral coordination, and sensation, and the upper levels are dexterity and daily living skills (including school tasks, self-help skills, and household tasks/ leisure activities). This theme drives the organization of the book, with individual chapters dedicated to each of these components. Other chapters focus on methods to motivate children to practice these skills, as well as overviews of fine motor and gross motor development in children with Down syndrome. Ms. Bruni ends the book with a chapter on sensory processing in children with Down syndrome.
Bruni’s text is succinct, and her numerous activities are easy to follow with her accompanying detailed step-by-step instructions and black-and-white photographs. The activities seem fun and generally do not require special or expensive tools (the appendix includes a list of common household items that can be converted to teaching tools). Each chapter is punctuated by a “Grandma’s and Grandpa’s list” of toys that help promote development of the particular skills described in the chapter, a list that many will likely find useful for gift-giving. Other gems in the book include a “handy basket” list for parents (a list of toys organized by age level), and a thorough chapter on school tasks, which includes sections on assessing readiness for and teaching printing skills, basics on hardware and software alternatives to printing, and examples of educational goals for children in inclusion settings (which may be particularly helpful for parents in developing their child’s individualized education program). The appendix includes several drawing worksheets and a list of resources for activity materials and various support organizations.
The “profiles” included in each chapter illustrate Bruni’s recommendations in the form of a vignette, but were more distracting than informative. The evidence for some of the treatment approaches for sensory differences is only vaguely described, although Bruni does note when studies of protocols have not been performed specifically on children with Down syndrome.
Overall, Bruni’s comprehensive book is highly practical and provides many activities for a wide age range of children. It should prove useful for anybody who is working with a child with Down syndrome to maximize his or her fine motor potential.
Patty Huang, MD
Division of Child Development and Rehabilitation
Children’s Hospital of Philadelphia