fine motor skills ( or lack of)

[Rhonda__0__0]

  My son is 6 years old. We are having problems with him in school.
  Although he tested ok for the entrance exams, for kindergarden, his
  teacher now feels he may be ADD or developmentally delayed.
  He has very poor fine motor skills. He can barely write his name,
  and then some of his letters are backwards. He can barely write a few
  of the numbers 1 - 20. He can not pronounce some of the letter sounds,
  for example- his L sounds like a W.
    I had never noticed him having a problem developing as an infant.
  Except with his balance, coordination. He walked on time, but was always falling.
  He had chronic ear infections, until he was 5. We had tubes put in and they
  helped, but he still gets the infections. Even washing his hair will give him
  an ear infection overnight it seems. His balance is still poor. He can hardly
  walk across a room without tripping,( I dont know on what).Until this fall, when he ran
  he outstretched his hands at his sides to balance himself. He was late at mastering bike
  riding. He was about 4 when he finally figured out his tricycle. Before he just never had the
  leg strenth ( it seems).
    Also he has a very poor apetite.The doctor said he would eat when he was hungry,
  but instead, he would go to bed with his tummy growling, and still not eat.
  He is a very finicky eater now. I have always limited his junk food and sugar intake.
  There are days that he does not eat his lunch at school.
    We have been to see a child psychiatrist who has referred us to a child
  neurology program in a nearby city. Our appointment is not until May 30, tho.
  I was just wondering if this sounds like ADD, or ADHD? or could it be a
  neurological imbalance of some kind, and what are the standard
  tests given to children, and how can you tell if the child is developmentally
  delayed or ADD?
    Thank you in advance, and thanks for this great site!!
   Rhonda

[HVM Ph.D. - KDK]

_
Dear Rhonda,
Your psychiatrist made a wise referral. There is no indication, based on the information you provided, that your son displays Attention-Deficit/Hyperactivity Disorder (often referred to as Attention Deficit Disorder, or ADD). At the very least, the symptoms you describe are not symptoms of ADHD (a 'neurobehavioral' condition manifested by an array of symptoms that involve inattention, hyperactivity and/or impulsivity.
It is quite probable that your son displays some developmental delays in several areas, among them fine motor development, gross motor development and speech (though it is quite common for children of your son's age to substitute the 'w' sound for 'l'). There may also be a learning disability. This will all be 'teased out' as your son's evaluation proceeds. If it turns out that your son's neurological status is OK (apart from some immaturity), you may be asked to consult with a developmental pediatrician and/or other professionals who are trained in the evaluation, diagnosis and treatment of developmental conditions/disorders. If there are developmental lags, the professionals will help you figure out precisely in what areas your son is progressing normally, in what areas/skills he is lagging behind his peers, and whether (for each of these areas) any specialized intervention (e.g., physical therapy, occupational therapy, speech/language therapy, special educational assistance) would be useful. It is important to remember that your son is still quite young, and it is very common for youngsters to display different levels or rates of development in various areas of functioning. Be patient - you are proceeding along a sensible course.
This information is provided for purposes of general medical education purposes only. Please consult your physician and other providers for diagnostic and treatment options that pertain to your specific situation/condition.
*Keyword: Development