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I have a son who is really clumsy with his overall motor skills and at the same time is a dreamer, who is not paying attention to his surroundings.

This leads to him having bruises all the time because there was some kind of furniture in the way he didnt see, or a ball in the schoolyard so he trips, etc.

Interestingly enough, this doesnt really bother him as "he got used to the pain". He is not whiny or anything, he just shrugs it off and continues in his ways. Even two bone breaks didnt change that behavior at all!

The problem is: He treats others the same.

His 7 year old sister is getting hurt by him on a nearly daily basis, because he "didnt see here standing there" or was curious what is in the cupboard he opened with her standing in front of it.

We tried to talk to him about this, and he learned to say sorry afterwards and its never on purpose, so all the usual advice is not applicable here.

Disciplinary things like taking away his devices every single time this happens annoy him deeply, but have no effect.

We even tried to give him a star each day he didnt hurt anyone and after 30 days, he actually managed to get 28 stars and a reward! The next day where there was no star in play anymore he hurt his sister...

Any advice on how to continue? Should I give stars for an extended period of time? Or is there a better way?

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There isn't really enough information in your post to make any recommendations other than that you seek professional medical care.

In a situation like this, someone who can make a decent determination of what to do would need to see the entire picture. That would actually take several hours, including a complete history, the social history, a thorough physical exam including eyesight/visual fields, complete neurological, other, etc.

Gross motor skills can be improved with therapy, and so can fine motor skills. Doing so sooner rather than later is better for the child.

Knowing the specifics about his inattentiveness (evaluated properly) may prove helpful in at least two ways: 1) it may prove to be treatable, decreasing such incidents, and 2) if it is not, you need not try to fix it, because he can't help himself. Understanding that something is out of one's control allows for adjusting expectations and decreasing frustration on the part of parents and sibling(s). Instead, it might be better to alter his environment to minimize the chance of his hurting others at home. If it is something he can improve, then he can do so with the right kind of help (the punishments don't help, so it can help you to find out what does.) I'm very hesitant to say more, not knowing the cause.

So really, this entire answer can be summed up by "see his doctor". If his doctor is not proactive, get a second opinion. Though it's not the most serious of problems, getting answers can help the entire family.

Parents tend to think they can fix problems if only they knew how. When they can't, it causes tension, frustration, and (when extreme) feelings of guilt/inadequacy which affects everyone in the family. It might be a great relief to know you cannot fix that which cannot be fixed, you can fix that which can be fixed with help, and that you got help to differentiate between them.

Adjusting the environment to prevent injury is done all the time, but people tend to think about it only in the extremes of age: babies/toddler's homes are child-proofed and the elderly employ grab bars, get rid of throw rugs, etc. But really, it can help at every stage of life. I used to joke (bad joke) that coffee tables kept us in business, as I sewed up kids so very, very often. Almost everyone has coffee tables, and half the kids I know/knew split their chins/lips/other on the corners of one... including two of my own kids!

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  • Urgh. Coffee tables. We had inherited a glass one. Consequently minor 1 now has a pretty large scar on his back and the table is gone for good.
    – Stephie
    Mar 3 at 20:40
  • Thanks! I will talk to a professional about this! And see if I change something in the environment, good point!
    – Nurator
    Mar 3 at 22:32
  • @Stephie - Glass and metal tables are the worst; we had a wooden coffee table with rounded edges, and one of mine still managed to split their forehead open (not too badly, though). Another fell at a friend's house. I've actually stitched up adults (or sent them to the OR) who had fallen through glass coffee tables.
    – anongoodnurse
    Mar 3 at 23:13
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My younger son hurt me inadvertently pretty often when he was little. (He's 18 now and has outgrown what I'm going to describe, to a great extent.)

Also he was constantly hurting himself, for example he couldn't just walk to the refrigerator, he had to get a running start, then slide into home base, but he would ALWAYS miscalculate and end with a crash. Sometimes when he was pretty small, when we were playing (it could be any activity!), and he'd make a sudden movement and crash his forehead into mine. So I can related to what you've described.

At some point the pediatrician suggested occupational therapy, to work on sensory regulation.

The OT we ended up with wasn't a great match and after a while we put it on pause -- which was a graceful way to bow out.

But sometimes an OT can provide helpful sensory regulation treatment.

I do think it can be worthwhile to get a good sensory evaluation, if for no other reason than to increase one's awareness of the child's particular sensory profile (it can be kind of complicated), and how the child's profile fits or doesn't fit with those of family members).

Also, if you suspect ADHD, ADD, or combined type, it might be helpful to get an evaluation. I was hesitant for some years, but in retrospect when I stopped worrying about labeling in school, and got some evaluations and diagnoses, I came to understand my kid better, and get better in sync with him.

If you're hesitating to have him evaluated for ADHD/ADD in school, keep in mind that the pediatrician can do the evaluation, and if he comes out positive for ADHD, for example, you get to choose whether (or when) to reveal the diagnosis to the school. Also, I want to point out that many parents think that an ADHD diagnosis automatically leads to medication. Not true. You and your child's doctor get to decide about that.

One thing that helped my son a LOT with sensory regulation was to have plenty of physical activity every day that he enjoyed. When he was a toddler or a pre-schooler, if the weather was atrocious, one of us would take him to Walmart for exercise! Sometimes we'd let him ride a bicycle with training wheels around the store (parent in close proximity). Also we learned to avoid a lot of stimulation before bed, and to keep to a regular sleep schedule as much as possible. I noticed that my son always needed more sleep than his peers. We had to make sure there were no roughhousing games in the hour before turning out the light, and keep to the schedule. Also, another rule my spouse and I worked out was, DO NOT draw a line in the sand at bedtime. The goal became, let the kid say whatever outrageous thing he might -- BUT DON'T ARGUE WITH HIM AT BEDTIME. As they say, "tomorrow is another day." Better to do the problem solving well before bedtime.

Another thing that helped was to work out an agreement with the school that there would be NO elimination or reduction of recess time as a consequence for behavior problems and/or incomplete academic work. This can be set up as an accommodation (in a 504 plan or an IEP -- if you're in the US). I think in the UK it's called an adjustment maybe. Having this as a recommendation in writing from the pediatrician can be helpful in getting it set up.

In middle school, when most students were going to PE every other day, our kid was going every day. That was quite helpful to get through the day.

Thinking about your 7yo daughter: I remember that the PE teacher explained to me some of the games the kindergartners played:

Game #1: hold out your arms straight out to the sides and imagine you're an airplane. The children run around the room in random, variable directions in a roomy gym. The goal is not to bump into anyone. The teacher explained that this game helps with the child's awareness of his own bubble and the bubbles around the other children. The teacher didn't do much explaining with the kindergartners. The children improved just by doing.

Game #2: right before going back to the classroom, the PE teacher had them play Pretend Sleep. The teacher would walk around the room gently touching anyone who was having trouble winding down. The teacher explained to me that the children needed to wind down, calm down, after so much stimulation in PE class, before heading back to the classroom.

I wonder if these two games would be particularly helpful for your son.

My son's classroom teachers tended to increase his distance from his neighbors, to prevent accidental harm to others, reduce distractions (in both directions), and to reduce over-excitedness (too much stimulation). That helped.

Could you work with your daughter to help her learn to gauge how much distance to keep between her and her brother?

If it becomes an issue at school, maybe having an extra adult in your son's vicinity (perhaps through special education) would help. But watch out, sometimes the paraprofessional (extra adult in the room) will set himself up as a behavior cop, and when that happened with my son, it was completely counter-productive.

If there are problems at home, for example when you're on the phone or cooking dinner, it might be helpful to have a Mother's Helper come over to prevent accidents. Or you might have them take turns talking to grandma on the phone. Your children might need more supervision than most, to avoid someone getting hurt.

My other two ideas to offer for your consideration are: 1 - it can be helpful for a child to be trained in winding down getting ready for bed, for example snuggle and read with a parent. If you're going to read two books, the exciting book comes first, finishing with the calming book. 2 - help the child build self-esteem by building skills in something the child enjoys and gradually gets good at. For my child, music lessons and supervised practice was very centering. He really enjoyed it and even when he felt like the bad boy at school, he could still be proud of his musical skills. It doesn't have to be music -- there are other abilities a child can develop over time.

No two children are exactly alike. For all these ideas I've shared, please sift through and see if any of them might fit.

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  • Wow thanks a lot foe the long writeup! I will answer in more detail tomorrow, its late here (Germany) :)
    – Nurator
    Mar 5 at 22:08
  • Alright, there are many good insights here! The airplane game is genius, I will definitely do that with my kids. Lots of physical exercise helps, I noticed that already, so we made a habit to always go swimming on the weekend. Unfortunately with the side effect, that now his little sister is two medals above him due to all of her swimming training as well.
    – Nurator
    Mar 6 at 12:51
  • I am still unsure about ADHD, as he is able to concentrate in school and has good grades there, it seems to me to be more physical than mental, but it doesnt hurt to check that out aswell. I will probably ask my pedeatrician about the whole situation and see what they propose. Thanks a lot!
    – Nurator
    Mar 6 at 12:52
  • @Nurator - great idea. So, the interesting thing about the sensory profile is that there may be "comorbidities" (ADHD/ADD/combined type), autism, and/or Tourette Syndrome, etc., etc., or no comorbidities at all. I believe Jean Ayres was sort of the mother of the study of sensory integration, but over time various people have, let's say, refined the field. If you want to do some reading, Winnie Dunn would be a good place to start. When I first started reading about it, the stuff I found (book lent by a friend, stuff on the internet) I found it pretty confusing. You might find it helpful Mar 6 at 15:27
  • ... to look at Living Sensationally the materials at Pearson, e.g., pearsonassessments.com/content/dam/school/global/clinical/us/…, by Winnie Dunn. (Dunn's approach to evaluation isn't the only one out there but at least where I live, occupational therapists with an expertise in sensory processing are few and far between.) / Re possible ADHD etc., what caught my eye was when you said, "dreamer, who is not paying attention to his surroundings." I know a successful scientist who is REALLY good at blocking out family life. ... Mar 6 at 15:31
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Congratulations, you have a boy. Bumps and bruises are fine, and to be expected. His clumsiness is most likely due to changes in his body size... ie. his arms and legs are longer than they were a month ago. Perfectly normal.

As for banging into siblings and other people, it doesn't sound like you think it's malicious, so I'd chalk it up to him just not paying attention and not being overly aware of his surroundings. Pretty normal.

Focus lessons on being considerate and aware of others. Have him slow down when others are near. Don't try to turn something that's just childhood innocence and carelessness into something clinical or over exaggerated.

It probably wouldn't hurt to teach the other children to be aware of him and what he might be doing so they aren't in his path. It's normal for a little boy to play rougher than a little girl might. Don't stress over it.

Seriously, it sounds like a little boy being a little boy.

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