Pediatrician, a square, and a triangle - did yours do this?

[annlaura]

Has a visit to the ped ever made you second guess yourself and overthink a comment the dr made? Today was DS4's checkup. At some point the dr used his pen and drew a small circle, square, and triangle on the paper on the exam table. Then he asked DS to draw them too. DS said no, he couldn't. He drew a few squiggles and lines, finally drew a circle, but refused to even try a square or triangle. The dr said I should start working on drawing and writing, for school readiness. (Nevermind that I haven't told him I plan to homeschool.) I've just managed to get more focused on this than maybe is necessary. On the one hand, I don't believe it matters that DS can't and/or won't draw a square or a triangle. I've seen him draw triangles, but I can't recall squares. I certainly haven't asked him to, anyway. On the other hand, now I'm wondering if maybe he should be able to and I just don't know. I remember reading when he was a toddler that he should make circles and straight lines at some developmental point. He did; I never thought much about it again. He can be a bit hard headed, and also refused to even attempt to hop on one foot for the dr. I may check again in a day or two to see if he really doesn't know how to draw squares and triangles, and if he doesn't, ask if he wants to learn. Can you tell me your thoughts so I can either calm down or realize he really does need to know this now? Thanks!

[Parrothead]

If I recall correctly the tracing then eventually drawing if the shapes came with the math readiness book I used in pre-K for dd.

[Sue G in PA]

First, yes you should calm down...said in a very nice way! :D If my ped had done that I would have made some snarky comment about her testing to see if her arm worked or something. NOT their job. Would have been checking for a new ped. after I got home. Clearly this one does not understand that all children develop at his/her own pace and being able to draw a square, circle and triangle does NOT indicate any future school success. AND, if the child cannot/will not and the ped makes the comment like "you should work with him" in the presence of said child...child could become a bit self conscious and worry he/she isn't "smart". Ugh..sorry to ramble on but things like this REALLY get to me. Reason we homeschool.

[Spy Car]

The doctor is checking on child development. That is the job of a good pediatrician. Being able to draw basic shapes is a reasonable skill to expect of a 4 year old (one of a great many) especially when the child is given the model to follow.

 

These are the kind of things a good doctor does.

 

Bill

[brehon]

I wouldn't worry too much about it. Only 1 of my kids could draw shapes at 4 and it was my dd (now 5). My eldest son couldn't and my current 4 year old son can't either.

 

If your son is interested in beginning writing (a big if for many young boys, regardless of what certain doctors may say), then you could start some simple tracing exercises: wavy lines, shapes, maybe letters/numbers. Kumon has some wonderful books for this and they're not too terribly expensive. I absolutely wouldn't force any formal handwriting at this point and would keep any lessons around 5 minutes. Unless, of course, your son decides wants to do more. Let it be interest driven right now. Also know that some boys' fine motor skills (those needed for gripping a pencil and writing) don't develop until later.

 

So, you're right about not needing to worry about your son right now. I'm sure he's fine.

[3andme]

One of our pediatrician's did this same test. I suppose these are developmental milestones. Since many dc are very anxious when visiting the dr. I'm sure that could throw off cooperation on this kind of thing. My ds won't even let them take his blood pressure.

 

I wouldn't worry too much unless you feel concerned for other reasons. I think the ped. is just trying to be proactive in identifying any potential delays and perhaps helping parents seek services if necessary.

[gardening momma]

Has a visit to the ped ever made you second guess yourself and overthink a comment the dr made? Today was DS4's checkup. At some point the dr used his pen and drew a small circle, square, and triangle on the paper on the exam table. Then he asked DS to draw them too. DS said no, he couldn't. He drew a few squiggles and lines, finally drew a circle, but refused to even try a square or triangle. The dr said I should start working on drawing and writing, for school readiness. (Nevermind that I haven't told him I plan to homeschool.) I've just managed to get more focused on this than maybe is necessary. On the one hand, I don't believe it matters that DS can't and/or won't draw a square or a triangle. I've seen him draw triangles, but I can't recall squares. I certainly haven't asked him to, anyway. On the other hand, now I'm wondering if maybe he should be able to and I just don't know. I remember reading when he was a toddler that he should make circles and straight lines at some developmental point. He did; I never thought much about it again. He can be a bit hard headed, and also refused to even attempt to hop on one foot for the dr. I may check again in a day or two to see if he really doesn't know how to draw squares and triangles, and if he doesn't, ask if he wants to learn. Can you tell me your thoughts so I can either calm down or realize he really does need to know this now? Thanks!

I wouldn't get all worked up about it (either second guessing yourself or getting upset at the doctor). Often pediatricians will check for certain developmental milestones so that if the child is behind, the Dr. can refer the family to the assistance programs that might help the child. Dd5 had speech therapy for 1.5 years through a publicly funded program that was open to all--not income-based. We had to have the Dr.'s referral, though.

 

If you want to help him develop those skills now rather than later, I wouldn't try to teach him--at least not in a way that he would be aware of it. You said he can be pretty stubborn, so I can see him resisting your trying to teach him how to draw a square, for example. I'd just casually draw stuff on paper with a crayon with him sitting next to you, and then let him have the paper and crayons. And then leave him be--don't worry about it if he doesn't attempt anything.

[kalanamak]

First, yes you should calm down...said in a very nice way! :D If my ped had done that I would have made some snarky comment about her testing to see if her arm worked or something. NOT their job. Would have been checking for a new ped. after I got home. Clearly this one does not understand that all children develop at his/her own pace and being able to draw a square, circle and triangle does NOT indicate any future school success. AND, if the child cannot/will not and the ped makes the comment like "you should work with him" in the presence of said child...child could become a bit self conscious and worry he/she isn't "smart". Ugh..sorry to ramble on but things like this REALLY get to me. Reason we homeschool.

 

Child development is part of what a good ped does. I'd have been pleased at some time spent. Sounds like a caring doc.

 

Ped had no idea child would be homeschooled. Children who enter KA without some basic skills MAY be mentally marked in the teachers mind as from a disadvantaged home or needing glasses or some such thing.

 

Again I reminded that a physician is "one we put our hopes on when sick, and our dogs on when well". :lol:

[AuntieM]

Copying shapes may help the doctor determine whether there are any visual processing issues. I don't know what level of accuracy would be expected of a four year old, though. I wouldn't be upset by it.

 

I would feel a bit pressured if he just handed over his pen and asked a four year old child to draw those three shapes without an image to copy.

 

And no need to mention your hsing plans yet. Just smile and nod.

[annlaura]

Thanks everyone! I do think it is reasonable for a 4yo to draw shapes. I got stuck on if it is necessary. My funny little guy noticed a Newsweek cover on the counter in the exam room and made a couple of politically aware comments, talked about antibodies when vaxs cames up, etc. But I'm obsessing over a square. :tongue_smilie: I'll calm down. Soon.

[Forget-Me-Not]

My DH is a family practitioner and I just asked him about this. He said it's a standard thing that they're supposed to do at well child checks.

 

I think at age 4, 2 out of 3 shapes isn't bad--especially if you have a kid like mine who refuses to perform simply because she was asked to do so :D My daughter is 5 1/2 and extremely bright, but up until recently was writing very little. In the last 12-15 weeks, her writing skills have shot up like a rocket. She just wanted to do it on her terms.

[sbgrace]

For you--I don't think a four year old needs to know how to draw a particular shape, no. That would be exposure. However, he/she should have the fine motor and other (visual spatial) skills to copy it in an age appropriate way (whatever that would be at four...we did have fine motor issues here and one of my kids has some pretty significant visual spatial issues as well!) So I guess in your place I would try to sort out if there might be fine motor/visual spatial issues or it's just a refusal to be on display in your son. But worry over what you described? No.

 

On personal level, I hate those sorts of things because they bring bad memories of my son "failing" them. Our past pediatrician did developmental type checks. My son has issues and she picked up on them and got him in early intervention. A lot of doctors/pediatricians don't look at development close enough to pick up problems and I think it's good to know about stuff early. So on the one hand I'm glad your pediatrician looks at development. They should. But I don't think your pediatrician followed up enough to know whether anything does or doesn't need to be addressed in this case.

Edited November 25, 2010 by sbgrace

[FO4UR]

When my oldest was 4yo, he failed the drawing test.:tongue_smilie:

 

The ped referred us to an Occupational Therapist for a better eval. It was a very positive experience. The OT gave me some very good advice (and encouraged homeschooling btw;)). My ds did have some minor fine motor delays that he outgrew with a little extra nudging by me.

 

He's a prolific drawer today. His cursive handwriting is better than mine most days.

 

 

If you REALLY want to see him drawing shapes, I would get a nice shape puzzle and show him how to put the pieces down on paper and trace around them. Make some houses, cars, etc out of the shapes *with* him a few times by tracing the shapes. That will probably be enough to spark an interest in drawing.

[LaissezFaire]

Our peds have always done the same. It doesn't bother me in the slightest. If there were to be something that raised their concern they could help direct you towards an occupational therapist or someone who could help with delays. This is why they do this. Of course the ped noted your child didn't need therapy, but another child who may be in need of that could be spotted this way. I know we as homeschoolers tend to jump to a conclusion that we are being 'tested' when they ask our kids questions but I promise they do this with every child.

[babysparkler]

The doctor is checking on child development. That is the job of a good pediatrician. Being able to draw basic shapes is a reasonable skill to expect of a 4 year old (one of a great many) especially when the child is given the model to follow.

 

These are the kind of things a good doctor does.

 

Bill

 

Child development is part of what a good ped does. I'd have been pleased at some time spent. Sounds like a caring doc.

:iagree:

[Suzanne in ABQ]

I have an occupational therapy diagnostic chart that shows at what ages (by percentage) that children are generally able to accomplish developmental tasks. It's called the Denver II (DA Form 564, May 1988).

 

For fine motor skills, it shows that 25% are able to copy a circle (or any closed form - not perfectly round) at age 3 yrs, and 75% are able by age 3 3/4 yrs. Above 75% indicates a possible delay, and 90+% are able at age 4 1/2.

 

The chart doesn't mention triangles, but it does show plus signs (+) and squares.

 

For + sign, 25% are able to copy + at age 3 1/3 yrs, and 75% are able at 4 1/4 yrs. Above that indicates possible delays, and 90+ are able at age 4 3/4 yrs.

 

For a square, 25% are able to copy one (with a demonstration) at age 4 yrs, and copy a model (without a demonstration) at age 5yrs. 75% are able to copy a demonstrated square at age 5 yrs, and an undemonstrated model at age 5 1/2. Above age 5 is considered possibly delayed for a demonstrated square, and above age 5 1/2 is possibly delayed for an undemonstrated square.

 

From what you said, your ds is right on track. He's doing circles. He's not delayed on squares (according to this chart) until he's 5 (for a demonstrated square) and 5 1/2 for a model square.

 

I definitely wouldn't stress over it, but if you want to get him some practice, I'd recommend a cheap pre-writing workbook, with lots of dotted lines and shapes for him to trace. My dd really liked the wipe-off marker books. We got them at Walmart, or Staples, can't remember which. She also liked dot-to-dot and maze books. All those kinds of things will get him to focus on his fine motor skills, without knowing that he's working.

[RoundAbout]

The above agrees with what my ped asked at DS's 3 year check up "Does he draw circles?" "Yes" Then he told me the next thing to watch for was plus signs or X's. We have our 4 year check up next month and I haven't even thought about checking for anything else since my DS hates to draw. He has excellent fine motor skills - mazes, lacing, cutting, etc. but just hates drawing and writing. I would probably be annoyed at that kind of on-the-spot test as well but I can see why they do it.

[annlaura]

I hope I didn't sound upset with the dr. I am happy for him to check for delays and am aware there is a method to his questions and queries. And while we don't always have the exact same opinion about every issue, I do think he is a caring dr. Thank you all for the info and BTDT, and thank you for the chart info, Suzanne! Very helpful! I probably should have asked the dr for more info on the hows and whys, but I was wrangling both boys through their checkups and didn't start worrying until we'd been home already.

 

ETA: I do know drs are human, so I will keep an eye on it and appreciate all the comments, not just the reassuring ones.

Edited November 25, 2010 by annlaura

[Suzanne in ABQ]

I hope I didn't sound upset with the dr. I am happy for him to check for delays and am aware there is a method to his questions and queries. And while we don't always have the exact same opinion about every issue, I do think he is a caring dr. Thank you all for the info and BTDT, and thank you for the chart info, Suzanne! Very helpful! I probably should have asked the dr for more info on the hows and whys, but I was wrangling both boys through their checkups and didn't start worrying until we'd been home already.

 

 

You didn't sound upset at all. I'm glad you were able to make sense of my chart description. It's so hard to look at a visual (this is a bar graph kind of thing), and describe it verbally!

 

Happy Thanksgiving!

[rootsnwings]

I think he's perfectly fine but if you just want something to help him work on this skill I. Highly recommend Rod & Staff's preschool workbooks, specifically the "Do it Carefully" workbook. Lots of pre-writing/tracing/thinking skills in that book. We have DIC & Adventures with Books. My ds3 loves them both & they were only like $2-3 each.

 

HTH! :)

[myfunnybunch]

I wouldn't worry. :) The task is a part of a developmental screen. If your pediatrician was concerned, he'd have commented in greater depth.

 

Cat

[tex-mex]

The doctor is checking on child development. That is the job of a good pediatrician. Being able to draw basic shapes is a reasonable skill to expect of a 4 year old (one of a great many) especially when the child is given the model to follow.

 

These are the kind of things a good doctor does.

 

Bill

:iagree: As a former pre-school and K-6 schoolteacher, that is a basic assessment for developmental skills any good doctor would do. And it is very reasonable -- he may be looking for eye to hand coordination, fine motor skills, or the hints of a learning disability (but at age 4, it is hard to detect, tho'). Kudos to him.

Edited November 25, 2010 by tex-mex

[Alessandra]

I think it's wonderful that your pediatrician did this. It's a screening tool that allows the doctor to assess development in an objective way. IMO, too many doctors assume that 'children develop at their own rates' -- true, but some kids do have developmental issues and the earlier any differences are picked up, the better. Probably if your dc had been off the charts, the doctor would have done another quick test... If you weren't referred to a developmental pediatrician, I wouldn't worry. (Plus, it's not about your teaching/parenting!)

[Joyofsixreboot]

It's a milestone listed on developmental screenings. Doesn't mean you're a genius or a doofus, just another milestone. Denver screening

[TheReader]

One comment I haven't seen, it's possible from the way you describe your son that maybe he is capable of doing a circle, triangle, etc. but felt he would have to "get it right" for the doctor. My oldest was that way. He was asked to draw a stick figure once, but the doctor said, "Draw a picture of your mom for me." My son refused, kept protesting he couldn't.

 

When the doctor said, "Okay, then just draw a person for me" my son was able to draw a figure.

 

Could be your son was not wanting to comply with his less-than-perfect attempt and thus "fail" the test (in his eyes). Just a thought; if I'm way off base, feel free to disregard.

[JudoMom]

I agree with the good pediatrician comments.

 

If it makes you feel better, I just had my youngest in for his 5 year well child check--we've been at the same pediatrician for 11 years, and he's told my boys they have the best teacher. Anyway, while my ds5 passed the fine motor tests, he totally flunked the gross motor tests (he's got loose joints and didn't even walk until 22 months). Dr. U smiled and suggested I add PE to his day.

[Melinda in VT]

Yes, my pediatrician did this at my youngest son's appointment this summer.

 

I have one child who had minor delays with fine motor skills, and I think it's great when doctors can alert parents that this may be a possible area of weakness. It's easier on the child to start gently working on it when they are younger.

[cbollin]

The doctor is checking on child development. That is the job of a good pediatrician. Being able to draw basic shapes is a reasonable skill to expect of a 4 year old (one of a great many) especially when the child is given the model to follow.

 

These are the kind of things a good doctor does.

 

Bill

 

:iagree:

 

It's part of a normal screening process. My ped used the pre printed version of it called a Denver Pre Screen.

 

It's just to check on developmental skills in several areas.

 

In my opinion, if the doctor just said work at home on it, then the doctor doesn't see a major issue that needs occupational therapy.

 

Very normal and good part of a check up.

 

-crystal (mom with kids who needed occupational and speech therapy when the kids were that age)

[bettyandbob]

This is an appropriate part of a well child check up. My son was asked to draw a person at age five. This evaluation looks at visual-motor, fine-motor and gross-motor development. Delays in these areas can have a major affect on academics a few years down the road whether you homeschool or go to public school.

 

Delays may be just delays or they may be a sign of a greater need. You may want to follow the pediatricians advice, but also look at adding gross motor upper body activities into your son's day. Then in a year you can evaluate it again. I suggest upper body gross motor because, a person needs upper body strength to maintain the control needed for fine motor activities.

[Sherry in OH]

I agree with those who said it is a standard developmental test. The pediatrician was not only checking to see if your child could draw the figures, but how he went about it.

 

If he had any concerns the pediatrician would have referred you to an OT. The OT would then do additional tests to check for delays. That is how we found out my oldest had issues. His fine motor skills were good for activities that did not require manipulation, but weak when finger strength was required. After a few months of OT, he enjoys mazes and dot-to-dot. He even does his HWOT workbook without complaint. He still does not like coloring, but now he can do it.

[FaithManor]

Just let it go....Peds do look for signs of developmental delays such as auditory processing deficiencies. So, they like to "give a child a command" appropriate for their age and see if the child can carry it out. The problem for some peds is that though they were trained in child development they seem to be unable to comprehend a few standard things about it. If the child is healthy and only comes to well-checks once or twice a year, then the ped basically a stranger and young children will only rarely do something like that for a stranger. It's not stubborness...they just aren't comfortable. Then there is sometimes a shyness factor and with a few children, a true stubborness factor. So, it kind of cracks me up that they check for developmental milestones but then seem to conveniently forget that from ages 2-4 children tend not to be willing to "perform tricks" for strangers or mere acquaintences and that this is developmentally normal!

 

Your son is fine....just let it go. We fired our ped for a variety of reasons and decided not to get another one but instead, just an old fashioned DO for family doctor. Our last ped made a huge deal about our youngest being accelerated in science and thought we should not allow him to work ahead of grade level because then he wouldn't be "normal". I don't even remember how that came up in conversation.

 

Faith

[OrganicAnn]

My DD has fine motor skill issues. If a kid can't or has difficulty draw lines, circles, squares etc it will eventually show up in difficulty writing. There is a big difference in refusing to do it and can't do it. But with my DD, she avoided things she wasn't good at or couldn't do, so it was difficult to see the issues.

 

Early intervention does help, so it isn't bad to keep an eye on this. But you shouldn't stress or go overboard. Cutting paper and using scissors also are pre-writing skills. Obvious if a kid can write letters, then drawing triangles aren't an issue. Writing is so important for early elementary.

 

Again - don't stress, but keep an eye on it.

[jujsky]

We didn't experience this with our pediatrician, but we did with our neurologist. DS was the same age, I think -- 4 or so. If it makes you feel better, he couldn't do it at that age either, but totally blew her out of the water 6 months later when she asked if he knew how to write the first letter of his name and he wrote his entire name :D

[annlaura]

I'm so glad I posted. What a great bunch you all are! I have so much to think about, and ideas to help. I always feel empowered when I have more information, of course.

 

Something interesting to watch when the child does draw a triangle, X, etc. See if the child draws funky little vertices and then fills in the sides or if the child draws the X from the center out and not as two criss-crossing line segments. Both of those are indicative of some brain oddities and it will show up in reading later.

 

Well that is interesting. I'll keep an eye out for this.

[Renee in NC]

The doctor is checking on child development. That is the job of a good pediatrician. Being able to draw basic shapes is a reasonable skill to expect of a 4 year old (one of a great many) especially when the child is given the model to follow.

 

These are the kind of things a good doctor does.

 

Bill

 

:iagree: This exercise was on the "Ages and Stages Questionnaires" that our previous ped used to measure development. I wish we had paid more attention to the fact that my boys couldn't do it - OT started at younger ages would have been very good for them.

[GraciebytheBay]

We have had three different peds in three different states (OK, IL and NY). All of them have done this with my pre-schoolers. I think it is a standard test.

 

My ds18 could draw a circle (sort of, more of an oval) and could not draw a square or rectangle properly at that age. He could also not cut with scissors very well (at home, not at ped). He was just fine, although his fine motor skills were never great. He is now a college student and a good driver who holds down a job. So, don't fret!:)

 

If my ped had done that I would have made some snarky comment about her testing to see if her arm worked or something. NOT their job. Would have been checking for a new ped. after I got home.

[annlaura]

Regarding the use of scissors as an indicator of fine motor skills: does the child need to be able to cut along a line, or just use them at all?

 

One comment I haven't seen, it's possible from the way you describe your son that maybe he is capable of doing a circle, triangle, etc. but felt he would have to "get it right" for the doctor. My oldest was that way. He was asked to draw a stick figure once, but the doctor said, "Draw a picture of your mom for me." My son refused, kept protesting he couldn't.

 

When the doctor said, "Okay, then just draw a person for me" my son was able to draw a figure.

 

Could be your son was not wanting to comply with his less-than-perfect attempt and thus "fail" the test (in his eyes). Just a thought; if I'm way off base, feel free to disregard.

 

I meant to comment on this earlier, but yes, this is possible. I generally set up freeform art projects so haven't had much opportunity to see how he reacts to "right or wrong" outcomes, but I have seen a bit of this lately.

[LittleIzumi]

This reminds me of my oldest dd. She flunked catching a ball (I think she'd STILL flunk that and she's 25 and professional violinist so I'm not worried about her motor skills) and she flunked "body parts". They asked her to show them her ankle and she had tights on. "Mom, I couldn't take my TIGHTS OFF!!!"

 

Something interesting to watch when the child does draw a triangle, X, etc. See if the child draws funky little vertices and then fills in the sides or if the child draws the X from the center out and not as two criss-crossing line segments. Both of those are indicative of some brain oddities and it will show up in reading later.

 

Interesting. Dd does that.

 

I agree that it's a normal eval. Ours uses the printed Ages & Stages Questionnaire that I perform & fill out myself, so no performance anxiety but similar questions.

[tex-mex]

Regarding the use of scissors as an indicator of fine motor skills: does the child need to be able to cut along a line, or just use them at all?

 

 

 

If it helps, when I taught K grades, we'd introduce scissor skills with a piece of construction paper with heavy (thick) black lines drawn on it in a "dotted" style like this - - - - - -. The paper was the size of an 8.5" x 11" and lines were drawn like so:

 

-----------------------------

-----------------------------

-----------------------------

-----------------------------

 

From left to right about 3/4 of the page. (It made a funny looking crown or octopus when done.) I'd draw the lines every 2 inches. We would have the kids cut in a center activity and it ended up being a social time with all of us chatting and cutting. Very fun. From strips, we'd go to cutting circles, triangles, etc. By the end of K, they would be able to cut most the traced shapes for all of our art projects. Great skill.

[wapiti]

Our ped asked DS4 to draw a person at his checkup. FWIW, none of my three older kids have passed this test (though they also have had developmental delays, fine motor issues, etc.; I also remember a similar test by the OT). So, when DS4 couldn't do it, I wasn't surprised, even though he hasn't had the types of delays his older siblings had. But both the doc and I were surprised to see that he had signed his name to his drawing quite legibly :lol:. The doc then announced that she was not concerned about him.

[dirty ethel rackham]

Yes, this is an appropriate developmental check. However, there is a difference between a child not being able to do something and a child refusing to do something. This sounds a bit more like the latter than the former. If the pediatrician cannot acknowledge this as a possibility, then he is being inappropriate. Some kids are just stubborn and won't perform like monkeys.

 

To the OP, I would just use this conversation as information to help you determine your next step. Can your child do these things? Can your child learn to do them? If so, then I would be reassured that all is well. However, if your child cannot do them after being taught, I would consider looking into appropriate therapies for developmental issues.

[annlaura]

Today during DS1's nap, DS4 and I played tic-tac-toe. He loves games, so I thought this might be a good start for some writing practice. He did fine. Not perfect, but fine. I didn't make the boards very big, and couldn't find his chubby pencil so gave him a regular pencil. The pencil had a cap eraser, so if he made a scribble he very cheerfully erased it to redo. Which lead to a few scribbles on purpose. :tongue_smilie: But he loved it! So on we go. :) Some shape-drawing art projects should be easy to think of with Christmas trees and snowmen.