Dropping things seems like carelessness. Letting a cup tip appears to be a deliberate way to make a mess. But if your child has low muscle tone, it's possible that she really can't hold a tight grip on a cup or glass. Holding a cup securely means tightening the joints into place around the vessel, and that's something your child may have trouble doing.

Similarly, holding a fork in a straight and secure way that facilitates neat eating, or a spoon in just the position needed to get soup from bowl to mouth, may be enormously challenging. Pencils, too, may be impossible to grip with sufficient force to write legibly. You may notice your child holding a pencil awkwardly, or so lightly that the letters stretch like bits of feather across the page.

There are things you can use to help your child hold things tighter. Pencil grips may give him a better handle on writing utensils. Forks and spoons with special handles are available that may make holding those items less trying. Cups with lids can prevent spills due to a loose grip, but keeping the glass on the table and letting the child drink with a straw may be a better strategy.

Most of all, it helps to know — and let your child know you know — that your child is not just dropping and spilling due to neglect or carelessness. She really does have trouble getting a grip.