Hand function and fine motor skills are important to all individuals. We require functional grasp and pinch in many different activities of daily living like, using utensils, playing board games, cutting with scissors, typing, coloring, and writing. Fine motor skills are precise hand movements that require sensory input, muscular strength, in-hand manipulation and eye-hand coordination. Our hand function is dependent on several different muscles acting from the shoulder all the way to the hand. Creating balance and stability of the shoulder, elbow, and wrist, allow for the hand to work dynamically. The muscles at the wrist act to provide stability, allowing the hand to manipulate, grasp and release objects. A dynamic grasp allows for the ability to change direction while writing without excessive wrist movement or rotating the paper.
Many school aged children have difficulty with fine motor tasks, specifically, pencil grasp. Efficient and mature grasps begin to develop between the ages of 4 and 6.5. Several factors can lead to an inefficient grasp. Signs that your child may be having difficulties with their pencil grasp include:
Difficulty to color or trace lines
Difficulty with or slow pace when taking notes
Difficulty keeping up with their peers at written tasks
Complaints of hand pain when writing or coloring
Avoiding pen and paper tasks or activities
Slouched or awkward upper body and arm posture when writing
Favoring the use of a laptop or tablet versus pen and paper for note taking or homework
Difficulties with fine motor and writing skills in elementary school aged children can be mended by our blend of occupational therapy and certified hand therapy services. Our knowledge of hand therapy helps us assess and target proper muscles and movement patterns for your child to achieve an efficient grasp. Our keen occupational therapist eye then allows us to break down each activity and intervene through various elements such as motor (strengthen muscles), environmental (use a different type of pen), or cognitive (make activities fun and engaging). Our assessment looks specifically at:
Posture: a stable shoulder and elbow allows for proper wrist and hand movement
Hand isolation: ability to us the thumb, index, and middle fingers (radial prehension) separately from the ring and little fingers (ulnar stabilizing)
Thumb web space: space between thumb and index finger needs to be open, forming a big O)
Joint laxity: tendency to hyperextend at the thumb joint or finger joints
Pencil grasp: holding the pencil with the thumb, index, and middle finger is the optimal pattern
Pressure: minimize the amount of pressure placed through the hand while holding the pencil or directly on the paper
Fine motor skills in children related to pencil grasp are complex and require several different skill sets to complete the task successfully. The omnipresence of screens and technology as well as budget cuts in public school services have left many elementary school aged children with delays in fine motor skills which can have a long lasting impact. Our hand therapy services in Edmonton are here to support your child by creating a fine motor program focusing on postural strengthening, wrist stability, hand strengthening, and using different pencil grips to assist in developing a more efficient grasp. Our Edmonton occupational therapists will design a home program with lots of fun activities that are tailored to each kid’s needs.
References
1. Benbow, M. (1995). Neurokinesthetic Approach to Hand Function & Handwriting. Retrieved from https://www.clinicians-view.com/univeristy/PDF/HFO1/HFO1TextPreview.pdf
2. Mc Cleskey, J. (2002). First Strokes Occupational Therapy Evaluation and Interventions for Fine Motor Skills for Handwriting and Tool Use Course (PowerPoint Slides). https://the-handwriting-clinic.newzenler.com/courses/fine-motor-skills-for-handwriting/dashboard