Dang, Your Motor Skills Are Fiiiiine.....
To be able to use your hands efficiently, some prerequistes must be in place. For starters, you must have a strong, stable center. This means that you must be able to maintain a steady position with your trunk and neck muscles, as well as stabilize at your shoulder to allow for their hands to move about freely. To learn more about"proximal control", check out the Core Skills link.
In addition to core strength and stability, a child mustdevelop an established handdominance. In the infant and early toddler years, it is perfectly appropriate for a child to switch hands, as they are still learning about how to move their body and working on strengthening and coordinating their muscles. By about age 3,a child should be using one hand more consistently for activities. And by kindergarten, or age 5, a child should be usingone handfor all fine motor tasks that require a hand dominance (i.e.holding a pencil, holding scissors,holding food utensils, etc).
Gross Grasp Patterns
Gross grasp is usually the first step in the process of developing fine motor skills.And the grasp first starts without any conscious control as an infant. The "palmar grasp reflex" is present in newborns and lasts until about 5 months. When an object touches an infants palm, the infant's fingers will reflexively close around the object. Many parents initiate "holding their baby's hand" in this manner - they find that stroking the side of the palm will result in little fingers curling around their finger. An infant will often "grasp" an object in this manner, but because it is a reflex, they do not have the ability to purposely release the object.
At around 4-5 months, an infant will begin to consciously use their fingers to grasp an object. They do not have finger isolation (or single finger movement) so they use all of their fingers as a whole unit to pull an object into their hand. In addition, they often bend their wrist inward as well to stabilize the object in their hands.This movement is termed "raking" and it is how most infants obtain objects of any size, small or large. Once in the hand, at this age, an infant is just able to squeeze the object. They can not move it in their hand. Around 6 months, an infant will begin to transfer objects between their two hands. They still use the whole hand as a unit, and lack controlled release.
As an infant becomes more interesting in obtaining items in their environment, they begin to realize that using their thumb provides them with a better grasp pattern. They also realizerely less on the wrist for grasp, and the move away from flexing it during grasping, andinstead, begin toslightly extend it. Immature movements typically involve thumb adduction, or the pulling of the thumb into the index finger. Mature movements involve thumb opposition, or the movement of the thumb across the palm. When the thumb is in an opposed position, the thumb webspace is opened, like the letter "O". The more rounded the webspace, the more control the child has in grasping. At first, the child will oppose all fingers to their thumb. As they gain strength and control, the pinkie and the ring finger will tuck into the palm and the middle and index finger will oppose the thumb. This is a mature grasp pattern for obtaining many objects, and it is called a "three jaw chuck" or "radial-digital"grasp pattern.
Depending on the size and shape of the object, we make small adjustments in our finger position. Generally speaking, a mature gross grasp pattern is defined by 1. a slightly extended wrist; 2 the pinkie and ring finger tucking into the palm; 3. the thumb opposed to the index and middle fingers and 4. an open, rounded thumb webspace.
Precision Patterns
Precision patterns are the "fine tuning" of gross grasp. It is used to obtain small items in our environment (i.e. about the size of a Cheerio). Precision patterns need good thumb-index finger opposition and control finger movements. Like gross grasp, precision patterns follow a developmental sequence.
Young infants do not have finger isolation, thumb opposition or control movement - and so rely on gross movements of the hand to obtain ANY size object. They tend to "rake" all of their fingers over small objects to pull them into their palms.Just like in development of gross grasp skills, the thumb will slowly come into play, as the child realizes that they can get a better grip on the object if they use it. You will notice that rather than using the thumb in opposition to the fingers,older infants tend to slide the thumb into the side of the index finger to obtain a small object. Thisprecision patternis called a "scissor pattern". It does not allow for much control.
Advanced Fine Motor Skills
Once a child is able to obtain objects in their environment, you will see that they will begin to develop more advance fine motor skills, to transfer the object between their two hands, to rotate the object in their hands to get it into a desire position (in-hand manipulation)and to move the object from their palm to their fingertips (translation).
These skills are considered more advance because they require the child to process many things. First, they must be able to move each finger independently from the others (finger isolation). A good way to assess finger isolation is to see if the childis able to touch their thumb to each of their fingers in a quick, precise manner with fluid movement.
A childassess the tactile (touch) input from the object to determine what it is. Think of when you are digging in yourbag looking for keys.Without looking into your bag, you can determine if you'veobtained a pack of gum, some loose change or your keys, just by the way it feels in your hand.This skill of using the sense of touch to determine what an object is, is called stereognosis. You use your fingers to move the object all around your palm and fingertips to "feel" for clues to determine what you are holding.
Stereognosisand tactile input is also important for another advance fine motor skills, in-hand manipulation. In-hand manipulation is the ability to turn an object in your hand without using a surface, your body or your other hand to help. It requires accurate tactile processing, good separation of the two sides of the hand and good finger isolation and movement. Similar to in-hand manipulation skills is translation skills. Translation skills is the ability to move an object from your palm to your fingertips. Stereognosis, in-hand manipulation and translation skills allow us to handle items functionally without dropping them or relying on our larger muscles to help us.
The How-To's On Pencil Holding
"I've got a student that holds his pencil funny." It's the most common complaint from teachers.
My own personal opinion is if a child can color in the lines, trace on a line and produce legible written work in a timely manner, who cares how they hold their pencil. I have friends that use thumb wrap grasps, relatives that use interdigitial brace grasps, and they are all very successful working professionals who have never had any "issues" because of their pencil grasp pattern. As a general rule - if it ain't broke, don't fix it.
It's when a child CAN'T color in the lines, trace on a line or produce legible written work in a timely manner.
The Development of Prehension Patterns
The pictures below were borrowed from http://sites.google.com/site/darceyot/pencil-grasp
Palmar Supinate Pencil Grasp
Just like gross grasps, prehension (or pencil) grasps also follow a developmental sequence. First, the toddler will use their whole hand as one unit, wrapping all of their fingers around the crayons with their thumb positioned at the top of the crayon and their pinkie toward the paper. This grasp pattern is called a "palmar supinate" or "gross grasp". They are still working on "proximal stability" and so they move the crayon with large arm movement originating from the shoulder. You see this grasp from about age 1-2 years old.
Radial/Digital Pronate Pencil Grasp
As they begin to have more finger isolation, they will begin using the thumb functionally for prehension grasping. Around age 2-3 years, they will use a "digital-pronate" grasp. In this grasp pattern, the arm is turned slightly inward (pronated) and the crayon is positioned under the palm. The tip of the crayon is held by a straight index finger and adducted thumb. Again, most of the movement is from the arm.
Static Tripod Pencil Grasp
Around 3 1/2 years, you will begin to see that the child is beginning to have more control of the crayon. The appear to have better separation of the two parts of the hand, and they use the thumb side for movement and the pinkie side for strength. It is at this time, you will begin to see the opening of the thumb webspace, and the use of the thumb, index and middle finger to control the crayon. This grasp, called a "static tripod" is the beginning of a mature grasp pattern. The child should be able to stabilize at the shoulder, rest the forearm on the table, and movement should be coming from the wrist, or fingers. Usually, the index and middle fingers are straight, which limits the amount of speed (or "dexterity) and precision available.
Dynamic Tripod Pencil Grasp
Finally, around 5 years, your child will demonstrate a mature prehension grasp pattern which will allow them to make smooth, colored strokes for coloring, tracing, drawing and printing. You will notice a nice, round, open web space. The index finger's PIP and DIP joints and the thumb's IP jointwill all be slightly bent. The crayon (or pencil) rests on the side of the DIP joint of the middle finger and most of the movement comes from the fingers.
When looking at how your child is holding a pencil, it is important to remember if the grasp is developmentally appropriate. Some children will have a mature grasp pattern earlier than others. The more exposure a child has to fine motor activities, the quicker the child will develop their skills. It's also okay for a child to develop slighty slower as well. When I assess children, I typically say that by 5 1/2 or by the middle of kindergarten, a child should be using either a static or dynamic tripod grasp consistently.
Inefficient Grasp Patterns
The pictures below were borrow from http://www.mcpasd.k12.wi.us/northweb/OT/motorgroups.html
Problems with prehension grasps can be divided into two types 1. immature prehension patterns and 2. inefficient prehension patterns.
Immature prehension patterns are the palmar supinate and radial/digital pronate listed above. An immature grasp pattern usually indicates that the underlying intrinistic hand strength, finger isolation and hand separation has not developed yet - and so the child will probably have difficulty with many other fine motor tasks. You always want to intervene if a child is using an immature prehension pattern.
An inefficient grasp pattern usually means that the child is holding the crayon in a way that does not allow for the "best" usage of the finger muscles to move quickly with control. MANY people use inefficient grasp patterns and DO just fine with writing tasks. Remember to look at the big picture.
Of course, if you see a younger child (typically I say kindergarten to second grade) who is using one of the below inefficient grasp patterns, you want to try to break the habit and teach them functional prehension patterns. But if you have a third grader who uses an inefficientprehension pattern, but produces legible work in an appropriate time frame, leave it be. However, if you have a third grade who is using an inefficient prehension pattern and is becoming tired, producing illegible work or can't finish written work in an expected time frame, then it's time to intervene.
The Thumb Wrap
The thumb wrap is one of the most common inefficient grasp patterns. One of the main reasons it's problematic is because the fingers are in a position where they actually block part of the visual field. It is very difficulty to see where and what you are writing with this grasp. Also, the index and middle fingers are stabilizing the crayon instead of moving it. As a result, movement comes from the wrist or arm, which leads to large strokes that lack control and precision.
The Thumb Tuck
The thumb tuck is a variation of the thumb wrap, where instead of wrapping the thumb around the fingers/crayon, it is tucked into the fingers. Once again, the fingers and thumb are stabilizing the crayon rather than moving it. Movement is distal, decreasing control and precision.
The Interdigital Brace
This is one of the strangest grasp patterns to see. The index and middle fingers are wrapped around the crayon, which is usually positioned way in the finger webspace between the middle and ring fingers. The thumb closes on the top of the fingers. This position significantly limits the visual field. It requires alot of bigger muscle movements of the forearm and wrist, resulting in fatigue. Typically, the child uses heavy pressure in an attempt to gain control of the strokes. While it can be functional, it is very rare. Typically children who use this grasp pattern cannot write for long period of time and cannot write as quickly as needed.
The Supinate Grasp
The supinate grasp is becoming more and more prevalent. Why? Because of VIDEO GAMES. Game controllers like PSP and XBOX position a child in a "supinated" position, where their forearm is turned outward. There is no need for finger isolation, so they are used as one unit to hold the controller. When the child goes to hold a crayon, they resort to this position, using the pink side of the hand to guide the crayon. As a result, they do not have good control, and tend to use very light pressure with jagged, sloppy writing strokes.
The Index ("Five Finger") Grasp
The index grasp is another interesting grasp is see. The index finger is positioned high on the crayon and the DIP joint is looped around it to stabilize it. The top of the crayon is positioned near the top of the ring and/or pinkie fingers and the thumb DIP tends to be straightened. Movement comes from the wrist, and the child tends to use light pressure.
Back to Blaming Technology
| Let me be clear again, I'm not a technology hater. But let me touch on something - next time you take out your iPhone or Android, or kill some zombies on Call of Duty on your Xbox - take a look at your hand. Your wrist is flexed, your fingers aren't moving at all, and your thumb is doing all the work by moving inward (adduction) and outward (abduction). Lucky you, you already developed all those other important hand muscles and movements, so you can still figure out how to hold a pencil. |
But what about that 6 year old, who has spent the last 1 or 2 years playing on that device. And you can do a TON of things on it - "color", "draw", "connect the dots" (notice my quotations). They have only learned how to position and move their hand in one way. Of course, when they go to hold a pencil in kindergarten, they are going to use the muscles that they have developed to do it. They are going to flex their wrists, adduct their thumb and use all of their fingers to hold that pencil. And man, is it going to be a HOT MESS.
Technology is cool. I agree. But don't forget to do the real thing. There is nothing more essential in child development that using their hands, FOR REAL, not in virtual reality.
The C-Word Again
We all put on that COVID weight because we weren't moving. But we also spent A LOT of time on computers. We gave up holding pencils, and writing on paper - for typing, dragging and dropping or pointing at a touch screen. When you don't use it, you lose it - and what happen was we ended up with A LOT of students who forgot how to hold their pencils, because they hadn't had to. Keep this in mind with your students as we transition back to pen and paper learning - be patient and allow fine motor skills to re-develop.
Fixing the Problem
To learn about activities that aide in improving fine motor skills development, including gross grasp and prehension grasp patterns, see the Fine Motor Activities page.
To learn about commercial and home-made pencil grips, see thePencil Gripspage.
