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                         *  Occupational Therapy *

 

 About Me- My name is Katherine Ferrara and I have been an occupational therapist for over 30 years.  I enjoy working with children both in special education and also in the regular education  setting.  I have a special passion for  individuals with autism and sensory differences.  Please feel free to reach out to me at any time with questions and concerns.  I look forward to hearing from you.  

Email-   [email protected]

 

Typical Pencil Grasp Development 

 

Proper pencil grasp development for writing starts a lot earlier than you think in children. From the time your child starts grasping for objects with their hands, they are developing pencil grasp.

 

Before we get started here are some term definitions that will help explain some of the hand grasps:

Radial – Thumb side of the hand

Digital – Finger or pinky side of the hand; can also mean digits (aka- fingers)

Palmar – Palm side, or inside part of the hand

Supinate –  Palm facing up or forwards

Pronate –  Palm facing down or backwards

Typical Pencil Grasp Development in Kids

Let’s start at the beginning. Again these are average ages ranges, every child is different.

 

 

Inferior Pincer & Pincer Grasp – 10 Months Old

By age 10.2 months, they should be able to use a thumb-finger grasp (pincer grasp). The difference between the Inferior Pincer Grasp and a regular Pincer grasp is all in the placement of the finger tips.

The index and thumb are used in for this grasp. If the pads of the fingers are holding the object, that is an Inferior Pincer Grasp. A true pincer grasp is using the tips of the pointer finger and thumb.

You may also see this referred to as the “Pincher” grasp, however the correct spelling is “Pincer”.

 

Palmar Supinate Grasp – 12-15 months old

At this age, a young toddler begin use a palmar supinate grasp. It is a fisted grasp with the thumb wrapped at the top of the writing utensil. This is usually accompanied by scribbling. This is considered a primitive grasp.

 

Digital Pronate Grasp – 2-3 Years Old

By 2-3 years old, a child moves to a digital pronate grasp, pictured below. This is the beginning of an efficient looking hand grasp. The fingers are now pointed down towards the bottom of the writing utensil, however all the fingers are being used along with a lot of whole arm movements. This is also a common grasp for self feeding with utensils.

 

Static Tripod and/or Quadrupod Grasp – 3-4 Years Old

By age 3 to 4 a child will switch to a static tripod grasp or quadrupod grasp. They hold the writing utensils crudely and use the whole pads of their fingers on the writing utensil. There also may still be some whole arm movement, with the wrists being still and not moving, or static. A quadruped grasp is also referred to as a 4 finger grasp, 3 fingers being on the pencil and then resting on the 4th finger.

Dynamic Tripod Grasp – 5-6 Years Old

By the time your child hits kindergarten they will use the most mature grasp, the dynamic tripod/quadruped grasp, when they use the tips of their fingers on the writing utensil and also hold the crayon/pencil more at an angle than vertical. This is much like an adult grasp.

Their wrist movements are also dynamic, which means they move back in forth without any full arm movement (the arm will be resting on the table or writing surface instead of floating above). This grasp is also referred to as a 3-finger grasp, the first 2 fingers on the pencil while resting on the middle finger.

 

Did You Know??

For a while, the tripod grasp was the only mature grasp to be considered an efficient grasp past the age of Kindergarten. However, an exception was made for the quadrupod grasp since so many people and children use that type of grasp (myself included) and are able to print neatly and at a decent writing speed. This grasp uses the thumb against all 4 fingers (not just the thumb and 2 fingers) 

I always encourage a mature dynamic tripod grasp when working with my students, however if they used a quadrupod grasp consistently and are able to produce legible work and good letter formations when writing I consider their handwriting/pencil grasp goals met.

 

Again, these are average ages ranges and every child is different. However, this gives you a good idea of what to look for as your student begins to write

 

ESSENTIAL DEVELOPMENTAL FINE MOTOR SKILLS 

 

CROSSING MIDLINE- ability to cross over the body midline to the other side of body 

General Activities

· Double drums or bongos: challenge your child to bang the right drum with the left hand and the left drum with the right hand.

· Push toy trucks and cars while crawling on the floor along a path made with tape; create lots of turns and waves

· Floor play: when playing on the floor, encourage your child to lean on one hand or elbow. Place the toys or games on the side being leaned on. This forces the child to cross the middle when playing.

· Play sorting games: place objects to sort on the left side and containers to place them in on the right side: sort coins, cars vs. trucks, pompoms, marbles, bingo chips, etc.

· Scoop sand into a bucket using one hand to hold the bucket and the other to scoop and reach across

· Play flash light tag in a darkened room on the ceiling and walls while lying on your back; be sure to hold the flashlight in the same hand

· Steering wheel (found in many playgrounds): encouraging using the same hand to turn the wheel all the way around

· Alternating hand-over-hand activities such as pulling along a rope while on a scooterboard

· Make figure 8's and other motions with streamers; one hand at a time and crossing left and right

· With a group of friends, play circle games to music while sitting crossed legged on the floor, such as passing a balloon or ball, toy, etc.

· Play body awareness games like the Hokey Pokey and Simon Says

Fine Motor Activities

· Draw a large circle, oval, horizontal line or any picture that requires a left to right reach. Position your child in the center. Have your child place stickers or a stamper along the lines of the picture using the same hand.

· Coin flipping: line up a row of coins, placing the child at the center. Flip coins one at a time with the same hand from one end to the other.

· Deal cards to a group using one hand to hold the deck and the other to deal to everyone around the table

 

BILATERAL COORDINATION- ability to use both hands together and both sides of the body

Simple Symmetrical Activities

· Blow bubbles and reach with both hands to pop them

· Pull cotton balls apart, glue on paper to make a picture

· Tear strips of paper, paste on paper to make a collage

· Squeeze, push and pull on clay, putty, play doh or modeling foam

· Pull apart construction toys (Duplos, Legos) with both hands

· Roll play doh, putty or clay with rolling pins

· Percussion toys: symbols, drums (both hands together), etc.

· Play with a toy Accordion

· Pull apart and push together crinkle tubes

· Play Zoom Ball

· Penny flipping: line up a row of pennies, start flipping with each hand at the far end until they meet in the middle

· Penny flipping: line up in an oval, start at the top with both hands and flip pennies simultaneously until hands meet at the bottom

· Jump rope

· Ball play: throw and catch with both hands together

· Bounce a large ball with 2 hands, throw or push a ball with 2 hands

Alternating movements

· Drum or Bongos: with both hands one at a time (reciprocally); try to imitate a rhythm

· Ride a tricycle or bicycle

· Air biking: while on your back, raise your feet up toward the ceiling and pretend you're pedalling a bike

· Walking, running, skipping, swimming

· Play follow the leader hopping on one foot, then the other; then 2 to 3 times on each foot, alternate repetitions and feet; add arm motions to increase the challenge

· Juggle scarves

Activities that require different skill sets for each hand

· Cut out all types of things with scissors: cut straws and then string up pieces for jewelry, cut play doh or putty, cut up greeting cards and make a collage, cut styrofoam packing peanuts

· Spread peanut butter, or any spread on crackers, frost cookies; be sure to hold the cracker or cookie still

· String beads to make jewelry

· Coloring, writing, drawing: be sure the other hand is holding down the paper

· Trace around stencils: the helper hand holds the stencil down firmly while the other

draws around the stencil

Body Awareness activities

· Simon Says, Hokey Pokey

· Wheelbarrow walking

· Crawl on all fours: forward, backward, sideways or change direction on command.

· Crawl through an obstacle course

· Animal Walking: Gorilla crouch walking, Bear walking, Inchworm walking, Snake crawling, Bird walking, Crab walking. Animal & Bug Walks

 

 FACILITATING HAND ARCHES - The hand has a power side (thumb, index, middle finger) and a stability side (ring and pinky fingers). Try to have the child cup their hand to form arches (as if they were carrying water within their palm)

 Developing the "Precision" side of the hand: Let the thumb, index and middle fingers do the work · cutting with scissors · scooping sand, rice, beans, etc. using Bubble Tongs · draw around small circles and fill in small circles · teach how to snap fingers · spinning tops · wind up toys · tennis ball "Hungry Guy" (see instructions) · try to twist a cap onto a small bottle or a tube of toothpaste with one hand · cupped hand activities: shaking dice, forming a ball of clay or putty by rolling it between both palms, see how much rice, beans, sand, etc. you can hold in your cupped hands, form fingers into a spider then bend and straighten fingers · Tongs, tweezers, connected chop sticks, strawberry hullers: use these to pick up small objects for sorting, such as beads, marbles, beans, pompoms and cotton balls. · corn cob holders, toothpicks or large push pins (thumb tacks): Place a picture over a sheet of craft foam or cork board. Then use the push pin or corn cob prongs to punch holes along the lines of a picture. Hold it up to let the light shine through. · Push a toothpick point into a styrofoam tray or plate, or in aluminum foil placed over craft foam or corkboard to make a picture. · Dress up dolls: requires a surprising amount of hand strength and endurance · corn cob holders, toothpicks or large push pins (thumb tacks) to make hole designs in putty, play doh, clay, etc. · place coins or bingo chips in narrow slots; a piggy bank is perfect, Connect Four game · eye droppers: make colorful dribble art creations by placing drops of colored water on a paper towel or coffee filter · geoboards: make shapes and letters using rubber bands on geoboards · pick-up sticks, Jenga, Don't Spill the Beans · coin flipping contest: line up rows of coins and see how fast you can flip them over · pegboard activities, Lite Brite · Tiddly winks games, Ants in the Pants · tong games: Operation, Crocodile Dentist, Bedbugs · Ziplok bags: encourage using fingertips to press and seal · Buttoning, snapping, zipping · pop beads · stringing beads · peel stamps and stickers · crumple small bits of tissue paper using fingertips, dip in glue and paste onto a paper plate or paper to make a flower bouquet · tear small pieces of paper with finger tips and paste them onto a sheet of paper to make a picture or collage Clay, therapy putty, Silly putty, play-doh, Sculpey, bread dough, modeling foam (see Homemade Play for putty) · break off small pieces, then try rolling the putty or clay between the pads of the thumb and index finger to make small balls · flatten small balls by pinching them between the pads of the thumb and index finger · starting with a larger round ball of putty or clay, form the thumb, index and middle fingers into a large round C shape

 

FINGER ISOLATION is the ability to move each finger one at a time. Infants move all fingers together in unison. As they develop, children learn to move the fingers individually. This ability is very important in the development of fine motor skills. It contributes to developing an efficient pencil grasp, typing on a keyboard, playing musical instruments, tying shoelaces and countless other daily living skills.

Finger Isolation games and activities

· play pointing games, such as "I Spy"; position child's hand to point with index finger extended outside of a fisted hand

· use pointing finger while reading books and looking for objects in pictures

· finger puppets

· shadow hand puppets using a flashlight to cast a shadow on a wall

· counting on fingers one at a time

· use pointing finger to trace shapes, numbers, etc. in sand, shaving cream, on paper, and so forth

· pick up small, light items on dampened fingertips of each finger (e.g., hole puncher cut-outs, sequins, glitter, beans, small beads)

· place tape around each fingertip, sticky side out, to pick up small, light items listed above

· musical instruments: castanets (finger symbols), recorder, tin whistle, toy flute, trumpet, toy piano, etc.

· play finger soccer: teach child how to "flick" the ball into the goal. Ball can be crumpled paper, ping pong ball, round bead, etc.

· keypad gadgets: calculator, adding machine, telephone, toy cash register

· finger games: Where is Thumbkin, Itsy Bitsy Spider

· teach finger signs such as "A-OK", V for Victory, thumbs up/thumbs down, Number 1, etc. · gel and gak baggies for finger drawing on (see Homemade Play) · finger painting (see Homemade Play)

· finger paint brushes (available at some teacher stores) · Practice making the American Sign Language alphabet with your fingers

Pinch strengthening and control Be sure that the thumb and index finger (and middle finger if needed) are doing the holding and squeezing:

· Tongs, tweezers, connected chop sticks, strawberry hullers: use these to pick up small objects for sorting, such as beads,

· eye droppers: make colorful dribble art creations by placing drops of colored water on a paper towel or coffee filter

· spinning tops

· pick-up sticks, Jenga, Don't Spill the Beans

· wind up toys

· pegboard activities, Lite Brite

· tiddly winks games, Ants in the Pants

· tong games: Operation, Crocodile Dentist, Bedbugs

· Ziplok bags: encourage using fingertips to press and seal

 

 

FINGER OPPOSITION- Ability to move the thumb and oppose it to the other fingers is a necessary skill to hold and manipulate objects. It is important the student can make a space (web space) like the OK sign  

Activities to Open the Web Space

squeeze foam balls, animals and shapes that are rounded

tennis ball "hungry guy": Hide pennies, pegs, beads and other small things inside. Squeeze to open and shake out the contents,

then feed the "hungry guy" by slipping in the "food". See Homemade Play for instructions on how to make this.

catch, throw and squeeze rubber "pinky" balls, tennis balls and similarly sized balls

bulb syringe games (usually in infant supply sections of stores) or turkey baster to squirt water, or have a race by squeezing

them to blow cotton balls and pompoms across a finish line.

craft activities that require using bottles to squeeze: glue, glitter glue, puffy paint, fabric paint, etc.

sponges: squeezing large sponges to wring out the water is great for opening and strengthening the hands. Help wash the car,

wash toys and dolls in the sink or bathtub, squeeze sponges on your friends during water play outdoors, bring a bucket or cooler filled with water and sponges to cool off on a hot day when on picnics, soccers games and other outings.

Shuffling cards using both hands with palms cupped

Try to keep the ring and pinky fingers tucked into the palm so that the THUMB, INDEX and MIDDLE fingers do the work

Tongs, tweezers, connected chop sticks, strawberry hullers: use these to pick up small objects for sorting, such as beads,

marbles, beans, pompoms and cotton balls.

corn cob holders, toothpicks or large push pins (thumb tacks): Place a picture over a sheet of craft foam or cork board (or

trivet). Then use the push pin or corn cob prongs to punch holes along the lines of a picture. Hold it up to let the light shine through.

Push a toothpick point into a styrofoam tray or plate, or in aluminum foil placed over craft foam or corkboard to make a picture.

place coins or bingo chips in narrow slots; a piggy bank is perfect, Connect Four game

eye droppers: make colorful dribble art creations by placing drops of colored water on a paper towel or coffee filter

spinning tops

geoboards: make shapes and letters using rubber bands on geoboards

pick-up sticks, Jenga, Don't Spill the Beans

wind up toys

pegboard activities, Lite Brite

tiddly winks games, Ants in the Pants

tong games: Operation, Crocodile Dentist, Bedbugs

Ziplok bags: encourage using fingertips to press and seal

Buttoning, snapping

pop beads

linking chains

stringing beads

peel stamps and stickers

Crumple small bits of tissue paper using fingertips, dip in glue and paste onto a paper plate or paper to make a flower bouquet

tear small pieces of paper with finger tips and paste them onto a sheet of paper to make a picture

pop the bubbles on large or small bubble pack by pinching with thumb and index finger

Clay, therapy putty, Silly putty, play-doh, Sculpey, bread dough, modeling foam (Crayola Model Magic)

roll small pieces between the thumb and index finger to make little balls

these are all excellent materials for squeezing, squishing, pushing, pulling and molding

try hiding small objects (beads, pennies, beans) inside and then try pulling them out

Clothespin games:

use the pads of the thumb and index finger to open the clothespin rather than pinching it open against the side of the index

finger

When pinching open, try alternating each finger to squeeze opposite the thumb.

place clothespins along the top of a container and then on top of each other to construct a design.

Pick up small objects with the clothespin: cotton balls, pompoms,crumbled paper, beads, pegs, etc.

Attach several clothespins along the bottom hem of shirt and then pull them off.

Place clothespins around an index card 

Hang up pictures or plush toys on a string, like a clothesline.

 

In-Hand Manipulation- Ability to move fingers to adjust and move items within the hand

Pick up a small object with fingers (bead, coin, M&M candy, popcorn, etc. ) and "hide" it in your hand. Then pick up another and another.

· Move one item from your palm to your fingertips and place it down on the table (or put it in your mouth if it's food)

· Practice removing small objects from a change purse, baggie or container one at a time and hiding each within the palm. Then placing them back, one at a time.

· Connect 4 game: hold several chips at a time within the palm while placing chips in the slots

· Place coins in a Piggy Bank starting with several coins in the palm. · Place items in Hungry Guy's mouth (see instructions) while palming several items in your palm

· Place items in slots (Bingo chips, coins, pegs) while holding several within the palm

· String beads holding 2 or 3 beads within the palm

· Pegboard games holding 2 or 3 pegs within the hand

· Twist open or closed lids on small bottles or toothpaste tube held within the palm of the hand

· Flip a coin from head to tail within the fingers of one hand

· Cut with scissors and practice adjusting the grip on the paper with the helping hand

· Practice buttoning, zipping and snapping snaps.

· Turn dice within the fingertips to see different sides.

· Hold a small cup filled with water. Practice turning it with the fingertips without spilling

· Play with construction toys such as Duplos, Legos and K'nex

· Pop beads: large size for preschool, small (play jewelry type) for older children

· connect linking chains

· Place clothespins around an index card or paper plate: encourage using only one hand to position/reposition the card or plate

· craft activities that require using bottles to squeeze: glue, glitter glue, puffy paint, fabric paint, etc.

· Lacing boards, sewing cards

Pencil Games

· Hold the pencil in the fingertips, ready for writing, then "walk" the fingers to the eraser end of the pencil, then back to the tip

· Turn the pencil between the thumb and fingertips: try turning it like a windmill in one direction, then the other

· Practice flipping the pencil from eraser end to tip end

 

 

Pinch strength and control - Strength within the hand to use muscles to grip and squeeze and pinch 

· Tongs, tweezers, connected chop sticks, strawberry hullers: use these to pick up small objects for sorting, such as beads, marbles, beans, pompoms and cotton balls.

· corn cob holders, toothpicks or large push pins (thumb tacks): Place a picture over a sheet of craft foam or cork board (or trivet). Then use the push pin or corn cob prongs to punch holes along the lines of a picture. Hold it up to let the light shine through.

· place coins or bingo chips in narrow slots; a piggy bank is perfect, Connect Four game

· eye droppers: make colorful dribble art creations by placing drops of colored water on a paper towel or coffee filter

· spinning tops

· geoboards: make shapes and letters using rubber bands on geoboards

· pick-up sticks, Jenga, Don't Spill the Beanswind up toys

· pegboard activities, Lite Brite

· Tiddly winks games, Ants in the Pants

· tong games: Operation, Crocodile Dentist, Bedbugs

· Ziplok bags: encourage using fingertips to press and seal

· Buttoning, snapping

· pop beads

· stringing beads

· peel stamps and stickers

· crumple small bits of tissue paper using fingertips, dip in glue and paste onto a paper plate or paper to make a flower bouquet

· tear small pieces of paper with finger tips and paste them onto a sheet of paper to make a picture

· Push a toothpick point into a styrofoam tray or plate, or in aluminum foil placed over craft foam or cork board to make a picture.

· Dress up dolls: requires a surprising amount of hand strength and endurance

Clothespin games:

· use the pads of the thumb and index finger to open the clothespin rather than pinching it open against the side of the index finger

· When pinching clothespins open, try alternating each finger to squeeze opposite the thumb.

· place clothespins along the top of a container and then on top of each other to construct a design.

· Pick up small objects with the clothespin: cotton balls, pompoms,crumbled paper, beads,

 

 

 WORKING ON  WRITING SKILLS WITHOUT EVER PICKING UP A PENCIL 

Handwriting doesn’t have as much to do with the pencil as one would think. Oh, yes, pencil grip is important. But haven’t you seen perfectly functional adults writing with pencil grips that look dysfunctional? So, although I need to help my students “get a grip,” there is so much more than a pencil grip involved in handwriting.

Efficient handwriting skills require some very complex skills that can be developed in some very simple ways. Children seem to know how to hone these skills when they are given the freedom to experiment. That’s called “play,” by the way! There are five areas where children need to be proficient in order to be “handwriters.” I will connect them here with some very simple and inexpensive activities that will create fun handwriting experiences – without a pencil!

· Visual Motor Skills –Eye-hand coordination- the ability to use our vision to control our movements. Children use these skills to reproduce shapes, letters and numbers; connect lines; start and stop at the correct spot; and to edit for accuracy. Activities that work on these skills are:

– playing catch with balls or balloons, chasing after bubbles, or a game of hopscotch

– pennies and a piggy bank, threading beads on a pipe cleaner, or weaving construction paper place mats – making a sandwich using directions, learning to tie shoes, or practicing the piano. There are many eye-hand coordination apps. 

· Visual Perception Skills – the ability to understand what we see. Children use these skills to remember letter formations and to produce them automatically and with appropriate speed. They are also important for recognizing the difference between letters (e.g., b and d) and for remembering the proper placement of letters within words for accurate spelling. Simple activities for these skills are:

– obstacles courses created with pillows, chairs, and blankets; musical chairs, or the crab walk

– puzzles created from used greeting cards, mosaic art designed with pieces of tissue paper, or a nature treasure hunt

– sorting laundry or socks, emptying the dishwasher, or organizing the play area

· Fine Motor Skills – the ability to use the small muscles of the hands for precision tasks, sometimes using vision to guide them. Children use these skills to write fluently and effortlessly. Before I resort to adaptive pencil grips, I like to see a child work on developing these skills with activities such as:

Blowing through a straw or whistle works on vision skills!

– blowing through a straw or a whistle (to work on visual skills), stacking blocks, or building a sandcastle – molding putty, stringing popcorn, or playing clothespin games

– learning to zip or button a coat, gardening, or polishing the furniture or cleaning the table

· Trunk Control Skills – the ability to maintain an appropriate sitting or standing posture. It’s very difficult for a child to work without fatigue if his body is working against him. Sitting at a desk, or even

running around the playground, requires strong trunk muscles. Fun indoor and outdoor strengthening activities include:

– balancing on one foot, hopping, or sack races

– yoga, kicking a balloon across the room, reading in a rocking chair

– carrying out the trash, using a shovel for snow or gardening, or riding a bike

· Shoulder Stability – the ability to produce slow, well controlled shoulder movements. Poor shoulder stability will result in fatigue and poor pencil control. The shoulder provides a stable base from which the arm and hand glide across the page. Shoulder strengthening activities can be:

– flying a kite, jungle gym activities, or wheelbarrow races

– art projects completed on a vertical surface, crawling on hands and knees, or working on a precision craft project

– hanging clothes outside to dry, making the bed, or vacuuming

You may have noticed that a pencil was not mentioned in any of my suggested activities! No, I didn’t forget it. It simply doesn’t have to be the only way a child masters handwriting skills!!

You may have also noticed that these activities are directed toward our younger learners. 

 

 

HANDWRITING MECHANICS

 

 

Handwriting Mechanics

 

Before we can expect our children to master handwriting mechanics (or pencil grasp), we need to build these foundational skills to set them up for success. This doesn't mean your child won't have struggles with handwriting mechanics if you address these areas, but it will give them the tools they need to work around any challenges.

 

Sensory Processing And Impact on Handwriting Mechanics

 

Sensory processing through the senses is the first thing to develop at birth. As a baby explores its environment, it learns to react to incoming sensory input. Children who struggle with sensory processing will struggle with other areas of development including poor reactions, attention, and poor body awareness.

 

The three sensory systems primarily responsible for these is the vestibular system, proprioceptive system, and the tactile system (or touch).

 

These three systems are responsible for how a child will hold a pencil later on, eye-hand coordination, writing on the lines, coloring between the lines, depth perception, bilateral coordination skills needed for holding the paper and writing with a pencil, using scissors, or using a dominant hand with writing, motor planning for new task, and attention to task.

 

 

Visual Perception & Ocular Control And Impact on Handwriting Mechanics

 

Sensory processing and visual perception are closely related through the three systems I mentioned above.

 

Visual perception is the process of the brain taking in and organizing the information we get through our eyes. When a baby is learning to pull its head up and begins to roll or crawl, it is also developing its visual perception skills.

 

Visual perception is also made up of various sub-skills. These include:

 

·eye-hand coordination (using the eyes and hands together to complete a task)

 

· visual discrimination (the ability to classify objects or shapes based on their color, shape, size, or position)

 

· position in space (the ability to process information about where you are in relation to things around you)

 

· figure-ground (seeing an object or form when it is in a complex background)

 

· visual closure (ability to process information when the object or word is hidden and decode it)

 

· form consistency (identifying objects, shapes, letters, numbers, or symbols when you see them in different ways)

 

· visual memory (being able to recall information about objects, shapes, symbols, or movements in your short term memory)

 

· visual sequential memory (the ability to recall and remember a sequence)

 

 

Ocular control refers to the ability to control the position and movement of the eyes in order to focus on an image or object. This is especially important for handwriting so that the student can visually focus on their handwriting and also copy from the board or a book.

 

 

Proximal Control and Proximal Stability and Impact on Handwriting Mechanics

 

Before we talk about proximal control and stability, we need to define proximal, which is a therapy term.

 

Proximal refers to the muscle groups closest to the middle or center of the body. So when we talk about proximal control and proximal stability, we are referring to the core strength (or control and stability in the trunk muscles) needed for different tasks.

 

When it comes to handwriting, children need the core control and stability to sit up straight and not slouch, arm and shoulder control as they move the pencil, and neck control to hold their head up straight.

 

If a child struggles with any of these large muscle groups and gross motor areas, handwriting may be a struggle because they lack the core control and stability they need to perfect smaller movements such as handwriting.

 

Proximal control and stability are dependent on visual perception to tell them where their body is in relation to things around them. And it is also depending on the sensory processing system which also supports body awareness. All of these systems need to work together in order for fine motor skills to be perfected for handwriting.

 

 

Foundational Fine Motor Skills and Impact on Handwriting Mechanics

 

Most of us probably think of fine motor skills when we think about the areas of development needed for handwriting. But as we have seen, we need all the systems above to be working properly for fine motor skills to develop functionally for handwriting and other every-day life skills.

 

There are specific fine motor skills that help with handwriting so let's take a look at those briefly. These are all  previously mentioned above 

 

·Bilateral skills using 2 hands and two sides of the body (that include gross motor)

 

·Wrist stability and wrist extension (functional positioning during handwriting includes the hand resting on the table with the wrist slightly bent back, or extended, while the fingers move the pencil for writing).

 

·Hand strength 

 

·Palmar arches (this is the inside of your hand where it bends and wrinkles and is needed for a functional grasp)

 

·Thumb opposition (movement of the thumb and ability to touch the tips of the thumb to each fingertip and is important for grasping a pencil and leaving an open web space between the thumb and index finger where the pencil lays while writing)

 

·In-hand manipulation (the ability to move objects within the hand using precise finger movements such as moving coins from palm to fingertip all within the one hand – no help from the other hand)

 

·Separation of two sides of the hand (the ability to move your thumb and index finger while the 4th and 5th fingers are used to stabilize

 

 

Spatial Awareness

Spatial Awareness is being aware of oneself in space. It involves positioning items in relation to oneself, such as reaching for items without overshooting or missing the object. Most of us realize as we walk through a doorway that we need to space ourselves through the middle of the door. Some with poor visual spatial skills may walk to closely to the sides and bump the wall. It also involves the fine motor tasks of coordinating handwriting with writing in spaces allowed on paper, placing letters within an area (lines), and forming

letters in the correct direction. Spatial Perception is made up of three areas:

· Position in Space- where an object is in space in relation to yourself and others. This skill includes awareness of the way an object is oriented or turned. It is an important concept in directional language such as in, out, up, down, in front of, behind, between, left, and right. Children with problems with this skill area will demonstrate difficulty planning actions in relation to objects around them. They may write letter reversals after second grade. They typically show problems with spacing letters and words on a paper.

· Depth Perception- Distances between a person and objects. This ability helps us move in space. Grasping for a ball requires realizing where the ball is in relation to ourselves. Kids with deficits in this area may have trouble catching a ball or walking/running/jumping over an obstacle. Copying words from a vertical plane onto a horizontal plane may be difficult and they will have trouble copying from a blackboard.

·Topographical Orientation- Location of objects in an environment, including obstacles and execution of travel in an area. Kids with difficulties in this area may become lost easily or have difficulties finding their classroom after a bathroom break.

 

Visual Spatial Skills develop from an awareness of movements of the body. If a child has true visual spatial skills, they will likely demonstrate difficulties with athletic performance, coordination, and balance. They may appear clumsy, reverse letters and numbers in handwriting, and may tend to write from right to left across a page. They will have difficulty placing letters on lines, forming letters correctly, and forming letters with appropriate size.

Use a Spacing Tool Activity for Kids with Spacing Problems in Handwriting

 

Spacing between words and letters can be easy with a popsicle stick or teaching the student to use their finger 

Use the spacing tool while your child is writing words and sentences. Show them how to place the spacer between words and sideways between letters.

 

More visual spatial relations activities (that cost little to nothing!):

· Create an obstacle course using couch cushions, chairs, blankets, pillows, and other items in the house. · Try this activity for teaching over, under, around, and through with pretend play.

· Create a paper obstacle course. Draw obstacles on paper and have your child make his /her pencil go through the obstacles. Draw circles, holes, mud pits, and mountains for them to draw lines as their pencil "climbs", "jumps", "rolls", and even erases!

· Write words and letters on graph paper. The lines will work as a guide and also a good spacing activity.

· Use stickers placed along the right margin of to cue the student that they are nearing the edge of paper when writing.

· Highlight writing lines on worksheets.

· Draw boxes for words on worksheets for them to write within.

· Play Simon Says

· Practice directions. Draw arrows on a paper pointing up, down, left, and right. Ask your child to point to the direction the arrow is pointing. Then have them say the direction the arrows are pointing. Then create actions for each arrow. Up may be jumping. Down may be squatting. The Left arrow might be side sliding to the left, and the Right arrow might be a right high kick. Next, draw more rows of arrows in random order. Ask your child to go through the motions and try to go faster and faster

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SELF-REGULATION AND SOCIAL-EMOTIONAL LEARNING

 

 

Social-Emotional Competency and  Social-Emotional Learning Skills Related to Each Competency

Self-awareness ¡ Label and recognize own and others’ emotions
¡ Identify what triggers own emotions
¡ Analyze emotions and how they affect others
¡ Accurately recognize own strengths and limitations
¡ Identify own needs and values
¡ Possess self-efficacy and self-esteem

Self-management ¡ Set plans and work toward goals

¡ Overcome obstacles and create strategies for more long-term goals
¡ Monitor progress toward personal and academic short- and long-term goals
¡ Regulate emotions such as impulses, aggression, and self-destructive
behavior
¡ Manage personal and interpersonal stress
¡ Attention control (maintain optimal work performance)
¡ Use feedback constructively
¡ Exhibit positive motivation, hope, and optimism
¡ Seek help when needed
¡ Display grit, determination, or perseverance
¡ Advocate for oneself

Social awareness ¡ Identify social cues (verbal, physical) to determine how others feel

¡ Predict others’ feelings and reactions
¡ Evaluate others’ emotional reactions
¡ Respect others (e.g., listen carefully and accurately)
¡ Understand other points of view and perspectives
¡ Appreciate diversity (recognize individual and group similarities and
differences)
¡ Identify and use resources of family, school, and community

Relationship  management
¡ Demonstrate capacity to make friends
¡ Exhibit cooperative learning and working toward group goals
¡ Evaluate own skills to communicate with others
¡ Manage and express emotions in relationships, respecting diverse viewpoints
¡ Communicate effectively
¡ Cultivate relationships with those who can be resources when help is needed
¡ Provide help to those who need it
¡ Demonstrate leadership skills when necessary, being assertive and
persuasive
¡ Prevent interpersonal conflict, but manage and resolve it when it does occur
¡ Resist inappropriate social pressures

Responsible decision making
¡ Identify decisions one makes at school
¡ Discuss strategies used to resist peer pressure
¡ Reflect on how current choices affect future
¡ Identify problems when making decisions, and generate alternatives
¡ Implement problem-solving skills when making decisions, when appropriate
¡ Become self-reflective and self-evaluative
¡ Make decisions based on moral, personal, and ethical standards
¡ Make responsible decisions that affect the individual, school, and community
¡ Negotiate fairly

Sources: CASEL, 2003; Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011; Elias, 2006; Kress & Elias, 2006;

 

 

 

 

 

 

PLEASE CLICK ON THE ACTIVITY SUGGESTIONS TAB ON THIS WEBSITE FOR GENERAL OT TIPS AND SUGGESTIONS