Category Archives: Fine Motor & Hand Skill Development
Explore tools, games, and activities that support fine motor skill development including grasp, dexterity, hand strength, and coordination essential for functional tasks.
Marcia has extensive experience in
school-based practice and currently provides both consultation and
direct service through her private practice in several Massachusetts
school systems. She specializes in providing services to students from
preschool through age 22.
Fine Motor Olympics has been revised to include a new Manual and 64 beautiful color photo cards of children’s hands performing fine motor tasks with instructions for the activity on the reverse side of the cards. A Guide to Hand Function, Quick Screening Form, Fine Motor Observation Checklist, Record Form, and In-Service Training Program are included in the Manual.
Within
her comprehensive review of motor development and hand function from
newborn to age 6, Marcia discussed functional fine motor skills expected
at the corresponding developmental stages. For example, around the age
of 8 months, development of the arches of the hand begins, essential for
providing stability, mobility, and opposition of the hand. She matched
simple therapeutic activities to this developmental level, including
cupping the hand to shake dice, rolling up paper, fastening a zip lock
bag, and cutting with a knife, to name a few!
Seminar attendees enjoyed breaking into groups at 8 stations where they tried out and analyzed original fine motor activities that Marcia created using inexpensive materials such as paper towel rolls, yarn, drinking straws, etc. The activities included activities like creating a spider web in a plastic basket and moving the spider in the web, using a variety of tongs to hunt tiny dinosaurs, balancing marbles on golf tees, and threading straws into paper towel rolls punched with holes. The groups engaged in activity analysis and shared their comments with the rest of the attendees. In addition to the new activities Marcia introduced today, she highlighted a number of fine motor Therapro products she loved, including, Boinks, Get a Grip Pegboard, Helping Hands Fine Motor Tool Set, and What’Zit Animals. She discussed conventional uses for the materials and also adapted the materials creatively and adeptly to help develop muscles of the hand. Some activities incorporated use of intrinsic muscles in translation activities, for example: moving a small single object fingers to the palm (1.5 – 2 years) and from palm to fingers (2.0 – 2.4 years).
Marcia
sparked attendees to share their own creative fine motor activity ideas
with the group. Everyone walked away with a toolbox filled to the brim
with fresh, low-cost, and fun activities to try out next week.
We can’t think of a more enjoyable way to spend a sunny, brisk New England Spring morning than analyzing fine motor activities and sharing thoughts on how to help develop better hand function in the classroom setting! Marcia’s skill at analyzing functional hand use is unsurpassed. She offered many innovative, easy-to-make fine motor activities that support fine motor skill development.
Here’s a sample of the many positive observations that attendees shared about this seminar:
“Excellent easily implemented activities. Energetic presentation. Great product. Kudos all around.” – Beth B., Occupational Therapist
“As a Pre-K teacher, I learned a lot and will be able to look for certain signs in my 4-5 year olds and activities to help.” – Jackie K., Teacher
“Loved hearing about the development of the arches. Great refresher to help me better analyze the activities I choose for my students.” – Jennifer N., Occupational Therapist
“It’s directly relatable in my practice!” – Jennifer C , Occupational Therapist
“Marcia was a warm, open, creative, and generous presenter who succinctly outlined foundations of hand function. We all left with user-friendly, inexpensive ideas we can implement immediately. Wonderful!” – Bernadette W., Occupational Therapist
OT goals on IEPs and IFSPs for young children commonly include teaching scissor skills. There is a good reason for this: using scissors independently and safely is an important preschool classroom skill. For OT’s, it is also a benchmark for bilateral control, dissociation of the sides of the hand, and the ability to control and grade force. But what do you do with kids that aren’t interested or prepared to cut?
Many young children are eager to learn to cut with scissors. They are excited to control such a grown-up tool and they like to see the immediate effects of their actions as the paper bits fall to the floor. Not all interest results in a good outcome. At times, they are so enthusiastic that they act in unsafe manner or use scissors in inappropriate ways.
Some kids fear scissors; they are often the children who fear failure and shrink from a challenge. And finally, there are children who have little interest or excitement in participating in any fine motor tasks. Whether due to frustration or a preference to act on their environment with sensory-based or gross motor skills, their behavior suggests that they couldn’t be bothered by learning to use scissors.
Children that struggle to cut can become discouraged and lose their initial excitement for mastery of this important skill. By allowing them to observe and practice pre-training skills before you introduce the act of cutting, you can improve your chances that they will develop and sustain enthusiasm and good safety skills with scissor activities.
There are children over 3 who have never been allowed to use a scissor due to adult safety concerns, lack of appropriate tools/assistance or developmental delays. A child’s initial exposure to scissors can be as simple as directing a child’s visual regard to your use of scissors as part of a therapy activity.
Make sure that you narrate your actions in short phrases with emphasis on action words.
Use an enthusiastic tone and gestures that sustain the child’s attention and interest.
Make practice short: in fact, end practice before a child is frustrated or bored.
Finally, make it clear that you expect that the child will be able to use scissors as they grow and develop more hand skills.
Children benefit from being able to see an adult’s hand movements while cutting. Your students may have been discouraged from being too close to an adult model due to safety concerns. Some adults are unaware that children need exposure to develop interest and excitement in the use of scissors. Use the safest scissors available with impulsive children who may reach for your scissor blades in their eagerness to learn about this exciting tool.
Ultra Safe Scissors
Once interest has developed, you may want to assist children as they open and close the blades. Scissors that are spring-loaded or have finger spaces for an adult can help, or you could place your fingers between the handles to facilitate movement. The sound of the blade movement is fascinating to young children, even without bringing the blades to the paper for cutting. Practicing alternating opening and closing the blades may be your entire activity for the therapy session. By breaking down the actions of scissor use into their precursor parts, you are decreasing a child’s frustration and increasing the likelihood of later success. Hand-over-hand assistance can be helpful when combined with independent scissor use. Gradually fade out this assistance out to allow maximal proprioceptive and kinesthetic input.
Children with hand and wrist weakness or poor sensory registration and discrimination benefit from scissors that provide more support and allow more of their hand to be involved in cutting. Create textured handles with tape on classroom scissors or use Fiskars Total Control Kids Scissors that provide more digital control and encourage activation of intrinsic musculature to support development of the horizontal and vertical arches in the hand while cutting.
Spring Action Blunt Tip Scissors
Provide additional postural support to children with instability and core activation issues. They may require more proximal stabilization than they appear to need for other tasks. Well-chosen classroom chairs or even a corner sitter may give a child the motor support needed to achieve optimal stability for learning a new motor skill. Beanbag chairs diminish sensory-based distractibility while providing full-body support. Once the new skill is mastered, the degree of support can be decreased gradually.
Bean Bag Chairs
By focusing more on pre-scissor activities and thereby maintaining a child’s enthusiasm and attention to task, you will increase their ability to persist with practice and have a more productive therapy session!
Guest Blogger: Cathy Collyer, OTR, LMT, PLLC
Cathy Collyer, OTR, LMT has treated children with neurological, orthopedic and sensory processing disorders for over 20 years. She is the author of The Practical Guide To Toilet Training Your Child With Low Muscle Tone.
Hippotherapy is a specialized treatment area used by occupational therapists, physical therapists, and speech and language pathologists. It involves utilizing the sensory-motor aspects of horses to achieve therapeutic goals such as improving sensory processing to tolerate touch and motor plan sequential movements. Although the horse functions as a therapy tool, it is obviously much more exciting than a swing or therapy ball, offering opportunities to develop an emotional bond, communication and social skills.
Let’s look at the basics of hippotherapy
Although the healing power of horses has been recognized for thousands of years (Hippocrates mentions it in ancient Greek writings), hippotherapy only developed in Europe in the 1960s and soon after in the United states as an adjunct to physical therapy. Therapeutic goals might have included improving the rider’s strength, postural control, balance and coordination. Hippotherapy’s versatility as a treatment tool gradually expanded as SLPs used it to improve communication skills. Occupational therapists recognized the power of sensory stimulation in promoting engagement and functional hand skills, such as manipulating fasteners. For example, this rider enjoys opening the zipper on my glasses case and then handing me the sun glasses. She loves to help out and make both the horse and me happy!
Hippotherapy is a type of Animal Assisted Therapy
Please note that “therapeutic riding” (TR) is a different type of animal assisted therapy (AAT) that is offered by certified therapeutic riding instructors who teach riding skills to people with disabilities. A TR instructor may or may not be an OT, PT or SLP. However, hippotherapy is ONLY performed by a licensed OT, PT or SLP practitioner. Training and certification requirements vary at facilities and many require that the therapist have certification in both TR and hippotherapy. As an OT, my goal is not to teach my client how to ride a horse, although frequently that is the result and many children transition from hippotherapy to do TR and eventually earn medals at the Special Olympics.
Why are horses special therapeutic friends?
Well, many animals are special in their ability to connect with people nonverbally and provide unconditional love. Cats and dogs also provide great heavy pressure and tactile sensory stimulation as they lie on laps and cuddle. However, a child with cerebral palsy may improve range of motion by straddling a horse and the repetitive, smooth vestibular movement can gradually reduce muscle tone. A horse’s gait is similar to the human gait in terms of timing. Clients who have never walked or have an abnormal gait can kinesthetically experience what normal pelvic movement feels like.
I have primarily worked with very young children who received services through their early intervention programs. Many had developmental disabilities, including Down syndrome and autism spectrum disorders. My goals often focused on decreasing sensory defensiveness while increasing engagement, postural control and hand skills. Of course, this involves using a variety of reaching, grasping and manipulation hand activities.
Hippotherapy Provides controlled and graded Sensory Simulation
Simply being on a horse provides sensory stimulation. Actually, as soon as a client enters the hippotherapy facility, they are impacted by happy sounds, smells and scenery. Bouncing on the horse while walking and bouncing even more when trotting provides heavy duty proprioceptive and vestibular sensory input. I control and grade the sensory input with choices such as whether to:
walk slow, fast and for how long before stopping
walk in straight, curved lines or in circles
walk uphill, downhill or only on flat surfaces
the child faces forward, sideways, and backwards or rides in a different position such as in quadruped or kneeling.
Using Sensory-Based Materials
Hipppotherapy horses are selected for many specific attributes including tolerance for riders who may hit, kick or scream. I also use a variety of sensory materials that must first be introduced when there is no rider so that the horse becomes desensitized to materials such as:
rings placed on top of a vibrating ring stack (see photo)
toys and sound puzzles that make funny sounds or vibrate
clothespins clipped onto or removed from the mane (this does not hurt the horse)
ball play, playing catch with toys like a Gertie Ball
The little girl in the photo is facing backwards while her hands bear weight on top of a vibrating cushion like a Senseez Vibrating Pillow. This helps to decrease her tactile defensiveness before asking her to engage in more complex fine motor tasks.
This vibrating ring stack is made by inserting a motorized pen, like a Squiggle Wiggle Writer Pen inside a swimming noodle.
Adapting activities to vibrate is one of the many sensory strategies described in my book From Flapping to Function: A Parent’s Guide to Autism and Hand Skills.
Hand Activities to Develop Postural Control
Clients may work on postural control while reach to touch body parts on the horse or therapist. I like to offer sensory materials to pull or squeeze such as Panic Pete (AKA Martian Popping Thing) while the client maintains a quadruped or kneeling position. The child in the photo squats to take rings out of the bag and stands up while stringing them. He typically has difficulty visually attending but it is difficult NOT to focus and be in the moment when standing on top of a large animal!
The girl in the photo reaches for rings positioned in front of her before rotating her body to place them over a ring stack. This “ring stack” is actually a cat toy and the mouse on top of a spring squeaks when moved. The sensory aspects of this activity help her to visually attend while developing postural control.
Hand Activities that Develop Cognitive and Manipulation Skills
In my book – From Rattles to Writing: A Parent’s Guide to Hand Skills I describe many simple adaptations that make it easier for children with and without disabilities to develop manipulation skills. For example, lacing boards can be cut out of cardboard and made to have just a few, big holes and thick cord that are easier than string to control.
During a typical Hippotherapy session, I spend time walking and trotting, followed by stopping to complete a simple hand activity such as this lacing board. When finished I encourage the child to say or sign “go” to continue movement. Most children are eager to resume movement.
A horse’s rear end is wide and functions as a convenient work surface. I adapted this puzzle by attaching the pieces with Velcro to the box cover. I encourage the child to use one hand to stabilize the box lid while pulling them off. Of course, this activity also teaches children to identify animals and imitate sounds. The Pizza Party is another activity that would be fun to use in this position.
Creating Functional Hand Skills Objectives
It’s a good idea to create OT objectives to improve functional skills such as opening and closing buttons because:
occupational therapy is all about increasing independence
this skill is measurable
insurance companies prefer work on functional, achievable daily living skills rather than abstract goals such as improving coordination
Therefore, I provide activities such as:
opening and closing extra large fasteners
opening bags and other containers (like my sunglasses case)
putting the helmet and gait belt on and off
unbuckling and putting away the reins, neck strap or other equipment
The first video shows how I made and use the “Sensory Pull Toy” (that I designed) during Hippotherapy to develop:
reaching, balance and postural control
hand strength
visual attention
eye-hand coordination
color identification
This toy is made out of detergent bottles and a strip of fabric. It’s simple to use – the child pulls the handle while in various positions. It can also be used during non horse activities to work on many skills. Please check out my book The Recycling Occupational Therapist for many other easy to make therapeutic activities.
The second video shows a few of the exciting ways therapists can use hippotherapy to develop hand skills. It is truly amazing how motivated children are to focus and engage in challenging hand activities because they love being cowboys and cowgirls!
Guest Blogger: Barbara A. Smith.
Barbara A. Smith has worked with children and adults with developmental disabilities for over 40 years! She is the author of the Recycling Occupational Therapist, From Rattles to Writing: A Parent’s Guide to Hand Skills and From Flapping to Function: A Parent’s Guide to Autism and Hand Skills. Learn more about her work at RecyclingOT.com.
