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.

Teaching Scissor Skills: Cutting Tips for Young Children

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 a great option when Teaching Scissor Skills
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.

Adapted scissor for Teaching Scissor Skills

Spring Action Blunt Tip Scissors for Teaching Scissor Skills
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 Chair
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

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 Activities that Help Build Hand Skills

 

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

child on horse

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.

child with ball
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
  • bubbles like Bubble Bear or No-Spill Bubble Tumbler
  • clothespins clipped onto or removed from the mane (this does not hurt the horse)
  • ball play, playing catch with toys like a Gertie Ball
 
child on horse

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.

 
Hippotherapy hand skill activity: ring stack

This vibrating ring stack is made by inserting a motorized pen, like a Squiggle Wiggle Writer Pen inside a swimming noodle.

child on horse

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!

 
child on horse during a hippotherapy session

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.

lacing board used for hand skills in hippotherapy

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 hand skill activity uses a pizza box and velcro during a hippotherapy session

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

buttons

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

Video Time!

Video: Sensory Pull Activity for Children with Autism or Sensory Processing Disorders

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
A toy used in hippotherapy made out of detergent bottles and a strip of fabric for hand skill activities

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.

Video: Hippotherapy with Children with Autism or Sensory Processing Disorders

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!

 
Barbara A. Smith

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.

Dyspraxia Tips: Teaching & Treating Coordination Challenges

Dyspraxia is one type of sensory processing disorder (SPD) that makes it difficult for children to plan and perform motor tasks such as stringing beads or riding a bicycle. Children with dyspraxia may

  • Appear clumsy
  • easily break things because they use too much force or
  • struggle to fit their arms into sleeves or sequence steps to shoe tying

Children with SPD often have more than one of the 6 subtypes that impact how their brains interpret and respond to what they see, hear, feel, smell, taste and how they move. They may seem extra active or lethargic, super sensitive or oblivious, have difficulty controlling their body while using their hands or can’t discriminate what part of their body was touched or is in pain.  Let’s take a look at a few strategies that may help children with dyspraxia and other types of SPD as well as children who are typically developing.

Simplify for Success

Nobody likes failure; especially young children who have poor coordination to stack rings, string beads or lace boards.  Consider purchasing, making or adapting these types of activities to make success easy and frequent. Try using

  • an extra large tube as a ring stack and rings to stack. The one shown in the photo is made by wedging a swimming noodle into a juice container and has a motorized pen inserted on top to make it vibrate.  Vibration helps children to focus on what their hands are doing.
  • thick cord and shower curtain rings for stringing instead of offering string and beads. Many toddlers will find this an easier introduction to stringing.
  • lacing boards with a few extra big  holes and thick cord. I attached the photo of a horse to this lacing board that I used with clients during Hippotherapy (therapy using a horse as a therapeutic tool).
 

Practice Makes Perfect

Design activities to require repetition. When a child closes a jacket there is usually only one zipper to connect or a few buttons. Many children benefit from the repetition of closing several button squares. As I describe in my book From Rattles to Writing: A Parent’s Guide to Hand Skills, these are made by sewing a large button or round plastic piece (see photo) to fabric. Then cut a slit into another piece.  As your child develops skill, offer button squares with smaller buttons.

Button Squares teaching activity for treating dyspraxia

Zippers teaching activity for treating dyspraxia

Many children are able to close a zipper once the slider is connected.  But connecting the slider onto the zipper is very tricky. In the photograph you see me wearing an old jacket and attaching several zipper sliders.  The sliders are sold in zipper repair kits or you can remove nice big ones from broken backpacks and suitcases. I have taught adults with developmental disabilities to zip their own jackets after practicing connecting and pulling up several slider every day.

Let’s Take Apart

Button Board teaching activity for treating dyspraxia

Opening buttons, screw caps, zippers and knots seems to be a lot easier than closing them.  One of the strategies I describe in my book From Flapping to Function: A Parent’s Guide to Autism and Hand Skills is to teach children to “ take- apart” before teaching them to “put-together”. In this way they will become familiar and successful with the materials before learning the more challenging motor skills of tying, buttoning, snapping, screwing lids etc. It is much easier to remove the fabric pieces from the “buttoning board” shown below and children will have many opportunities to practice. This board was made by drilling holes into a book stand and tying the “buttons” onto cord that is knotted through the holes.

Manipulation Box teaching activity for treating dyspraxia

In my book The Recycling Occupational Therapist I describe how to make activities that are perfect for opening and taking apart. The Manipulation Box shown in the photograph has screw covers, Velcro strips, pull lids, and magnets attached to a cookie sheet so that children can remove a variety of objects to drop inside.

Keeping It Fun

Yes, practice is important but we need variation and to add sensory stimulation to keep it fun. That’s why I love

  • form boards and ring stacks that make music
  • adding a motorized pen inside containers to make insertion tasks vibrate
  • using materials such as Velcro and elastic cord that feel good to pull
  • toy animals with clothing fasteners to manipulate
  • using pretend play toys such as “Feed the Bunny”
Bunny Insertion Task teaching activity for treating dyspraxia

I covered an oatmeal container with fur, attached a face to the lid and photocopied some food items. Now “Feed the Bunny” is more than a plain old shape sorter. This great for working on choice making (i.e. shall we feed bunny a carrot or tomato?), identifying pictures, counting and of course promoting a healthy diet.  I hope that you have fun implementing some of these strategies!

Here are some great Therapro products I recommend that you might use in addition to the activities I’ve discussed:

Squiggle Wiggle Writer Pen
Squiggle Wiggle Writer Pen
Sound Puzzles
Sound Puzzles
Giant Plastic Nuts and Bolts
Giant Plastic Nuts and Bolts
Learn to Dress Monkey
Learn to Dress Monkey

 

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.