With many of our young kiddos transitioning to school after the summer one of the biggest challenges they may face is using a pencil and pencil grasp.

In this blog post, we will be discussing fine motor development from a sensory-based motor perspective, specifically as it relates to pencil grasp development, which can help a lot of our kiddos who will be transitioning to school soon.

   

Body Stability

The first concept to understand is that proximal stability promotes distal mobility. This means that the development of body stability and control begins at larger muscle groups and then progresses to smaller muscle groups. As it relates to fine motor control, the progression looks like this:

  • Trunk/core control –> shoulder –> elbow –> wrist –> hand

When we focus on trunk/core strength and stability, we are helping to support the increased movement of the arms and hands.

For example, to help understand this concept, think of a toddler trying to feed himself a Cheerio – the toddler must have a stable chain of muscles running from the core to the shoulder to the wrist and to the hand/fingers to pick up the Cheerio and bring it to his mouth. If this muscle chain is not strong, it would be difficult for the child to bring the piece to his target.

Core control and stability is needed to sit up straight, keep the head up straight, and control the shoulder and arm. When children have unstable cores, they end up using excess energy to maintain their balance, which in turn decreases their ability to perfect smaller movements.

Think of certain kids who consistently appear to be slouching or placing their heads on the tables. In the classroom setting, some may label these kids as “lazy” or “unmotivated” but the reality can be that it can take so much energy for kids to work against gravity to maintain an upright position to the point where it compromises their endurance to complete fine motor tasks.

To put it in perspective think about trying to lay over a yoga ball in the Superman position (with arms and legs off the ground) while attempting to complete a fine motor task. All of our focus and energy is placed on attempting to keep ourselves stable on the yoga ball, which decreases our fine motor control and accuracy.

Shoulder Strength

The next muscle group to target is the muscles at the shoulder girdle. If you watch some of our younger kids write or color, you may notice that they initiate the movement from their shoulders instead of their wrists.

You may see tension at the shoulders during fine motor tasks as it takes a lot of effort to initiate movement from the shoulder, and this can easily cause fatigue. When this is the case, it is important to work on strengthening the shoulder girdle to help reduce fatigue and increase endurance for fine motor tasks. Here are some ideas that can address shoulder strengthening:

Tips for Strengthening Shoulder Muscles

  • Wheelbarrow walks
  • Wall push up (pushing hands against the wall while keeping arms slightly bent)
  • Chair push ups
  • Play with toys that provide resistance or require force such as Play-Doh, pop beads, Lego or other construction toys.
  • Writing on vertical surfaces – tape a piece of paper up on the wall to work on writing/coloring tasks. Writing on a vertical surface will make a child’s shoulder work harder against gravity to complete this task and therefore increase strength, endurance, and stability.
  • Animal walks

To help understand what some of our kids may experience, I would recommend practicing writing your own name 2-3 times while intentionally facilitating the movement from your shoulder rather than the wrist – see how your shoulder feels and if you notice any challenges with your fine motor control.

Wrist Stability

The next area to address is wrist stability. A stable wrist impacts hand strength, specifically as it relates to grip and pinch strength. Handwriting should come from isolated mobility (flexion/extension) at the wrist, and the wrist should be slightly extended when using writing utensils for a functional grasp and optimal position of the fingers in opposition to the thumb.

When the wrist is flexed (bent forward towards curved fingers in a grasp), there is little chance of fine motor dexterity. Any activity that involves weight bearing through the hands (i.e. climbing, crawling) can help support wrist stability.

Finally, we can address hand strength. Before placing the demand of holding a writing utensil, it is important to build up intrinsic hand muscle strength. These are the muscles in our hands that need to be strong in order to formulate the proper grasp and finger movements around a writing utensil.

Muscles in Our Fingers

  • Thenar (thumb abduction/adduction (moving thumb away and to the hand), flexion)
  • Hypothenar (pinky flexion, adduction, abduction, opposition)
  • Interossei (finger adduction, abduction (spreading fingers away from each other and moving them back next to each other))
  • Lumbrical (MCP flexion, PIP/DIP extension)
  • Open thumb web space: In order to grasp small items with your thumb and index finger, you need to oppose the tip of your thumb to the tip of your pointer finger. Some of our kids have difficulty opening this web space due to decreased strength, so it is essential to work towards promoting an open web space before expecting them to grasp a pencil.

Some ideas of activities that support intrinsic muscle strengthening can be found on the attached handout and include:

  • Anything that involves the weight-bearing through the hands (crawling, climbing)
  • Tearing up small pieces of paper
  • Manipulating Play-Doh
  • Squeezing sponges during water play
  • Picking up objects with kitchen tongs
  • Playing with squigz

Once we strengthen the intrinsic muscles, we can work on progressing through the different “milestones” for pencil grasp (as pictured on the attached handout). It is important to remember that it is a progression, so we need to support our friends throughout the various stages of grasp development (palmar supinate grasp, digital pronate grasp, etc.) – our kids will not automatically hold a pencil using a perfect dynamic tripod grasp, and that’s OKAY! We just need to meet and support our kids where they are at.