Pawprint, September 2014
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Therapist's Corner
Deanna Maciole
Activities to Help Fine Tune Early Fine Motor Skills
Deanna Macioce, MS, OTR/L

Being back at school means that as therapists, teachers, and parents we start to pay a little closer attention to educational needs. We go from making sure our children are getting enough outside play during summer to what the needs are for them to breeze through their school day with ease. This includes attention and focus, handwriting and visual motor skills, as well as, social skills. From preschool through high school, much of a student's day involves utilizing their hands. Therefore, it is important to establish good fine motor and dexterity skills early on in order to set them up for success. Strong foundational hand skills help establish proper handwriting and scissor skills.


Some children naturally develop typical fine motor skills. Moving from a mass grasp to the ideal tripod pencil grasp through everyday play. However for many, especially those lower tone, sensory children this does not always happen. Without proper attention to developing these skills, it can have a long-term affect, making handwriting, coloring and scissor skills more difficult, especially in the realm of endurance to carry them out.  


Highlighting some activities and developmental needs will help to focus on how you can work on these with your child, especially the younger ones who are starting to piece together the fine motor puzzle.


Infancy offers a time of exploration. Pay attention to the toys that they are presented with, making sure the toys are of varying sizes. This will allow the child to develop different grasp patterns, strengthening the muscles of the hands. In addition, play with these toys in varying position, such as on the belly or sitting upright.   As a child begins to move by crawling always encourage crawling with opened hands to ensure proper weight bearing through the elbows, wrists, and hands. To strengthen palmer arches set up activities that allow them to crawl with objects in their hands. Such as crawling through a tunnel to obtain a puzzle piece and then crawling back through to place it into the board.


Moving through the toddler stage, grasp and fine motor development begin to take on the focus of using writing tools and scissors. Giving children the opportunity to play with manipulatives is key. From stacking blocks of varying sizes and shapes to negotiating different pieces into a shape sorter, many of the early hand skills are developed through play. Therefore, pulling out those traditional toys of puzzles, snap beads, lacing activities and blocks offers more opportunity for fine motor development than just the push-button toys. In addition, with supervision allow your child to explore with crayons and markers. And once again, utilizing ones of various sizes is beneficial. There is no need to throw away those broken crayons, using them while drawing and coloring helps to encourage the development of a triad grasp.


To help develop finger strength, activities using play dough, putty, and items such as Moon Sand provide opportunities for play, while improving fine motor skills. Hands working to knead and mold these substances encourage individual finger and grasp strength. Rolling out the dough and pinching both help improve palmar arches and pinch grasp. You can also work on these skills in the kitchen with cookie and bread baking. Finger strengthening and dexterity can naturally be addressed in day-to-day tasks, such as opening and closing small plastic containers and bags. By placing snacks and toys in these, children are naturally working on fine motor skills, and they are easy to take on the go.


In regards to grasp development, early on we look at how a child develops a pincer grasp (using the tips of the thumb and pointer finger together). As toddlers, presenting them with small objects to safely eat, such as Cheerios, Gerber Puffs, etc. helps to encourage them to use a pincer grasp. To assist in the process, you can gently hope their hand allowing them only use of the thumb and pointer finger. In addition, at this stage, it is important to pay attention to isolated index finger use. This means that as children are pointing at objects in a book, activating push button toys, etc. they are using a single pointer finger and not the entire hand.   As children grow older, you can help to encourage the use of the thumb and index finger only by placing a small object or cotton ball in the palm of their hand to hold during activities, such as writing, coloring or game playing. This helps them improve finger grasp strength and use the thumb and pointer finger on their own.


Providing activities that directly work on these skills are beneficial. Magna Doodle boards and Aquadoodle Mats allow them to work on grasping and holding different tools to perform drawing and pre-writing activities. In addition, crafts are an ideal way to pull in fine motor skills, from ripping small pieces of paper to glue onto a template, crumbling tissue paper, and using pincer grasps to obtain objects to glue such as macaroni and buttons. Another way to work on finger strengthening through ripping paper is by allowing your children to rip up your daily junk mail.


Playing and using large tweezers, strawberry hullers, or even kitchen tongs to obtain and move objects, such as blocks, pom poms, or beads and place into a bowl or egg carton container. In addition, there are games and toys on the market that provide these items, such as Operation.


So, it is never too late to fine tune your child's fine motor strength. It will be only make the daily tasks they face at school easier.

Southpaw Products
Southpaw Helicopter Swing

   Helicopter Swing
The Helicopter Swing offers responsive support in a flexion position. The swing can be used lying face down or on the back, and helps the most nervous client gain confidence in swinging.

Southpaw Scooter Board Ramp  
Scooter Board Ramp
Finally a scooter board ramp made only for scooter activities, that's easy to assemble, lightweight, and easy to store! Ramp design includes a safety lock end which secures the ramp to the base. The base folds flat to store, and goes together with only four screws.

   Southpaw Sensory Rockers
 Sensory Rockers
These soft, contoured rocking chairs offer gentle sensory stimulation while holding the user in a very comfortable position. An ideal positioning product for those who only need mild vestibular input.

For the Therapist
Zoe Mailloux How Can Ordinary Movement Be Scary?
Understanding Gravitational Insecurity©
Zoe Mailloux, OTD, OTR/L, FAOTA

More basic than our ability to form relationships with people, or to interact with objects, is our ability to respond to gravity and to relate our bodies to the space around us. This sense, which comes from the vestibular system, is a crucial and fundamental aspect of developing a sense of
feeling secure and comfortable in the world.

As infants, we begin to develop a sense of trust as we move through space and as our nervous
system provides accurate information about the direction we are going, how fast or slow we
are moving and in which way we are oriented in space. We are able to sense these things when
our head position changes, through stimulation to a part of the vestibular system that reacts to
the earth's gravitational pull.

Children who do not perceive gravity in the usual ways are often very fearful of movement,
heights and/or change of head position. This type of problem was called "gravitational
insecurity" by Dr. A Jean Ayres, the founder of Ayres Sensory Integration® theory and practice.
Most of us can imagine feeling threatened by being at the edge of a ledge that is very high, or
by feeling disoriented by being moved through space so quickly that we cannot immediately
distinguish up from down. For some individuals, however, even slight changes in height or
position create an extreme feeling of disorientation, fear and anxiety. It is probably verydifficult for those of us who do not have this reaction to imagine what it must be like to experience these sensations. If you cannot trust your body as it moves through space, it would be very hard to trust anyone or anything else.

Because it is difficult to understand this problem, it may often seem that someone who
experiences gravitational insecurity has a psychological or behavioral problem, but the basis of
this disorder is related to inefficient sensory integration. However, it is certainly easy to imagine
how psychological or behavioral problems could develop from experiences that create so much
discomfort in everyday life actions.

Most children go through periods of development in which they react somewhat fearfully to
some types of movement or to heights. There are also many individual differences in the way in
which people react to heights and to fast motion. However, when reactions to heights or
motion which are not usually noticed or bothersome become extreme, or when they begin to
interfere with the ability to participate in activities, a problem may exist. Some of the signs
which Dr. Ayres considered suggestive of gravitational insecurity included the following:
  • Anxiety when feet leave the ground
  • An unnatural fear of heights or falling
  • An unusual dislike of having one's head upside down
  • Fear or uneasiness when walking on uneven surfaces or on stairs 
  • Alarm at being tipped backwards
Another related problem is called "intolerance to movement." The main characteristic of this
problem is an extreme reaction to linear or rotary motion that is usually not perceived as
threatening or significant. People who have intolerance to movement may experience nausea
and queasiness and may also be prone to extreme car and seasickness. We don't know as much
about this problem as we do about gravitational insecurity, but we've observed it in children
who have other sensory integrative problems. We also know that people naturally have less
tolerance for movement as they get older.

Try These Activities

Here are some ways you can help a child with gravitational insecurity:
  • Acknowledge that this is a real problem for the child and respect the child's reactions to various situations. Treating it as an emotional weakness or behavior problem is likely to make things worse.
  •  Help the child gradually engage in activities which are threatening. For example, if a child is
    frightened by being on a swing, first try a swing in which the child's feet can touch the ground or hold the child in your lap on a swing.
  • Extra proprioceptive sensation (pressure to the muscles and joints and through the trunk) may
    help a child feel more secure. For example, if the child is fearful when walking up stairs, try
    holding him at the hips and applying gentle pressure. This may feel more secure than being held by the hand.
  • Gentle, back and forth movement is usually easier to tolerate than rotary movement. Try
    moving the child in the most comfortable ways first.
  • Being tilted backward is often especially threatening. Do not attempt this kind of movement
    until the child is clearly ready to tolerate it.
  • Engaging in play and imagination during challenging activities may help distract from the scary
    aspect of the situation.
  • Practice engaging in movement activities with the child's eyes closed. This may help the child
    "tune in" to the position of his body in space.
  • Adding weights (for example, wrist or ankle weights or a backpack filled with beans or rice) may also help a child feel more secure.
Check with your therapist to see if these activities are appropriate for your child and for more

HOW CAN ORDINARY MOVEMENT BE SCARY? UNDERSTANDING GRAVITATIONAL INSECURITY © is part of a series of "Parent Pages" on the topic of sensory integration written by Zoe Mailloux, OTD/L, FAOTA. May be reprinted for educational purposes, with full title and copyright information included.

Article originally published online here.

Learn more about Ayres Sensory Integration 2020 Vision -

The year 2020 marks what would have been the 100 year birthday of Dr. A. Jean Ayres.  In commemoration of this milestone, professionals from all over the world have proposed the following vision:

Ayres Sensory Integration will have a strong, international presence with demonstrated scholarship, means for valid, comprehensive assessment and pathways for training to ensure the ongoing development, standards of excellence and effective implementation of this important work.

For more articles and information about Zoe Mailloux, visit her online at
Activities with Mr. Alex
Mr. Alex's 4 Favorite Therapeutic Activities with Southpaw's Dual Swing in Prone

Alex Lopiccolo, COTA/L, CPT, NC 


1. Comet Blasting - The adult will squeeze the upper extremity ropes together and the lower extremity ropes together. Next, the adult will press the child up and swing the child in a orbit motion (large circle motion without spinning). The child will then reach for a small tactile ball out of the adult's hand while moving in motion and then throw at or into a target.


2. The Climb Up and Rescue - The child will climb their hands up a high suspended bungee or Lycra rope by alternating their hands. Once the child has maxed out their strength the child will reach for a Beanie Baby animal (object with weight vs.stuffed) then throw it at or into a target.
3. Row your Boat - The child with hold onto a long Lycra rope with both hands while suspended in the swing. Another peer will sit on the floor or crash mats in a long sit with both hands. The children will take turns pumping with their arms to propel the child in the swing linearly, rotatory and in orbital motion for a certain amount of reps or until the end of their song. 
4. Drum Mime - The child will use a lip of a mat or the floor to pull and push themselves in a linear motion. The child will watch a peer or adult make a drumming pattern on paddle drums. The child in the swing will then mimic their same pattern with their peer holding the paddle drums at the peak of their motion.

Southpaw Enterprises Dual Swing
Mr. Alex in Southpaw's Dual Swing

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