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.

How Can Ordinary Movement Be Scary?

• 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

• 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.

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

Mr. Alex in Southpaw's Dual Swing

Southpaw's Dual Swing