Gripping Issues by The Shoreline Occupational Therapy Staff last updated March 2004

What do you see? Child has a tight grip. (No space between thumb and fingers) Child holds pencil within the palm. Child’s thumb wraps around fingers on the tool. Or fingers wrap the thumb. Child’s hand tires easily. Child cannot change his way of holding the tool. Wrist is bent down. Hand and arm “float” in the air while writing.

Do you see this?

Why? Grip patterns may be immature. Muscles within the hand do not work in concert. Grip patterns are developed through exposure to manipulatives and large motor activities. Grip patterns are habit based as a result of the above. Grip patterns are almost impossible to change as they are HABIT based. These grip patterns are observed in ALL ages, preschool through adult. The optimal time to change these patterns is preschool through 3rd grade, however, as the child ages, it is easier to change a habit when engaged in learning a new activity.

What it should look like: Wrist bent up-see #1 (when arm is on table, hand is bent upward) Open web space-see #2 (circle between thumb and fingers) Fingers and thumb move the tool 2 1

2 other good grips Quadrapod 3 fingers and thumb direct the tool Maintains position of wrist and open web space Adapted tripod 2 fingers and thumb direct the tool Maintains position of wrist and open web space

How does grip effect output? If the wrist is bent down or the fingers not moving, a child engaged in writing tasks will have: Difficulty controlling the tool if the writing space is too large Too tight or too loose grasp on pencil effecting pressure on the paper or into the tool Letter forms which are distorted due to poor motor control Decreased output in speed as well as volume Fatigue more quickly than his peers *Child may shake or rub hands frequently during writing (motor) *Child may refuse to write or take a lot of “breaks” (cognitive/social)

Keep in Mind Habits are very hard to break This habit was likely formed several years before the child entered school The best time to teach a “new” habit is when something new is being learned Know your child’s tolerance level for change Know your own tolerance level for change

So, What Now? There is a lot you can do All students can benefit There are simple changes which can be made to positively effect the child’s ability to participate in the classroom

External Support - Position Child seated at desk with feet on the floor To decrease fatigue Desk height appropriate for child (2” above bent elbow when seated at desk) To decrease fatigue Position of paper - slanted to same angle as forearm of writing hand To improve the position of the wrist Upright surface - slant board, chalkboard work, tape paper or project to wall or cupboard space. To improve the position of the wrist Short pencils or crayons (1-2” in length-golf size) For increasing movement within the fingers

External support -pencil grips For placement of fingers on pencil shaft Stickers or rubber band on the pencil shaft Foam gripper to assist with increased pressure on the tool Plastic gripper that helps with where to hold on the length of the tool and with comfort (available in different shapes) Available at Kmart or similar store OR catalog For specific position of thumb and index finger Modeling clay around pencil. Stetro grips identify specific finger position on a tool “The Pencil Grip” promotes correct grip pattern Available: through catalog or at academic aid store

Pencil Grips for placementfor position

External Support-Size matters! If you are writing within a large space (1 inch or more ruled paper, i.e. kindergarten paper), write with a large diameter tool. Ex. Fat crayons, Kindergarten pencil, markers If you are writing within a small space (less than 1 inch, i.e wide or college ruled paper), write with a small diameter tool. Ex. Standard #2 pencil or pen

Pre-writing warm-ups Push hands Pull hands Hug yourself Reach

Pre-writing warm ups pull up on chair sit up tallget outrageous sit up tall

Free Time Activities Small manipulatives that include fingers moving. Example, Jr. Boggle game, pegs and pegboards, building blocks (not necessarily legos), Hi-Ho Cherry-O, marble games, card games, geoboards, spinning tops, dice games Hiding and retrieving small objects from clay An “office station” with tools - templates, staplers, hole punches, tape, paper clips, envelopes, small stickers, etc. Creating with small objects - popcorn, beans, buttons, packing peanuts, toothpicks, marshmallows, etc. Tool use - tongs to transfer items (moving game pieces to a playing place), clothespins, plastic knives to spread or cut, eyedroppers Classroom jobs - spray bottles to water plants, wringing out sponges, wiping down desks, picking up small pieces of paper from the floor, mail into student cubbies or passing out papers

References and Resources Benbow, Mary, Loops and Other Groups, Therapy Skill Builders, Benbow, Mary, Understanding the Hand from the Inside Out, Developmental Activities Based on Hand Anatomy, Workshop, Benbow, Mary, Understanding the Hand from the Outside In, Developmental Activities Based on Hand Anatomy, Workshop, Olsen, Jan, Handwriting Without Tears, 5th ed. published by Jan Z. Olsen, Knight and Gilpin Decker, Hands at Work and Play, Therapy Skill Builders, 1994(Another handwriting warm-up available by request) Web pages Look for the Tidbits articles -especially winter issues