Toddlers and children with movement conditions such as joint hypermobilty, low muscle tone, developmental coordination disorder, dyspraxia, Down's syndrome and autism often have difficulties performing everyday fine motor tasks that require good hand and wrist muscle strength and coordination.
In this post I describe all the different ways the hands are used to grasp and manipulate objects, and how these different grasp patterns are used in everyday activities. This will help you to identify the activities that your toddler or child has not yet mastered effectively.
Different hand tasks have different strength requirements
Because the combination of finger and wrist movements, and the strength requirements, are specific to the particular hand task, the most effective exercise programs include all the different ways the hand is used to grasp and manipulate objects in everyday life.
Use this as a guide to identifying exercises and activities to include in your hand task training program.
Tasks that require a hook grip
These are tasks where the fingers wrap around a long object with a small diameter. The fingers are bent at all the joints.
A hook grip is used for holding a bucket and hanging from an overhead bar. .
Tasks that require a power grip
A power grip is used to grasp and hold a cylindrical object between the fingers and the the thumb.
The strength of the grip needs to be carefully adjusted to ensure that the object is firmly held and does not slip out of the hand.
Many power grip activities also involve movements of the wrist or elbow to move the lift, tip or tilt the object.
Everyday activities that use a power grip
Picking up and pouring from a bottle or beaker
Picking up a bottle by a handle and pouring
Grasping a jar when twisting the lid open
Climbing on a climbing frame
Climbing activities require a strong power grip to support the weight of the body.
Raking and sweeping require a strong grip
A palmar grasp is used to hold tools with a long handle
The handle of the tool is held diagonally across the palm of the hand. The thumb is used to stabilize ti grasp.
In some tasks the thumb is used along the length of the object, such as when holding a hammer.
Everyday activities that use a palmar grasp
Hammering with a hammer
Depending on the size of the hammer, either wrist or elbow movements are used to move the head of the hammer up and down.
Holding a cooking pot with a long handle
The handle of the pot rests across the palm of the hands. To pour from the pot that forearm is twisted.
Young children use a palmar grasp to hold a spoon.
A spherical grip is used with round objects.
A spherical grip is used when the fingers need to be shaped to grasp a round object. This grip is used to grasp a ball shaped or flat round object, such as the lid of a tub.
A spherical grip is used to screw and unscrew a jar lid, open a tap,
When unscrewing the lid of a jar, one hand is used to stabilize the jar - this action requires a power grip.
Cupping the hand uses the same combination of thumb and finger movements
A lumbrical grip is used when the fingers need to be straight
A lumbrical grip is used to hold an object without wrapping the fingers around it. .
The fingers need to be straight, rather than curved. This grip is difficult to maintain if the small hand muscles are weak.
This grip is often weak in children with hypermobile fingers.
Everyday tasks that require a lumbrical grip
Squeezing an oval shaped honey or shampoo container
Holding and moving a book or other flat object
A pincer (precision) grip is used for small objects
Small objects are picked up between the tip of the thumb and forefinger. From 8-10 months of age infants use this grip to pick up small objects.
This grip is less effective when a child has hypermobile finger joints.
A key grip is used to firmly hold small flat objects
Many activities involve gripping a small flat surface between the thumb and side of the forefinger.
Everyday activities that require a key grip
A key grip is used when tearing paper or card
A key grip is used to grasp and pull up or trousers.
A key grip is used to pull open a velcro shoe tab.
Puling on socks requires a firm grip.
A chuck grip is important for tool use
Tools, such as a spoon or knife are often grasped using the thumb, fore and ring finger.
The fingers need to firmly grasp and stabilize the tool while at the same time move the fingers to manipulate the tool.
This is a complex action which young children only start to effectively master at 4-5 years.
Everyday actions that require a chuck grip
A chuck grip is used to hold a spoon when eating.
A chuck grip is used for screwing a small lid on and off.
Spinning a top is another example of grip and move
A dynamic tripod grip
A tripod grip is used for holding a pen when drawing and writing