Welcome to Kokanee's OT/PT Department

Intervention Strategies and Activities For Fine Motor Development:

 

Working on a Vertical Surface:

• Strengthens the muscles of the shoulder, arm, wrist, and hand. 
• Puts the wrist into extension, which allows for greater control of the pencil by the fingers.
• Position children so their vision is in the vertical plane versus the horizontal plane.  The vertical plane is the first visual plane to develop and mature.  It allows work in the plane that is aligned with the body.

Many different school and play activities can be done on a vertical surface.  An easel can be made or purchased that provides a surface for drawing or painting with markers, crayons, or watercolors.  (A chalkboard creates more resistance and provides better strengthening for hand muscles than a whiteboard.) Ordinary book holders purchased from an office supply store can be used to make tabletop activities, such as a pegboard, into vertical activities.  Some commercially available games, such as Lite Brite, are designed in the vertical plane.  Other activities, such as placing clothespins on a line at shoulder height or reaching for items on a shelf at shoulder height or higher, are beneficial.  Students can shelve books, hang up the class artwork on a clothesline to dry or on the wall for display, and/or help change the bulletin board.                                                                                                                                 

Developing the Natural Arches in the Palm of the Hand:

• These are the arches in the palm that form the cupping position of your hand.
• Allows for the use of a mature pencil grasp.
• Assists the thumb to be rounded around to the fingers to form a circle.

The arches in the palm are emphasized when the hand is cupped (as in cupping one’s hand to hold water).  Even when the hand is held outstretched and flat, the arches should still be visible.  When children make handprints using paints there should be some parts of the hand that do not touch, leaving blank spaces.  These represent the arches of the hand.

Activities that encourage the development of the hand arches include:    

• Molding and rolling play-dough (clay, silly putty, gak, etc.) into little balls using the palms of the hands. Note: the fingers need to be slightly curled towards the palm.
• Rolling a golf ball deep into the palm of the hand.
• Using pegs or toothpicks to make designs in clay or putty.
• Cutting clay or putty with a pizza cutter, play-dough cutters, or cookie cutters.
• Wringing wet clothes or washcloths or scrunching up paper.
• Flicking paper wads with the thumb and index finger (such as the folder paper football game).

Separation of the Two Sides of the Hand:

• The ability to have the thumb, index, and long finger move while the ring and little fingers are out of the way.
• Allows each finger to move as an independent unit for isolated finger control.
• Allows for the formation of the tripod position of the thumb, index, and middle fingers while the ring and little fingers are curled out of the way. 
• Allows for in-hand manipulation of small objects.

Very young children tend to use their entire hands as units.  When they want to grasp an object, all the fingers work together.  As the muscles of the hand become more refined with age and muscle development, children are able to use a pincer grasp or a tripod grasp for activities that require precision.  The power fingers (the ring and little fingers) are curled against the palm.  If an object is stored in the palm of the hand, it can be retrieved by moving the object out of the palm with individual fingers and into a pincer grasp. This is called translation.

Activities that encourage the separation of the two sides of the hand include:

• During writing, coloring, or painting, have the child hold a penny, cotton ball, M&M, or some other small motivating object in the palm of the hand with the ring and index fingers.  If it doesn’t fall out, then they get to eat it or get a sticker prize.
• Squeeze the trigger of a spray bottle filled with water.  Note: make sure only the index, or index and middle fingers are on the trigger.  The child can do window cleaning, watering the plants, cleaning the sidewalk chalk off outside surfaces…
• Use tweezers to pick up small objects or put coins in a piggy bank slot.
• Turning over cards or coins.
• Putting coins into a slot or a piggy bank.
• Cutting with scissors if the hand is positioned so that the thumb is in one handle hole and the index and middle fingers are in the other handle hole.  The ring and little fingers are curled against the palm.

Developing the Thumb Web Space:

• Allows the thumb to form a circle or “Okay” sign with the fingers
• Creates stability and control of objects such as the pencil in the tripod pinch

When holding a pencil, most people have a “circle” formed by their index finger and thumb (such as when making the O.K. sign with the fingers).  This position allows the thumb to rotate around so that the tip of the thumb and index fingers meet.  In this position, the thumb provides stability to the fingers.  During writing, the rounded web space allows the small muscles of the hand to control the fine movements of the hand needed for neat, legible handwriting. 

Activities that encourage the development of the thumb web space include:

• Using small screwdrivers to screw screws into Styrofoam
• Punching toothpicks into Styrofoam
• Popping plastic bubbles on packing sheets
• Zipping and unzipping
• Snapping snaps
• Lacing shoes or lacing cards
• Winding wind-up toys
• Using eye droppers
• Applying nail polish with the small brush provided in the bottle
• Picking up Cheerios or small marshmallows with tweezers
• Spinning tops
• Snapping fingers
• Stringing paperclips, Cheerios, or small beads by using the fingertips on the string.
• Threading and sewing with large plastic needles, such as those used with plastic canvas craft projects.
• Rolling small balls of tissue paper or play-dough using only the fingertips.
• Stacking cards, checkers, coins, etc. 
• Squeezing a tennis ball that has a 2-inch slit in it, so that an opening appears.
• Inserting pegs, sticks, or toothpicks into play-dough or clay.
• Flicking fingers (snapping the index finger out from under the thumb).

Home Activities to Foster Fine Motor Skill Development:

 

To Strengthen the Arm, Hand, and Finger Muscles:

• Play with play-dough, clay, or silly putty. Use fingers to push, pull, flatten, roll, and sculpt into various shapes. Try burying pennies, beads, or other small toys in the putty for a game of hide and seek.
•  Place clothespins around cardboard cutouts, on a box or can.  Use clothespins or chip clips to hang art projects for display, or create books by clipping pages of artwork together.
• Play with squeeze toys such as air rockets or stress balls. Use spray bottles to mist plants or spray letters or numbers on the sidewalk.
• Work on vertical surfaces, tape paper to a wall for drawing and writing.
• Wheelbarrow walk with a friend or over a large exercise ball. See if you can balance on one hand to pick up items from the floor or complete a puzzle in this position.
•  Imitate your favorite critters using animal walks.  Try bear, crab, seal, and inchworm walks.
• Crawl inside tunnels and under pillows.
• Side-sit and bear weight on your arms or lay on your tummy propped on your elbows while playing board games or doing puzzles.
• Go for a ride on a scooter board on your tummy and propel yourself using your arms. Don’t let your feet drag on the ground.
• Get outside and play at a park or school playground. Climb on jungle gyms, monkey bars, and rock walls, or swing on a trapeze.
• Get involved in sports that will help build strong muscles: swimming, gymnastics, bowling, or tennis.

To Refine Grasping Patterns and Finger Coordination:

• Store toys in a variety of containers, including Zip-lock bags, Tupperware, or dairy containers, and plastic bottles or jars with twist-off lids to incorporate fine motor practice into daily play.
• Play card games like Uno and Go Fish with friends and see if you can hold all your cards while you play. Practice shuffling and dealing the cards one at a time.
• Start a wind-up toy collection. Test your toys by racing them on different surfaces to see which one moves the fastest, travels the farthest, or is best at staying on track.
• Collect spare change and use your fingers to place coins in a piggy bank.
• Play with construction toys with interlocking parts like Legos, Mr. Potato Head, and miniature snap beads. The smaller the toy the bigger the challenge.
• Pick up small items with tweezers, tongs, strawberry hullers or adaptive chopsticks and place them into containers.
• Use broken crayons or chalk to create works of art, or try painting using a small piece of sponge to dab and spread the paint.
• String beads, cut up straws, Cheerios, paper clips, or dried pasta to make necklaces, lace your shoes, or play with lacing cards.
• Place pipe cleaners or toothpicks into the holes of an overturned colander, or make designs in clay, play-dough, or Gak, or make a porcupine with toothpicks in clay.
• Play string games like Jacob’s ladders or Cat’s cradle with loops of yarn or shoestrings.
• Practice snaps, zippers, and buttons.
• Use school tools like scissors, a tape dispenser, a hole punch, or a stapler.
• Enjoy activity books with dot-to-dot pictures, mazes, coloring, and find the hidden picture.

Do Finger Gymnastics:

 Use a Pencil:

• Do finger batons-twirling the pencil around between your thumb, index, and middle fingers.
• Climb the pencil from the point to the eraser and back using only your thumb, index, and middle finger.
• Roll the pencil from your knuckles to your fingertips and back again.

Use Clay or Playdough:

• Poke individual fingers into the clay to work on finger isolation.
• Make snakes by rolling clay between the 2 hands or on a table surface.
• Make small balls and place them in the palm of one hand. Then, using your thumb of the same hand, roll one ball out to your fingertips, then put the ball into a cup or bag. Repeat with the other clay balls, one at a time, to work on squirreling.
• Place a small ball of clay on the end of each finger, first with palms up and then with palms down, and do finger push-ups with each finger.

Squirreling with Pennies or M&M’s:

• Put 5 pennies in the palm of one hand, then use your thumb to work one penny at a time to your fingertips, then use your thumb, index, and middle fingers to place the pennies into a container.
• Place 3-5 raisins or M&M’s into the palm of one hand, then use your thumb to push one raisin at a time to your fingertips to put into your mouth.

 

 Classroom Warm-Up Exercises for Handwriting:

To Strengthen the Arm, Hand, and Finger Muscles:

1.  Play with play-dough, clay, or silly putty. Use fingers to push, pull, flatten, roll, and sculpt into various shapes. Try burying pennies, beads, or other small toys in the putty for a game of hide and seek.
2. Place clothespins around cardboard cutouts, on a box or can.  Use clothespins or chip clips to hang art projects for display, or create books by clipping pages of artwork together.
3. Play with squeeze toys such as air rockets or stress balls. Use spray bottles to mist plants or spray letters or numbers on the sidewalk.
4. Work on vertical surfaces, tape paper to a wall for drawing and writing.
5. Wheelbarrow walk with a friend or over a large exercise ball. See if you can balance on one hand to pick up items from the floor or complete a puzzle in this position. 
6. Imitate your favorite critters using animal walks.  Try bear, crab, seal, and inchworm walks.
7. Crawl inside tunnels and under pillows.
8. Side-sit and bear weight on your arms or lay on your tummy propped on your elbows while playing board games or doing puzzles. 
9. Go for a ride on a scooter board on your tummy and propel yourself using your arms. Don’t let your feet drag on the ground.
10. Get outside and play at a park or school playground. Climb on jungle gyms, monkey bars, and rock walls, or swing on a trapeze.
11. Get involved in sports that will help build strong muscles: swimming, gymnastics, bowling, or tennis. 

1. Store toys in a variety of containers, including Zip-lock bags, Tupperware, or dairy containers, and plastic bottles or jars with twist-off lids to incorporate fine motor practice into daily play.
2. Play card games like Uno and Go Fish with friends and see if you can hold all your cards while you play. Practice shuffling and dealing the cards one at a time. 
3. Start a wind-up toy collection. Test your toys by racing them on different surfaces to see which one moves the fastest, travels the farthest, or is best at staying on track. 
4. Use your fingers to place coins or buttons in a piggy bank.
5. Play with construction toys with interlocking parts like Legos, Mr. Potato Head, and miniature snap beads. The smaller the toy, the bigger the challenge. • Pick up small items with tweezers, tongs, strawberry hullers, or adaptive chopsticks and place them into containers.
6. Use broken crayons or chalk to create works of art, or try painting using a small piece of sponge to dab and spread the paint.
7. String beads, cut up straws, Cheerios, paper clips, or dried pasta to make necklaces, lace your shoes, or play with lacing cards.
8. Place pipe cleaners or toothpicks into the holes of an overturned colander, or make designs in clay, play-dough, or Gak, or make a porcupine with toothpicks in clay. 
9. Play string games like Jacob’s Ladders or Cat’s Cradle with loops of yarn or shoestrings.  
10. Practice snaps, zippers, and buttons.
11. Use school tools like scissors, a tape dispenser, a hole punch, or a stapler.
12. Enjoy activity books with dot-to-dot pictures, mazes, coloring, and find the hidden picture.

1. Use a Pencil:

• Do finger batons, twirling the pencil around between your thumb, index, and middle fingers
• Climb the pencil from the point to the eraser and back using only your thumb, index, and middle fingers. 
• Roll the pencil from your knuckles to your fingertips and back again. 

2. Squirreling with Pennies or M&M’s: 

• Put 5 pennies in the palm of one hand, then use your thumb to work one penny at a time to your fingertips, then use your thumb, index, and middle fingers to place the pennies into a container.
• Place 3-5 raisins or M&M’s into the palm of one hand, then use your thumb to push one raisin at a time to your fingertips to put into your mouth. 

• Poke individual fingers into the clay to work on finger isolation. 
• Make snakes by rolling clay between the 2 hands or on a table surface.
• Make small balls and place them in the palm of one hand, then using the thumb of the same hand, roll one ball out to your fingertips, then put the ball into a cup or bag. Repeat with the other clay balls, one at a time, to work on squirreling. 
• Place a small ball of clay on the end of each finger, first with palms up and then with palms down, and do finger push-ups with each finger. 
• Smash small balls of clay with finger tips.

•  Good in-hand manipulation skills, wrist stability, separation of the two sides of the hand, good thumb development, and hand arches. 
• The small finger muscles of the hand move in a coordinated fashion to form simple shapes and letters properly. 
• Shoulders must be strong to hold the arm so the fingers can move. 

• Strengthening and Foundational work before writing. 
• Handwriting MUST be taught and practiced. It’s not learned incidentally. 
• Practice needs to be multisensory & FUN. Practice until the skill is automatic and can be done without thinking about it. Best Daily for short periods of time. Writing rugs, on their backs, with flashlights, air writing, and clay trays with chopsticks 
• Use Two Hands: one hand holds, and the other hand moves the pencil.

Foundation Skills Development:

 

• Lite Brite (play with this lying on your stomach on the floor)
• Putting toothpicks (broken in half) into Styrofoam balls (draw a face on the ball, and they make the spiky hair)
• Putting pennies into a container with a slit cut in the top or a bank.
• Putting pennies into a tennis ball with a slit cut in it. (harder than a plastic container or bank because it also involves squeezing the ball to get the slit to open).
• Peg boards- place the board on a vertical surface at eye height to encourage the wrist to be back. This puts the fingers in an ideal position for a tripod grasp.
• Coloring with broken, small crayons 1-1.5 inches long (it makes the fingers grasp them correctly in a tripod grasp).
• Painting someone else’s fingernails. (The shorter the brush handle, the better.) It works on developing the small muscle in the thumb web space that helps to push/pull the pencil.
• Playdough- use scissors to cut it, cookie cutters, doh-stampers, rolling pins, and plastic knives to cut it.
• Water squirt bottles- have an adult or the child draw the prewriting shapes on a wall outdoors with sidewalk chalk. Pre-writing shapes include __, |, O, +.