Fine motor in the Classroom

The Give Yourself A Hand Program

(by: Jayne Berry, OTR/L)
TRICS for Written Communication
(by: Susan J. Amundson)
Presented by:
Sheri Burrill OTR/L
 Hand Development
Critical for early learning and information gathering
Weightbearing/crawling/pulling up develops musculature
Provides basis for all manipulative activities and tool use
Hands manipulate the environment in order to learn
Develops proximal to distal (core to shoulder to fingers)
Increased awareness of hands (kinesthesia) is crucial for
 GOAL
Is to implement these skills without extensive investments of training,
time and money or consuming precious resources!

Seamless integration/incorporation
New Epidemic
Increased joint laxity influencing grasp patterns
Lack of readiness skills
Decreased exposure to developmental activities and environments
Video game thumbs
Many students complain of fatigue during writing, few complain of pain
until later years
3.5-4.0 year olds tripod grasp (kinesthetic awareness)
4.0 year olds forearm and wrist stability during coloring
5.0 year olds refined forearm and wrist stability
5.0-5.5 year olds refined radial manipulation and ulnar stabilization
5.0-6.0 year olds dynamic control-excursion
 AGES & STAGES SCREEN/PEABODY TEST ITEMS
48-59 months

AGES & STAGES SCREEN PEABODY TEST

48 months-Both tasks at the 42 months plus.. G 24: Child buttons and unbuttons 1 button

Copy 3 of 4 shapes G 25: Child grasps marker with dynamic tripod grasp
(l, +, O, L)
G 26: Touches fingertips of each hand successively with thumb of same hand
Unbutton 1 button
VMI 64: Child copies square
Draw picture of person with 3 of following parts:
head eyes nose mouth neck hair trunk arms hands
legs feet VMI 65: Child cuts circle

Color within shape without going outside more than

VMI 66: Child builds steps

54 months-All tasks at 48 months plus VMI 67: Child connects dots

Trace on 3 inch (small marker width) line without going off VMI 68: Child cuts square
more than 2x
VMI 69: Child builds pyramid
Draw picture of
person with 4 parts VMI 70: Child folds paper in half

Cut on line across paper

 AGES & STAGES / PEABODY TEST ITEMS
60-71 Months

AGES & STAGES SCREEN PEABODY TEST

60 months-All tasks at 54 month level plus.. VMI 71: Child colors between lines

Copy square VMI 72: Child folds paper in half twice

Copy triangle

Copy 4 of these letters V H T C A

Copy first name (Some letters can be reversed)

Hand Strength, why is it important?
Hand strength allows us to efficiently grasp and use tools
Develop skill and control for functional activities
Increased our overall awareness and control of our hands
Strengthening allows us to develop the appropriate muscles to
increase our function in everyday tasks
Writing
Keyboarding
play
Self cares: dressing, fasteners, containers, meals, hygiene, transport, doors
Hand strength (cont)
Initially writing is a visually directed task/experience
Without adequate kinesthetic awareness writing is:
Slow
Mechanical
Time consuming
Effortful
Energy drain
Emotionally taxing
Foundations for Writing
skills you need in order to learn and write effectively

Hand development: dominance and separation, manipulating small objects

Visual perception: Use of visual information to recognize/organize symbols.
Sensory Motor: Processing input from multiple sensory systems into refined motor responses.
Tool use: Use of an object to accomplish a task
Language: Concepts-Understanding auditory and visual cues. Use of words indicating size,
direction, position
Executive functioning: Ability to conceive, plan, initiate, execute, terminate actions for a
specific purpose
Visual motor integration: Processing visual input into an automatic motor response.
Motor Planning: Knowing what to do and how to do it with your body. Motor planning
contributes to automatic movement.
 Right/Left, Top/Middle,
Up/down, Space

L a n g u a g e *

Handwriting

Tool Use * Executive Function *

Spoon
Marker Recognize name
Memory
Scissors
Attention
Paintbrush Sequencing
Toothbrush

Visual motor integration

Imitate gestures
Copy manipulative
patterns
Connecting end points
Copy pre-writing shapes
Materials to develop Fine Motor skills
Tongs
Clothes pins
Small chips
Broken crayons
Games with small pieces
Legos, unifix cubes
Q-tips

Favorite activity modified!

Getting Ready to Write
STABILITY
Appropriate tools (size/proportional and feedback)
Appropriate materials and placement (attention/focus)
Instruction and understanding
Simple
Consistent
Relateable/schema
Developmental Progression
Coloring
Making marks
Scribble, single direction
Scribble, multiple directions
Scribble in general vicinity of target
Color in target with regard to outline
Color target with regard to details
Variation of stroke pattern specific to image

(% filled in, deviations, pressure, stroke pattern)- why are these important?
Pre-Writing / Writing
l - O + / \ X

Developmental progression (imitate, trace, copy, memory)

Why imitate first vs tracing
representational drawings (person, house, tree, boat)
Letters (mastery with eyes closed)
Uppercase ( developmental, consistent starts, shapes, size and placement, safety signs,
keyboard, partner letters-C J K O P S T U V W X Y Z, maybe I F L M )-83% taught
Lowercase (variable starts, shapes, size and placement on the line, increased reversals)
Consistency is key, otherwise its drawing and not automatic
Components of Legibilty
The Print Tool-companion to HWT
1. Memory (copy)
2. Starts
3. Sequence
4. Size
5. Placement
6. Spacing
7. Control
Memory
This is a cognitive task and is often misinterpreted as poor fine motor
skills
Often kids will write sloppy in order to hide their difficulty with
spelling
Have kids copy individual letters (from a near model) and compare
that to work that requires composition
True fine motor delays will yield similar results whereas cognitive
issues you will see higher skills with copying than with composition
Starts (where do they start their letters)

Many students start their letters at the bottom

What plane are they functioning in?
Many student vary where they start the same letter
In this case they are drawing and letters are not yet a symbol that represents
something but rather a combination of familiar shapes
Consistency is crucial for speed and precision as well as making room for
thoughts and ideas (content)
if it aint broke, dont fix it- its legible and they are consistent
Use starting dots, where do you start your letters, at the top song,
rainbow writing to establish motor pattern
Sequence (letter strokes)
Many student vary how they form the same letter
In this case they are drawing and letters are not yet a symbol that represents
something but rather a combination of familiar shapes
Consistency is crucial for speed and precision as well as making room for
thoughts and ideas (content)
if it aint broke, dont fix it- its legible and they are consistent
Consistent verbage for letter strokes (schema is important!), self talk
during writing, rainbow writing to establish motor memory
Struggling students may need to be taught proper formation to
reduce confusion (b d 6 p)
Size (how big or small)
Children are prone to write large
If they are given a large empty space, they will fill it!
The larger the body parts they are using to make marks, the larger the
letters will be (fingers, wrist, elbow, shoulder)
Grasp is important- where is the motion coming from?
Define writing space: use open box, shape sorter boxes, strips of paper,
Highlight word area, post it notes,
Placement (on the line)
Letters tend to float in the air above the line
Letters bisect the line as if literally on the line
Letters go just below the line
Highlight bottom line (toxic sludge), red line, add kite strings, talk
about extra writing
Choice of paper is important!
2 lined paper much less confusing.
Shape boxes for proportions
Spacing (between letters and words)
Start with tangible and progress to visualization

Make space tangible (cup full of space, seating arrangements)

Use spacers (dots, stickers, popsicle sticks, finger, circles, erasers)
Spaghetti and Meatballs (wikki sticks)
Control
Neatness of writing
Smooth curves
Straight lines
Accurate targets
Appropriate diagonal lines (slides)
Proportions (big/little, big/big, little/little) h/n

Analogies for poor control- avoid personal you

stinky letters
super heroes, diggers
tweeners
plus sign, not a T
rainbows vs divers
1:l, 2:D, 3:B, 4:L, 7:Z, 8:S, 9:a
Sneaky, peek-a-boo
fly like a kite (K)
baseball, house, line (e)
quick, get away (q)