Thursday, June 4, 2009

Discard those mittens!

In a typically developing child, the development and refinement of grasp is incredibly swift. In a few short months, the baby moves from this



to this.


But children who have various developmental problems usually develop these skills more slowly and need some intervention to facilitate their progress. Delays in the refinement of grasp and fine motor function may occur due to spasticity, lack of stability in the trunk and shoulders, poor sensory processing, weakness, or poor coordination.

Some of these older children may still be using the gross grasp the baby is using in the first picture. It is almost as if they are trying to grasp and manipulate objects with mittens on. Imagine performing any fine motor task, such as putting pegs in a board or buttoning your shirt, with mittens on your hands! You would not be able to use fingers individually nor would you be able to adequately feel the objects in your hands. This is how many of our children are trying to accomplish what they want or need to do.

So what we want to do is help them discard those mittens. We want to improve their inner awareness of their hands and fingers (proprioception). We want them to improve their ability to accept and discriminate tactile input. We want them to have adequate hand and finger strength to accomplish age appropriate tasks such as taking Legos apart or pulling the cap off a marker. We want them to use each finger individually so they can pick up that last crumb of cookie or hold a pencil correctly.

Whew! We want a lot, don't we? But it doesn't have to be done overnight and it doesn't have to be drudgery. You also don't have to run out and buy a lot of expensive toys. As a home health therapist, I had to provide all of my own materials for therapy, so I usually tried to find inexpensive toys or devise my own games which would help my patients develop the desired skills. I don't claim that all of the ideas I'll present here are original, as I've drawn on the expertise of others, too. I hope the ideas I share here will be helpful to you and your child or patients.

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