Fine motor development process?

What contextual factors influence hand skill development?

social and cultural factors

How does culture influence hand skill development?

- determines objects held (chopsticks vs spoon)

- norms vary on age expected to achieve skills

- influence perception of child's need for manipulative materials

What are some general developmental considerations?

1. Development of movement patterns from mass to specific

2. Proximal to distal

3. Ability to combine patterns of stability and mobility

4. Joints must be able to stabilize at any point in the normal range of motion

How do somatosensory functions contribute to hand skills?

a. Haptic perception (knowledge of objects gathered

through active touch)

b. Somatosensory information guides the amount of

force required in grasp and manipulation

How do sensory integration functions contribute to hand skills?

a. Hypersensitivity can affect development of hand

skills

b. Motor planning deficits associated with limitations in

somato-sensation.

How do visual perception and cognition functions contribute to hand skills?

• Vision guides fine motor development

• Cognition influences fine motor interests, child's attention, interest in fine motor tasks, curiosity

How do skeletal integrity and cognition functions contribute to hand skills?

• Hand's joint and bone structures

• Range of motion

• Muscle function

How do strength and cognition functions contribute to hand skills?

• Limitations in strength and endurance

• Muscle tone: hyper- and hypotonicity

What is reaching?

Extension and movement of the arm for grasping or placing objects

What is grasp?

attainment of an object w the hand

What is carry?

Transportation of a handheld object from one place to another

What is voluntary release?

Intentional letting go of a handheld object at a specific time and place

What is in-hand manipulation?

adjustment of an object within the hand after grasp

What is bilateral hand use?

use of two hands together to accomplish an activity

What is the developmental sequence of reach and carry skills?

1. Visual regard

2. Midline orientation

3. Symmetric then unilateral

4. Increased smoothness, consistency, ability to adjust movement

5. Increased shoulder rotation with supination

What is the developmental sequence of grasp patterns?

1. Reflexive grasp

2. Voluntary palmar

3. Radial palmar

4. Radial digital

5. Pincer grasp, precision grasp

6. Wide variety of grasping patterns based on object size and shape.

What is the developmental sequence of in-hand manipulation?

1. Finger-to-palm translation

2. Palm-to-finger translation

3. Shift

4. Simple rotation

5. Complex rotation

What are the motor skill prerequisites for in-hand manipulation?

a. Movement into and stability in various degrees of supination

b. Wrist stability

c. Opposed grasp with thumb opposition and object contact

with the finger surface (not in the palm)

d. Isolated thumb and radial finger movement

e. Control of the transverse metacarpal arch

f. Dissociation of the radial and ulnar sides of the hand

g. Successive increases and decreases in fingertip forces.

What is the developmental sequence of voluntary release?

• Child initially stabilizes on surface to release

• Learns to release without stabilizing

• Release pattern is refined

• Learns to modulate force—demonstrates stacking

What is the developmental sequence of bilateral hand use?

• Symmetric patterns dominate initially

• Bimanual action emerges in 10-12 months

• Reciprocal and alternating hand movement

• Simultaneous manipulation

• Differentially uses two hands

What is the developmental sequence of ball-throwing skills?

1. Fling

2. Child learns to dissociate trunk and arm movements

3. Can control direction with shoulder stability

4. Accuracy and distance increase

What are some types of motor problems associated with impaired hand skills?

• Disorder in bilateral integration and control

• Trunk instability or abnormal posture

• Compensatory patterns of movement

• Inadequate isolation of movements

• Poorly graded movement

• Lack of ability to use the middle ranges of movement

• Insufficient force

• Poor timing of movements

• Limited variety of movement patterns

What are some somatosensory problems that affect hand skills?

- Poor tactile discrimination: less feedback from the hand's movement.

- CP: may have tactile discrimination problems.

- Children with developmental coordination disorder can have limited somatosensory perception

What can somatosensory problems relate to?

motor planning problems

Is degree of tactile impairment always associated with degree of motor impairment

no

How does learned nonuse affect hand skills?

children with hemiplegic CP can have learned nonuse and not use the weak arm because it is easier to use the unaffected arm

What are some disorders that cause hand skill problems in children/adolescents?

Visual impairment/blindness

Attention deficit-hyperactivity disorder

Autism spectrum disorders

Development coordination disorder

Cognitive disorders

Motor disorders