Gross and Fine Motor Development in Pre-school and School Aged Children

By age _________________ most of biological development for gross motor skills is evident

2

Balance requires the development of the

-vestibular system
-visual system
-proprioceptive system

Balance and coordination require

•Attention and concentration
•Body awareness and proprioception
•Bilateral integration
•Crossing mid-line
•Hand eye coordination
•Muscular strength and endurance
•Self regulation
•Postural control
•Sensory awareness
•Isolated movement

Gross motor skills at age 2 (24-35 months)

-walks alone
-runs with wide based pattern
-climb up and down stairs with support
-push and pull toys while walking
-kicks a ball
-stands on tiptoe

Gross motor skill development at age 3 (36-47 months)

-run and walk easily; change direction
-climbs up stairs independently
-pedals a trike
-jumps forward with 2 feet

Gross motor skill development at age 4 (48-59 months)

-runs and jumps
-hop on onen foot for a few seconds
-climbs up stairs with alternating feet
-throws a ball overhead
-starting to skip
-catches a ball with two hands

Gross motor skill development at age 5 (60-71 months)

-balances on one leg
-copies triangle and star
-prints name and numbers
-imitates folding paper into a triangle
-skips smoothly
-laces shoes

increasing activites and exposure =

increased skill

Integration of perceptual development + gross motor exposure facilitates

further skill development

Prehension

fine motor skills, hand function

Activities related to prehension

Reaching, grabbing, holding, manipulating objects

Components of Prehension

-stabilization
-visual regard
-approach
-grasp
-manipulation
-release

Stabilization

-all movement is considered dynamic
-hand mobility requires stability in hand muscles/joints
-stability comes from trunk and upper limb joints

the trunk

-building block for stability
-also called postural control

the ability reach depends on

•Integrity of spine
•Abdominal muscles
•Lower extremity muscles (hip extensors)
•Development must have moved down to the level of hips before reaching really can occur

What fire's first when you reach for something?

the trunk muscles!

What type of trunk contractions help with stability

isometric

What type of contractions happen in the arm during reaching?

Isotonic distal arm contraction

What determines what joint needs to be stabilized

task demands

What joints are stabilized during distal movements?

proximal joints

What joints are stabilized during proximal movements?

distal joints

Optimal forearm positioning for prehensile skills

slight pronation, supported on table top

optimal wrist positioning for prehensile skills

•Slight extension (~20-30 degrees)
•Ulnar deviation (~10 degrees)
•Places long finger flexors in best biomechanical position

Visual regard

key role in motivation for reach and grasp

Visual regard is depedant on:

•Attention (cognition)
•Visual acuity (perception)
•Ocular control (motor)

Accommodation (ocular control)

adjusting lens for distance

Convergence (ocular control)

maintaining single vision, input from both eyes

Visual perception

Ability to use visual info to recognize, recall, discriminate and understand what we are seeing

Visual regard and perception

Ability to affect accurate and controlled prehensile skills

What is the 'approach'

reaching for an object

Developmental sequence of the approach

•Random swiping (infancy) - to accurate , controlled, continuous approach

Visual motor control

•Using visual info for accurate movement to plan/guide movement
-practice is key

Power

•Forceful - fingers / thumb against palm

Sustained muscle contraction examples

•Cylindrical grip
•Spherical grip
•Hook grip

precision grasp examples

+tip-to-tip
+pad-to-pad
+tripod
+lateral (key)

static prehension (grasp)

•Object does NOT move in hand
•I.e., holding glass of water

Dynamic prehension (grasp)

•Object manipulation in hand
•Manipulating a coin to see year

grade force of movement (grasp)

•Previous learning
•Memory - weight of object

Thumb's role in grasping

-In all grasps - most important digit
-40-70% total hand function
-Ability to oppose

Index finger role in grasping

-2nd most important
-Mobility, independent musculature

Long finger role in grasping

longest and strongest

Index & long finger in grasping

-Prehensile digits
-Most stable anatomically

Small & ring finger in grasping

-Recruited for power grip
-Most mobile, yet weakest

Tenodesis grasp

Passive grasp using wrist extension
-In wrist flexion, composite extension of fingers and thumb
-In wrist flexion, composite flexion of fingers and thumb

What does manipulation involve?

small intrinsic/extrinsic muscles of fingers and thumb

Categories of moving objects with one hand:

-translation
-shift
-rotation

translation

•Moving object from fingers to palm, or vice versa

shift

•Move object on the surface or among fingers

Rotation

•Moving object around its axis using fingers

What are the types of rotation

-simple rotation
-complex rotation

Bilateral integration

bilateral hand use (differentiation, asymmetry)

Manipulation and hand dominance

•2 hands to 1 hand
•Hand dominance fully developed
•age 3 but starts as early as 2-3 months

Stereognosis

•Ability to recognize object without seeing them
•Receptors - fingertips, muscles, joints
•Memory of object makes it recognizable

Release

•Letting go of held object OR taking pressure away

crude release example

drop handle of hot pan

graded and controlled release:

from trunk, shoulder girdle, elbow to forearm, wrist, thumb & fingers

graded and controlled release examples

setting crystal glass on counter

Graded release

mastered through practice

graded release examples

-concert pianist vs. novice
-using screwdriver - adult vs. child

Fine motor skill development at 2 years (24-35 months)

-builds tower of 6 blocks
-copies horizontal and vertical lines
-reaches with both hands
-paints on easel with brush
-places simple shapes in correct holes

fine motor skill development at 3 yrs (36-47 months)

-builds tower of 9 blocks
-copies circle and cross, letters
-reaches with preferred hand
-holds crayons with fingers, not fist
-strings 4 beads using large needle
-screws/unscrews jar lids

fine motor skill development at 4 yrs (48-59months)

-builds tower of 10+ blocks
-copies square
-prints simple words
-uses scissors
-uses correct pencil grip
-strings 10 beads

Fine motor skill development at 5 years (60-71 months)

-builds 3 steps from 6 blocks
-copies triangle and star
-prints name and numbers
-uses eating utensils correctly
-traces around an object
-dress/undress independently (buttons, zippers, laces, shoes)

What are two interventions to facilitate motor development

grading and adapting

grading

•Simplify activity OR make more challenging
•Considers acuteness and prognosis

adapting

•Modify method or environment for success
•Use of assistive devices
•"Functional" hand use