in hand manipulation developmental stages

0-6 months

palmar grasp (reflective → voluntary), hands primarily used together, limited object manipulation; fingers flex around object; often ulnar side of hand is more active

6-9 months

radial palmar grasp, voluntary release begins, transfers objects hand to hand; radial side of hand becomes more active; thumb begins to oppose index & middle fingers; 2 ulnar digits flex more into palm

9-12 months

inferior pincer grasp, isolated finger movement emerging, purposeful object exploration; thumb opposes pad of index or middle finger; Thumb MCP & IP joints extend, index MCP & PIP flexes with DIP extension

12-18 months

neat pincer grasp, intentional release into containers, beginning tool use (spoon with assistance); tips of thumb opposes index & middle fingers rather than pads; more flexion in all digits

18-24 months

simple manipulation (turning pages, stacking), beginning crayon use, improved bilateral coordination

2-3 years

refined grasp control, manipulation within one hand emerging, increased accuracy with small objects

3-5 years

skilled in hand manipulation, increased speed and precision, and use of tools for functional and academic tasks

1-3 months (motor development)

swiping, inaccurate movements; cannot reach and grasp together

3-6 months (motorr development)

becomes more accurate, reaches to midline, bilateral reaching and grasping combined

6-9 months (motor development)

able to change direction of reach, reach in all directions, reach is smooth and efficient, combines reach and grasp, able to carry objects

2-5 months (grasp motor development)

voluntary grasp @ 2-3 months

thumb not involved

inefficient grasp with random release

6-12 months (grasp motor development)

active use of thumb, explores with mouth, transfers objects hand to hand

voluntary release @6-7 months

radial palmar and radial digital grasp patterns dominate

12 months to 2 years (grasp motor development)

pincer grasp by 12 months; precise pincer by 18 months

dynamic grasp for tool use by 2 yrs old

blended grasp patterns, able to grasp and move object at the same time