CD: Fine motor skills

Ulnar/ Radial side

U: Power and strength

R: dexterity and precision

Dexterity

•dependent upon interaction between multiple body functions and performance skills, including

•Grasp, prehension, and manipulation patterns

•Postural mechanisms

•Cognition

•Visual perception

•Sensory processing

Factors influencing FM

•Visual skills and visual perception

•Somatosensory functions

•Sensory integration

•Cognition

•Body structures

•Range of motion

•Muscle strength, tone, and endurance

•Motor control – calibration & timing

•Social and cultural factors

•Play and sensory exploration, ADLs, IADLs

Prehension = Grasp

•Can be generally categorized as grasps for power and grasps for precision

Early grasp: First year

•Raking Grasp

•Palmar Grasp

•Ulnar Palmar Grasp

•Radial Palmar Grasp

Further grasp: 18-36 months

•Hook Grasp

•Power Grasp

•Spherical Grasp

•Cylindrical Grasp

•Disk Grasp

•Lumbrical grasp

•Lateral Pinch

Pinches

•Inferior Pincer (thumb to extended finger)

•Pincer Grasp (pad to pad)

•3-point Grasp (3-jaw chuck)

•Tip Pinch (neat pincer)

Hand function and structure

• Thumb opposition

• finger isolation

• Arches of the hand

• dissociation to two side of hands

Pre-requisite performance skills

• controlled release

• calibrating and timing

• efficient placement

In hand manipulation

•Finger-to-palm translation

•Palm-to-finger translation

•Shift

•Simple rotation

•Complex rotation

•In-hand manipulation with stabilization

Foundational Skills for
In-Hand Manipulation

•Movement in and out of supination

•Wrist stability

•Thumb-finger opposition

•Isolation of finger/thumb movements

•Dissociation of two sides of hand

•Controlled use of force at fingertips

Precursors to writing

•Balance without use of arms for support

•Voluntary grasp and release of objects

•Using hands in lead/assister positions

•Constructive play stage of development

•Ability to coordinate eyes and hands

•Exposure to a variety of sensory and motor experiences

Pre-Writting skills

•Are learned through the use of a variety of modalities

•Are acquired in a variety of positions

•Writing requires executive functioning, working memory, motor planning

Pencil grasp

•1 - 2 years: Palmar supinated grasp

•2 - 3 years:  Digital pronated grasp

•3 years:  Emerging tripod grasp

•4 years: Emergence of dynamic tripod grasp

General Development os Scissor usage

•Interest in scissors, brings to paper in attempt to imitate scissor use

•Holds and manipulates scissors, possibly incorrectly

•Opens and closes scissors in a controlled fashion

•Makes short, random snips without forward or lateral direction to cutting

•Manipulates scissors in a forward motion, aiming for opposite side of paper

•Attempts to follow a wide, straight line, making many adjustments in direction

Progression of purposeful Scissor Use

•Follows straight line accurately

•Cuts simple geometric shapes, changing direction of scissors

•Cuts simple, then complex figures

•Cuts non-paper materials