Gripping Issues by The Shoreline Occupational Therapy Staff last updated March 2004

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Gripping IssuesbyThe Shoreline Occupational
Therapy Stafflast updated March 2004
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What do you see?

• Child has a tight grip. (No space between thumb
  and fingers)
• Child holds pencil within the palm.
• Childs thumb wraps around fingers on the tool.
  Or fingers wrap the thumb.
• Childs hand tires easily.
• Child cannot change his way of holding the tool.
• Wrist is bent down.
• Hand and arm float in the air while writing.

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Do you see this?
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Why?

• Grip patterns may be immature.
• Muscles within the hand do not work in concert.
• Grip patterns are developed through exposure to
  manipulatives and large motor activities.
• Grip patterns are habit based as a result of the
  above.
• Grip patterns are almost impossible to change as
  they are HABIT based. These grip patterns are
  observed in ALL ages, preschool through adult.
  The optimal time to change these patterns is
  preschool through 3rd grade, however, as the
  child ages, it is easier to change a habit when
  engaged in learning a new activity.

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What it should look like

• Wrist bent up-see 1 (when arm is on table, hand
  is bent upward)
• Open web space-see 2 (circle between thumb and
  fingers)
• Fingers and thumb move the tool

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2
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2 other good grips

• Quadrapod
• 3 fingers and thumb direct the tool
• Maintains position of wrist and open web space
• Adapted tripod
• 2 fingers and thumb direct the tool
• Maintains position of wrist and open web space

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How does grip effect output?

• If the wrist is bent down or the fingers not
  moving, a child engaged in writing tasks will
  have
• Difficulty controlling the tool if the writing
  space is too large
• Too tight or too loose grasp on pencil effecting
  pressure on the paper or into the tool
• Letter forms which are distorted due to poor
  motor control
• Decreased output in speed as well as volume
• Fatigue more quickly than his peers
• Child may shake or rub hands frequently during
  writing (motor)
• Child may refuse to write or take a lot of
  breaks (cognitive/social)

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Keep in Mind

• Habits are very hard to break
• This habit was likely formed several years before
  the child entered school
• The best time to teach a new habit is when
  something new is being learned
• Know your childs tolerance level for change
• Know your own tolerance level for change

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So, What Now?

• There is a lot you can do
• All students can benefit
• There are simple changes which can be made to
  positively effect the childs ability to
  participate in the classroom

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External Support - Position

• Child seated at desk with feet on the floor
• To decrease fatigue
• Desk height appropriate for child (2 above bent
  elbow when seated at desk)
• To decrease fatigue
• Position of paper - slanted to same angle as
  forearm of writing hand
• To improve the position of the wrist
• Upright surface - slant board, chalkboard work,
  tape paper or project to wall or cupboard space.
• To improve the position of the wrist
• Short pencils or crayons (1-2 in length-golf
  size)
• For increasing movement within the fingers

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External support -pencil grips

• For placement of fingers on pencil shaft
• Stickers or rubber band on the pencil shaft
• Foam gripper to assist with increased pressure on
  the tool
• Plastic gripper that helps with where to hold on
  the length of the tool and with comfort
  (available in different shapes)
• Available at Kmart or similar store OR catalog

• For specific position of thumb and index finger
• Modeling clay around pencil.
• Stetro grips identify specific finger position on
  a tool
• The Pencil Grip promotes correct grip pattern
• Available through catalog or at academic aid
  store

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Pencil Gripsfor placement for position
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External Support-Size matters!

• If you are writing within a large space (1 inch
  or more ruled paper, i.e. kindergarten paper),
  write with a large diameter tool. Ex. Fat
  crayons, Kindergarten pencil, markers

• If you are writing within a small space (less
  than 1 inch, i.e wide or college ruled paper),
  write with a small diameter tool.
  Ex. Standard 2 pencil or pen

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Pre-writing warm-ups

• Push hands Pull hands Hug yourself
  Reach

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Pre-writing warm upspull up on chair sit up
tall get outrageous sit up tall
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Free Time Activities

• Small manipulatives that include fingers moving.
  Example, Jr. Boggle game, pegs and pegboards,
  building blocks (not necessarily legos), Hi-Ho
  Cherry-O, marble games, card games, geoboards,
  spinning tops, dice games
• Hiding and retrieving small objects from clay
• An office station with tools - templates,
  staplers, hole punches, tape, paper clips,
  envelopes, small stickers, etc.
• Creating with small objects - popcorn, beans,
  buttons, packing peanuts, toothpicks,
  marshmallows, etc.
• Tool use - tongs to transfer items (moving game
  pieces to a playing place), clothespins, plastic
  knives to spread or cut, eyedroppers
• Classroom jobs - spray bottles to water plants,
  wringing out sponges, wiping down desks, picking
  up small pieces of paper from the floor, mail
  into student cubbies or passing out papers

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References and Resources

• Benbow, Mary, Loops and Other Groups, Therapy
  Skill Builders, 1990.
• Benbow, Mary, Understanding the Hand from the
  Inside Out, Developmental Activities Based on
  Hand Anatomy, Workshop, 1992.
• Benbow, Mary, Understanding the Hand from the
  Outside In, Developmental Activities Based on
  Hand Anatomy, Workshop, 1992.
• Olsen, Jan, Handwriting Without Tears, 5th ed.
  published by Jan Z. Olsen, 1999.
• Knight and Gilpin Decker, Hands at Work and Play,
  Therapy Skill Builders, 1994 (Another handwriting
  warm-up available by request)
• Web pages
• http//www.swsc.org/littlecrowsped/occupational_th
  erapists.htm
• Look for the Tidbits articles -especially winter
  issues
• www.members.tripod.com/imaware/fmotor.html
• www.shrewsbury-ma.gov/schools/beal/readiness/finem
  otoractivities.html
• http//www.drawwrite.com/grip.html