FINAL: FINE MOTOR Flashcards
Motor skills defined:
“movements that are goal-directed, organized and adaptive”
- intention = cognitive process
- organized, adaptive = precise; for specific tasks
- goal-directed = action specific
Components of hand skills:
- sensorimotor system
- muscles and skeletal system
- but also: self-efficacy, focus on and comprehension of task, motivation, perception
- experience, repetition, practice (motor learning/ control) KEY to helping kids transfer/generalize
How to determine what is needed:
- Know development.
- Know what capacities underlie skills.
- Know what is required (expectations/support)
- Know what matters to parents/child
- Use your clinical reasoning.
How to assess fine motor skills:
- work samples
- file review
- interview (likes and dislikes will give you a clue!)
- observations
- assessments: (Denver, PDMS-2, Battelle, HELP)
What do we look for?
- positioning (and their environment)
- everyday tasks
- specific tasks that challenge them
Flexor or extensor synergy pattern:
This is when movement is constrained by either flexion or extension. You can break up the pattern by applying its opposite, or try to use what is there functionally. *Consider how movement patterns work together/impact each other.
Activity demands to consider:
- objects and properties
- space demands
- social demands
- timing/sequence needed
- required actions
- required body functions and structures
Perceptual/cognitive demands to consider:
- Visual system: vis. attention (alertness, selective attn), vis. memory, vis. discrimination
- attention and cognition
- Also: Imitation, analysis, imagery, flexibility
Tx planning for hand skills:
Address:
- positioning for task engagement
- tone/postural stability (because stability typically precedes the use of mobility)
- relationship betw. sensory and motor control
Also:
- Select materials for ease of handling.
- Provide sufficient time for task completion.
- Use appropriate cueing for hand skills.
Models of practice to guide intervention: Soundbyte for
- neurodevelopmental
- developmental/acquitional
- biomechanical
- sensorimotor
Neurodevelopmental: helps brain and body make new connections that support movement
Developmental/Acquisitional: supports development and acquisition of skilled movements
Biomechanical: helps restore ability for motion w/ remedation and compensation
Sensorimotor: incorporates sensory strategies to facililate motor skills
NDT: postural preparation for fine motor skill development:
For low tone: Bounce, jump, use gross motor play to activate trunk musculature for stability.
For anyone: Sit on therapy ball or T stool for different pelvic tilt, movement, alertness.
NDT: Proximal stability and control:
- Weight bearing on arms is good prep. for fine motor activities. (It usually develops through crawling but can be activated via side sit with leaning or reaching other arm across.)
- Vertical surface for writing (for support)
- tummy time
NDT: Forearm rotation
- stabilize humerus against trunk (elbows at 90) in proneto for pronation
- elongation of ulnar side of wrist (to stretch supinators)
- gentle oscillation ulna/radius (to stretch fascia)
NDT: for wrist extension / hand expansion
- wt bearing activities on flat hands: wheelbarrow, donkey kicks
- slantboard, easel, chalkboard, (vertical surfaces)
- rolling pins
- heavy work - moving chairs, holding heavy bag - to develop stability (correct flexion if you see it)
- wt bearing on open hand (lateral movement, anterior/posterior weight shift)
- *to open flexed hand: pressure on thenar eminence, then open hand out to radial side to encourage extension and E.R.
NDT: arch development for grasp
- pressure on mid-palm to facilitate arches
- tapping (for low tone)
- wt bear on hands with something held in palm
- for spasticity: just firm pressure / opening
Developmental/Acquisitional to develop and acquire these skilled movements:
forearm supination/pronation: open doors, screw lids on / off, turn over cards, spin tops, scoop/dump rice
radial/ulnar dissociation (precision/power grasp): squirt bottle, ASL, putty, clothespins, syringe, tongs
development of arches (dice in cupped hands, squeeze-purse, balance books atop fingers)
distal finger control (put penny in bank, use pushpin, pegboard/lite brite, lace boards, dress up w fasteners)
perception (explore visually for similar different things, physically manipulate objects, repetition, variation)
Biomechanical solutions for:
- balance
- stability
- grasp/release
- shaking, tremors
- limited vision or visual perception
- for balance: foot rest, side or arm support
- for stability: overstuffed chair, corner chair, arms on desk or lapboard
- for grasp/release: electric scissors, loop scissors
- for shaking, termors: weighted cuff
- for limited vision: constrast colors, thick lines, colored glue
Biomechanical approach to positioning:
Support sitting and positioning with:
- chair height
- chair support
- table height
- position of toy/task
Biomechanical approach to materials:
Use alternate materials:
- enlarge
- lengthen
- amplify characteristics
Sensorimotor approach for writing tools, writing surfaces, positions:
not sure. vibrating pen?
Things to consider for school readiness:
- perceptual readiness
- linguistic readiness
- maturity of pencil control (grasp?)
- first 9 forms of the VMI
- kinesthesis
- fine motor skills
- visual motor abilities
- posture
pre-req’s for using scissors:
- balance, shoulder stability
- forearm control, wrist stability
- grasp, finger isolation, release
- lead assist (?)
- eye-hand coordination
- developmental readiness includes: interest in materials, holds eating utensils in distal part of fingers, shows dominant and assistive hand use w cutting
TRUE or FALSE: cognitive development and motor development are not connected
FALSE. They are closely related and have a reciprocal relationship, each contributing to the development of the other.
What is the overall goal with fine motor skill intervention?
The child’s ability to engage in occupational tasks with greater skill.
What intervention model is typically used for hand skill intervention?
Hand skill intervention typically integrates a variety of strategies and models to address all possible aspects of problems.
