Lecture 4: Fine Motor Flashcards
how much of a students day comprises of fine motor activities
more than 50%
what is an example of how culture might impact fine motor skills?
some cultures eat with their hands, so using eating utensils isn’t important to them
what are the 7 basic components of fine motor skill development for occupations
- Postural Mechanisms
- Hand Skills
- Patterns of Hand Function
- Cognition
- Visual Motor Integration
- Sensory Integrative Functioning
- Social Emotional Functioning
what are the 3 aspects of postural mechanisms?
Trunk Control and Stability
Shoulder Stability and Mobility
Wrist Stability and Mobility
what is trunk stability?
A strong and steady trunk (proximal stability) provides a base of support needed for activities requiring fine motor skills
what are 3 signs of trunk instability?
slouched posture
supporting body with arms
falling out of chair
what to do if the Childs feet don’t reach the ground
use stool, container, block of wood
what to do if chair is too deep or wide
add cushion/ foam to back of chair or sides
what is shoulder stability and mobility
Muscles around the shoulder joint make it stable
To write, we use slow, controlled shoulder
movements
what are 3 signs of shoulder instability?
Students may hold arms close to body or up by ears during fine motor task
May hold fine motor tools (such as a pencil) too tightly:
slight shoulder internal rotation, adduction or flexion
what is wrist stability and mobility?
The wrist should be slightly extended so the small muscles of the hand are in the best position for effectively manipulating objects.
allows for:
finger opposition and arching in the hand
Speed and precision of fine motor activities
what are 3 signs of wrist instability?
Elbow positioned above wrist (not stabilizing forearm)
Excessive wrist flexion
Excessive ulnar deviation
what are 3 activities to support shoulder and wrist development?
monkey bars
animal walks
working on vertical surfaces
what are the 5 aspects of hand skill development
arches of the hand
separation of both sides of hand
finger isolation
opposition
web space
what 2 things does fine motor skill efficiency significantly influence?
quality of the task outcome
the speed of task performance
why are hand arches important?
they allow the hand to conform to objects being held
what are 2 functional signs of difficulty with arches
difficulty with opposition and cupping hands
what are 3 activities to promote hand arches?
making balls with play-doh
shuffling cards
scoop to fill containers
what is motor separation of the two sides of the hand
radial side of hand: skilled side (precision and manipulation)
ulnar side of hand: power side (stability and power grip)
what does separation of the two sides of the hand allow us to do
crawl and carry
develop fine motor control and skilled small movements like writing, cutting, etc
what are 3 functional signs of difficulties with separation of the two sides of the hand
difficulty isolating skilled and power sides
unable to hold multiple objects
whole hand functions as unit
what are 3 activities to promote separation of the two sides of the hand
beads into bottle
operation game
taking off cap with one hand
what 4 things do finger isolation, opposition, and open web space allow us to do?
Skilled fine motor manipulation
Grasp and use tools
Finger feed
Manipulate clothing fasteners
what are 4 functional signs of difficulties with finger isolation, opposition, and open web space?
Lack of circular space between thumb and index
Difficulties with pincer grasp
“Raking” to retrieve items
“Thumb wrapped” position for pencil grip
what are 3 activities to promote finger isolation, opposition, and open web space
finger puppets
musical instruments like recorder
clothespin activities
what are 3 signs of difficulties with reach or carrying
Abduction and internal rotation is used to initiate reach
Shoulder elevation and lateral trunk flexion used as compensatory movement
Difficulty staying upright when reaching or carrying
what is the main activity to improve reach and carry
Activities to encourage reach to an item, progression of difficulty of object placement
what is the grasp pattern sequence?
Ulnar before radial
Palmar (proximal) before finger (distal) grasp
Extrinsic muscle activation before intrinsic
3 indications of difficulty with grasp
Holds items in palm rather than fingertips
Uses whole hand as a unit
Difficulty with play
what are some activities to promote grasp
Pincer Grasp – cheerios, clay
Radial Digital Grasp – peg boards, large puzzle pieces
start with larger objects first
what are the 3 major categories of in hand manipulation
translation
rotation
shift
what is Finger to palm translation
Holding with our fingers and moving it to hold it in our palms
what is palm to finger translation
Holding something in our palm to hold it with our fingers
what is simple rotation?
Turning an item in hand 90 degrees or less
what is complex rotation?
Turning item 180-360 degrees
what is shift?
Moving the item between our fingers to repositioning
what are 2 indicators of difficulties with in hand manipulation
awkward with small toys
transfers objects from hand to hand
how is cognition linked with hand function
Early exploration using manual skills helps a child learn about their environment and refine visual- motor skills
why are OTs concerned with handwriting?
Children who fall behind may miss learning opportunities, lack self-esteem, and have difficulty being accepted by their peers.
one of the most common reasons for referring students to see an OT
what is the most efficient pencil grip?
tripod
what is a hook grasp
Needed for carrying bags, lifting mugs
what is a power grasp
Handling tools, toothbrushes, brushing hair
what is a palmer supinate pencil grasp
Pencil enters open palm, fingers curl around it, arm supinated (arm moves as a unit)
what is a Palmer pronate pencil grasp?
Pencil is picked up off table into palm, arm is pronated (arm moves as unit)
what is a static tripod pencil grasp
Thumb, index, and middle finger on pencil but not precise, wrist in neutral, still unit
what is a dynamic tripod pencil grip?
Thumb, index and middle finger more precisely placed, digets 4 and 5 flexed out of the way, wrist extended. Movement happening in PIP joints
what is the order of the 7 grasps
Ulnar Palmar grasp
Radial Palmar grasp
Raking
Radial Digital
Lateral/Key pinch
inferior pincer
superior pincer
