M1-L11: Ax Fine Motor Flashcards
_____ and ______ represent some of the highest levels of performance
Hand skills; expressive speech
What are 10 hand functions?
- grasp, hold, release
- manipulation of objects
- feeding
- shielding the body
- protection during falls
- support, balance
- communication: writing, gesture
- interpretation of sensation
- social responses
- music and art
What are the 5 dveelopments of hand function?
- Neural growth
- Sensory development
- Neuromuscular control
- Muscle strength & joint range
- Experience & practice
What is neural growth as a development of hand function?
Maturation and integrity
What are 5 sensory development of hand function?
- touch: leads the hand to grasp & the eye to look
- vision: eye-hand control
- position awareness: important for manipulation
- movement: important for development of function
- feedback for co-ordination
What is neuromuscular control as a development of hand function?
stability muscles must provide a postural background for
mobility muscles
What is the ICF participation for education?
What is the ICF participation for play?
What is the ICF participation for outdoor play?
What is the ICF participation for ADL?
What are 4 important features in the assessment setting?
- Quiet, tidy environment
- Seated at a table
- Table and chair height is size matched (ergonomic) for child
- Demonstrate using the child’s perspective (mirror image across the table may be difficult)
- Can sit across (interaction with toys) or next to child (same perceptive –> writing or tracing, using pen)
What is the order of development in the hand?
What is the age emerged, stimulus and response to the reflex grasp?
Age emerged = Newborns
Stimulus = Touch in the palm
Response = All fingers to palm
What does an atypical reflex grasp look like? When is it atypical? What is the complication?
- Persistent reflex, inability to open hand
- Could trigger continuously with own thumb in palm
- In older children
- Long term can cause contracture
What is the age emerged, stimulus, response and atypical response to the tactile grasp?
Age emerged = 10-12 weeks
Stimulus = Touch to the ulnar border
Response = Hand turns, follows then grasps
Atypical = absence of response
What is the age emerged, stimulus, response and atypical response to plucking/clutching?
Age emerged = 3 months
Stimulus = contact with clothing/fabric
Plucks = with lateral / ulnar 3 fingers
Clutches with palm and fingers
Atypical = absence, or persistent grasp
What is the age emerged, stimulus and response to m maintaining grasp on a toy?
Age emerged = 4 months
Stimulus = reaches for toy (eyes watch hand)
Response = grasps, and maintains grasp
Recognise toys coming towards them
Gross motor: prone on elbows (can reach forward to grab toy) or supine to reach antigravity
What is the age emerged for hands to feet?
6 months
- Abdominals working very hard
What is the age emerged for palmar approach?How does the child approach the palmar grasp?
- 6 months
- Child approaches toy with open hand
What is the age emerged and position for radial palamar (gross pincer)?
- 7 months
- Use base of thumb (radial) side of their hand and all fingers to grab objects into the palm
What is the age emerged and position for radial digital grasp?
8 m
- Holds with tips of thumb, index & middle fingers
- Sometimes called “Immature Tripod” or “Jaw Chuck Grasp”
What is the age emerged and position for the ranking grasp?
- 8 months
- Can see toys/food that are further away –> reach pass BOS –> rake grasp
- Need to be very careful as a parent as can start to pick up things on the floor
What is the age emerged and position for the take-from-transfer?
- 6-9 months
- Awareness of 2 sides of body
- Unable to release grip from hand
What is the age emerged and sequence (3) for the awareness of 2 sides?
6-9m
- Drops 1 object when offered another
- Holds 2 objects simultaneously
- Bangs 2 objects together
What is the age emerged and position for thefine pincer grasp?
- 9-10months
- Pincer grasp is a thumb-finger grasp
- Fine pincer – thumb to lateral border of index
What is the age emerged and position for the pincer grasp?
- 10 months
- Pincer grasp is a thumb-finger grasp
- Requires opposition – rotation of thumb pad to face index
- “Inferior Pincer Grasp” = pads of fingers
- “Pincer Grasp” = tips of fingers
What is the age emerged and position for index pointing?
- 10 months
- Index into holes in toys
- Important sensory finger
What is the age emerged and position for give-but-no-release?
Will hold out hand to give, but unable to release
What is the age emerged and position for clapping?
- 11 months
- Clapping – use of 2 sides together
- Should be able to clap by their first birthday
What are the 15 hand movements before the first year of life?
- Reflex grasp
- Tactile grasp
- Plucking/clutching
- Maintains grasp on toy
- Hands to feet
- Palmar approach
- Radial palmar (gross pincer)
- Ranking grasp
- Radial digit grasp
- Take-from-transfer
- Awareness of 2 sides
- Fine pincer grasp
- Index pointing
- Give-but-no-release
- Clapping
What is the development of the upper limb after the first year?
A time of rapid and diverse development of tool/object use (e.g. handwriting, toys and games) and higher technical skills (e.g. musical instruments, occupational tasks)
What is the age emerged and position for the posting?
- 12months +
- Placement of one object inside another with controlled release e.g. start with a small ball into hole –> longer cylindrical shape –> flat disc shape –> complex shape
- Able to manipulate object to go into slot
What is the age emerged and position for the placing of object?
- 15 months
- Placement of one object on top of another with controlled release e.g. build a tower: 3-4 cubes (18m); 6 cubes (2y); 9 cubes (3y)
What is the age emerged and position for the palmar supinate grasp?
- 12-15 months
- Grasp pencil/crayon in palm in a vertical position
- Use whole arm to colour.
What is the age emerged and development of intrinsic muscles?
- 18 months
- Interossei and lumbricales → MCP flexion and interphalangeal extension e.g. turning pages of a book
- For fine control
What is the age emerged and position for forearm rotation (pronation and supination)?
- 2 years
- Pronation → supination e.g. feeding with a spoon, look underneath an object (see pic), page turning
- Supination → pronation, e.g. helps with better posting, placing, unscrewing, page turning
What is the age emerged and position for screw/unscrew?
- 2 years
- The ability to use the fingers, hand and forearm to unscrew lids, door handles, taps etc will emerge during the 2nd year and become more advanced with age and tool exposure
What is the age emerged and position for the digital pronate grasp?
- 2-3 years
- Start of real-looking pencil grasp.
- Fingers now pointed down towards the bottom of the pencil
- Use all fingers along with whole arm movements
What is the age emerged and position for thestatic tripod/quadruped grasp?
- 3-4 years
- Use the whole pads of their fingers on the writing utensil
- There also may still be some whole arm movement
- Wrist is still, not fluidly moving
What is the age emerged and position for the dynamic tripod grasp?
5y
- Ulnar border support
- Wrist in extension, and moving during writing
- Pencil on middle finger + thumb for stability
- Index for pencil control
What is the drawing skills for the dynamic tripod grasp in 3, 4 and 5 years old?
Drawing skills
- 3y Copies circle, draws man on request
- 4y copies a cross
- 5y Draws a man and copies a triangle
What are the 2 options for alternate tripod grip?
Option 1
- Both fingers forward forming a tripod with the thumb
- Legibility and speed can be as good as dynamic tripod
- Uses the outside of the hand which is the power side
Option 2
- Thumb wraps around
What does in-hand manipulation look like?
What does tool use look like?
What does grip strength look like?
What does isolated finger movements look like?
What is the handwriting sequence?
- Palmar supinate grasp
- Digit pronate grasp
- Static tripod/quadruped
- Dynamic tripod
What is the age emerged and position for the palmar supinate grasp in the handwriting sequence?
- 12-15 months
- Grasp pencil/crayon in palm in a vertical position
- Use whole arm to colour.
What is the age emerged and position for the digit pronate grasp in the handwriting sequence?
- 2-3 years
- Start of real-looking pencil grasp.
- Fingers now pointed down towards the bottom of the pencil
- Use all fingers along with whole arm movements
What is the age emerged and position for the static tripod/quadruped grasp in the handwriting sequence?
- 3-4 years
- Use the whole pads of their fingers on the writing utensil
- There also may still be some whole arm movement
- Wrist is still, not fluidly moving
What is the age emerged and position for the dynamic tripod grasp in the handwriting sequence?
- 5 years
- Ulnar border support
- Wrist in extension, and moving during writing
- Pencil on middle finger + thumb for stability
- Index for pencil control
What are the catching ball skills from 3 years old to 8 years old?
- 3 years – catch against body
- 4 years – catch in elbows (elbows flexed,
- arms supinated)
- 5 years – catch a 20cm ball in hands
- 6 years – will move body to catch ball
- 6 years – tennis ball ‘cup catch’
- 7 years – tennis ball ‘spider catch’, pat
- bounce; pluck ball from air
- 8 years – advanced skills e.g. throw and catch self, throw to wall and catch return
What are the catching ball skills from 3 years old?
catch against body
What are the catching ball skills from 4 years old?
catch in elbows (elbows flexed, arms supinated)
What are the catching ball skills from 5 years old?
catch a 20cm ball in hands
What are the catching ball skills from 6 years old?
- will move body to catch ball
- tennis ball ‘cup catch’
What are the catching ball skills from 7 years old?
tennis ball ‘spider catch’, pat bounce; pluck ball from air
What are the catching ball skills from 8 years old?
advanced skills e.g. throw and catch self, throw to wall and catch return
What are the throwing ball skills from 2 years old to 8 years old?
- 2 years – with forearm extension only
- 3 years – throw ball overhead
- 5 years – immature underarm pattern
- 6 years – Can throw a tennis ball with trunk rotation and weight shift (*7-8 years can throw across tennis court)
- 7-8 years – early sports e.g. Net-Set-Go (netball), Kanga cricket – so development of sport specific throwing skills such as chest passing, shoulder passing, throwing from the ground
What are the throwing ball skills from 2 years old?
with forearm extension only
What are the throwing ball skills from 3 years old?
throw ball overhead
What are the throwing ball skills from 5 years old?
immature underarm pattern
What are the throwing ball skills from 6 years old?
Can throw a tennis ball with trunk rotation and weight shift (*7-8 years can throw across tennis court)
What are the throwing ball skills from 7-8 years old?
early sports e.g. Net-Set-Go (netball), Kanga cricket – so development of sport specific throwing skills such as chest passing, shoulder passing, throwing from the ground
What age are most skills developed by?
8 years old
- Most gross, fine motor control has been developed
- Most reactions/ postural control have also been developed
Want child participating in various activity to develop more skills (not ideal to only do one activity)
