Pediatric fine motor skills (grasps and dressing)

Question 1

prerequisites for using scissors

Answer 1

1. open and close hand
2. isolate movements of thumb, index, and middle fingers
3. use hands bilaterally
4. coordinate arm, hand, and eye movements
5. stabilize the larger joints so movement can happen distally
6. interact with the environment

Question 2

scissor skills

Answer 2

1. interest (age 2)
2. hold and manipulate (age 2)
3. learn that they open and close (age 2)
4. snipping randomly (age 2-3)
5. forward then lateral motions, not straight (age 2.5)
6. cut in a straight forward line controlled (age 3)
7. circles (3.5), squares (4.5), geometric shapes (age 6), figures (6), non-paper items (6+)

Question 3

in hand manipulation

Answer 3

1. finger to palm translation 12-15mo
2. palm to finger translation 2yrs
3. shift (separating paper) 3-5yrs
4. simple rotation 2yrs
5. complex rotation 6yrs
6. in hand manipulation with stabilization

Question 4

pre-writing grasps

Answer 4

1. palmar supinate grasp
2. digital pronate grasp
3. static tripod
4. dynamic tripod

Question 5

palmar supinate grasp

Answer 5

writing tool held with fisted hand, wrist slightly flexed and supinated; arm moves as a unit
1-1.5 years

Question 6

digital pronate grasp

Answer 6

writing tool held with fingers, wrist neutral with slight ulnar deviation, forearm pronated; arm moves as a unit
2-3 years

Question 7

static tripod

Answer 7

writing tool held with approximation of thumb, index, and middle fingers, middle/ring fingers slightly flexed; hand moves as a unit
3.5-4 years

Question 8

dynamic tripod

Answer 8

held with precise opposition of distal phalanges of thumb, index, and middle fingers, ring/pinky form an arch, wrist extended slightly; localized movements of PIP joints
4.5-6 yrs

Question 9

grasp of a pellet

Answer 9

Raking grasp (6 mo) - fingers ext
Inferior scissors (7 mo) - fingers flexed
Scissors (8 mo) - thumb and lateral index finger
Inferior pincer (9 mo) - ventral surfaces of thumb and index, start to see thumb opposition
Pincer (10 mo) - pads of opposed thumb and index finger
Fine pincer (12 mo) - tips of opposed thumb and finger

Question 10

grasp of a cube

Answer 10

(university of puerto rico)

Primitive squeeze - 4 mo, no thumb, bring object into body
Ulnar palmar - between 4 and 5 mo
Palmar - 5 mo
Radial palmar - 6 mo
Radial digital - 8 mo

Question 11

release stages

Answer 11

no release 0-1mo
involuntary 1-4mo
two stage transfer 5-6mo
one stage transfer 6-7mo
voluntary release 9mo
release by full arm extension and refinement

Question 12

dressing skills

Answer 12

1 - holds out arms, pulls off shoes and socks, pushes arms and legs through
2 - helps pull down pants, finds armholes in pullover shirt
2.5 - removes pull down pants with elastic waist, assists with socks on, puts on front button coat, unbuttons large buttons
3 - puts on pullover shirt, shoes w fasteners (may be on wrong foot), socks on (heel may be up), zip/unzip once on track, buttons large buttons
3.5 - finds front of clothing, unzips, buttons 3-4, unbuckle shoes
4 - orients clothes and shoes, laces shoes with some assistance
4.5 - belts in loops
5 - ties and unties knots, dresses unsupervised
6 - closes back zipper, ties bows, buttons back buttons, snaps back snaps

Question 13

toileting progression

Answer 13

1 - discomfort when wet/soiled (cries)
1.5 - sit on toilet when placed there (short time)
2 - urinates regularly
2.5 - regulated toileting with occasional daytime accidents, rarely has bowel accidents, tells someone they need to go, may need reminders to go
3 - goes independently, may need help with wiping
4-5 - independent with all toileting (tearing toilet paper, flushing, washing hands, manage clothing)

Question 14

household management progression

Answer 14

13 mo - imitates housework
2 - picks up and outs toys away with reminders, copies parents
3 - carries things w/o dropping, wipe up spills, dust/dry with help
4 - fixes dry cereal and snacks, helps with sorting laundry
5 - put toys away neatly, make a sandwich, take out trash, make bed, answers telephone, put dirty clothes in hamper
6 - household chores without redoing, wash dishes with help, cross street safely
7-9 - cook simple meals, hang clothes, manage small amounts of money, use a telephone
10-12 - cook, simple repairs, laundry, set table, wash dishes, care for pets with reminders
13 -14 - cooks meals and does laundry

Question 15

prewriting skills

Answer 15

Vertical Line – (Age 2 imitates, age 3 copies/masters)
Horizontal Line – (Age 2 1/2 imitates, age 3 copies/masters)
Circle Shape – (Age 2 1/2 imitates, 3 copies/masters)
Cross Shape (+) – (Age 3 1/2 imitates, age 4 copies)
Square Shape – (Age 4)
Right/Left Diagonal Line – (Age 4 1/2)
copy some letters and numbers (4-5)

Question 16

Child with thumb weakness, most difficulty performing

Answer 16

complex rotation because it uses thumb opposition – turning a pencil over to erase