Get a GRIP...?

October 12, 2017

When a child begins to struggle with handwriting, teachers and parents are quick to grab a pencil grip - all with great intention, but it's a quick and typically temporary fix, for a deeper problem. This technique/strategy may further hinder the child's hand development, as well as invite additional issues, such as heavy pressure, to compensate for lack of strength and stability during distal motor activities. 

 

As a child begins to use tools with their hands they move through a series of developmental grasp patterns; each one building upon the last. They first assume a fisted position with thumb up (shown below), then move to fisted with thumb down pattern. 

These fisted grasp patterns are helping the child develop strength within the hand, as well as visual-motor control (using hand and eyes together). In addition, these patterns (specifically when thumb is down) begin to differentiate the two sides (power vs. refined) of the hand - so essential! Most of the purposeful movement in the early stages of tool use, comes from the shoulder girdle, with little to no isolation of wrist/hand movement.

 

As the child moves through the next phase of transitional patterns, we will often see a degree of variation. Some children might move into a pointed palmer grasp (thumb still pointing down, but index finger is extended and guiding movement), a four fingers or modified and static tripod/quadrupod grasp, and finally to a matured and dynamic tripod/quadrupod pattern (transitional progression below). Other children may go straight to a static pattern, where movement still comes from the elbow/shoulder, before assuming a dynamic pattern. Once a child reaches a dynamic pattern, they will begin to isolate wrist/hand movement while using the forearm to stabilize. You will also notice the web space begins to open up.

 

When we push children to deviate from this natural developmental progression, we encourage use of compensatory strategies (often immature or alternative grasp patterns) to adapt to our increased demands/expectations. This is when we see grasp patterns that involve thumb wraps (closed web space) to lock the pencil in place for greater stability and control, or those that cause collapsing of the middle thumb joint (hyper-extension). 

 

 

 

 

 

 

 

 

 

 

 

 

 

We might also see an increase in pencil pressure when writing/coloring/drawing if grasp patterns are immature, or a child assumes an alternate pattern as they seek additional strength and stability. 

 

Now... why can't a pencil grip help all of this? Pencil grips are great for providing added comfort, but that's about it. These grips place the hand (fingers) in a fixed and locked position; likely in a position that the child isn't comfortable in to begin with (or they wouldn't have a funky grasp we are trying to correct!). Pencil grips don't allow for that natural progression of hand development, nor do they help strengthen the hand; which is often the underlying problem. If your child has lower muscle tone (often noticeable as skin dimples on top of the knuckles), these grips begin to encourage locking of the hand and finger joints for stability and control. This can cause quick fatigue, and an aversion to using and exploring tool use over time. Do you know a child who "hates" handwriting? I bet you do!

 

More often than not, using a pencil grip to correct the "pattern" reduces strength of the hand altogether, forcing the child to use maladaptive patterns and/or increased pressure to gain stability and control of their writing tool. 

 

NOTE: Grasp patterns become most permanent around the age of 7. Correcting a grasp after 7 is difficult, which is why it's so important to allow for the developmental progress to unfold naturally. The child (their hands) will show you when they are ready to write!

 

What can I do instead of reaching for that pencil grip? 

Below is a list of great preparatory activities to get the hand ready to use tools, as well as specific accommodations/adaptations that promote adequate posture and body positioning, while encouraging the natural progression of grasp development.

 

Preparation

  • Sensory play with Play Doh, slime, silly putty, sand, etc. to wake/warm-up the intrinsic hand musculature: squeeze it, pull it, squish it, mold it, or cut it!

  • Build with small manipulatives such as Legos, K'Nex, Connectagons, Bristle Blocks, Squigz, or Zoob Challengers!

  • Create games using tongs/tweezers/chopsticks to sort, transfer, pick-up, or pinch small objects.

  • Use spray bottles, or squirt guns for a FUN way to develop hand strength!

  • Tear, rip, cut, or crumple paper: make it a race! 

  • Use scissors and squeeze glue bottles to create fun works of art, or craft projects. 

  • Commercial games such as Mr. Potato Head, Sneaky Snacky Squirrel, Don't Break the Ice, Pop Beads, Don't Spill the Beans, etc.

  • Origami or other paper folding/weaving activities.

  • Paint with q-tips or cotton balls - this requires the child to use the "refined" side of their hand and work on a pincer grasp; working on those intrinsic hand muscles!

  • Finger games such as "Where is Thumbkin", Finger Family Song, and touching thumb to each finger.

 

Accommodations/Adaptations

  • Use a more vertical surface: tape homework to the wall or window, or use a slant board to promote natural wrist extension (up to 30 degrees). 

  • Ensure the child's feet are grounded on the floor!! This means entire foot touches the floor - not just the toes. Changing to a smaller desk, or using thick books (large phone books wrapped in duck tape work really well!) to bring the floor up to them. 

  • Break crayons/chalk/pencils into smaller parts - the child is forced to use a more refined grasp to maintain a hold on the smaller tool!​

  • Add weight to the pencil (see photo to right) - so simple and inexpensive; great for ALL children! The weight provides additional sensory input to the hand, which reduces the need for them to push through the pencil (seen as heavy pencil pressure) to get the same input. The weight also encourages natural wrist extension, and ultimately a better grasp pattern overall. I use a foam pencil grip (hehe - yes it's a pencil grip) cut in half and placed on both ends of the hexagon nuts, which is where the weight comes from! I generally start with 2 nuts, but you could add or subtract based on the needs of your child. Ask them - they'll be able to tell you what feels good to them.

 

 

 

Photos taken from: 

http://www.thewritingpenstore.com/c-112-pen-and-pencil-grips.aspx

http://lifeonthevside.blogspot.com/2012/01/easy-valentines.html

http://www.lonnydeschrijvercoaching.nl/maar-wat-bedoel-je-eigenlijk-met-primaire-reflexen-lonny/

http://www.skillsforaction.com/handwriting/overview-difficulties-joint-hypermobility-DCD-dyspraxia

 

 

 

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