Dr. Anne Zachry

occupational therapist & child development specialist

Category: Blog Posts (page 1 of 24)

Skills Needed for Handwriting

Writing is a multifaceted activity in which a child has to pay attention to many separate tasks at one time. Initially, a child has to think of a topic about which he is going to write, or formulate an idea for the text. He has to remember how to form each letter, and make sure to write the letters in the designated space and in the correct sequence on the page. Finally, there are the rules of spelling, grammar, and punctuation that must be attended to- all of this while staying focused amidst the many distractions that might occur. Considering all of these components, it’s no wonder that many children find handwriting to be a challenging task. 

The foundation for good fine motor skills is postural control, so this is usually the first area that I assess when a student is referred to me for poor handwriting skills. If core weakness is present, the child will most likely have difficulty sitting at a desk with a proper “handwriting posture.” 

Once I know that postural stability is being addressed, I typically look at some of these basic hand skills: 

  • Can the child rotate a pencil with one hand to use the eraser?  
  • Can he bring coins from the palm out to the fingertips, as if putting money in a soda machine? 
  • Can he perform that same task, with several other coins held in the palm, while bringing each coin out one at a time?  
  • Can he pick up a handful of change from a table, one coin at a time, bringing each coin into the palm and storing it while picking up the rest? 
  • Is he able to rapidly and sequentially touch the tip of each finger to the thumb? 

If the child has problems with any of these skills, it might be an indication that there is weakness in the muscles of the hands and fingers. In my next post, I will share some activities that are great for strengthening the muscles of the hands and for improving fine motor coordination. 

Developmental Milestones

Use this infant developmental milestones chart as a general guide to see what skills and behaviors are common for each age level. 

Infant Developmental Milestones Chart:

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Newborn

  • Closes fingers around toy place in hand
  • Brings hands to mouth
  • Watches adult’s face when feeding

One to Two Months

  • Regards a toy in the line of her vision
  • Holds hands open for a 5 minute period
  • Shows awareness of hands
  • Visually follows a toy past midline
  • Focuses on toy for 5 seconds
  • Recognizes familiar person
  • Smiles or gurgles to a familiar person

Three to Four Months

  • Manipulates hands at midline
  • Reaches out for toy
  • Grasps toy crudely
  • Holds bottle for one minute
  • Laughs out loud when stimulated
  • Puts hand in mouth
  • Raises head and chest when lying on stomach

Five to Six Months

  • Reaches and attains toy
  • Bangs in play
  • Transfers toy hand-to-hand
  • Grasps tiny toy with palm and fingers

Seven to Eight Months

  • Shakes rattle in imitation
  • Grasps toy with thumb and fingers
  • Pokes at tiny toy with index finger
  • Picks up food to place in mouth
  • Responds to name
  • Shows shyness around strangers
  • Rolls from back to stomach and stomach to back

Nine to Ten Months

  • Grasps pellet with thumb and index finger
  • Holds a toy in one hand- reaches with the other
  • Points with index finger
  • Good release of objects is present
  • Responds to image in mirror
  • Responds to familiar words
  • Smiles selectively
  • Sits without support
  • Crawls

Eleven to Twelve Months

  • Removes lid from box with no assistance
  • Places one cube/block in a cup
  • Removes cover to attain hidden toy
  • Repeats a performance to draw laughs
  • Drops a toy deliberately
  • Brings spoon from bowl to mouth
  • Temporarily responds to “no” or “stop”
  • Walks with or without support

Thirteen to Eighteen Months

  • Pulls to stand
  • Walks with or without support
  • Squats down and picks up a toy
  • Eats with fingers
  • Turns pages of a board book
  • Drinks from a cup independently
  • Throws a ball underhand
  • Stacks 4 blocks
  • Removes basic clothing

Nineteen to Twenty-Four Months

  • Runs with stiff legs
  • Eats with spoon (some spillage)
  • Kicks a ball forward with one foot
  • Scribbles in circles
  • Jumps in place two times
  • Points to specifics in a book
  • Assists with some dressing
  • Stacks 6 blocks

Other Types of Sensory Defensiveness

If your child has tactile defensiveness, it’s likely that there are some other issues going on as well. You might notice a resistance to eating certain textures of food, which is called oral defensiveness. If your child demonstrates oversensitivity to light and visual distractibility, it’s possible that there is some visual defensiveness going on. If certain sounds are particularly annoying or even painful to your child, this is called auditory defensiveness. One type of defensiveness that I didn’t mention in my earlier post is gravitational insecurity. This is an extreme sensitivity to heights, movement and/or a change in head position in space. When a child is experiencing defensiveness in more than one sensory system, it’s likely that this is impacting his or her quality of life. That means it’s time to seek therapy from an experienced therapist.

A common treatment for sensory defensiveness is the Wilbarger Deep Pressure Protocol. This involves deep touch pressure using a special brush along with joint compressions. The program is typically done in conjunction with a “sensory diet” of activities that include vestibular and proprioceptive input. For little ones with oral defensiveness, there are special techniques that a trained therapist will utilize to address this issue. With the Wilbarger Protocol, the therapist will provide hands-on training so that the parents and other adults who work with the child can administer the program. It is typically carried out approximately every 2 to 3 hours throughout the day. Your therapist will supply brushes or let you know where to order them.              

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