By: Nina Chesno
At The Therapy Place, we are excited to introduce our latest video series “Live with Leah”!
These short one-minute video clips get broadcasted once a week on our WhatsApp status, and we’ll also be sharing them here on the blog, and on our YouTube channel! Each week we share a common question that parents have relating to Occupational Therapy and Speech Therapy.
Leah, our experienced director, shares a valuable answer along with video content of a child performing the appropriate skill she is explaining.
These clips are a way for parents to gain information and practical tips to try at home with their children. As educators and therapists, we feel that part of our job is to provide parents with material and recommendations relating to what we do. This allows them to reinforce and further develop skills that are acquired at the Therapy Place.
Why Is Hand Strenghtening Important?
This week’s topic is about hand strengthening exercises, and how we can help young children who struggle with their hand motor skills. We often take it for granted that we use our hands to help us function daily by completing tasks. For many kids with developmental delays or disabilities, it’s incredibly difficult for them to use their hands for functional tasks. Occupational therapists aim to help these children learn and exercise their hand muscles through various activities.
In this week’s Live With Leah video, Leah Gross provides parents with practical ideas on how their child can strengthen their hands by cutting pieces of cardboard from a cereal box. In the video, you will see that Initially, the child battles to manipulate the scissors around the large piece of cardboard.
The skills required to cut are not only holding the scissors and developing the strength to cut the cardboard but manipulating the cardboard with the non-dominant hand to guide the scissors.
You will also see in the video that initially, the child uses his whole body to move when cutting the large piece of cardboard. Once the therapist provides a smaller piece of cardboard, it becomes more manageable for the child to cut it.
The Occupational therapists at The Therapy Place, develop skills from simple activities like cutting paper, to complex activities, such as cutting cardboard. This enables your child to achieve success and then advance to challenging tasks.
Some cutting activities include cutting pieces of paper or cardboard in half, then on a straight line and around different shapes. It is recommended that children who are left-handed use left-handed scissors.
How Are Developmental Delays In Hand Strength Assessed?
Initially, the occupational therapist will assess the strength of your child’s grip required for different activities.
The occupational therapist will take a case history, where she will talk to you about your concerns. This will include observation and assessment of their development.
There are developmental skills that need to be in place for a baby to master the handgrip and pincer grasps, such as core and shoulder stability.
The Palmar grasp reflex (or grasp reflex) is the first primitive and involuntary reflex, where babies grasp a parent’s finger when feeding.
4-6 Months Old
From 4 to 6 months the child develops the Palmer grasp. The baby grasps objects by pressing the fingers against the palm.
Then they develop a full-hand grasp using a few fingers and eventually using the thumb to hold an object.
Thereafter, they develop their hand and wrist muscles by picking up objects and turning them around with their entire hand.
7-8 Months Old
From about 7-8 Months babies start to develop more advanced grasping:
- a raking grasp.
- Radial grasp – the child’s thumb is on the side of the hand.
- Digital – this refers to any of the fingers .
- Palmar – The child holds their palm side up.
- Supinate – The child holds their palm facing up or forwards.
8-10 Months Old
Once they reach 8-10 months old, the child develops the pincer grasp:
- The pincer grasp involves using the thumb and index finger. Picking up blocks
- Picking up puzzles with a handle.
Developmental Difficulties To Look Out For
Some difficulties may not be expected at a certain age, such as buttoning up shirts, a zipper, and tying laces. However, if they are not able to carry out tasks that are expected within their age range, occupational therapy will be recommended.
If your child gets tired of carrying out daily activities, these may be due to low muscle tone which is part of core stability. This means that it takes more effort for the child to sit up straight to work and they do not have sufficient strength to manipulate the muscles of their fingers, hands, and wrists to hold a crayon or pencil, which impairs the pace and accuracy of their writing.
As a result, their ability to execute certain activities needed for carrying out daily living tasks and coping with the demands of school are impaired.
The occupational therapist will develop the child’s ability to use the energy of their muscles more effectively and improve their endurance for completing tasks.
Hand Strengthening Exercises
Hand strengthening exercises don’t only begin with a preschool or school-aged child. The aim of all hand strengthening exercises is to enable your child to achieve independence in play, dressing, and fine motor patterns. Hand strengthening encompasses the fingers, hands, and wrists.
Hand strengthening exercises aim to improve the strength of their grip. In occupational therapy, each hand strengthening exercise will be individually adapted to suit the appropriate needs of the child. These will be practiced using a variety of fun activities.
The child needs to develop correct patterns for holding toys, pushing blocks into holes, and opening pegs, which are great activities for improving the strength of their fingers. Later on their pattern for holding a pencil when drawing and writing will be corrected.
If they have weak hand or wrist muscles, they may tire easily and be unable to complete the work expected during class. This can become stressful for the child as he may need to remain in class during recess to catch up on his work.
This is where teamwork is emphasized. The occupational therapist will work in close contact with the parents and teachers. Most wrist activities require rotatory skills, where adequate shoulder stability is required for any tasks that require using their wrists.
Visual perceptual skills, using shapes, will be integrated into the hand strengthening exercises, where the child will be given a circle, square, and triangle to cut around. This is a higher-level skill, as the child is required to manipulate the scissors around the various shapes while holding the paper with the non-dominant hand,
Examples of Hand & Wrist Strenghtneing Exercises
The following hand and wrist strengthening exercises aim to develop correct motor patterns, so they can carry out all tasks of daily living
- Rolling playdough into a snake or other shapes.
- Popping bubble wrap
- Squeezing, or kneading play dough
- Squeezing spray bottles
- Squeezing glue bottles instead of using glue sticks
- Picking up little cereal pieces
- Squeezing pegs
- Pushing baking shapes into dough.
- Coloring with broken crayons
- Opening and closing lids of various containers: Mayonnaise bottles, Ketchup, cooldrink bottles.
- Older children may practice locking and unlocking cupboards.
- Hold their arms out in front of them with their palms up.
- Hold their arms out in front of them with their palms down and bend their wrists up and down towards the floor.
- Baking, which requires measuring ingredients, pouring, kneading, or stirring.Your child’s occupational therapist will guide you along with these activities to strengthen your child’s hands and wrists. All activities will be fun and catered to your child’s individual needs and pace of work.
What Can Cause Weakness In Hands or Arms?
Weakness in your child’s hands may be due to a broken or fractured arm, where the hand was immobilized for some time. Weakness is sometimes associated with pain. It may be difficult to hold a fork and cut with a knife. This is an example of one activity of daily living that can be affected by weak hand and wrist muscles.
Once your child has improved their hand and wrist muscles for carrying out activities of daily living, such as dressing, doing buttons, and a zipper, the next step is to develop good fine motor control for writing is important for academic competence.
Some children hold their pencils very tightly to get sensory feedback or they press very hard on the paper that it breaks. This requires them to use a greater effort when writing. Sitting up straight for writing may be difficult if your child has a low muscle tone. The occupational or physical therapist will work on strengthening core muscles and posture.
The occupational therapist will extend activities to climbing and hanging from monkey bars. This involves motor control of the whole body. This requires adequate strength and shoulder stability to use monkey bars.
Do not hesitate to contact the therapy center or discuss your or the teacher’s concerns.
These professionals work in a team to enable your child to become proficient in the skills required for playing, dressing, eating, and writing.
Admin, K. S. W. (2011, May 5). Low muscle tone. Kid Sense Child Development.
BabySparks. (n.d.). The evolution of grasping. Babysparks.Com. Retrieved March 22, 2022, from https://babysparks.com/2020/03/03/the-evolution-of-grasping/
Greutman, H. (2020, July 24). Hand strengthening activities for children. Growing Hands-On Kids. https://www.growinghandsonkids.com/hand-strengthening-activities-for-children.html
The Therapy Place. (2020, November 22). The Therapy Place. https://www.therapyplacenj.com/