Class 9 & 10 Hand Skills, Handwriting (Pediatric Eval/Intervention)

Ambulation or weight-shifting

Letting go-if reflexive, use tenodesis-voluntary at 9 months

At any point in motion, can have some stability and mobility

Finger to palm: 12-15 monthspalm to finger: 24-30 months

3 yearslinear movement of object on finger surface (usually radial)

Simple: 90 degrees, 24-30 monthscomplex: 180+, 30-36 months
useful at 4 years

Hand performs as a unit: one side stabilizes, other manipulates
6 years

6 months
7 mos.
8-9 mos.
12 mos.

Hook (like suitcase)power (gross grasp for strength, palm touches)lateral pinch (holding key)

Pincerthree-jaw chuck (more refined radial digital)sphericalcylindricaldisclumbrical (serving a plate)diagonal volar (cutting with knife, finger on top)

Reachgraspreleasein-hand manipulationbilateral skilltool usepostural alignmenthand strength

10-12 mos: scribbling2 years: imitate line, circle scribble3 years: copy vertical/horizontal line, circle4-5 years: copy square, +, /, some letters and numbers5-6 years: copy triangle and upper/lowercase letters, print name5-7 years: ready for writing

-review chart, history-observe motor control and sensorimotor skills-examine written samples (variety)-interview other team members-clinical and task observation-eval handwriting performance-select appropriate assessments to further probe issues

1-1.5 yearsslight supination, gross fisted grasp, arm moves as a unit

2-3 yearsslight pronation, held with all fingers, forearm moves as a unit