Pre-writing skills and development

 
10-12 months
 
Scribbles on paper
 
1 to 1 1/2 years
 
Palmar-supinate grasp: Writing tool held with fisted hand, wrist slightly flexed and slightly supinated away from mid-position; arm moves as a unit
 
 
 
2 year
 
Imitates horizontal, vertical, and circular marks
 
2-3 years
 
Digital-pronate grasp: Writing tool held with fingers, wrist neutral with slight ulnar deviation, and forearm pronated, arm moves as a unit
 
 
 
3 year
 
Copies a vertical line, horizontal line, and circle
 
3 1/2 to 4 years
 
Static tripod posture: writing tool held with crude approximation of thumb, index, and middle fingers, ring and little fingers only slightly flexed, grasped proximally with continual adjustments by other hand, no fine localized movements of digit components; hand moves as a unit
 
 
 
4 1/2 to 6 years
 
Dynamic tripod posture: writing tool held with precise opposition distal phalanges of thumb, index, and middle fingers, ring and little fingers flexed to form a stable arch, wrist slightly extended, grasped distally, MCP joints stabilized during fine, localized movements of the PIP joints
 
 
 
4-5 years
 
Copies a cross, square, diagonal line
 
5-6 years
 
Copies a triangle, prints own name, copies most letters
 
OT intervention to support the development of readiness skills
 
-fine motor control
-isolated finger movements
-prewriting lines and shapes
-left- right discrimination
-print orientation
-letter discrimination
 
Grasp Progression
 
Primitive grip: whole hand or extended fingers, pronated forearms; movement comes from shoulder -> transitional grip: fingers flexed with pronated forearm, radial side down progressing to supinated forearm -> mature: supinated forearm, stabilization by distal phalanges of thumb, middle, and index finger, wrist slightly extended
 
Functional grips for handwriting
 
Dynamic tripod
Lateral tripod: pencil rests on radial side of middle finger, thumb on DIP of index finger
Dynamic quadruped: pencil rests on distal phalanx on radial side of ring finger, thumb opposed to index finger
Lateral quadruped: pencil rests radial side of ring finger, thumb on DIP of index finger
 
Handwriting intervention
 
NDT
Acquisitional: handwriting taught directly and implemented
cognitive phase-develop cognitive strategy for required motor movements; associative phase- practice and self monitor, proprioceptive feedback and visual cues essential; autonomous phase- performance with minimal conscious attention
Sensorimotor: use of mulitple writing tools, writing surfaces, and positions for writing
Biomechanical: focused on ergonomic factors- sitting posture (table 2 inches above flexed elbows), paper position, pencil grips
Psychosocial: focus on improving self control, coping skills, social behaviors, and self confidence
Posted in Special Education on March 17 at 09:54 PM

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