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Why Is A Full Occupational Therapy Evaluation Beneficial When My Child’s Only Difficulty is Handwriting?

Child practicing handwriting

Handwriting is a complex task that involves many prerequisite skills, including visual skills, ocular motor control, body awareness, fine motor planning, shoulder stability, and hand and finger strength. Each prerequisite skill contributes to efficient and fluid handwriting:

  • Visual skills are needed to accurately distinguish and interpret letters and shapes on a page, essential for writing. Ocular motor control is needed to move one’s eyes across the paper to write in an organized manner.
  • Body awareness is required to accurately move the hands for writing, as well as knowing how much force is needed to make marks on the paper with the pencil or pen.
  • Fine motor planning is needed so that your child can easily identify, plan and execute the task of writing letters, words and sentences.
  • Shoulder stability is required to control the pencil.
  • Hand and finger strength is required for endurance that is needed to write many letters to form words and sentences. Hand strength is also needed for an appropriate grasp on the pencil.

In order to address handwriting in therapy, it is imperative for the occupational therapist to assess your child’s current level of functioning in each of the above areas. The root cause of your child’s handwriting difficulties may be his or her struggle in either one area or multiple areas. A full occupational therapy evaluation is very comprehensive; it allows the therapist to get a baseline level of performance to identify your child’s strengths and weaknesses in the prerequisite skill areas, and unveil the source of your child’s difficulty with handwriting.

Following the evaluation, your therapist will develop goals based on your child’s performance and design a treatment program that concentrates on improving these foundational skills, and ultimately improve his or her handwriting organization and legibility.

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How Household Materials Can Be Used For Occupational Therapy Goals

In occupational therapy sessions, we often use common materials and games to make our sessions therapeutic and fun.

Here are some ways that you can use materials and equipment that you may have lying around at home to help your children reach their occupational therapy goals:

Children play household games

  1. Board Games Board games are a great way to help your children develop their social skills and fine motor skills. Board games can be a way to improve eye contact, turn taking, and sharing. Many board games, such as Battleship, Trouble, and Perfection, involve small pieces that need to be placed into the game board. By having your child use his fingers to manipulate these pieces, it can help him understand how to hold small objects which can facilitate learning how to properly hold writing utensils. In addition to helping to hold small pieces, it can also assist your child to develop other fine motor skills, such as manual dexterity and in hand manipulation skills. For example, you can have your child hold onto several of the pieces with one hand and put them into the game board one by one. Using board games that also have cards, such as Sorry, can also help improve manual dexterity by means of shuffling, dealing, and manipulating the cards without dropping them or revealing them to the other players.
  2. Play-Doh Play-Doh is a wonderful tool to improve fine motor skills in children. Play-Doh can be used as a medium to practice writing, drawing, and cutting. You can trace different geometric forms (circle, square, and triangle) into the Play-Doh with a pencil and have you child copy the shapes in another piece of flattened Play-Doh and cut them out with scissors. Using Play-Doh to practice drawing and cutting is often a good precursor to writing with a pencil and paper as the texture of Play-Doh is more resistive which makes cutting and tracing easier. Play-Doh can also be used to help strengthen the small muscles in their hands by rolling it into a snake, ball, and flattening it into a pancake.
  3. Puzzles Puzzles can be used to help your children improve their visual-perceptual skills which is important for many school tasks, such as copying things from the board and finding items in their desk. The complexity of puzzles can very greatly, from simple large peg puzzles in a wooden form to 100 piece jigsaw puzzles. If you have an older child, using a complex jigsaw puzzle can be a great way to work on planning, sequencing, organizing, and problem-solving skills.
  4. Playground equipment Using the playground or the jungle gym in the backyard is the perfect way to help your children increase their core strength, upper body strength, and bilateral coordination. This will help build up the strength in your children’s larger muscles so that when they have to work at their desk or a table, their core and upper body will have the stability and endurance to sit and complete fine motor activities.
  5. Balls Playing catch, kicking, dribbling, and volleyball are just a few of the many ways balls can be therapeutic. All of these activities involve using eye-hand coordination, balance, and core strength which are great skills to have for a variety of gross motor and fine motor activities. These activities can also help with ocular motor skills as your child needs to track the object through space.

There are many types of equipment and materials used during therapy that can be adapted to meet the needs of your child. You can find these materials and many more around your house in order to improve your child’s skills so he or she can be successful in school and play activities!

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Using Games as Fine Motor Practice to Improve Handwriting | Pediatric Therapy Tv

In today’s Webisode, an Occupational Therapist introduces us to beneficial games and tools to aid efficiency of handwriting practice for children.  For more on your child’s handwriting, click here.

In this video you will learn:

  • How certain game pieces prepare your child for writing
  • Which games are recommended to use for handwriting practice
  • Useful tools to warm up hands for writing

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now, your host, here’s
Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman and today I’m standing here with a Pediatric Occupational
Therapist, Lindsay Miller. Lindsay, can you explain to us what are some
games that you can play with children to help with their fine motor and
handwriting?

Lindsay: Sure. Some of the games that I like to play with children involve
small pieces and small pegs, such as this piece right here. This is from a
game called HiHo CherryO, and you use it by holding your thumb and your
index finger and middle finger to hold onto the piece. So that kind of
mimics the way that you would hold a writing utensil, such as a pencil.
Other games include Lite-Brite and Battleship. This is a piece from Lite-
Brite, and, again, you can see that I’m holding it with my thumb, index,
and middle finger. So it’s kind of a way to warm up the hands, before we do
handwriting tasks.

Some other games that I like to use with children involve tongs or
children’s’ chopsticks or tweezers. These are tongs, and, again, you can
see that I’m using it with my thumb, index, and middle finger, which mimics
the way that you would hold a writing utensil. Some examples of games that
use tongs and tweezers would be Operation and Bed Bugs. So those are just
some of the ways that I like to warm up the hands before we do handwriting
tasks.

Robyn: All right. Thank you so much, Lindsay, and thank you to our viewers.
And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

What do Occupational Therapists Look for During your Child’s Handwriting Sample?

Handwriting is a lifelong skill. It begins as young as 3 years of age, when children start identifying shapes, letters, and numbers.  Handwriting and letter recognition are important for communicating (e.g. sending cards and emails) and for completing age-appropriate tasks (e.g. homework assignments; writing grocery lists).child pencil grasp

Below are many of the components your child’s occupational therapist looks for during a handwriting sample in order to work towards a clear and legible final product:

  • Sizing: Are the letters all relatively the same size (e.g. all upper case the same size and all lower case the same size)?
  • Spacing: Are the letters and/or words too close together?  Or is there at least a finger or pencil width between each word?
  • Mixing of upper case and lower case:  Is there inconsistency between the use of upper case and lower case letters?  Are upper case letters used correctly (e.g. start of a sentence or for a name/title)?  Mixing of upper case and lower case letters is appropriate until 6 years of age.
  • Capitalization: Are names, titles, and beginning letters of a sentence appropriately capitalized?
  • Formation of letters Does the child form each letter in the right direction?  (e.g. ‘b’, ‘d’)  Does the child use the correct number of lines and curves? (e.g. ‘m’, ‘n’)  Letter reversals are appropriate until 7 years of age.
  • Complete sentences Are there clear and complete thoughts?  Is the correct punctuation used at the end of the sentence?
  • Floating letters: Do all of the letters sit clearly on the line?
  • Pencil grasp:  Does the child hold the pencil or marker age appropriately?  The static tripod grasp is expected around 3 ½ – 4 years of age.  This is when the pencil is held between the thumb and index finger, with the pencil resting on the middle finger and the child uses and moves his wrist/arm to make movements with the pencil.  The dynamic tripod grasp is expected around 4 ½ – 6 years of age.  This is when the pencil is held between the thumb and index finger with the pencil resting on the middle finger, and the child uses and moves his fingers to make movements with the pencil.
  • Posture in chair:  Is the child slouching or falling out of the chair?  Is the child propped or leaning?  Are his feet flat on the floor?  Is the table the appropriate size?
  • Pressure used:  Is the child’s writing legible?  Or does he press down too hard or too lightly with the pencil, causing the writing to be hard to read or his hands to fatigue more easily?

This list of handwriting aspects may give you ideas of what to look for in your child’s handwriting during activities/assignments at home.   If you notice that your child is having trouble in any of these areas, encourage him to focus on one of those aspects each time he practices writing (to break down the task).  Your child will work on these aspects of handwriting during his occupational therapy sessions, but it is also very important to provide your child with similar learning opportunities and feedback at home.

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