Development of Grasp Patterns

When assessing a child, we look first at functionality along with other factors such as hand fatigue and pencil control, speed, and legibility. Children pick up habits for grasp patterns early on. Depending on exposure, preschool and kindergarten are the optimal times to try to make adjustments to a child’s grasp. Once a grasp pattern has been established, it’s very hard to change. As long as it is functional and not interfering with their writing speed and legibility, we wouldn’t look to intervene in changing it. If, however, it is not functional and is impacting their ability to perform adequately an occupational therapist (OT) would look to make adjustments or adaptations to the grasp.

Grasp Pattern Development

- Palmar-Supinate Grasp (1-1½ years)

  1. Pencil is held within whole hand/fist.
  2. The entire arm moves when attempting to write.

- Digital-Pronate Grasp (2-3 years)

  1. Pencil held with all 5 fingers with hand facing down towards the table and pencil across the palm. **This is the beginning of the separation of the sides of the hand.**
  2. Elbow remains still with movement coming from the shoulder.

- Static Tripod Grasp (3½-4 years)

  1. Pencil is held with three fingers.
  2. Fingers are held still with movement coming from the hand and wrist.

- Dynamic Tripod Grasp (4 ½-5 years)

  1. Pencil is held with three fingers.
  2. Grasp allows isolated finger movements to help with precision and control of writing utensil.
Components to a Functional Grasp:
  1. Holding the pencil with the thumb, index, and middle fingers with the ring and pinky fingers tucked out of the way
  2. Thumb web space (curved part between your thumb and index finger) is open
  3. No finger joints are hyperextended or overly bent
  4. Pencil movement is coming from the fingers
  5. Pencil is resting back into the thumb web space
  6. Forearm is resting on the writing surface
  7. Wrist is bent slightly backward (extended)
  8. Holding the pencil at the distal end - helps improve control of pencil

Kids pick up their own writing habits; these habits may look awkward, but if handwriting is legible, then an OT wouldn’t try to correct or change anything. As previously mentioned, OTs typically don't try to change a grasp pattern in 1st grade; we typically try to address this in preschool/kindergarten. As children grow and become more developed, their grasp patterns change over time.

Factors Affecting Grasp:

Hand strength and fine motor skills rely on the ability to control and coordinate the small movements in hands and fingers. The hand needs adequate strength to hold on to a writing utensil and to write with appropriate pressure. Mature fine motor skills are needed to produce writing by moving the pencil with the fingertips as opposed to using the whole hand.

Activities to Develop Grasp and Fine Motor Skills:
  1. Using tweezers or tongs to pick up small objects
  2. Pegboard activities
  3. Craft activities
  4. Lacing or threading
  5. Playing with Play-Doh
  6. Puzzles

-Krystan Inman, COTA/L