Handwriting Archives - Page 2 of 2 - Carolina Therapy Connection

Does My Child’s Pencil Grasp Matter?

Posted on March 1, 2022October 4, 2023

Does the way children hold their pencil really matter?

If you have a pencil handy, pick it up and notice how you hold it. Which fingers does the pencil rest between how are you supporting it? How much pressure do you use when you write? Does it really make a difference in your handwriting? The answer is YES, it does matter! How you hold your pencil really does make a difference—and it will also impact your writing. Your pencil grasp is directly related to handwriting speed and legibility, as having a mature grasp is more efficient and less tiring on your hands (Schwellnus, et al., 2012). Having a mature grasp also directly correlates with fine motor skills and your ability to manipulate other things (i.e. tying your shoes, picking up small objects, flossing, zipping up your jacket, using a fork or spoon).

Handwriting is essential for academic success and a foundation for efficient writing lies in how the child holds their pencil and the order in which letters are formed. It is important to address these concerns as early as possible. After the age of 8, changing grasp and formation patterns is difficult, but not impossible.

What are the stages of pencil grasp development?

There are several stages of pencil grasp development needed to develop a functional grasp that can be used to write efficiently and legibly. Each stage is important and helps to develop different muscles in the hand. Children typically develop control over the larger muscles of the trunk and arms before developing the smaller muscles of the hands. This is why grasp changes over time. Not all children will use all of these grasps during their fine motor development. Some children will use more than one grasp at an age as their skills develop and change. However, they should develop a functional mature grasp similar to the tripod grasp listed below.

Palmer grasp/Fisted grasp: typically develops between 12-18 months.

Digital pronate grasp: typically develops at 2-3 years.

5 finger grasp: typically develops between 3-4 years

Four finger/quadrapod grasp: typically develops at 3.5-4 years

Tripod grasp: typically develops at 5-6 years

What is letter formation?

Handwriting is a complex process that involves many skills and body functions to work in a precise manner. Letter formation refers to the order in which each line segment is produced to make a single letter. Children should learn to form letters from top to bottom and from left to right. The order in which letters are formed either aids or interferes with efficient, legible writing.

Why is proper letter formation important?

Children who have poor letter formation usually do not enjoy handwriting and/or the process takes longer than they would like.
Proper letter formation increases handwriting legibility, speed and accuracy.
Without the proper order of formation, letters are being ‘drawn’ more than formed and handwriting suffers.
Teaching proper letter formation can help to limit letter reversals such as b and d.
Practicing proper letter formation teaches higher cognitive skills ( i.e. working memory, sequencing, self-monitoring).

It’s important to note that every child’s handwriting style and process of learning is different and THAT IS OKAY! Our occupational therapists use a child-centered approach to help your kiddo become confident in their abilities while making handwriting FUN! If you are concerned about how your child forms letters or holds their pencil, an occupational therapist should evaluate your child. The therapist will determine if there are any skill or strength deficits and formulate a plan that is individualized for your child’s unique needs.

Written by: Amanda Easter, MS, OTR/L, CAS

References

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting in children. American Journal of Occupational Therapy, 66: 718–726.

Should My Child Be Using a Visual Schedule?

Posted on January 3, 2022October 4, 2023

What is a visual schedule?

As adults, many of us live by our planners. We gain satisfaction from marking off our to-do lists and being organized with our daily activities. Children are better able to learn, grow and adapt to changes using this same strategy! Although there are many types of visual schedules, they all typically contain images, symbols, photos and/or words to better communicate a task or activity. Depending on your child’s age and specific needs, their visual schedule may contain activities by the minute, hour, day or week. For example, if your child requires more structure, they may use a visual schedule that uses “first, next, then” language to communicate activities for the next few minutes. If your child requires less structure with their daily activities, their visual schedule may list tasks by hour for an entire day. Check out these examples below!

What are the benefits of a visual schedule?

Visual schedules are a powerful tool that can help kids perform complex tasks, organize their day, or follow a routine. Here are a list of benefits that result from using visual schedules:

Visual schedules provide structure and predictability. Has your child ever become upset because they didn’t want to complete a task or weren’t expecting an upcoming activity? Visual schedules provide a consistent reminder of what activity is next and can show a reward that follows a non-preferred activity. For example, if your child doesn’t like bath time, they can use their visual schedule to understand they will get to watch their favorite TV show following their bath.
Visual schedules encourage independence. Once your child becomes comfortable with using their schedule, they can help create it and plan for each day. It will also allow them to select preferred activities or rewards between non-preferred activities. When a child helps create their own schedule, the sense of independence promotes completing activities without being asked to do so.
Visual schedules reduce negative behaviors and meltdowns. When kids know in advance what’s happening, it can help them feel more in control and at ease. If there is a change in their routine, they can plan and prepare themselves for that change.
Visual schedules work with your child’s visual strengths. Although visual schedules can use words, pictures and symbols often times create ease for reading a visual schedule. You can also use pictures that are specific to your child’s household or routine. For example, you can use a picture of their favorite book using your phone camera instead of a generic or cartoon book.
Visual schedules teach a variety of skills during childhood development. Visual supports open the doors of communication, increasing your child’s ability to interact with his or her surroundings. Creating and utilizing visual schedules promote visual motor skills, fine motor skills, organization, positive self-esteem, decision making, and a wide variety of executive functioning skills.
Visual schedules can be used for more than just sequencing activities. You can use visual prompts similar to visual schedules to break down one task into steps. For example, if your child has difficulty with sequencing the steps of toileting, they can use a chart similar to the one below provided by A Day In Our Shoes.

Tips For Implementing a Visual Schedule With Your Child

Before using the visual schedule, ensure that your child understands the purpose of it and how to use it.
The schedule needs to be manageable. Start with a small schedule that only contains a few tasks and uses language such as “first, then” or “first, next, then.”
Mix preferred activities with non-preferred ones. This helps to motivate children to persevere through non-preferred activities.
Personalize the schedule with their favorite characters or colors. Use pictures of your child’s specific toys or items in the household. If your child is able, let them help create it!
Cue your child to use the schedule or ask them to check it when they begin an activity. Repetition is key!
If your child gets satisfaction from marking off completed activities, place a check box beside each task.
Use these instructions for tips on creating your own visual schedule at home.
This awesome resource from A Day In Our Shoes has plenty of FREE visual schedules you can print from the comfort of your home.

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, we offer pediatric occupational therapy to addresses concerns with things such as self-care skills, including feeding, bathing, and dressing; fine motor skills, including writing, tying shoes, and picking up small objects; neuromotor development; and sensory integration. Our occupational therapists can work with your child and family to ensure they are using the right type of visual schedule for their routine and help them create the perfect one just for them! Our experienced therapists can help your child use a visual schedule in the clinic, as well as carryover of using them in the home or school. As our team of specialists work to help your child reach their goals, you will begin to see remarkable changes in their skills and abilities. More importantly, you will see the happiness, confidence and sense of independence this brings to your child, and the peace of mind this brings to your family.

If you have any questions regarding visual schedules or your child’s development, call Carolina Therapy Connection at 252-341-9944 to speak with one of our occupational therapists! We currently offer occupational therapy, physical therapy and speech therapy in Greenville, Goldsboro and New Bern, NC.

Importance of Developmental Reflexes

Posted on December 1, 2021October 4, 2023

What are developmental reflexes?

A reflex is an automatic and instantaneous response to a sensory stimulus. Remember when you were a child at the doctor’s office and they tapped your knee with a small mallet to check if your leg kicked upwards? You didn’t decide to kick your leg, it just kicked. There are many types of reflexes like this one and almost all of us have them. In fact, we’re born with most of them. The reflexes we are born with are called primitive reflexes and the ones we develop during the first years of life are called integrated reflexes. From infancy, reflexes are vitally important for proper development of the brain, nervous system, body and sensory systems. Some reflexes are meant to stay with us our whole lives. Others are designed to be dormant after their function is fulfilled – also called integration. Check out this awesome resource from Tools to Grow to learn more about specific reflexes and how they impact a child’s function during their daily life.

What are primitive reflexes?

Primitive reflexes are present at birth and should be integrated by 12 months to two years of age. Reflexes are the basis of our nervous system and our ability to move. Reflexes are automatic movements that happen without conscious thought that help us to survive, search for food, seek protection, avoid danger, and to walk. Reflexes originate in the brain stem, which is the area of the brain responsible for survival. If these reflexes are not integrated, the body stays in “survival” and “stress” mode which can cause difficulty with concentration, anxiety, poor behavior, deficits in coordination, and poor performance in developmental skills and school tasks. There are many risk factors for retained primitive reflexes including, but not limited to, the following: multiple births, prematurity, c-sections, lack of tummy time, higher instances of alcohol and drug abuse, and poor awareness of developmental stages.

What are integrated reflexes?

Integrated reflexes are important for developing motor control. A child needs motor control to maintain proper posture at a desk in school, ride a bike, read a book, cross midline, write, and get dressed. A child with integrated reflexes has normal movement patterns to complete these functional tasks at home and at school. A child with unintegrated reflexes could benefit from skilled reflex integration therapy which will essentially train a child’s brain by establishing an efficient movement pattern that supports higher level motor skills or cognitive tasks.

How do you know whether or not your child has integrated these reflexes?

There are many common areas of difficulty that may suggest a retained reflex including the following:

“Bouncing” Child: Constantly moving, can’t sit still on a chair, hyperactive
“Noodle” Child: Leans on everything, rests head on table
“Shirt Chewers”: Constantly chewing on shirts or pencils, and touches everything
“Emotional Child”: Challenges with regulating emotions, easily frustrated or upset, difficulty with utilizing age appropriate coping strategies to calm body
School Performance Challenges: difficulty with reading, handwriting, language/speech, poor sitting balance and immature grasp on writing utensils
Coordination Challenges: Chronic body aches, poor endurance, fatigue, muscle weakness, poor concentration, fidgeting, disorganization

What does treatment look like?

Once your Occupational Therapist suspects a retained reflex, he/she will educate the caregiver on the importance of carryover for treatment recommendations. Caregivers play an important role in seeing progression in their child’s everyday activities. It is typically recommended that the child completes a set of tailored exercises to meet your child’s needs, 5-10 minutes per day, for 30 consecutive days in order to see any progress. Your therapist may recommended a reward or sticker chart in order to keep your child motivated towards an end goal. Progress can be noted short term and over 9-12 months. In addition to exercises, your Occupational Therapist will make recommendations for modifications in the school and home environments which may include changing positioning during school work, movement breaks, sensory techniques, relaxation techniques, decreasing auditory and visual stimulation, and organizational skills, just to name a few!

In order to determine whether your child would benefit from direct treatment for Reflex Integration, it is recommended that your child be evaluated or screened by an Occupational Therapist at Carolina Therapy Connection. Give us a call at 252-341-9944 today to schedule your FREE occupational therapy screening with one of our experienced and knowledgable OT’s.