We take them for granted, they exist at the ends of our arms, and so integrated are they in our total being, that we use muscle memory to carry out an incredible range of movements and tasks; interpret sensory signals from those supporting personal safety to those providing access to complex literature and use them creatively to express ourselves in so many ways.
If we look at the fine motor skills identified with children between the ages of 12 to 18 months…
- Point to pictures in books
- Build a tower using 2 blocks
- Use her hands together to hold a toy at the middle of her body
- Scribble with a crayon
- Point with his pointer finger
- Hold her own cup and drink, with some spilling
- Feed himself using a spoon, with some spilling
- Remove his own socks
- Put her hat on her head
…we can see that already quite a complex series of movements and understanding is expected of them.
So what if the child is not following the ‘normal’ developmental pathway? How does this impact on their interaction with others; with the world and the objects around them? From early sensory exploration through to specific skills such as handwriting, if a child cannot (or will not) isolate fingers, grasp, reach and hold we begin to build up another series of barriers for communication and learning.
It is not enough to suggest that merely making the stimulus enticing or engaging enough will evoke the correct fine motor response; we need to work on the actual ability of the child to carry out the movement successfully. So this may mean working at the very earliest stages of body (in this case hand) awareness with torches shining on their hands in a darkened room; jingling bracelets; hand massage; tactile experiences and so on.
This level of work needs to be seen as preparation for other work. So before expecting a child with profound and multiple impairments to explore a range of textures for example, it may well be necessary to massage the fingers, hands and wrists in order to release movement potential. Before a child is expected to sit and learn letter formation, or copy this week’s spelling list, they may need to run through a series of fun exercises to get their fingers, hands and brain connecting effectively.
It is also vital to correctly identify those children who are tactile defensive, for whom touch activities that we might consider everyday or pleasurable, are unpleasant, even threatening or unbearable. For these children, careful and structured support to participate in fine motor activities will be required, and stages of engagement might need to be altered or adapted, for example using brushes to paint before using hands which is not the normal way round.
As for the majority of us, these skills just develop with little or no specialist intervention, it is easy to forget that all of the ways we use our hands are skills-based. Just think of when you tried to learn to type; perhaps to play a musical instrument; to drive; to knit or sew; all of these required you to learn new ways of using and controlling your hands, and initially, this is no easy task!
So, time to think, to remember, that working specifically with hands can indeed be one of the most profitable areas of intervention that we can use. It can provide successful routes for engaging with an incredible range of learning, creative and communicative activities. To ignore this, and to allow deterioration of hand function, where no underlying deteriorating condition exists, is to crucially reduce and restrict a child’s access and entitlement.
Independent Educational Consultant.
Hear more of Carol’s ideas for engaging children in hand play at the BIG AUTISM PLAY DAY in London on 17 March 2017!