The maturation of fine prehension in yound children

Qualitative age-related changes in fine motor skill performance among 3- to 6-year-old typically developing children

This study described intra-task fine motor skill components of the Manual Dexterity tasks (Posting Coins; PC, Threading Beads; TB, Drawing Trail; DT) of the Movement Assessment Battery for Children-2 Test for typically developing children and investigated age- and sex-related differences. Three- to six-year-old Dutch children (n = 182, Mage 4.5 ± 1.1 years, 51.1% boys) were observed with regard to intra-task fine motor skill components, and changes in intra-task components of the Manual Dexterity tasks were analyzed across age using of the Kruskal-Wallis test with post-hoc Mann-Whitney U tests, and differences between sexes using the Mann-Whitney U test. The following intra-task components were observed: grip type, manipulation, non-dominant or non-writing hand, grip position, posture, head, coin placement, placement of the bead on the lace tip and joint movement. Results showed that the younger children (3-year-olds) more frequently used a grasp with the full hand (PC, TB), more often put the coin on the container and sliding it in (PC), more often supported the side or top of the container (PC), used more bi-manual manipulation (transferring from hand-to-hand or hand, body or surface assist) (TB, DT), more frequently used primitive, too high grips, predominantly used their proximal joints, and did not support the paper (DT). This in comparison with more frequent use of three-point pinch, direct coin placement, grabbing the front or back of the container, in-hand-manipulation, mature grips and correct height, distal joint use and supporting the paper from the side or below by most 5- and 6-year-olds. Furthermore, most sex-related differences were found in the younger age-groups (3- and 4-year-olds) in the DT tasks with girls outperforming boys. Results from this study add to the knowledge on qualitative fine motor skill performance in a convenience sample of 3- to 6-year-old typically developing children. A limitation of the current study was the relatively small sample size of 6-year-old children. The strength of the current study is its novelty in providing qualitative descriptions of intra-task fine motor skill components in typically developing 3- to 6-year-old children.

Kinematic analysis of handwriting movements and pencil grip patterns in children with low vision

PURPOSE

Handwriting skills are important for the academic life of children and the lack of visual-motor performance leads to writing problems in children with low vision. This study aims to reveal handwriting kinematics and pencil grip features in children with low vision by means of a novel method.

MATERIALS AND METHODS

18 children with low vision (mean age: 9.83 ± 1.54 years) and 18 children with typical development (mean age: 9.83 ± 1.62 years) were included in the study. Children performed a sentence writing task on a digitizer tablet. During the task, the writing hand of children was photographed to analyze pencil grip patterns.

RESULTS

Children with low vision performed greater stroke size except for the vertical size, slower writing speed, more dysfluent movements, and less pen pressure than children with typical development. However, participants preferred mature pencil grip patterns and had high grip scores independent from the diagnosis.

CONCLUSIONS

The findings indicate that children with low vision have difficulties in handwriting in terms of spatial and temporal features. These results would be important for interventions to develop specific programs on writing skills to support their educational life.

Guidelines for designing age-appropriate cooking interventions for children: The development of evidence-based cooking skill recommendations for children, using a multidisciplinary approach

Cooking interventions have been criticised for their weak designs and 'kitchen sink' approach to content development. Currently, there is no scientific guidance for the inclusion of specific skills in children's cooking interventions. Therefore, a four step method was used to develop age-appropriate cooking skill recommendations based on relevant developmental motor skills. The steps include: 1) a critical review of academic and publicly available sources of children's cooking skills recommendations; 2) cooking skill selection, deconstruction and mapping to relevant motor skills; 3) grouping the cooking skills by underlying motor skills for age appropriateness to generate evidence based recommendations; 4) establish face validity using a two-stage expert review, critique and refinement with a multidisciplinary international team. Seventeen available sources of cooking skills recommendations were identified, critiqued and deconstructed and cooking skills mapped to developmental motor skills. These new recommendations consist of 32 skills, across five age categories: 2-3 years, 3-5 years, 5-7 years, 7-9 years, and 9+ years. The proposed recommendations will strengthen programme design by providing guidance for content development targeted at the correct age groups and can act as a guide to parents when including their children in cooking activities at home.

The Relationship of Motor Coordination, Visual Perception, and Executive Function to the Development of 4-6-Year-Old Chinese Preschoolers' Visual Motor Integration Skills

Visual motor integration (VMI) is a vital ability in childhood development, which is associated with the performance of many functional skills. By using the Beery Developmental Test Package and Executive Function Tasks, the present study explored the VMI development and its factors (visual perception, motor coordination, and executive function) among 151 Chinese preschoolers from 4 to 6 years. Results indicated that the VMI skills of children increased quickly at 4 years and peaked at 5 years and decreased at around 5 to 6 years. Motor coordination and cognitive flexibility were related to the VMI development of children from 4 to 6 years. Visual perception was associated with the VMI development at early 4 years and inhibitory control was also associated with it among 4-year-old and the beginning of 5-year-old children. Working memory had no impact on the VMI. In conclusion, the development of VMI skills among children in preschool was not stable but changed dynamically in this study. Meanwhile the factors of the VMI worked in different age range for preschoolers. These findings may give some guidance to researchers or health professionals on improving children's VMI skills in their early childhood.

Development of Pencil Grip Position in Preschool Children

Pencil grip is an aspect of handwriting that has been addressed by occupational therapists who treat children with handwriting difficulties. However, there has been little research investigating the developmental progression of pencil grip in Taiwanese children. Without knowledge of normal development, therapists cannot justify a diagnosis of “unusual” or “bizarre” pencil grips.

This study was designed to investigate the developmental progression in pencil grips in Taiwanese children. The subjects were 326 children aged 2.5 to 6.4 years. The type of grips each child used to perform a drawing task was videotaped. A developmental assessment of pencil grips compiled by Schneck and Henderson was used to rate children's grip positions.

A developmental pregression was noted and 14 grip patterns were identified. About half of the 3- to 3.4-year old children were able to employ a mature grip when drawing in a 7.89 cm x7 cm box. By the age of 4, about three fourths of the children were able to use mature grips to draw. For children aged 5 years and older, the percentage increased to more than 90%.

Comparison of the results with those of Schneck and Henderson (1990) suggests that Taiwanese children 3.5 to 5.9 years of age are more advanced than American children of the same age. In addition, the percentage of Taiwanese children using the lateral tripod is much higher than that of American children. Possible reasons for these differences are proposed. Implications for occupational therapy and suggestions for future studies are discussed.

Tool Using

Research on the development of tool use in children has often emphasized the cognitive bases of this achievement, focusing on the choice of an artifact, but has largely neglected its motor foundations. However, research across diverse fields, from evolutionary anthropology to cognitive neuroscience, converges on the idea that the actions that embody tool use are also critical for understanding its ontogenesis and phylogenesis. In this article, we highlight findings across these fields to show how a deeper examination of the act of tool using can inform developmental accounts and illuminate what makes human tool use unique.

Effect of Pencil Grasp on the Speed and Legibility of Handwriting in Children

OBJECTIVE. Pencil grasps other than the dynamic tripod may be functional for handwriting. This study examined the impact of grasp on handwriting speed and legibility.

METHOD. We videotaped 120 typically developing fourth-grade students while they performed a writing task. We categorized the grasps they used and evaluated their writing for speed and legibility using a handwriting assessment. Using linear regression analysis, we examined the relationship between grasp and handwriting.

RESULTS. We documented six categories of pencil grasp: four mature grasp patterns, one immature grasp pattern, and one alternating grasp pattern. Multiple linear regression results revealed no significant effect for mature grasp on either legibility or speed.

CONCLUSION. Pencil grasp patterns did not influence handwriting speed or legibility in this sample of typically developing children. This finding adds to the mounting body of evidence that alternative grasps may be acceptable for fast and legible handwriting.

Effects of pen design on drawing and writing performance

Two experiments are reported with the aim of determining the effect of pen shape and size on two different types of task: drawing and writing. Experiment 1 attempted to determine the optimum shape and size of shank for ball-point pens used to perform an accurate drawing task. Twenty-seven participants used a total of nine different pens. Drawing performance was measured by having the subjects follow mazes of different size. The dependent variables were drawing movement time and drawing accuracy. The results indicate that the pen with an equivalent diameter of 8mm had the best accuracy during drawing, even though it had the lowest speed. The results confirm the applicability and validity of the Drury tracking model for such a task. Even though users tended to prefer larger pens, their accuracy with such pens tended to be low. In a second experiment, subjects performed a writing task (with no accuracy constraints) and rated their preference for types of pen. An attempt was made to determine the preferred dimensions of ball-point pens for writing in Chinese and English. A total of 36 'bare-bodied' pens and 20 Chinese subjects were used to evaluate the effects of shape, size and weight on time to write a sentence. The Writing Ability, Comfort and an Overall Rating were given by the subjects. The results indicate that the Chinese subjects preferred a circular shaped pen for writing in both languages. A factor analysis showed that speed, comfort and writing ability are independent parameters in pen evaluations.

Task constraints on preschool children's grip configurations during drawing

Traditional accounts of motor development have described the development of grip configurations in terms of a global maturational change from immature to mature grips. We present data that demonstrate that the grip configurations of preschool-aged children are greatly influenced by task demands and are more variable than previous research has suggested. Grip configurations were most variable during free drawing. Three- to 4-year-olds with highly variable grips produced poorer quality drawings in a shape copying task than children with relatively stable grips. It is argued that the study of the development of drawing skills may best be captured by an approach which emphasizes the role of task requirements and various external and internal constraints which shape variability in grip configurations.

Quality of motor performance in preterm and full-term 3-year-old children

BACKGROUND

A combined assessment of motor performance and behaviour (CAMPB) was introduced previously for use in a longitudinal study of children who needed neonatal intensive care (NIC) and were born very preterm (n = 68), moderately preterm (n = 81) and full-term (n = 77) and in a reference group of neonatally healthy full-term children (n = 72). Aim To follow up the quality of motor performance at 3 years of age in the above groups of children.

METHOD

A detailed assessment of motor performance and an assessment of co-ordination were performed according to the CAMPB protocol. The results were compared between the different groups of children, and the relation between the two ways of assessing quality of motor performance was examined.

RESULTS

The detailed assessment showed that the very preterm children had a significantly higher total score of deviations than any of the other gestational age groups of children. Also, some types of deviations were much more frequently observed in the very preterm children than in the other three groups. Some types of deviations were more often seen in children with pronounced incoordination than in children with no incoordination. The results from the two ways of assessing motor performance were strongly correlated.

CONCLUSION

At 3 years of age, NIC children born very preterm have a lower quality of motor performance than NIC children born at a higher gestational age and healthy children born at term. The two ways of assessing quality of motor performance proved useful in identifying children with deviations indicating minor motor impairments.

Determining the effectiveness of pencil grips: an electromyographical analysis

Objective data regarding the effectiveness of various shaped pencil grips is not available to support the recommendations of such tools by occupational therapy practitioners. Eighteen right-hand dominant participants, ages 18 to 35 years, completed a writing sample using the three writing tools being tested: a standard #2 pencil with no grip, a standard #2 pencil with a triangular grip, and a standard #2 pencil with a pear-shaped grip. Surface electromyography was used to record the muscle activity in the four primary muscles used during handwriting to determine which writing tool elicited the least amount of motor unit recruitment. Although no significant difference was found, trends were noted that warrant further investigation to ensure practitioners recommend the appropriate pencil grip.

A model for combined assessment of motor performance and behaviour in 3-year-old children

This paper presents a new model for combined assessment of motor performance and behaviour (CAMPB) in 3-year-old children. It is intended for simultaneous use with a scale for assessment of motor-perceptual development. The child's performance is observed and compared with detailed descriptions of performance in gross and fine motor functions, and descriptions of coordination, attention and social behaviour, included in a protocol. An overall evaluation is also made. These assessments have been performed in a longitudinal follow-up study of children who needed intensive care neonatally and a control group of 72 neonatally healthy children. In this report the results from CAMPB assessments in the control group are presented. CAMPB together with the motor-perceptual scale was feasible in these 3-year-old children and CAMPB was sensitive enough to detect differences between children. The motor performance in most children conformed with the descriptions of gross and fine motor function in the protocol, and clear deviations were few. Seven per cent of the children had considerable problems in motor function and/or perception, in combination with a lack of attention, according to the overall evaluation.

Childhood dysgraphia. Part 1. An illustrated clinical classification

In this paper we propose a clinical neurological classification of childhood dysgraphia (medical model). The subject is introduced by briefly considering the childhood learning disorders as a whole, and subsequently dysgraphia will be considered in particular with description and illustration of the different types. In our second paper we report a detailed neuropsychological study which we made of 66 children with dysgraphia. In view of the differing definitions used between professionals, this first paper is an attempt to define the terms used in our classification so that subsequent statistical analysis of individual factors in aetiology and neurology can be interpreted.

A neurological study of hand function of hemiplegic children

Twenty-five children with hemiplegic cerebral palsy between the ages of five and 15 years were examined in more detail, using a torque generator motor. A significant reduction in distal power, fatiguability and speed of movement was found on the hemiplegic side. Proximal power was relatively well preserved. Muscle tone, as would be expected, was significantly increased on the affected side and this was demonstrated by a significant rise in measured resonant frequency. Phasic spasticity in response to stretch was found on EMG to be much more common than phasic and tonic combined. Hand function correlated well with the loss of distal power and speed of movement. There was wide individual variation in the relationship between increased muscle tone and hand function. Thixotropy was normal in spastic muscles. Use of the unaffected hand had a marked effect on muscle tone and EMG of the affected side.

Developmental assessment: 18 months to 4 1/2 years. Performance tests

Performance tests of young children in the age range 18 months to 4 1/2 years have been studied in a sample of 425 children living in an inner city area and a rural market town. Our results show that there is a minimum number of cubes built into a tower related to age which may indicate developmental delay. There is a developmental sequence of pencil grasp, and useful development scales in copying cube models, drawing geometric shapes, and the draw-a-man test. Girls are significantly ahead of boys in drawing skills.

A classification of manipulative hand movements

The nature of manual manipulation of objects is discussed. It is argued that a functional distinction should be made between palmar grips which immobilise an object in the hand, and digital patterns which permit manipulation. Such a distinction is separate from any anatomically defined power and precision configurations. Manipulative hand movements may be grouped into three classes, based on differences between sequenced patterns of movement and synergies, the latter being further subdivided into simple and reciprocal patterns. Within each of the three classes, a number of individual movement patterns are described. These differ mainly in the number of digits involved and the way in which the thumb is employed. The classification is concerned with movements of the digits directed at manipulating an object within the hand. It is not concerned with movements of the hand as a whole, using the wrist or more proximal joints, while holding an immobilised object.

Qualitative changes in dynamic tripod grip between seven and 14 years of age

The dynamic tripod grip during handwriting was examined among seven- to 14-year-old children. Four components were measured: (a) degree of index-finger flexion; (b) degree of forearm pronation/supination; (c) number of fingers used on the pencil shaft; and (d) thumb and forefinger opposition. Developmental trends were identified for measures (a) and (b), suggesting refinement of the dynamic tripod grip with age.

A method of developmental assessment at four years and some associated findings

A method of assessing the developmental status of 4-year-old children, which can be included in a comprehensive medical examination, is described. It was designed for research purposes, so that a global score, and separate scores for each sector of development, are obtained. Girls, children in the upper social classes, and those who attended nursery school had higher scores, in general, at this age. The importance of assessing and investigating the factors associated with lack of cooperation is stressed.