Pediatric Occupational, Physical, Behavior,
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1080 Neal Street, Suite 300
Cookeville, TN 38501
Phone: (931) 372-2567, Toll-Free: (877) 372-2567
Fax: (931) 372-2572
Email: covd@covd.biz
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Creeping and Fine Motor SkillsCenter of Development 931-372-2567
Occupational Therapy Recommendations Increase use hands and overall fine motor skills *When a child crawls on their palms and is weight bearing through their arms and hands, this is the beginning of motor coordination, fine motor development, and strengthening and development of the small muscles in the hands. If a child does not weight bear on their palms with the fingers spread and wrists extended then they often have difficulty with fine motor control as evidenced by poor or delayed grasp and release skills, pre-writing and scissor skills, in hand manipulation of small objects, and many other fine motor skills. Crawling (on belly) and creeping (on hands and knees) is also the first time that the two hemispheres of the brain communicate between each other, if the crawling or creeping stage is shortened by infant walkers, too much standing or walking, or too much time in a playpen or Johnny jumper, then the child often has difficulties with learning to read, write, and do math later in life. As you can tell, the crawling stage is one of the most important stages, do not rush your child to walk or stand too early!
Even after the child has had weight bearing on the palms, it is often necessary to give them weight bearing through the palms and extended wrist to prepare the muscles for fine motor movement.
The best way to encourage more use of the hand is to incorporate it into the child's learning through PLAY! Sensory motor experiences are very important before sitting down to concentrate on higher learning tasks such as prewriting, fine motor skills, and self-help. The following are some ways to help increase proximal stability, muscle tone, and sensory motor skills:
* Give opportunities for vestibular (swinging, jumping, lots of movement activities, therapy ball) and proprioceptive input (pushing, climbing, pulling, wheelbarrow walking, carrying heavy objects, stacking books, removing books from shelves and putting back, reaching up on shelves for toys) For the child having difficulty even remaining on their belly, try to encourage belly tolerance by just carrying the child in a "football" hold with their head down and you hold them under their chest and pelvis. You can gently swing them side to side in this position as well. Try to carry them in this prone position as much as possible.
Next, try to lay them over your lap when playing on the couch or in the floor with a stimulating toy or brother or sister to entertain them while they are over your lap or leg playing.
Next, try a large ball and with a warm towel from the dryer over the ball, lay them over the ball with a fun toy on the opposite side and you holding behind them. This is a fun game with two people, one holding behind and one in front, or in front of a mirror then the child sees themself coming towards the mirror. Rock the child on their tummy gently over the ball. You can work up to them catching themselves on the floor with hands wt. bearing, then pushing back later on.
Then try different pillows, rolled up towels under their chest to help them stay on their belly. There are a lot of toys on the market to help stimulate belly time, request these for holidays! Once the child tolerates the belly position, then start encouraging pushing up on hands, open hands with wrist extended is optimal!
Again, use the pillows, therapy ball, towel rolls, and toys to help them weight shift from side to side to reach to play. Help them to rock on hands and knees by supporting her hips, their arms should straighten to support themselves. Rock forward and back, then side to side, and then diagonally.
Then, once child is maintaining an all fours position, help them to lift up an opposite leg, you may need to put support under their tummy with your hand or a towel.
Once creeping on their own, encourage creeping over pillows and your legs to strengthen. Teach safely how to go up and down stairs later on!
Other ideas:
Some Fine Motor suggestions for 1year-5 years: Fine motor skills should not be a main focus the first year of life, the child needs to gain gross motor control and bilateral coordination before focusing on fine motor skills.
** Working on a vertical surface helps to encourage use of both hands more and wrist extension which is important for proper hand development and coordination. Tape large pieces of paper to the wall or the floor. Use easels often! * Crossing of Midline and Midline Hand Skills: midline skills are automatically encouraged through using both hands together in midline. Crossing of midline takes a little more work! Playing hand games such as patty cake and singing rhymes while touching opposite body parts or crossing arms, self hugs, etc. can begin to encourage that motion passively. Then begin to place much wanted toys a little out of reach for that hand and use hand over hand assist if necessary to help the child reach across midline for the above stated activities. * It is very important to do activities on an easel or incline and use small pieces of chalk of golf pencils to help encourage the wrist extension and stability needed to hold a pencil correctly.
Any Questions or comments (or ideas!) Please contact me!
Heidi Clopton, OTR/L Center of Development
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