Meet Bob; a perfect fine motor toy

Meet Bob; a perfect fine motor toy

Bob is a hard working guy I know.  My friend Katie introduced him to me a couple of months ago.  What she actually did was asked me if Bob could stay at my house, or if  I knew anyone who would like to keep Bob.  Once I checked out the size of his rig, I knew I’d keep him for myself!  I knew LOTS of kids who would benefit from spending some quality time with Bob, his forklift, and his big rig.

Bob’s truck is one of those “perfect” OT toys.  Perfect in that it promotes play skills with an emphasis on imaginary play.  In addition it captures many of the elements of the foundation fine motor skills that we are looking to develop in children.  Lastly, it involves some problem solving and sequencing skills.

What does the toy do?

Bob is a forklift and big rig driver.  His job, with the help of a child, is to load two pallets of four barrels into the back of his big rig and deliver the freight to another location, and unload the pallets.

The barrels must be placed carefully on the pallet.  I usually have kids use their fingers or ice tongs for this step.  The forklift must be all the way in the down position to pick up the pallet with the barrels on it.  To raise and lower the forklift it has to be wound from the back with the wooden knob.  The forklift has to be raised up about half way to load into the back of the big rig.  The forklift can tip, so care must be taken to regulate the amount of pressure on it.  The first pallet loaded must be slid back deep into the truck by hand to allow room for the second pallet.  The process is repeated for the second pallet.

Even though I described it as the perfect toy earlier, it actually has a few little quirks that make it interesting and challenging for kids.  One of those is that the doors on the back of the big rig are quite hard to open, so kids have to really pull hard on them.  Another is that Bob does not easily slide into the big rig cabin, and must enter through the rear window.  The trailer unhooks, but then it tips, and the barrels go rolling around in the back, causing the kids to stress about their carefully loaded goods.  Overall, the toy requires a lot of pressure regulation of the hands.

The kids I have used it with in therapy want me to bring it every week forever and ever.  I usually repeat the same activity for 3 sessions in a row, or until mastery has been achieved, depending on what each child needs.  We make up fun scenarios about what is in the barrels and where Bob is going to drive to.  It is delightful to hear what kids have to say on this!

Katie said she bought the toy at Pike Place Market in Seattle.  Thanks again Katie!

Handwriting in the 21st Century

Handwriting in the 21st Century

An Educational Summit was held on January 23rd hosting 150 of the country’s top thinkers on the topic of education and handwriting including one of our own; Jane Case-Smith, OTR.  You can read the white paper at .  It is great food for thought and brings together some meta-analysis on handwriting instruction, its impact on reading writing and language abilities, and also it’s impact on brain function.

This last part, the impact on brain function definitely caught my attention.  Why?  Because of people’s willingness to quickly jump to keyboarding as a substitute for handwriting.  Studies in the white paper show the relationship between letter printing and brain activation.  In the brain’s visual regions, when comparing writing, typing, tracing and visual control much more activation was exhibited after the writing experience than any of the other experiences.

This information is so important for our young learners.  The interplay between receptive language, reading, expressive language and writing and decoding, comprehension, spelling and composition are all supported when children learn to print their letters.  Once handwriting becomes automatic, students can focus on the cognitive task of writing to communicate their ideas.  

Thank you to Zaner-Bloser and Saperstein Associates for this important White Paper.

Make you own handwriting worksheets!

Make your own handwriting worksheets!

Each handwriting program I have used has some really great qualities that I love about it.  I had always wanted to create professional looking worksheets for my students and clients, when I discovered the wonderful world of Educational Fontware!

This software can be found at and is a great way to create your own worksheets, just the way you want them to look.  There is definately a learning curve for the program, and adding cursive is a whole other dimension, but once you get going, you will be glad you purchased this program.  It comes with over 200 fonts!

What I love about it is that the materials you create make such “clean” copies.  For kindergarteners, I love to create each students’ name page in the font to match what each teacher is using, and get their name letters down into rote memory with correct top down left to right formation. For example, you can create student’s name in any size font, with the little letter arrows, with or without lines, all capitals, lower case etc.  You can mix and match the size, and variables to match where your students are at in penmanship.

For any Kindergarten or first grade teachers on your Christmas list, it makes a great gift!

Choosing a handwriting program.

Choosing a Handwriting program.

A I mentioned in my previous post, each program has its merits and its shortcomings and I prefer not to endorse a particular product.  What I have done to meet the needs of my students and individual clients is evaluated what their needs are and provided an individualized program.  This is a luxury that therapists enjoy!

I have used each of the “big three” handwriting curriculum (among others) and have enjoyed success with them.  I encourage you to check them out at their respective web sites:-

Here’s my quick overview:

HWT is good for kids who have no prior experience with alphabet.  Teaches developmentally sequenced learning approach which is a plus for learning the top down left to right sequence of penmanship.  On the downside, it moves very slowly and starts with the capital letters only, and feels like it takes a while to get to the lower case letters.  Uses two lines which is typically not seen anywhere else.

Zaner-bloser uses the 3-lines which you can’t beat for learning placement of letters on the line. They also teach in a developmental sequence but they teach the upper and lower case letters together.  They immediately put them into the big picture by having students fill in the letter they are learning (that letter is missing) into an alphabet set.  They have it tied together very closely with literacy, and their materials are beautiful.  On the downside, it is a little more expensive for class sets than HWT.

D’Nealian was developed originally to help with the transition from manuscript to cursive, and I have known teachers who won’t use anything else.  D’Nealian also progresses students through letter sets that have similar characteristics to learn the top down left to right motions needed for fluent handwriting.  Fluency is tops for D’Nealian.  While many teachers don’t realize it, if they are using “monkey tails” they are using D’Nealian!  On the downside, many OTs believe that the monkey tails are extra visual clutter that is unnecessary.  This has not been proven.  D’Nealian does indeed transition well into cursive.  However, it is difficult to find D’Nealian workbooks. 

Which handwriting program should I use?

Which handwriting program should I use?

Instruction on penmanship is part of the foundation of building solid handwriting skills.

There are about a dozen well known handwriting programs on the market.  They each have their merits and their shortcomings.

The one you use, depends on the population you serve, and the goals of your program.

The “big three” handwriting programs that are commonly used in elementary schools today are;

  • Zaner-Bloser,
  • D’Nealian, and
  • Handwriting Without Tears. 

There are also handwriting programs embedded in other curriculum.  These are not considered, by occupational therapists, to be as comprehensive as the “big three” because they typically do not provide much in the way of instruction.  They are seen, rather, as an add-on to other curriculum, for example, literacy curriculum.

So, who is your population?

Have your students attended pre-school and received any instruction on the alphabet?

Is your school going to require the use of cursive writing in the upper grades?

Do you prefer 3-lined paper as guideposts for letter placement?

These are some questions that you and your staff can be thinking about as you decide on a handwriting curriculum.

Will you even have a choice?

If not, don’t despair, something that many experienced teachers and therapists know is….you can create your own!

Time Flies!

Time Flies!

Whew!  Time flies for busy OTs.  I cannot believe we just flew through the first semester of school!  Together with school, students, family life, it goes by so fast.  Before I began working in the schools, time went by a lot more slowly than it does now!

Progress reports.  Angst or exhilaration?  I prepared many progress reports recently, with lots of growth shown through work samples and increase in ability levels for the children I work with. 

When working with children who have emerging skills in handwriting, I focus on the gestalt, or the big picture, on the long term goal.  The long term goal is that the child will be able to communicate through written work.  Whether that’s to show a math problem, or to write a story, children need to be able to write legibly.

Many children need to change their pencil grasp from a less mature grasp to a mature dynamic tripod grasp.  I frequently use pencil grippers to accomplish this, although it’s only part of the story. 

Children also need to have adequate foundation skills in the area of fine motor, using the small muscles of their hands, in order to have good pencil control.  This is true with or without a pencil gripper!

There are MANY MANY fine motor skill activities out there.  Keep in mind that building fine motor skills is almost always going to involve low-tech toys.  You really are not building fine motor skills when you are playing video games that work on rapid thumb control.

I discovered a great website for activity ideas for building fine motor skills in children.  You can visit the site;

Review of Pencil Grasps

Review of Pencil Grasps

Ideally, we are trying to promote a dynamic tripod grasp that will result in a relaxed hand that can write several, or many sentences or paragraphs without becoming fatigued.  A dynamic tripod grasp looks like this:

My friend Xavier has a beautiful pencil grasp.  I asked him what he likes to do at home for fun, and he shared with me that he spends time with his grandfather on woodworking projects.  “Do you watch much TV?” I asked.  He replied “No”.  There is definitely a strong correlation between time spent on fine motor activities and ease of maintaining a dynamic tripod grasp. 

Another dynamic grasp is the modified tripod grasp which looks like this:

and is a fine and acceptable pencil grasp.

When you see a child with this pencil grasp, remember that you are seeing a good, dynamic grasp!

Just twiddling my thumbs

Just twiddling my thumbs

Whoa!  I’m seeing so many of those sneaky lateral pencil grasps this school year!  What is going on??  Could it be that fewer children have developed the necessary fine motor skills for handwriting?  Looks like!  Here’s one that I saw this week:


You’ll notice that it almost looks like a thumb wrap, except that what distinguishes it from a thumb wrap is that he has a very loose hold on the pencil overall, and his thumb does not cross over in front of his index finger.

Step 1. I gave him one of those small stetro grippers and it changed to this:


I wasn’t 100% happy with the result, as I’m not too sure he’ll maintain the tripod grasp with the stetro gripper.  He has an awesome teacher who will follow through with the gripper.  This should help.

What’s notable, is that he does not have very good muscle definition.  As my daughter says “you can’t see his bones”.  True.

Pencil grippers don’t work well in isolation from some actual skill building.  Yep.  Back to those fine motor skills, and to twiddling the thumbs.  And fingers. 

Step 2.  Twiddling the Thumbs. And index fingers!

I learned this simple remedy from Mary Benbow, OTR/L. 

  • Clasp hands together in a relaxed manner.  Unlock the thumbs and rotate them around each other first in one direction, then switch to the opposite direction.  You can sing the alphabet song, or count to 30 while you’re doing it, to keep it fun. 
  • Do the same for the index fingers.  Have the child clasp their hands loosely, then slide hands back so that the index fingers are free to rotate around each other first in one direction, and then the opposite direction. 
  • Tip:  Make sure the child is really forming circles with their fingers, not just going back and forth.  (For OTs, you want to engage the lumbricals).

Step 3.  Twiddle the thumbs and fingers 3 times a day for one week!

Small stetro grippers can make big changes

Small stetro grippers can make big changes

I love stetro grippers, although not many of my OT co-workers use them.  Which surprises me.  This little gripper can make big changes!  I have used it for everything from a tight thumb wrap to a digital brace with great results.  I think the key to this gripper is that the user has to be highly motivated.  I once saw a 4th grade boy who loved the stetro so much after using a digital brace grasp because he could then write in cursive and fulfill his dream of going to college.  Wow!

Most commonly, I use this gripper for the sneaky lateral grasp.  This grasp is hard to capture, and questionable to change.  The indication to change it, is if it’s static and the student is complaining of fatigue when writing.  Overall, the lateral grasp is not that bad.  It’s a tripod, and can work pretty well for a lot of people. 

Here’s how it looks:

The reason it’s sneaky is because it doesn’t look too bad.  But on closer examination, you’ll see that the pencil is being controlled by the sides of the index finger and thumb, not the pads, which is what makes this a static grasp.

The stetro gripper puts those finger pads firmly into position:

And you can see that the index finger now has more control with a fully flexed PIP joint and an extended DIP joint, with tall man tucked in the back.

With the stetro gripper, point the arrow toward the tip of the pencil.  Place the thumb on the star.

**For lefties, I put the stetro gripper on upside down with the arrow pointing at the eraser, thumb on the star.

When using stetro grippers you will need to use a slightly thicker pencil shaft than typical yellow school pencils.  That’s why I custom order my own line of pencils for Write Interventions so your grippers will NOT slide!!

When to use a bulb pencil gripper

When to use a bulb pencil gripper

Bulb grippers are sort of the “jack of all trades” gripper.  I use them for a variety of grasps that I see mostly in kids who haven’t really established a proper grasp yet.  Sometimes a kid will have a very immature supinate grasp (caveman grasp).  Or they might have a vague idea of holding the pencil, but not where to hold it, and are holding it near the middle.  What’s great about the bulb gripper is that it opens up the web space between thumb and index finger to allow for that space to form the tripod grasp.  Here’s how it looks:

And into the dynamic tripod pose:

You will want to be sure to position the gripper so that the edge of the gripper is just where the wooden part of the pencil begins.  The bulb gripper has 3 positions to choose from so kids can find the most comfortable position for their fingers to be in.  The thick part goes toward the eraser to form the bulk in the thumb web space.

Digital brace grasp needs a Twist ‘n Write pencil

Digital brace grasp needs a Twist ‘n Write pencil

I was sooooooooo happy when the makers of Twist ‘n Write came out with this new pencil for children earlier this year!  It is just the trick for those awkward digital brace grasps.  Like the thumb wrap grasp, a digital brace is a static grasp, but in addition, it uses the pinkie (small finger) side of the hand to control the pencil.  Crazy huh!?  Here’s what it looks like:

When you give a child a Twist ‘n Write pencil, there’s really nowhere else to go except into a dynamic tripod grasp like this:

Isn’t that just beautiful? 

The things OTs love!

For a thumb wrap grasp, use a grotto gripper

For a thumb wrap grasp, use a grotto gripper

A thumb wrap grasp is often tight, putting a “death grip” on a pencil, and frequently results in heavy pressure when writing.  It is, by its nature, a static grasp, and causes LOTS of fatigue and pain when writing.  It looks like this:

In fact, it usually looks worse than this, with hyperextension of the thumb interphalangeal joint also.

Use a grotto grip to correct a tight thumb wrap grasp to separate the thumb and index finger and tuck tall man in the back like this:

And you have a dynamic tripod grasp.

Kids will tell you that it “feels funny”.  It does.  It feels strange to change which muscles are controlling the pencil. 

Pencil Grippers to improve pencil grasp

Pencil grippers to improve pencil grasp

There are 4 main types of pencil grippers that I use as an occupational therapist.  The goal of each of these pencil grippers is to promote a mature dynamic tripod grasp.  A mature dynamic tripod grasp is a grasp that uses the thumb side of the hand to control the pencil as well as the small muscles of the hand.  And, as the name suggests, is a dynamic (moving), rather than a static (still) grasp.  The reason to achieve a dynamic tripod grasp is that it prevents fatiguing of the hand, allows for fluency when writing, and therefore allows for writing several sentences, paragraphs, or pages, at a time.

From top to bottom they are:

  1. Grotto gripper
  2. Bulb or peanut gripper
  3. Stetro gripper
  4. Twist ‘n Write pencil

While there are other grippers out there, I find myself coming back to these four consistently and getting great results.

I’ll explain when to use each one in the following days.

Help, this child has never held a pencil before!

Help, this child has never held a pencil before!

This is the call I receive from Kindergarten teachers at this time of the year!  Yes, there are many, many children who (collective gasp) really never have held a pencil before!  Amazing as that is, let’s focus not on the why of why that is, but how we can support the little tykes to become successful students.

Which leads us back to, you guessed it, fine motor skills!

Here is the list of my top fine motor skills/activities for the preschool, kindergarten, and first grade classrooms.  Of course these activities can be used for older children too.

  1. PlayDoh - roll into snakes, round balls etc.
  2. Fiskar scissors - use to cut the playdoh
  3. clothespins around a container
  4. wooden beads to string
  5. wooden beads to stack with eraser heads

When you put this all together, it looks like this (shameless plug)!

We’ll look at pencil grippers tomorrow and how they help.

In search of the “right” pencil grasp; A dynamic tripod pencil grasp.

In search of the “right” pencil grasp; A dynamic tripod pencil grasp.

A mature dynamic tripod grasp means that the pencil is being controlled by using the small muscles of the hand, and by the thumb side of the hand.  Children (and adults) can write several paragraphs when using this type of pencil grasp because it does not cause fatigue in the hand. 

We use fine motor skills as a pre-requisite for hand writing to strengthen the small muscles of the hand and improve coordination in preparation for the control needed for writing.

The focus of fine motor skills, therefore, are activities that use the fingers, with emphasis on the thumb side of the hand.  Many teachers and parents are surprised to learn that scissors skills/cutting activities are used as a pre-requisite skill for handwriting! When we cut with scissors we are using a lot of thumb motion that requires coordination and control that are the same things needed in pencil control.

I invented the Write Interventions Fine Motor Tin with my favorite fine motor activities for pre-writing skills.  Check it out at