Grasp Patterns and Fine Motor Development
Gross motor milestones are a big focus as babies grow--but once kids are crawling, cruising, and climbing, what comes next? Big muscles develop before small ones, which means children learn how to move their whole bodies before they can perform precise tasks with smaller muscles. Fine motor coordination is how one learns to move smaller muscles of the hand and upper extremities in order to grasp, release, and manipulate toys and utensils.
Humans are equipped with 4 fingers and thumbs, which means they can grasp all kinds of objects. The fingers can flex (bend) and extend (straighten) with ease, and the position of the thumb enables opposition, which allows fingers to come together in order to pick up an item.
However, babies have to learn how to use their hands and coordinate their fingers to develop these functions. Initially, it appears as if babies do not recognize their own hands are part of their little bodies. Early on, they may stare at their hands, but not yet use them in an organized way. Babies often display a palmar reflex, in which their fingers curl around something (usually a parent's finger) placed in their palms. This reflex becomes integrated around 4 months old, and is replaced by volitional behavior, meaning the child has to intentionally initiate the action.
At this point (4 to 6 months old), the early grasp pattern is characterized as a palmar grasp. The object is stabilized against the palm, as the fingers curl around it. The thumb does not yet oppose the fingers.
At around 6 to 8 months, the thumb becomes more involved in a radial palmar grasp. The object continues to be stabilized against the palm, but is now supported by fingers around the top and the thumb on the side. The radial (thumb) side of the hand is known as the precision side, meaning this grasp pattern is now more precise than before.
At around 8 to 10 months, a radial digital grasp typically develops, in which an object is held between the fingers and opposed thumb. The fingers are now strong and coordinated enough to hold an object without exterior stabilization from the palm.
At around 10 months, an immature (gross) pincer grasp begins to emerge. A pincer grasp relies on isolated fingers and the opposed thumb to grasp an object. While emerging, a raking pattern may be noted, as the child sweeps all fingers to pick up an object. Closer to 12 months old, a fine pincer grasp develops, involving the isolated index finger and thumb to pick up an object with increased precision. As the pincer grasp evolves, finger feeding becomes a great way to build your baby's independence!
Around 12 months old, finger isolation also enables pointing. This is an important foundational skill for joint attention and communication, as your child points to share an exciting sight with you!
Grasping Writing Utensils
A pencil or crayon grasp introduces a new set of challenges, because now purposeful movement is required once the object is grasped. Consider your own pencil grasp--even adults may do this differently. The key to an effective grasp is one that allows for dynamic finger movements (to move the pencil around to write), slight wrist extension, and appropriate force so the hand does not become fatigued during writing tasks.
Initially, at around 12-18 months, children typically rely on a palmar or gross grasp, similar to when grasping toys. Sometimes, this is also referred to as a fisted grasp, because it appears as if the child is holding the crayon in the middle of a fist. This grasp does not involve finger movements to color, instead relying on less precise movements at the elbow and shoulder joints.
Around 2-3 years old, a pronated grasp appears. Pronation refers to when the wrist is rotated to point the palm of the hand down toward the floor. A pronated grasp begins to involve the fingers as they now wrap around the crayon, but active movement continues to come mostly from the elbow joint, which is often elevated in this grasp pattern.
Around 3-4 years old, a gross 5-finger grasp develops. All of the fingers are involved in holding the writing utensil here, which may continue to limit dynamic finger movements. But, it marks the first turn toward a neutral wrist position (no longer pronated) and begins to appear similar to a functional grasp. Hand dominance typically solidifies around age 4, so writing activities should be performed with the more consistent dominant hand.
Around 4-5 years old, a static quadrupod grasp develops. Static means that the fingers still do not actively move, instead writing motions are driven by the wrist, elbow, and shoulder joints. Quadrupod refers to the 4 fingers that are involved (index, middle, ring + thumb). Children begin to show separation of the digits of the hand as the pinky finger is not actively engaged in grasping the writing utensil.
Finally, around 5-6 years old, a dynamic tripod grasp develops. Dynamic means that the fingers are now actively moving the writing utensil to produce written strokes. This helps prevent fatigue and increase legibility during writing tasks. Tripod refers to the 3 fingers involved (index, middle + thumb), as the ring and pinky finger are now separated and tucked into the palm.
It is important to note, that many children continue using a quadrupod grasp with dynamic finger movements into adulthood. If it is functional and allows them to write efficiently and without fatigue, then there is no reason to push a tripod grasp.
Nearly the same grasp pattern development holds true for grasping feeding utensils, as well. Try it out yourself--most people hold a spoon or fork with a dynamic tripod grasp, simply in a different orientation to be able to scoop or poke food. Both coloring and self-feeding are great activities to foster fine motor development in a real-life, functional way!
Tips to Improve Grasp
While this developmental trajectory may occur naturally, some activities can support fine motor development:
Placing small toys in an ice cube tray to encourage use of a pincer grasp
Coloring with broken crayons to encourage use of a tripod grasp
Hide a small item under your child's pinky/ring finger to promote separation of the digits
Practice writing or coloring on a vertical surface to promote wrist extension and dynamic finger movements
Write on top of sandpaper or using a chalkboard for added feedback to the muscles and joints
Try different pencil grips to facilitate alternative grasp patterns
Engage in tactile play to help with mapping the hand
Strengthen finger and arm muscles. Some fun activities include using squirt bottles, doing wheelbarrow or animal walks, playing with Legos, and squeezing resistive putty.
Note if the grasp is causing any functional challenges at school. If not, it may not need to be changed. If your child requires extra time during writing/coloring activities, complains of the hand feeling tired, or avoids participation in fine motor tasks, it may be helpful to seek professional help.
See an occupational therapist is you notice grasping delays - the earlier, the better!