MOTOR DEVELOPMENT: GROSS AND FINE MOTOR SKILLS 7 Developmental ...

Perkins Activity and Resource Guide

CHAPTER 3 by Kathy Heydt and Monica Allon

MOTOR DEVELOPMENT: GROSS AND FINE MOTOR SKILLS

7

Developmental Screening Checklist: Fine Motor Skills

The following informal screening tool is a composite of many checklists that are commonly used in evaluating children with visual and multiple disabilities. Although this checklist is not specifically normed for children who are blind and have additional disabilities, it does follow a developmental sequence. Age equivalencies have been provided so that a student's progress can be viewed in light of her chronological age.

This checklist offers some developmental guidelines, but it is not meant to be followed rigidly. Assess the student's skills, evaluate the information, and identify the functional skills which are the most critical for her to acquire.

Further assessment may be indicated by an occupational therapist using standardized tests and scales. For related information see Tools for Assessment in this chapter.

One Month o Grasp reflex (hands clench on con-

tact) o Thumb maintains curled-in position

Two Months o Grasp reflex in pronation o Briefly holds rattle placed in hand

Three Months o Disappearance of grasp reflex (no

longer are hands tightly closed) o Arms begin to activate at sight of

toy* o Reaches for dangling object with

wrist flexed* o Holds hands together

Four Months o Visually attends to object, will

approach if within one inch* o No thumb involvement (e.g., when

grasping a cube) o Hand carries object to mouth,

mouth then sucks on both object and hand

o Finger movements are simultaneous o Hands fisted

o Frequently opens hands o Outside finger strongest

o Watches movements of own hands* o Holds toy actively, no thumb

involvement o Middle finger strongest, followed by

ring and little fingers o In supported seating, reaches for

and touches cup on table

o Retains object placed in hand for prolonged period

o Pushes up on partially extended arms while raising head

o With arms at rest, holds thumbs outside of palms

o Overshoots reach

* Difficult skills for the visually impaired to acquire

Perkins Activity and Resource Guide

CHAPTER 3

MOTOR DEVELOPMENT: GROSS AND FINE MOTOR SKILLS

8

by Kathy Heydt and Monica Allon

o Manipulates table edge when sitting on lap

o Hands engaged in midline (in preparation of transferring object from one hand to the other)

o Plays with own fingers

Five Months o Reaches for objects with or without

touching objects*

o Reaches persistently for stationary object, first underreaching, then adjusts hands held open*

o Reaches for objects with both hands (two-handed approach to objects)

o Holds bottle with both hands when feeding

o Plays with feet

Six Months o One-handed approach to object--

with excessive finger extension, elbow fully extended, wrist held straight with overreaching

o Control from shoulder and shoulder girdle

o Reaches purposefully with corralling movements

o Holds two objects, one in each hand

o Palmar grasp in pronation--hand held with palm facing down, object held with fingers and adducted thumb

o Lying on back, finger scratches and clutches at own hair, clothes, or body; when held at someone else's shoulder, fingers scratch and clutch the clothing and hair

o Retains two cubes o When prone, puts weight on

forearms o Precarious grasp--unsteadily

grasps one block between fingertips and palm (grasp is limited to large objects) o Reaches out with one hand

o Makes scooping motion with hand in grasping pellet

o Holds feet to mouth o Bangs toys in play o Plays with string o Supported in sitting, fingers the

edge of the table o Drops object when given another o Resecures dropped object

* Difficult skills for the visually impaired to acquire

Perkins Activity and Resource Guide

CHAPTER 3

MOTOR DEVELOPMENT: GROSS AND FINE MOTOR SKILLS

9

by Kathy Heydt and Monica Allon

Seven Months o Begins to reach for objects with one

hand at a time o Pauses before moving to grasp o Radial-palmar grasp--wrist straight,

grasps one block on the thumb side of palm (radial side of hand stronger) o Rakes objects--fingers and thumb move in a scratching motion o Retains object when grasping another (holds two objects as if to compare)

Eight Months o Reaches for objects beyond reach o Supination (palm up) coming in o Radial-raking--attempts to pick up

pellet with thumb side of hand leading o Scissor grasp--crude pincer grasp (attempts to pick up pellet, thumbs move to side of curled index finger, distal thumb joint slightly flexed) o Elbow flexibility o Uses forearms o Holding one toy, grasps another o Grasps one block in each hand for a long time o Pulls string to secure ring o Bangs toys together and on table o Hand drops, throws, pushes, pulls object

o While seated, uses fingers as a unit o Shakes one or both objects o Plays vigorously with a noise toy o Pulls out peg from pegboard o Transfers objects from one hand to

the other o Hands cross midline o Release against resistive surface

o Radial-digital grasp--grasping cube with wrist extended, fingers on radial side (tips of thumb, first, and second fingers)

o Provides pressure on object o Wrist flexibility o Controlled supination and prona-

tion o Holds own bottle o Extends index finger to poke and

probe o Waves and shakes bell o Plays with two objects together (cup

and cube) o Manipulates string o Crude release--clumsy release of

pellet into large container (start of voluntary release) o Reaches for object with one hand at a time

* Difficult skills for the visually impaired to acquire

Perkins Activity and Resource Guide

CHAPTER 3

MOTOR DEVELOPMENT: GROSS AND FINE MOTOR SKILLS

10

by Kathy Heydt and Monica Allon

Ten Months o Index finger approach to object o Inferior pincer grasp (beginning

thumb opposition) o Three-jawed chuck--dowel held

with thumb and first two fingers o Hand pokes with index finger, other

fingers are slightly flexed o Tries to reach into container to

remove objects

Eleven Months o Supination more frequent o Pushes car or toy train o Imitative scribble* o Removes cube from cup in imitation* o When sitting, rolls or begins to

throw tennis-size ball

Twelve Months o Superior pincer grasp (between

fingertips, distal thumb joint flexed, wrist ulnar deviated) o Voluntary control of supination to help grasp o Good digital manipulation, good use of fingers when playing with toys o Uses fingers without resting arm on table o Rolls ball imitatively o Uncovers lid to get object o Mouthing objects is replaced by active manipulation (e.g., squeezing, transferring)

o Increasing finger differentiation o Removes loose lid from box o Attempts to hold three cubes in one

hand at a time o Rings bell with purpose o Voluntary crude release--

controlled release of pellet into large container; lets object go deliberately, not accidentally

o Fingers the holes of a pegboard o Uncovers hidden toy o Frequently drops object on purpose o Pincer release

o Learning to release efficiently (voluntary release)

o Palmar grasp of crayon (holds crayon across palm of hand, with a fisted grasp and wrist slightly flexed)*

o Marks paper occasionally in imitation (arm moves as one unit)*

o Precise controlled release of one block into large container

o Brings one block over another (attempts unsuccessfully to make a tower of two )

* Difficult skills for the visually impaired to acquire

Perkins Activity and Resource Guide

CHAPTER 3

MOTOR DEVELOPMENT: GROSS AND FINE MOTOR SKILLS

11

by Kathy Heydt and Monica Allon

o Takes rest of blocks apart

o Places one three-inch peg repeatedly

o Clumsy release of pellet into small container

Fifteen Months o Superior forefinger grasp--wrist

extended and deviated to ulnar side for efficient prehension, smoothly and accurately reaches for objects

o One hand holds object while other manipulates it

o Hand and object do not have to be in same visual field for manipulation

o Turns container over to reach objects

o Holds spoon upside down

o Closes lid of round box

o Pulls wheeled toy

o Helps turn pages in a book, pats pages

o Casts ball crudely o Precise release into small container,

wrist extended o Marks rather than bangs* o Begins imitative stroke* o Builds tower of two blocks o Takes three at a time, two held in

one hand at the same time o Releases six blocks into cup o Six pegs in 70 seconds o Puts one pellet in bottle on com-

mand, shakes to get it out

Eighteen Months o Maintains open hand until toy is

reached o Uses one hand for support while

reaching objects o Reaches for close objects (13 inches

away) automatically o Holds two objects in one hand o Turns two or three pages of a book

at a time o Presses button o Pulls pop-it beads apart

o Scribbles spontaneously* o Has motor ability to draw a line* o Makes stroke imitatively* o Stacks three to four o Releases ten blocks (cubes) into cup o Round shape o Straightens shoulder, elbow, and

fingers while throwing tennis ball o String into bead

* Difficult skills for the visually impaired to acquire

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