Fine Motor

Monkeying Around – Engaging the Thumb

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A huge milestone for a 9 to 11 month old is being able to grasp an object with the thumb and forefinger. But when your kid cannot master this at one let alone five or 10 years old, you need some intervention in the form of an OT (occupational therapist) to improve upon the fine motor skills that are delayed. There is plenty of material on this blog and on our YouTube channel, “Play All Day,” for way to improve on your kid’s fine motor skills, but here we focus on engaging our thumbs in things that we do everyday.

I don’t know about you, but I often hear from various therapists and doctors the word: “Huh?” That’s a funny word to hear so often, but they often make snap judgement on Alex.  For instance, I have heard within the first five minutes of a meeting that Alex is autistic.  Further through the meeting, they take that diagnosis away (he isn’t autistic).  That’s where the “huh” comes in.  They get stumped.  They can waste my time and money for weeks because they just can’t figure my kid out, so we move on and on to therapist and therapist.  I have since found some wonderful people who start treating, adjusting the treatment, and creating creative ways to help us out.

When Alex was seven we saw on OT at Cook Children’s Specialty Clinic in Mansfield, Texas.  She discovered when Alex was swinging from the trapeze (his favorite therapy “toy”) that he was not engaging his thumb (like the pictures below).

 

He would dangle and quickly fall off once his other four fingers slid off the bar.  So, we got to work securing his thumb in place with hand-over-hand assistance. We would not allow him to swing on the trapeze until he utilized his thumb using a basic command “use your thumb, Alex.” It took forever for him to do this on his own, and he still has trouble grasping with his thumb unless we tell him to use his it.

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Correct Grasp

Here is where I figured out how to “Play All Day” with Alex.

Alex loves the monkey bars or the uneven bars at the playground and at school.  He loves sweeping, vacuuming, raking the leaves, mowing the lawn, pushing strollers, hanging from railings waiting in line at Six Flags, and the list goes on. We continued to reinforce the rule of using our thumb in all these tasks.  While sweeping the kitchen floor, I will model for him, sweep with him hand-over-hand, and then allow him to sweep only if he engages his thumb.  I repeat the idea of I do, we do, you do to reinforce the skill.  We always encourage monkeying around whenever an opportunity presents itself and there is a bar or handle to hold on to.

Of course we can ADD some speech!

From the first post, we talked about our speech therapist’s use of “making your motor go” (voice).  I will often not let Alex swing or sweep without vocalizing the word “go.”  Practice the “g” by saying “go” before starting the task, or use any word that you are currently working on. Variations might be “on” before you place your hands on the bar.  “ME” to indicate you want a turn. “Please” to help with manners.

Use your AAC and practice “my turn,” “thumb,”  “go…”

Sign and gestures also work…just depends on what you want to work on with their voice.

Sensory Overload?

Add some compression to your kid’s joints (see compression video) particularly the wrist, elbow, and shoulder.  Massage their hands and fingers with deep pressure before starting the activity.  You can also brush their arms and hands before they grasp (see brushing video).  These are a few things to help desensitize their body before beginning the activity.

There are a million ways to have fun while engaging your thumb.  Take a look around you wherever you go, and see what you can grasp on to.

Leave a comment if you want to add constructive variations that work for your kid.

Search the site for other forms of therapy that can be done at home or anywhere you happen to be. Because all moments can be therapy moments, so that you can PLAY ALL DAY!