The ability to hold an object in one hand and move it without assistance from the other hand.

Children start to develop these skills between 2-4 years old with a single object. The order of development of these skills are first finger to palm translation, palm to finger translation, rotation, and lastly shift. By the ages of 6-7, children are able to manipulate and stabilize more than one small object within their hand. This allows children to use these in-hand manipulation skills more purposefully and functionally to complete everyday tasks. 

A child with poor in-hand manipulation can be observed manipulating objects with both hands and/or stabilizing the object with a table or body. Children who have difficulty with in-hand manipulation may be unable to complete certain tasks, require additional time, or may appear clumsy when handling objects. Many daily tasks required these higher level hand skills. Examples include: using a fork and knife, adjusting grip on paper when cutting with scissors, positioning a grip when writing/drawing, manipulating clothing fasteners, and operating tools. 

Poor or delayed in-hand manipulation skills can result in difficulties with the following: 

The components of in-hand manipulation: 

 The ability to turn an object end over end. An example of this is flipping a pencil over in one hand to use the eraser instead of writing with the tip of the pencil.

Simple rotation is the ability to roll a small object between the thumb and finger tips. An example of simple rotation is using the fingertips and thumb to open a small jar. 

 Complex rotation is the ability to turn an object end over end. An example of this is flipping a pencil over in one hand to use the eraser instead of writing with the tip of the pencil.

simple or complex rotation is being performed while holding an object with the hypothenar aspect of the hand (ring and pinky finger). 

 The ability to move objects between the fingers. A couple examples of this are when you try to separate two pieces of paper that are stuck together, or when you move your fingers closer to the end of your pen/pencil to begin writing. 

the ability to move an objects in a linear manner with finger tips while holding an object with the hypothenar aspect of the hand (ring and pinky finger). 

 Translation can be broken into two separate skills: finger to palm translation and palm to finger translation. Kids use finger to palm translation when they pick up small objects like pebbles, marbles, or cheerios one at a time, moving them with the fingers of only one hand into their palm. They use palm to finger translation when they move those small objects from their palm back to their fingertips one at a time to place them on the floor or table.

 the ability to move an object from fingertips to the palm of the hand. Ex: picking up marbles with fingers and thumb and moving them into the palm. 

 the ability to move an object from the palm of the hand to the finger tips. Ex: moving coins from the palm of the hand to the finger tips to insert them into a piggy bank.  

 holding an object with the hypothenar aspect of the palm (ring and pinky finger) while moving objects from palm to fingertips or fingertips to palm.

Activities that promote in-hand manipulation skills

In-Hand Manipulation

Like many OT’s I love encouraging my patients to engage in sensory play. Previous blogs have given suggestions for fun sensory play ideas for the great outdoors, but if you’re anything like me once it’s cold you’re not venturing out! I wanted to share some of my favorite sensory play activities for inside to keep your children busy while fostering cognitive, social, developmentall, and language skills. 

Sensory play is great for all kids, even those who are not currently being treated for sensory processing difficulties through occupational therapy. Sensory play helps children experience different textures, smells, sights, movements, and sounds through various play mediums. This is beneficial in so many ways. Sensory play helps the body learn to process these different sensations, it helps children learn body awareness and where they are in space, it can be calming or have an alerting effect, and it’s just fun. No matter the reason behind it sensory play is a great way to help fill your child’s day with new, fun, and engaging play activities. 

Here are six of my favorite sensory play activities for kids of all ages:  

Shaving cream is a great play activity, rub it on a mirror to practice writing letters, drawing shapes, or fun pictures! Or bury your favorite washable toys in it and dig around to find them. Add food coloring for more fun and the addition of a more intense visual stimuli. A taste safe alternative for younger children is using an electric mixer to whip the juice from a can of chickpeas into a foam. 

Shaving cream can also be a great way to incorporate self care skills such as hand washing or teeth brushing. Use a toothbrush and the bottom of a plastic pop bottle as your “tooth” and practice brushing all around it and in the crevices. Or practice brushing the teeth on a doll or other toys.

 For easy clean up do this play activity in the bathtub!

Cooked pasta is a great tactile play experience, add food coloring to the water when boiling to make fun colors. Let it cool, and add a little bit of water to make them slippery, then let the little hands dive in! Add in some of your favorite washable toys and containers to increase the imaginative play and fun. This is also a great activity for working on utensil use or cutting. Practice scoping and using a fork or snip the noodles with scissors to work on some of those self help and fine motor skills.

Water is a simple and easy sensory play activity. Fill a tub with some water, your kiddo’s favorite waterproof toys and some cups, big spoons, or measuring cups to encourage scooping, dumping, and pouring. To increase the fun, freeze water proof toys in ice cube trays or small containers of water then use dumping the water, hammers, or syringes of water to free the trapped toys. 

Sensory bins are a simple and inexpensive way to create sensory play experience. Some great sensory bin base items are rice and beans, oatmeal, easter basket grass or shredded paper, cotton balls or pom poms, sand (crush graham crackers or cheerios for a taste safe option), or water beads (use tapioca pearls for a taste safe alternative). Start with your base then add in scoops, tongs, toys, and containers. The joy of this type of play is it gives a base for your child’s imagination to run free and learn new ways to engage with everyday items. 

An obstacle course is one of the best ways to bring proprioceptive input into your child’s play, and get some of those wiggles out when we’re stuck inside. See Kelley Harlan’s ‘Let’s Make an Obstacle Course!’ blog post for some great information and ideas for your obstacle course. 

You can easily turn Kool-Aid packets into water color paints to create masterpieces with a fruity twist. Just mix the powder from a packet of kool-aid with a small amount of water to create your paint. Use the activity to talk about different scents, fruits, and colors with your kids. 

An added bonus to sensory play is that it opens an opportunity for discussion about new experiences and can help with language development. While doing all these activities talk to your child about what they are feeling, smelling, seeing, and hearing. Is it slimy, sticky, warm, or cold? Does it feel hard or soft? How does it make them feel? Help your child put language to what they are experiencing. Play is the best way for a child to learn, seize this opportunity to help them gain a new skill. Most of the time they’ll be having so much fun they won’t even realize how much work their brain and body is doing. Don’t be afraid to jump right in with them Mom and Dad, you deserve some play time too!

Sensory Play For When We're Stuck Inside

Being able to identify a child’s basic and physical needs such as nutritious food, shelter, warm clothing, and a reasonable bed time is obvious and easy to recognize. However a child’s mental and emotional needs are more difficult to identify and notice.

The environment you provide for your child each day holds many opportunities and chances for nourishing good mental health. Having good mental health helps and allows your child to learn and develop appropriate skills to influence, enhance, and improve communication and expression, social skills and interactions, emotional regulation, and confidence in themselves. Your child’s mental health is vital and plays a major role in their overall wellbeing. Here are some tips and strategies you can implement and apply in your daily lives to help support, encourage, and influence your child’s emotional, psychological, and social wellbeing.

1. Active Listening and Communication View your child’s behaviors as a window to their needs and feelings. Your child is communicating something. What is it? Be patient and engage in active listening before offering your advice. Take time to sit down and ask open ended questions, to gather information, promote discussions, and give yourself as a parent opportunities for validations. As parents you are trying to encourage communication, not to discourage it. Be mindful of how you respond verbally and emotionally.

2. Model Healthy Behaviors Children are influential and developmentally are constantly growing and learning. They are like little sponges soaking up everything around them. Children see how you handle stress, how you manage and deal with your feelings, how you problem solve, and how you communicate with others. It’s hard to model appropriate behaviors all the time but striving to model the behavioral and emotional responses you want your children to engage in.

3. Establishing Boundaries and Structure Consistency and structure are beneficial both for children and parents. Clear structure, rules, and expectations provide limits and boundaries. Children need boundaries without them they lose their way. They need clear rules and consistent consequences. But they need them to be delivered with love, understanding and kindness. Talking about the reasons for both rules and consequences helps children understand why they need to follow rules.

4. Building Relationships & Connections Making a connection and a bond with your child should be the upmost highest priority. Paying attention to your child’s point of view, thoughts, feelings, and concerns helps develop a bond and a healthy connection. Prioritizing time with your child is essential to developing the relationship. Scheduling or setting specific time aside for your child and family can only be beneficial for everyone.

5. Providing Praise Providing praise to children helps build and develop confidence and a sense of selfworth. By providing praise you’re showing your child you acknowledge them, your encouraging them, and helping them develop awareness to when they do well. Praise also influences feelings of being proud.

“We see how early childhood experiences are so important to lifelong outcomes, how the early environment literally becomes embedded in the brain and changes its architecture.” ~ Andrew S. Garner

How to Nurture a Child's Mental Health

With the unpredictable weather and virtual school instruction, it can be hard to find ways to keep your child moving and active! Obstacle courses provide a great way to allow children to work on a wide array of skills with one fun activity and just a few simple household items.

Obstacle Courses allow children to address multiple skills they may need to practice in one activity. By selectively choosing specific activities in your obstacle course, children can engage in activities that challenge them and build their own self-confidence no matter their age or abilities. Obstacle Courses build multiple skills that children will utilize throughout their daily routines including:

Tips and Tricks to Build an Obstacle Course at Home!

Work together with your child to brainstorm fun activities to include in your obstacle course. Some children will love to pick a theme (ex: volcanoes, sharks) and use their imagination throughout the entire course! Help your child identify activities that will provide an appropriate challenge and a sense of accomplishment. Based on your child’s age and abilities adjust the number of activities you may include in your obstacle course. Younger children or those who are working on sequencing and memory can benefit from 3-6 step obstacle courses, while older children and those whose strengths include planning and memory may be able to complete obstacle courses with 5-10 different activities.

So what activities can you include to address specific skills your child may need to work on? Below are some ideas for you to try and to spark your own creativity!

One of the great benefits of obstacle courses is that common household items can be used to foster challenges and fun for your child.

Ways to Make Your Obstacle Course More Challenging:

Ways to Make Your Obstacle Course Accommodating to Your Child’s Abilities:

Before engaging your child in the obstacle course you have created, review each step to ensure understanding and safety rules. This is especially important for children who have difficulty with planning, memory, and sequencing. Then, run through your obstacle course with your child! Have fun and enjoy watching your child work towards their goals while engaging in active play!

Let’s Make an Obstacle Course!

Are you concerned that your child is not talking? Most children say their first words around 12 months, and can expand their vocabulary up to 50 words by the time they are 18 months old! Children are so smart, and can often do this on their own. However, oftentimes there are children that need a little encouragement. Here are some tricks to get your child talking:

If you don’t see improvement in your child’s vocabulary after trying these strategies, it might be time to seek the help of a Speech Language Pathologist.

From Our Experts

In-Hand Manipulation

Sensory Play For When We're Stuck Inside

How to Nurture a Child's Mental Health

Let’s Make an Obstacle Course!

Addressing Early Language Skills at Home