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Positioning is very important for engagement in fine motor tasks. A child's seat
should allow him to sit comfortably with his feet placed firmly on the floor. His hips, knees, and ankles should be at 90
degree angles, with his torso slightly forward. His desk height should be approximately 2 inches above his elbows when his
arms are at rest at his side. If the child's chair is too tall, leaving his feet dangling, create a make shift footrest out
of old telephone books bound together with masking or another strong tape to provide added stability. Keep in mind that trunk
stability is necessary for good mobility of the arms, hands, and fingers.
Children with visual perceptual difficulties often benefit from using a slant board for presentation of work. Slant boards
are available commercially, or you can create your own by using a 3 to 4 inch binder. Place the narrow end of the binder closest
to the child and the wider end farthest from the child. Wrinting on an incline surface also helps to place the wrist into
extension for a more optimal tripod grasp for dynamically moving the pencil.
Children should be helped early to develop a functional pencil grasp for handwriting tasks. A child should optimally use a
dynamic tripod grasp or a modification such as a quad grasp. A tripod grasp is achieved by holding the pencil between the
pads of the thumb and index fingers, with the first knuckle of the middle finger supporting the pencil on the side. The web
space, the space between the thumb and index finger at the base of the thumb, should be open and rounded to allow the fingers
to move the pencil dynamically. A quad grasp is similar to a tripod grasp except the pencil is held between the pads of the
thumb, index and middle fingers, with the first knuckle of the ring finger supporting the pencil on the side.
Some children tend to slump in their chairs or have difficulty sitting still due to attention or sensory issues. This is where
a seat cushion might come in handy. Most school chairs naturally position the child's pelvis in a posterior tilt (tilted back),
which is why I sometimes cue my children to sit more toward the edge of the seat so that they are able to sit up straighter.
Seat cushions such as "Fit Sit," "Move 'n Sit," "Disc 'O Sit" or one of the other commercially
available brands can help your child to sit up straighter which improves his postural stability, allowing him to use his hands
more effectively. These seat cushions also allow for controlled movement, and are "bumpy" to provide additional
tactile/proprioceptive input. My favorite is the "Fit Sit" cushion, because it is rounded on the front and sides,
but wedged in the back to provide a more anterior tilt (tilted forward) to the pelvis.
There are various pencil grips available to help your child achieve and maintain a functional pencil grasp. Speciality grips
such as "The Pencil Grip," and the "Grotto Grip" are my personal favorites. Other grips include the "Stetro,"
"Solo," "Tri-go," "Tri-Soft," and "Start Right" grips, to name a few. There are also
pencils, crayons, and markers designed to encourage the use of a tripod grasp. These include "Hand Hugger Pencils"
"Ferby" brand pencils, and "Crayola Write Start Colored Pencils." Hand Hugger crayons and markers are
excellent as well but can be difficult to find.
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