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Developing a Tripod Grasp For Handwriting - featured November 21, 2011

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Developing a Tripod Grasp For Handwriting

By: Loren Shlaes, OTR
Certified Teacher of the Alexander Technique

[Image: tripodgrasp.JPG]
Image Credit: OTPlan

In order for a child to be able to control his pencil successfully and to be able to write without pain, it's important to develop a good pencil grasp. The standard grasp is called a dynamic tripod. It consists of the pencil being held between the tips of the flexed thumb and the forefinger, with the middle finger resting behind. The reason it is referred to as dynamic is because in this position, the fingers are able to move freely while holding on to the pencil.

The key here is that the thumb web space remains open, as if you are making an "OK" sign. There are a few variations on this grasp, like a quadrupod, which is essentially the same grasp with the ring finger added for extra support.

Generally, if the thumb web is open and the child's fingers can move freely, even if it is an eccentric grasp, I won't try to change the way he is using his pencil. However, if he is holding his pencil in such a way that he can't control it properly, he can't move his fingers because he is holding the pencil in his fist or some other way that he has to use his entire arm to write, or if he complains of hand pain because of his grasp, I will work with him on improving his grip.

According to the literature, a dynamic tripod does not fully come into being until the child is at least six, and sometimes seven. Unfortunately in New York City, children are being expected to write at younger and younger ages, sometimes as young as four. This is incredibly counter productive and sets the child up for a lifetime of bad habits as he contorts himself in order to use his hands in such a precise way, long before he has developed the strength and stability to support it. It would be so much better to wait until the child is at least six before requiring him to write.

The first thing I do to promote good grasp, especially if the child is writing with the thumb in a closed position, is to give the child an adaptive grip to slip over the shaft of his pencil. The ones I have had the most success with over the years are the Grotto Grip or a Start-Write. These encourage a tripod grasp and are very comfortable to use. Then we will play a game together like Make a Square, or draw some pictures together so that the child becomes comfortable with the new grip before I require him to start using it for writing. I tell the child that he doesn't have to take the grip to school unless he wants to, but that I want him to use it for all of his homework and for any drawing he may do. If he uses it every day, even if it's just for a few minutes, he'll have a good chance of developing that tripod. Children are often motivated to work on that tripod when they see the difference between their writing with and without it. The amount of control over the pencil they gain is remarkable.

Two other grips I use, but less frequently, are the Tri-Go and the Stetro. Some children like them better, for some reason. If the child has a very strong habit of locking the thumb over the fingers, though, the Grotto and Start Write are better at forcing the thumb web to stay open.

For a child who still enjoys coloring, I keep a stash of Handwriting Without Tears Flip Crayons. They are small enough so that the child must use them by pinching them between the thumb and forefinger, which strengthens the tip to tip opposition needed for holding the pencil securely.

If it's at all possible, if the child's nursery school, kindergarten and first grade teachers could be persuaded to get rid of all of the markers and fat crayons and only provide very small pieces of chalk and crayon to write with, all of the children in the classroom would develop very good grasps. If you give the child a big marker, he has all kinds of room on it to develop a dysfunctional grip pattern. He will especially do that if he's not ready to write and his hand hasn't developed sufficient strength or stability for him to hold the pencil. If he only has a small piece of crayon to use, however, he will be forced to hold it in a strong pinch.

I also recommend cracking off the handles of paintbrushes so that the child is only able to hold them between the tips of fingers for painting or spreading glue.

I often work with the child in upright, either writing on the chalkboard or at an easel or on a slant board. One of the reasons why the child has to manufacture extra stability in his grip is because it's lacking in his trunk or shoulder, so by having the child use his whole arm against gravity by writing, he's working on strengthening it at the same time.

Make sure that the child gets sufficient exercise and time out of doors. One of the reasons a child doesn't have a good pencil grip is because he hasn't developed enough strength and stability in his trunk and shoulders to support the fine motor control in his fingers. Time spent riding a bicycle, skating, playing sports, or anything the child enjoys doing will help.

In the clinic, we have the children swing on a trapeze bar, and I always tell them to wrap their thumbs around the bar. This separates the thumb from the rest of the hand, which is critical for fine motor control. If your child is so inclined, installing a chin up bar for him to hang on will give him lots of upper body strength and help him work on separating that thumb. So will wheelbarrow walking, cross crawling, or having push up contests with siblings or dad.

Crafts are great for developing eye hand coordination, mid range control, and tip to tip finger opposition. Some activities that work on pinch include perler beads, sewing, leather lacing, modeling clay, and Lite Brite.

Featured Author: Loren Shlaes, OTR

Many thanks to Loren Shlaes for providing us with these ideas to help handwriting for our newsletter.

Loren Shlaes is a pediatric occupational therapist specializing in sensory integration and school related issues, particularly handwriting. She lives and practices in Manhattan. She blogs at http://www.pediatricOT.blogspot.com/.

Tags: Article OT Handwriting Newsletter 25 November 2011