Hand Manipulation Skills in Child Development
Children are often referred to pediatric occupational therapy for concerns related to fine motor skills. Generally thought of as the movement and use of hands and upper extremities, fine motor skills include reaching, grasping and manipulating objects with your hands. Fine motor skills also involve vision, specifically visual motor skills, often referred to as hand-eye coordination.
One main element of fine motor skills refers to grasp patterns. An occupational therapist helps improve grasp with a variety of grasp patterns and pinches needed for participation in daily tasks. There is another aspect of fine motor skills less frequently discussed but crucial to participation: hand-manipulation skills.
Grasp VS Manipulation
Fundamentally, the difference between grasp and manipulation is the purpose of the fingers within a task. With grasps, the fingers are meant to stabilize and secure an object. Some grasps may be more dynamic than others, allowing for some level of movement, but in general the purpose of grasp is to stabilize an object in the hand. The purpose of manipulation is to move an object through space with the fingers themselves. The three categories of manipulation include translation, shift, and rotation.
3 Categories of Manipulation
- Translation is the ability to move an object from fingers into the palm and vice versa. Finger to palm translation is the first manipulation skill to emerge and generally emerges between 1.5 and 2 years of age. This allows a child to obtain an object with a precise pincer grasp but then stabilize that object in the palm to maintain hold of it. The next step is palm to finger translation which emerges between 2 and 2.5 years. This skill allows the child to take that object secured in the palm and move it to the finger tips for more precise fine motor skills.
- Shift is the ability to move an object along a path using the fingers. Simple shift, which emerges around 2.5 years, is the ability to move all fingers on an object either forward or backward. This can be seen when a child threads a string through a lacing card or places a coin in a piggy bank. All the fingers move as a unit. Reciprocal shift is the next pattern to emerge at approximately 3 years of age. A reciprocal shift involves fingers moving in opposite direction. Most often this is the thumb moving in the opposite direction of index and middle finger. A reciprocal shift is required for tasks such as turning a page or flipping over a card when playing a card game. A complex shift involves fingers moving individually to accomplish movement of an item, such as shifting a pencil up or down in your hand.
- The final type of manipulation skill is rotation skills. Simple rotation occurs at 2 to 3 years of age. Simple rotation involves fingers moving as a single unit and thumb moving independently in order to move an object along an axis. This movement pattern is used to screw and unscrew lids or wind up a toy. Complex rotation occurs after age 3 and involves isolated movement of fingers in order to successfully move an object 180 degrees or greater. This skill is often seen when flipping a pencil over in order to erase.
The combination of these manipulation skills allow us to dynamically move objects around within the hand, which in turn facilitates complex fine motor skills. If you are concerned about any aspect of your child’s fine motor skillset, a pediatric occupational therapist may be able to assist. Occupational therapists have access to a number of pediatric assessments that specifically target fine motor skills. Scores from these assessments, along with clinical observations at the time of the evaluation, allow us to design intervention plans that will specifically target your child’s needs. If you’re in Arizona, please contact Kids Place Pediatric Therapy to set up an evaluation. We’d love to help!
Reference
Edwards, S.J., Gallen, D.B., McCoy-Powlen, J.D., and Suarez, M.A. (2018) Hand Grasps and manipulation skills: clinical perspective of development and function (2nd edition). Thorofare, NJ: Slack
