Pediatric Grasping Patterns

Why is grasping important?

Children learn to play through touch or tactile exploration. This results in them reaching for and grasping objects. These grasping patterns, in turn, promote independence with play and school-aged tasks, specifically handwriting. Children typically progress through grasp development in a predictable pattern. All patterns can vary in timing, and it does not always follow the exact progression or develop at exactly the following ages, which is okay. Mastery of the following grasp patterns assists with the development and use of a mature grasp on writing utensils. If your child does not demonstrate an interest in grasping or playing or has difficulty demonstrating and mastering a mature grasp on items, it may be beneficial to contact an occupational therapist.

Palmar Grasp Use of entire hand to grasp an object. Typically develops at 4-6 months.
Raking Grasp/Motion Use of thumb and all fingers to grasp objects off of a surface. Typically develops at 7-8 months.
Pincer Grasp Use of pads of thumb and index finger to pick up and hold an object. Typically develops at 8-11 months.

There are 3 main categories of grasp development when using writing utensils. These 3 categories include: Primitive, Transitional, and Mature.

Primitive Grasps

Palmar Also called a fisted grasp. Use of whole hand and fingers to hold a writing utensil.  Whole arm movements with moving the pencil. Typically develops between 1-1/5 years.
Digital Pronate Grasp of an object with the whole hand.  Thumb points towards paper with pink up/towards the end of writing utensil. Typically develops between 2-3 years.

Traditional Grasps

Four Finger Writing utensil held between thumb and tips of the pointer, middle, and ring finger. Forearm/wrist moves pencil. Typically develops between 3.5-4 years.
Quadrupod  Writing utensil held between the thumb, pointer, and index finger. Movement at forearm and wrist. Typically develops between 3.5-4 years.
Static Tripod Writing utensil held between thumb and index finger with the pencil resting on the last joint of the middle finger. Movement at wrist and forearm. Typically develops between 3.5-4 years.

Mature Grasp

Dynamic Tripod Writing utensil held between thumb and pointer finger with the pencil resting on the last joint of the middle finger. Typically develops between 4-7 years.

Tips & Tricks to help with grasp & hand strength:

• Small toys or food in ice cube tray – pincer grasp
• Coloring with broken crayons/golf pencils – tripod grasp
• Small object held in palm while holding writing utensil – tripod grasp
• Present child with food or toys while using a pincer grasp, to promote the use of a pincer grasp to retrieve item – pincer grasp
• Writing/coloring on a vertical surface (wall) to promote fluid movements or wrist and digits with handwriting and coloring – tripod grasp
• Using pointer finger to pop bubbles, push buttons, or point to items – pincer grasp
• Tweezers, tongs, clothespins to pick up small objects – pincer and tripod grasp
• Play-doh/putty with objects hidden in it – hand strength
• In hand manipulation – tripod grasp:
  • Holding small items (pennies, small erasers, etc.) in the palm, have child work object out to pad of thumb and index finger to put into a container.
  • Have the child pick up small objects one at a time, using thumb and index finger, and hold in palm while picking up other objects.
• Stickers on a pencil for placement of fingers – tripod grasp
• Pulling stickers off of the sticker sheet and putting on paper – pincer grasp

Ashton Bowerman, OTR/L & Melanie Lucius, OTR/L