The Pseudo Pencil Grip

As an OT, when I evaluate a child I see many funky grasp patterns.  And we won't discuss my own, but lets just say I would have benefitted from an OT's expertise in this area as a child.  That is part of why I think it is important to facilitate a child's grasp early on.  This post will just scratch the surface.   It isn't a be-all-end-all to correcting grasp patterns, as there are so many factors not listed here, but you will find the components I work on the most as an OT.

Not being a fan of pencil grips for correcting grasp patterns, I was extremely happy to discover the Adaptive TIP Grip. The pseudo pencil grip. But first, let's discuss what appropriate grasp patterns look like.

The Tripod Grasp: Using three fingers to control the pencil.  This is typically referred to as the perfect pencil grasp. 

The Quadrupod Grasp: Using four fingers to control the pencil. This is like the tripod but with the ring finger also used. The quadrupod grasp is just as functional as a tripod and can even provide a little more stability for kids with hand weakness.

Because there is more to correcting grasp patterns than the use of a grip on a pencil, it is important to facilitate the foundational skills for a correct grasp pattern.  It is important to develop the following:

Separation of the hand-The hand has two sides; a side for mobility and a side for stability. Typically, the thumb, index, and middle fingers are mobile (the movers), and the ring and pinky are the stabilizers (the sleepers…it motivates the kids!) You can help facilitate this by  what OTs call translation, by bringing small items from fingertips to palms and palms to fingertips.  I like to use Travel Connect 4 checkers. Use more than one checker in the palm at a time to have the stabilizers practice keeping a single checker still, while the mobile fingers move another checker to place in the slot.

Strengthening- Theraputty is like a resistive PlayDoh that can help strengthen the hand muscles.  The child also must develop strength in their upper body, not just the hand. By creating upper body support by working on core strength, shoulder, elbow, and wrist stability.  You can do this by wheelbarrow walking, crab walking, using a scooter board, etc. to name a few.

Sitting posture- It is important to have the child at a proper height writing surface, and also that their feet can touch the floor to again create more stability.

Hands grasp reflex- I could write a whole post on this one (maybe I will).  For now, know that when this reflex is stimulated, there are many patterns of grasps you will see and all of the kids I see who have poor pencil grasps have this reflex off. See previous MNRI post

Now that we've gone over some (not all) of the important underlying skills necessary for correct pencil grasps, take a look at the Adaptive TIP Grip!

The TIP Grip protocol was created by Jan McClesky, an occupational therapist from The Handwriting Clinic/First Strokes program.  You create an Adaptive TIP Grip by using The Pencil Grip and cutting it in half and flip it over placing a rubber band below, to promote a proper grasp with appropriate joint positioning.  I like this grip because it is supporting a proper grasp with thumb flexion as the child actively grasps around the grip to the rubber band, instead of using the grip as support to their fingers.  I got a ton of hair bands from a local drug store and the kids can pick their color, which is motivating.

The TIP Grip

The Pencil Grip

You can also put the TIP Grip on other fine motor developing tools like tweezers, tongs and chopsticks.  Once the child understands the proper grasp and is doing well with the TIP Grip, you can take it off for some writing tasks so they can practice without the support.  If the child isn't able to wean off of using the TIP Grip there are still underlying factors to work on.

Watch this YouTube video for the TIP Grip protocol https://www.youtube.com/watch?v=uwfRnePcmY0