Kids learn and explore with their hands. Holding a pencil. Buttoning a shirt. Lacing up shoes. These simple tasks we take for granted actually rely on strong fine motor skills, a correct grasp, and controlled hand and finger movement. Struggling to perform basic tasks that their peers can do may impact a child's self-confidence, academic and independent functioning. Paediatric hand therapy is an intervention program that incorporates child-specific exercises, activities and education to facilitate the development of skills necessary for school and daily living success.

What causes hand problems in kids?

There are many possible reasons why kids may have challenges with hand skills – from developmental delays and low muscle tone to hypermobility, autism spectrum conditions, sensory processing disorder, or an injury to the hand. Sometimes the symptoms are hard to notice – for example, a child who is easily frustrated or reluctant to do colouring, puzzles or activities that tire the hands too quickly. In other cases, it's more obvious - a child with an awkward pencil grasp, a weak grip, or problems with coordinating both hands together, for example. Early intervention with an experienced therapist can be a game-changer, and an orthopaedic hand surgeon may also be involved in care if there are structural issues.

Fine motor development: Strengthening and control

Fine motor skills provide the basis for almost all of the activities children perform with their hands. Goals of paediatric hand therapy include strengthening small hand and finger muscles and increasing coordination and accuracy. Therapists often mask required exercises as games to encourage a child to perform them.

Therapists may also implement silly or messy fine-motor strengthening tasks, such as tweezers and peg games, to pick up small objects to strengthen fingers and improve a good pincer grasp. Playdough and putty work are common, as squeezing, rolling, and manipulating these resistive substances strengthen the intrinsic muscles of the hand.

Occupational therapists often include buttoning and zipping practice as fine-motor strengthening activities since buttons and zippers are difficult to manipulate and require good bilateral coordination as well as finger dexterity. Cutting tasks with child-safe scissors are also used to build fine motor skills, since they isolate hand movements and enhance motor planning.

Facilitating handwriting skills

Handwriting is an important life skill that all kids should learn. Kids who struggle with handwriting often feel frustrated, disengage from classroom activities, and perform poorly at school. Hand therapy can address:

1. Hand and wrist strength

Kids need a stable wrist and strong hand muscles to write without discomfort. Therapists can guide kids through specific exercises and positions that encourage good posture and increase endurance.

2. Grip patterns

Many children hold a pencil in a quirky or inefficient way. An immature or poorly adapted grip pattern can make writing feel like a laborious task that takes effort to write just a short sentence. Paediatric hand therapists can guide children in adopting a functional tripod grasp. They can also recommend and instruct children on the use of adaptive pencil grips and other tools as needed.

3. Letter formation

Therapists use a multisensory approach to practice letter formation in a way that is also fun and engaging. This can be as simple as tracing in sand or shaving cream, writing on vertical surfaces, or forming letters out of clay, etc. There are many ways to reinforce the proper shape of letters.

4. Visual-motor integration

Handwriting also requires a child’s ability to coordinate their eyes and hands. Activities that combine visual scanning and tracking with fine and gross motor movements can help a child develop their visual-motor skills.

Treating sensory difficulties

Children can also have difficulty understanding and responding to sensory information. Touch, pressure and movement may be confusing or unpleasant for them. Sensory-based hand therapy can help children:

• Experience different textures (sand, rice, foam, etc.)
• Know how much force is appropriate
• Develop body awareness and coordination
• Self-regulate sensory information for easier, calmer hand control

Treatment that begins with sensory processing helps children be more comfortable and confident with their hands.

Tips for parents to help at home

Parents are one of the most influential forces in a child's hand therapy. Easy things you do every day can support their skills and goals. Make it part of their play so it doesn't feel like homework by trying some of the following activities:

• Provide hands-on play opportunities: Block building, stickers, painting, puzzles and crafts are all great for building fine motor strength.
• Let them help independently: Buttoning their own coat, pouring water, and opening snack packets are great opportunities for practice.
• Use vertical surfaces: Drawing on an easel or windows is great for wrist strength and proper grip formation.
• Don't overdo screen time: Children with a lot of screen time have less opportunity for tactile and motor learning.
• Practice small and often: Short repetitive tasks are less tiring and more beneficial than lengthy sessions.

Above all, reward your child's effort, not their "perfect" product.

Paediatric hand therapy develops the fine motor skills necessary for children’s daily activities, including writing, play, self-care and classroom activities. Parents and families interested in learning more about or receiving practical solutions to support their child’s skills can access hand therapy on the Gold Coast. With supported practice through childhood, children gain the coordination, stability and confidence required to perform well and interact socially at school and home.