When should I be concerned about my child’s grasp?
This is a common question that is often asked of a pediatric OT when working with kids ages birth to 6 years of age. To answer this question let’s first look at some red flags that may indicate a concern in a child’s grasp development and then discuss the typical sequence of grasp development in children.
Some circumstances in which we should be concerned about a child’s grasp development are:
- If at any point the child is fatiguing quickly during coloring/writing.
- If child displays weakness or poor stamina during fine or gross motor play
- If the child complains of pain with grasping or writing
- If the grasp is not functional and is not reflective of typical grasping patterns
- If there is a significant delay in the typical age ranges listed below such as a child past 3 years old still using a fisted grasping pattern
- If the child is using both hands on the writing utensil past age 3
- If the child is not using fingers to move pencil by age 5
- If there is no progression of fine motor skills over a few months
- If there is difficulty with the child completing age-appropriate functional tasks
A note to remember: We are looking for functional, not perfect. Many people do not use a perfect tripod grasp and are doing just fine! It is okay if there is some variation in a child’s mature grasping pattern. As long as the child can write legibly, complete schoolwork without fatiguing, and write within an appropriate amount of time, then their grasp variation is functional and the best fit for them.
What does typical grasp development look like?
Children will develop grasping patterns at various ages and rates, but there is a typical sequence of grasp development that is a part of expected development. It is important to remember that every child is different and there will be variation in the age when a child hits the grasping benchmarks listed below. This information provides typical age ranges for what to look for as your child develops their grasp. Developing a dynamic tripod or quadrupod grasp is a process that we want to nurture and not rush. Make sure to nurture each one of these developmental steps as the child progresses through the stages of grasp development.
Around 12- 15 months a child will grasp an item such as a crayon or marker using a palmar supinate grasp which is the whole hand or fist with the thumb wrapped around the writing utensil. They will switch between hands often.
Between the ages of 2-3 the child will begin to develop a digital pronate grasp in which the fingers are now pointed down toward the bottom of the writing utensil. The fingers are being used with whole arm movements.
Between 3-4 years of age the child will begin to hold the marker with what is known as a quadrupod grasp or will use a static tripod grasp. A quadrupod grasp is when 3 fingers are pinching the pencil and the fourth finger is tucked to the side. This grasp can be static or dynamic.
A static tripod grasp is when 2 fingers are pinching the writing utensil and the 3rd (middle) finger is tucked to the side of the pencil forming a tripod. The 4th and 5th fingers will be static next to these fingers, but not yet tucked in the hand. They will hold with whole pads of fingers on writing utensil. There will be wrist or forearm movement to move the pencil with the fingers staying static, or not moving.
Between 4-6 years of age a child will begin to use the most mature grasp which is the dynamic tripod or dynamic quadrupod grasp. They will use the tips of their fingers on the writing utensil and hold utensil at more of an angle rather than vertical. The fingers will be dynamic meaning they are creating the movement with minimal or no wrist or forearm movement. The arm will be resting on the table rather than floating above. In the dynamic tripod, or 3 finger grasp, the first 2 fingers are on the pencil while the pencil rests on the middle finger which is tucked to the side The 4th and 5th fingers are tucked into the palm of the hand and help to stabilize the hand on the table.
Greutman, H. (2010, September 28). Typical pencil grasp development for writing. Growing hands-on