Articles category: infants toddlers

Tummy Time and Handwriting

200909-baby Often, we don't think about how much work is involved in handwriting. However, handwriting is more than grasping an object and scribbling. Although a baby's ability to grasp establishes a developmental foundation for the handwriting skill, the ability to write requires simultaneous movement and work from the fingers, wrist, elbow and the shoulder.

First, once you have pen in hand and you begin writing, the wrist rotates and continues to rotate while the hands moves across the page. Second, the elbow flexes and extends as hand moves across and down the page. Lastly, the shoulder, in sync with the first two movements, must stabilize to allow the upper arm to rotate independent of the shoulder. The bicep must suspend the forearm so the hand is able to freely move; if the forearm was bearing weight, the fast and agile movements in writing would not be possible.

We found that the stability for each of these pieces develops in an infant through weight- bearing on the wrist, forearm and shoulder. When a baby is on on his or her tummy, the act of pushing through the hand, forearm and elbow is essential to forming the stabilization and motor patterns used years later in handwriting. The Kinetic Bridging Method has enabled this stabilization to the wrist, elbow and shoulder in only a few sessions.

Using Kinetic Bridging we connect the essential stability patterns in both the dominant and non-dominant hands. Better function in the fingers improves letter formation. Stability patterns in the forearm allow the hand to rotate and shift position as the hand traverses the page. Next, comes restoration of elbow stability which allows the hand to be suspended making letter strokes effortless. The last piece is shoulder stability which allows for the smooth movement across the page and return to the side with a new line. Once we see how many individual patterns combine to enable writing it's easy to understand why many children struggle. And to think early Tummy Time is responsible for naturally developing so much!

Tummy Time & Grasp

As parents, we hear the importance of providing your newborn with tummy time from your pediatrician or healthcare provider. Tummy time helps develop core strength and coordination. Well, we also are finding that tummy time is pivotal in the development of the fingers and stability in the hand within the first six weeks of life.

There are various development stages of the hand for a newborn. First, a newborn holds a clenched fist; within the next few weeks the tension in the grip lessens; and lastly the hands and fingers spread ready to begin touching and grasping. Watch a newborn and you will be fascinated by the fingers and toes flexing and extending nonstop.

This tight fist grasp is commonly referred to as the Palmer Grasp Reflex, which is supposed to disappear by 6 months. This infant grasp is too strong for fine motor control and purposeful grasp to occur.

The initial stages of grasp revolve around the stabilization of the thumb. At birth the thumb is held tight within the fist. As the base section of the thumb develops, stability from pushing against the floor, the thumb rotates around to its proper position at the side of the palm. This rotational stability sets up the foundation for two key aspects of grasp—the opposable thumb and the lateral arch which enables curvature of the palm.

The position of the thumb was the subject of a study at the Technion Institute of Technology, Israel, published in the March 2000 edition of Pediatrics. In 125 infants (62.5%) of the total study population, a TIF (Thumb In Fist) was noted. The mean age of disappearance was 1.5 months, and no TIF persisted after 7 months old. The TIF posture in infancy was noted in 65% in this study of 200 apparently healthy full-term newborn infants, and it had resolved in all of these infants by 7 months old. Therefore, a TIF posture after this age should alert the clinician to the possibility of possible neurological dysfunction.

Development of the refined finger function corresponds to the stabilization development in each finger segment which occurs primarily from pushing against the ground. As stability builds, so does the ability for the hand to begin grasping objects. Toddlers explore the world using their fingers and, in the process, refine the many highly specialized tasks their fingers must master.

Individuals who have difficulty with functional grasp patterns (there are many!) can still get help. There are myriad adaptive devices currently available (consult an Occupational Therapist for specific recommendations). We also find that the Kinetic Bridging™ method is particularly effective in reconnecting missing stability in the thumb and fingers in just a few sessions.

Furthermore, we observed that the stability of the hand also relates to one's handwriting. We explore that topic next month, along with my own experience on how the Kinetic Bridging Method has helped me with my handwriting, even as an adult.

Motor Skill Development Delay and Infant Sleep Positions

I see so many children with poorly developed shoulder stability and function which makes me wonder what these children didn't do to miss this development. My suspicions lie in too little tummy time and too much car seat/bouncy seat/stroller/high chair time. A study from Canada was just released which compared motor development between infants who slept on their backs (supine) and those who slept on their fronts (prone).

"Motor delays were documented in 22% of babies sleeping supine. Prone sleep-positioned infants were more likely to sit and roll. Daily exposure to awake prone positioning was predictive of motor performance in infants sleeping supine. At 15 months, sleep position continued to predict motor performance." The research article, "Association Between Sleep Position and Early Motor Development" is from McGill University and published in the Journal of Pediatrics.A significant number of the infants who slept on their backs had delayed motor skill development. The development is also greatly influenced by the amount of time spent in alternative positions during non-sleep time.

The results of this study align with another observation of mine. I see very few first or only children unless they have another concurrent condition. The younger siblings are the ones spending more time being schlepped around to the older siblings activities, etc. A younger sibling also gets put into seats to make it easier to keep watch on two or more children. Parents, please start trying to make more time for floor time and tummy time for the siblings. There are many creeping and crawling games that are great fun with just a pinch of imagination!

Have fun with tummy time! Cara