Hand Control 

What is hand control? 

Hand control is the ability to use and manipulate objects successfully, e.g. using utensils and tools. One of the most significant underlying skills required is finger strength. It influences the ability to maintain effective finger positioning for very precise movements required to achieve hand control. 

Why is hand control important? 

Without good hand control it can affect our basic life skills such as our ability to use cutlery, write, use a computer, turn pages in a book and self-care tasks, such as dressing, toileting and grooming. Poor hand control can influence a child’s to academic performance, attention and make independent participation in classroom activity difficult. 

Underlying skills required for hand control include: 

• Attention and concentration: the child must be able to sustained physical effort long enough to complete the tasks. The child should be able to concentrate long enough to complete an activity without getting too distracted. 
• Body awareness: The child should know their body parts and understanding their body’s movement in space in relation to their limbs and objects around them.
• Sensory processing: The child should be able to accurately registrar, interpret and respond to sensory stimulation in the environment and from within their own body. 
• Postural control: They should be able to stabilize their trunk and neck so that they can coordination themselves. 
• Shoulder stability: The shoulder muscles should be able to engage so that they can hold the shoulder steady which will to allow the arm to be held in different positions while the forearm and hand do an activity. 

How would I notice hand control difficulties?

• The child would appear to have an awkward pencil grasp and poor pencil control. 
• The child would have difficulty holding and manipulating scissors. 
• They may use their whole hand to manipulate an object rather than just a few fingers. 
• Has poor endurance for fine motor skills such as pencil and scissor based activities? 
• The child may have lots of difficulty with self-care tasks, such as tying shoelaces and doing up buttons. 
• The child has difficulty with both grasp and release.
• The child’s handwriting may appear “messy” and is slow. 
• They may have difficulty staying within the lines when colouring or cutting out shapes. 
• They may have difficulty opening containers or unscrewing lids. 

When you see difficulties with hand control, you might also see difficulties with: 

• Fine motor skills: 
• Gross motor Skills
• Behaviour
• Persistence to task 
• Hand dominance
• Bilateral integration
• Self-care 

What can be done to improve hand control? 

In order to work on hand control it may be necessary to work on some underlying difficulties including:

• Hand dominance: Determine the child’s dominant hand and work on reinforcing it frequently and use in repeatedly in tasks requiring lots of precision. 
• Grasping and manipulating: Use lots of activities that require grasping and manipulating small objects, such as drawing, puzzles, opening containers and threading. 
• Finger games: Practice activities that require the use of just one or two fingers (e.g. poking and picking games). 
• Fine motor activities: Make sure the child hears lots of encouragement and when they engage in fine motor activities, especially if they persist in an activity that they find difficult. 
• Hand and finger strength: Practice activities that develop hand and finger strength (e.g. scrunching paper, using tweezers, play-doh, pegs). 
• Sensory play: Encourage the child in sensory play activities e.g. rice play, finger painting, shaving foam, sandpaper etc. to assist with their development of tactile awareness. 
• Hand-eye coordination: Work on activities that involve hand-eye coordination e.g. throwing and catching and crossing the midline e.g. reaching across the body to pick up items. 
• Upper limb strength:  Play games that develop upper limb strength e.g. climbing ladders, pull ups, wheelbarrow walking etc. 

Activities that can help improve hand control include: 

• Scrunching and tearing paper. 
• Using tweezers to pick up small items (e.g. marbles). 
• Pick up objects: Pick up objects using thumb, index and middle finger while keeping other fingers tucked in palm. Operation, hanging monkeys etc.
• Play-doh Play with the play-doh using imaginative paly; roll it into shapes with hands or a rolling pin; hiding a penny or other object in the play-doh etc. 
• Kneading dough, or wallpaper paste
• Squeezing sponges or water toys in the bath. 
• Threading beads onto a string. 
• Every day activities, such as opening containers and jars.
• Scissor work

Poor hand control can lead to:

• Difficulties with academic work due to poor handwriting skills and rapid fatigue. 
• The child may develop poor self-esteem, self-confidence or anxiety due to the pressure of struggling in class and the inability to complete the same work as their peers. 
• They may struggle with exams due to difficulty answering all written questions within the allocated time. 
• Inability to perform in higher levels of education and written examinations. 
• Difficulties filling in forms, such as job and rental applications. 
• Difficulty developing efficient typing skills. 
• Difficulty manipulating items for construction (e.g. puzzles, Lego).