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Grasping the Pencil Grasp

Author: Ronit Kabazo, MedSchoolForParents.com Expert
One of the most common reasons children are referred to me is an immature pencil grasp. Sometimes, the issue is just the pencil grasp itself, but often, it is just one symptom of sensory-motor dysfunction. Skilled and experienced occupational therapy professionals will be able to assess the child's sensory-motor foundation and confirm what is preventing the development of an efficient pencil grasp. 
For children, the development of pencil grasp follows a predictable sequence. Usually a child begins by holding the pencil with the whole hand, pronating the forearm and using the shoulder to move the pencil. Later, the child uses a more mature pencil grasp, holding the pencil between the distal phalanges of the thumb, index and middle fingers (known as a 'Tripod grasp'). In the latter stage of grasp development, typically between the ages 4 ½ - 6 years of age, the forearm is supinated and the child can move only his fingers to control the pencil. At this stage the shoulder, elbow and a raised (extended) wrist provide increased stability and contribute to a controlled movement of the fingers.  
Children who start Kindergarten and still have an immature grasp would benefit from using a pencil gripper attached to the pencil. There are many types of grippers and they all operate in the same basic manner - by thickening the pencil. This makes it easier for young hands to hold the pencil, properly align the fingers on the pencil shaft and assist in promoting a circular and open web space between the thumb and index finger. This open web space allows maximum range of motion of the fingers to move the pencil. Since it is often difficult to know which pencil grasp to use, experimentation is recommended and you can let the child try and choose a preferred pencil grip. 
Pencil grips are generally very economical. For Kindergarten and Grade One students I prefer the Crossover Grip and for older students I recommend The Pencil Grip (both manufactured by the company The Pencil Grip).
For older students who use a four-finger grasp or haven't received early intervention for their inefficient pencil grasp, I highly recommend the Twist'n'Write pencil which is an ergonomic pencil with extra support for the index finger (manufactured by Pen Again).  
Children and adults employ a variety of pencil grasps. However, there is no need to change the pencil grasp in every case. We would consider changing one's grasp when it creates tension and tiredness, or when the handwriting itself is inefficient (i.e, low speed of letter formation). 
For working on grasp skills, the occupational therapist can promote a pincer grasp pattern by strengthening the small intrinsic muscles of the hand:
Using finger abduction to stretch rubber bands placed around 2 or more fingers,
Holding or hiding objects in a cupped hand,
Squeezing clay or tiny balls of Silly Putty between the pad of the thumb and the pads of one or more fingers and picking up small objects with tweezers or small tongs.
updated 03/08/2017


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