THE ULTIMATE

GRASP
DEVELOPMENT
CHEAT SHEET

[Link]
Hi there! I’m Laura.

I’m a pediatric Occupational Therapist

who specializes in sensory integration.
I have a passion for educating others
about the importance of sensory
motor development and how everyone
(even non-OTs) can put their OT lenses
on to find ways to adapt environments
and support children’s functioning at
school and at home.

Questions about age appropriate

grasps is probably one of the most
frequently asked questions I get as a
pediatric OT.

Use this guide as a quick reference to

understand where your child/client is
at developmentally, what makes a
grasp “functional”, and how you can
help encourage a more age
appropriate grasp pattern.

Connect with me:

This informational handout is meant to be used as a basic introduction to fine
motor grasp patterns.
Therapists: Use this handout to inform parents about their child’s fine motor
development. Accompany this handout with specific exercises and activities
that they can do with their child to strengthen and refine their fine motor
development.
Parents: Refer to this handout when you are observing the development of
your child’s grasp pattern. Keep in mind that all children develop uniquely,
and while there is a general progression of grasps, every child meets
milestones in their own time. OT is only warranted if it impacts a child’s
ability to function in their daily lives. Seek OT support if you have concerns
about fine motor development or other sensory motor development.

This resource does not provide in depth education or discussion related to

underlying sensory or motor conditions that may be impacting fine motor
skills.

The “When to refer to OT” checklist is not standardized or associated with

any state legislature or specific school district guidelines. Rather, it is a
general list of functional implications in which a student might benefit from
an OT evaluation or screening. THIS CHECK LIST DOES NOT SIGNIFY
QUALIFICATION OF IEP OR ANY OTHER SCHOOL SERVICES.

3
Grasp pattern development tends to unfold in a predictable progression, though the
milestones and specific ages each grasp emerges can vary widely among children.

The ages included in this handout are not to be considered ”deadlines”, but rather
general guidelines of what you can expect in a certain time of development. Each
grasp pattern is identified by the age at which it typically emerges, but it is common
for children to switch between grasp patterns (“regress”) while they are refining
their intrinsic hand muscles. Not all children will exhibit every grasp; some grasps
will be skipped.

The grasp patterns depicted are the most commonly seen grasp patterns in
relation to handwriting, but does not include some earlier fine motor grasp
milestones. In addition, there are several variations within each grasp pattern that
is not explored in this handout.

Copyright 2020 The OT Butterfly

 Fisted Grasp (1-2 yrs): Babies develop the power side (ring and pinky
side) of their hand first. For example, when they do a “raking” motion to
pick up peas or cheerios from the highchair trey. The first grasp pattern
typically to develop around age 1 to 2 is the power, or fisted grasp. At
this stage, toddlers are just getting used to holding on to a crayon, chalk,
or marker and there is no precision in their scribblings or coloring.

Digital Pronate (2-3 yrs): As the child develops more proximal stability (i.e.
strength in their arm muscles, trunk muscles), they can start using the
precision side of their hand (thumb and index finger). Because they still
haven’t quite figured out how to efficiently separate the both sides of their
hand, the grasp still looks bit awkward. Drawing and writing movements are
still being controlled by the shoulder and arm.

Quadrupod Tripod

Tripod or Quadrupod (3-4 yrs +): Once we reach this 3rd grasp pattern, you will see
several variations based on the placement of the thumb on the pencil shaft, and how open or
closed the webspace (space between the thumb and index finger) is. These are the 2
general grasp patterns that we see.
A quadrupod grasp controls the pencil by the thumb, index finger and middle finger while
being supported by the ring finger. A tripod grasp controls the pencil with the thumb and
index finger, supported by the middle finger with both the ring finger and pinky fingers
tucked into the palm.
These grasp patterns are the most functional and appropriate for fine motor precision such
as writing letters and drawing shapes.

Copyright 2020 The OT Butterfly

 One of the keys to a functional, sustainable grasp
(no matter how awkward it looks) is establishing an ce
pa
open webspace (the space between your thumb bs
and the index finger. When the webspace is closed we
(such as in the fisted grasp), the intrinsic muscles of
the hand are not being used efficiently. With an
open webspace, the muscles of the hand are being
used more efficiently, which allows for increased
endurance for fine motor output.

There are even some awkward grasps (like this 5

finger grasp on the right) that can be considered
functional as long as the webspace is open, the
child is not fatiguing and is able to produce legible
letters and shapes.

This is the main function of pencil grips: to open up

the webspace. Despite dozens and dozens of styles
of pencil grips out there, they all share the same
function and goal: to provide cues for the fingertips
to rest on the pencil in order to open up the
webspace.

Before adding pencil grips to a child’s pencil, try

naturally developing their open webspace and an
efficient grasp. For example, use a broken crayon,
broken chalk or a shortened pencil (like a golf
pencil).

ref :Occupational therapy for children and adolescents

Copyright 2020 The OT Butterfly Jane Case-Smith-Jane O'Brien - Mosby - 2015
 The following list of activities offers opportunities to promote: hand strength, an open
webspace and a strong tripod grasp.

[Link] games, activities or crafts: Use clothespins to pick up cotton balls, or use a
clothespin to pinch a pom-pom and paint a craft with it.
[Link] Bottles: I got mine from the Dollar Store! Fill with water color paint, chalk paint
or just water and allow child to spray plants, spray the fence or help wash their
outside toys.
[Link]: Use large lacing beads (Melissa & Doug has some nice wooden ones), or go
old school and use some rigatoni pasta and yarn.
4.Q-tip painting: Use Q-tips dipped in paint to do dot-painting (Pinterest has some super
cute Q-tip painting ideas.)
[Link] in a piggy bank: (supervision required) Picking up coins with finger tips and
placing them into a piggy bank is great for practicing a tripod grasp and manual
dexterity
[Link] scratchers: No, I’m not suggesting your child play the lottery scratchers, but
there are some fun scratch art paper crafts you can buy and use coins to scratch
with.
[Link]: rolling it, kneading it, using stamps, cutting it with scissors or a knife.
[Link]: Good, old fashioned fun. Legos are wonderful for building visual motor skills,
hand strength and bilateral coordination. Bonus points for copying a model!
[Link] paper: seriously, ripping paper is a great fine motor activity! It requires
bilateral coordination and strength for those little hands. Find a fun pinterest ripping
paper craft, or shred some of that mail in that junk pile on your kitchen counter (you
know which pile I’m talking about.)
10. Stickers: Peeling stickers off of a sticker page require a good pincer grasp and
bilateral coordination. Here’s a hack for you: Peel off the outside edge of the sticker
page so little fingers are more successful at peeling off the page. Draw a line, circle,
or zigzag on a paper with a marker and have the child put stickers along the path.

ref :Occupational therapy for children and adolescents

Copyright 2020 The OT Butterfly Jane Case-Smith-Jane O'Brien - Mosby - 2015
 Keep in mind that all children develop uniquely and some may meet milestones earlier or later
than others, without requiring OT services. Use this checklist as a guide to determine if your
child’s fine motor grasp may benefit from being assessed by an Occupational Therapist.
Yes No

1) Is the child having difficul ty keeping up with

the pace of peers in group settings or the
classroom in relation to: handwriting,
drawing or coloring?

2) Is the child fatiguing quickly (having to take

frequent breaks, shaking their hands,
always switching hands) or more often than
peers?

3) Is the child experiencing fine motor

difficul ties across mul tiple activities and
environments (e.g. dressing, feeding, and
school work)

4) Does engaging in fine motor activities such

as drawing, writing or coloring stress out
the child or resul t in avoidance or aggressive
behaviors?

5) Does the child’s output (writing, drawing,

coloring) seem to be below average quality
when comparing to peers?

6) Is it interfering with their ability to

participate in age appropriate activities at
home, school or in the community?

If you selected Yes in 1 or more of the questions above, you may benefit from consul ting with
an Occupational Therapist.

Copyright 2020 The OT Butterfly

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Occupational Therapy Disclai mer: Utili zing these OT related activities, printables and handouts does not
replace Occupational therapy services; they are to be used by an OT or in conjunction with an OT
treatment plan. All activities suggested by The OT Butter fly should be done with a supervising adult. The
OT Butter fly is not liable for any resulting injuries as a result of utili zing these activities.

Graphics & Fonts credit: Works referenced:

Occupational therapy for children and adolescents
Jane Case-Smith-Jane O'Brien - Mosby - 2015

copyright 2019 The OT Butterfly