0-2 months:
- The palmar grasp reflex is present in newborn babies
- Hands are closed into fists most of the time
- Brings hands to mouth
What is the palmar grasp reflex?
The palmar grasp reflex is a primitive reflex that causes babies to reflexively grasp objects that are placed in their palm. To test this reflex, place your finger in your baby’s palm.
2-4 months:
- The palmar grasp reflex is still strong
- Hands are closed into fists about half of the time
- Begins to clasp hands together at around 3.5 months
- Begins to reach for objects
- Briefly holds onto objects with palmar grasp
- Puts hands in mouth often
What is the palmar grasp?
The palmar grasp is the earliest voluntary type of grasp in which the all the fingers curl around an object holding it against the palm. This grasp pattern begins as a “crude palmar grasp” in which the baby grasps objects using the side of the hand near the pinky. As the grasp develops further, the baby will begin to grasp objects in the center of the hand. The thumb is not used with this grasp pattern.
4-8 months:
- The palmar grasp reflex integrates (goes away) at around 4-6 months.
- Hands are open most of the time
- Reaches for objects
- The crude palmar grasp (also called the ulnar palmar grasp) is used until around 4.5 months
- The palmar grasp develops starting at around 4-5 months
- The radial palmar grasp develops starting at around 4.5-6 months
- Uses “raking” motion (uses all fingers at once and bends wrist towards body) to help pick up small objects
- Reaches for toys with both arms from around 4-5 months
- Reaches for toys with one arm starting at around 5.5 months
- Emerging ability to hold onto object with both hands together
- Begins to transfer object from one hand to the other
- Begins to use radial digital grasp at around 7 months
- Begins to use inferior pincer grasp at around 7.5 months
What is the radial palmar grasp?
The radial palmar grasp involves holding an object against the palm using the thumb, index, and middle fingers.
What is the radial digital grasp?
The radial palmar grasp involves holding an object using the thumb, index, and middle fingers without stabilizing the object against the palm.
What is the inferior pincer grasp?
The inferior pincer grasp involves holding an object using the pads of the thumb and index finger.
8-12 months:
- Continues to use radial digital grasp to pick up objects
- Emerging ability to release objects from hand voluntarily starting at around 9-10 months
- Extends index finger to poke at around 9-12 months
- Mature pincer grasp emerges starting at around 10-12 months
- Holds onto object with both hands together
- Improved ability to transfer objects from one hand to the other
- Bangs objects (e.g., blocks) together
- Takes objects out of container (9-11 months) and puts objects in container (10-11 months
- Tries to imitate scribbles on paper (10.5-12 months)
- Begins to try stacking one block on top of another with little balance (11-12 months)
What is the mature pincer grasp?
The mature pincer grasp involves holding an object using the tips of the thumb and index finger.
1-2 years:
- Extends index finger to point (12-16 months)
- Stacks one block on top of another (12-16 months)
- Uses palmar supinate grasp to hold crayon
- Scribbles on paper (13-18 months)
- Turns container upside down to release object after demonstration (12.5 months) and independently beginning at around 13.5 months
- Improved ability to release objects from the hand voluntarily
- Improved ability to place multiple objects into containers, including placing tiny objects into small containers starting at around 14-15 months
- In hand manipulation begins to develop; can move objects from fingers to palm
- Holds object at midline using one hand and manipulates object using other hand
- Builds a tower using three blocks (16-18 months), four blocks (18-22 months), and six blocks (22-24 months)
- Imitates drawing vertical stroke (18-24 months)
- Imitates drawing circular scribble (20-24 months)
- Can string one large (1 inch) bead (20-23 months) and three large beads (23-24 months) onto lace
- Begins to snip with scissors starting at around 23-24 months
What is the palmar supinate grasp?
The palmar supinate grasp is the earliest pencil grasp. The child holds the pencil or other writing utensil with all fingers wrapped around the pencil with the writing side coming from the pinky side of the hand.
What is the body’s midline and why is it important?
Midline is an imaginary line that divides the body into two sides (left and right sides). It is important to develop the ability to bring the hands together at midline to manipulate objects using both hands together, which is called bilateral hand use. Using the hands bilaterally is necessary for certain types of play as well as other functional tasks including dressing and using scissors. Crossing midline, or the ability to reach across the body’s midline, is another important skill that develops throughout childhood. This skill is important for many tasks including writing.
2-3 years:
- In-hand manipulation continues to develop; can move objects from palm to fingers
- Begins holding writing utensil with digital pronate grasp (2-3 years)
- Imitates drawing horizontal line (24-30 months)
- Imitates drawing a cross (24-36 months)
- Folds paper in half (24-30 months)
- Copies an already drawn circle (25-36 months)
- Builds a tower using eight blocks (28-31 months) and nine blocks (32-36 months)
- Emerging ability to snip along a line using scissors (28-35 months)
- Begins stringing medium (1/2 inch) beads onto lace
What is the digital pronate grasp?
The digital pronate grasp is the second pencil grasp that develops after the palmar supinate grasp. The digital pronate grasp involves holding the writing utensil with the fingers with the palm facing down and the thumb held near the paper.
3-4 years:
- Uses “helper hand” to stabilize paper while drawing with the other hand
- Cuts along straight and curved lines on a paper
- Begins stringing small beads onto lace
- Colors inside the lines
- Copies simple shapes
- Can cut out a circle with scissors (3.5-4 years)
- Begins using static tripod grasp to hold writing utensil (3.5-4 years)
What is the static tripod grasp?
The static tripod grasp involves using the thumb, index, and middle finger to hold the pencil, but the fingers remain still and stabilize the pencil while writing. Writing with this grasp requires wrist and/or arm movements.
4-6 years:
- Learns to tie shoes
- Draws a picture of a person (4-5 years)
- Can cut out a small triangle and square with scissors (4-5 years)
- Traces pencil around own hand (4.5-6 years)
- Begins using dynamic tripod grasp to hold writing utensil (4.5-6 years)
- Begins writing; writes name, copies letters, numbers, and short sentences
- Puts together puzzles of up to 20 pieces
What is the dynamic tripod grasp?
The dynamic tripod grasp involves using the thumb, index, and middle finger to hold and move the pencil while writing. This grasp is a mature and efficient way to hold a pencil.
7-10 years:
- May learn to write in cursive
- Improved dexterity
- Can tie knots
- Learns to type on keyboard and text on cellphone
10-18 years:
- Improves typing speed on keyboard
- Handwriting improves
