Building Blocks Pediatric Occupational Therapy Services

Fairfield Connecticut Occupational Therapist

203-341-0178
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Let’s Learn About In-Hand Manipulation

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What is in hand manipulation?

In hand manipulation is when you handle and move an object within your hand. These skills will typically start forming around preschool age, but by 5 years old these skills should be utilized consistently. In order for a child to accurately handle an object within their hand they will need fine motor skills, strength, and coordination. These skills consist of the ability to shift, rotate, and translate. 

  • Shift 
    • The ability to shift can be explained through moving an object with the fingertips
      • Ex: Moving a pencil down closer to the fingertips
    • How to work on shifting
  • Rotation 
    • Complex rotation 
      • When an object is turned from end to end
    • Simple rotation
      • When the object is turned within the pads of the fingers (including the thumb)
    • How to work on rotation 
  • Translate 

What do we use in hand manipulation skills for?

  1. Writing 
  2. Cutting
  3. Playing with toys or games
  4. Eating 
  5. Dressing  
  6. Money into a piggy bank or money into a vending machine 
  7. Flipping a pencil from writing to erasing 
  8. Spinning a top

How OTs can help

When it comes to in hand manipulation, the role of occupational therapy is to engage the child in an activity that targets the skills of shift, rotate and translate in a way that is engaging and meaningful to the child. Some examples include:

  1. Practice tying shoes 
  2. Working with puzzle pieces 
  3. Incorporating twisting on and off lids 
  4. Practice buttoning on dolls 
  5. Cutting activities 
  6. Playing cards 
  7. Reading (flipping the pages)
  8. Making a necklace with beads

How you can incorporate the use of in hand manipulation skills at home! 


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