Early Intervention Strategies for Success

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  • 2 Simple Tricks for Tiny Fisted Hands(current)

It’s Thursday, the week’s almost over, and I bet you were just thinking…man, I sure wish I had a few ideas to help (insert child’s Woman's hands cradle baby handname) use his hands to play! 🙂

You may be supporting an infant or toddler who has cerebral palsy or another neurological condition that causes increased muscle tone. If the child has tightly fisted hands or indwelling thumbs (or both), his opportunities to play and explore can be quite limited. So much of how a baby learns is through touching and manipulating things around him. Actively being able to open and close his hand, grasp toys, and hold them is an important part of early development.

Read on for a few very simple tricks to add to your early intervention toolbox!

Trick #1 – Opening that Little Hand

Here are a few ideas you can teach parents to use to get those little hands ready to explore:

Massage that little hand. Use your thumb to massage the child’s hand from the center of the palm outward using a circular motion to open up the child’s hand and fingers. For an indwelling thumb, massage it open using your thumb.

Wake up the tactile sense. Help the child rub his open hand on the carpet or another texture to wake up those nerves and muscles. Play pattycake. Explore textured books or toys.

Bear weight on those hands. When the child is in a sitting position, use hand-over-hand support to help him lean forward on his hands while they are palm down on the floor. Put the child in a hands and knees position (over your thigh or a pillow) and help him bear weight on his hands.

With these simple activities you are activating and stretching those tiny muscles. You’re also helping the child feel what it’s like to have his hand open and ready to use.

Trick #2 – Releasing a Tight Grasp

Oops, the infant’s hand is tightly fisted in your hair. You don’t want to pull his hand and you’d like to keep your hair intact, but he’s really tangled in there. What can you do?

There’s a very simple yet effective trick that will not only save your hair but is also useful in other ways too: gently bend his little hand at the wrist (palm down) to help him release his grasp. It’s that easy. Once his fingers come open, you can unhook your hair and no harm is done.

So what else is this trick good for?

Teaching grasping – If you have a child with tightly fisted hands, you can use this trick to help her open her fingers enough to slide a rattle into her palm. Try using a rattle with a thin ring or handle. Gently press the rattle into her palm and she will likely close her hand around it. You’ve just helped her move through the motor pattern of opening her hand and grasping a toy, even if she wasn’t able to do it on her own. It’s a great start.

Teaching “give me” – If the infant or toddler has a toy in hand and can’t let go (or won’t let go), you can gently bend her wrist to help her release the toy into her mother’s hand. Pair this action with the command “give me your rattle” to help her learn what the command means. Over time, you might be able to fade out bending her wrist and just touch the back of her hand as a cue to open her fingers.

This is the great thing about early intervention. It doesn’t have to be complicated. Sometimes, the simplest tricks and techniques are the most useful!

What other simple strategies can you suggest for supporting hand use with little ones with fisted hands?

4 comments on “2 Simple Tricks for Tiny Fisted Hands

  • Belkis says:

    In the past, with children that have spasticity, I have tried strain counter strain techniques by holding the hand in the position of maximum comfort( fisted with indwell thumb), passively for 90 seconds. Upon slow release, the hand opens up, and then I encourage weight bearing. Has anyone tried this?

    • Thanks for the suggestion, Belkis. How long does the hand usually stay open after using this technique? It sounds like it’s sort of a passive stretch – is that correct? I’m obviously not a PT but am just trying to envision what you describe. 🙂

  • Cheryl says:

    We’ve been doing high fives with our 5 month old and helps getting our 2 and 4 year olds involved with his therapy


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