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Fine motor skills in older children with osteogenesis imperfecta

Fine motor co-ordination involves the ability to control the small muscles of the body, in particular the hands.

Children with (osteogenesis imperfecta) OI often have very hypermobile hands (bendy with a weak grip). They may find fine motor activities more difficult than other children. They will tire more quickly and therefore stamina may be affected. This may also impact on handwriting activities. Children with hypermobile hands may struggle to keep up in class when asked to finish long pieces of written work.

By encouraging participation in fun fine motor activities your child will develop strength and skill in the small muscles of the hand. The activities suggested in this resource are examples of how to encourage fine motor progression in your child.

Easel board activities

One of the most important items that you can provide for your child is a vertical or inclined surface to work on. Their wrist is properly positioned to develop stability and skilful, balanced use of the finger muscles. Inclined surfaces support the development of arm and shoulder muscles and encourage the proper positioning of the arms and shoulders for work.

When working on a flat surface children tend to straighten or bend their wrist which interferes with using the small muscles in the hand properly.

Many activities can be adapted for use on an inclined surface by using book holders on a table, table top easels, or regular floor easels.

Modelling clay

Modelling clay is ideal for helping children develop their creativity and their fine motor skills. This soft dough is firm when dry and colours can be mixed to create new colours.

Use the clay to create animals, monsters, or whatever you can imagine. This is a really fun way to get children using muscles they don’t even know they have.

Paper mache

Paper mache is a 3D craft to build fine motor skills. Rip newspaper into strips and dip into glue. Wrap around wire frame shapes, moulds or blown up balloons. Once the newspaper is dry, your child can paint and decorate the paper mache.

Sewing activities

Sewing is a great skill to learn and is good for developing hand eye co-ordination and fine motor skills. You can create your own sewing activities or buy ready made sets from places like Hobby Craft and plenty of online retailers.

Tissue paper art

Roll scraps of tissue paper into small balls by using only the thumb, index and middle fingers. Glue the balls onto thick paper or thin card to make a picture, birthday card or other special occasion card. Encourage fine motor progression by having your child draw a picture onto thick paper and fill the picture with strips of tissue paper and tissue balls.

Nuts, bolts and screws

The twisting action of turning screws, nuts and bolts is a great exercise for manual dexterity, coordination, control and concentration.

Get some thin strips of wood and drill small holes into them. Encourage children to fix them together with nuts and bolts. Old fashioned analogue clocks with lots of moving parts are great for exploration. Provide a small screw driver and encourage your child to take it apart (and maybe even try to put it back together again). You can also try construction kits such as Meccano, Gears and Knex.

Cooking and baking

Cooking and baking need fine motor skills such as measuring out the ingredients, cutting and chopping, breaking the eggs, stirring the bowl and frosting and icing cakes. Have your child decorate the cake or cupcake using tiny candies, sprinkles and icing.

You can also make your own bread or pizza. Kneading your own dough is great for developing muscle strength in the wrists and hands. Spread and sprinkle your home made pizza with your favourite toppings.

Other things to consider

  • Rubiks cube is great for manual dexterity
  • game of darts is great for encouraging a lateral pinch grip otherwise known as a key grip
  • use tennis balls to ‘walk’ their fingers on the tennis ball up and down their legs. You could even go up one leg, across the tummy and down the other leg. A larger plastic ball also works well.

This is not an exhaustive list of all possible fine motor activities. Please don’t be afraid of experimenting; you know your child better than anyone else.

Tips for success

  • watch how your child performs the activities as precise and specific finger movements are need to develop fine motor skill
  • adopt a low pressure, encouraging attitude with your child
  • make activities fun

Contact us

If you have any questions or concerns, please call the metabolic bone team on 0114 226 7890 or email sheffield.boneteam@nhs.net

Further information

For any further information please contact the metabolic bone disease team on 01142267890 or email on sheffield.boneteam@nhs.net

Clinical nurse specialists: Gemma Greenacre, Liz Lee, Clare Crossland, Rebecca Dhillon

Physiotherapists: Claire Hill, Davina Ford, Caroline Marr

Occupational Therapists:  Jill Baker, Kieran Murphy, Nicola Holland

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Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

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