FINE PSYCHOMOTRICITY IN
ACHONDROPLASIA
PracticalPractical
exercises
Amparo Santos GonzálezEulalia Bonilla Morales
Yolanda Sánchez Fernández para Fundación ALPE 2010
Trad. Cristina Terceros
FINE MOTOR AREA
Acquire a better mobility of hands.
Develop a better hand-eye perception.
Improve the hand graph coordination area.area.
Improvement in the personal independence habits area.
SPECIFIC OBJECTIVES
• Develop the child fine motor skill.* Developing the manual coordination
area.* To develop the graph manual * To develop the graph manual
coordination area.* Stimulate the tactile perception.* Improve hands muscular strength.
CHARACTERISTICS TO BE CONSIDERED.
• Short upper limbs compared to torso (trunk).
• Difficulties with elbow flexion.• Difficulties with elbow flexion.• Trident hand, (split between the ring and
middle finger).
FINE MOTOR AREAINTERVENTION.
• ¿Why the intervention? The intervention in this area is very important because of child characteristics, as trident hands, elbow flexion, and so on. These special flexion, and so on. These special characteristics in children with achondroplasia will hinder their manipulative skills, so the intervention in this area at early ages, will be fundamental.
THESE EXERCISES ARE ORIENTATIVES. EACH CHILD HAS A DIFFERENT LEVEL OF
DEVELOPMENT, SO WE WILL BE GUIDED NOT BY AGE , BUT WHEREBY THE CHILD IS ABLE TO DO.
TO GET STARTED…
• Control the environmental conditions: light, temperature, security, etc.
• Respect the call time the child can give to the objects, games or situations.
• Without neglecting the safety, let the child explore his environment.
• Give to the child opportunities ofchild explore his environment.
• Give to the child opportunities ofrelationship with other children.
• Spend always some time to play with him.
• Promote the autonomy and let he do things by himself.
• ALL THE TOYS MUST BE ADAPTED TO HIS AGE.
FINE PSYCHOMOTOR EXERCISES
• WE WILL DIVIDE BY AGES:
• O TO 6 MONTHS
• 7 TO 12 MONTHS
• 1 TO 2 YEARS
• 2 TO 3 YEARS
• 3 TO 6 YEARS
• 6 YEARS HEREINAFTER
• All the exercises can be done
at home.
Exercises from 0 to 6 months
FROM 1 TO 3 MONTHS
• Offer variety of objects in the hand
• Move objects close to his/her face so he/she can follow visually
• Make sounds with objects so he/she can follow aurally
EXERCISE 1Offer variety of objects in the hand
At first we will place the objects in the hand to stimulate the beginning of the manipulative skills. The child’s hand will be closed most of the time, so that we will have to stimulate that he/she go opening. Please note
that the motor development will be slower.We can use: rattles, small balls, little dolls, etc.
EXERCISE 2To move objects close to his/her face, so he/she can
visually follow
First of all we can call the child attention on the object, which we’ll move from side to side, up and down, making it slowly and using always
striking objects. The kid will like mother or father face even more than any toy.
We can use: rattles, little dolls, toy keys, small balls, etc.
EXERCISE 3Make sounds with objects to follow aurally
We will blow the object at both sides of the child, trying he/she cannot see, so the child will direct the head to the object.
We can use: rattles, toy telephones, crib mobiles, etc.
FROM 3 TO 6 MONTHS
1. Offer different sizes and textures objects for he/she to grip, placing them at different distances.
2.Let the child grab, hit, shake and throw objects with one or both hands.
3.Provide mobiles over the crib, feet pianos, etc., to further the coordination and perception skills.further the coordination and perception skills.
EXERCISE 1
Offer different sizes and textures objects for grip, placing them at different distances.
We will offer the toy to get his/her attention and then we put it at different distances, so he/she try to grab it (always at hand or nearby, in order to
favor his/her mobility).We must not forget that the development of his/her motor development will be
much slower.We can use: rattles, dolls, balls, toy mobiles, etc.
Take into account the characteristics of the child’s hands, ( more shorter fingers, thicker hands).
EXERCISE 2
Let the child grab, hit, shake and throw the objects with one or both hands.
We offer to the child different toys, letting him to explore them, prompting him to shake them and to pull them (shooting is another
way to explore for him). If they are sonorous and with bright colors, it will be much better.
We can use: rattles, variety of toys, dolls, small balls, etc.
EXERCISE 3Provide mobiles over the crib, pianos for the feet, etc.,
to further their coordination and perceptive skills.
Place the mobile on the cradle and put it when the child is awake. We’ll make the same for the pianos for the feet which will encourage the
mobility of the child and their perceptual abilities, gain in motor agility, and we will have a good boost on the lower limbs.
Exercises from 7 to 12 months
FROM 7 TO 12 MONTHS• Offer to the child different objects to:
1. Passed from one hand to the other.2. Hit an object on a surface or two objects
one to another (8-9 months).3. Pull the objects on the floor and to look
with the eye side (8-9 months).4. Uncap an object that we’ve hidden from
his/her presence (9-10 months).5. Take out and insert objects into a 5. Take out and insert objects into a
container (10 months).6. Explore with the index finger objects that
have buttons, or that the point to (11 months). Start the gripper.
7. Use strategies to achieve something (pull a cord to sound music), (11 months).
EXERCISE 1Pass objects from one hand to the other.
Don’t forget that the ages are such as indication, because in each child it will be depends on its development.
Offer different kind of objects, first in one hand and then on the other. Give then one object in one hand and encourage to pass to the other
hand, helping him at the beginning(making us, so he/she will imitate us, or doing with him and then letting him to do it alone), in the beginning.
EXERCISE 2
Hit an object on a surface or two objects one against the other.
Give to the child an object and take another. We’ll beat on the floor so he/she can imitate us. Do the same with two objects, beating one to the
other. We can help the child to begin the activity and then we’ll left him, to do it alone.
EXERCISE 3
Throw objects on the ground and seek for them with the eyes.
We’ll let accessible objects for the kid to throw them, and we’ll play to watch them as they fall. An appropriate place for do this is the high
chair.
EXERCISE 4
Uncover an object that we have hidden from his/her presence
We’ll show to the kid an attractive object and we’ll hide before his sight, under a scarf or inside a pot and we’ll encourage him to seek for it. I
he/she don’t try, we’ll search for it and we’ll encourage again for do it.
EXERCISE 5
Remove and insert objects from a bowl.
We’ll offer a pot with big objects inside (preferably bold, with bright colors) and we’ll encourage him to take out of the pot with the hand
(without spilling) and to insert them again. If he/she doesn’t do it, we’ll do it for the child imitate us.
Those kids will take more time to get remaining seated.
EXERCISE 6
Explore with the index finger objects with buttons or pointing objects. Beginning the pinch grip.
We’ll offer to the child objects that have buttons to press with the index finger , we’ll encourage him to point at objects that he likes or that
attract the attention. We’ll also offer small objects (carefully) to start the pinch grip. Don’t forget that the pinch grip will be more delayed.
EXERCISE 7
Use strategies to achieve something (For example, pull a rope to make music sound).
We’ll offer (for example), toys with rope which can pull to sound music. At first we’ll teach how to do it and then we’ll encourage to do it alone.
Exercises from 1 to 2 years old
FROM 1 TO 2 YEARS OLDProvide to the kid appropriate objects for:
1. Hitting, fit, stack, remove, insert and scribble.
2. Throwing objects and follow their route through the space.
3. Hitting objects on different surfaces 3. Hitting objects on different surfaces and throw them to make noise.
4. The child look for objects that have moved before his eyes.
5. Can use instruments as a way to obtain the object (e.g. Pull a string to get a truck).
EXERCISE 1
To hit, to fit, to stack, to get, to put objects
and to scribble.
We will give to the child appropriate objects so that he/she can do these activities (boats, snaps, cubes, fat waxes, paper, etc.). First of all, we
will have to provide a model and then let he/she to do it alone. The
beginning of the scribbling is important at this stage.
EXERCISE 2Throwing objects and follow their route through the space.
Let the child throw the objects and follow them with the eyesight. We can use balls, cubes, etc.
EXERCISE 3
Hitting objects on different surfaces and throw them to make noise.
Give objects to the child which he/she can hit, preferably sounds objects like drums, rattles, etc. Let the child throw them (he/she needs this
experience to learn).
Exercise 4
The child actively seeks objects that have been displaced before his/her eyes.
Hide objects before his/her eyes, so that he/she look for them. If the child does not initiate the search, encourage he/she doing us the
first times, and showing surprise when find it.
EXERCISE 5
Use instruments as a mean to obtain the object
(e.g.: pull the rope to reach the car).
Giving the model, pull the rope to get the toy to do so by himself/herself. We can do other exercises such as using a stool to reach something, or to use some object to get a toy from under the
coach, etc.
Exercises from 2 to 3 years old
FROM 2 TO 3 YEARS OLD Use a pencil or a wax pencil more shorter and thick.
• Give to the child appropriate objects so that he/she
can:
1. Place cubes in decreasing size.
2. Build towers up to 8 blocks.
3. Imitating strokes. (First guiding in the air and
after on the paper).
4. Make puzzles of 2 or 3 pieces.4. Make puzzles of 2 or 3 pieces.
5. Insert figures in a board.
6. Pass sand or water from one container to
the other.
7. Modeling clay.
EXERCISE 1
Place cubes in decreasing size.
We can use any model of diminishing cubes. Serve as model doing us first, or starting the tower and let him/her putting more buckets.
EXERCISE 2
Build towers up to 8 blocks.
Provide to the child blocks to make towers, and play with him/her to make taller towers. The blocks still need to be large.
EXERCISE 3
Imitating strokes.
Using fat waxes and larger paper (A3), we will sit with the child and we will make an horizontally or vertically line, for him/her to imitate it.
We can also draw for him/her a circle or a cross. At the beginning we will guide the child’s hand, to let him/her to do that alone little by
little.
EXERCISE 4
Make puzzles of 2 or 3 pieces.
We will offer to the child very simple puzzles of two or three pieces, adapted to his/her age. First, we will do and then we will help him/her to do it alone, placing the pieces in order, or putting us the first piece, and then the second, letting him/her to put the third. At the end, we will let
the child, to do it alone.
EXERCISE 5
Insert figures in a board.
We will offer to the child fit boards, starting with a simple ones (few pieces and geometric shapes) to go to other more complex with
animals, transport media, etc. Initially, we will help the child to fit the piece, guiding his/her hand, for later leaving him/her alone.
EXERCISE 6
Pass sand from one container to another.
Take the child to the park or to the beach, with some blocks and a shovel, so he/she can play to pass sand or water from one container to
another. We will offer, as always, the model, so that he/she can do it by himself/herself alone.
EXERCISE 7
Modeling clay.
Offer to the child different colors clay to model, giving as a model simple forms as “churros” or balls. Help him/her at the beginning, to get
them leaving alone.
Exercises from 3 to 6 years old
FROM 3 TO 4 YEARS OLD• Give to the child appropriate objects so that he/she can:
1. Make puzzles from 4 parts.2. Insert the cord through a buttonhole.3. Imitate more complex strokes.4. Use safety scissors. It’s advisable to be scissors
with smaller holes.
5. Review discontinuous points to complete 5. Review discontinuous points to complete a draw.
6. Use the glue to make a collage.7. Buttoning buttons. With help.
8. Insert large skewers on a board. At the beginning free, later guided by us.
9. Mold clay making shapes torepresent things.
EXERCISE 1
Make puzzles from 4 parts
We can give to the child puzzles of 4-6 pieces to complete it. We can start with them and let him/her finish, then leave him/her alone. We will provide a model to the child and we will tell him/her to look at the
picture. We can increase gradually the pieces.
EXERCISE 2
Insert a cord through a buttonhole.
We can use balls to bind, link games or make one “homemade”, even use the own child shoes with laces.
We’ll help at the beginning, giving to the child a model, and then leaving him/her alone.
EXERCISE 3
Imitate more complex strokes.
We will give to the child models of strokes, for example in W or in zigzag, so that he/she can imite. We can help him/her giving a stippling.
He/she can also imitate a square.
EXERCISE 4
Use safety scissors.
We will help the child to use the scissors to do free clippings on the paper. With help he/she could follow a line or a single border, when he/she is
about 4 years old.
EXERCISE 5Review discontinuous points to complete a draw.
Make a simple drawing and let him/her to complete it (a square, a circle, etc.), placing discontinuous points for him/her to go over (review). We can guide a little hand at the beginning, and then letting him/her alone
little by little.
EXERCISE 6
Use the glue to make a collage.
Let the child free to cut papers and to use glue to stick on a sheet. We will explain him/her how to do it, and we will be his/her model. At first time we will he/she, and then we will let him/her let to do it alone. Try to get into
the habits child to close the glue when he/she finished.
EXERCISE 7
Buttoning buttons.
Do the child use any clothing with large buttoms to practice buttoning and unbuttoning. We will start the activity and we will offer to him/her the model so that he/she can do it by himself/herself. This activity is very
important to promote his/her autonomy.
EXERCISE 8
Insert large skewers on a board.
Offer to the child games with large skewers so that he/she can fit them on the board. Help the child at the beginning, and then let him/her do it
by himself/herself Try the child make simple drawings or series of colors to reinforce other skills and abilities.
EXERCISE 9
Mold clay making shapes to represent things.
Offer clay to the child and give him/her a model to do simple forms. He/she can learn to make human figures, snails, worms, etc. Previously
he/she should be acquired the ability to mold clay.
FROM 4 TO 6 YEARS OLD
• Give to the child appropriate objects so that he/she can:
1. Make puzzles of more than 6-8 pieces.
2. Trim with scissors more complex figures.
3. Make a drawing following the points.
4. Draw free pictures. Human figure.
5. Imitate complex strokes (letters and numbers)5. Imitate complex strokes (letters and numbers)
6. Insert little skewers on a board.
7. Buttoning his/her own dress (zipper, buttons, snaps, laces…)
8. Define the laterality.
EXERCISE 1
Make puzzles of more than 6-8 pieces.
Gradually increase the complication of the puzzles. We will continue helping the child, giving to him/her the model and beginning us to put the first
pieces.
EXERCISE 2
Trim with scissors more complex figures.
Give to the child more complex figures to trim (circles, squares, triangles, simples formats…). Guide him/her at the beginning.
EXERCISE 3
Make a drawing following the points.
Use review tokens with points. Let him/her do it alone. Try to correct as little as possible and reinforce always his/her achievements.
EXERCISE 4Draw free pictures. Human figure.
Give to the child a drawing model to imitate. Tell him/her that he/she has to draw the head, the body, the arms and the legs,
the eyes, the nose and the mouth to go slowly adding more details. Let him/her do free drawings. Encourage his/her imagination and reinforce always his/her achievements.
EXERCISE 5Imitate complex strokes (letters and numbers).
Reinforce at home the imitation of letters and numbers (especially vowels and the numbers from 1 to 5). Do not force the child. Let he/she do it alone and reinforce always his/her achievements. We will offer always
the model or begin the stroke, to then let him/her doing it alone.
EXERCISE 6
Insert little skewers on a board.
Provide little skewers to the child but adapted to his/her age. Help he/she at the beginning, then let him/her do it alone. Let him/her draw free
pictures to promote his/her imagination.
EXERCISE 7
Buttoning his/her own dress (zipper, buttons,
snaps, laces…).
Try that the child buttoned alone, varying buttons, zipers, velcro, snaps, laces, etc.). This activity will promote his/her personal autonomy, so
important in this age groups.
Exercise 8
Define the laterality.
Encourage his/her laterality toward his/her dominant side. If the child is lefthanded is important not contradict he/she.
AFTER 6 YEARS OLD:
• We will continue to undertake these activities but in a more complex way.
*Fit pieces in boards.
*Modeling clay.
*Building blocks.*Building blocks.
*Imitate strokes with much more complexity.
*Clothes for spinning.
*Review discontinuos points in a draw.
*Using the glue.
*Using scissors (with smaller holes).
*Pass objects from one container to another.
*We will use a prehension (gripping) ball.
*We will use smaller skewers.
*We will make different activities with the prehension (gripping) dice.
* We will make graphomotricity sheets (the pencil * We will make graphomotricity sheets (the pencil will be smaller and thicker).
