What are Fine/Visual Motor Skills?
Fine motor skills involve the coordinated movements of the small muscles in the hands and fingers. These skills include, but are not limited to, using manipulatives (small objects), grasping, and tool use (scissors, tweezers, writing instruments such as pencils, markers, and crayons). In most cases, these types of activities also require vision. This combination of motor skills (movement) and vision is referred to as visual motor skills, and may include such activities as coloring, tracing, writing, and cutting with scissors. Where it is fine motor skill that allows the child to hold the pencil, and grasp the scissors, it is visual motor skill that allow them to connect the dots, and cut on the line. These general skills, among other more specific abilities like in-hand manipulation (moving small objects around in one hand), visual perception (interpreting what is seen), and motor planning (thinking of, planning, and carrying out a movement) are necessary for virtually all academic, play, and self-care activities. These typically develop along a similar timeline for all children, and progress in a manner of skills being built upon one another.
Fine and visual motor skills have been a focus of teachers, therapists, and parents, and play a large role in child development. They should be strongly addressed when delays exist, as deficits in underlying skills may hinder the development of more complex and age-appropriate abilities. This is especially evident in handwriting, a complex ability heavily scrutinized in school, which is built upon a variety of underlying, prerequisite skills. Fine and visual motor skills are developed through an experiential approach of using tools and various grasp patterns when exploring and performing tasks, as well as the building of prerequisite factors, such as strength, range of motion, and coordination.
What does the literature say?
Fine and visual motor skills have been the topic of research literature for many years. They have been examined in numerous studies, looking closely at both the general abilities and the underlying skills. These underlying skills, and their role in handwriting, were explored in a study by Volman in 2006, stating that “children with handwriting difficulties appear to perform less proficiently on measures of visual perception, fine motor skill, visual-motor skill, and cognitive planning. The area of fine motor skill, which was further analyzed by Schneck in 1991, showed that problems manipulating a pencil, were due in part to deficits in proprioceptive-kinesthetic sensation (sensing pressure and movement). This difficulty with proprioceptive-kinesthetic feedback ultimately required compensatory techniques (ways to adjust for deficits) according to Schneck. Compensation was noted in two forms. The first being visual, where “the eyes are kept fixed on the pencil point”, which caused significant fatigue due to such intense visual focus. The second form of compensation was a “tight grip of the pencil in order to provide some feedback from the joints”, which also led to fatigue (Schneck, 1991).
Fine motor skill, especially that specific to handwriting and pencil grasp, is also built on another prerequisite ability called in-hand manipulation, which refers to “the process of using one hand to adjust an object for effective placement in that hand before use, placement, or release” (Lee-Valkov, 2003). This skill emerges alongside hand preference (using one hand more than the other) on the developmental timeline at approximately two to three years of age. The relationship between hand preference and coordination has been shown by Schneck, in 1991, claiming “that a child who develops a hand preference early is likely to develop motor activities demanding coordination and fine dexterity earlier than a child who develops hand preference late”. These two underlying components were shown to significantly impact the development of a mature pencil grasp for handwriting. Schneck in 1991, showed that “a relationship exists between the development of a preferred hand and the development of the dynamic tripod grip”. This dynamic tripod grasp, Schneck claimed in 1991, was most efficient, and involved the aforementioned in-hand manipulation. According to the study by Schneck in 1990, “Children 3 years of age can be expected to use pencil grips ranging from primitive to mature, By the age of 4 1/2 years, children can be expected to use transitional or mature grips, Children 6 years of age and older typically use the lateral tripod or the dynamic tripod grasp”. Where Schneck claimed that the dynamic tripod grasp was most efficient, with the lateral tripod being a close second, it was Schwellnus in 2012, that added the quadrupod grasps, both dynamic and lateral, stating that “No differences were found in speed or legibility among the four mature grasp patterns” and “Dynamic and lateral tripod, and quadrupod pencil grasp patterns produced writing with similar speed and legibility and are suggested to be equally functional for writing”. It was study by Lee-Valkov in 2003 that identified a distinct difference in grasp patterns, stating that power grasps (used for strength) were often static (hand and fingers are locked in position), where as precision grasps (used to delicate operations) were dynamic (the fingers move). This idea was demonstrated by Schneck in 1990, showing that children tend to use more of a power (static) grasp when coloring the center of a picture, and a precision (dynamic) grasp when coloring the edges. With that said, it was further explained in this study that “as a child refines their skills, they tend to use the same grip for both the edge and the center of a picture”.
Fine motor skills for children also encompass scissor use. This is a complex task requiring a variety of the aforementioned prerequisite skills. The combination of proper grasp, positioning of the scissors, and coordinated movements is necessary for effective use. Mitchell in 2012 summarized the grasp, position, and movement, explaining that the scissors are held “with the thumb through the top loop and radial fingers (index and middle) through the bottom loop, positioned between the DIP and PIP joints. The fingers of the cutting hand were flexed (bent), and movement of the radial fingers was used to open and close the scissors. The ulnar fingers (ring and pinky) remained flexed and fairly still. The forearm of the cutting hand was maintained in mid-position with regard to supination and pronation (as if shaking someone’s hand), and the elbow was flexed at approximately 90 ̊”. The scissors should be upright, with the top loop and blade being directly above the bottom loop and blade.
The fine motor and visual motor abilities, and their associated prerequisite skills mentioned are of significant importance in the overall development of a child. It is imperative that these areas remain a strong focus, and that intervention, when necessary, is effective. Fine motor interventions have been shown to be most effective when a “child-centered activity approach”, utilizing “behavioral (reinforcement and fading) and learning (cueing and motivating) principles to undergird interventions” (Case-Smith, 2013). Furthermore, it has been stated that “a child’s functional performance is intricately influenced by the opportunities and challenges presented by the social and physical environments” (Case-Smith, 1995). This means that the environment and context can impact how a child performs tasks. These contextual factors were shown to have the greatest beneficial effect when based on play. Case-Smith in 2000 noted the “importance of therapeutic use of play in intervention”, and again in 2013, stating “Motor interventions that resulted in significant changes in children’s motor performance incorporated use of meaningful play activities”. This idea of using play activities to teach and develop skills has been proven, and should certainly be incorporated into interventions. Where “short-term interventions have had a significant effect on fine motor and visual–motor integration skills” (Ohl, 2013), so have long term programs, and curriculum modifications. McHale, in 1992 stated that effective modifications of curriculum might include the “providing of alternative modes of response and learning, or the reduction of the volume of written work while ensuring that adequate practice for learning new tasks is being provided”. Lust, in 2011 added the idea of all students, not only those with significant fine motor delays, benefitting from this type of curriculum modification.
Finally, it was shown that specific fine motor programs, beyond that of modification of a curriculum, had significant benefit. Lust (2011) stated that a multi-sensory, fine motor program was more beneficial that merely handwriting activities. This was confirmed by Ohl, in 2013 citing the benefits to both fine and visual motor skills from this type of programming. The aforementioned studies are merely a small sample of information. Fine motor skills have been examined thoroughly over the years, and will continue to be considered paramount in the overall development of children. They encompass a variety of abilities, and a wide range of underlying skills. These skills and abilities must be addressed, and as shown, it is the inclusion of play that has the potential to improve the effectiveness of interventions. “Play is our brain’s favorite way of learning” – Diane Ackerman
Why is play so important?
Development of skills in children, be it fine motor or any other, is contingent upon motivation. When a child is enthused about and willing to engage in a therapeutic or educational task, they are more apt to improve. Fred Rogers stated that “Play is the work of childhood” and that “Play gives children a chance to practice what they are learning”. Often in the attempt to teach children such mundane skills as handwriting, scissor use, or grasping, the idea of fun or play is lost. Interventions can lack fun and enjoyment, leading to a loss of motivation. With that said, it is imperative that the aforementioned skill development continue to be addressed, but with the inclusion of a sense of play and fun, ensuring motivation and therefore the cooperative engagement in therapeutic and educational interventions. Noggins are the culmination of fine and visual motor skill development, and motivational play.
What are Noggins?
Noggins are a product meant to be used in the education of tool use and the development of fine motor skills. They are highly play-centered, transforming a variety of skill development interventions into motivating and fun activities for children. It is a foam sticker, to be used in conjunction with existing tools and objects (scissors, pencils, etc.). It is merely attached to a variety of items, ultimately turning those items into characters. These characters, when used, act to teach skills and develop prerequisite abilities.
Is there anything similar out there?
There are products currently available which function to address areas included in the scope of this invention. However, there is no such comparable product in existence encompassing the range of this intervention. Pencil grips are a widely available product designed to prompt a child into using a correct grasp on a writing utensil. They come is a variety of forms, colors, textures, and designs, but all function similarly. The problem with these is the lack of generalization, allowing them to be utilized with writing utensils varying in size and shape. They only fit and allow usage with standard circumference pens and pencils, and are therefore limited in their ability to cater to a larger range of abilities and preferences. Furthermore, they do not possess significant motivational qualities in the form of play. They are designed for function alone, and lack any entertainment value.
Children’s scissors come in a variety of designs. These current designs are focused on proper sizing for children which allow for correct finger placement and grip. However, they too lack any entertainment value. Although many are available in vibrant colors, patterns, and shapes, they do not motivate children to use scissors. These products especially neglect any form of cuing regarding the concept and effective usage of scissors. This lacking of built in prompts allows for incorrect handling and positioning of the scissors (holding them with two hands, upside down, or sideways). Finally, there is no current product being utilized in conjunction with existing tools (tweezers, clothespins, etc.) to address fine motor skills and the associated prerequisite areas of finger strength, range of motion, and coordination, as well as education in the proper usage of the tool itself. Furthermore, no existing product is able to be used directly with the fingers, which allows practice of various grasps and in-hand manipulation skills.
What is the purpose of Noggins?
The purpose is two-fold. It is first to be used as a motivator for younger children to engage in educational and therapeutic tasks focusing on the development of fine and visual motor skills, and prerequisite abilities by transforming mundane objects and activities into fun, enjoyable, play. This is accomplished by turning objects (scissors, writing utensils, etc.) into characters. These items and tools become creatures and animals by adding a head, simply by adhering the sticker onto them. The second, and equally important purpose is to teach and facilitate proper grasps, tool usage, and prehension patterns by cuing and prompting. For example, when adhered to the top blade, scissors become an animal or character. The bottom blade becomes the jaw, and the concept of scissor use is taught by making the character “bite” paper. Correct orientation of the scissors is cued visually by seeing the character positioned upright, looking forward. When adhered to writing utensils, this product acts a physical prompt for correct finger placement, while also becoming a character with its tongue out, allowing the child to have their character “lick” the paper. Furthermore, these stickers may be adhered to children’s fingers themselves, transforming their own hands into puppets. Various prehension patterns (pincer grasp, lateral pinch, etc.) may be taught by having the character “chew” or “bite”. The combination of these two areas allows children to develop skills and abilities, while engaging in fun and motivating play activities.
How are Noggins unique?
As mentioned, many current products addressing these areas are solely focused on function, and lack any motivational qualities. Noggins are heavily focused on motivation, and transforms mundane educational interventions into play. Furthermore, they not only allow for, but encourage imagination in children, affording them the opportunity to explore their creativity while simultaneously working on skill development. Noggins exclusively teaches all aspects of scissor use, from concept, to orientation, to action. It offers a visual cue of how scissors are to be positioned properly and used effectively. By prompting the child to have the character keep its head up and looking forward, it ensures the scissors are in the correct orientation. By allowing the child to imagine the character is biting, and by letting them see and associate the movement of the blades to eating, it solidifies the concept of scissor use and the effective movement necessary for usage. Finally, it is able to be fitted to a variety of existing designs. It is easily adjustable and accomplishes its purpose when used in combination with various shapes and sizes of children’s scissors.
Where other pencil grips do exist, Noggins alone transform writing utensils into characters, with the added availability of a verbal cue to have the character “lick” or “smell” the paper in order to facilitate writing in a fun and imaginative way. It is also adaptable and able to fit virtually any size or shape writing utensil, where other similar products are not. Furthermore, it is a comfortable physical prompt facilitating proper grasp. Noggins are the only product that allows use with a variety of existing tools (tweezers, pliers, etc.) to not only teach the usage of those tools, but also utilize their function to address prerequisite fine motor skills, such as strength, range of motion, and coordination. By again, attaching this product to various tools, it transforms them into characters, allowing children to operate them using proper orientation, positioning, and technique. It further acts as a motivator, by turning tools into toys and exercises into play. Noggins are also able to be used in the absence of any other object or tool, by adhering directly to the child’s fingers. Depending on positioning of this product, the child’s hand becomes a character, and various prehension patterns may be addressed, including lateral pinch and pincer grasp. The child is entertained and motivated by the imaginative play of acting out various movements and motions of their finger puppets. Finally, Noggins possess two qualities of significance not currently seen in comparable existing products. First, they are repositionable and adjustable. This product utilizes a very specific adhesive that allows it to be securely attached to a variety of surfaces, but removed and reused again and again. This capability allows for skills to be developed with the product applied, but then carried over and generalized when removed. Second, there is no limit to the variability in characters. There is a virtually infinite amount of characters, from robots and monsters, to fish and birds. This selection allows the child a choice, and continued motivation and imaginative play.
What can Noggins do?
Noggins have the potential to address virtually all areas mentioned in the literature regarding fine and visual motor skill development. Depending on placement of the Noggins, they can either turn objects into characters and teach tool use, or turn the child’s hand into a puppet, teaching various grasps or in-hand manipulation. When used in conjunction with the accessory worksheets, visual motor skills may be addressed, including coloring, tracing, and cutting with scissors. These worksheets also include various visual perception tasks, and require motor planning to complete. The combination of these fine and visual motor skills addressed by the Noggins and their associated worksheets assist in the development of handwriting. The underlying skills mentioned earlier may also be either worked on directly or compensated for through the use of Noggins. Hand preference may be encouraged by using the Noggins only on one hand during grasping activities. And the lack of proprioceptive-kinesthetic sensation may be compensated for during writing/drawing tasks by giving feedback from the soft foam texture, and input from the added weight when attached. Specific pencil grasps may be worked on using Noggins. All four of the aforementioned appropriate grasps (dynamic tripod / quadruped and lateral tripod / quadruped) are able to be addressed depending on how the Noggin is attached to the writing instrument.
Grasping in various ways are also able to be taught. By attaching the Noggins to the child’s fingers in different positions, they are able to teach a variety of prehension patterns, including a pincer grasp, lateral pinch, and tripod. This option also allows for focus on both strengthening and range of motion, depending on what is being grasped. As mentioned, scissor use is a complex skill, encompassing multiple aspects. All of these may be taught using Noggins. When attached to virtually any style of children’s scissors, they help to address the concept of use, proper grasp, and orientation. Furthermore, this benefit could possibly be carried over beyond scissors, to tweezers, pliers, or clothespins.
With those specific skills mentioned, it is the idea of play where the Noggins truly shine. They are able to transform the mundane interventions used to teach those skills into a fun, imaginative, and playful activity motivating to children. The child can be lost in the fantasy world of Nogginsland, while unwittingly receiving education and skill development. With that said, the Noggins are also removable from any objects they are being used, allowing for a generalization and carry over of skills. Finally, with the specific language used to instruct movements and tasks, as well that the accessory worksheets and wide range of available activities, Noggins is ideal for a large scale fine / visual motor program or to fit into virtually any curriculum or Response to Intervention setting (a multi-tier approach to the early identification and support of students with learning and behavior needs). Please see the instructions section for specific information regarding Noggin placement and usage to address various skills and abilities.
Volman, M. J. M., van Schendel, B. M., & Jongmans, M. J. (2006). Handwriting difficulties in primary school children: A search for underlying mechanisms. American Journal of Occupational Therapy, 60(4), 451-460.
Lee-Valkov, P. M., Aaron, D. H., Eladoumikdachi, F., Thornby, J., & Netscher, D. T. (2003). Measuring normal hand dexterity values in normal 3-, 4-, and 5-year-old children and their relationship with grip and pinch strength. Journal of Hand Therapy, 16(1), 22-28.
Ohl, A. M., Graze, H., Weber, K., Kenny, S., Salvatore, C., & Wagreich, S. (2013). Effectiveness of a 10-week Tier-1 Response to Intervention program in improving fine motor and visual–motor skills in general education kindergarten students. American Journal of Occupational Therapy, 67(5), 507-514.
Schneck, C. M. (1991). Comparison of pencil-grip patterns in first graders with good and poor writing skills. American Journal of Occupational Therapy, 45(8), 701-706.
Schneck, C. M., & Henderson, A. (1990). Descriptive analysis of the developmental progression of grip position for pencil and crayon control in nondysfunctional children. American Journal of Occupational Therapy, 44(10), 893-900.
Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting in children. American Journal of Occupational Therapy, 66(6), 718-726.
Mitchell, A. W., Hampton, C., Hanks, M., Miller, C., & Ray, N. (2012). Influence of task and tool characteristics on scissor skills in typical adults. American Journal of Occupational Therapy, 66(6), e89-e97.
Case-Smith, J. (1995). The relationships among sensorimotor components, fine motor skill, and functional performance in preschool children. American Journal of Occupational Therapy, 49(7), 645-652.
Case-Smith, J. (2000). Effects of occupational therapy services on fine motor and functional performance in preschool children. American Journal of Occupational Therapy, 54(4), 372-380.
McHale, K., & Cermak, S. A. (1992). Fine motor activities in elementary school: Preliminary findings and provisional implications for children with fine motor problems. American Journal of Occupational Therapy, 46(10), 898-903.
Lust, C. A., & Donica, D. K. (2011). Effectiveness of a handwriting readiness program in Head Start: A two-group controlled trial. American Journal of Occupational Therapy, 65(5), 560-568.
Case-Smith, J., Clark, G. J. F., & Schlabach, T. L. (2013). Systematic review of interventions used in occupational therapy to promote motor performance for children ages birth–5 years. American Journal of Occupational Therapy, 67(4), 413-424.