Learn what in-hand manipulation skills are, and how they are linked to developing more efficient fine motor skills, and writing skills.
In-hand manipulation is the ability to move an object in your hand using only your thumb and fingers.
As a Pediatric Occupational Therapist of 15+ years, this is a skill that I look for in every evaluation that I complete. Kiddos will begin to learn this skill typically between the ages of 2 and 4 years old and should be mastered around 7 years old.
There are some easy ways to detect if a kiddo is struggling with their ability to use their in-hand manipulation skills. These kiddos will often use their other hand, chest, or another surface such as a table or the floor to reposition the item. They will also frequently drop items that they are trying to hold.
How You Use In-hand Manipulation Skills Everyday
The most commonly known activity that uses in-hand manipulation skills is writing. In writing, you move your fingers to adjust the pencil for letter formation, letter placement on a line, and coloring.
But in-hand manipulation is also used for adjusting your toothbrush while brushing your teeth, picking up multiple pieces of silverware from the table after dinner, folding laundry, and adjusting the shoelace when tying your shoes.
More examples would be managing change to give someone a specific coin, and opening the plastic bag for fruit or vegetables at the grocery store.
I could keep going on how we use in-hand manipulation skills for everyday tasks, but I think you have the idea!
In-hand Manipulation Skills Broken Down
There are 3 different skill sets for in-hand manipulation: translation, rotation and shift. In my experience as a Pediatric Occupational Therapist and mom, kids typically learn this skill in 4 stages.
Translation is the first skill learned. Followed by rotation and then shifting. The 4th step is being able to manage all of these skills with multiple items in their hand. This typically does not happen until around 6-7 years old.
Translation is the ability to move an object from your palm to your fingertips.
Kids will start working on translation by picking up an object with their fingertips and then moving it into their palm. As they master this direction, they will then begin to move an item from their palm to their fingertips.
Activities That Work On Translation
- Place a coin, pompom, or small piece of food in your palm and use your fingers to move it between your thumb and pointer finger tips before dropping it in a slot
- Pick up a small object and store them in your palm. See how many you can hold before one falls out!
- Store beads in your palm – Work one bead to your fingertips and string it onto a pipe cleaner. How many can you store in your palm before one falls out?
- Crumble a piece of paper into a ball using only one hand
- Pick up crayons, teddy bear counters, or lego pieces one at a time, using one hand, and store it in your palm before picking up another one with the same hand
A kiddo who struggles with translation will empty their hand on a table or floor and then pick up the item one at a time. These kiddos will also use their other hand to pick out the desired item while in the other palm.
Also, watch for kids to drop the item before moving it all the way to the tip of their fingers. Kids will often stop at the point where their thumb is fully extended and without bending their pointer finger.
Rotation is the ability to turn an object using the pads of your fingers.
There are two types of rotation: simple and complex. Simple is when you twist open or close a lid on a container. Complex rotation is when you turn an object over to the other side. For example, flipping a coin from heads to tails.
Activities that Work On Rotation
- Flip items laying on a table: coins, cards, popsicle sticks
- Twist lids off – snack containers
- Easy-Twist Animal Builders, or turn nuts onto a carriage bolt
- Make small balls using play dough
- Activate Wind-up Toys
- Spin a top
- Alphabet Locks – insert and turn a key to unlock a lock
- Tennis Ball Letters – Write letters on a tennis ball. Use one hand, and move the ball with only your fingertips to find the desired letter. “Press” the letter with your thumb!
A kiddo who struggles with rotation may use two hands to move an object. They may also drag an item to the edge of the table to pick it up rather than pick it up where it was positioned. They will also use their other hand in order to flip their pencil to erase a mistake.
Shifting is the ability to move an object using only your fingertips in a forward or backward motion.
This is most commonly seen when a kiddo adjusts their hand position on a pencil by moving their fingers up or down the shaft without using their other hand or the table to assist them.
Activities that Work On Shifting
- Pull or push paper through a slot – Kids will try to do this using their whole arm. To help make them use just their fingers, have them lay on their stomachs and then prop themselves up onto their elbows.
- Pick up one card at a time on a table – make sure that your kiddo does not drag the card to the edge of the table to help assist picking it up!
- Turning one page at a time in a book
- Pencil Walks
A kiddo who struggles with shifting, will often use two hands to reposition an object. They will also “drop” their pencil or crayon between their fingers until it hits the table. This action changes the position of the pencil rather than them using their fingers to move the pencil.
Why Work on In-Hand Manipulation Skills
Increasing the accuracy and proficiency of your kiddo’s in-hand manipulation skills will positively impact their ability to use their hands.
A study published by the Journal Of Physical Therapy Science, concluded that in-hand manipulation skills was one of the two fine motor skills that impacted writing legibility.
It also mentioned that if children do not develop readiness skills that include in-hand manipulation “they are at risk for developing bad writing habits“.
In-hand manipulation development impacts writing legibility because you learn how to move your fingers in order to move an object, in this case a pencil.
Kids who do not have the opportunity to learn how to move their fingers efficiently will revert to alternative methods. These methods can cause inefficient movement patterns that cause clumsiness, requires additional time to complete, and decreased task endurance.
Where to Start?
If you are not sure where to start, I would recommend starting with translation, picking up items one at a time and storing them in their hand. This works great for picking up Lego pieces, snacks, or crayons. Make it a game to see how many pieces they can store in their hand before one falls out!
The most important Occupational Therapist tip that I have for you, is to meet your kiddo where they are. If an activity is too hard, make it easier for them. Once they get better at the skill then make it a little harder.
Lastly, be patient. In-hand manipulation takes years to develop. It is a skill that takes time to mature, but once it’s mastered your kiddo will utilize it throughout their lifetime.
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If you have any questions, please leave a comment below. I am sure that you are not the only one with the same question! I read all comments and would love to hear from you!
Kelly is a licensed Occupational Therapist with 15 years of experience servicing school-aged children and Early Intervention. She is the founder of OT Perspective and a mom to 4 children. To learn more about her, check out her About Me page, here.