Minimize or eliminate fine motor activities that are very difficult for your child.
Use everyday activities:
1. Provide clothing with elastic waistband, elastic shoelaces, shoes with Velcro tabs, pullover shirt, and Velcro sewn into clothing.
2. Use modified equipment such as:
- cup with a handle
- “sippy” cup
- suction plate and bowl
- weighted utensils
- pencil grip
- fat pencil or marker
- adaptive scissors
- thick paper for cutting
3. Provide play materials and activities that develop coordinated use of hands and fingers, such as string/beads, Play Doh, Legos, finger paints, and crafts.
4. Allow student to choose either cursive handwriting or manuscript printing if one is easier than the other.
5. Having your child “warm up” his hand and finger muscles before he starts a fine motor task may decrease tremors. Lifting or squeezing a heavy object can provide such a warm-up.
Change the environment:
1. Make sure your child is well supported physically, with his desk or table at elbow height, for activities that require fine motor skills, including eating, drawing, handwriting, and desk work.
2. Use widely spaced lined paper, colored line paper, or tactile paper (paper with raised lines).
3. Let your child take a break from pencil/paper tasks. He can work on handwriting skills with activities such as:
- drawing with shaving cream or funny foam on a mirror or on the side of the bathtub.
- finger painting
- making words with magnets on the refrigerator or a magnetic board
- working at the chalkboard or dry erase board
4. Provide pre-cut materials for projects and craft activities.
5. Limit activities that require skilled fine motor control. If your student has trouble with paper and pencil tasks, substitute a magnetic letter/number board to ease the task of learning basic arithmetic, spelling, and writing.
6. Limit the number of items on a child’s desk. Make utensils and work materials easy to find and easy to access. Use:
- color coded file folders
- see- through plastic bins for pencils, scissors, etc
7. Provide alternatives to handwriting, such as a keyboarding, oral reports, dictation, and AlphaSmart.
8. Use a clipboard or tape paper to the table.
9. Supply teacher-prepared lecture outlines and notes of classroom presentations.
10. Decrease written language requirements in school with the following interventions:
- use a “scribe”
- fill-in-the-blanks, true-false, and multiple choice questions
- provide keyboarding and word processing instruction
- allow tests to be read aloud, and let student respond orally
- allow student to dictate rather than write
11. Many technological adaptations are available to facilitate computer use, including voice activated programs, word prediction programs, oversized keyboards, and a variety of mouse styles.
12. If your child has difficulty with hygiene skills (brushing his teeth, combing hair, and dressing), provide him with the help he needs on school days, and work to increase independence on weekends when both of you have more time.
Teach new skills:
1. Prioritize the skills that your student needs to learn or relearn. Fine motor skills, including handwriting, may be low on the list of priorities, considering all his educational needs.
2. Teach your student to use his index finger to make space between words when printing.
3. Teach your child to stabilize his worksheet or paper with his other hand when printing or writing.
The BrainSTARS manual was written by a team of professionals who have worked for many years with children and young adults who have brain injury. We wrote it because pediatric brain injury is very confusing for parents and teachers — and you are the most important people in the recovery of your child. It is important that a child's parents and teachers are well-educated so that they can work well together to provide the best chance for a child's recovery. Our goal is to make sure that every child has a safety net of support and understanding underneath him as he makes the leap back into life following a brain injury.
From BrainSTARS, Brain Injury: Strategies for Teams And Re-education for Students, © 2002 Jeanne Dise-Lewis, PhD. Used with permission. The manual is available in English and Spanish. For more information or to order copies, call 720.777.5470 or firstname.lastname@example.org. A short video on how to use the BrainSTARS manual is available at www.youtube.com/BrainSTARSprogram.