Postural Control and Shoulder Stability for Fine Motor Skills

The foundation of fine motor control starts with other factors.  A child can’t have good control of his/her hand if their body, shoulder and arm are not stable first.  If your child has good postural control and a stable shoulder, his/her fine motor skills are bound to improve.  How can we address this?  Activities performed while on their tummies, in kneeling, crawling and bearing their weight through their arms are a good place to start. Remember, you can work on strengthening and improving hand function alone all you want, but if your child continues to have poor postural control and shoulder stability deficits, functional fine motor skills will continue to be difficult.

Let’s look a bit more at core strength for postural control...
The body’s “core” refers to the muscles of the abdomen, pelvis, hips, back and neck.  It is the center of gravity and affects all functions of movement and postural activities.  For building core strength, try some of the following:

Downward Dog yoga pose
-a variation of this would be to have the child assume this pose with his/her hands on 2 frisbees and push the 2 frisbees across the room with their knees slightly bent (but not crawling).  Have them go through an obstacle course in this manner.

 Bridge pose
-have child lie on his/her back on the floor, bend knees and lift their pelvis off of the floor.  Roll a ball underneath them as they sustain the pose, or see how long they can sustain it.

 In a group situation, have the kids sit in a circle and pass a ball to each other using only their feet.  Change the size of the ball for a variation (use a beach ball, balloon, football, etc).

 Curl ups
-have child lie down on the floor, legs together, knees bent and feet flat on the floor.  Put a bean bag between his/her knees to keep knees together.  Hands on thighs, have child raise head off of floor and slide hands up to knees.  Try to hold this position.

 Walk a tight rope
-put a tape line on the floor and practice the following:
walk heel to toe on the line (if too hard, just walk normally along the line without stepping off)  For variations:
have the child balance a bean bag on their head while walking the line
make the path curve
half way down the line, place an object on the floor, and have the child slowly bend to pick it up without stepping off of the line or dropping the bean bag

 Crab/Animal walks
-Have the child push up and raise pelvis off the floor to crab walk (seated on floor with knees bent and leaning on arms behind them).  Have the child crab walk for a distance, or have them balance a bean bag or a plush toy on their stomach while crab walking. Try other animal walks:  bear walk, seal walk, etc.

 Chair leg-lifts
-have the child stand sideways behind a chair and rest their hand on the back of the chair.  Have them slowly lift their leg, bending the hip and knee to 90 degrees.  Hold it briefly, and then slowly lower the foot until it almost touches the floor and then raise it again.  Do it on the other side as well.  For variations:
after raising their leg, let go of the chair and keep their balance
try it with their eyes closed

 Use a playground/jungle gym
-have the child pull themselves up on a knotted rope, chin up bar or hanging rings, cross the monkey bars, etc.
**any activity that requires the child to lift both feet together at the same time addresses core muscles

 Wheelbarrow walk
-child supports self on extended arms with an adult holding at the ankles, and they walk on their hands.  Variations:
roll over a large exercise ball into weight bearing through their hands.  Have them walk themselves forward and backward back onto the ball
in same position over the exercise ball, roll lower extremities up (so that their bottom is higher up in the air and their feet are on the ball)

 Straight body hold
-place a stack of mats (of even height) parallel to each other.  Have the child lay their head and shoulders on one stack of mats, and legs on the other (so that their middle is what is not supported by the mats).  Have the child keep their mid section elevated off of the floor and hold the position.  Variations:
have them try to roll over while sustaining the position
move the mats further apart

Sustaining a position
-have the child balance in a push up position.  Have them lift up one arm to pick an object up off of the floor and put it into a container while sustaining this position (or put a simple puzzle together).  Try the other arm, too.  Variations:
pick up and throw an item at a target while in this position
have 2 children face each other in this position.  Have them each lift up a hand to high five each other
balance in this position, and raise one arm up while slightly turning the body
too hard?  Weight bear through an elbow instead of a hand

Completing activities while kneeling forces kids to use abdominal/postural muscles. Try playing a game of catch or other activity while "tall kneeling", and don’t allow your child to sit back on their heels while in this position.

For shoulder work, have your child make big circles on a chalkboard (or white board, or paper taped to wall), or have him/her erase/wash a chalkboard or window.

Another activity that I do often in therapy sessions is to have the child tailor sit (sit with legs crossed) on a scooterboard and pull them with a jump rope (they hold the jump rope while you are pulling them).  This makes them have to sustain their balance as well as use muscle co contraction in their upper extremities.

Bat/ball activities work on shoulder control as well, and are activities that you can try in your yard while playing with your child.

Some of these activities may be too hard for your child to start out with, and you may have to modify them to make them easier for them to complete (do them less times, for a shorter duration, etc.).  Make it about playing, not about work, because if it is perceived as work, it’s just not as much fun!