The Importance of Upper Extremity Weight Bearing

I have a few little people on my caseload this year who, for various reasons, have had very little sensory/proprioceptive input to their upper extremity joints/hands as they have grown and developed. In a couple cases, the kids have had significant sensory defensiveness, and have not been able to tolerate holding anything or touching anything with their palms.  In another case, the child was developmentally delayed, and had very little to sporadic stimulation/intervention early on.

So, what are the consequences of kids not having had weight bearing experiences over time?  

• weak hands
• poor grasp patterns
• poor fine motor skills
• poor body awareness

**Prone activities (when babies/kids lay on their tummies and play), crawling, and weight bearing through the arms and into the shoulders are all important for fine motor development. 

Do you have a child or work with a child who has weak hands/grasp patterns, poor fine motor skills and/or decreased awareness of how his/her body works in space?  You should think about trying to encourage some weight bearing activities as a means of improving some of the above mentioned deficit areas.  

Here are some activities to encourage weight bearing:

-Have the child lay on their stomach on the floor while completing an activity, such as coloring, putting together a puzzle or playing a game

-Have the child complete an activity, such as a game or puzzle, while on their hands and knees (4 point position).  Have them try not to sit back on their heels, as this discourages having to bear weight through their arms.

-Laying on their stomach, roll over a therapy ball on to extended arms.  While in this position, have the child pick some items or toys up off of the floor and put them into a container.  Have them vary which arm they use, how far you put the container away or to which side you put the container to encourage weight shifting.

This little girl is a reluctant weight bearer, but seeks all kinds of deep pressure and tactile input
by slapping her hands hard on surfaces.  Loves to be over the ball, though.

Same little girl weight bearing while over a therapy ball- she is picking up small blocks
and putting them into a container.

-Wheel barrow walk, or do various animal walks (crab walk, bear walk, seal walk, etc)

-Have the child sit in a side sitting position and lean on an extended arm while doing an activity

-Have the child lay on their stomach on a scooter board and pull themselves along with their upper extremities

-While on hands and knees, have your child help you "clean" the floor with a sponge, or draw/color/play with sidewalk chalk

-When kids are sensory defensive and do not tolerate you assisting them or imposing weight bearing on them, you can get creative by setting up the environment or their play so that they are weight bearing all on their own (for example, put something just out of their reach while they are playing on the floor so that they lean forward on their hands to reach for it).

This child is not one to tolerate assistance with weight bearing through his hands- here he is leaning on a table to
reach at some items that I have placed across the table from him.