School Readiness Skill Building
from an OT perspective
Paola Azzuolo OT Reg(Ont.)
All Kids Can Fly
www.allkidscanfly.ca
Paola.azzuolo@allkidscanfly.ca
What skills are required to be
school ready?
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Good Hand Skills
Upper Extremity Control
Grasp Patterns
Bilateral Hand Skills
Visual Motor Control
Activities of Daily living.
Self-Regulation
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paola.azzuolo@allkidscanfly.ca
Hand Developmental
Milestones
• Development of arches in the hand
• Development of wrist extension.
• Development of an awareness of the
skilled side of the hand..
• Development of an open web space.
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paola.azzuolo@allkidscanfly.ca
Upper Extremity Control
• This control comes from the ability
to move your arm with precision as
well as the ability to vary the
strength or force of movement.
• Factors that contribute to upper
extremity control are shoulder,
forearm, wrist strength, and good
body in space awareness.
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paola.azzuolo@allkidscanfly.ca
Grasp Pattern Development
• Fisted grasp: The pencil is held in a
fisted hand with the point of the
pencil on the fifth finger side of the
hand. Child’s wrist is slightly flexed
and forearm supinated. This is typical
of children ages 1-1.5 years.
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paola.azzuolo@allkidscanfly.ca
Pronated grasp:
• The pencil is held with the all fingers
and thumb with tip in thumb and
index. This is typical of children ages
2 to 3 years.
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paola.azzuolo@allkidscanfly.ca
Static Tripod Grasp :
• Grasp with tip of pencil in the thumb,
index and middle fingers, movement
comes from arm and shoulder. This is
typical of children ages 3-4 years.
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paola.azzuolo@allkidscanfly.ca
Dynamic Tripod Grasp:
• Grasp with tip of pencil in the thumb,
index and middle fingers, movement
comes from fingers while pinky side
of hand rests on table. This is typical
of children ages 4.5-6 years.
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paola.azzuolo@allkidscanfly.ca
Inefficient Grasp Patterns
• Five finger grasp: The pencil is held
with the tips of all five fingers. The
movement when writing is primarily
on the fifth finger side of the hand.
• Thumb tuck grasp: The pencil is held
in a tripod or Quadripod grasp but
with the thumb tucked under the
index finger.
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paola.azzuolo@allkidscanfly.ca
Inefficient Grasp Patterns
• Thumb wrap grasp: The pencil is held
in a tripod or Quadripod grasp but
with the thumb wrapped over the
index finger.
• Tripod grasp with closed web space:
The pencil is held with the tip of the
thumb and index finger and rests
against the side of the third finger.
The thumb is rotated toward the
pencil, closing the web space.
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paola.azzuolo@allkidscanfly.ca
Inefficient Grasp Patterns
• Finger wrap: The index and third fingers
wrap around the pencil. The thumb web
space is completely closed.
• Flexed wrist or hooked wrist: The pencil
can be held in a variety of grasps with the
wrist flexed or bent. This is more typically
seen with left-hand writers but is also
present in some right-hand writers.
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paola.azzuolo@allkidscanfly.ca
Examples of Pencil Grasp
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paola.azzuolo@allkidscanfly.ca
Bilateral Hand Skills
• Refers to the ability to use your hands
together to accomplish a task.
• For example, when drawing, the pencil is
held in the dominant hand & the nondominant hand is preventing the paper
from moving.
• Another example is when using scissors,
the lead hand is operating the scissors &
the assist hand is holding & turning the
paper when cutting around a corner.
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paola.azzuolo@allkidscanfly.ca
Age Expectations for Scissor Skills
2-3 years:
• often holds scissors with two hands to
open and close
• Begins to open and close the scissors with
a mature grasp
• Learns to snip paper; there is no forward
movement of the scissors
• May be able to use “helping hand” to hold
paper and bring into scissors
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paola.azzuolo@allkidscanfly.ca
Age Expectations for Scissor skills
3-4 years:
• Cuts on straight lines with some accuracy
• Cuts on curved lines and around corners, but
without accuracy
• Begins to turn the paper with “helping hand”
4-5 years:
• Can cut fairly accurately along curved lines and
around shapes
• Turns the paper fairly effectively with “helping
hand” to stay on the line
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paola.azzuolo@allkidscanfly.ca
Visual Motor Control
• Refers to the ability to coordinate
eyes, arms & hands.
• Contributes to one’s ability to learn
new shapes, cutting, drawing and
writing
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paola.azzuolo@allkidscanfly.ca
Age Expectations for Visual Motor
Skill Development
• One year old: scribbles
• Two year old: imitates vertical lines,
horizontal lines, paints
• Three year old: copies circles, imitates
oblique lines
• Four year old: Draws a person with 3 body
parts, copies a cross
• Five year old: Copies a triangle, draws a
person
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paola.azzuolo@allkidscanfly.ca
Activities to improve Visual Motor
Integration
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Salt tray
Clay tray: use gold tees to draw
Shaving cream
Popsicle sticks
Pegboard or Lite Brite
String colored beads with a pattern
Sidewalk chalk
Lacing
Coloring
Origami
Flashlight tag
Play catch with various balls
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paola.azzuolo@allkidscanfly.ca
Activities to Promote Hand Skill
Development
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Squirt bottles, turkey basters, eye dropper activities
Bead stringing/lacing
Pouring
Practice opening different lids
Spin tops or play with wind-up toys
Various small writing tools (chalk, pastel)
Pop Bubble Wrap
Play dough/Silly putty
Use of various tongs
Tearing paper or crumpling paper into balls
Handful of pennies into slots
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paola.azzuolo@allkidscanfly.ca
Activities to Promote Handwriting
Development
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Painting, chalk, coloring,
Drawing people or homes or animals
Building letters with straws or popsicle sticks
Learn upper case letter formation before learning lower
case.
• Use small writing tools
• Encourage top to bottom formation for vertical lines; left
to right formation for horizontal lines (unless left-handed);
and counterclockwise rotation for O, C, Q, G (unless lefthanded).
• Recommend Handwriting Without Tears (www.hwtears.com)
program for learning letter formation.
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paola.azzuolo@allkidscanfly.ca
Correct Seating/Posture
• Look Out For:
1. Tables that are too high/too low
2. The students legs dangling from the chair
without support under their feet
• What Can You Do:
1. Place the child’s feet on a couple of phone
directories or a small stool
2. Raise the height of the chair or the table
3. 90-90-90 rule
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paola.azzuolo@allkidscanfly.ca
Dressing Skills
One year old:
• Removes socks
• Puts on and takes off hat
• Assists with dressing
Two years old:
• Removes shoes
• Pulls down pants
• Assists with undressing and dressing
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paola.azzuolo@allkidscanfly.ca
Dressing skills (continued)
Three Years:
• Can button large front buttons and zip and unzip a
jacket if the shank is already connected.
Four years:
• Able to insert the shank together to zip up a
jacket with practice
Five years:
• Able to dress independently depending on how
much practice he has had
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paola.azzuolo@allkidscanfly.ca
How to promote dressing skills
• Use backward chaining approach
• https://www.canchild.ca/en/canchildresour
ces/resources/chaining.pdf
• Visual schedules can be useful for some
• Best to encourage parents to work on such
skills at bath time (for undressing) or
during weekends as it needs not to be
rushed.
www.allkidscanfly.ca
paola.azzuolo@allkidscanfly.ca
Self-Regulation
• Is a critical competency that underlies the
mindful, intentional, and thoughtful
behaviors of younger and older children
alike.
• Self-regulation or Executive function
refers to the capacity to control one’s
impulses whether it be to stop a behavior
or to start, if needed.
• Self-Regulation is not obedience or
compliance
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paola.azzuolo@allkidscanfly.ca
Development of Self-regulation skills
• Self-regulated children can delay gratification,
suppress impulses long enough to think ahead to
the consequences of their actions and to consider
alternatives actions
• Not limited to the social-emotional domain
• Also applies to the cognitive behaviors such as
remembering or paying attention.
• Self-regulation is ranked as the most important
competency for school readiness
www.allkidscanfly.ca
paola.azzuolo@allkidscanfly.ca
How to promote it?
• Eliminate waiting in line with nothing to do,
wandering around the classroom during
center time, being unclear about what to
do during an activity, and not being able to
get help.
• Rather, create a consistent classroom in
which expectations are clear and fairly
enforced and where children are engaged
in meaningful activities at all times.
www.allkidscanfly.ca
paola.azzuolo@allkidscanfly.ca
Make-believe Play
• Mature, intentional make-believe play is
foundational for self-regulation
development in preschool
• All play is NOT created equal
• Make-believe play provides the three
types of interactions which lead to selfregulation:
1. Regulation by others
2. Regulation of others
3. Self-regulation
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paola.azzuolo@allkidscanfly.ca
Do you have any
questions?
www.allkidscanfly.ca
paola.azzuolo@allkidscanfly.ca
References
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American Occupational Therapy Association (2002). Occupational
therapy practice framework: Domain & process. American Journal
of Occupational Therapy, 56, 609-639.
Bridgeman, M. (2002).The Finer Motor Olympics. Maine: Therapro,
Inc
Case-Smith, J. (2005). Occupational Therapy for Children.
Missouri: Elsevier.
Erhardt , R. (2009). Erhardt Developmental Products Hand Poster.
Texas: Pro-Ed.
Frick, S.M & Kawar, M.J. (2004). Core concepts in Action.
Wisconsin: Vital Links.
Henry, D. (2004). Sensory Integration Tool Chest: For Teachers,
Parents and students. Arizona: Henry Occupational Therapy
Services.
Sena, L. (2004). Fingermania: Program for hand skill development.
Maine: Therapro.Inc.
www.allkidscanfly.ca
paola.azzuolo@allkidscanfly.ca
Links
• http://www.choc.org/wp/wpcontent/uploads/2014/11/Rehab-Developmentaldressing-skills.pdf
• http://dcd.canchild.ca/en/EducationalMaterials/r
esources/dcd_scissor_skills_2013.pdf
• https://www.naeyc.org/files/yc/file/201107/Self
-Regulation_Florez_OnlineJuly2011.pdf
• http://illinoisearlylearning.org/tipsheets/self.pdf
• http://www.toolsofthemind.org/philosophy/selfregulation/
• http://developingchild.harvard.edu/resources/too
ls_and_guides/enhancing_and_practicing_executi
ve_function_skills_with_children/
www.allkidscanfly.ca
paola.azzuolo@allkidscanfly.ca