Evan is diagnosed with sensory processing disorder. He also is struggling mightily to present legible handwriting. He is referred by his teacher to the school-based occupational therapist for an evaluation. The evaluation reveals that Evan has poor finger strength and the therapist suggests finger weights as part of her treatment plan.
Poor finger strength can stem from a variety of factors. As you have seen with Evan, poor finger strength can result in fine motor isms and impact the skill of handwriting.
Finger weights may serve as an additional therapeutic tool to support children struggling with fine motor and handwriting isms. These little, adjustable weights placed on the fingers can benefit children with fine motor isms especially if finger weakness is related to sensory isms.
Whole Body Handwriting Session with an Occupational Therapist
Gwen Wild, OTR/L of Sensational Brain shares, “If I’m working with a child with handwriting isms and I know that some of problem is due to inadequate sensory processing, I will start the therapy session with whole-body activities.
I will have the child go through an obstacle course that includes a lot of crawling and rolling.
Then we would sit at the table, address stability and posture, do some finger warm-ups like finger push-ups, finger pulls or play with therapy putty.
Finally, we would work on handwriting.
At this point, after properly preparing the whole body, I find that finger weights are beneficial in providing increased feedback from the small muscles and joints in the fingers and hands.
Additionally, kids seem to enjoy them. The kids I work with demonstrate an increased awareness of their grip and finger movements.”
Input, Feedback & Amplification
Finger weights offer kinesthetic feedback, proprioceptive input and amplification of spatial awareness when used in occupational therapy sessions. What does all that mean, exactly?
The knowledge individuals have about the position and movement of their bodies based on nerves in their joints and muscles. Sound familiar? It is also known as proprioception.
Proprioception is the sense that indicates whether the body is moving with required effort. It also tells us where the various parts of the body are located in relation to each other.
Spatial awareness deals with the body’s position in space.
Under-Responsive Kids Benefit from Finger Weights
- use too much or too little pressure on their utensils,
- have difficulty learning to write,
- lack refined finger movements and
- struggle with manipulatives.
Finger weights increase the proprioceptive feedback to their brains. This increased feedback results in improved fine motor skills while they are wearing them. I have found that if a child wears finger weights while learning to print a new letter or master a fine motor task, they continue to have improved success with that particular task once the weights are removed.”
Target the Larger Joints
Teresa Fair-Field, OTR/L of Sandbox Therapy Group shares, “In my experience, the isolated muscles of the finger is not the real issue. For sensory benefit, you’d want to target larger joints for weighting. When working with kids that have deficits in proprioception and kinesthetic awareness, it still needs to be addressed in a proximal to distal way. Address seating balance and core stability before addressing the larger joints. Address the larger joints of the shoulder prior to addressing smaller joints in the fingers.”
If that was a wee bit clinical, here is a breakdown of the terms.
Proximal – situated nearer to the center of the body or the point of attachment such as the shoulder. The shoulder is proximal to the elbow.
Distal – situated away from the center of the body or from the point of attachment. The fingers are the most distal from the shoulder.
Fair-Field continues, “Kids need deep pressure in the heavy load-bearing joints such as the temporal mandibular joint (jaw), the hips, knees and shoulders”.
Joni Redlich, DPT of Kid PT mirrors Fair-Field’s thoughts. Redlich elaborates, “If the fingers appear weak, it is more likely that there is weakness or a lack of motor control for stability higher up, such as in the shoulder or core.
However, from a sensory perspective, increasing kinesthetic feedback to the body could be helpful for fine motor skill development. This feedback would occur after all the larger issues were addressed.”
Teach Compensation or Treat the Source
Redlich continues and questions, “Do you teach compensation or treat the source of the problem? It isn’t an either or. We often have to do both at the same time.
I believe that finger weights are a teaching tool to help a child compensate for decreased finger sensory awareness and control. We have to make sure we address the source of the lack of awareness, otherwise, all we teach are splinter skills.”
Alternatives to Finger Weights
Nancy Silverman-Konigsberg, OTR/L of Milestone Mom suggests simple exercises in place of the use of finger weights.
Get clothes pins of different sizes – smaller clothes pins is harder to open, longer and bigger are easier.
Hang a clothesline overhead and have the child reach up and clip the pins.
This activity is great for shoulder, upper extremity and grasp strength.
An alternative is to give the child a paper plate and have the child put clothes pins all around the edges.
Have the child drag the dowel through the putty in different directions.
Also, just using fingers, have the child make a claw hand and push the backs of the fingers against the putty. Pull the putty with the palm side of the fingers.
Who Would Receive the Greatest Benefit from Finger Weights?
Wild shares, “I feel that the kids who will benefit from finger weights the most are the kids who demonstrate adequate strength but struggle with motor planning due to poor body awareness.
When used in conjunction with a handwriting program, I have found finger weights to be helpful to use during therapy sessions while teaching new letter formations. This is especially beneficial for kids who need increased proprioceptive input.”
Kids with Writer’s Cramp
Wild shares, “In my experience, writer’s cramp is usually due to an inefficient grasp pattern. An efficient grasp is dependent on proximal stability in addition to hand and finger strength.
I have used finger weights as an addition to a therapeutic plan addressing the many components of grasp and handwriting. The many components include core stability, shoulder and elbow stability, isolation of finger movements, as well as, hand and finger strength.”
Finger Weights a Nice Addition
Wild wraps up, “The bottom line is I like them! I think finger weights are a nice addition to a therapeutic program addressing fine motor skills and handwriting. They are especially beneficial for kids who demonstrate poor body awareness and seem to need more proprioceptive feedback to experience success.”
Redlich closes, “Finger weights could be helpful from a sensory perspective, providing increased proprioceptive input to learn how to control the fingers better.”
If you are an occupational therapist, we would love to hear your thoughts or experiences on the use of finger weights in therapy.