Fine Motor Development
It's exciting to watch babies learn to use their arms and hands. By the age of 1, most of the foundation for hand usage has been established. Here's the development you should see during the first year.
Newborn
A newborn tend to keep the arms and hands tucked in close to the body in a position called flexion. The shoulders are rounded, elbows are bent, and hands are closed loosely. But the baby does not always stay in one position; the arms and hands can move a great deal as the baby kicks or is moved.
When your baby is in the back lying position, the hands will randomly swing out wide. Sometimes the hands land on the head, face, or ears, and the baby begins to learn about the body.
The baby touches and feels, and is soon sucking and learning about the hands. The newborn's arm and hand movements are not truly controlled; they usually occur in response to movement in the rest of the body. The newborn's grasp is a reflex the hand automatically closes on objects the baby touches. This reflex, when baby clings tightly to a finger, is a favorite for most adults. The baby can feel but not control the grip.
1 to 3 months
Now the baby works hard to develop head and trunk control. The baby grows more able to hold the head steady in all positions and to raise it while tummy lying. The arms and hands are busy, too, working to support the actions of the head and trunk. They push down to help the baby lift and balance the head. This control of the body also helps the arms and hands.
For good reaching patterns to develop, the baby must gain control of the trunk and the shoulder girdle (the muscles, bones, and ligaments that surround the shoulder and support the use of the arms). Increased head and trunk control lets the baby use the arms for reaching and playing rather than for support.
During the first three months, there are changes in the general position of the arms when the baby is tummy lying. At firs, the arms are tucked in close to the body with the elbows near the ribs.
By the third month, the elbows are almost in line with the shoulders. Now the baby can prop up briefly on the arms and can move them away from the body more freely. Arms can swing out to the side but not yet directly to the front. The baby's eyes can focus to the length of the arm; now the baby begins to look at this wonderful new toy, the hand. The grasp becomes more controlled and voluntary and the hands can adjust to the shape of objects.
Early grasping patterns begin now and develop over the next months. At firs, most of the activity or control is at the pinky side of the hand. Most of the grasping is in the area where the palm meets the fingers. The fingers follow around the object without being too active yet.
4 to 5 months
Head and trunk control have improved; now the baby can prop up on the forearms to look around. In this position, the baby can shift from side to side, which helps to develop the ability to turn the palms up and down. The shoulder girdle muscles develop as the baby pushes up and down and moves from side to side. By the fifth month the baby can push up onto straight elbows and shift the weight over the hands. This helps develop the small muscles of the hand, so that fine grasping patterns can develop.
Reaching patterns are developing, too. At firs, the baby cannot reach while tummy lying. With practice, the baby learns to reach with one arm while on the forearms and later while on an extended arm. The shoulder girdle and trunk are stable enough now for the baby to reach forward while back lying. At first the baby can reach only to the knees; the feet come within reach by the fifth to sixth month.
The baby can now use hands together, one hand holding and one playing or bringing the toy to the mouth. Toys are fascinating, and the baby loves to play. The grasp is now more active at the middle of the palm, and the whole hand closes. The thumb is not too useful yet. The baby might be able to switch a toy from one hand to the other but the processes will be a bit awkward, with a delay in the middle.
6 to 8 months
The next important step for the arms and hands comes when the baby begins to sit. Again, the arms and the body help each other. At first, the baby is unsteady when sitting and uses the arms and hands for support. Often the arms and shoulders are held high and flexed. When the baby learns to balance and sit steadily, the arms are again free to develop new skills.
By this time, all of the shoulder muscles work together to help the arms move smoothly. The reach is more accurate now, toys are easily switched from hand to hand, and the thumb moves in to help grasp. The baby is not able to control the tightness of the grip and usually presses hard on toys.
Now moving on to more advanced gross motor skills, such as crawling, the baby can better coordinate the arms and body. Fine motor skills are improving now, too. By 8 months the baby can reach out for objects and reach across the midline of the body without losing balance. The thumb can wrap around objects-now the baby can hold two small objects, such as cubes, in one hand. The baby loves to shake and bang toys, which helps develop the ability to let go.
9 to 12 months
The baby learns more about using arms, hands, and body together while pulling up to standing. Some babies start to walk now. The baby loves to explore objects and the surrounding area.
Games such as "so big" and "wave bye bye" are fun and help develop fine motor skills, too. Reaching overhead to show" how big", uses good sitting balance, and exercises the low back muscles. Waving "bye-bye" practices wrist control, and "pat-a-cake" works on coordination of both hands at midline.
The index finger starts to move separately from the rest of the hand when poking at toys and faces. This leads to the pincer grasp, with the tips of the thumb and index finer meeting in a precise pattern. The pincer grasp is used to pick up small objects. The baby starts out using the thumb at the side and lower end of the index finger. Gradually the baby gets control of more and more of the index finger. A true pincer grasp appears at about 12 months.
The baby's ability to let go of an object smoothly has also improved. The 9 month old uses the whole arm to drop an object. A slightly older baby can use primarily the hand and wrist to drop a cub into a container. At 12 months, some babies can release one cube onto another to build a two block tower.
The 9 to 12 month old may prefer one hand over the other. This can change. True "handedness" does not come until much later. The baby will still use both hands together and switch hands easily for quite some time.
The baby now has a basis for good arm and hand usage, but the the skills will continue to improve over the next several years.
by Jeanne Sangirardi Ganz, O.T.R.
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