Fine Motor Skills Development in Children with Autism
Creating the Learning Environment
Strategies to create an optimal learning environment for autistic children include reducing auditory and visual distractions, using positioning devices such as bean bag chairs that provide calming sensory input, effective teaching techniques such as backward chaining and hand-over-hand assistance and sensory reinforcement.
Other examples of positioning that provide sensory input is when a child sits on a small ball with his feet flat on the floor (the ball should have small “feet” that prevent rolling) while working at a table or sitting on top of a seat cushion that enables the child to move while sitting in place. A reinforcement is anything that makes a child want to do the activity again. Praise and food are common reinforcements that are often effective, but sensory reinforcements such as tight hugs or movement may not only motivate, but also provide the needed sensory stimulation that children with autism often seek. The term “sensory processing” refers to how the child’s brain uses information such as what he or she sees and feels and uses it in a useful manner. This process leads to fine motor skills development in children.
The technique called “backward chaining” is very effective when the child needs to learn several steps to a task such as closing a zipper or tying shoe laces. The child is taught the last step of the task first so that completion and a feeling of success can be achieved and reinforcement provided quickly. In the case of closing a zipper the last step would be to pull up the already attached zipper tab. The last step to tying shoe laces is to pull tight the already created loops. In both of these examples, the last step is relatively easy compared to the first steps required to attach the zipper parts or make the bow. Therefore, using the backward chaining technique is ideal in promoting fine motor skills development since starting out with easier steps will encourage the child to persist and learn the harder steps later.
Hand-Over-Hand Teaching Techniques
Children with motor planning difficulties often benefit from hand-over-hand teaching techniques. These are children who struggle to learn and remember new motor skills and learn best when they can feel the movements required to perform a task. This technique may be used to teach children how to cut with scissors, spread jelly with a butter knife or move a crayon to form a square. Children who demonstrate an aversion to being touched (this is called tactile defensiveness) may benefit from touch desensitization first by having their hands rubbed with a terry cloth or lotion or pressing their hands between two pillows. Children who tolerate hand-over-hand physical contact can be taught how to perform tasks such as closing buttons or moving a crayon as the adult places her hand around the child’s fingers to perform the required movements. Children can also learn motor skills using adapted equipment such as dual control scissors. These have four holes that enable both the adult and child to grasp scissors together. The child can then experience the needed motions without actually being touched.
Children with autism often seek out sensory stimulation such as swinging movement or the deep pressure felt by rolling over a carpet. Sensory stimulation such as jumping on a trampoline or bouncing on top of a large ball can be offered after a step or sequence of steps to a fine-motor task have been completed. The sensory input would then function as reinforcement because it is enjoyable and will motivate the child to continue the behavior. Another example is when a child is positioned in or on a movement apparatus such as a swing as she performs steps to a task such as pulling string through a lacing board hole and is immediately rewarded with a small push after the string is pulled through a hole and a larger push when the entire board is completed.
Adapting Activities with Sensory Components
Toys and activities may also be adapted with sensory components to promote attention and motivation. For example, if you place the motor to an electric toothbrush inside an empty coffee can- it will vibrate and make a motor-like sound. This container can then be used for insertion tasks by cutting an opening in the lid (such as a slit to insert small cards). The motor sound and vibration may help the child focus on the task. If this activity is offered after other less preferred tasks are completed it will then function as a sensory reinforcement. Fine motor skills improve after practice bringing success that will motivate further hand use.
Promoting Fine-Motor Skills
Teachers, parents and therapists can look at the various daily living skills and fine-motor activities that children engage in every day and look for ways to incorporate sensory components or reinforcements. Many activities can be performed while the child is standing, kneeling or on the belly while lying over a bolster, so be sure to explore positioning options that work best with an individual child.
My experience has been that effective teaching strategies such as backward chaining and/or hand-over-hand training bring quick success, and when they are followed by a sensory reinforcement children with autism are more motivated to engage in fine-motor tasks that they might otherwise avoid.
Disclaimer: The information in this article is based on the author’s personal experience.