Fine motor of pediatric cerebral palsy rehabilitation, i.e. finger function and hand coordination function. From the human anatomy, the hand is composed of many bones, joints and muscles, but the reason why the human hand function is different from other animals is that the human cerebral cortex is well developed and controls the hand movements, in fact, all the movements are controlled by the motor cerebral cortex.
The hand is not only a motor organ, but also a sensory organ, a weight reflecting organ, an action trigger and a communication tool, which is undoubtedly very important for everyone. As the saying goes, “the mind and the hand” is used to enlighten certain smart and capable people who are sensitive and crafty, and the “mind” is seen as the reason for the “hand”. But from the point of view of raising children, it should be “handy” to promote “mind”. Without hands or hand injuries, functional activities are limited, will bring great inconvenience to work, study, life. The educator Tao Xingchi said, “The two great treasures of life are the hands and the brain.” Let’s talk about
The developmental pattern of pediatric finger function
The development of finger functions in children has certain rules. The first is the development of the ulnar side of the movement, then the radial side, and finally the development of finger function. When fetching things, the first four fingers and the palm of the pair of pinch, then the thumb and show finger pinch things. Grasping is the main focus first, followed by conscious release of the hand. Generally speaking, the child starts to have a kind of non-random hand support action from 3 months of age, and then appears with certain random action after 5 months of age. 5 fingers have division of labor until half a year later.
The age progression of hand function development is as follows.
1 month: both hands make a fist and clench more tightly after stimulation.
2 months: both hands are still in a clenched fist, but the tension is gradually reduced.
3 months: The hands can open frequently and can hold the flower prong rod for a few seconds when it is placed in their hands.
4 months: When lying on the back and awake, the two hands can come together and play with the fingers in front of the eyes, which is called “gaze at the hand movement”, and this movement disappears after 6 months.
5 months: Can grasp objects within a hand’s distance, holding objects with the entire palm of the hand to grasp.
6 months: Can hold a bottle and play with their feet. When a dark-colored handkerchief is used to cover the child’s face, he will use his fingers to grasp it off, and when one upper limb is pressed, he will use the other finger to throw the handkerchief off, which is called the “face masking test”. If one side cannot pull off the handkerchief when pressing both upper limbs separately, it reveals the possibility of hemiplegia.
7 months: The baby can touch things with one hand, take cookies by himself, and switch from one hand to the other when playing with blocks.
8~9 months: The thumb can pinch with other fingers.
10 months：The thumb can be used to touch objects and can place objects on the table.
11 months: Can pinch and hold smaller objects with thumb and index finger. Can put something in the basket and take out another one.
12 months: Can give toys to others and can hold a pencil to scribble.
12~15 months: No longer puts blocks in mouth, can stack 2~3 blocks, likes to throw objects to the floor.
2 years old: can build 6~7 blocks into columns without collapsing, can turn door handles, rotate round plates, and turn books page by page.
3 years old: can build 9~10 blocks into columns without collapsing, can dress and undress without difficulty, and can draw a circle and the word “ten”.
4 years old: copy the square and simple 5 parts of a person (such as head, eyes, mouth, nose, ears).
Differences in hand function development, individual children can hold things at will at 3 months of age, and there are normal full-term children who do not hold things at will at 6 months of age. The level of intelligence is not necessarily the same as the hand manipulation skills of the child. Delayed hand development may be associated with mental retardation. Blindness, severe hypotonia or increased muscle tone can affect hand movement development.
Therefore, parents must first understand the normal ones before they can know the abnormal ones and do the usual training to promote their children’s fine motor development.