Support from Therapists

Support from Therapists

Occupational Therapist Support - Introducton


David - Introduction

Katalin - Introduction


The aim of Hand Gym is to provide a programme, which the child has contributed to, which is fun and not just a boring routine.  It has been devised to help children to improve their hand/eye co-ordination and specific hand/wrist function. 

15 minutes each day at least, would be most beneficial to improve both hand function and strength.  Aim to exercise mainly the writing hand if hand function/strength is required for handwriting, or both hands to improve hand/eye co-ordination.  A shoebox is ideal and should be personalised by the child by decorative artwork, stickers etc, as this will keep all items together.



  • Playdough or therapeutic putty – roll ball into a sausage, pinch along length and then squeeze back into a ball 3x
  • Square of strong card for placing coloured paper clips around or small stationery pegs (similar to clothes pegs but much smaller – available from WH Smith, John Menzies etc)
  • Square of strong card with holes punched at regular intervals with ace for threading and bow-tying practise.
  • Length of Velcro to pull apart and, using pincer grip, to squeeze together again.
  • Pegs – wooden or plastic spring-type to practise opening with thumb and first, second, third and fourth fingers of both hands.
  • Bulldog clips – both hands at the same time.
  • Multi-link bricks – children use these in school for counting, colour measurement, construction.  These bricks snap together.
  • A small Marmite jar with hole in plastic top made by hot skewer – craft matchsticks (without match head) can be picked up and posted through hole.  (Try turning them in your hand before you post them).
  • Lid of jar can be screwed/unscrewed (very sizes of jar lids to encourage span grip and hand strength).
  • Matchsticks can also be picked up and placed horizontally over small jar to build up in layers.
  • Plastic film container with either lentils, split peas, dried peas inside.  Place lentils/peas to one side and container to other. Pick up, cross midline, and drop in.
  • Plant sprayers – use watering plants outside, or draw monsters onto a white board and melt them with the water.
  • Play Dice games – beetle drive
  • Two people hold a small piece of card between the Index and middle finger and thumb, and pull away from each other i.e. finger tug o war.
  • Lacing activities – through a card, cut up straws, beads, cheerio’s.
  • Eye droppers- use to drip food colouring on paper, to make gift wrap
  • Tissue paper pictures – tear pieces, roll into ball to make collages
  • Super Hot corn Poppers – available from newsagents or U Need Us, Arundel Street, Portsmouth, or large toy shops.  These plastic domes can be turned inside out, placed on table/floor, and they slowly release pressure and spring up into the air.  If the child is able they can catch the poppers when they spring up.
  • Thick rubber bands, whether stretched out using both hands or wrapped around mid position of thumb and fingers and stretched against resistance of band.  Good for finger extension and wrist strengthening.
  • A few lengths of string to practise making knots and undoing them (Macramé)
  • Pick up sticks – drop matchsticks on a random heap and pick them up one by one without moving the others.
  • Nuts and bolts of different sizes for screwing and unscrewing (possible adding a timer to encourage speed)
  • Coins and buttons – turn over without bringing to edge of table, order them in sizes, pick up and post through a slot.
  • Travel version games with very small pegs.
  • Stress ball – available from U Need Us, Arundel Street, Portsmouth.  Can be squeezed or pressure placed by individual fingers to make doughnut shape.  The ball re-inflates itself.
  • Scissors skills can be incorporated into the Hand Gym.  FISKAR children’s scissors are recommended for both right- and left-handed children and have a slightly larger loop for fingers.  Thin card is a good medium to use for first snipping attempts.  Encourage thumbs-up technique with both scissors hand and hand feeding the card.  Young children tend to invert hands when using scissors and this should be discouraged.  Scissors are available from McIlroys, Havant, or Debenhams, Southsea.  Knowledge of other sources would be useful.
  • Cooking activities – sprinkles on to cakes from a bowl, tearing lettuce, pressing out pizza dough, and any other kind of food prep using their fingers.
  • Games using finger puppets
  • Waterful games or play station – these games have an huge impact on thumb strength, stability and isolation.


  • Square pieces of paper approximately 8”x8”, corners folded into middle, turn over and repeat.  Fold in half, then half again, unfold and ease into star shape.  Place thumb and fingers of both hands into the four pockets.  Shapes/colour/numbers can be drawn on external flaps and again on inner triangles.  The child then manipulates thumb and index finger to open shape horizontally and vertically in rhythmical movements.
  • A friend chooses Numbers/colours/shapes on three levels, and the fortune is concealed under the triangular flap when the shape is opened out.  Good exercise to encourage pincer grip and rhythmical opposition.  Some children have great difficulty with this.


An Example Sleep Routine (.pdf file)

RCOT Advice TopTips supporting children at home D3 (.pdf file)

Video Models to Support the Development of Daily Living Activities

The following are some examples of video models that could be used to support children/young people in practising daily living activities.


Please click on the link to see the model.  Often the video will play the whole task first and then break it down into steps (but not all do this).  So please keep watching for the break down. 


Tips on how to use a video model: 

•Typically it will help the child/young person to watch the video and then immediately to go and practice. 

•It may also assist to lay out items/equipment  in the same or similar way to the video to support your child/young person. 

• They could also use the step by step prompt and pause the video after each step if this helps them. 

• It may work better to watch the video together and then go and do the activity together with your child/young person initially. 

• Depending on your child’s level of ability/experience of the activity, aim to gradually increase the amount of steps in the activity they do.  For e.g. start with completing the  first step together with them (and you complete the rest) but then gradually add in the 2nd, 3rd and 4th steps etc. when they are confident/able with the previous step(s).

• Choose one daily activity to work at any given time. 

• Provide regular (daily) practice where possible.

• Provide plenty of praise/encouragement for efforts made. 

Note: appropriate levels of supervision/support are required for daily living activities and the use of electronic devices near certain activities e.g. kitchen activities is not recommended. 

Please adapt how you use the video model to support your child/young person.

How to get a drink of water


How to make cereal


How to make a cup of tea


How to set the Table for Lunch


How to Brush Hair


How to wash up


How to use a knife and fork


How to tidy up after lunch


How to put on socks


How to put on shoes
(Velcro fastening)


How to do up a zip


How to tie shoe laces