Pencil Grasp Development

Pencil grasp development

Pencil grasp development is a common concern for many parents, teachers, and therapists. So often, we see children holding a pencil with all of their fingers wrapped around the pencil, or very awkward pencil grips and wonder what is a typical pencil grasp. But, did you know that children typically progress through pencil grasp development in a predictable pattern? It’s true! Let’s talk pencil grasp.

First, when it comes to writing with a pencil, there are a few things that therapists want parents to know about pencil grasp.

Secondly, it’s important to note that grasp development, while it can be predictable, can also vary in timing. And when grasp doesn’t follow the progression listed below…it can be ok! In fact, a functional pencil grasp is perfectly fine for children.

Pencil grasp development in kids

Pencil Grasp Development

Grasp development follows three main categories: primitive grasps, transitional grasps, and mature grasps.

Primitive Pencil Grasps

In this beginning pencil grasp, the whole arm moves the pencil. These grasps include two specific grips which are described below:

Primitive pencil grasp

 ​1. Whole Hand Grasp/Palmer Supinate Grasp- (Typically seen between 12 months-1.5 years) Child holds the crayon with their whole hand, with the writing end of the crayon sticking out near their pinkie side of the hand. I​t looks like they are holding a paint stirrer or potato masher.

Digital pronate pencil grasp

2. Digital Pronate Grasp/ Pronated Wrist Grasp- (2-3 years) Crayon is held in the hand so the tip of the crayon (or the drawing end) is held on the thumb side of the hand.

Transitional Pencil Grasps

In the transitional pencil grasp stage, the child’s forearm and/or wrist moves the pencil.

Four finger or five finger pencil grasp

1. Four Fingered Grasp- (3.5-4 years)- Crayon is held between their thumb, and tips of the pointer finger, middle finger, and ring finger. As the child progresses, these four fingers may pull down to the tip of the finger into a quadrupod grasp.

Static tripod pencil grasp is a mature pencil grasp pattern

2. Static Tripod Grasp- (3.5-4 years)- Child holds the writing utensil with the thumb, pointer finger, and rests the utensil on the last joint of the middle finger. The ring finger and pinkie fingers are tucked into the palm of the hand.

Quadrupod Grasp- If the thumb opposes the pointer finger, middle finger, and ring finger this may be called a quadrupod grasp. A quadrupod grasp can also occur with the pencil resting on the side of the ring finger.

3. Other grasp patterns- There can be many variations of grasp patterns that occur in the transitional stage, marked by the use of the wrist or forearm to move the pencil.

Mature Pencil Grasps

In the mature pencil grasp stage, the child holds and maneuvers the pencil using mobility in the fingers or the hand.

Dynamic tripod pencil grasp is a mature pencil grasp

1. Dynamic Tripod Grasp- (4-6/7 years) Thumb and pointer finger hold the pencil as it rests on the last joint of the middle finger. Pencil movements occur via manipulation of the fingers and hand. Note that a true dynamic tripod grasp may not be established up until around 14 years of age.

2. Lateral Tripod Grasp- Thumb is pressed in against the pencil (or adducted) to hold the pencil against the side of the pointer finger. The tip of the thumb may bend over (or flex) over the pencil in a “wrapped” position. This grasp is sometimes called a thumb wrap grasp because the thumb is not involved with the distal movement of the pencil. Distal mobility occurs, but it is the index and middle fingers manipulating the pencil.

3. Dynamic Quadrupod Grasp- Grasp is similar to the dynamic tripod grasp, but opposition includes the thumb, pointer finger, middle finger on the pencil shaft.

4. Lateral Quadrupod Grasp- Grasp is similar to the lateral tripod grasp, with its thumb wrapped positioning of the thumb, but uses the pointer, middle, and ring fingers are on the pencil shaft and manipulate the pencil.

Other Functional Pencil Grasps

There are other grasps that can be considered “functional” in which the child holds the pencil differently than described here, but can also write in an efficient manner.

These can include (but not be limited to) a thumb wrap grasp, thumb tuck grasp, inter-digital brace grasp, or a finger-wrap grasp.

How to help with pencil Grasp

Want to know more about pencil grasp progression, development, and strategies to use to help children build a strong, efficient, and functional pencil grasp? It’s all in the Pencil Grasp Bundle!

Pencil Grasp Bundle

The Pencil Grasp Bundle is for those struggling to help students with carryover of skills. It’s designed to make pencil grasp practice meaningful and motivating. The Pencil Grasp Bundle is 16 pencil grasp resources, guides, worksheet sets, and tools.

Pencil Grasp Success Was Never Easier.

  • It can be a real struggle to help kids address tricky pencil grasps.  
    It is frustrating and difficult to weed through all of the information and pull out what will work for a child.  
  • You struggle with kids who work on skills but can’t carryover handwriting and pencil grasp into the classroom. 
  • Therapists may search for fresh ideas to address pencil grasp needs and wonder whether a grasp is considered functional or needs changing. 
  • Therapists need pencil grasp screening and educational materials to address a huge influx of therapy referrals.
  • Parents wonder about development and skills. 
  • Teachers will love the Centers activities to incorporate into learning to impact carryover of handwriting skills.

The Pencil Grasp Bundle includes 16 products and is valued at over $73. It’s bundled together and offered at just $42.

Colleen Beck, OTR/L is an occupational therapist with 20 years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to

Sensory Processing Disorder Checklist

sensory processing disorder checklist

Sensory processing disorder is a condition where the brain misinterprets sensory information so that the body responds in atypical ways. Sensory processing disorder can be broken down into different categories, but one thing is clear: interpretation of sensory input is “off”. Here, you will find a list of common sensory responses that might be seen with sensory processing disorder. Use this sensory processing disorder checklist to better understand responses to sensory input.

Sensory Processing Disorder checklists for each sensory system

With sensory processing disorder, input from each of the sensory systems can be interpreted by the brain in different ways. Kids can hyper-respond or overreact to sensory input. Or, they can hypo-respond, or under-react to sensory information.

Sensory processing disorder can be seen in children or on adults.

These sensory processing disorder checklists are broken down by sensory system

Sensory Processing Disorder Checklist

Putting it all together – Let’s look at all of the sensory systems in a list:

  • Visual System (Sight)
  • Auditory System (Sound)
  • Tactile System (Touch)
  • Gustatory System (Taste)
  • Olfactory System (Smell)
  • Proprioceptive System (Position in space)
  • Vestibular System (Movement)
  • Interoceptive System (Inner body)

Typically, dysfunction within these three systems present in many different ways.  A child with sensory difficulties may be over- or under-responsive to sensory input.  They may operate on an unusually high or unusually low level of activity.  They may fatigue easily during activity or may constantly be in motion.  Children may fluctuate between responsiveness, activity levels, and energy levels.

Additionally, children with sensory processing dysfunctions typically present with other delays.  Development of motor coordination, fine motor skills, gross motor skills, social-emotional skills, behaviors, executive functioning skills, language, and learning are all at risk as a result of impaired sensory processing.

Sensory processing disorder checklists for responses seen to sensory input.

Sensory Processing Disorder Checklist- Tactile System

Hyper-responsiveness of the tactile sense may present in a child as over-responsiveness or overreaction to tactile sensation. This looks like:

  • Overly sensitivity to temperature including air, food, water, or objects
  • Withdrawing when touched
  • Refusing certain food textures
  • Dislike of having face or hair washed
  • Dislikes of hair cuts
  • Dislikes of having fingernails cut
  • Excessively ticklish
  • Avoidance to messy play or getting one’s hands dirty
  • Avoidance of finger painting, dirt, sand, bare feet on grass, etc.
  • Clothing preferences and avoidances such as resisting shoes or socks
  • Annoyance to clothing seams or clothing textures
  • Resistance to hair brushing
  • Overreactions to accidental or surprising light touches from others
  • Avoids affectionate touch such as hugs

Hypo-responsiveness of the tactile sense may present in a child as under-responsiveness or under-reaction to tactile sensation. This may look like:

  • Seeks out tactile sensory input
  • Bumps into others
  • High pain tolerance
  • Stuffs food in mouth
  • Licks items or own skin
  • Not aware of being touched
  • Seems unaware of light touch
  • Startles easily when touched
  • When getting dressed, doesn’t notice clothing that is twisted
  • Tendency for self-abusiveness: biting self, rubbing self with heavy pressure, head-banging, pinching self, etc.
  • Doesn’t notice a runny nose, messy face, or messy hands
  • Puts items in the mouth
  • Lack of personal space
  • Runs into other children without noticing
  • Has difficulty maintaining space in line; bumps into others without noticing
  • Falls out of chair
  • NEEDS to touch everything
  • Uses a tight pencil grip on the pencil
  • Writes with heavy pencil pressure
  • Tears paper when cutting with scissors
  • Unintentionally rough on siblings, other children, or pets
  • Always touching others or things
  • Seeks out messy play experiences
  • Prefers to rub or feel certain textures
  • Difficulty with fine motor tasks
  • Craves touch


The Proprioception Sensory System is the recognition and response to the body’s position in space with an internal feedback system using the position in space of the joints, tendons, and muscles.  This sensory system allows the body to automatically react to changes in force and pressure given body movements and object manipulation.  The body receives more feedback from active muscles rather than passive muscle use.  Related to the proprioception system is praxis or motor planning.  Individuals are able to plan and execute motor tasks given feedback from the proprioceptive system. Praxis allows us to utilize sensory input from the senses and to coordinate hat information to move appropriately.

Hyper-responsiveness of the proprioception sense may present in a child as over-responsiveness or overreaction to proprioceptive sensation. This may include postural insecurity. This may look like:

  • Uses too little pressure when writing or coloring
  • Prefers soft or pureed foods
  • Appears lethargic
  • Bumps into people or objects
  • Poor posture, slumps in their seat
  • Poor handwriting
  • Inability to sit upright when writing or completing desk work; Rests with head down on arms while working
  • Poor awareness of position-in-space
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Poor body awareness
  • Poor attention
  • Poor motor planning

Hypo-responsiveness of the proprioceptive sense may present in a child as under-responsiveness or underreaction to proprioceptive sensation. This looks like:

  • Uses excessive pressure when writing or coloring
  • “Jumper and crasher”- seeks out sensory input
  • Can’t sleep without being hugged or held
  • Bumps into people or objects
  • Seems aggressive
  • Grinds teeth
  • Walks on toes
  • Chews on pencils, shirt, sleeve, toys, etc.
  • Prefers crunchy or chewy foods
  • Cracks knuckles
  • Breaks pencils or crayons when writing or coloring
  • Pinches, bites, kicks, or headbutts others
  • Difficulty with fine motor skills
  • Poor handwriting
  • Poor awareness of position-in-space
  • Stomps their feet on the ground when walking
  • Kicks their chair or their neighbors chair in the classroom
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Constantly moving and fidgeting
  • Poor attention


The Vestibular Sensory System is the sense of movement and balance, and uses the receptors in the inner ear and allows the body to orient to position in space.  The vestibular system is closely related to eye movements and coordination.  Vestibular sensory input is a powerful tool in helping children with sensory needs.  Adding a few vestibular activities to the day allows for long-lasting effects.  Every individual requires vestibular sensory input in natural development.  In fact, as infants we are exposed to vestibular input that promotes a natural and healthy development and integration of all systems. 

Problems with the Vestibular Processing System can present as different ways:

  • Poor visual processing
  • Poor spatial awareness
  • Poor balance
  • Difficulty with bilateral integration
  • Sequencing deficits
  • Poor visual-motor skills
  • Poor constructional abilities
  • Poor discrimination of body position
  • Poor discrimination of movement
  • Poor equilibrium
  • Subtle difficulties discerning the orientation of head
  • Trouble negotiating action sequences

Hyper-responsiveness of the vestibular sense may present in a child as over-responsiveness or overreaction to vestibular sensation. This look may look like:

  • Experiences gravitational insecurity
  • Overly dizzy with motions
  • Resistant to moving activities such as swings, slides, elevators, or escalators
  • Fear of unstable surfaces
  • Unable to tolerate backward motions
  • Unable to tolerate side to side motions
  • Illness in moving vehicles
  • Avoids swings or slides
  • Gets motion sick easily
  • Appears “clingy”
  • Refuses to move from the ground (i.e. jumping or hopping activities)
  • Difficulty/fear of balance activities
  • Refusal to participate in gym class
  • Fearful on bleachers or on risers
  • Fear or dislike of riding in elevators or escalators
  • Fearful of movement
  • Dislike of spinning motions
  • Avoids chasing games
  • Overly fearful of heights
  • Nauseous when watching spinning objects
  • Poor posture
  • Easily fatigued
  • Poor coordination
  • Low muscle tone
  • Poor motor planning
  • Fearful when a teacher approaches or pushes in the child’s chair
  • Clumsiness
  • Poor attention

Hypo-responsiveness of the vestibular sense may present in a child as under-responsiveness or underreaction to vestibular sensation. This may look like:

  • Constant movement including jumping, spinning, rocking, climbing
  • Craves movement at fast intervals
  • Craves spinning, rocking, or rotary motions
  • Poor balance on uneven surfaces
  • Constantly fidgeting
  • Increased visual attention to spinning objects or overhead fans
  • Bolts or runs away in community or group settings, or when outdoors or in large open areas such as shopping malls
  • Difficulty maintaining sustained attention
  • Impulsive movement
  • Constantly getting up and down from desk in the classroom
  • Walks around when not supposed to (in the classroom, during meals, etc.)
  • Loves to be upside down
  • Head banging
  • Leans chair back when seated at a desk
  • Loves spinning
  • Rocks self-back and forth when seated
  • Poor posture
  • Poor coordination
  • Poor motor planning
  • A deep need to keep moving in order to function
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Poor attention


Eighty percent of the information we receive from our environment is visual.  When perception of this information is not processed correctly, it can create an altered state that influences many areas:  eye-hand coordination, postural reflexes, and vestibular processing are all influenced and reliant upon the visual system. 

The visual system is the sensory system that most individuals rely upon most heavily for daily tasks.  Visual information is perceived by cells in the back of the eye.  These cells (rods and cones) relay and transfer light information into information that is transferred to the central nervous system.  These photoreceptors are able to perceive day time vision and night time vision, with adjustments to sensitivity of light intensity.  They are able to respond to different spectrum of color and differentiate color information.  The rod and cone cells, along with the retina, process a great deal of visual information in the neural structure of the eye before transmitting information to the central nervous system. 

The relay of information from the eyes to the central nervous system are made up of three pathways.  Pathways project to different areas of the brain and allow for a) processing and recognition of faces/shapes/motion (the “what” and “where” of objects), b) integration of information in order to coordinate posture and eye movements, and c) oculomotor adaptation.

Hyper-responsiveness of the visual sense may present in a child as over-responsiveness or overreaction to visual sensation. This may look like:

  • Complains of lights being too bright
  • Unable to tolerate certain lighting such as fluorescent overhead lights
  • Struggles with sudden changes in lighting
  • Challenged by bright or flashing lights
  • Colorful lights “hurt” the eyes
  • Complains of headaches in bright light
  • Complains of the “glow” of unnatural lighting
  • Distressed by light sources
  • Sensitive to light
  • Sensitive to certain colors
  • Distracted by cluttered spaces
  • Avoids eye contact

Hypo-responsiveness of the visual sense may present in a child as under-responsiveness or underreaction to visual sensation. This looks like:

  • Attracted to spinning objects
  • Difficulty with visual perception
  • Difficulty with eye-hand coordination
  • Difficulty with reading and writing
  • Holds or presses hands on eyelids in order to see flashing lights
  • Squints or presses eyelids shut
  • Flaps hands or objects in front of eyes


Receptors for the auditory system are located in the inner ear and are responsible for receiving vibration from sound waves and changing them to fluid movement energy.  Information is projected to the central nervous system and transmits sound frequency as well as timing and intensity of sound input.  The auditory system is integrated with somatosensory input in order to play a role in controlling orientation of the eyes, head, and body to sound. 

Hyper-responsiveness of the auditory sense may present in a child as over-responsiveness or overreaction to auditory sensation. This may look like:

  • Startles easily to unexpected sounds
  • Dislikes noisy places
  • Overly sensitive to speakers on radios
  • Fearful of smoke detectors, overhead speakers
  • Shushes others or asks others to stop talking
  • Holds hands over ears
  • Sensitive to certain sounds such as lawnmowers or the hum of the refrigerator
  • Easily distracted by sounds and background noise
  • Hums to block out background noise

Hypo-responsiveness of the auditory sense may present in a child as under-responsiveness or underreaction to auditory sensation. This looks like:

  • Seems to be unaware of sounds
  • Holds radio speakers up against ears
  • Doesn’t respond to alarms
  • Makes silly sounds at inappropriate times or frequently
  • Mimics sounds of others
  • Talks to self
  • Difficulty locating sounds, especially when in a noisy environment
  • Hums in order to hear the sound of humming


The gustatory system perceives input through the tongue.  Taste cells in the mouth perceive five sensations: salty, sweet, bitter, sour, and savory.  The gustatory system is closely related to the sense of smell and proprioception.  How we perceive taste is deeply influenced by the sense of smell. 

While many children with sensory needs have a tendency to chew on their shirt collars or pencils as a sensory strategy in order to seek proprioception needs, the behavior may occur as a result or as a reaction to under-responding to oral input.  Other children may seek out intense taste sensations and in that case put non-edible items into their mouth to satisfy that sensory need.  Still other children may over-respond or under-respond to certain flavors or taste sensations.  For those children, it is common to experience food refusal related to texture or taste.

Hypersensitivity to oral sensory input may present in a child as over-responsiveness or overreaction to gustatory sensation. This looks like:

  • Dislike of mixed textures (cereal in milk or chunky soup)
  • Resistant to trying new foods
  • Avoids certain textures
  • Avoids straws
  • Avoidance of specific food or drink temperatures
  • Picky eating
  • Preference for bland foods
  • Avoids temperature extremes (unable to tolerate hot or cold foods)
  • Prefers foods that do not touch or mix on their plate
  • Use of only a specific spoon or fork or no utensil at all
  • Intolerance to teeth brushing.
  • Anxiety or gagging when presented with new foods
  • Drooling

Hypo-responsiveness of the gustatory sense may present in a child as under-responsiveness or underreaction to gustatory sensation. This may look like:

  • Licking objects
  • Bites others
  • Chews on clothing
  • Hums all the time
  • Prefers a vibrating toothbrush
  • Prefers spicy foods
  • Stuffs food into cheeks
  • Prefers food very hot or very cold temperature


The olfactory system, or the system that enables the sense of smell, has receptors in the tissue of the nose that are connected by pathways to the brain.  Connections occur via two pathways, one being a direct route to neurons in the brains and the second being a path that passes near the roof of the mouth.  This channel is connected to the taste of foods.

There is some evidence indicating that the sense of smell is more associated with memory than the sense of vision or the other senses.  The connection of the olfactory sense to the emotional part of the brain and previous experiences, as well as hypersensitivity or hyposensitivity to smells can cause anxiety or sensory related breakdowns in children with sensory processing difficulties. 

Hyper-responsiveness of the olfactory sense may present in a child as over-responsiveness or overreaction to olfactory sensation. This may look like:

  • Overly sensitive to smells
  • Notices smells others don’t
  • Anxious around certain smells
  • Holds nose in response to certain scents

Hypo-responsiveness of the olfactory sense may present in a child as under-responsiveness or underreaction to olfactory sensation. This may look like:

  • Smells unusual items like paper or certain materials
  • Prefers strong scents


The interoceptive sensory system is an area that most people are not as familiar with.  This system is connected to amygdala, the emotional system, the limbic system, our emotional awareness, our feelings, and subconscious arousal.  Receptors for the interoceptive system are in our organs and skin.  The receptors relay information regarding feelings such as hunger, thirst, heart rate, and digestion to the brain.  This is the foundation to sensations such as mood, emotions, aggression, excitement, and fear and in turn, promotes the physical response of our bodies. 

Physical responses include functions such as hunger, thirst, feelings, digestion, heart rate, and body temperature.

Hyper-responsiveness of the interoceptive sense may present in a child as over-responsiveness or overreaction to interoceptive sensation. This may look like:

  • High pain tolerance
  • Distracted and overwhelmed by feelings of stress
  • Distracted or overly sensitive to sensations of stomach digestion
  • Distracted or overly sensitive to sensation of heart beat
  • Always hungry or thirsty
  • Eat more and more often to avoid feelings of hunger
  • Unable to sense the feeling of being full; overeats or overdrinks
  • Overwhelmed by feelings of sadness, anger, happiness, etc. and unable to respond appropriately
  • High urine output
  • Use the bathroom more often than necessary to avoid feelings of a full bladder or bowel
  • Distracted by changes in body temperature
  • Distracted and overly sensitive to sweating
  • Overly sensitive to feeling ticklish or itchy
  • Overly sensitive to cold or heat
  • Overly sensitive to signs of illness
  • Fearful of vomiting

Hypo-responsiveness of the interoceptive sense may present in a child as under-responsiveness or underreaction to interoceptive sensation. This may look like:

  • Low pain tolerance
  • Poor or low response to interoceptive stimuli
  • Doesn’t know when to go to the bathroom
  • Never says they are hungry or thirsty
  • Does not drink or eat enough
  • Difficult to toilet train
  • Never complains of being cold or hot (always wears shorts in the winter or pants in the summer)
  • Never complains of sickness
  • Difficulty falling asleep
  • Unable to identify feelings of stress
  • Unable to identify specific feelings and appropriate responses

Sensory Checklists, explained

There is a lot to think about here, right? Taking a giant list of common sensory processing disorder lists and knowing what to do with that list is complicated. What if you had strategies to address each sensory system’s over-responsiveness or under-responsiveness so you could come up with a sensory diet that helps kids function?

In The Sensory Lifestyle Handbook, I do just that.

The Sensory Lifestyle Handbook

Sensory processing is broken down by sensory system so you can understand what you are seeing in the sensory responses listed above. Then, you can use the lists of sensory activities to help the child complete functional tasks while they get the sensory input they need to focus, organize themselves, and function.

The sensory activities are presented as meaningful and motivating tasks that are based on the child’s interests, making them motivating and meaningful.

You can get the Sensory Lifestyle Handbook and start building a sensory diet that becomes an integrated part of each day’s daily tasks, like getting dressed, completing household chores, school work, community interaction, and more.

Get your copy of The Sensory Lifestyle Handbook here.

Colleen Beck, OTR/L is an occupational therapist with 20 years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to

Pen Grip for Handwriting Pressure

Pen grip handwriting trick

Today, I wanted to share a tip for addressing handwriting pressure…using a pen grip! Pencil pressure when writing is something that comes up a lot. You may have seen children who press so hard on the paper that the pencil tip breaks or smudges and mistakes don’t fully erase. You might have a child that writes so lightly that it is hard to read their writing or their written work is brushed away by their sleeve. Writing pressure is a hot topic in handwriting legibility. We have a previous resource on pencil pressure when writing. There are many tips and tricks for addressing handwriting and writing pressure there.

Pen grip handwriting trick for helping kids with pencil pressure.

Today’s tip has more to do with the sensory benefits of writing with a pen to address heavy or light writing pressure.

Related read- Here are 5 things therapists want parents to know about pencil grasp.

Pen Grip

Did you know that sometimes using a pen can help with handwriting? When a child presses so hard with their pencil, or writes so lightly that it’s hard to read their writing, there could be a sensory component. The child typically can’t regulate the amount of pressure that they need to use to press and hold the writing utensil.

Pen trick for handwriting

One strategy to help with writing pressure that is too dark or too light is to use a pen.

The sensory concerns might be that the child can’t tell how hard they are pressing on the utensil and so press very hard. Their ability to register proprioceptive input may be off. Check out these proprioception sensory activities to help with this sensory input.

Or, they might not notice that they care holding the writing utensil with a very loose grasp.

Using a pen to write is one way to help the child get around these sensory issues. Using a pen that writes smoothly across the page can help with kids that write too lightly.

When writing with the pen, they can use their normal grasp and clearly see the written work because the pen slides more smoothly across the writing surface and they don’t need to accommodate for the resistance of the paper.

Other kids who write very dark can benefit from using a pen to practice ghost writing. The child can use the pen to write on a notebook with paper underneath. When they turn the page, if they can read their writing on the next paper, you can teach the child that they are pressing too hard. Keep trying to write without “ghost letters” left behind.

The issue with using a pen to write is many times, the shaft of the pen is thinner, requiring more precision of grasp and more developed arches in the hand. The intrinsic hand strength that allows for developed arches is required so the child can write for an extended amount of time without hand fatigue.

Having a pen grip is ideal to help in these situations.

Triangle pencil grip

One way to address the smaller shaft on a pen and the need for hand strength (which many of our kids lack), is using a triangle pencil grip on the pen, so that the child has placement for their fingers and a built up shaft for their fingers to grip.

Benefit of a triangle pencil grip with the block portion that prevents the fingertips from moving too far up or down the writing utensil. Also, the triangle pencil grip is commonly known, so kids are familiar with this pencil gripper.

Left handed writers and right handed writers both can use the triangle grip, making it easy to use for either writer.

The triangle pencil grip promotes a tripod or modified tripod grasp. For more help on building a stronger grasp and a functional pencil grasp, try using these activities to develop pencil grasp through play.

Pen Grip

What if you had the chance to try a pen grip to work on handwriting, writing pressure, and grasp? Now you do! I’m so excited to partner with Two Sparrows Learning Systems to offer this Dex Pen Grip!

Dex comes complete with our patent pending stopper to support your grip for all your writing and drawing needs.  

The pen grip’s triangular shape provides comfort and ease for a functional grasp.  The pen comes already installed on a beautiful designer pen and comes with textured or soft grip options.  

  • Dex grip comes pre-installed on a beautiful pen which can be refilled with ink cartridges.
  • Dex pen grip is ergonomically designed for comfort.  The grip tapers at the end and the stopper is tapered in so that you can easily see over top of it and it sits comfortably in your hand. 
  • Using the Dex grip you do not have to press or grip as hard when writing, so your hand does not tire as easily. 
  • This is the perfect grip for teens to adults. 
  • The pen is sleek and stylish and when paired with the grip, this will quickly become your favorite, go-to pen.
  • Dex comes complete with our patent pending stopper to support your grip for all your writing and drawing needs. 

Colleen Beck, OTR/L is an occupational therapist with 20 years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to

Developmental Checklist

developmental checklist and milestones for kids from birth to 2 years old

Parents and therapists alike often look for a developmental checklist. Having a list of developmental milestones in physical development, emotional, and social development would be handy, right? A printable resource that acts as a guideline to child development could be useful for parents to track the milestones of their child for the first two years of life. A pediatric developmental checklist can help to identify red flags or to reference a child’s growth and development.

developmental checklist and milestones for kids from birth to 2 years old

Today, I wanted to share developmental checklists that are available here on The OT Toolbox, so you can have a one-stop spot for understanding growth and development stages in children. AND, I have a giveaway item of a birth-2 years pediatric milestones resource to share.

This giveaway is part of our Christmas in July series, and you can enter each giveaway this week.

Childhood developmental milestones

It is important to note that all children develop at their own pace; however, there are a set of developmental guidelines that are accepted steps in development by doctors, service providers and educators alike. 

Here are developmental milestone lists that we have here on The OT Toolbox. Use these to better identify any developmental concerns:

Visual Motor Integration Developmental Milestones

Spatial Awareness Development in Babies

Foster Development with Block Play

Development of Oral Motor Skills

Development of Eye-Hand Coordination

Development of bilateral coordination and how this skill impacts feeding

Executive Functioning Skill development

Boost child development with rhyming games

Scissor Skills development

Grasp development

Developmental progression of pre-writing lines

Development of Play

Developmental Milestones in Kids Getting Dressed

Knowing all of this information on typical child development, it would be very handy to have a complete checklist of aspects of developmental progression from birth to two years.

Developmental Checklist

I’m so excited to partner with Two Sparrows Learning Systems to offer this The Accommodation Station Milestone’s Checklist: Birth to Two Years Old.

This book comes in three variants – Digital PDF, Digital PDF and Spiral Bound Bundle, and a Spiral Bound only option.

This book was created to serve as a guideline, and reference, for parents to track the milestones of their child for the first two years of life. Ideally, this book will be brought to all doctor appointments in order to guide the conversation with your child’s provider in reference to their growth and development, and to any concerns which become apparent. 

It is important to note that all children develop at their own pace; however, the guidelines provided in this book are the accepted steps in development by doctors, service providers and educators alike. 

For ease of use, this book is broken down by the general developmental month span utilized in the medical community (i.e. 0-3 months, 3-6 months, etc.). This book covers the following:

  • Speech/language milestones
  • Feeding milestones
  • Fine motor milestones
  • Gross motor milestones 
  • Activities to address each of the above
  • Red flags to look for in each range
  • Pre-K readiness checklist
  • Kindergarten readiness checklist
  • Potty training tips
  • Expected stages of play
  • Pre-writing progression
  • Resources (websites and podcasts)

In addition, this book provides pull out checklists for increased ease in filing and long term record keeping for each of your children, as well as the ability for your child’s provider to make copies of, and keep the information for their own files. 

Colleen Beck, OTR/L is an occupational therapist with 20 years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to

Letter Sizing Activity

letter sizing activities

Working to help a child write with correct letter sizing and placement on the lines? Are you trying to come up with letter sizing activities to help kids write smaller letters that fit between the lines on the paper? Are you struggling with a child that forms letters without regard to size or line awareness? Letter size awareness is a real struggle for some kids!

This post is part of our Christmas in July giveaway series.

Letter sizing activities to teach kids to write the correct size.

Here, you will find suggestions to work on letter size awareness, along with a letter sizing activity that can be including into any handwriting curriculum. It’s one that focuses on how to form smaller letters, numbers so kids use a more precise pencil control that they can use when writing on any paper.

Letter Sizing Strategies

Do your students have trouble making their letters or numbers the right size? You might have seen kids that write without regard to the lines. Or, they may copy or independently write letters that take up the whole space, no matter what lined paper is used.

Other kids form letters that are correctly sized on the lines…but only when they have boxes drawn for each individual letter. But, that accommodation simply isn’t a possible option all of the time, for consistency and carryover.

During their earliest exposure to handwriting activities, young children at the preschooler and kindergarten ages may form large letters. Letters might fill the whole page or the whole available space. These forms are not always completed with a motor plan in place. the lines of the letters might be more of strait lines that intersect.

As kids gain more experience with writing with a pencil and with writing letters, they gain a motor plan that they can use on any surface and without a visual model for the letter.

Students then start to notice and use a letter size differentiation, or letters that are tall letters and reach the top line (e.g. b, d, f, h, k, l, t), letters that have tails that hang below the bottom line (g, j, p, q, y), and letters that rest in the bottom half of the writing space (a, c, e, i, m, n, o, r, s, u, v, w, x, y, z).

Kids will notice the differences between these differently sized letters and the upper case letters which are all the same size.

All of this letter size awareness occurs through experience and practice.

However, when there isn’t experience or practice time…or there is a visual perceptual concern, or a visual motor issue, there may be trouble or inconsistencies with letter placement.

That’s when interventions may be needed to help work on letter sizing.

Try some of these letter sizing activities

>> Using regular notebook paper, or bold lined, baseline paper, highlight the bottom half of the writing space. This is where the small letters are placed. Explain to the child that the tall/Capital letters start in the white, and the little letters start the grey(photocopied paper or yellow highlighted area). This writing paper is an easy fix for many writing situations.

>> Use modified paper. Here are free adapted paper types for all handwriting ages.

>> Try the box and dot strategy. This is a nice way to teach size awareness for kids who are just beginning to notice letter size.

>> Re-teach letter size of the upper case letters. Allow the child to notice where each letter starts. Then work on tall letters which start at the same point on the writing area. Next, teach the letters that are located in the bottom half of the writing space (the small letters). Finally, re-teach the tail letters which hang below the baseline. In each set of letters, allow students to notice where each letter rests.

>> Try any of these letter size activities.

>>Reduce distractions on the page by using black paper with white forms in increasingly smaller form size, like in the BlackBack writing program. This writing program allows students to form the motor plan for upper case letters and lower case letters, as well as numbers.

The BlackBack Writing Program depicts strokes, upper and lower case letters and numbers in white on a black background which helps the child see their strokes as they use the white space. Additionally, there is only one image on the page eliminating distraction from competing images and increasing attention to the single task on the page. Each letter, number and stroke has 6 sizes. The first size is very large and the last is the height of a wide-ruled notebook paper.  

The BlackBack Writing Program can be customized to begin where the child is in his/her writing journey. The letters, numbers, and strokes can be used on its own or as a supplement to any writing program.  The BlackBack Strokes, Letters and Numbers programs can be combined or used separately. 

Black Back Writing Program

I’m so excited to partner with Two Sparrows Learning Systems to offer this Black Back Writing Program.

It’s an awesome handwriting tool that addresses pencil control, motor planning, size awareness, visual motor skills, visual distraction, and more.

Therapy Box

therapy boxes for occupational therapy activities

This year, as we prepare for back-to-school, many therapists are asking how to create therapy kits. Many parents are wondering how to set their child up for success in hybrid schooling. Many with kiddos that will attend full or part-time online school are trying to figure out how prepare for the upcoming school year.

As a pediatric occupational therapist, I have always come up with small occupational therapy boxes or “kits” to use in practice. I love to create a themed box or bin of OT activities and use that to work on a certain set of skills.

Occupational therapy boxes for using to work with kids in OT or at home to enhance learning through play.


In this upcoming school year, we will be using themed kits in our home to help my youngest learn and develop skills (handwriting, precision in cutting with scissors, reading, manipulatives and math). This was one way that I was able to hold her attention for schooling at home this past Spring, and we will continue with that strategy this school year.

Some ideas that help to hold a child’s attention and get them excited for therapy or learning include these therapy boxes based on a theme:

Back-to-School Therapy Kit

Toddler Color Bin

More themed occupational therapy kits

Mini-Stars Sensory Bin

Deep Blue Sea Book Sensory Bin

Each of these themed therapy bins takes a common theme and offers ways to build skills- fine motor skills, sensory exploration, and more- through play!

Having a boxed set of therapy materials allows children to explore tools that help them grow stronger as they explore and play. Kids love to “unbox” the materials and use them while they discover the therapy box materials.

It’s a great way to get kids excited about therapy this Fall when school and learning routines are out of the ordinary.

Themed occupational therapy kits or OT boxes for kids.


That’s why I am SO excited to partner with Two Sparrows Learning Systems to bring you this OT for Me therapy box.

OT for Me is a subscription box designed and created by two pediatric Occupational Therapists and is a school-based OT box for activities to enhance kids’ academics through play.

The boxes are available as a single box purchase or in a monthly subscription model so that each month, you have a new therapy box arrive at your door. What a great way to get the kids excited about building developmental skills!

When you receive your box, you will be provided with activities for fine motor development, gross motor development, sensory play and family fun to enhance opportunities for growth & development.

Check out the items in this giveaway box…add these tools to your OT sessions or at home activities:

Occupational therapy giveaway items

OT for Me, is dedicated bringing families quality, hand-picked products and activities that have been tested and approved by the occupational therapy creators.

The therapy box aims to enhance kids’ individual skills and is cognizant that not all children develop at the same rate, so descriptions of the skills each product targets include strategies to make each activity harder or easier for that “just-right challenge”.

Each month, the therapy boxes are packed with new and exciting activities, meant to motivate children to “work” on developmental skills, all while having fun. Each box will always have an activity or product targeting the following 4 domains: Fine motor, Gross Motor, Sensory, & Academic/Family Fun- as well as other fun items! 

I’m so excited to partner with Two Sparrows Learning Systems on this OT for Me Therapy Box.

Colleen Beck, OTR/L is an occupational therapist with 20 years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to

Cutting with Scissors Program

Tips to teach kids to hold scissors

Teaching kids to cut with scissors depends a lot on the type of cutting scissors that are used. Ask any pediatric occupational therapist, and you will find recommendations for kid-friendly scissors that actually allow kids to cut paper. You know…the training scissors to introduce kids to scissor skills…the ones that don’t just tear through paper.

Choosing the best scissors for kids

When it comes to finding the best scissors for kids, there is a lot more to it than you might think. Cutting scissors need to fit the child’s hand and feel comfortable. They need to be safe and allow the child to learn to manipulate the scissors while cutting paper (and nothing else). They need to have molded handles that are easy to hold in the correct position. And they need to grow with the child so they can progress from cutting snips to shapes and multi-angled forms.

Teaching kids to cut with scissors is a progress. There are tips that can help along the way and there are strategies that can help a child succeed.

Having scissors and a strategy can help!

Why is teaching scissor skills important? Teaching kids to cut with scissors helps with fine motor skills and more.

Why is cutting with scissors important?

When we teach kids the correct way to hold scissors, kids find so much more success in cutting shapes. You probably have seen the child that holds scissors sideways on the paper. They open and close the scissor blades but nothing happens.

Maybe you’ve seen the child that pushes the scissors through the paper. They tear and rip the page instead of cutting along the lines.

You might recall the child that holds the scissors with their elbow out and up in the air so they are cutting in toward their body instead of out and along the lines.

All of these positioning tactics lead to poor scissor skills and a frustrated kiddo.

Importance of Scissor Skills

When we show kids how to properly hold scissors we set them up for success. When we hand scissors that properly fit the child, we are providing the tools for accuracy.

Teaching kids to hold the scissors correctly allows them to position correctly so they can cut along the lines and feel success as they cut shapes.

When kids open and close the scissor blades, they gain precision of fine motor skills. And, those same fine motor skills allow the child to gain accuracy in cutting more complex shapes and forms.

Cutting with scissors builds bilateral coordination skills so they can use both hands together in a coordinated manner.

Cutting along lines offers a way to gain accuracy and precision in eye-hand coordination skills.

Not only are kids gaining developmental motor skills, they are completing a functional task, too. Teaching kids the proper way to hold scissors allows them to open and close the blades to cut along the lines with accuracy. They can snip the paper rather than tear. They can progress in scissor skill development from showing an interest in cutting with scissors to cutting complex shapes.

So how to teach kids the right positioning for cutting with scissors?

use these tips to teach kids to hold scissors

Positioning for scissor skills

First in addressing positioning for scissor skills is sitting posture. Make sure the child is seated at a desk or table with their feet flat on the floor and arms at a functional position. Using a table that is too high puts the elbows and shoulders into too much flexion.

Tuck the elbows into the sides. Many times, we see new scissor users holding their elbows way out to the sides as they attempt to bring the scissor work closer to their face and body. Actually, having the child tuck their elbows into their side offers more support so they can work on refining those fine motor skills.

Make sure the scissors are positioned on the hand correctly. Kids often times, place their thumb in the small loop of the scissor handles and push all of their other fingers into the larger hole. If possible, ensure that the thumb is in the smaller loop and the middle finger is placed in the larger loop with the ring ginger and pinkie finger tucked into the palm for support.

If that positioning isn’t possible, allow the child to use their middle, ring, and pinkie fingers in the larger loop.

Be sure that the scissors are positioned perpendicular to the paper. When the scissors tilt sideways due to upper body positioning, the paper tends to tear rather than cut.

All of these tips, and much more are available in The Scissor Skills Book, created by an occupational therapist and physical therapist team that covers all things development and motor skills needed for cutting with scissors.

Scissor Skills Curriculum

So, if working on scissor skills, positioning, and building scissor accuracy is something you are working on with kids, then you are going to love this item!

Noggins is a 4 Pack Reusable Stickers, Scissors, and Scissor skills Curriculum

This scissor curriculum provides reusable stickers to help with positioning the scissors so kids can cut along lines.

You also get 3 pairs of scissors and a FREE download of our custom Nogginsland curriculum – which is a 22 page guide jam packed with activities to help your child grow and develop their fine motor skills. 

 Noggins spark imagination and motivate children to learn through pretend play.

  • When Noggins are attached to pencils, markers, or crayons, they turn those objects into creatures, with the tip of the writing utensil becoming the nose. This allows the child to pretend the Noggin is smelling flowers or sniffing through a maze, rather than merely tracing or drawing. The Noggin also acts a pencil grip, cueing correct finger position on the writing utensils.
  • When Noggins are placed on scissors, they act as a visual cue, guiding the child to orient them correctly. They turn the scissors into a creature, with the bottom blade becoming the lower jaw. This enables the Noggin to “bite” and “chew” paper, showing the concept and technique of scissor use in a fun and playful way.
  • When Noggins are attached to fingers, they transform the hand into a creature. This allows practice and development of a variety of grasps in a fun and playful way. Children are able to pinch and squeeze play dough and small objects, imagining that the creature is eating, while their own pincer grasp and lateral pinch develops.

Use the foam stickers to help with positioning of pencils, too.

Sensory Backpack

What is a sensory backpack

Today, we are starting off our Christmas in July celebration with a giveaway on a Sensory Backpack! Sensory backpacks are a powerful calming tool for children of many needs. There are weighted backpacks, compression packs, and book bag fidget tools out there. Here, you’ll find out some information on these sensory resources AND, can enter for a chance to win a Relax Pack Sensory Backpack of your own!

What is a sensory backpack?

What are Sensory Backpacks?

Have you heard of the term “sensory backpack”?

Most kids you know probably have a backpack that weighs way too much for their age or size. But for some children, the added weight of a backpack is calming. It’s proprioceptive input that has an organizing effect on kids.

Sensory diet bags are tools that help to support a child’s sensory needs, while on the go, at school, or in the community. Understanding your child’s Sensory Needs is just part of the puzzle.

A sensory kit can be used to meet the needs of a child and can look like many things: Sensory kits like a weighted backpack offers calming sensory input that can be used to both calm and stimulate a child’s sensory system.

Typically, it is portable and easy to maneuver as a way to make the tools accessible at all times to the child or children in need. Since all children have sensory needs, a sensory backpack can be a way to provide sensory input in a discreet and engaging way.

Sensory backpacks offer proprioceptive input in the way of pressure and weight.

They offer a means for the child to fidget and move their hands.

Many times, there are chewable items for the child to gain calming, heavy work through the mouth.

By using all of these items on a sensory backpack, kids can gain calming, heavy work input that allows them to focus, pay attention, remain safe in group settings, and help to organize the child during community settings or outings.

Calming Sensory Input

Children with sensory problems often are either at high alert hyper-reactive or unresponsive (hypo-reactive) to the input from their environment. They become overly distracted by outside stimuli, or they may seek out additional sensory input from the world around them. Over responsiveness or under-responsiveness can mean difficulty with paying attention or focusing.

The proprioceptive system receives input from the muscles and joints about body position, weight, pressure, stretch, movement and changes in position in space.  Our bodies are able to grade and coordinate movements based on the way muscles move, stretch, and contract. Proprioception allows us to apply more or less pressure and force in a task. But, the sensory system allows us to accept input too, in a way that is calming and organizing, so that we can self-regulate input from the world around us.

Self-regulation is an issue in sensory integration disorders and other diagnoses…as well as in children without a specific diagnosis. Children with self-regulation problems usually demonstrate unusual sleeping patterns, eating difficulties and self-calming issues. They struggle to cope with sensory input and need coping strategies.

Sensory input in the way of deep pressure, weight through the muscles or joints, chewing on resistive surfaces, or bear hugs are some coping tools that can have a grounding effect on kids with sensory issues.

Sensory Backpack Calming STRATEGY

That’s why a sensory backpack offers such a calming and organizing input for kids.

It’s a powerful way to help kids feel safe, pay attention, focus on walking in the hallway, or on the bus.

This year, children may return to school with an even higher level of anxiety or worries. Things are different this year and the school schedule may be different. Maybe kids are not in school at all.

A sensory backpack can offer a routine for schooling at home and allow them to self-sooth using proprioceptive input so they can complete distance learning tasks.