Finger Opposition

finger opposition

In this blog post, we’re covering an important piece to the fine motor skills puzzle: finger opposition! Finger and thumb opposition is a dexterity and precision skill that develops from a young age, and is very important in eye-hand coordination tasks that we complete every day. Let’s cover what this term means and how to support finger to thumb opposition skills.

finger opposition

Finger Opposition

Have you heard of the term “opposable thumbs”? You probably heard it as a reference to the difference between human hands and other, less advantaged animals. However, many other animals have opposable thumbs which work much like ours!

But what does it actually mean to have opposable thumbs? What are we talking about when we say “finger opposition”? Why is it advantageous? 

What is finger to thumb opposition?

Finger opposition, thumb opposition, and finger to thumb opposition all refer to the same thing. When we say these phrases, we are referring to the range of motion of the thumb (thumb ROM) as is rotates and flexes (or bends) to touch the pad of the thumb to the pad of the pointer finger.

To break it down further, the word “opposition” refers to something being placed opposite of another. So, having an opposable thumb means one has the ability to place the thumb opposite to, or across from the other digits (the fingers).

This thumb ROM is useful in order to grasp objects between the thumb and fingers.

Many grasps involve the oppositional movement of the thumb, think: picking up coins, grasping a baseball, or turning the pages of a book. An occupational therapist can begin to assess for strengths and weaknesses in thumb opposition by asking their patient to tap their thumbs to the tip of each finger. 

A hand assessment typically addresses the thumb ROM to oppose several areas:

  • Thumb to tip of each finger
  • Thumb to base of each finger

These motions allow the hand therapist to assess the ability to flex the thumb CMC joint, the thumb MP joint, and thumb IP joint for functional use in picking up and handling objects.

Also a major part of this assessment is a detailed look at finger ROM (range of motion). The following areas will also be assessed in a typical hand therapy evaluation:

  • Finger isolation
  • Range of motion of finger MP joints
  • Range of motion of finger PIP joints
  • Range of motion of finger DIP joints
  • Pinch strength
  • Grip strength
  • Sensation
  • Edema (swelling)
  • Pain
  • Coordination and precision skills
Development of finger opposition to thumb

DEVELOPMENT OF THUMB OPPOSITION

We can follow the development of an infant’s thumb oppositional skills by observing their grasps on rattles, bottles, cheerios, or whatever they may have nearby. A typically developing infant is expected to go through this timeline of grasping skills:

Newborn: Reflexive Grasp (Palmar reflex)

  • Newborns (up to 3 months of age) will reflexively hold whatever is placed in their hands. This reflex lays the foundation for a purposeful grasp in the baby’s life! 
  • Opposition? No thumb opposition yet, as the reflexive grasp focuses on the fingers curling in. 

4-6 Months: Purposeful Palmar Grasp

  • Little ones this age are just starting to figure out how to reach for a desired object and grab a hold of it. They tend to hold the object between the palm and fingers, which is why this is called a “palmar” grasp.
  • Opposition? No thumb opposition just yet; the thumb may begin to move towards the palm, but is usually unused in the grasp, placed away from the hand, as in a “thumbs up”. 

6-8 Months: Radial Palmar Grasp

  • In a radial palmar grasp, the thumb is secured along the side of the palm or the side of the index finger while the fingers hold the object in the palm. This demonstrates increased strength and precision of movement.  
  • Opposition? Here we can see the beginning of oppositional skill, but we aren’t quite there yet. 

8-10 Months: Radial Digital Grasp

  • All of these grasp names sound confusing, but do you see how we went from “palmar” to “digital”? In other words, the thumb went from touching the “palm” to touching the “fingers”! 
  • Opposition? Ladies and gentlemen, thumb-to-finger opposition has officially begun. 

10-12 Months: Immature and Mature Pincer Grasp 

  • First, the immature pincer grasp will develop. This is the grasp when a baby will hold a cheerio (or another small item) between the thumb and the side of the index finger. 
  • Later on, the mature pincer grasp develops which means that the thumb can oppose to the index finger! This is also known as a “tip” pinch, where the tip of thumb and the finger tip are together, much like the “okay” signal. 

Over the next several months and years, the developing toddler will hone their fine motor skills to be able to oppose their thumb to each finger and coordinate their movements to complete tasks. To support these skills, age-appropriate toddler play activities are essential.

In most cases, the development of thumb to finger opposition is considered “complete” around age five. The average five year old should be able to demonstrate certain movements that indicate developed hands, for example: a functional pencil grasp, stringing beads, zip/unzip, button/unbutton, and various in-hand manipulation skills. 

To promote these skills during the ages of 3-5 (and if motor skills appear to be delayed), try some of these preschool activities for age-appropriate motor tasks to support development.

WHY IS OPPOSITION USEFUL?

This movement is essential for how we function with the world around us. For the koala (another member of the opposable thumb family), they are skilled climbers and tree-dwellers by use of their thumb wrapping around a branch, towards their other digits, as a way to secure their bodies for safety.

Most humans are not quite as skilled in tree climbing, but will instead use our opposable thumbs for complex skills like playing guitar, tying our shoes, and handwriting. 

For the able-bodied, one way to feel how we may function without the use of our opposable thumbs is to try to zip or button an item without using the thumbs…it is quite the challenge! 

Delayed Finger to Thumb Opposition

What happens when finger to thumb opposition is delayed or a challenge for kids? 

There are some cases where finger-to-thumb opposition becomes challenging. This could be due to weakness, injury, muscle tone, weakness, range of motion difficulties, or malformation of the hand, fingers, thumb, or wrist.

Really, anything that leads to reduced mobility of the thumb carpometacarpal joint (the point near the wrist that the thumb rotates on) can result in reduced thumb opposition. 

When there is a lack of thumb opposition, one solution to increase function is to provide interventions for joint range of motion and muscle strength. This can be done in play-based ways that are therapeutic but tons of fun! 

ACTIVITIES FOR Finger to Thumb Opposition 

Craft and play-based activities are one great way to increase thumb to finger opposition in kids. The best part, though, is that you are increasing so many more skills at the same time! We’re talking fine motor strength and coordination, visual motor skills, bilateral coordination, social skills, and more! 

Along with the many great activities below, check out our page all about Fine Motor Skills and our Fine Motor Checklist for more information on development of these skills. 

Activities to Open Thumb Web Space – These activities open the thumb web space so a nice round circle is seen during thumb opposition. This enable precision of motor skills and a refined pincer grasp.

Finger Play Songs– These opposition activities promote thumb ROM and coordination of the thumb and finger movements.

Hand Eye Coordination Activity– Precision and motor planning go hand in hand with eye-hand coordination tasks. This is where you will see thumb and finger opposition in action.

Finger Isolation Crafts– Isolating a single finger is a refined and graded motor task that enables opposition movements from the thumb to a single finger.

Fine Motor Travel Box– This activity is a fine motor tool that makes working on thumb and finger opposition skills fun.

Separation of the Hand Activity– The thumb is on the precision side of the hand and along with the pointer finger and middle finger is responsible to precise motor movements and dexterity in tasks. Finger to thumb opposition is a main piece of this.

Play Doh Fine Motor – Opposable thumb activities like this one support strengthening and thumb ROM.

Tongs Activities– Strengthening the arches of the hands allows for a stable and supportive base for thumb opposition in functional tasks.

Stickers for Fine Motor – Stickers are a therapist’s best friend when it comes to finger opposition activities.

The way we move our hands can be synonymous with the way we interact with our environment. For a lot of us, the use of our hands are the way that we function in daily life!

Build finger to thumb opposition with these activities:

Working on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, or scissor skills? Our Fine Motor Kits cover all of these areas and more.

Check out the seasonal Fine Motor Kits that kids love:

Or, grab one of our themed Fine Motor Kits to target skills with fun themes:

Want access to all of these kits…and more being added each month? Join The OT Toolbox Member’s Club!

Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her
background is in Human Development and Family Studies, and she is passionate about
providing individualized and meaningful treatment for each child and their family. Sydney is also
a children’s author and illustrator and is always working on new and exciting projects.

Easy Fine Motor Precision Activities

Precision activities

Helping kids develop and strengthen fine motor skills is essential for functional tasks, and this resource on fine motor precision activities supports that development. Here, we are addressing what fine motor precision means and specific activities to do with kids to help with grasp manipulation, dexterity, and graded movements like managing a zipper, buttons, and adjusting a pencil within the fingers to write and erase. These are just a few examples of how grasp and release activities support fine motor skill development. Let’s break this down…

Fine Motor Precision Activities

Before we get to the fun stuff…the actual fine motor activities that support graded grasp and release, manipulation of objects within the hand, and various amounts of pressure and precision needed to perform functional tasks, let’s cover exactly what precision skills look like, what the term means, and why this area of development is so important.

At the bottom of this post, you’ll find specific strategies to support precision development so that kids can complete these tasks and not fumble with objects in the hands.

A good place to start is with our resource listing games with paper clips as a tool to support precision and refined dexterity.


This post is part of my 31 Days of Occupational Therapy series where you can find 30 more ideas like this one with easy treatment materials.

Easy precision in grasp, release, and rotation in fine motor skills for kids.  Precision is so important in dexterity in many skills like handwriting, cutting with scissors, and everything done with the hands!

What is Fine Motor Precision?

Fine Motor Precision refers to the ultra-fine motor skills in the hand, broken down into areas: grasp and release, fine motor rotation, in-hand manipulation, and proprioception. Together, these precision skills enable us to pick up an object with the right amount of pressure and motor dexterity so you can grasp the object accurately taking eye-hand coordination skills into consideration. After grasping the object without overshooting or missing the item, it is necessary to position or rotate the object within the hand

Let’s cover each of those areas in greater detail below.

But first, it’s important to note that a child’s ultra fine motor dexterity is dependent on bigger things.  And by that, I mean that in order for a child to use their hands super fine motor tasks, they first must demonstrate strength and control of their core, shoulder, and arm.  If any of these areas are not fully developed in stability or control, then the child will show compensatory strategies as they try to use their hands in handwriting or cutting with scissors. Gross motor coordination is a great place to start if precision skills seem to be “off” or delayed. Related to that is the key input of body awareness and the impact of heavy work on more distal motor coordination skills.

One way to remember this is this:

Proximal stability allows for distal mobility.”

Colleen Beck, OTR/L

Before a child can manipulate and move an object with dexterity and refined motor skills, there needs to be a base of support in stability in the core and upper extremity, mobility and coordination in the proximal joints (shoulder before elbow…elbow before wrist…and wrist before hand).

Breaking it down further, arch development and strengthening of the intrinsic muscles in the hands are both areas that are essential for precision in the fingertips.

The following resources will be a great way to break these areas of development down:

Fine Motor Precision

Kids and fine motor skills go hand-in-hand. (That is my funny-OT attempt at a fine motor skills joke!) But really, fine motor skills are a staple of a child’s development and are essential to function.

Precision occurs with development of grasp when child to use the pads of the index finger, middle finger, and thumb to manipulate objects with opposition.  I talked a little about strengthening these types of grasp patterns.  

Today, I’m sharing ways to work on the controlled use of these fine motor patterns in controlled dexterity tasks.  The precision of grasp and release is essential for very small motor movements in activities like picking up beads and releasing items like blocks with precision. This is broken down into areas of dexterity that all work together:

  • Grasp and release (we’ll break these two areas down even further)
  • Fine motor rotation
  • In-hand manipulation
  • Muscular force, or the amount of force applied through the muscles in small motor use, also referring to proprioceptive input through the hands and fingers.

What is precision of grasp and release?

Precision in grasp, manipulation, and release of small objects makes the difference between fumbling with zippers and buttons and efficiently grading movements in very small dexterity patterns like threading a string through a needle (kid-friendly, of course!) 

Precision in grasp is related to the picking up of items.  A graded lateral grasp is needed to cut with scissors and only squeeze the scissors halfway shut for accurate cutting lines in some situations.  Around 3-4 years, a preschool aged child typically develops a greater variety of grasping patterns, including precision.  They begin to grade their scissor strokes so that they can cut a line or shape without opening and closing the scissors completely.  Grasps in babies typically begin with a raking motion and work towards a pincer grasp.  Precision in this skill occurs when the child is able to pick up very small items like beads with accuracy and graded movements.  

Precision release is needed for stacking blocks without toppling them over, placing cards on a pile, opening scissors just a small amount, or placing small beads into a bowl.  Precision is needed for a child to let go of an item in a controlled manner.  If they are not exercising precision in release, you might see them rolling or tossing an object as they let go.  They will knock over a stack of blocks, or over open the scissors when cutting lines, making their accuracy very choppy.   

Precision in rotation is another task that children develop around age 5. Rotation is a portion of in-hand manipulation and seen when turning a coin on the edges and the child rotates it in a circular motion.  Precision in rotation also occurs when holding a pencil between the fingers and the child rotates it over and over. 

Easy precision in grasp, release, and rotation in fine motor skills for kids.  Precision is so important in dexterity in many skills like handwriting, cutting with scissors, and everything done with the hands!

One way to develop these skills is through practice! One precision grasp and release activity I love is using popsicle sticks in various colors. You can stack the popsicle sticks so they build a wall without toppling over. Using the different colors allows kids to see how the sticks are aligned by offering contrasting colors. If they see a bit of yellow stick under the green stick, then they need to adjust the top stick with refined motor movements.

Grade this activity for younger kids or those developing skills:

  • Simply place a single popsicle stick down on a table surface. Then pick it up.
  • Younger kids can stack just one stick on top of another.
  • Match colors.
  • Make a wall of popsicle sticks to develop more refined precision skills.
  • Place and sort popsicle sticks into a container on the vertical position (shown below)

To practice precision in grasp and release, I showed my preschooler how to pick up and stack Popsicle sticks.  Picking up the sticks required a tip-to-tip grasp.  We used different colored Popsicle sticks for my 4 year old and my 17 month old.  

The preschooler was able to pick up the sticks accurately without pushing other sticks around.  She could grasp the specific stick she wanted by an end or middle accurately.  

The toddler grabbed the sticks with a pincer grasp, but showed much less accuracy.  

Easy precision in grasp, release, and rotation in fine motor skills for kids.  Precision is so important in dexterity in many skills like handwriting, cutting with scissors, and everything done with the hands!

To advance this popsicle stick sorting, the next step is precision in rotation. This can be addressed by asking the individual to sort popsicle sticks into containers.

Different small cups (Dixie cups would work) but we used a popsicle mold to encourage a single hand to hold the mold as the assisting hand.

We used an empty Popsicle mold to place the sticks into the cups.  What a great way to practice grasp precision!  We worked on sorting the craft sticks by color and had to hold the mold with one hand to work on bilateral hand coordination.  For the activity, we placed the mold on the floor and sorted the colored sticks without knocking the Popsicle mold over. Both the preschooler and the Toddler loved this simple activity.  

Easy precision in grasp, release, and rotation in fine motor skills for kids.  Precision is so important in dexterity in many skills like handwriting, cutting with scissors, and everything done with the hands!

 Another precision in release activity was simply stacking the craft sticks.  The four year old could do this, but used her non-dominant hand to stabilize. 

Precision in in-hand manipulation- In hand manipulation skills include different components as well. In our blog post, we cover rotation, refined movements within the hand, and how to actually move objects from the fingertips to the palm and ice versa. These are precision skills at work!

Muscular force- This refers to knowing how much force to use to pick something up. When it comes to muscular force in fine motor skills this can mean the difference between overshooting an object when picking something up, fumbling with small objects, pinching things with too much force, or dropping items because not enough force is applied.

As described above, muscular force also refers to the amount of force applied through the muscles in small motor use, also referring to proprioceptive input through the hands and fingers. Another term for this concept is force modulation, or graded force.

Muscular force is a must for picking objects up, putting them back down, manipulating them within the hand, and rotation.

We go into greater detail on the proprioceptive input in our blog post on proprioception. In summary, muscular force means the ability to inherently know how much force is needed to pick up and hold and manipulate a ladybug as opposed to a heavier rock. Too much force and the bug is squashed. Not enough force, and the rock slips through the fingers. Another example is pressing too hard when writing and holding a pencil. This experience and muscle knowledge happens through play!

As you can see, all of these concepts work together to enable precision skills in functional tasks!

Precision Activities

We’ve covered a couple of precision activities related to grasp and release and rotation, but let’s go over a few more that include all aspects of precision, including muscular force activities and how these are related to functional participation.

Easy precision in grasp, release, and rotation in fine motor skills for kids.  Precision is so important in dexterity in many skills like handwriting, cutting with scissors, and everything done with the hands!

This post contains affiliate links.

Looking for more ways to practice precision in grasp, release, and rotation with Occupational Therapy students or your kids?  Try some of these ideas.  While they are not all free (going with our series this month!), they are creative ways to practice precision.  

  • Precision engineering activities that use play dough and blocks to work on force modulation in the hands as well as eye-hand coordination.
  • Small motor pegboards like this precision pegboard activity combining crafts with fine motor skills
  • Perler beads- Try manipulating Perler Fuse Beads with Pegboards (affiliate link) for precision in grasp and release. These pegboards are very small and work on very fine dexterity with precision. 
  • Stamp sets (affiliate link)- Playing with stamps is a good way to practice graded grasp and release. Use these stamp blocks to accurately stamp within a specific area on a page. Draw squares or circles and the child needs to stamp in those areas. 
  • Tweezer games and activities like this Bed Bugs Game (affiliate link) encourage a precise and graded grasp and release of the small game pieces using tweezers. This game is on my must-buy list for Christmas this year! 
  • This Avalanche Fruit Stand (affiliate link) for another fun way to practice precision with a pair of tweezers. Stack the fruit with precision of grasp and release in a fun and colorful way! 
  • The Perfection Game (affiliate link) is another game that is great for precise grasp and release. Encourage kids to rotate the pieces by twirling the peg of the game pieces to work on precision in rotation as well. 
  • Jenga (affiliate link) is a precision work out in grasp and release of the blocks. My kids love this game!
  • Stacking blocks is a precision pattern activity that is perfect for working on graded grasp and release. 
  • This Tobbles stacking toy (affiliate link) is a version of that, with bright and bold colors. Try stacking and taking these balls down without knocking them over! 
  • Sometimes, simple is best! These Wooden Color Cubes (affiliate link) are perfect for simple block building and stacking while working on precision of grasp and release. 
  • Kids need precision of the thumb, too. These Slide Puzzles (affiliate link) are not only fun, they work on small motor skills needed for graded movements in cutting and pencil control.
Easy precision in grasp, release, and rotation in fine motor skills for kids.  Precision is so important in dexterity in many skills like handwriting, cutting with scissors, and everything done with the hands!

It’s my hope that this post and ideas were helpful and a resource for you!  Looking for more fine motor activities for functional grasp?  Try these: 

Working on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, or scissor skills? Our Fine Motor Kits cover all of these areas and more.

Check out the seasonal Fine Motor Kits that kids love:

Or, grab one of our themed Fine Motor Kits to target skills with fun themes:

Want access to all of these kits…and more being added each month? Join The OT Toolbox Member’s Club!

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.