Why Vertical Surfaces Work: The Research Behind One of OT’s Best-Kept Secrets

Walk into most elementary classrooms and you’ll see children writing flat on their desks. Worksheets flat. Drawing flat. Coloring flat. Everything flat.

Walk into my OT class push-in session and the first thing I do is prop something up.

I’ve been recommending vertical surface work to teachers for over 25 years, and I still have to explain it at nearly every IEP meeting and professional development session I run. Not because it’s complicated — the reasoning is actually pretty clear — but because it looks different from what teachers expect, and “different from expected” tends to require a conversation.

So here’s the conversation. Let’s talk about why vertical surfaces work, what the research supports, and what this has to do with pencil grasp.

 What Counts as a “Vertical Surface”?   

Before anything else: vertical surfaces aren’t complicated or expensive. We’re talking about:

• A whiteboard or chalkboard (the original)

• A piece of paper taped to the wall

• An easel

• A three-ring binder standing upright on a desk

• A slant board propped at an angle

• A window with washable markers

• A full length mirror or sliding glass door

The defining feature is that the writing surface is positioned at roughly 90 degrees — or at least at a significant incline — rather than flat on the desk. The exact angle matters less than the shift away from horizontal.  Technically, a slant board or three-ring binder is in between, but it still counts for this conversation.

What Happens to the Hand and Wrist on a Vertical Surface  

Here are the biomechanics, as simply as I can put it.

When a child writes on a flat surface, the wrist tends to rest in a neutral or slightly flexed (bent downward) position. For many children — especially those still developing wrist stability or a mature grasp — a flat or flexed wrist puts the hand at a mechanical disadvantage. The web space collapses, the fingers can’t move efficiently, and the large muscles of the forearm and arm end up doing work that should belong to the small muscles of the hand. That’s why we see whole-arm coloring and static grasps at the tabletop.

When the surface is vertical, the wrist naturally moves into extension (bent slightly back). That position:

 

1. Promotes wrist extension, which is one of the foundational prerequisites for a mature pencil grasp. Benbow (1998) specifically identifies wrist stabilization in extension as the first motor milestone the hand must develop in preparation for functional handwriting. A vertical surface promotes this without any explicit instruction.
2. Encourages the open web space. When writing upright, the thumb and index finger naturally form the circular open web space that supports a functional grasp. On a flat surface, children with immature grasps often collapse this space, tucking the thumb or wrapping fingers around the pencil. The vertical position makes the correct position mechanically easier to achieve.
3. Supports shoulder stability. Working above eye level on a vertical surface requires holding the arms up against gravity, strengthening the muscles, and encouraging shoulder stability.
4. Promotes distal control. Writing on a wall or easel requires the shoulder to work isometrically to hold the arm in place. That co-contraction builds the proximal stability that underlies distal (finger) control. You cannot have precise finger movements without a stable shoulder — fine motor development proceeds from the center of the body outward, and the shoulder is the foundation.

The “Why” Behind Vertical Surfaces  

This isn’t a new idea. Occupational therapy practitioners have recommended vertical surface work for decades — not because it’s trendy, but because the mechanics make sense and clinicians keep watching it work.

The wrist extension piece is the best-documented part. Strickland (1995) noted that positioning the wrist in extension supports the thumb abduction and opposition required for a tripod grasp, and Benbow (1990) found that wrist extension promotes balanced use of the small muscles of the hand. A vertical surface is one of the most efficient ways to encourage this position because it’s embedded in a functional activity. The child is drawing or playing, not doing a rote exercise.

The benefits go beyond handwriting. Myers (1992) pointed out that this same principle applies to fine motor play: toys positioned vertically encourage finger isolation, manipulation, and separation of the two sides of the hand (the foundational skills that underlie mature grasp patterns for writing, play, and self-care).

There’s also a strength and stability component. Working on a vertical surface means holding the arm up against gravity, which builds shoulder stability and arm strength. That proximal stability matters because controlled finger movements depend on a stable base — fine motor development proceeds from the center of the body outward.

Practical Classroom Applications  

This doesn’t have to be elaborate. Here’s what I actually recommend when I consult with teachers:

For the whole class (Tier 1):

• Use the whiteboard or chalkboard for letter formation practice instead of worksheets whenever possible

• Have children complete morning work or spelling practice on paper taped to the wall at least two or three times per week

• Keep an easel in the classroom writing center

• Allow children to lay on the rug, writing on a clipboard. Although the surface isn’t vertical, the child’s positioning encourages the same benefits.

For small groups (Tier 2):

• Vertical surface drawing and writing as part of a fine motor station

• Using a three-ring binder propped upright on the desk as an inexpensive slant board substitute

• Coloring books propped against the wall — yes, coloring on a vertical surface counts

• Fine motor centers and activity stations with vertical toys (pegboards, lite brite, etc.)

For individual students (Tier 3 / direct OT):

• Specific slant boards prescribed by angle based on assessment

• Vertical surface activities explicitly included in the home program

• Monitoring wrist position and grasp quality in the vertical versus horizontal position to identify what the child actually needs

The Grasp Connection  

Here’s why this matters specifically for pencil grasp, and why it’s in a book about grip and grasps.

One of the most common patterns I see in referrals is a child who “knows” the correct finger placement but can’t sustain it. They start with a tripod (fingers in the right spots). But within minutes, they’ve migrated back to a fisted grasp or a wrapped thumb. Teachers sometimes interpret this as carelessness or lack of effort. It’s usually neither.

What’s happening is that the underlying prerequisites for that mature grasp aren’t stable yet. The wrist isn’t strong enough in extension. The shoulder isn’t providing enough proximal support. The proprioceptive feedback isn’t clear enough to help the child self-monitor.

Vertical surface work builds those prerequisites. It doesn’t replace explicit grasp instruction — but it creates the foundation that makes grasp instruction stick.

I tell teachers: if you want the pencil grasp lesson to last longer than the day you taught it, add vertical surfaces and visual reminders (such as a poster of correct grasp) to your classroom routine. It’s not a replacement for anything. It’s the support structure underneath everything else.

A Note on Slant Boards  

Slant boards (angled writing surfaces that sit on the desk) are a middle ground between flat and fully vertical. They’re commonly recommended by school OTPs for children who need more wrist extension than a flat desk provides, or for situations where full vertical work isn’t practical (like a classroom desk during writing instruction).

The rationale is the same as with vertical surfaces: angle the surface, encourage wrist extension, and make it mechanically easier for the small muscles of the hand to do their job. Slant boards are covered in depth in Gripipedia, where we walk through the specific angles, the populations they tend to help most, and how to trial them with students before committing to purchasing them for a classroom.

The Bottom Line  

Vertical surfaces are not a trend. They are not occupational therapy magic. They are a straightforward application of what we know about hand development: that the wrist must be stable in extension, that proprioceptive input builds motor awareness, and that proximal stability precedes distal control.

If you’re working with a child who struggles to maintain a functional grasp, or a classroom full of kindergartners who are still working through the transitional stages, adding vertical surface opportunities to the day is one of the highest-leverage, lowest-cost interventions you have available.

Tape some paper to the wall. You’ll see the difference.

References  

Benbow, M. (1990). Loops and other groups: A kinesthetic writing system. Instructor’s manual. Therapy Skill Builders.

Case-Smith, J. (1991). The effects of tactile defensiveness and tactile discrimination on in-hand manipulation. American Journal of Occupational Therapy, 45(9), 811–818.

Cornhill, H., & Case-Smith, J. (1996). Factors that relate to good and poor handwriting. American Journal of Occupational Therapy, 50(9), 732–739.

Henderson, A., & Pehoski, C. (2006). Hand function in the child: Foundations for remediation. Mosby.