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.

A Visual Guide to Pencil Grip Development That Actually Makes Sense

Last week, a kindergarten teacher showed me her classroom pencil grasp poster and asked, “Why doesn’t this match what I’m seeing with my kids?” She pointed to five different children, each holding their pencils in completely different ways, and honestly looked a bit defeated.

This happens all the time because most developmental charts show you the end goal without explaining the amazing journey children take to get there. Today, I’m sharing the visual progression I use every single day in my practice – one that shows you what normal development actually looks like, not just what we hope it becomes.

Stage 1: Early Immature Grasps (Under 3 Years)  

The “Whole Body Writer” Phase  

Children with immature grasps use their full arm, hand, and fingers as one unit to control the movement of the pencil. These grasps are typically seen in children under three years old, but don’t panic if you see them in slightly older kids who haven’t had much crayon or pencil exposure!

Radial Cross Palmar Grasp & Palmar Supinate Grasp  

These are your classic “fisted” grasps. I watch toddlers use these patterns and they’re absolutely perfect for this stage! The radial cross palmar has the thumb wrapping around to meet the fingers, while the palmar supinate looks like they’re holding a hammer with the thumb pointing up. Both give children the stability they need when their small finger muscles aren’t ready for precise control yet.

Digital Pronate, Brush Grasp & Grasp with Extended Fingers  

These patterns show children starting to use their fingertips more, but still with that whole-arm control. The digital pronate has the wrist turned down, the brush grasp looks exactly like holding a paintbrush, and the extended fingers pattern shows all fingers involved but not quite flexed properly. I love seeing these because they tell me a child is experimenting and building strength!

Stage 2: Transitional Grasps (Ages 3-6) 

Where Development Gets Interesting   

These grasps develop as the child gains stability in their shoulder and elbow. The movement of the pencil is controlled by extrinsic hand and arm muscles, and finger movements are beginning to develop. Schneck & Henderson (1990) identified these as transitional because they continue until six years of age – and that timeline is completely normal!

Cross Thumb/Lateral Pinch, Quadrupod & Static Tripod Grasps  

Here’s where things get really interesting! The cross thumb pattern has the thumb crossing over the pencil – looks “wrong” to many adults but often provides amazing stability for kids. The quadrupod involves four fingers with movement coming from the wrist. The static tripod looks mature but the fingers move as one unit instead of independently. All three are perfectly appropriate for this developmental stage!

Stage 3: Mature Grasps (Ages 4-6 and Beyond)  

Dynamic Movement Takes Center Stage  

Mature pencil grasps are characterized by dynamic finger movements and ulnar stabilization (pinky and fourth finger are “tucked into” the palm). The wrist and forearm are positioned on the table for stability. Here’s the game-changer: there are four equally mature and functional patterns!

All Four Mature Patterns: Equally Functional!  

• Dynamic Tripod: The classic three-finger grasp everyone recognizes
  
• Lateral Tripod: Three fingers with thumb crossing over – still dynamic and efficient
  
• Dynamic Quadrupod: Four fingers with movement from finger joints, not the wrist
  
• Lateral Quadrupod: Four fingers with thumb crossing over but maintaining finger mobility

(Gripipedia, © 2026; Donica et al., 2013)

What Really Matters in Development  

After seeing hundreds of children progress through these stages, I’ve learned that development is beautifully individual. Some kids show mature patterns by age 4, others develop them closer to 7 or 8. Hand size, joint mobility, muscle tone, sensory preferences, and even personality influence this timing.

When to Actually Be Concerned:

• Consistent complaints of hand or finger pain during writing activities

• Complete avoidance of fine motor tasks that peers enjoy

• Significant fatigue after age-appropriate amounts of writing

• Grip patterns that consistently interfere with letter legibility

• No progression in grip development over 6-12 months with regular exposure

• Regression to earlier patterns after mastering more mature ones

Supporting the Natural Progression  

Understanding this visual progression changes how we support children’s development. Instead of forcing specific grip patterns, we can build the foundational skills that allow natural progression to unfold.

Want This Complete Visual Reference?   

This developmental progression chart is just one tool from my comprehensive Gripipedia resource collection. Having clear visual references transforms how you understand and explain pencil grip development to parents, teachers, and colleagues.

My upcoming book includes this complete visual progression plus detailed intervention strategies, troubleshooting guides, and evidence-based approaches for supporting each developmental stage.

You’ll never again wonder if what you’re seeing is normal variation or a pattern that needs support. The visual clarity makes all the difference in confident clinical decision-making!

Ready to have the visual tools that make you the go-to expert for pencil grip guidance? Join my email list for early access to these comprehensive resources!

References  

Donica, D. K., Goins, A., & Wagner, L. (2013). Effectiveness of handwriting readiness programs on postural control, hand control, and letter and number formation in Head Start classrooms. Journal of Occupational Therapy, Schools, & Early Intervention, 6(2), 81–93. https://doi.org/10.1080/19411243.2013.810938

Gripipedia. (© 2026). Developmental progression of pencil grasp—right hand [Developmental progression chart]. Gripipedia Publications.

Schneck, C. M., & Henderson, A. (1990). Descriptive analysis of the developmental progression of grip position for pencil and crayon control in nondysfunctional children. American Journal of Occupational Therapy, 44(10), 893-900.

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting after a 10-minute copy task in Grade 4 children. Australian Occupational Therapy Journal, 59(3), 180-187.

If you’ve been in the school-based therapy world for more than a minute, you know the feeling of looking at the teachers’ salary schedule, looking at your master’s or doctoral degree, looking at your mountains of specialized continuing education… and feeling completely invisible.

I felt that exact frustration for more than two decades. But today, I’m writing to tell you that the ceiling has officially cracked.

My home district just ratified a historic CSEA contract. We didn’t make a few minor tweaks—we rewrote the blueprint for how NYS school-based therapists under Civil Service are valued in our schools.

Here is exactly what we secured for OT and PT:

• A $10,886 Master’s stipend
• Brand-new Master’s +30 stipend of ($16,424) and Master’s +60 stipend ($21,926)  — earned through specialized professional continuing education (CEUs) and graduate courses converted into salary credits
• A dedicated Doctoral stipend ($24,894) recognizing our highest-level degrees
• A $5,000 specialized stipend for holding an Assistive Technology Professional (ATP) certification

In all of my research into NYS school district contracts so far, I have not found another CSEA Civil Service contract that has successfully built educational lanes like this for OTs and PTs. So how did we pull off the “impossible”? And more importantly, how can you do it in your district? Let’s dive in.

The Root of the Problem: Why OTs and PTs Get Left Behind in NYS

To fight a system, you have to understand how it’s wired. In New York State, the wage gap between teachers and therapists isn’t usually personal — it’s structural.

Under the New York State Education Department (NYSED), professions like speech-language pathology, school psychology, and social work are housed under Pupil Personnel Services (PPS) within the Office of Teaching Initiatives. Because they’re classified as instructional, they automatically land on the teacher salary schedule, complete with built-in lanes for professional growth (those coveted +30 and +60 columns).

Occupational and Physical Therapists are missing from that PPS list. Instead, we’re classified under Civil Service.

Because of that classification, administrators and union reps have historically thrown up their hands and said, “Civil Service contracts don’t have educational lanes. There’s nothing we can do.” For decades, we’ve been boxed into a medical mold, fighting a constant battle to prove we are educators and vital Specialized Instructional Support Personnel (SISP).

But “we’ve always done it this way” is no longer an acceptable excuse.

The Advocacy Blueprint: Data, Presentation, and Persistence

Our peer-reviewed research (published in JOTSEI) found that 96% of school-based OTPs are calling for systemic change to how we’re classified and compensated. This isn’t one frustrated therapist’s problem — it’s a profession-wide structural gap.

When it came time to advocate in my own district, I didn’t just go to administration and complain that things weren’t fair (this time). I treated advocacy like a professional presentation. If you want to change the minds of a Superintendent, an HR Director, or a Union Board, you have to speak their language.

Here is the three-step framework I used:

1. Present the Data Professionally

I built a side-by-side comparison the district couldn’t ignore:

• The salary schedules. In my district, the Master’s stipend for OTs and PTs had been frozen at $2,500 since 2001 — while the same degree earned other related service providers a differential of $10,672 to $21,593 on the teacher schedule.
• The duties. A comparison table showing that OTs and PTs perform the same IEP-mandated, legal responsibilities — standardized testing for eligibility, parent communication, aligning goals with curriculum, superintendent conference days — as the providers being paid on the teacher schedule.
• The cost avoidance. Our district’s assistive technology caseload had grown 460% in four years. Contracted AT services in New York run $110–$150 per hour, with formal evaluations costing up to $3,200 per case. Certified in-house expertise saves the district real money.
• The regional picture. Neighboring districts with similar tax bases already compensate OTs and PTs on the teacher salary schedule — proof that parity is fiscally achievable in our region.

I handed over data that proved a stable, well-compensated therapy department directly protects the district’s special education infrastructure.

2. Offer a Creative Solution

Administrators are busy. If you bring them a problem, you must bring the solution on a silver platter. I proposed a clean, realistic framework showing exactly how clinical CEUs could be mathematically converted into salary credits to mimic the teachers’ +30 and +60 columns — without violating Civil Service rules, and without creating an administrative headache for HR.

3. Relentless, Gracious Follow-Up

Change doesn’t happen in a single meeting. I met with administration, submitted the data, and followed up with unwavering consistency and professional grace. I didn’t let the paperwork gather dust on a desk.

When my union board saw the data and realized we had a viable framework, they stepped up and advocated fiercely for us at the table. When administration reviewed the numbers, they opened their minds to a brand-new way of doing things.

Don’t Give Up: Your District Could Be Next

If you’ve been told by your union or your district that educational columns “can’t be done” for Civil Service OTs and PTs, I’m living proof that they’re wrong. The mold has been broken right here in New York. When you present the right data to the right leaders, structural change is entirely possible.

You are a vital piece of the instructional team. Your advanced training directly impacts student success, safety, and classroom independence every single day. It’s time our contracts reflected that.

Grab My Free District Advocacy Template

You don’t have to reinvent the wheel or spend years staring at a blank page. To help you kickstart the conversation in your own district, I’ve put together a Free District Advocacy Template.

It’s completely customizable — plug in your own district’s salary schedules, caseload data, and regional comparisons. It’s the exact proposal framework that unlocked an $10,000+ raise and historic educational columns for my department.

Present the data.

Play the long game.

And go get what you’re worth.

Here’s something that should make every school-based PT and OT practitioner sit up and pay attention: we completed groundbreaking research showing that 94.9% of New York school physical therapy providers believe they should have the opportunity to pursue educational administrative positions. And yet, state policy continues to block this path entirely. Our data proves that physical therapy providers deserve equal access to these pathways.

Let me explain why this matters—and what we can do about it.

The Classification Problem

Within the New York State Education Department Office of Teaching Initiatives framework, both Occupational Therapy and Physical Therapy services are currently not classified under Pupil Personnel Services.

Pupil Personnel Services include school counselors, school psychologists, and school social workers. Notice who’s missing? OTs and PTs. This classification exclusion means we cannot obtain an educational credential, which renders us ineligible to pursue the coursework required for educational administrative certificates—the gateway to positions like principal, director of special education, or superintendent.

This isn’t just about career advancement. This classification inequity affects recognition, hiring practices, pay equity, tenure opportunities, and ultimately, the quality of care our students receive.

Spencer, J., MEd, OTR/L, Zeidler, S., OTD, OTR/L, & Wiggins, K., OTR/L. (2024). Perceptions of Occupational Therapy Practitioners as Leaders within the New York State Education System. Journal of Occupational Therapy, Schools, & Early Intervention, 17(3), 569–584. https://doi.org/10.1080/19411243.2024.2315579

What the Research Shows

Dr. Serena Zeidler, Kim Wiggins, and I conducted research examining school-based physical therapy providers’ perceptions of leadership within the New York State Education Department. Our PT-specific study, “Perceptions of School-Based Physical Therapy Providers as Leaders Within the New York State Education System,” surveyed 86 physical therapy providers (84 PTs and 2 PTAs) currently working or formerly working in New York schools.

The findings are striking:

Most respondents (94.9%) agree that New York school physical therapy providers should advocate for policies that would provide them the opportunity to pursue educational administrative coursework. Nearly half (49.3%) would actively consider pursuing this coursework if it became available. Another 24% were unsure, and only 26.7% said they wouldn’t consider it.

Think about that. We’re not talking about a small group of disgruntled practitioners. We’re talking about an overwhelming majority who recognize that something is fundamentally broken in how our profession is positioned within the educational system.

Our parallel research on occupational therapy practitioners—published in the Journal of Occupational Therapy, Schools, & Early Intervention—found nearly identical results among OTs, with 94.7% supporting advocacy for change and 94.6% agreeing we should pursue policies allowing access to administrative coursework.

Why This Matters Beyond Career Ladders

I’ve spent over 25 years in school-based practice, and here’s what I know: this isn’t just about who gets to be a principal. The lack of inclusion in Pupil Personnel creates real obstacles to best practices in service delivery for students who need our support.

When OTs and PTs are systematically excluded from the opportunity for formal leadership roles, it affects team collaboration, decision-making processes, and service quality. We’re the only Specialized Instructional Support Personnel (SISPs, or what some still call “related service providers”) who cannot pursue the coursework to become school administrators. We’re left out of critical conversations about programming, scheduling, and resource allocation—conversations where our clinical expertise could directly improve student outcomes.

APTA’s Vision talks about “building a community that advances the profession of physical therapy,” but that vision hits a wall in the school setting when state policy prevents us from accessing leadership pathways. In fact, Dr. Serena Zeidler and I were accepted to present this critical data at the New York State APTA Conference in 2025. While we ultimately did not attend the event, we made sure that APTA leadership received this groundbreaking research firsthand. The federal Every Student Succeeds Act (ESSA) encourages greater involvement for therapy practitioners, yet state policy restricts our advancement. This misalignment between federal intent and state regulation needs to be addressed.

Current Legislative Opportunities

Right now—not someday, but right now—there are concrete opportunities to change this situation. Two bills and a NYSUT resolution are currently pending that directly address these barriers for OTs and PTs in New York schools. Senate Bill S6581 would align PT/OT pay with the state career ladder framework, and S5612 addresses OT roles in school districts and BOCES, our lack of opportunities to be leaders, and the pay disparity.

These legislative initiatives represent years of advocacy work by practitioners who refused to accept that our exclusion from leadership is inevitable or justified.

NY State Senate

NY State Senate Bill S5612

Authorizes OT services to be
provided in school to certain students

Download, Support,
Sign up for Status
Updates on this Bill at
the link above.

Status: All three (3) bills as of Dec 15, 2025 in they are in Assembly (or Committe Senate), which is Step 2 in a 6-step process.

The Bigger Picture

This research represents the first comprehensive look in New York at how classification barriers affect physical therapy providers’ ability to lead and advocate within educational settings. But it’s not just a New York problem—in most states, OTPs and PTs face restrictions on advancing to formal school leadership positions.

As occupational therapy practitioners who led this research, we’re committed to building cross-disciplinary solutions. Dr. Zeidler, Kim Wiggins, and I conducted this work because we believe that when PTs and OTs work together to address systemic barriers, everyone wins—especially the students we serve.

The data is clear. The will is there. Now we need the policy to catch up with what 95% of us already know: physical therapy and occupational therapy providers deserve equal access to school leadership positions, and our students deserve to benefit from our expertise at every level of the education system.

See Why This Matters

• Why do Occupational Therapists want Educational Credentialing?
• I Want the Red Shirt.

As OTs conducting this research, we’re committed to cross-disciplinary solutions. When therapeutic professionals address systemic barriers together, students receive better, more integrated care.

Join the conversation about improving PT services in educational settings!

#PhysicalTherapy #OccupationalTherapy #EducationalServices #InterdisciplinaryResearch #ProfessionalAdvocacy #PublishedResearch #NYSED #TherapyServices

In most states, OTPs and PTs are restricted from advancing to formal school leadership positions. The absence of pathways to leadership may limit the ability to fulfill AOTA’s Vision 2025 and Every Student Succeeds Act (ESSA). This study investigated how limited opportunities for career advancement affect school practice trends. We explore the perceptions of school practitioners in New York State concerning leadership, advocacy, and state policies. Seven hundred and fourteen current and former occupational therapy practitioners in New York schools completed a researcher-developed online survey. Notably, almost all respondents (94.7%) agreed that practitioners should be able to pursue educational administrative coursework.

 

Most (94.6%) agreed that practitioners in New York should advocate for policies that would allow them to pursue such coursework. 

 

Many respondents reported that they would consider pursuing the coursework if available. This research emphasizes the misalignment between federal and state policies. Federal policy (ESSA) and Vision 2025 encourage greater involvement for occupational therapy practitioners, but state policy restricts their advancement. The findings demonstrate the pressing need for reform and the creation of pathways that enable occupational therapy practitioners to assume formal leadership positions in school settings, thus enhancing their contribution to the school community.

The Truth About Pencil Grip Research That Every OTP, Teacher, and Parent Needs to Know

I cannot tell you how many times I’ve heard it in IEP meetings, teacher lounges, and even OT conferences: “Well, research shows that grasp doesn’t really matter for handwriting.” 

Every time I hear this, my heart sinks a little. Because here’s the thing – that statement isn’t wrong, but it’s dangerously incomplete. And it’s leaving struggling kids without the support they desperately need.

What the Research Actually Shows  

Let me break down what multiple studies from 1993-2018 have actually discovered, because the full picture tells a completely different story.

The Four Functional Grasps   

Current research recognizes these four grasp patterns as equally mature and functional:

• Dynamic Tripod – The “classic” three-finger grasp

• Dynamic Quadrupod – Four fingers with dynamic movement

• Lateral Tripod – Three fingers with thumb crossing over

• Lateral Quadrupod – Four fingers with thumb crossing over

(Donica et al., 2018; Schwellnus et al., 2012)

So yes, if your child uses any of these four patterns, grasp truly doesn’t impact their handwriting speed or legibility. The dynamic tripod isn’t the “gold standard” anymore – it’s just one of four equally good options!

But Here’s Where Grasp ABSOLUTELY Matters  

The Missing Piece: Studies consistently show that immature or static pencil grasps lead to increased fatigue and decreased legibility (de Almeida et al., 2013; Dennis & Swinth, 2001; Schwellnus et al., 2012).

I see this every single day in my school. The second-grader whose hand cramps after writing three sentences. The kindergartener who holds their pencil in a fisted grasp and can barely form recognizable letters. The fourth-grader who avoids writing assignments because “it hurts.”

In Schwellnus et al.’s 2012 study of 120 students, guess what happened to the three children with immature grasp patterns? They were classified as “dysgraphic writers.” Every. Single. One.

The Problem with the Research  

Here’s why that “grasp doesn’t matter” statement is so misleading. The studies have significant limitations:

• Exclusion bias: They excluded children with immature or “atypical” grasps

• Sample size: Many studies had very small samples (i.e., 46 children) with only 1-3 children using atypical grasps

• Writing duration: Most only analyzed 1-4 sentences, not real classroom demands

• Limited scope: They omitted children receiving OT services

(Donica et al., 2018; Schwellnus et al., 2013)

The Hidden Cost: Missing Out on Daily Fine Motor Strengthening  

Here’s something that keeps me up at night as an OT; and it’s something most people never consider when they dismiss grasp concerns.

Think about a typical school day for a moment. Kids use pencils during morning work, math worksheets, spelling practice, journal writing, note-taking, homework, art projects, and about a dozen other activities. We’re talking about hours of pencil use every single day!

But here’s what breaks my heart: when kids use immature or compensatory grasps, they’re essentially doing bicep curls when they should be doing finger exercises. Instead of strengthening the small, intricate muscles needed for button fastening, shoelace tying, and precise manipulation, they’re reinforcing inefficient movement patterns hour after hour, day after day.

I had one third-grader whose teacher said, “He writes so much better in the morning, but by afternoon, his letters fall apart.” That’s not a motivation problem – that’s a child whose forearm muscles are exhausted from doing a job they were never meant to do!

The research on grasp strength and functional independence backs this up beautifully. Alaniz et al. (2015) found that grasp strength correlates directly with pencil control AND independence with daily activities. When children develop strong, coordinated hand muscles through proper pencil use, those benefits extend far beyond the classroom.

What This Means for Your Practice  

Stop feeling guilty about addressing grasp patterns! If a child is struggling with handwriting endurance, complaining of pain, or showing decreased legibility over time, their grasp absolutely could be the culprit.

The research supports us when we say: Functional grasp matters. Mature patterns matter. And children with immature patterns may deserve our intervention.

Want to Dive Deeper?   

This blog post barely scratches the surface of what current research tells us about pencil grip, fine motor development, and handwriting outcomes.

I’ve spent years analyzing the research, working with hundreds of children, and developing evidence-based strategies that actually work.

My upcoming book breaks down all the latest research in practical, actionable ways that will transform how you think about pencil grasp intervention. Want to be the first to know when it’s available?

Join my email list for research updates, clinical insights, and early access to evidence-based resources that will change your practice!

References  

Alaniz, M. L., Galit, E., Necesito, C. I., & Rosario, E. R. (2015). Hand strength, handwriting, and functional skills in children with autism. American Journal of Occupational Therapy, 69(4), 6904220030.

de Almeida, P. H. T. Q., da Cruz, D. M. C., Magna, L. A., & Ferrigno, I. S. V. (2013). An electromyographic analysis of two handwriting grasp patterns. Journal of Electromyography and Kinesiology, 23(4), 838–843. https://doi.org/10.1016/j.jelekin.2013.04.004

Dennis, J. L., & Swinth, Y. (2001). Pencil grasp and children’s handwriting legibility during different-length writing tasks. American Journal of Occupational Therapy, 55(2), 175-183.

Donica, D. K., Goins, A., & Wagner, L. (2018). Effectiveness of handwriting readiness programs on printing performance in kindergarten students. Journal of Occupational Therapy, Schools, & Early Intervention, 11(4), 484-496.

Koziatek, S. M., & Powell, N. J. (2003). Pencil grips, legibility, and speed of fourth-graders’ writing in cursive. American Journal of Occupational Therapy, 57(3), 284-288.

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting after a 10-minute copy task in Grade 4 children. Australian Occupational Therapy Journal, 59(3), 180-187.

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2013). Effect of pencil grasp on the speed and legibility of handwriting in children. American Journal of Occupational Therapy, 67(6), 718-726.

Wallen, M., Duff, S., Goyen, T.-A., & Froude, E. (2013). Respecting the evidence: Responsible assessment and effective intervention for children with handwriting difficulties. Australian Occupational Therapy Journal, 60(5), 366–369. https://doi.org/10.1111/1440-1630.12045

No one has to convince school-based OTPs that fingerprint and thumbprint crafts are excellent activities that support many important skills in school-based settings. These activities develop:

1. Fine motor skills – Pressing fingers with controlled pressure and precise placement develops dexterity and finger strength
2. Visual-motor integration – Coordinating hand movements with visual input to create specific patterns or designs
3. Sensory processing – Providing tactile input through finger pressure and paint/ink texture
4. Bilateral coordination – Using both hands together (one to hold paper, one to make prints)
5. Hand-eye coordination – Precisely placing fingerprints to create intended designs
6. Motor planning – Organizing sequential movements to create complex patterns or pictures
7. Proprioception – Developing awareness of finger position and pressure required
8. Grasp development – Supporting proper finger positioning and grip strength
9. Visual perception – Recognizing patterns, spatial relationships, and visual discrimination
10. Attention and focus – Maintaining concentration to complete detailed work
11. Creativity and self-expression – Allowing personal artistic choices and design

These activities can be easily adapted for different developmental levels and can incorporate academic concepts (counting prints, creating letter shapes, etc.) while simultaneously building foundational skills for handwriting, scissor use, and other fine motor tasks.

Level 1

Angie Holden from Country Chic Cottage (via Pinterest) makes these adorable ladybugs with red and black paint and a marker! Simply adorable.

Level this up by leaving off the legs and antennae, cutting each ladybug out and using black construction paper to glue legs and antennae cutouts to the bodies!

Level 3

In this example, I made thumbprints and drew faces on them to prompt an SEL  discussion about feelings and how to regulate the strong feelings when they get overwhelming.

This could also be birds on a wire or a tree branch.

Maybe it’s a family portrait with a little imagination.

Level 5

Think forsythia! Those cheerful yellow bursts that bloom before anything else dares to wake up! Draw or paint a simple branch, then press bright yellow fingerprint clusters along it to mimic the blooms. Simple, stunning, and a great conversation starter about the first signs of spring.

Level this up by adding tiny green fingerprint buds at the branch tips, or spreading across a long sheet of paper for a hallway display.

Level 6

Take it off the page and onto the real thing! Use hard-boiled or blown-out eggs as the canvas. Fingerprinting on a curved surface is a whole different challenge. Kids naturally adjust their pressure and grip as they rotate the egg, without even realizing the great fine motor work they’re doing.

Level this up by asking kids to plan a color pattern before they start, whether rainbow order, alternating, or section-by-section. Once the paint is fully dry, seal with a brush-on coat of Mod Podge using a foam brush to protect the design and keep them as keepsakes!

Last Tuesday, after school, I did something that honestly scared me a little. I loaded my 5-year-old into the car, threw on my “School-Based OTs Looking for Change” t-shirt, and headed to the library for my local senator’s (Senator Steven Rhoads) public meeting hours.

Taking a stand for attaining equity in school-based practice is critical right now. Racing from work to educate elected officials about OT practice realities with a preschooler in tow felt like a classic OT move, right?

The Reality Check

I walked in with printed copies of the two bills and the NYSUT resolution that are currently pending, ready to talk about the pressing issues facing school OTs and PTs in New York.

What I discovered? This well-meaning elected official knew basically nothing about NYSED or how our roles actually work in schools.

I found myself explaining inequities he’d never considered – how we can’t become educational leaders despite our advanced degrees and expertise, how that limitation directly impacts our ability to help kids, and how many of us are stuck on civil service pay scales that leave us making $30,000 less annually than our teaching colleagues.

The moment that really got to him? When he glanced at my daughter happily building with Legos and I said, “We have the same expenses as all the other teaching staff, and our education costs more.”

The Lightbulb Moment

By the end of our conversation, I could see understanding dawning. He realized we weren’t asking for special treatment – we were asking for equity. For recognition of our expertise. For the ability to truly lead and advocate for the students we serve.

He said, “This (us getting into Pupil Personnel so we can be equal to teachers, social workers, etc.) seems like common sense” (Ya think!?)

His advice? “You need to get Senator Shelley Mayer on board. She’s key to moving these bills forward.”

This Is Our Moment

Here’s the thing – those bills are pending RIGHT NOW. This is our crucial window to make our voices heard. We can’t wait for someone else to do the work for us. We ARE the experts on what school-based OTs and PTs need.

Senator Shelley Mayer contact info: ​smayer@nysenate.gov​

Dear Senator Mayer,

As a school-based occupational therapist/physical therapist in New York (or the USA), I’m writing to urge your support for Bills ​S5612 ​& ​S4820 ​and the NYSUT resolution addressing inequities in our field.

Despite our advanced degrees and specialized expertise, we cannot advance to educational leadership roles, limiting our ability to advocate for students with disabilities. Additionally, the designation of civil service often leads to pay scales that create significant salary disparities compared to our teaching colleagues, often $30,000+ annually.

These issues directly impact student services and contribute to critical staffing shortages in our schools. We need your leadership to ensure equitable treatment for school-based therapy professionals.

I urge you to

• Publicly support the bills
• Issue statements endorsing the legislation
• Lobby Assembly members to pass them
• Advocate with the Governor for signing

Thank you for considering our concerns.

Sincerely,[Your name, credentials, district]

The Ripple Effect

That library meeting reminded me that our community leaders want to help – they just need to understand the issues first. When we show up authentically (even with Legos scattered around us!), we create real change.

Every message matters. Every conversation counts. Every one of us has a story that illustrates why these changes are crucial for our students.

Ready to Speak Your Truth?

Send that message to Senator Mayer. Share your story with local representatives. Wear your OT or PT t-shirt with pride! Our students deserve therapists who can lead, grow professionally, and stay in the field long-term.

Let’s educate our elected officials together!

Click the image to view the series of handouts I brought to the Senator. This is called a “Leave Behind”.

P.S. – My 5-year-old asked why I was “talking to the important man about work.” I told her sometimes grown-ups need to speak up so other grown-ups can help kids better. She got it immediately. Maybe we should all think like 5-year-olds more often!

A good bulletin board decorates the space. A great one helps your students feel seen, supported, and understood.

Looking for school bulletin board ideas that actually work this back-to-school season? Trust me, I’ve been there – staring at blank walls wondering how to make them both beautiful AND functional for our OT practice.

Last year, I had one of those lightbulb moments. I was walking past my bulletin board (you know, the one I’d been meaning to update for months) when I overheard a teacher say, “I wish I understood what sensory processing actually looks like in my classroom.” She was literally standing three feet from my wall, but my display wasn’t doing its job of educating anyone about what we do.

That’s when I realized something game-changing: our interactive bulletin board displays aren’t just decoration – they’re our most powerful advocacy tools. They work 24/7 to educate staff, support students, and spark those conversations that make our jobs so much easier.

After trying everything from Pinterest-perfect boards that fell apart in a week to overly complicated displays that nobody looked at, I finally cracked the code. The best OT bulletin board posters do something magical – they teach while you’re busy seeing clients. They explain sensory needs while you’re in an IEP meeting. They advocate for our profession even when we’re not there to do it ourselves.

So what if your bulletin board could help teachers understand visual perception skills? What if it could give students calming strategies right in the hallway? What if it could finally show everyone that OT is about so much more than handwriting?

Here’s what I’ve learned works – 7 bulletin board ideas that are practical, purposeful, and honestly pretty easy to put together. Each one has been tested in real schools with real kids (and some very patient custodians who helped me hang things at just the right height ).

Ready to transform those blank walls into working tools for your practice? Let’s dive into what actually makes a difference…

1. OT Bulletin Board Posters

Also known as the “Oh wow, you do that too?” posters.

These printable visuals are a game changer for explaining school-based OT to teachers, parents, and students. Stick them in a hallway, your therapy room, or on your office door. They’re colorful, clear, and cover the many areas OT supports in schools.

2. Whole Child Posters (Free Download)

Because every child is more than a test score.

These posters remind students and staff alike that learning and growing isn’t just about academics. They highlight skills like emotional regulation, independence, motor development, and more. These are perfect for calming spaces, SEL walls, or even parent meeting rooms.

3. Visual Perception Posters

Visual perception terms can be confusing. These posters make them click.

There are so many terms to learn like visual discrimination, figure-ground, and spatial relations. These posters explain each one in plain language with classroom-based examples so anyone can understand how they impact a student’s learning.

4. Sensory Processing Posters

When people understand sensory systems, they understand your students better.

These posters introduce the eight sensory systems and the three subtypes of Sensory Processing Disorder. They offer real-life examples and explanations of how sensory differences affect behavior and learning. Perfect for hallways, staff rooms, or parent nights.

5. Calming Corner Posters

A little peace and regulation goes a long way.

These calming visuals from The Butterfly Teacher help students self-regulate and feel supported. They’re beautiful, inclusive, and easy to add to a cozy nook with pillows, sensory tools, or flexible seating. A calming corner is great for all students, not just those with identified needs.

6. Make Your Board Interactive

Let your students be part of the display.

Interactive bulletin boards help students feel seen and involved while keeping your space fresh and fun. From reading walls to kindness challenges, even weekly puzzles or STEM prompts, there are so many ways to turn your board into a meaningful part of the day.

We Are Teachers shares a great roundup called 40 Unique Interactive Bulletin Boards to Engage Your Students with tons of easy ideas you can try right away.

7. Set Up a Reading Strategy Wall

Reading is more than decoding, it’s thinking, connecting, and understanding.

This Pinterest find is a great example of a bulletin board that supports reading comprehension. It breaks down strategies like predicting, visualizing, and asking questions. It’s a fantastic resource to keep up all year long.

The key is making them interactive and personal. When students see their own learning reflected in these displays, or when they can contribute their own insights and experiences, that’s when the real magic happens. It transforms a simple bulletin board into a collaborative learning space that evolves with each cohort of students.

What are some of your favorite bulletin board ideas? Do you create the same bulletin board for each new school year? Comment below and share your favorites!

Hey there! As an occupational therapist, I’m always looking for activities that are both fun AND secretly working on those important developmental skills. Finding the perfect Memorial Day & 4th of July crafts makes holiday planning easy. These patriotic crafts hit the sweet spot – kids think they’re just having fun while they’re actually strengthening their fine motor skills, bilateral coordination, and visual motor integration. Plus, they get to show off their American pride!

1. Patriotic Bead Bracelets

This is one of my absolute favorites because it sneaks in so much skill development while kids are just focused on making something beautiful.

What you need:

• Red, white, and blue beads
• Elastic beading cord
• Scissors
• Optional: Alphabet beads for “USA” or names

How to make it:

1. Cut string to fit wrist with a little extra for tying
2. Let kids sort and plan a pattern using colored beads
3. String the beads (this is where the magic happens – hello, pincer grasp!)
4. Tie off the ends securely!

2. Patriotic Popsicle Stick Wall Vase

This one takes a bit more time, but the end result is so worth it. Kids feel so proud when they create something this functional!

What you need:

• Cardboard backing
• About 28 popsicle sticks
• Paper or styrofoam cup
• Red, white, and blue craft paint
• Brushes
• Craft glue
• String for hanging

How to make it:

1. Paint 20 sticks red and white, alternating for flag background
2. Paint 8 sticks blue for the vase, let dry
3. Cut paper cup in half across the middle
4. Glue red and white sticks side by side on cardboard
5. Glue cut cup to lower center of flag background
6. Glue blue sticks vertically around cup to form vase
7. Add white stars to blue sticks
8. Add string to back for hanging

3. Q-Tip Fireworks Painting

I love this one because even kids who say “I can’t draw” end up creating something amazing!

What you need:

• Q-tips (cotton swabs)
• Red, white, and blue paint
• Black construction paper
• Paper plates for paint

How to make it:

1. Pour paint onto paper plates
2. Give each child 3-4 Q-tips (or bundle them with a rubber band for bigger bursts)
3. Dip in paint and stamp on black paper to create firework explosions
4. Add glitter glue when dry for extra sparkle

4. 4th of July Sailboat Craft

These little boats have been a hit in every session I’ve used them. Kids love the fact that they actually float!

What you need:

• Pool noodle (cut into 3-inch sections)
• Blue and white foam sheets
• Paper straws
• Blue washi tape
• Star stickers
• Scissors

How to make it:

1. Adult cuts pool noodle into 3-inch boat bases
2. Cut sail shape from foam sheet
3. Cut two small slits in the sail and slide onto straw
4. Add blue washi tape to top of straw, cut into triangle for flag
5. Cut small stars from white foam and glue onto sail
6. Push straw into center of pool noodle

5. Patriotic Windsock

There’s something magical about watching these dance in the breeze. Kids get so excited to hang them outside!

What you need:

• Tissue tube (toilet paper or paper towel tube)
• Blue, red, and white construction paper
• Matching crepe paper
• Glue
• String
• Scissors

How to make it:

1. Cut and glue blue paper around tissue tube
2. Cut stars from white paper and glue on blue tube
3. Cut red, blue, and white crepe paper into long strips
4. Glue strips inside bottom of tube
5. Create two holes at top of tube
6. Tie string through holes for handle

6. Fourth of July Star Wands

These are perfect for kids who love to move and dance. I’ve seen the shyest kids come alive when they have a star wand in their hand! 

What you need:

• Cardboard for star
• Red, white, and blue construction paper
• Scissors
• Glue
• Paper straw or wooden skewer
• Ribbon
• Optional: glitter

How to make it:

1. Cut star shape from cardboard
2. Cover with patriotic paper in whatever pattern kids choose
3. Adult uses glue gun to attach straw to back
4. Tie ribbons under star for trailing effect
5. Add sparkle with glitter if desired

A Quick OT Note

Here’s what I love – these crafts sneak in SO much skill development! Every cut, glue, and thread builds the foundation for writing and daily tasks. Plus, there’s no “perfect” way to do them, which means confidence wins every time.

Safety reminders:

• Always supervise with small parts and sharp tools
• Keep glue guns for adult use only
• Have fun and don’t worry about perfection!

You know what’s magical? Watching kids go from “I can’t do it” to “Look what I made!” The combination of patriotic pride and hands-on creating just clicks for kids, and parents are always amazed at the skills they’ve practiced through play.

Which craft are you most excited to try, and what skill do you think your kiddo needs to work on most? I’d love to hear about your crafting adventures in the comments!

Happy crafting, and Happy Independence Day!