Both hands are one of the most valuable tools for children to learn and explore their environment. The development of hand function affects a child's ability to manipulate objects with both hands and is therefore closely related to academic performance, self-care, peer interaction and play.

Abnormal muscle tone, poor stability or motor control of the trunk or upper extremities, sensory integration disorders that result in physical impairment, developmental delays, poor bilateral integration, sensory-perceptual immaturity and inexperience may all affect a child's fine motor and writing skills. Children with poor hand function may experience the following conditions:

• Dropping stuff when playing with toys or handling objects
• Drawing or writing with too much or too little force, or with poorly executed movements
• Strange pencil grip
• Long writing sessions, complaining of sore hands, or slow writing
• Characters often written too small, crammed on one side of the grid or beyond the grid
• Dislikes or is not good at crafts, assembling models, folding paper, stringing beads, jigsaw puzzles, maze games, etc.
• Has difficulty buttoning, tying shoelaces, or pulling zips

Through appropriate assessment and activity design, the occupational therapist can assist the child in improving the following skills related to hand function development, which in turn can enhance the child's fine motor skills, writing skills and self-care:  

• Trunk control and scapular stability
• Elbow movement control and wrist stability
• Hand arch and web space stability, and intrinsic muscles manipulation techniques
• Bilateral integration
• Tactile and proprioceptive feedback
• Visual motor integration (ability to use visual information to guide movement accuracy)
• Visual perception
• Correct pencil grip and writing posture

Parents can also learn more about the development of children's hand functions, the core issues that cause children's fine motor and writing difficulties, and ways to train children's hand functions in their daily lives by reading Tuan-wen Wu's book, "The Hand Makes Perfect."