As children develop, they will gradually show a progression through the developmental stages of pre-writing skills. It is important to understand the developmental stages so that we are not forcing a 3 year-old to write with a tripod grasp. That would do more harm than good! As the child's muscles develop through crawling and other gross motor tasks, shoulder stability and hand strength will increase. Shoulder strength, shoulder stability, hand strength and the ability to dissociate the muscles in the hand are all needed before the child is able to write and color in a controlled way using a tripod grasp.
Typical Developmental Sequence
Typical by 12-15 months. The hand is held in a fist with the wrist slightly flexed. The shoulder is stabilized while the arm moves as a unit. The utensil is grasped proximally.
Typical by age 2-3 years. Utensil is held with fingers while wrist shows a slight ulnar deviation with the forearm pronated. The arm continues to move as a unit.
Static Tripod Posture
Typical by age 3.5 to 4 years. Utensil is grasped proximally with the forearm supinated. The wrist is stabilized while the hand moves as a unit. Pencil held with crude approximation of thumb, index and middle finger with ring and little finger slightly flexed.
Dynamic Tripod Posture
Typical by age 4.5 to 6 years. The utensil is held by the thumb, index and middle finger. The ring finger and pinky are flexed to form a stable arch. Wrist is slightly extended and forearm is slightly supinated. The knuckles (MCP joints) are stabilized while only fingers move.
When to change a pencil grasp:
Thumb Tuck Grasp
Erhardt, Rhoda P. (1994). Erhardt Developmental Prehension Assessment (Revised). Maplewood, MN: Erhardt Developmental Products.
Fleming-Castaldy, Rita P. (2009). National Occupational Therapy Certification Exam: Review & Study Guide (5th ed.). Evanston, IL: TherapyEd.