By: Josh MacDonald
The Basics – I lay a pile of small objects on the table and an open container for the client to put them into. What object I use depends on the client’s level. We’ll get to that later. Then, they use a 2-point pincer grasp to pick up one and shift it finger-to-palm. They do this 3-4 more times. Each time, shifting it fully to the palm. Then the objects are taken, one at a time, from palm to pincer grasp and dropped into the container.
“Using translation gives me a task to work on fine motor skills and dexterity that is gradable and functional.”
Special Rules – To keep the client from cheating and to meet the purpose of the task we have a few special rules.
- No using momentum to ‘throw’ the object from palm to finger. They need to use finger and thumb motion to advance the object.
- No using gravity to let the object fall from palm to fingers. AKA: no cheating
- Take it all of the way to the tips of index and thumb. It’s harder but it matters.
Make it fit – This task is highly scalable to meet the client’s needs and the ‘just right challenge’. Here is the sequence I use as the client improves:
- Slow foam squares cut into ¾” squares
- Squares mixed with marbles (pick up 2 of each) and sorting them for sensation work.
- Mancala pieces or just plain marbles
- Coins – Pick them up off a towel if flat on a table is too much
Bonus!! – Aside from the obvious benefits there are a few other added extras that pop up. Sometimes I even use these as the primary reason for picking this task.
Supination/pronation – The forearm is pretty darn active during this whole process
Tactile work – Stereognosis and discrimination skills can be refined with this task
Thumb work – When done right, the thumb is getting a solid workout (e.g. Joint stiffness work)

Whatever you want…
This task can be converted into whatever you want it to be. Use dice to play a game. Use grapes or other food for a self-feeding goal. Use small beads and work on ‘storing’ the extras in the ulnar side of the palm while stringing the bead. The options are ENDLESS! This is one of my favorite tasks and I can’t wait for you to try it and tell us what you think.
1 Comments
Leave a Comment
More To Read
Use of Compression Gloves for Distal Radius Fractures
Use of Compression Gloves for Distal Radius Fractures Miller-Shahabar, I., Schreuer, N., Katsevman, H., Bernfeld, B., Cons, A., Raisman, Y., & Milman, U. (2018). Efficacy of compression gloves in the rehabilitation of distal radius fractures: Randomized controlled study. American Journal of Physical Medicine & Rehabilitation, 97(12), 904–910. By Brittany Carrie The Skinny Distal radius fractures are a…
Read MoreEarly Mobilization After Volar Locking Plate Osteosynthesis of Distal Radius Fractures in Older Patients: A Randomized Controlled Trial
By: Rachel Reed Sørensen, T. J., Ohrt-Nissen, S., Ardensø, K. V., Laier, G. H., & Mallet, S. K. (2020). Early Mobilization After Volar Locking Plate Osteosynthesis of Distal Radial Fractures in Older Patients-A Randomized Controlled Trial. The Journal of hand surgery, S0363-5023(20)30276-8. Advance online publication. https://doi.org/10.1016/j.jhsa.2020.05.009 The Skinny: The purpose of this randomized controlled trial was…
Read MoreHand therapy intervention activities for Chemo-Induced Peripheral Neuropathy (CIPN)
Blog Post Written By: Rita Steffes Patients with CIPN may present with symptoms that include numbness, tingling, hypersensitivity to cold, loss of tactile or vibration sensitivity, decreased balance, and shooting burning pain in their hands These symptoms make it difficult for oncology patients to participate in all activities of daily living with dressing, meal preparation,…
Read MoreSign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.
When I worked in pediatrics in the school system, I cut aslit in a tennis ball, drew a face on it, called it Mr. Hungry. I had students translate pennies and fed Mr. Hungry. This was one of their favorite activities!