How to Improve Fine Motor Translation Skills

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.

  1. No using momentum to ‘throw’ the object from palm to finger. They need to use finger and thumb motion to advance the object.
  2. No using gravity to let the object fall from palm to fingers. AKA: no cheating
  3. 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:

  1. Slow foam squares cut into ¾” squares
  2. Squares mixed with marbles (pick up 2 of each) and sorting them for sensation work.
  3. Mancala pieces or just plain marbles
  4. 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 Comment

  1. Robin Kanagy on January 18, 2022 at 4:51 am

    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!

Leave a Comment






More To Read

Carpal Tunnel Syndrome Treatment: Surgical vs. Hand Therapy Outcomes

May 21, 2026

Carpal Tunnel Syndrome Treatment: Surgical vs. Non-Surgical Outcomes Verdugo, R. J., Salinas, R. S., Castillo, J. L., & Cea, J. G. (2008). Surgical versus non-surgical treatment for carpal tunnel syndrome. Cochrane Database of Systematic Reviews, (4). The Skinny This article compares surgical treatment to non-surgical management such as hand therapy for individuals with carpal tunnel…

Scapholunate Wrist Injuries in Hand Therapy 

January 2, 2022

Scapholunate Wrist Injuries in Hand Therapy  In outpatient hand therapy, we get a variety of referrals ranging from post-operative patients to those looking to avoid or prolong surgery.  These referrals come from a variety of sources ranging from primary care doctors to experienced hand surgeons.  The therapy orders can be vague to very specific.   …

Is HEP Just as Good as Therapy for Metacarpal Fracture Rehab?

July 7, 2019

Gülke, J., Leopold, B., Grözinger, D., Drews, B., Paschke, S., & Wachter, N. J. (2018). Postoperative treatment of metacarpal fractures – Classical physical therapy compared with a home exercise program. Journal of Hand Therapy, 31(1), 20-28. The Skinny – Medicine is moving towards a model that encourages less direct intervention and a more DIY focus…

Top 5 Hand Therapy Toys for Kids

November 3, 2019

Many therapists in hand therapy clinics have a lot of tools for their adult patients, but may not have as many tools for the less common pediatric patient. With nearly 20 years experience in pediatrics, we’ve compiled a list of our top 5 picks for tools to use with pediatric patients in hand therapy. We…

Envelope_1

Sign-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.