Fig. 4.1
Playing with building bricks. a Placing shapes into a shape sorting box. b Building a tower
When manipulating small balls, precision grip, accuracy and eye–hand coordination can be observed (see Fig. 4.2a,b). Two-year-old toddlers should be able to pick up a ball with a spoon.
Fig. 4.2a,b
Manipulating small balls
Simple threading games show accuracy, fine adjustment of grip strength and bimanual coordination (see Fig. 4.3).
Fig. 4.3
Toddler manipulates a simple threading game
In the observation of older children (from about 4 years) the emphasis is on the assessment of the use of tools and the maturity in manipulation of complex tasks.
Fig. 4.4
Assessment suggestions for children from about 4 years. a Tweezers game. b Hedgehog with clothes pegs and paper clips. c Use of pencil, scissors and sticky tape to make a small ‘drum’. d,e Building a lawn mower with a construction toy, e. g. Baufix
With a simple tweezers game (see Fig. 4.4a), grasping a cylindrical object and opening a screw top, e. g. the little jar pictured, can be assessed. Both of these activities can be difficult for children with EB because of their often-limited abduction of the thumb.
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