1. Pre-Braille Skills
CONCEPTS AND LIFE EXPERIENCES
Just like words, braille is a symbolic representation of
real objects and experiences
Provide & expose child to as much of the real world
as possible while adding the language to describe it;
this is how we all learn concepts. (example: door knob)
Lightly touch while exploring and when possible from
left to right
Your child's hands are their eyes. Let them see the
world as you do! They will understand more then you
2. Pre-Braille Skills
Sighted children see letters and words all day and
every day. Let your child see braille in their natural
environment as the sighted child sees words.
The exposure to braille will help them understand
what the meaning of braille represents.
Read story books to them with braille and tactual
Count to your child in patterns of six and play
using toys to help represent the braille cell
3. Building Blocks
IN ALL INFANTS: The body matures and develops from its core to
A stable shoulder allows position and support for hands and arms to be
used for fine motor (FM) tasks.
All FM activities are build upon THREE basic strategies
REACH, GRASP, RELEASE
* Grasp cannot be taught, but by observing the type of grasp your
child is using, you can provide the toys and activities to help
them move along to the next developmental stage.
It is important that your child has the pre-development skills, before
you ask them to complete a FM activity they are not developmentally
Ex: Children should have strength and dexterity in their hands
and fingers before being asked to use a pencil, paper or
braillewriter. Working on the pre-developmental skills prior to the
task can eliminate inappropriate pencil grasp; which is becoming
more common as children are pushed to use their hands before
they are ready.
4. Importance of Weight Bearing!
The connection between weight bearing and
learning to use one’s hands is very important!
Weight bearing gives the type of feedback
that makes the baby aware of his/her arms
It also provides the stability for the arms to be
raised/straightened out and be used. Only
then can they be used for purposeful activity!
Weight Bearing Activities include:
Lying on his/her tummy and pushing up to
hands, sitting, rocking on hands and knees
This is often delayed in blind or low vision
babies because sight is the motivator to lift the
head in prone.
5. Birth to 3
During this stage your child should begin:
Playing with hands
using hands for purposeful action
retaining objects placed in hands
playing with toys that produce sound.
Full fisted or Palmer Grasp: at this stage this grasp
pattern is a reflex and the child has not obtained
the concept of ‘release’ yet.
-at this stage you should choose toys with a variety
of textures, sizes, shapes and weights
(take some time to play with developmentally
appropriate toys for this age group!)
*Use hand under hand as much as possible to
‘invite’ but not force your child’s hands. Studies
show that many children are tactually defensive
with their hands by kindergarten because their
hands have been handled too much!
6. 4 to 6 Months
At this stage of Development your infant should begin:
Reaching for objects in contact with body with one hand
Place objects in mouth
Use pads of fingers to grasp small objects (building blocks of pincer
Transfer an object from hand to hand
Bring an object to midline (building blocks for bilateral coordination)
Pull objects out of container
*Draw attention to their hands by painting his/her nails, having them
wear bracelets or half gloves or mittens.
(Take time to look and play with toys for this stage of your infants
7. 7 to 9 Months
At this stage your child should begin:
Using purposeful reach to explore different
Placing an object in container
Pulling strings to activate toy
Playing patty-cake (playing or manipulation at
*Bilateral Hand use involves stabilizing with one hand
and manipulating with the other hand
*Pincer Grasp (using thumb and forefinger together)
develops between 8-12 months
-this skill allows them to pick up small objects and
will be later used for holding an eating utensil or
buttoning a shirt.
The brain seeks novelty: changing or rotating toys
frequently keeps a child’s interest.
8. 10 to 12 Months
At this stage the following are appropriate:
Placing one peg repeatedly into a hole
Using pincer grasp
Releasing objects into the air using full arm muscles to throw
Manipulating objects with moving parts
Removing rings from stack
Turning pages of a book
*Child typically uses pincer grasp to manipulate toys, pick up small objects and
to complete other purposeful activities
-Place rings back on post
-Attempts to use mechanical means to activate toys
(pulling, twisting, turning)
-Places objects through small opening
It is important for low vision kids to add
contrast to activities.
Ex: if picking up cheerios from highchair
tray, use black or dark placemat or outline
tray with colored electrical tape to show visual
boundaries of a specific space.
10. 22-24 Months
Child should be able to complete some of the following activities
during these months:
Stack large objects
Pound pegs with a hammer
String large (1 inch) beads
Roll, pat, pound and pinch clay/play-doh balls
Adjust finger opening according to toy/object size and shape
For sighted children this is done visually. Totally blind kids only k
now how far to open hands to grasp an object. The brain now
learns by repeated exposure.
Take time to get some hands on experience with the appropriate
toys for this age group!
11. 24 Months-3 Years
Child should be able to:
Close Ziploc bags
Manipulate objects with both hands
Use hands for complex tasks
Throw a ball
Turn knobs on toys, TV and stereo
Unscrew threaded objects
Make horizontal, vertical and circular
*Using Rotary Motion which takes place
from the wrist with a stable arm.
-This is also a function of vision-turning
the wrist to see the object from another
* Using Finger Isolation which will be
necessary for using a Braille writer
Now that your child has developed
most of these FM developmental
milestones you can begin
strengthening and refining
movements, fingers and grasps.
There are many, many activities to do
this, we will take some time to show
you a few.
It is important to remember:
the month that a skill is expected to develop
is not important as the sequence. Many
children have neurological issues or were
born premature. So the month a skill is
learned or integrated is not the measure of
the child. Knowing the sequence helps
determine which toys and activities will