In-Hand Manipulation Activities for Children

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In-hand manipulation skills are a very important part of fine motor development that affects your child's future handwriting and pencil grasp skills. Today we are going to take an in-depth look at in-hand manipulation development and also some in-hand manipulation activities for children.

Child holding red and yellow toothbrush in their hand. blue box overlay with the text "in-hand manipulation activities for children."

What is In-Hand Manipulation?

This fine motor skill allows you to hold an object in your hand and move it around within your hand. This skill is fully mastered when you are able to hold objects with your 4th and 5th fingers, while the thumb and index finger (with assistance from the middle finger) are performing the fine motor task.

This skill is very important for handwriting by allowing you to move the pencil around in your hand to make corrections and adjustments for writing. Also, many every-day life and community skills require this such as using a vending machine, using credit cards or exchanging money, etc. ⠀

There are 3 sub-categories of in-hand manipulation skills:
?️ translation – moving objects from the fingers to the palm and the palm to the fingers ⠀
?️ shift – moving objects in a linear direction in the hand (ex. fanning cards out or repositioning a pencil. ⠀
?️ rotation – simple rotation is moving objects within the fingers and thumb and complex rotation would be turning an object from end to end. ⠀

In-Hand Manipulation Skill Development

There has yet to be a standardized test for in-hand manipulation skills, but there are some studies that suggest the following ages for development of this skill.

Many 4 and 5-year-olds are able to complete some in-hand manipulation skills, but a study also found that they use a lot of compensatory techniques while doing these activities, which suggests that these skills are still being developed. (See source #3 below).

By age 7, children are able to complete more complex in-hand manipulation skills, which some researchers have also suggested is because they are able to plan ahead and not use as many compensatory techniques as younger children. (See source #4 below).

All of the studies have found rapid development of hand skills between the ages of 4 and 6 years old. This means that encouraging fine motor exploration and play is crucial for this age group as they master important fine motor skills for future academics and every-day life skills.

In-Hand Manipulation Activities

Here are some activity ideas for promoting in-hand manipulation skills in children.

  • Picking up and flipping coins ⠀
  • Spinning tops ⠀
  • Stringing beads or paper clips ⠀
  • Cotton swab painting ⠀
  • Hole punch art ⠀
  • Playing a game of Jacks ⠀
  • Playing card games 

For more resources on this topic, you can visit the following links below:

Developmental Skills: In-Hand Manipulation Skills – The Inspired Treehouse

What Are In Hand Manipulation Skills? – Your Therapy Source

In Hand Manipulation Activities – Fun Therapy Zone


1. Humphry R, Jewell K, Rosenberger, R.C.; Development of In-Hand Manipulation and Relationship With Activities. Am J Occup Ther 1995;49(8):763–771.

2. Pehoski C, Henderson A, Tickle-Degnen L. In-hand manipulation in young children: rotation of an object in the fingers. Am J Occup Ther. 1997;51(7):544-552. doi:10.5014/ajot.51.7.544

3. Visser, M., Nel, M., Vries, J.D., Klopper, E., Olën, K., & Coller, J.M. (2014). In-hand manipulation of children aged four and five-years-old: translation, rotation and shift movements, in Bloemfontein. South African Journal of Occupational Therapy, 44, 22-28.

4. Visser, Marieta, Nel, Mariette, du Plessis, Carla, Jacobs, Shame, Joubert, Amor, Muller, Martli, Smith, Bianco, van Heerden, Tania, & van Soest, Renette. (2016). In-hand manipulation (IHM) in children 6 and 7 years of age: A follow-up study. South African Journal of Occupational Therapy46(2), 52-58.

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Heather Greutman, COTA

Heather Greutman is a Certified Occupational Therapy Assistant with experience in school-based OT services for preschool through high school. She uses her background to share child development tips, tools, and strategies for parents, educators, and therapists. She is the author of many ebooks including The Basics of Fine Motor Skills, and Basics of Pre-Writing Skills, and co-author of Sensory Processing Explained: A Handbook for Parents and Educators.

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CONTENT DISCLAIMER: Heather Greutman is a Certified Occupational Therapy Assistant.
All information on the Website is for informational purposes only and is not a replacement for medical advice from a physician or your pediatrician. Please consult with a medical professional if you suspect any medical or developmental issues with your child. The information on the Websites does not replace the relationship between therapist and client in a one-on-one treatment session with an individualized treatment plan based on their professional evaluation. The information provided on the Website is provided “as is” without any representations or warranties, express or implied.

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All activities outlined on the Website are designed for completion with adult supervision. Please use your own judgment with your child and do not provide objects that could pose a choking hazard to young children. Never leave a child unattended during these activities. Please be aware of and follow all age recommendations on all products used in these activities. Growing Hands-On Kids is not liable for any injury when replicating any of the activities found on this blog.

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