In-Hand Manipulation Among Intellectually Disabled Children: A Study

Introduction: In-hand manipulation (IHM) refers to the ability to move objects within one hand without the assistance of the other hand, a critical component of fine motor skills. This ability enables a range of everyday tasks, such as rotating a pencil, flipping a coin, or adjusting a button, which are essential for daily living and academic activities. For children with intellectual disabilities (ID), in-hand manipulation often presents significant challenges due to the interplay between cognitive impairments and motor deficits. Hand function plays a vital role in accomplishment of all Activities of Daily Living (ADL) and it depends upon a complex interaction of visual-perception and fine motor function which together known as visual perceptual fine motor function. These children may experience delays or difficulties in developing the fine motor control necessary for effective IHM, impacting their ability to perform basic self-care tasks, engage in play, or participate in school activities. The development of IHM is often hindered by reduced muscle tone, coordination issues, and slower cognitive processing, which are common in children with ID. As a result, these children may struggle with tasks that their typically developing peers can perform with ease, leading to further delays in their overall development and independence. Understanding and addressing the challenges of in-hand manipulation in children with intellectual disabilities is crucial for educators, therapists, and caregivers. Through targeted interventions, such as occupational therapy and specialized exercises, it is possible to improve these children’s fine motor skills, enhancing their ability to participate more fully in everyday activities and ultimately improving their quality of life. Aim: To evaluate the In-hand manipulation skills among children with intellectual disability and compare the scores obtained by different types of ID. Objectives ● Select a special school for intellectually disabled. ● To assess the In-hand manipulation skills of the children with standardized assessment tool of in-hand manipulation. ● To check the in-hand manipulation skill among mild & moderate intellectually disabled children.  Method of Study: Ezhuchi special school for intellectually disabled children was selected for the study. A sample of 40 students, both mild and moderate intellectually disabled were selected. There were 20 male and 20 female children among the sample aging between 7 to 10 years. Assessment of in-hand manipulation by standardized assessment includes, with hand manipulation tasks administered. During the assessment, some of the activities were to be demonstrated due to problem for children to perform with just the verbal instruction. Such as performing the activity with stabilization and without stabilization (assessment procedure involves this). Their total score with the mean value of their total score were compared to make qualitative analysis. Result: The study shows that the moderate intellectually disabled children have scores of lower mean when compared to score of mild intellectually disabled. The mean of moderate ID total score is 23.3 and the mean of mild ID score is 33.9. Paired sample t-test gives a t-value of 5.06 and the probability value of 0.001 at 0.01 level of significance. Conclusion: Form this study it is concluded that there is delay in development of in-hand manipulation among intellectually disabled children. The moderate ID children lack IHM skills compared to mild ID children. Intellectually disabled children have problem in advancing and refining their skills. It is important for an occupational therapist to assess the level of in-hand manipulation of the children and provide intervention.