Discussion on chain procedures

Training Fine Motor Skills with the Big 6+6 A Precision Teaching Approach

E. Anne Desjardins, M.Ed.

The Big 6+6 are basic fine motor movements, or elements, that all individuals must have at fluent performance rates if they are to be proficient at manipulating any objects for stimulation, at self-help skills, at mobility, non-verbal communication, etc.

The ''Big 6" is a convenient label for the elements of reach, point, touch, grasp, place and release. The "+6" stands for pull, push, shake, squeeze, tap and twist.

If you are working with children who have motor delays, it is often extremely helpful to practice and measure these skills in isolation as well as practicing and measuring them as compounds.

Another essential component you must have to work on these skills is channels. We use channels to describe the input we give to the child and the output or response the child makes. We pay close attention to getting children to performance standards on each channel and watch carefully their performance levels when we shift to a less supportive channel. A common channel sequence for ''Big 6" topics flows like this:

Input Output Abbreviation Guide Reach G/Reach Touch Reach T/Reach Hear-Touch Reach H-To/Reach Hear Reach H/Reach See Reach Se/Reach

Do not necessarily work on only one channel at a time. An individual's curriculum may include a G/Reach as well as a To/Reach and a H-To/Reach. Try to move through the channels as quickly as possible without losing the performance frequency.

I would advocate working on each ''Big 6+6" topic in isolation as well as in a compound. We have had a good deal of success teaching skills this way.

Training Fine Motor Skills with the Big 6+6 A Precision Teaching Approach

E. Anne Desjardins, M.Ed.

Big 6 in isolation

B.eruili - hold up an object for the child to reach towards - give whatever assistance your channel stipulates - as soon as the child moves towards theiobject, move the object in another

direction so the child is tracking the object with their hand - do not let the child make contact with the object after each reach. You want the

movement to be repeated over and over again. Since grasping and manipulating the object can be a natural reinforcer, you may want to build up the ratio of reaches to reinforcement when you first begin

- practice the reaching for a few minutes. Time the child for 15 or 3 0 seconds, counting the number of reaches

- chart the information on the Standard Celeration Chart - it is very important to always give assistance at normal levels of performance.

For example, if you are guiding, you should be guiding at a rate of200-300 reaches/minute.

:e.oint - have objects in front of the child, on the wall etc. - have the child point, preferably with an outstretched finger, to each object one

after another - keep repeating the sequence - practice for a few minutes then time for 15 or 3 0 seconds, counting the number of points

- chart the information on the Standard Celeration Chart

Touch - this can be done in the same way as point, the only difference being that the child actually touches the object.

Crrasp and Release - this can be done with any object. Squeak toys are fun, as are marbles in a can.

We have used wooden spoons and pencils or markers. Here the teacher holds the pencil and the child grasps and releases repeatedly.

- remember the only movement being done here is grasping and releasing, so the child does not reach for the object or place the object anywhere. Ifyou are using something like marbles in a can, use the large marbles and hold the child's hand over the can. You put the marble in their hand. All they do is grasp and release it.

- practice for a few minutes, then time for 15 or 30 seconds. - count the number of marbles in the can and chart the information on the Standard

Celeration Chart

Training Fine Motor Skills with the Big 6+6 A Precision Teaching Approach

E. Anne Desjardins, M.Ed.

:eI.ac.e. - here we put something small in the child's hand and have them hold onto it. - place a container in front of the child - the child is to reach and place their hand over the container and then bring their

arm back to a starting position. This is one place. - they repeat this movement over and over again, but they do not release the

object. - practice and then time for 15 or 3 0 seconds, counting the number of places - chart the information on the Standard Celeration Chart

Big 6 as a compound - here the child reaches for an object, touches it, grasps it, places it over a

container and releases it. We have used marbles in a can or basin, small blocks, clothespins etc.

·_have the child practice and then time the child for 30 seconds or one minute - count the number of objects in the container and chart the information on the

Standard Celeration Chart

Pull-Push - use Fisher-Price corn poppers, small brooms, desk or file drawers, toy

cars with sirens etc. - the child pushes the object forwards and pulls it back. This is one pull

movement. They repeat it over an over again. - practice for a few minutes, then time for 15 or 30 seconds, counting the

number of movements. - chart the information on the Standard Celeration Chart

Shake. - use rattles or anything that makes a noise when you shake it - the child repeatedly shakes the object - practice; then time for 15 or 30 seconds, counting the number of shakes - chart the information on the Standard Celeration Chart

Squeeze - we have had the most success with plant atomizers, Windex bottles, water pistols, squeak toys etc.

- the child squeezes the handle of the atomizer and shoots a stream of water into a container, onto a plant, etc. - practice, then time for 15 or 30 seconds, counting the number of squeezes - chart the information on the Standard Celeration Chart

Training Fine Motor Skills with the Big 6+6 A Precision Teaching Approach

E . Anne Desjardins, M.Ed.

Iap. - use xylophones, drums, table tops etc. - have the child extend a finger and tap repeatedly on the surface - practice, then time for 15 or 30 seconds - chart the information on the Standard Celeration Chart

Tuist - we have had the most success using doorknobs - place the child's hand on the doorknob and have them twist it repeatedly - practice, then time for 15 or 30 seconds - chart the information on the Standard Celeration Chart

All these elements should be at 200-300/minute. We usually work with both hands on all "Big 6+6" topics and chart each hand separately.

The amount of practice time you provide during the day will be critical. Always have objects for the child to reach for and manipulate. The assistance you provide during direct teaching will start impacting their behavior when they are out of the program. The child will begin reaching out for people, toys, eating utensils, etc. One interesting outcome we had was the children were able to brush away flies and mosquitoes in the summertime!

It really will make the difference when you get these skills to fluent levels of performance with your students. I have seen children who have spent years in bed start to manipulate toys, feed themselves, balance themselves and gain mobility (crawling) once we have the "Big 6+6" at fluent performance levels. Even when we have been working on Guide and Hear-Touch as inputs, we see children begin to operate on independent channels.