The occupational therapists involved the subjects in small object manipulation and sensory experiences meant to be generalized into improved tool use and increased functional abilities. Many of the therapy activities emphasized the development of (a) wrist stability and extension, (b) fleXibility and stability of the palmar arches,
(c) isolated finger use, (d) thumb stability and mobility, and (e) control of radial fingers with ulnar fingers stabilized. These components seemed to be fundamental to dynamic control of tools, such as a pen, and handling of small objects (e.g., moving them in and out of the hand).