What Is a Built-Up Handle?
A Built-Up or Englarged handle is an adaptation that makes grasping easier. It may be used for one handed tasks such as using a spoon or to stabilize materials. In the above photo a stencil with a handle pressed onto the paper enables a person with hemiplegia to use the more coordinated hand to color inside a boundary.
A baby's first toy is often a rattle that is large enough to fit comfortably inside the palm. In fact, this type of grasp is called a palmar grasp and babies are typically experts at using this grasp by 6 months of age.
Why adapt with a large handle?
Many children and adults have difficulty grasping small objects. This is why pencil grips are popular. They make the grasping surface larger and easier to control.
Utensils with a larger grip surface put less stress on the small joints of the hand and may decrease pain, as well as increase motor control. Foam is sold to enlarge handles on writing tools, utensils and other tools. In addition, securing a tool with an EasyHold strap may also improve motor control.
Enlarged handles may benefit people with arthritis or spasticity due to brain injury, stroke or cerebral palsy. In addition, grasping a larger handle requires less strength and many of my clients with Down Syndrome have benefited from using them. Utensils are sold in varying sizes, textures, angles, lengths and weights so that they can be individualized. Foam is also sold in various sizes.
And then there are Plastic Bottles....
I also like to adapt activities by either
- making the activity out of the bottle or
- cutting the handle from the bottle to adapt materials
Either way, you can individualize by
- matching handle size to the person's hand size
- pick from a variety of vibrant colors
- Add vibration
- Position in the vertical plane
- Positioning for most comfortable reach and grasp as shown in the video below
Heart Stencil
I created the heart stencil shown in the feature photo by cutting the shape out of a large detergent bottle. It was used by a client with hemiplegia. She had adequate motor control to color inside the stencil when pressing down on the large handle on top of the table. Some individuals may be able to perform this task by pressing the stencil against a vertical surface.
Sponge Holder
This same individual wanted to paint and had difficulty grasping brushes, even brushes with large handles. The adapted sponge holder enabled her to paint more easily. The diagram below is from my book The Recycling Occupational Therapist.
The following video demonstrates how to make the sponge holder jig.
Insertion Task with Large Handled Bottle
Cut one or more holes to create a shape sorter. The pink bottle has a slot cut to insert picture cards. Cutting a square shape to insert blocks would be a bit more challenging.
Velcro Task Bottle with Large Handle
Attach shapes with Velcro to remove and insert. The more Velcro used, the greater strength required to remove it. Screwing the cover on and off is also a wonderful fine-motor activity and convenient way to store materials.
Unscrewing Caps to Insert into Bottle
Removable Handle Attached to Container
The 2 year old girl shown above is unable to stabilize the coffee can using her spastic right hand. I cut the handle out of a bottle and attached velcro to the flaps as shown below. 
The following video demonstrates how to make a handle that is attached by inserting the flaps through slits when using a plastic container. The 2 year old girl shown in the photo was unable to stabilize the container during an insertion task until I attached the green handle with Velcro.
Sensory Stimulation Handles
The following adaptations involve attaching sensory materials to the handle that the person is shaking to enjoy the movement and visual and auditory stimulation.
Balloon Holder
Handle with Button Music Switch
Magnet on Handle
Pom Pom Maker
This is the same gentleman with hemiplegia shown painting on an easil. He is able to independently grasp the handle in his right hand after relaxation exercises.
I slipped cord inside the wrapped yarn and tied a knot before cutting to remove the yarn from the jig.
Here are a few seasonal crafts using pom poms that this individual enjoyed. http://www.redtedart.com/2014/09/17/spider-craft-pom-pom-spider/
or use orange yarn to make pumpkins
http://www.craftsunleashed.com/seasonal/fall/fall-crafts-pom-pom-pumpkins/
thecrafttrain.com/pom-pom-hedgehog-craft
It is wonderful when you adapt materials so that children and adults with physical and/or developmental disabilities can engage in functional activities! Learn more in my book- The Recycling Occupational Therapist. If you order using paypal- it is $25.00 with free shipping.