Spinal Cord Injury Journal

Tools & Techniques for Writing with Paralyzed Fingers

Written by Spinal Cord Team | August 31, 2022

With the advent of touch screens and the computer, writing is becoming a lost art form. And for the quadriplegics of the world, writing with an actual pen or pencil is even more intimidating since these devices can be difficult to hold. This is why many people with quadriplegia will use various gadgets and techniques to write in a legible manner.

 

Many of these techniques are learned in therapy, but many learn them in the real world. Not everything can be taught by an occupational therapist. Even though the writing is becoming more uncommon, it is still a skill everyone with quadriplegia can do. Even those who can’t move their arms can write using mouth tools, which we will cover below. Read on to learn about writing tools and techniques for quadriplegics.

 

Traditional Hand Cuff

 

Sometimes referred to as a "universal cuff" on medical supplies sites or simply a "quad cuff," a handcuff can be a simple and inexpensive solution for writing with paralyzed hands. Made from hard plastic, leather, or nylon, these cuffs have a Velcro strap to secure them around the palm, and they'll have a pocket for inserting things like a pencil or pen, or anything else you have difficulty holding such as a fork or spoon. See here: https://www.alimed.com/enlarged-grasp-adl-cuff.html?pid=94011&gclid=CjwKCAjw6MKXBhA5EiwANWLODACTRruMMV6PDeK0lH0mtU5Df52JOZuFG7vaOq6U0mI_zHlDkKA5WxoCAiIQAvD_BwE&fbclid=IwAR2ovlCNZsSM9NwESKmZRNLQ_BWAWUoruu24B2oKEKrAT4fGnK3bSuPZ_IA 

 

Some of these cuffs have no Velcro and slide onto the palm from the side, making it easy to take on/off independently, like this cuff made especially for writing. It also has a small plastic holder for a pencil or pen. Check it out: https://www.etsy.com/listing/1157461998/adaptive-writing-mobility-aid-hand-cuff?fbclid=IwAR2ovlCNZsSM9NwESKmZRNLQ_BWAWUoruu24B2oKEKrAT4fGnK3bSuPZ_IA 

 

Finger Weave

 

Many people with quadriplegia, will forgo any kind of extra equipment to hold a pen or pencil and will instead wedge a pen or pencil in between their fingers. This takes some practice since you need to figure out the tightest area between your fingers for which to place the pen or pencil, but it can work very well. Typically, people will weave the pencil behind their middle and ring fingers, while others will put it directly in the middle of their fingers. Also, using a pen or pencil that has a rubber outside grip can help immensely with this technique, as it will help keep the pencil or pen in place. 

 

Two-Hand Technique

 

Many quadriplegics have limited wrist strength. These individuals will often use a two-hand technique to write. To do this, they will first put the pen or pencil in their hand the best they can, and then they will use their other hand to press the pencil down to the paper and move the pencil. This can be very difficult, but it is used to sign checks and cards, however, most quads of this level use voice activation instead to write.

 

Rolling or Felt Tip Pen

 

Those who forgo any kind of equipment, are aware of the kind of pen they use. A rolling tip or felt tip pen is the easiest to write with limited dexterity since they both leave marks easily. 

 

Mouth Stick

 

For people with no arm movement but still want to write, they will use a mouth stick, with a pen or pencil taped to the end of the mouse stick. Others will use a mouth stylus pen by gluing it to a Popsicle stick for easier use. Check out a mouth stick: https://www.amazon.com/dp/B002BUQG5A?ref=nb_sb_ss_w_as-reorder-t1_ypp_rep_k0_1_16&amp=undefined&crid=2CZ0RAHV8X2YQ&sprefix=clamp%2Bon%2Bmouthst&th=1&fbclid=IwAR1D_mcmNjoeGSxA6ciLfDEVu7azjbIm47vpW5ueEwDQBpL-gnVVL4_o-Hc 

 

Push Gloves

 

And finally, if you have a pair of fingerless push gloves for your manual wheelchair, one of these gloves can be used to hold a pen or pencil. People will wear one of their push gloves on their writing hand and will wedge a pen or pencil on the inside of the palm in the glove (so make sure the glove is snug) to hold a pen or pencil.

 

We encourage you to keep up your ability to write, even with the advent of voice control. There will always be a time in your life when signing your name or jotting down a few things will be needed.