Wendy Tomhave 
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Wendy Tomhave 
Thumb Assessment
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Wendy Tomhave

Wendy TomhaveWendy TomhaveWendy Tomhave

Occupational Therapist 

Clinical Research Specialist and Consultant 

Lead Thumb Grasp and Pinch Assessment

 (T-GAP) Developer

wendytomhave@gmail.com

Wendy Tomhave

Wendy TomhaveWendy TomhaveWendy Tomhave

Occupational Therapist 

Clinical Research Specialist and Consultant 

Lead Thumb Grasp and Pinch Assessment

 (T-GAP) Developer

wendytomhave@gmail.com

Background

Resources to View or Print

Resources to View or Print

Welcome!


I’m Wendy Tomhave OTR/L, and this site is dedicated to advancing the field of upper extremity pediatric orthopedics. My goal is to provide free, accessible resources to support clinicians, researchers, and learners.


With a robust tenure at Shriners Children’s as a Senior Occupational Therapist and Clinical Researcher, I’ve spent my career specializing in the assessment and treatment of children with congenital hand differences, cerebral palsy, arthrogryposis, upper limb prosthetics and more. 


Collaborating with dedicated staff, supportive families, and inspiring children has fueled my passion for knowledge sharing. On this site, you’ll find my favorite past presentations, home exercise programs, and everything you need to learn and administer two assessments I've helped develop, the T-GAP and the UBET.


I hope these resources empower you in your practice and deepen your understanding of pediatric upper extremity care. 


Thank you for visiting!




Resources to View or Print

Resources to View or Print

Resources to View or Print

The Thumb Grasp and Pinch Assessment (T-GAP)

  • T-GAP Publications
  • T-GAP Presentations
  • T-GAP Manual
  • T-GAP Score Forms
  • T-GAP Video Examples


Unilateral Below Elbow Test (UBET)

  • UBET power point presentation 2006
  • UBET Instruction manual and score forms
  • UBET Individual task set and scoring


Diagnosis: Arthrogryposis

  • OT arthrogryposis general evaluation
  • Presentation: Evaluation and treatment of children with arthrogryposis - 2023
  • Presentation: Occupational therapy in the early stages of children with arthrogryposis - 2023
  • Presentation: Physical therapy and post surgical occupational therapy in UE arthrogryposis - 2023
  • Presentation: Arthrogryposis evaluation and treatment - 2018
  • Upper body dressing device
  • Dressing tree assembly instructions parts 1 and 2


Diagnosis: Cerebral Palsy

  • Stereognosis measurement form
  • Presentation: Evaluation and treatment of children with hemiplegic cerebral palsy - 2023
  • Presentation: Upper extremity hemiplegic cerebral palsy - 2015
  • Presentation: Hemiplegic cerebral palsy UE strength and dexterity - 2014
  • Research published: Affected and contralateral hand strength - 2015
  • Activities: Elbow, forearm, wrist and hand
  • Activities: Bilateral arm and hand
  • Activities: Letter reversals


Upper Limb Transverse Deficiency

  • Presentation: Assessment and treatment of pediatric hand differences: What's in your tool kit? - 2022
  • Presentation: OT for upper limb prosthetics - 2013
  • Activities: UE prosthetic training- school age


Radial Longitudinal Deficiency

  • Presentation: Use of the T-GAP in pediatric patients - 2023
  • Presentation: Golden nuggets in the treatment of children with radial longitudinal deficiency - 2023
  • Presentation: T-GAP assessment in children with RLD - 2023
  • Presentation: Pollicization - Italian protocol with early mobilization, Silvia Minoia - 2023


Core Strengthening

  • Ball exercises
  • General activities
  • Yoga poses -  beginner
  • Yoga poses -  intermediate


Fine Motor Activities

  • In hand manipulation
  • Pinch strength and control
  • Hand and fine motor skills


Upper Extremity Strengthening Activities

  • Upper extremity weight bearing
  • Progressive resistive exercises - shoulder and elbow
  • Wrist extension
  • Finger extension
  • Finger flexion and extension
  • Thumb abduction
  • Thumb extension and abduction
  • Thumb flexion and opposition
  • Hand strengthening


Upper Extremity Range of Motion

  • Range of motion measurement form
  • Passive ROM elbow, forearm, wrist and hand
  • Upper extremity exercises
  • Hand and finger stretching


Other Resources

  • Grasp pattern hierarchy
  • General thumb assessment


Strength and Dexterity Norms

  • Box and blocks test norms: ages 3-10 and 6-19
  • Grip and pinch strength norms: ages 3-5 
  • Grip and pinch strength norms: ages 5-19
  • Nine hold peg test norms: Ages 3.5 and 6-19


Typical Motor Skill Development

  • Gross and fine motor development
  • Development of pencil grasp


Activities of Daily Living

  • Loop method for shoe  tying
  • Self dressing home suggestions
  • Handwriting tips for parents


Upper Limb Deficiency: Books to Read

  • Book list for elementary school kids with limb differences
  • Book list for younger children with limb differences


Support Groups

  • Hand differences support group


Wendy Tomhave - Curriculum Vitae  

  • Background: Publications and  presentations 


Thumb grasp and Pinch Assessment (T-GAP)

Everything needed to learn, administer, and score the T-GAP are available at this site and can also be found at Wendy Tomhave / Shriners Hospitals for Children® .


This site is available for learners to ask questions or share comments about pediatric upper extremity assessment and treatment to facilitate their professional development.


Contact Information

For more information and assistance

Message any questions or comments you have on this site or directly at wendytomhave@gmail.com

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