Effect of the Grasp and Grow Program on Fine Motor Development Among Preschool Children in Pathum Thani Province, Thailand
Abstract
Objective: This study aimed to evaluate the effect of the Grasp and Grow program on fine motor development among preschool children (Kindergarten 2) in Pathum Thani Province, Thailand, compared with routine art instruction. Materials and Methods: A two-group pretest-posttest design was implemented, with one school allocated to each condition (single-cluster-per-arm) at two government primary schools in Pathum Thani, Thailand, between July and September 2025. Ninety-two Kindergarten 2 children (age 4-5 years) were allocated by school-level lottery to an experimental group (n=46), receiving an 8-week, classroom-delivered program of seven structured art-based activities grounded in Gesell’s Maturational Theory, or a comparison group (n=46) receiving routine art instruction. Fine motor development was assessed using a 20-item structured observation instrument. Results: Baseline fine motor scores were lower in the experimental group (28.63 vs. 33.63, p<0.001). At posttest, the experimental group scored higher (48.43 vs. 37.00, Cohen d=2.14, p<0.001). The ANCOVA-adjusted between-group difference was 12.98 points (95% CI: 10.74-15.22), F(1, 89) = 132.66, Cohen d=2.59, p<0.001). Three analyses (the primary analysis and two additional sensitivity analyses) showed a consistent direction (Cohen’s d range: 2.49-2.59), though this consistency does not establish a causal effect given shared design limitations. Conclusion: In this exploratory, single-cluster-per-arm study, children receiving the Grasp and Grow program showed significantly greater fine motor improvement than those receiving routine art instruction. Given the unreplicated school-level allocation, this finding should be treated as hypothesis-generating rather than evidence of a causal program effect. Given its low cost, the program may offer schools in resource-limited settings a feasible option pending confirmation through a teacher-led, cluster-randomized trial.