Children with trisomy 21 display atypical manual skills that change to some extent during development. We examined grasp characteristics and their development in 35 children with trisomy 21, aged 4-18 years, who performed simple manual tasks (two manual tasks of the Movement Assessment Battery for Children, and grasping of five wooden blocks whose size was determined by their hand size). The age-matched comparison group included 35 typically developing children. Children with trisomy 21 were found to use fewer fingers than children in the comparison group in each task. They also used specific grasps and tended to extend fingers that were not involved in the grip. While some specific grasp characteristics of children with trisomy 21 decreased with age, other did not, and remained present throughout development. The perceptual-motor development of children with trisomy 21 should be analyzed in terms of atypical development rather than developmental delay.

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