The utensil holder has a polypropylene webbing with a utensil pocket. It adjusts via a velcro hook and a loop closure with a D-Ring thumb loop. To find the right size, measure your hand across the top of the knuckles. This Pediatric size loop fits sizes 2.25" to 3", Small/Medium sizes 3.5" to 4.25", Large/x-Large sizes 4.25" to 4.75".