What are Fine Motor Skills:

Fine motor skills involve the small muscles of the body that enable such functions as writing, grasping small objects, and fastening clothing. They involve strength, fine motor control, and dexterity.  These skills are important in most school activities as well as in life in general. Weaknesses in fine motor skills can affect a child's ability to eat, write legibly, use a computer, turn pages in a book, and perform personal care tasks such as dressing and grooming.  

As clinicians, we find that more an more children are presenting with delays in fine motor skills.  While there isn’t one specific cause, children’s tendency to gravitate to digital entertainment vs. traditional manipulatives and drawing activities is contributing to their lack of hand strength.  As a teacher, look for opportunities to include fine motor and hand strengthening activities into you instruction.  Check out our “Handouts for Fine Motor Skill Development” for some great ways to integrate fine motor skills in your classroom!

In making referrals for OT, it’s important to understand what is “typical” for a student at a given age.  For students with severe neuromuscular issues, such as CP, it is also helpful to have a developmental perspective on where they are in terms of grasp and other fine motor skills as you plan and adapt activities.

What is the Typical Progression of  Fine Motor Development?

hands most often remain closed has grasp reflex (grasps objects involuntarily if placed in palm)

reaches for ("swipes at") objects inaccurately

3-3 1/2 MONTHS
clasps hands together often

3 1/2- 4 MONTHS
begins purposeful, visually directed reaching

can hold small objects in hand

can transfer objects from one hand to the other can pick up cube/medium sized object easily

develops accurate forward and side reach

"rakes" or "scoops" small objects to pick them up (i.e. using fingers/palm/whole hand to scoop up Cheerios, raisins etc.

intentionally able to drop/release objects (get ready for the "watch-me-drop-this-watch-mommy/daddy-pick-it-up-AGAIN" game!)

able to pick up small objects using thumb and finger/fingers

pokes and/or points with index finger

12-18 MONTHS
holds crayon with whole hand, thumb up

2 YEARS holds crayon with thumb and all fingers, forearm turned so thumb is pointing down puts on shoes, socks, and shorts; takes off shoes and socks can use a spoon by himself, keeping it upright can draw and copy a vertical line

2 1/2- 3 YEARS
strings large beads snips paper with scissors rolls clay/playdoh into "snake" can draw and copy a horizontal line

3-3 1/2 YEARS
able to complete simple puzzles can build a tower of nine small blocks or more can get himself dressed/undressed independently; only needs help with buttons; still confuses front/back for clothes, and right/left for shoes can feed himself with little or no spilling, drinks from a cup/glass with one hand

3 1/2- 4 YEARS
can pour his own drink from a pitcher if not too heavy can place small pegs into small holes able to string small beads can hold a pencil with a "tripod grasp" (3 fingers), but moves forearm and wrist to write/draw/color

4-4 1/2 YEARS
can use scissors to follow and cut both straight and curved lines can manage buttons, zippers, and snaps completely can draw and copy a cross (one vertical and one horizontal intersecting lines)

4 1/2- 5 YEARS
can hold fork using his fingers can feed himself soup with little or no spilling folds paper in half, making sure the edges meet puts a key in a lock and opens it

can get dressed completely by himself, and usually tie shoelaces cuts square, triangle, circle, and simple pictures with scissors uses a knife to spread food items (jelly, peanut butter, mayo etc.), uses a dull knife to cut soft foods able to draw and copy a diagonal line uses a "tripod grasp" on writing utensils (thumb & tips of 1st two fingers) and uses fingers only (because small muscles of hand have developed) to write/draw/color

5 1/2- 6 YEARS
can build a five block "bridge" sufficient bilateral hand coordination to cut out complex pictures, accurately following the outline able to copy a sequence of letters or numbers correctly

able to complete complex puzzles