This post is designed to inform and educate on the importance of fine motor skill development, and how this can be addressed in a variety of settings for children. Specifically, ways these skills are a primary focus of OT intervention at ABS Foundations. 

Fine Motor Skills impact a child’s functional use of their hands in small motor tasks, these tasks directly impact how a child interacts with his or her environment. The hands play an important role in most daily tasks and occupations that we perform. From early development of learning where our hands are, to grasping and releasing toys, writing, getting dressed, feeding, toileting, etc, a majority of our daily tasks involve the proficient use of our hands. Therefore, when fine motor control and dexterity impacts functional performance, it can be a reason to work on fine motor control via direct Occupational Therapy intervention.

What are Fine Motor Skills?

Fine motor skills are the refined movements and actions of the hands, fingers, and wrists. These refined movements allow a child to engage and interact with their environment. 

The development of fine motor skills is necessary for almost every task that a child completes. Areas of a child’s life impacted by fine motor skill development include, but are not limited to: self-care, daily hygiene, toileting, dressing, feeding, play, and school-related activities such as coloring and handwriting. Fine motor skills make up a huge part of learning, and a child’s participation in school tasks. 

Fine motor skills consist of a variety of components. These include:

  • Bilateral Coordination:  Ability to use both sides of the body together in a coordinated way. Many childhood and school activities require your child to be able to use both hands together well. For example, in handwriting and/or coloring, one hand is responsible for holding the writing utensil, while the other hand stabilizes the paper. When cutting, one hand manipulates the scissors, while the other hand holds and turns the scissors. 
  • In-hand Manipulation:  Ability to hold and move an object within one hand. Think of holding a pencil while writing/coloring.  
  • Hand Strength: Ensuring a child has the muscle strength within the hand to perform the fine motor skills expected. If a child is experiencing decreased hand strength, they may fatigue when completing activities requiring the use of those muscles. Kids may respond with “this is hard” or “I don’t like to use my coloring hands”. These reactions may be because they are tired, and using these muscles is difficult for them. 
  • Separation of the sides of the hand: Separation of the sides of the hand refers to the imaginary line drawn from your wrist directly down the middle of your hand and between your ring finger and middle finger, separating the precision side of the hand (thumb, pointer finger, and middle finger) with the power side of your hand (pinkie finger and ring finger). This can be seen with cutting and scissor skills. 
  • Eye-hand Coordination: Coordinated control of eye movement with hand movement and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to guide the eyes.
  • Finger Isolation: Isolation of finger movements from one another to perform a task.
  • Precision: Performance fine movements of the hand, for example stacking small blocks. 
  • Shoulder and wrist stability: Ensuring a child’s wrist and shoulder movements and position are functioning correctly to support and stabilize distal movements. 
  • Core strength and stability: We develop proximally to distally. Therefore, a weak core leads to weak fine motor skills distally. Working on a child’s core strength to ensure they have the stability to support fine motor skill development is a key aspect of intervention. If a child is experiencing a weaker core, they may show difficulty sitting in a chair for periods of time. They may appear to slouch or lean on their desk. Working on a child’s core strength and stability will assist with proper posture and positioning to engage in fine motor tasks. 
  • Functional grasp patterns: Promoting a child to utilize the appropriate grasp pattern for the task performed. 

Ensuring these areas are functioning correctly, and cooperatively are essential in the Occupational Therapy intervention protocols designed around fine motor skill development. 

Fine Motor Skills Intervention: 

Occupational therapists strive to make therapy sessions fun, but still functional. By participating in motivating activities (i.e. board games, crafts, obstacle courses, group play, and more) children are developing fine motor skills while having fun! Using a child-led approach, Occupational Therapy intervention for fine motor skills development won’t always seem like “work” for the child. At ABS Foundations, the OT intervention can happen both in-conjunction with other therapies during co-treatments, or during one-on-one individual sessions.  Using group sessions is another way to motivate and encourage a child’s engagement in fine motor skill intervention, while also encouraging social-emotional development.

Here, I will highlight just a few examples of methods used during intervention:

Individual:

  • Handwriting practice while using wiki-stix to address precision and bilateral coordination.
  • Drawing on a dry erase board mounted to the wall to encourage shoulder and wrist stability.
  • Color-by-number activity to facilitate proper grasp on a writing utensil and eye-hand coordination. 
  • Sitting on a yoga ball while completing finger-thumb touches to address core strength and separation of two sides of the hand. 
  • Scissor skill practice while making a preferred craft. 

Co-treatment:

  • While working in conjunction with a Speech Therapist, an Occupational Therapist can have a child participate in a core strengthening task, such a swing or obstacle course while the SLP addresses speech goals. 
  • The Occupational Therapist can work with a BCBA during a session by having a child follow 1-2 step directions while playing a board game which encourages use of a pincer grasp. 

Group Session: 

  • Two children working on peer play can practice turn taking while playing a game promoting the use of eye-hand coordination (ex: pop-up pirate or Jenga). 
  • A small group of children can work on social skill interactions while working together to build a lego design, which encourages the development of hand strength and precision. 
  • Beginning a social skills group with brain gym exercises to promote bilateral coordination. 

There are an abundance of ways and opportunities to address the development of fine motor skills. It’s the goal of the OT to find what motivates a child, and use that to create the “just right challenge” during the session. Meeting a child where they are, and not where you “expect” them to be, is crucial. Creating a safe and fun environment for a child to grow and progress will yield the best results. In children, fine motor skills allow them to experience the world around them:

Feeding: Picking up food and bringing it to their mouth. Grasping a utensil or cup. Opening/closing food containers. 

Self-care: Pulling up/down clothing for toilet hygiene. Turning faucets for hand-washing. 

Dressing: Completing buttons, zippers, snaps, buckles, and shoe-tying. 

Play: Manipulation of game pieces, blocks, tablets, etc. 

School Activities: Coloring, painting, handwriting, cutting with scissors, typing. 

When working on increasing a child’s independence and overall participation in their world, fine motor skills are crucial. The OTs at ABS Foundations are here to assist your child in meeting their fine motor skill goals so they may fully participate and engage in their environment.