Audrey Dwinnel, OTD, OTR/L
January 03rd, 2023
What Are Fine Motor Skills?
If your child attends occupational therapy, you will likely hear their therapist talk about fine motor skills. Fine motor skills are the coordinating of the smaller muscles of the body, most frequently in the hand, wrist, and fingers. This also includes the coordination of the eyes and what you have probably heard as “eye-hand coordination.” In this blog, NAPA pediatric occupational therapist discusses fine motor development, including fine motor examples and activities by age.
Fine motor skills are used throughout everyday life in ways adults typically don’t even realize! For example, fine motor skills are needed for things like self-feeding, dressing and undressing, grooming/bathing, toothbrushing, writing, and even texting. For a child, fine motor skills are important for completing school work such as drawing, coloring, and writing their name. They are also important for independence with self-care.
Before going through fine motor skills examples by age below, we’ll first share a general overview of some of the most common things that require fine motor skills:
- Writing, drawing, coloring
- Cutting with scissors
- Clapping hands
- Waving
- Using utensils for eating
- Brushing teeth
- Tying shoes
- Turning the pages of a book
- Playing Legos
- Putting together a puzzle
Motor skills develop in what is called the developmental sequence, which moves from head to toe. This essentially means that skills appear as they build upon each other starting with head and trunk control, working down to shoulders, elbows, wrists, and fingers, as well as hips, legs, feet, and toes. You have likely heard of the terms ‘milestones’ or ‘inch stones’ which are the skills that are achieved as a child develops. Children typically grow from their torso or core, out. Because of this, children also develop gross motor skills before fine motor skills.
We need the basis of gross motor skills and strength before we can strengthen the smaller muscles.
Fine Motor vs. Gross Motor
Now, let’s quickly explain the difference between fine motor skills and gross motor skills and how they work together. Essentially, gross motor skills involve the large muscle groups of the arms, legs and trunk, whereas fine motor skillsinvolve small muscles of the body, typically thought of as the movements that involve the fingers and the hands.Gross motor skills are the larger, more stabilizing skills such as balance and locomotion including things like sitting, crawling, creeping, and walking. Examples of fine motor skills are things like coloring, drawing, writing, grasping, and dressing.
Therapists will often say “proximal stability leads to distal mobility.” Proximal means closer to the body, like your shoulders and hips, where distal means farther from the body, like your wrists and ankles. So, without stability and strength in your bigger muscles, it is much harder to achieve mobility in your smaller muscles. This is why you will often see therapists focusing on gross motor movements before fine motor movements.
Fine Motor Skills Examples by Age
Below, you will find some examples of fine motor skills by age. This is a general guideline as each child develops at a different pace. Typically, fine motor development milestones for infants, toddlers, and children are as follows:
0-3 months:
- Brings hands to mouth
- Moves arms against gravity
- Might try to swing arms at toys
- Hands begin to open more
3-6 months:
- Holds small object (without thumb tucked)
- Holds hands together
- Reaches for items with both hands
- Pushes up on arms during tummy time
Briefly sustains grasp on a toy (ex. rattle) - Follows objects with eyes
6-9 months:
- Shakes and bangs rattles
- Brings toys to mouth
- Uses a raking grasp (all fingers rather than just 2-3)
- Transfers objects from one hand to the other
- Keeps hands open and relaxed
- Starting to try to pick up small items like Cheerios
9-12 months:
- Able to release an object
- Hands toy to caregiver
- Bangs items together
- Turns pages of book (one at a time if cardboard, 2-3 together if paper)
- Begins to put items into a container
- Points
- Stacks 2 blocks
- Uses a pincer grasp (index finger and thumb)
12-18 months:
- Claps
- Puts things into containers
- Waves
- Uses both hands to play
- Can isolate index finger
- Beginning to use spoon and cup
1.5 – 2 years:
- Utilizes palmar supinate grasp (hand fisted) on writing tools
- Scribbles
- Can manipulate items to move from fingers to palm
- Scoops with a spoon
- Stacks 3-4 blocks
- Puts rings on ring stacker
- Begins to hold crayon with fingertips and thumb
2-3 years:
In addition to the skills listed above, fine motor skills for 2 year olds include:
- Holds crayon with fingers
- Snips with scissors
- Able to imitate vertical and horizontal strokes, and scribble in circular pattern
- Strings beads
3-4 years:
Examples of fine motor skills for 3-4 year olds include:
- Stacks up to 9 blocks
- Copies a circle
- Imitates a cross
- Manipulates Playdoh
- Uses non-dominant hand to stabilize
4-5 years:
Fine motor skills for 4 year olds include:
- Cuts on a line
- Copies square and cross
- Writes names (Upper case letters)
- Copies letters
- Handedness established
Fine Motor Development Activities
0-6 months:
- Lots of tummy time (strengthens head, neck, shoulders, wrists, hands)
- Visual stimulation – hang mobiles/toys for them to explore visually and hit when they are ready
- Offer a variety of touch experiences – children tend to explore with their hands and mouths, offer lots of different textures for them to begin to explore
3-6 months:
- Offer toys when they are on your lap – allow them to hold with both hands
- Introduce self-feeding and messy play opportunities
- Use suction toys when seated in a highchair
6-9 months:
- Basic shape sorters
- Tape things down on their highchair and have them “rescue” the items by pulling the tape
- Wood, form board puzzles – start with basic shapes and work towards more complex shapes
- Put in/Take out activities – dropping and releasing items into a container, get creative and use items around your house!
9-12 months:
- Allow them to help turn pages and/or lift flaps in books
- Place pom poms or cotton balls into a whisk, have your child help to get them out
- Practice waving hi and bye to friends and family
- Finger painting! (At this age, make sure it is edible to be safe as children like to explore new textures with their mouths)
- Have them practice using utensils – it may be too difficult for them to spear with a fork or scoop with a spoon, so you can load the utensils and have them practice bringing it to their mouth independently
- Stacking cups – this is a good prerequisite to stacking blocks as it requires less control and dexterity
- Opening and closing – this can be simple pop-up toys or even drawers and doors!
- Popping bubbles!
1.5-2 years:
- Edible Playdough (here’s some recipe options!)
- Painting (outside is less messy)
- Sponge activities – practice squeezing the sponge with hands or feet!
- Water pouring into different size containers
- Pulling scarves out of boxes
- Pinching – place small items like pom poms into ice trays and have them practice taking them out with their “pincher fingers” (index and thumb)
- “Poke-It” books – practice index finger isolation
3 years:
- Coloring/scribbling with different tools such as crayons, markers, chalk
- Building with blocks or Legos
- Stacking items
- Snipping with scissors
- Putting together simple puzzles
- Playing simple board games
- Stringing large beads
4-5 years:
- Q-tip painting – practice pencil grasp
- Squeeze painting – fill some squeeze bottles or use pipettes and watered-down paint
- Use clothespins to pick up cotton balls and paint using the cotton balls
- Play with pipe cleaners to make sculptures
- Use Playdoh to make the letters of their name
- Sort items by color using tongs or tweezers
Find Additional Resources and Activities in the NAPA Blog:
- 32 Fine Motor Activities: Our Therapists Ultimate List
- Fine Motor Skills Defined by an Occupational Therapist
- 5 Fine Motor Skills Toys Recommended by an OT
- Gross Motor Development for Infants and Toddlers
- 15 Activities to Build Gross Motor Skills for Summer
About the Author
Audrey is an occupational therapist at NAPA Center Denver. She is a Colorado native but spent 6 years in Texas before coming back home. She was a competitive gymnast and cheerleader growing up and in her free time she enjoys playing with her pup, Ellis!
TAGS: Blogs, OT
