“It’s a Fine Motor Issue…”

Dissecting Fine Motor Skills

A common reason that children are referred to OT is for “fine motor issues.” However, it usually isn’t just a fine motor issue. There could be other factors involved.

What are fine motor skills? They are the coordinated movement that involves the use of fingers, hands, and arms. This includes:

  • Reaching
  • Grasping
  • Object manipulation (buttoning a button or putting coins in a piggy bank)
  • Tool usage (eating utensils and writing utensils)

These skills develop at birth and work with other areas of development, such as vision, touch, and postural and proximal strength/stability.  

So, how do these other skills affect fine motor skills?

Visual processing skills – Vision is important for learning new motor skills or when activities require precise movements. As the child begins to manipulate the objects around them, their visual perception increases. With additional help of their tactile system, children begin to understand an item’s characteristics (size, shape, texture) and how much force or power is needed to interact with it appropriately in a task. 

For example, if an infant wants to grab something, they will adapt their arm positions and shape their hands according to what they are grabbing. As they age, toddlers will modify their approach to objects in anticipation to their weight. If the visual system is affected (seeing double, blurred vision, eye fatigue) or if they difficulties coordinating hand-eye movements, a child may not be able to accurately complete fine motor tasks. 

Tactile processing skills – Touch is crucial to understanding objects and necessary for building fine motor skills. Along with the visual system, tactile processing allows a child  to collect information about an object’s attributes through their fingertips. As the child ages, they can identify and manipulate objects through touch alone, judging weight, force, position, etc. 

A child with poor touch discrimination may appear clumsy when completing fine motor tasks. Also, if a child does not like touching certain substances or textures (tactile defensiveness), they may avoid exposure to various objects and limit their chances to refine their fine motor skills. 

Postural and proximal strength/stability – “Proximal stability allows for distal mobility.” This means larger muscles in the trunk and shoulders must be secured in order for smaller muscles in the arms and hands to complete detailed movements. 

Some fine motor activities require the larger proximal joints at the shoulder to be stable, such as writing or grasping an object from a table. However, other fine motor activities require distal joints at the wrist and fingers to be stable, like carrying objects from one point to another.

Joints along both large and small muscle groups should have the ability to stabilize or move when necessary. 

If there is a problem in this area, the child may need additional time and effort to complete fine motor tasks, such as using silverware or cutting with scissors.

How can I help my child sharpen fine motor skills?

The playground is your friend. Playground equipment works wonders as it challenges balance and upper body strength. Encourage them to crawl through tunnels, climb on ladders, hang on the monkey bars, balance on the beam, etc. It all helps exercise fine motor skills. Bonus: it also gets all that excess energy out so they can focus on their work afterwards. 

Yoga or weightbearing activities. Any weightbearing position helps stabilize trunk and upper limb muscles. Planks (forearm or straight arm), downward facing dog, tabletop (quadruped) position, and bridge positions are great options. Try to hold them for at least 10-15 seconds. To make it more dynamic, your child can crawl in a tabletop position or add leg lifts in bridge or downward facing dog positions. 

Play with small objects. Think Legos, beads, or even nuts and bolts. You can also add other textures or substances into the activity by hiding the objects in Play-Doh, sand, rice, dried beans, water, shaving cream, or water beads.

If you are concerned that fine motor skills are affecting your child’s academic or daily performance, it doesn’t hurt to request an Occupational Therapy Evaluation. This would determine what skill set is being affected and what to do. 

Case-Smith, Jane. (2005). Occupational Therapy for Children, 5th ed, pg. 305-308.
Cook, David, L. (2004). When Your Child Struggles.
Fine Motor Development 0-6 years“. Skill Builders Pediatric Occupational Therapy, http://www.Skillbuildersonline.com.
“Interventions for Handwriting and Fine Motor Problems”, Dr. Sonia Kay. Live lecture at Nova Southeastern University, 2008.

What are Fine Motor Skills?

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