Fine motor skills

The term 'fine motor' means 'small muscles'. Small muscles in the fingers, hand and arm are used when a child manipulates, controls and uses tools and materials. Hand-eye coordination is also an essential component of fine motor skills, as the child uses their vision to control the movements and actions of their small muscles.

Fine motor skills are essential for performing everyday tasks such as buttoning or zipping clothing, opening a lunch box, cleaning teeth, using cutlery, drawing, art and craft, writing, cutting and pasting.

Research has shown that due to the significant amount of time spent performing fine motor tasks, and the impact that difficulties in this area can have on a student, that development of fine motor skills are an essential component in a child's overall development. Studies have also shown that fine motor performance in kindergarten is a strong predictor of later math and reading achievement. Occupational Therapists can assist children who experience fine motor difficulties to flourish to their full potential and encourage engagement in the occupational tasks that are so important to being a student.

As in all areas of development, every child will develop at their own pace, however, there is a general pattern that fine motor skill development should follow. 'Typical' milestones at particular age ranges have different characteristics;

Younger babies

- By five months, can reach out for and hold objects for brief periods of time.

Older babies

- By six to nine months, can hold and shake objects.

- By nine months, can transfer object from one hand to the other.

- Use a thumb and forefinger pincer grip to pick up small object.

Toddlers

- From 16 months to three years, children refine their fine motor skills, begin to stack blocks, make marks with drawing tools using a 'fist' grip.

Pre-school age

- Begin to master tasks including buttoning, using scissors, begin to produce pre-writing patterns eg l - + O, and shapes. From approximately three years of age most children develop a hand preference.

School age

- Enhancing fine motor skills, colouring and scissor skills, development of letters and number formations, become fluid with writing. Tasks become less taxing to complete.

If a child is having difficulties with fine motor control they may;

- Have an awkward or immature pencil grasp for their age.

- Display messy, slow or laborious drawing, colouring or writing skills.

- Have difficulty using scissors

- Have difficulty mastering letter formation

- Have difficulty manipulating small items such as lego or puzzle pieces

- Have difficulty completing self care tasks involving use of cutlery, buttons, threading or tying shoelaces

- Become tired quickly when engaging in fine motor tasks.

- Avoid or refuse to participate in fine motor tasks.

Occupational therapy intervention for a child experiencing difficulties with fine motor control will assist the child;

- Improve their ability and persistence with fine motor tasks required for day-to-day activities at home and school including self-care tasks.

- Increase school readiness and academic performance in colouring, drawing, writing, cutting and pasting.

- Avoid disengagement in an academic environment due to difficulties completing tasks.

- Maintain and develop a positive sense of well-being.

When doing activities with children to develop their fine motor skills, Occupational Therapists know that if children succeed at an activity, they are more likely to enjoy it and continue to practice it or attempt a bigger challenge. However, if they fail, the opposite is true. This may mean starting with activities that the child can do and move on to more challenging activities gradually. For example, in relation to colouring or scissor work, start with very thick outlines, gradually reducing width to provide the 'just right' challenge.

When doing activities remember that short periods of motivated practice can often be more effective than extended practice, which can lead to fatigue, frustration and mistakes.

Activities to support and develop fine motor skills

- Use of cloth dressing books and toys that have a variety of fastenings.

- Dressing a large doll or cuddly toy.

- Any kind of threading game - sewing, making necklaces with string and pasta.

- 'Feely' bags containing a variety of interesting objects for child to manipulate and identify by touch

- Cooking - kneading dough, stirring cake mix, using a rolling pin, scooping.

- Playing 'Connect 4' or 'Pick up Sticks' which require manipulation of small objects.

- Using spray water bottle to water plants - same action as required for cutting with scissors.

- Using scissors to cut playdough, or other materials such as soft fabrics, felt, bubble wrap or wrapping paper) as a fun way to practice cutting skills.

- Using tongs or tweezers to move small items from one place to another ie. jelly beans or buttons into a jar.

- Using jars with screw lids as storage containers that need to be opened and closed when playing and packing away.

- Finger isolation games such as finger puppets, finger soccer using a ping pong ball or scrunched up paper as a ball, finger painting, sticky fingers which requires placing tape around each fingertip with sticky side out, then ask child to pick up light items off table with specific fingers.

- Playing with playdough and utensils - rolling, squishing, squeezing, poking, pinching and pressing.

References:

Cameron, C. E., Brock, L. L ., Murrah, W. M., Bell, L. H., Worzalla, S. L., Grissmer, D., & Morrison, F.J. (2012). Fine motor skills and executive function both contribute to kindergarten achievement. Child Development, 83(4), 1229-1244. doi:10.1111/j.1467-8624.2012.01768.x

Dobson, F., Smith, M., Taylor, A. (1997). Activities for little fingers: Helping young children to develop fine motor skills: An occupational therapy guide for teachers. Sutherland Hospital and Community Health Service.

Grissmer, D., Grimm, K. J., Aiyer, S. M., Murrah, W.M., & Steele, J.S. (2010). Fine motor skills and early comprehension of the world: Two new school readiness indicators. Developmental Psychology, 46(5), 1008-1017. doi:10.1037/a0020104

Jackman, M., & Stagnitti, K. (2007). Fine motor difficulties: The need for advocating for the role of occupational therapy in schools. Australian Occupational Therapy Journal 54(3), 168-173. doi:10.1111/j/1440-1630.2006.00628.x

National Childcare Accreditation Council (NCAC) (2008). Supporting children's development: Fine motor skills. Putting children first, 28. 3-5. Retrieved from http://ncac.acecqa.gov.au/educator-resources/pcf

articles/Supporting_children's_development_gross%20motor_Jun09.pdf

Ohl, A.M., Graze, H., Weber, K., Kenny, S., Salvatore, C., & Wagreich, S. (2013). Effectiveness of a 10-week Tier-1 Response to Intervention program in improving fine motor and visual-motor skills in general education kindergarten students. American Journal of Occupational Therapy, 67(5), 507-514. doi:10.5014/ajot.2013.008110