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Fine Motor Skills: In-Depth Guide with Therapy Exercises

Lily Baiser, MS OTR/L

Fine motor skills allow us to use our hands in a coordinated manner.  We rely on these skills to do key tasks in play, school and everyday life. Fine motor skills begin to develop in early infancy and continue to develop through preschool and early elementary school. Control and coordination of the small muscles of the hands contribute to several skills for your child, starting from grasping a toy for the first time to legible writing skills for school. [2], [3] If you are concerned that your child might have fine motor delays, early detection is key. An occupational therapist can help evaluate and determine if your child needs intervention. Let’s start by learning more about fine motor skills.

What are fine motor skills?

Fine motor skills are coordinated movements of the smaller muscles in your child's hands, thumbs, and fingers. These movements are considered essential in the physical development of children. These skills dictate the ways your child uses their hands for simple activities such as grasping things, grabbing them, tying laces, holding a pencil, playing with toys, and so on. [4] While these seem to be simple activities that a child does during the early years, they can impact academics, learning, and other skills that children typically develop during their schooling years. [6] Self-care activities such as buttoning shirts and tying shoelaces are also examples of fine motor skills. Fine motor skills are classified as fine motor coordination and fine motor integration. [7] Let's explore some activities that your child can do to develop fine motor skills [8]:

  • Grasping small objects

  • Holding a pencil

  • Copying letters

  • Copying shapes

  • Touching fingertips

  • Threading beads

When should I be concerned for my child's fine motor skills?

As parents, you constantly observe your child's activities. Hence parents, caregivers, pediatricians are the ones who notice the warning signs when your child fails to develop a particular fine motor skill during the expected milestone. The following are the typical developmental milestones for fine motor skills in your child from birth to five years [7]:

  • Newborn: Grasps with hand

  • Two months: Holds a rattle.

  • Four months: Brings hands together, extends arms, reaches hands out to grasp.

  • Six months: Shakes rattle, grasps between fingers.

  • Nine months: Develops pincer grasp, i.e., transfers things between thumb and other fingers, touches cheerios rings.

  • Twelve months: Releases cube in cup, holds the bottle.

  • Eighteen months: Feeds with own fingers, places shapes in relevant slots.

  • Two years: Uses spoon, help to dress, copies vertical line

  • Three years: Uses fork and spoon properly, undresses, wears socks, copies horizontal line

  • Four years: Cuts paper, dresses, copies cross

  • Five years: Washes and dries hands thoroughly, develops good pencil grasp, colors between the lines, dresses properly

Any problem while developing these skills can be a warning sign of fine motor skills development delays. Children with specific disorders such as cerebral palsy and muscle impairment may delay fine motor skill development. Children with neuropsychiatric problems like autism spectrum disorder and attention deficit disorder also show a developmental delay in fine motor control. 

Activity ideas to develop fine motor skills

Occupational therapists use an evidence-based approach to design activities and exercises to improve fine motor skills. They provide tools and materials to children with fine motor delays and provide therapy either to individual children or a group. [9] With an occupational therapist, these ideas could be fine motor fun! Speed and precision-oriented tasks help children develop the necessary dexterity. [10] Here are some fine motor activities to develop the skills [11]: 

Exercises for improving grip strength

  • Use a tweezer to pick up beads

  • Cut shapes and lines on paper with scissors

  • Put on and take off clothespins on the edge of a cardboard box

  • Make snowflakes from folded papers

  • Spray from a water bottle

  • Wipe with a sponge

  • Use a squeezy bottle to apply paint

  • Knead cookie dough and cut cookies

Exercises for improving dexterity

  • Screw and unscrew jar caps

  • Play with beads, string them, put them size-wise, make a necklace

  • Roll a pencil between thumb and fingers without dropping

  • Put on a button, zip a bag, or tie shoelaces

  • Play wind-up toys

  • Sort shapes

  • Take a handful of coins and place them into the piggy bank through a slit

  • Cut small pieces of paper and paste them on another paper to create a mosaic

Exercises for improving pinching ability

  • Pick up blocks or cotton balls with tongs and transfer them to a container

  • Crumple papers into small-sized balls and play

  • Play games that contain coins, cars, or pegs

  • Play pick-up sticks

  • Play with LEGO

Your occupational therapist can suggest the above activities and exercises, or variations of them, to improve your child's fine motor skills. Theme-based activities such as coloring, cutting, tracing will also help your child build fine motor skills. [12] Keep a lookout for what your child enjoys so your occupational therapist can cater to what they love.

How do fine motor skill developmental issues manifest in a child's daily life?

The coordination and control of activities that involve smaller muscles play an essential role in your child's developmental process. A delay in a child's fine motor development may affect the child's daily activities in many ways. [3], [13] For example: 

  • It affects your child's action, perception, and cognition, which means they may have difficulty with the movement of a small objects and their ability to control it.

  • They might lack the manual dexterity necessary to dress up and other social abilities to interact and play in teams.

  • They might face difficulties writing legibly or drawing.

How can you help your child?

Speak to a therapist. Follow their advice for activities and exercises catered to your child's developmental needs. As they go through therapy, you can help your child in many ways [12], such as:

  • Guiding them to use tools such as zippers, buttons, and clothespins

  • Encouraging them to repeat and improve hand-eye coordination activities

  • Create an enjoyable environment and make activities fun so that your child is more receptive and enjoy practicing independently

  • Speak and work out problems with your child to promote cognitive development


Fine motor development delays may affect your child's routine life activities. However, with the correct diagnosis of the problem and timely intervention by the occupational therapist, your child can develop the necessary fine motor skills. 

The fun exercises engage children in meaningful activities that help develop the skills that eventually enable your child to perform self-care activities and confidently participate in school activities independently. Your participation as a parent will significantly influence and benefit your child as they go through this journey with you together.

Kinspire can help

Looking for routine eye exercises for your child? Kinspire makes developmental therapy accessible, affordable and do-able for families just like yours.


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