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By Rynette R. Kjesbo, M.S., CCC-SLP
April is “National Occupational Therapy Month,” a month dedicated to raising awareness about the benefits of
occupational therapy and the professionals who provide it. So what is occupational therapy and what do occupational
therapists do? OTs provide a wide variety of services. OTs work with individuals of all ages with the goal of
facilitating meaningful engagement in everyday life. Though in reality OTs address many different types of skills,
many people consider OTs to be “fine motor experts.” They might help children with their fine motor skills so that
they can participate in school and social activities with their peers, help people who are recovering from injuries
to regain motor skills they have lost, or provide support for older adults who have undergone physical and mental changes.
What Are Fine Motor Skills?
Fine motor skills are any skills that require the use of the small (or “fine”) muscles that control the movements
of our eyes, mouth, feet, and – most notably – our fingers and hands. They make it possible for us to hold a pencil,
cut with a pair of scissors, pick up small objects, button clothing, and put puzzles together. Having age-appropriate
fine motor skills is critical to every area of a child’s life!
How Do I Know If My Child Is Struggling With Fine Motor Skills?
Like speech and language skills, children develop fine motor skills in a typical sequence or progression. Some
fine motor skill milestones expected at certain ages include:
18 Months to 2 Years of Age
- Stacks 3-5 blocks
- Snips paper with scissors
- Strings 2-3 large beads
- Copies circular scribbles
- Turns pages in a book one at a time
- Completes a 3-piece geometric puzzle
2 to 3 Years of Age
- Cuts paper into two pieces
- Unscrews screw-top lid
- Copies horizontal and vertical lines
- May uses one hand consistently in most activities
- Rolls, pulls, and squeezes clay
3 to 4 Years of Age
- Stacks 5-7 small blocks
- Strings ½” beads
- Copies a circle
- Completes a 5-6 piece puzzle
- Begins to hold a crayon with three fingers (tripod grasp)
- Colors or draws by moving whole arm
4 to 5 Years of Age
- Stacks 10 or more small blocks
- Cuts on a straight line
- Strings ¼” beads
- Copies a square and cross
- Buttons one button
- Can draw diagonal lines more consistently
- Begins copying basic letter shapes
5 to 6 Years of Age
- Stacks 12 or more small blocks
- Cuts out simple shapes
- Sews lacing cards
- Copies a triangle
- Colors within lines
- Writes first name
- Uses a dynamic tripod grasp; arm remains stationary while fingers move
If you think your child may have difficulties with fine motor skills, do not hesitate to ask your child’s
physician for more information regarding occupational therapy services. If your child is in school, you can
discuss your concerns with his/her teacher. Finally, you can visit the American Occupational Therapy
Association’s website ( www.aota.org ) for more information about occupational
therapy and a list of occupational therapists in your area. For additional information related to fine motor
skills and occupational therapy, see Handy Handouts #121 “Help Your Preschool Child Develop Fine Motor
Skills,” #145 “Fine Motor Milestones,” and #165 “What Is An Occupational Therapist?”
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