Parent Education

Fine Motor Skills Milestones & Activities

Buttoning, zipping, gripping, eating, cutting, writing, tying—pretty much all things accomplished with the fingers, hands, and arms—are perfect examples of our fine motor skills in action.

Involving the use and coordination of these small muscles, fine motor skills are important for many life skills as well as the self-help skills children need to complete daily tasks.

Not surprisingly, these skills also support the development of literacy and numeracy for children underscoring participation in a variety of activities such as games, arts and crafts, musical instruments, and, eventually, educational exercises on digital devices.

Fine Motor Milestones for Toddlers and School-Age Children

As with all areas of child development, there are certain fine motor milestones to watch for at all age ranges.

Toddlers—16 months to 3 years:
  • Stacks blocks and toys
  • Draws with crayons or markers using a firm fist grip
  • Uses spoon and fork to feed himself
Preschoolers—3 to 5 years:
  • Manipulates buttons and fasteners on clothes
  • Traces, draws and writes shapes and letters
  • Uses scissors
  • Establishes hand dominance
School Age—5 to 7 years of age:
  • Dresses self
  • Ties shoes
  • Prints letters, numbers and words
  • Cuts on the lines
  • Colors inside the lines


Fine Motor Skill Activities for Kids

There are a variety of simple at-home activities you can introduce and implement to help your child build hand strength and hone his fine motor skills as he grows. Some activities you can do incorporate into playtime on a daily basis include:

Pompom Play

Set up an activity with small, soft pompoms from a craft store and a muffin tin. Ask your child to place the pompoms in the muffin tin. Older children can also sort them by color or make color patterns.

Get to Gluing

Put dots of glue on a piece of paper and ask your child to stick small objects such as beans, buttons, or beads on the glue dots. Watch your child closely during this activity to ensure the small objects are put on the paper and not into the mouth.

Tweezer Time

Place a variety of small items in a bowl, muffin tin or ice cube trade and ask your child to pick them out with tweezers.

Bring on the Beads

Using colorful pipe cleaners and assorted beads, encourage your child to make a bracelet or necklace. Ask your child to string the beads by size or by color. Do keep a watchful eye on your child during this creative project to make sure the beads are not placed in the mouth.   

Pull Out Playdough

Playing with playdough offers a great opportunity for children to strengthen their fine motor muscles. Ask your child to squeeze and stretch playdough into various shapes. Hide small objects in the playdough for your child to find and pick out.

Finger Painting

Finger paintings are much more than a messy masterpiece! The process of finger painting helps a child with dexterity as well as hand-eye coordination to support fine motor skills.

Broken Crayon Coloring

Brand new crayons are great, but using small, broken crayons will encourage your child to firm up his grip and hold the crayon correctly.


Fine Motor Control Concerns

If you are concerned your child may not be meeting certain age-appropriate fine motor milestones, you should consult your pediatrician. A referral to a licensed occupational therapist may be recommended to assess your child’s fine motor abilities further and determine if he could benefit from therapy to increase his skills.

  Filed under: Occupational Therapy, Parent Education, Parenting Tips, Therapy Ideas

What is Autism Spectrum Disorder?

National Autism Awareness Month is underway, and it’s time to “Light It Up Blue” to increase understanding and acceptance for individuals with autism spectrum disorder (ASD) and provide support to their families.

A neurological and development disorder caused by genetic and environmental factors, autism is characterized by a variety of issues including social and relational challenges, speech and non-verbal communication deficiencies, and repetitive behaviors. Estimating that 1 in 68 children in the U.S. has autism, the Centers for Disease Control and Prevention affirms that:

There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

As with most disorders, early diagnosis and intervention are key to helping improve a child’s prognosis. Though it is becoming more common to diagnose autism spectrum disorders earlier and earlier, the most obvious signs and symptoms of autism emerge between 18 months and three years of age.

Signs of Autism

The symptoms and effects of autism may vary widely from child to child. While some children may have only a few, mild symptoms, other children may be faced with more severe challenges. Either way, autism is a lifelong condition which affects people of every race, gender, and background.

While there are many warning signs to watch for as your child develops, the most common autism red flags include: impaired social skills, communication struggles, and behavioral difficulties.

Autism: Social Difficulties

A child struggling with autism spectrum disorder social and relational difficulties may demonstrate the following:

  • Appears to be distant, in his or her own world
  • Does not frequently respond to his or her name when called
  • Lack of warm, joyful facial expressions such as smiles
  • Difficulty playing with others or making friends
  • Aversion to being cuddled or touched
  • Trouble engaging in pretend play or using toys in abstract ways
Autism: Communication Difficulties

A child struggling with autism spectrum disorder verbal and non-verbal communications difficulties may demonstrate the following:

  • Avoids eye contact
  • Difficulty communicating simple needs and wants
  • Offers no spoken words by 16 months
  • Echolalia or “parroting” questions and words offered to him or her without comprehension of the communication offered
  • Trouble understanding routine directions or simple questions
  • Uses few gestures such as pointing, waving or reaching
  • Does not understand facial expressions
  • Appears sensitive to sounds, smells, and textures
Autism: Behavioral Difficulties

A child struggling with autism spectrum disorder behavioral difficulties may demonstrate the following:

  • Self-stimulatory behaviors such as rocking, hand-flapping, moving fingers in front of his or her eyes, spinning, or head banging
  • Appears to be inflexible with routine
  • Difficulties adapting to changes in routine or environment
  • Arranges objects or toys in certain ways such as color, shape, or size
  • Seems fixated on certain toys or strange objects including light switches, rubber bands or keys

The Modified Checklist for Autism in Toddlers—Revised with Follow-Up (M-CHAT-R/F™)

The American Academy of Pediatrics recommends that all children receive autism screening between 18 and 24 months of age by using The Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F).

The M-CHAT-R/F is a checklist tool that pediatricians use to identify children who may need a more thorough assessment of possible early signs of autism or developmental delays. If the results of initial screening indicate the need for further evaluation, parents will be directed to contact the local Children’s Developmental Services Agency to begin the process of evaluation and therapy as warranted.

Does My Child Have Autism?

If you are concerned that your child may be exhibiting signs of autism, contact your pediatrician to schedule an appointment to voice your concerns.

Your pediatrician will speak with you about observations and conduct an assessment of your child as well to determine next steps.


Autism Speaks | The World of Autism PSA

  Filed under: Advocacy, Autism, Parent Education, Raleigh Therapy Services

Thumb-Sucking Solutions

Are you battling your little one’s thumb-sucking habit?

Children are born with natural rooting and sucking reflexes that often cause them to put their fingers and hands in their mouths. Very often this action makes them feel safe and secure and becomes a habit that helps to soothe and calm.

When should my child give up thumb-sucking?

Many children will give up their thumb- or finger-sucking habit by the age of 5 without impeding dentition and speech sound development.

However, if thumb-sucking persists past kindergarten and becomes a more long-term practice, it can affect the development of the child’s teeth and jawbones and may alter normal speech sound development.

What issues can long-term thumb-sucking cause?

One of the most common speech-sound development issues that prolonged thumb-sucking may cause is a tongue thrust or reverse swallow. This occurs when the tongue lies too far forward at rest or protrudes between the top and bottom teeth during speech and swallowing. The speech sounds most often distorted by a tongue thrust include forms of d, l, n, s, t, and z. For example, a child may say “thumb” instead of “some.”

A child who persists with thumb-sucking for longer periods may also experience increased illness from placing dirty fingers in his mouth, social insecurities arising from peer pressure and teasing about the habit, or an eventual need for orthodontics.

If you are concerned that your child’s habit may be causing some of these issues, please consult with a pediatric dentist who can further assess his tooth eruption and the alignment of his jaw and teeth. A speech-language pathologist can also help evaluate your child’s speech development and tongue movement.

What can I do to help my child stop?

Curbing a long-term thumb-sucking habit can be challenging, especially if the child isn’t ready to give it up yet. Here are some ideas to consider.

Talk about it

Talk with your son about his thumb-sucking habit and his own desire to stop. Empower him to be a part of the plan to quit the behavior. The best results often happen when a child is motivated to quit on his own accord.

Ignore the habit

For some children, negative attention is better than no attention at all. If you are continuously drawing attention to your son’s thumb sucking, you may be reinforcing the behavior. Simply look the other way.

Skip punishments

Your child is most likely sucking his thumb to calm down, and punishing that self-soothing behavior can be ineffective. Avoid placing a plastic thumb guard or glove on his hand and stay away from putting awful tasting mixtures on the thumbnail. These types of products are generally ineffective and may cause your child frustration and anger.

Switch and swap

Have you figured out when, where and why your child sucks his thumb? Does he do it when he is tired, hungry or upset? Does he do it more often in his bed or on the couch while watching TV? Once you’ve determined the source, try and offer age-appropriate alternatives to the behavior like offering him a stuffed animal toy or gum.


  Filed under: Parent Education, Parenting Tips, Speech and Language Development