Therapy Ideas

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

Mastering After School Meltdowns

School is back in session. New kindergarteners are learning what it means to be a student. First-graders are getting reacquainted with their desks and new classroom routines. The big kid third-, fourth- and fifth-graders are catching up with friends, navigating the schoolyard and digging into their studies and homework. And nearly all of them are coming home and melting down, right?

I hear from many parents of elementary-age children who share similar stories about the challenges they face after school dismal. The struggle is real.

“My son is a kindergartener, and while he’s excited to go to school each day, he’s coming home exhausted and emotional,” said Allison Crumpler, speech-language pathologist and director of clinical compliance for Raleigh Therapy Services. “I know he is trying hard to sit still and pay attention during class and that takes a lot out of a new student. It’s no wonder he comes home ready to fall apart.”

It is common for children, especially for younger students, to come home mentally and physically exhausted from school. Consider your student’s day—new learnings, exciting experiences, and fast-paced transitions. Not to mention, your student may eat lunch early in the day and come home with a hungry tummy. No wonder your little one is tired and emotional and nearing the brink of a meltdown every afternoon.

Hopefully, your student will soon acclimate to the school setting and build stamina to take on school-day demands, and you’ll see her behavior improve. In the meanwhile, here are some strategies to consider as you address her challenging behaviors.

Keep quiet

Sure you want to know all about your daughter’s day and what she did in class, but better to wait a bit before you start your questions. Greet her with a simple hug and positive “hello” and then permit her time to decompress. Give her the time and space to zone out and settle in your home setting and then ask her about class.

Attack with a snack

Does your child arrive home from school starving dangerously close to entering the “hangry” zone? Face that hunger head on with a healthy snack to boost her energy and mood.

Limit screen time

It’s not a bad idea to let your daughter watch her favorite TV show to calm down upon arriving home. However, you should try to limit after-school screen time to a maximum of 20 or 30 minutes.

Avoid overscheduling

Do your best to avoid overscheduling your daughter’s afternoons. She will come home tired from a full day at school and will need free time to wind down and relax.

Make time to play

Try to find time to play with your child—coloring, crafting, tossing a ball, anything she finds fun. Your one-on-one attention will help her reconnect with you and feel less overwhelmed from her school day.

Hunker down with homework

Set up a designated space and specific time for your daughter to do her homework. She will find comfort knowing her homework routine, which will help to lessen her stress for this daily task. 

Stick with bedtime

One, if not the most important, ways for you to help your daughter navigate her new school schedule is to keep her bedtime consistent. Most 5-year-olds need 10 or more hours of sleep each night to feel well rested the next day. A well-rested child will have a leg up on a new day.


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  Filed under: Parent Education, Parenting Tips, Therapy Ideas

Eating Smart and Moving More

~Submitted by Whitney Woodhull-Smith, DPT-Raleigh Therapy Services Physical Therapist

Eat Smart, Move More!

Childhood obesity is a growing epidemic in North Carolina and the United States. Physical activity is one of the key lifestyle factors that can help you and your children achieve and maintain a healthy weight. 

Please visit for more information. 

A take home message to apply to your every day life from this great site: “5-3-2-1-Almost None”

  • 5 or more servings of fruits and vegetables daily
  • 3 structured meals daily – eat breakfast, less fast food, and more meals prepared at home
  • 2 hours or less of TV or video games daily
  • 1 hour or more of moderate to vigorous physical activity daily
  • Limit sugar-sweetened drinks to “almost none”

  Filed under: Awareness, Physical Therapy, RTS Team, Therapy Ideas