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Fine Motor Milestones
by Tara Calder, OTR/L
Fine motor skills generally refer to the purposeful and controlled movements of the small muscles of the fingers and hands. These movements usually coordinate with the larger muscles of the arms and trunk for stability and with the eyes for eye-hand coordination. Children develop fine motor skills in a step-by-step progression. Development occurs at an uneven pace, with periods of little progression. Typically, this is part of normal development; however, if you think your child may have a delay in his/her fine motor skills, contact your physician for more information regarding occupational therapy services.
Birth to 3 Months
  • Arm movement is mostly random (non-goal directed) and asymmetrical
  • Hands are fisted
  • Grasping reflex when placing a finger or object in hand
  • Brings hands to mouth
  • Watches the movements of his/her hands
3 Months to 6 Months
  • Movements are mainly purposeful and more symmetrical
  • Reaches for toys with both hands
  • Hands are primarily open with thumbs out
  • Holds toys with palm and fingers but not thumb
  • Brings hands to midline
  • No longer stares at his/her hands
  • Looks at objects a few feet away
6 Months to 9 Months
  • Transfers objects hand to hand
  • Straightens elbows when reaching
  • Rakes pellet-sized items with fingers
  • Holds items with fingers and thumb
  • Claps hands
9 Months to 12 Months
  • Points with index finger
  • Uses a neat, tip to tip pincer grasp on small pellet-sized items
  • Places items into an open container or into adult's hand
12 Months to 18 Months
  • Stacks two to three small blocks
  • Holds crayon in closed fist (power grasp)
  • Scribbles with a crayon using whole arm movements
  • Turns pages in a cardboard book (more than one at a time)
  • Holds object with one hand and manipulates it with the other
  • Places small items in a closed-neck bottle
  • Places one to two shapes in a three-shape geometric puzzle
  • Places large pegs in a pegboard
18 Months to 24 Months
  • Stacks three to five blocks
  • Snips paper with scissors
  • Strings two to three beads
  • Imitates vertical and circular scribbles
  • Turns pages of a book one at a time
  • Places three shapes in a three shape geometric puzzle
2 Years to 3 Years
  • Imitates simple horizontal and vertical block designs
  • Imitates a circle and vertical and horizontal lines
  • Unscrews screw-top lid
  • Begins manipulating small items within the hand
  • Cuts paper into two pieces
  • Holds crayon with fingers, not fist (pronated grasp)
  • May use one hand consistently in most activities
3 Years to 4 Years
  • Stacks five to seven small blocks
  • Imitates circle and cross
  • Manipulates clay and dough (pinches, rolls balls, snakes)
4 Years to 5 Years
  • Copies a square and cross
  • Cuts on a straight line
  • Begins to use thumb and index finger to hold pencil/crayon (tripod grasp)
  • Touches each finger to thumb
  • Buttons and unbuttons one button
  • Stacks 10 plus small blocks
5 Years to 6 Years
  • Colors inside the lines
  • Cuts out simple shapes
  • Copies triangle
  • Writes first name
  • Handedness well established
  • Mature, adult grasp of pencil well established (dynamic tripod)
By 7 to 8 years of age, children generally are proficient with most fine motor skills. As with many skills, practice improves performance; therefore, refinement of already acquired fine motor skills can continue into adulthood.
Resources
Beery, K. E., & Beery, N.A. (2006). The Beery-Buktenica Developmental Test of Visual Motor Integration. Minneapolis: NSC Pearson
Folio, M. R., & Fewell, R.R. (2000). Peabody Developmental Motor Scales, 2nd Edition. Austin: Pro-Ed
Retherford, K. S. (1996). Normal Development: A Database of Communication and Related Behaviors. Greenville, SC: Super Duper Publications
American Occupational Therapy Association, Inc. www.aota.org
 
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