fine motor development

role of OT

improve health and quality of life through facilitating participation and engagement in occupations, the meaningful/necessary/familiar activities of everyday life (ADLs); peds: assist w independence, strengthen fine motor skill dev, sensory skills, emotional reg, cognition, communication, visual motor skills, for participation and socialization

occupation of a child is the participate with

participation with family/peers, socialize, play

0-3mo: reaching what to what

hands to mouth

2-4mo: reaching to what

swipe, bat at toys

4-7mo: reaching with how many hands

reaching w one hand, then tries to get objects out of reach

6-9mo: reaching with how many hands

reach with both hands

0-3mo: grasp

grasps and shakes toys

4-7mo: grasp

raking grasp (all fingers but thumb)

8-10mo: grasp

thumb-opposed grasp

10-12mo: grasp

pincer grasp (index finger and thumb coordination)

10-14mo: grasp

spherical grasp

18-24mo: grasp

digital grasp of writing tools

3-4yo: grasp

modified tripod grasp

4-6yo: grasp

mature tripod grasp

fine motor skill development

becomes more precise over time, based on motivation, opportunity, practice

relationship between gross and fine motor skills

competence in gross motor skills aids in fine motor skill progression (and vice versa)

red flags indicating OT

1.hands in …….. position after 6mo
2. unable to prop ……. up when in ……. 0-8mo
3. not bringing ….. …….. to ………. by 10mo
4. not using …….. ……. grasp by 18mo
5. not able to use …………. by 30mo
6. using only ……….. hand to complete tasks
7. …………… during tasks that require ………..
8. uncoordinated/jerky movements
9. hand and arm ……………
10. frequently dropping objects
11. one hand "mirrors" the other's (unable to have asymmetrical movement)
12. unable to use hands together for activities like stringing beads, cutting paper

1. hands in fisted position after 6mo
2. unable to prop self up when in prone 0-8mo
3. not bringing both hands to midline by 10mo
4. not using mature pincer grasp by 18mo
5. not able to sue scissors by 30mo
6. using only one hand to complete tasks
7. drooling during tasks that require concentration
8. uncoordinated/jerky movements
9. hand and arm tremors
10. frequently dropping objects
11. one hand "mirrors" the other's (unable to have asymmetrical movement)
12. unable to use hands together for activities like stringing beads, cutting paper

red flags indicating OT at 12mo

1. not ………
2. not deliberately ………… objects
3. not able to hold ………. by themselves and keep it up without lying down

1. not clapping
2. not deliberately releasing objects
3. not able to hold bottle by themselves and keep it up without lying down

PT/OT collab

1. compare goals/expectations
2. communicate
3. PT suggest positioning/postural control during sessions to optimize use of UEs for object manip during OT
4. improving ability to perform daily activities through training and education
5. using fine motor skills for equipment safety (ex, fastening seatbelt and using brakes on wheelchair
6. ex. OT was working on behavioral feedback for child and recommended specific method to use in PT session too so feedback was consistent across all therapies