Fine Motor Skills

What are fine motor skills?

Fine motor skills are the small, precise movements we make with our hands, fingers, feet and toes. They involve the complex coordination of your muscles, joints and nerves.

We mainly think of hand, wrist and finger movements when it comes to fine motor skills, like picking up an object by pinching it with your pointer finger and thumb. But you can also make fine movements with your foot, ankle and toes. These motions are necessary for sports, like dancing and soccer, or for people who use their feet for tasks instead of their hands.

Fine motor control is a complex process that requires:

• Awareness and planning.
• Coordination.
• Muscle strength.
• Normal sensation in your hands and fingers (or feet and toes).
• Precision (dexterity).

Issues with fine motor skills can develop at any age. But healthcare providers put a lot of focus on fine motor skills in child development. Child development refers to how your child grows and changes over time. Experts divide child growth and development into four areas:

• Physical development. Fine motor skills fall under this category.
• Cognitive development.
• Language development.
• Social-emotional development.

Providers carefully assess fine motor skills because significant delays in these milestones can be a sign of a variety of neurological and physical conditions. And the sooner your child’s provider can catch it, the sooner your child can get the help they need.

What are examples of fine motor skills?

Examples of fine motor skills include:

• Holding a pencil and writing or drawing with it.
• Using scissors.
• Folding clothes.
• Typing on a keyboard.
• Fastening a button.
• Zipping a zipper
• Tying your shoes.
• Twisting a doorknob.
• Eating with utensils, like a fork and spoon.
• Playing video games using a controller.
• Playing an instrument, like a guitar, flute or piano.

Why are fine motor skills important?

Life would be quite different if humans hadn’t developed fine motor skills.

Countless everyday tasks require tiny, precise movements — from holding a toothbrush to cooking and eating to putting on clothes. Even texting and giving your dog a belly rub require these skills. All of these tasks are important for independence and self-care. They also allow us to enjoy certain hobbies, like playing instruments and video games and crafting.

For a child, fine motor skills are important for doing schoolwork, like drawing and writing. Several work-related tasks involve fine motor skills, too — like using construction tools or a computer or performing surgery.

What are fine motor skill milestones?

Developmental milestones are the behaviors that mark stages of typical growth. Children all develop at their own pace. However, most children pass through specific changes at roughly the same time as they get older.

Examples of fine motor skill milestones for infants and children include (but aren’t limited to):

Fine motor skills continue to develop and strengthen after these ages. It’s important to remember that each child develops at their own pace. If you’re concerned about your child’s fine motor milestones, talk to their healthcare provider.

How do you develop fine motor skills?

Fine motor skills start developing as soon as you’re born. For example, babies are typically born with an involuntary (not by choice) grasp reflex. If you graze your finger along their palm, they’ll usually close up their hand and cling to your finger. This is the earliest type of fine motor movement.

These tiny movements keep improving as a child gets older — and into adulthood. Over time, your child’s muscles get stronger, and they develop more coordination to perform more precise movements.

Even adults can refine their fine motor skills. For example, rock climbers may work on improving their grip strength to better cling to rock crevices. And surgeons may do exercises to practice making accurate, steady and precise movements with their hands.

There are also ways to help your child practice fine motor skills.

Fine motor skill activities for children

Here are some activities you can do to help your infant or child develop fine motor skills:

What conditions can affect fine motor skills?

Issues with any of the following body areas can affect fine motor skills:

• Brain.
• Spinal cord.
• Peripheral nerves (the nerves outside of your brain and spinal cord).
• Muscles.
• Joints in your hands and feet.
• Bones in your hands and feet.

Because of this, hundreds of conditions can interfere with fine motor skills. The interference can range from mild to severe. For example, it may take more focus and time than usual to fasten a button, or you may not be able to complete the task at all.

Some of these conditions are treatable or manageable. Others may cause permanent issues with fine motor skills.

Conditions that can affect fine motor skills in children include (but aren’t limited to):

• Autism spectrum disorder.
• Cerebral palsy.
• Developmental delay.
• Down syndrome.
• Dysgraphia (difficulty with writing).
• Developmental coordination disorder.
• Hydrocephalus.
• Sensory processing disorder (a condition that affects how your brain processes sensory information, like things you touch, see, hear, smell or taste).
• Spina bifida.

Conditions that can affect fine motor skills in children and adults include (but aren’t limited to):

• Genetic conditions.
• Brain tumor.
• Muscular dystrophy.
• Juvenile rheumatoid arthritis.
• Muscle, nerve, joint and bone injuries, like a brachial plexus injury.
• Stroke (before, during or after birth).
• Traumatic brain injury.

Conditions that can affect fine motor skills in adults include (but aren’t limited to):

• Rheumatoid arthritis in finger, wrist, ankle or toe joints.
• Carpal tunnel syndrome.
• Multiple sclerosis (MS).
• Dementia.
• Huntington’s disease.
• Parkinson’s disease.
• Peripheral neuropathy that affects your hands and/or feet.

Adapting to fine motor skill difficulties

It may be challenging at first to learn you or your child has fine motor skill difficulties. The good news is that there are countless ways to adapt or modify everyday tasks and activities to make them more accessible.

An occupational therapist can help you. An occupational therapist is a healthcare provider who helps people of all ages improve their ability to perform daily tasks. They’ll help you learn how to use different tools or techniques to participate in your activities safely. The therapist may help you learn exercises and ways to manipulate objects. For children, this can include playing with toys and using school manipulatives. Occupational therapy helps people live as self-sufficiently as possible. They’ll provide ideas, exercises and tools to use at home.

Examples of adaptations include:

• Stabilizing: This refers to making toys or objects more stable while someone interacts with them. To prevent toys or objects from tipping over too easily, you can use Velcro®, suction cups, clamps or magnets to keep them in place while your child uses them.
• Extending or enlarging: This refers to adding something to a toy or object so that it’s easier to manipulate or grasp it. For example, you may add a large pencil grip to a pencil to make it easier to hold. Or you could add knobs to puzzle pieces to make them easier to manipulate.
• Simplifying: This refers to reducing the steps necessary to complete a task. For example, your child could wear Velcro-fastening shoes instead of shoes with laces to put on shoes more easily. Stretchy clothing may be easier to put on and take off than clothing that has zippers or buttons. Using a straw to drink may be easier than grasping and lifting a cup to your mouth.

There are also several types of adaptive equipment. For example, a button hook allows you to fasten buttons without using your fingers (you grasp the base of the hook). There are also eating utensils of various types that are specially designed to allow you to eat independently.

When should I call my provider about fine motor skill issues?

If you’re worried your child isn’t reaching fine motor skill milestones, talk to their pediatrician. They’ll ask questions about your concerns and can perform tests. You can also reach out to your child’s school for an evaluation.

If you or your child has a regression (worsening) in fine motor skills, talk to your healthcare provider as soon as possible, especially if the regression is sudden. This could be a sign of a serious underlying condition.

A note from Cleveland Clinic

Fine motor skills develop throughout your life from birth to adulthood. While simply exploring their environment can help infants and children develop these skills, there are activities you can do to help support their development. If you’re concerned about your child’s fine motor skills, talk to their healthcare provider. Several conditions can interfere with these tiny movements.