Fine motor skills generally refer to the small movements of the hands,
wrists, fingers, feet, toes, lips, and tongue.
Motor skills are actions that involve the movement of muscles in the body.
They are divided into two groups:
gross motor skills
, which include the larger movements of arms, legs, feet, or the entire
, running, and jumping); and fine motor skills, which are smaller actions,
such as grasping an object between the thumb and a finger or using the
lips and tongue to taste objects. Both types of motor skills usually
develop together, because many activities depend on the coordination of
gross and fine motor skills.
The hands of newborn infants are closed most of the time and, like the
rest of their bodies, they have little control over them. If their palms
are touched, they will make a very tight fist, but this is an unconscious
reflex action called the Darwinian reflex, and it disappears within two to
three months. Similarly, infants will grasp at an object placed in their
hands, but without any awareness that they are doing so. At some point
their hand muscles relax, and they drop the object, equally unaware that
they have let it fall. Babies may begin flailing at
objects that interest them by two weeks of age but cannot grasp them. By
eight weeks, they begin to discover and
with their hands, at first solely by touch, and then, at about three
months, by sight as well. At this age, however, the deliberate grasp
remains largely undeveloped.
begins to develop between the ages of two and four months, inaugurating a
period of trial-and-error practice at sighting objects and grabbing at
them. At four or five months, most infants can grasp an object that is
within reach, looking only at the object and not at their hands. Referred
to as "top-level reaching," this achievement is considered
an important milestone in fine motor development. At the age of six
months, infants can typically hold on to a small block briefly, and many
have started banging objects. Although their grasp is still clumsy, they
have acquired a fascination with grabbing small objects and trying to put
them in their mouths. At first, babies will indiscriminately try to grasp
things that cannot be grasped, such as pictures in a book, as well as
those that can, such as a rattle or ball. During the latter half of the
first year, they begin exploring and testing objects before grabbing,
touching them with an entire hand and, eventually, poking them with an
One of the most significant fine motor accomplishments is the pincer grip,
which typically appears at about 12 months. Initially, infants can only
hold an object, such as a rattle, in their palm, wrapping their fingers
(including the thumb) around it from one side. This awkward position is
called the palmar grasp, which makes it difficult to hold on to and
manipulate the object. By the age of eight to 10 months, a finger grasp
begins, but objects can only be gripped with all four fingers pushing
against the thumb, which still makes it awkward to grab small objects. The
development of the pincer grip—the ability to hold objects between
the thumb and index finger—gives the infant a more sophisticated
ability to grasp and manipulate objects and also to deliberately drop
them. By about the age of one, an infant can drop an object into a
receptacle, compare objects held in both hands, stack objects, and nest
them within each other.
Toddlers develop the ability to manipulate objects with increasing
sophistication, including using their fingers to twist dials, pull
strings, push levers, turn book pages, and use crayons to produce crude
scribbles. Dominance of either the right or left hand usually emerges
during this period as well. Toddlers also add a new dimension to touching
and manipulating objects by simultaneously being able to name them.
Instead of only random scribbles, their
include patterns, such as circles. Their play with blocks is more
elaborate and purposeful than that of infants, and they can stack as many
as six blocks. They are also able to fold a sheet of paper in half (with
supervision), string large beads, manipulate snap
, play with clay, unwrap small objects, and pound pegs.
The more delicate tasks facing
children, such as handling silverware or tying shoelaces, represent more
challenge than most of the gross motor activities learned during this
period of development. The central nervous system is still in the process
of maturing sufficiently for complex messages from the brain to get to the
child's fingers. In addition, small muscles tire more easily than
large ones, and the short, stubby fingers of preschoolers make delicate or
complicated tasks more difficult. Finally, gross motor skills call for
energy, which is boundless in preschoolers, while fine motor skills
require patience, which is in shorter supply. Thus, there is considerable
variation in fine motor development among this age group.
—A test that identifies problems with visual perception, fine
motor skills (especially hand control), and hand-eye coordination.
—An unconscious action in infants in which if a palm is touched,
the infant makes a very tight fist. This instinct disappears within two
to three months.
Developmental coordination disorder
—A disorder of motor skills.
Gross motor skills
—The abilities required to control the large muscles of the body
for walking, running, sitting, crawling, and other activities. The
muscles required to perform gross motor skills are generally found in
the arms, legs, back, abdomen, and torso.
—The ability to grasp or touch an object while looking at it.
Lincoln-Oseretsky Motor Development Scale
—A test that assesses the development of motor skills.
—A young infant's primitive ability to hold an object in
the palm by wrapping fingers and thumb around it from one side.
—The ability to hold objects between thumb and index finger,
which typically develops in infants between 12 and 15 months of age.
—The ability of an infant to grasp an object that is within
reach, looking only at the object and not at the hands. Typically
develops between four and five months of age.
Fine motor skills can become impaired in a variety of ways, including
, and congenital deformities. An infant or child up to age five who is not
developing new fine motor skills for that age may have a developmental
disability. These problems can include major health conditions including
, blindness, deafness, and diabetes. Children with delays in fine motor
skills development have difficulty controlling their coordinated body
movements, especially with the face, hands, and fingers. Signs of fine
motor skills delays include a failure to develop midline
Fine motor skills
(Table by GGS Information Services.)
A toddler demonstrates his fine motor skills by grasping and
munipulating building blocks.
(© S. Villeger/Explorer/Photo Researchers, Inc.)
orientation by four months, reaching by five months, transferring objects
from hand to hand by six months, a raking grasp by eight months, a mature
pincer grip by one year, and index finger isolation by one year.
Developmental coordination disorder is a disorder of motor skills. A
person with this disorder has a hard time with things like riding a bike,
holding a pencil, and throwing a ball. People with this disorder are often
called clumsy. Their movements are slow and awkward. People with
developmental coordination disorder may also have a hard time completing
tasks that involve movement of muscle groups in sequence. For example,
such a person might be unable to do the following in order: open a closet
door, get out a jacket, and put it on. It is thought that up to 6 percent
of children may have developmental coordination disorder, according to the
2002 issue of the annual journal
Clinical Reference Systems
. The symptoms usually go unnoticed until the early years of elementary
school. It is usually diagnosed in children who are between five and 11
Parents, teachers, and primary caregivers need to have a clear
understanding of how young children develop fine motor skills and the
timetable for development of the skills.
The Lincoln-Oseretsky Motor Development Scale is an individually
administered test that assesses the development of motor skills in
children and adults. Areas covered include fine and gross motor skills,
finger dexterity and speed, and hand-eye coordination. The test consists
of 36 tasks arranged in order of increasing difficulty. These include
walking backwards, standing on one foot, touching one's nose,
jumping over a rope, throwing and catching a ball, putting coins in a box,
jumping and clapping, balancing on tiptoe while opening and closing
one's hands, and balancing a rod vertically. Norms have been
established for each part of the test for children aged six to 14.
, also known as VMI or Developmental Test of Visual-Motor Integration, is
designed for individuals two years of age through adult. The text
identifies problems with visual perception, fine motor skills (especially
hand control), and hand-eye coordination. It is usually administered
individually but can also be given in groups. The child is given a booklet
containing increasingly complex geometric figures and asked to copy them
without any erasures and without rotating the booklet in any direction.
The test is given in two versions: the Short Test Form, containing 15
figures, is used for ages three through eight; the Long Test Form, with 24
figures, is used for older children, adolescents, and adults with
. A raw score based on the number of correct copies is converted based on
norms for each age group, and results are reported as converted scores and
percentiles. The test is not timed but usually takes 10 to 15 minutes to
Some symptoms of impaired fine motor skills may appear up to age two.
These symptoms include having a difficult time sitting up or raising the
head, being unable to stand without help or having a very hard time
standing without help, being unable to crawl or having a very hard time
crawling, and walking very late or having a hard
time walking. Other symptoms usually appear during the preschool or grade
school years. These may include the child having difficulty holding a
pencil or drawing, throwing a ball, riding a bicycle, playing sports,
having a hard time with clothes that have buttons or zippers, having poor
handwriting, and being clumsy.
Children with any one or combination of these symptoms should be seen by a
pediatrician who specializes in motor skills development delays. Children
who lose previously acquired motor skills should also be seen by a doctor.
There are many ways to address fine motor skills impairment, such as
physical therapy. This type of therapy can include treating the underlying
cause, strengthening muscles, and learning how to compensate for impaired
Gross motor skills
Motor Skills Acquisition Checklist.
San Antonio, TX: Therapy Skill Builders, 2003.
Kurtz, Lisa A.
How to Help a Clumsy Child: Strategies for Young Children with
Developmental Motor Concerns.
London, UK: Jessica Kingsley Publishing, 2003.
Liddle, Tara Losquadro, and Laura Yorke.
Why Motor Skills Matter: Improving Your Child's Physical
Development to Enhance Learning and Self-Esteem.
New York: McGraw-Hill, 2003.
Smith, Jodene Lynn.
Activities for Fine Motor Skills Development.
Westminster, CA: Teacher Created Materials, 2003.
Jeansonne, Jennifer J. "Motor Skill Learning Research Looks Beyond
Outcomes—Understanding the Components Needed for Skilled
Performance Helps Develop Instructions and Training Methods."
(June 1, 2004): 69.
Rink, Judith E. "It's Okay to Be a Beginner: Teach a Motor
Skill, and the Skill May Be Learned. Teach How to Learn a Motor Skill, and
Many Skills Can Be Learned—Even After a Student Leaves
The Journal of Physical Education, Recreation & Dance
(August 2004): 31–4.
"Should the Main Objective of Adapted Physical Education Be the
Development of Motor Skills or the Development of Self-Esteem?"
The Journal of Physical Education, Recreation & Dance
74 (November-December 2003): 10–12.
Vickers, Marcia. "Why Can't We Let Boys Be Boys?"
(May 26, 2003): 84.
American Academy of Pediatrics.
141 Northwest Point Blvd., Elk Grove Village, IL 60007. Web site:
Developmental Research for the Effective Advancement of Memory and Motor
273 Ringwood Road, Freeville, NY 13068. Web site:
"How to Help Your Toddler Develop Fine Motor Skills."
, 2004. Available online at
03E; (accessed November 18, 2004).
"Movement, Coordination, and Your Newborn."
, May 2001. Available online at
(accessed November 18, 2004).