Pediatric occupational therapists work with children, youth and their families to promote active participation in activities or occupations that are meaningful to them. Occupations are activities that allow children to participate in play, learning and self-care tasks within their natural environment. In order to participate in these activities, children need to have good fine motor skills, hand-eye coordination, visual processing skills, sensory processing skills, cognitive skills, executive functioning, and so much more. An occupational therapy evaluation evidenced based treatment techniques are appropriate for your child and family. Our goal is to promote independence and engagement in everyday routines by addressing your child’s individual needs.
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Developmental Fine Motor Skills

0-2 Months

• Lying on back, tracks rattle 90 degrees from midline to each side • Tracks rattle to midline on both sides • Places open hand on table • Lying on back, turns head to avoid approaching rattle • Looks at hands for 3 seconds • Tracks small ball beyond midline on both sides • Lying on back, head turned to side, tracks rattle through midline on both sides • Closes finger in tight grasp • Secures in hand a cloth hanging from adult’s arm • After holding rattle for 5 seconds, drops rattle within 3 seconds • Grasps rattle • Holds rattle for 30 seconds

3-5 Months

• Lying on back, extends straight arms toward rattle •Lying on back, moves hand within 4 inches of midline to reach for toy •Lying on back, engages fingers in mutual touching •Moves rattle 15 degrees •Picks up rattle •Grasps string, pulls it, and obtains toy •Secures paper •Graps and holds cube

6-8 Months

• Sitting, brings hands together to secure block • Lying on back, extends straight arm toward rattle while other arm remains stationary • Picks up 2 cubes and retains both • Transfers cube to other hand and picks up 2nd cube with original hand • Touches pellet with fingers • Bangs cup on table • Pokes finger in hole of pegboard • Moves rattle through 90-degree arcs • Grasps cube with thumb and 1st and 2nd fingers with space visible between cube and palm • Using a raking motion, secures 2 pellets at once • Crumples paper with palms (1 or 2 hands) •Grasps pellet with thumb against side of curled index finger

9-11 Months

• Brings 2 cubes together at midline • Claps hands • Extends hand toward 3rd cube while holding cube in each hand • Secures string to retrieve out of sight attached toy • Removes 3 pegs from pegboard • Releases cube into adult’s hand • Removes both socks • Picks up pellet with thumb and index finger and drops it in cup • Places 3 to 7 cubes in cup • Grasps pellet with pad of thumb and pad of index finger, with hand, wrist, and arm off table • With hand approaching from top, grasps cube with thumb opposed to 1st and 2nd finger pads with space visible between cube and palm

12-14 Months

• Opens book • Stirs spoon in cup • Turns bottle over and dumps out pellets • Places 7 cubes in cup • Places 3 pegs in pegboard • Taps cup horizontally with spoon • Places 1 shape into correct hole in formboard • Puts pellet in bottle • Makes at least 1 scribble more than 1 inch long on paper •Picks up 2 cubes with 1 hand and holds them

19-24 Months

• Turns 3 pages in book, 1 at a time • Places 3 shapes in correct holes in formboard • Stacks 4 to 6 cubes •Draws vertical line

25-30 Months

• Removes screw on lid from bottle • Stacks 8 to 10 cubes • Cuts paper in 1 place • Draws horizontal line • Bends paper, producing crease • Using 4 cubes, aligns 3 cubes and positions top cube on one end to form train • Strings 2 to 4 beads

31-36 Months

• Builds bridge of 3 blocks • Draws Circle • Builds wall of 4 blocks

37-42 Months

• Cuts paper into 2 pieces • Laces 3 holes • Cuts within 1/2 inch of line for entire length of line • Draws a cross • Puts 10 pellets in bottle • Traces horizontal line • Grasps marker with thumb and pad of index finger, other 3 fingers are secure against palm, upper portion of marker rests between thumb and index finger, child moves hand as unit when drawing • Unbuttons 3 buttons

43-48 Months

• Buttons and unbuttons 1 button

49-54 Months

• Draws a square • Cuts out circle printed on paper • Builds steps of 6 blocks • Conects dots by drawing straight line • Cuts out square printed on paper • Builds pyramid of 6 blocks • Grasps marker between thumb and pad of index finger, marker rests on first joint of middle finger • Touches each finger to thumb

55-60 Months

• Folds paper in half lengthwise with edges parallel • Colors between vertical lines

61-72 Months

• Folds paper in half twice with edges parallel

6-10 Years

• Good dexterity for crafts and construction with small objects • Bilateral coordination for building complx structures • Precision and motor planning evident in drawing • Motor planning evident in completion of complex puzzles • Plays games that require problem solving and abstract thinking • Peer play predominates

15-18 Months

• Stacks 2 to 3 cubes • Places 2 shapes into correct hold in formboard • Grasps marker with thumb and 1st finger toward paper and remaining fingers around marker