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Fine motor skills in preschool and younger children

Fine motor co-ordination involves the ability to control the small muscles of the body, in particular the hands.

Some children find fine motor activities more difficult than their peers for a number of reasons.  Your child may have hypermobile joints (bendy with a weak grip). They will tire more quickly and their stamina may be affected. Other children may have an underlying diagnosis such as ‘juvenile idiopathic arthritis (JIA) which makes fine motor tasks more difficult due to stiff, painful, swollen joints.

By encouraging fun fine motor activities your child will develop strength and skill in the small muscles of the hand. The activities suggested in this resource are examples of how to encourage fine motor progression in your child.

Why are fine motor skills important?

Fine motor development always follows gross motor development. Gross motor skills develop from the centre of the body outwards, and from head to toe. Gross motor skills are those skills which help your child control the large muscles of the body, including those in the arms and shoulders, legs, feet and chest.

Large muscles are used in movements such as:

  • crawling
  • walking
  • skipping
  • running
  • hopping
  • clapping

Gross motor development is therefore an important first step to your child’s fine motor development.

Before beginning fine motor activities encourage good arm and shoulder stability by playing with your child:

  • crawl on all fours through an obstacle course
  • commando crawl under a limbo stick
  • encourage play whilst lying on their tummy
  • draw large shapes and pictures on chalk boards or white boards and walls, using both hands at the same time

Developmental milestones

Just as your child goes through developmental milestones for gross motor skills, a similar progression of developmental skills occurs in the hand. Listed below are the typical fine motor milestones:

  • development of the slight curve shape of the palm of the hand
  • development of wrist extension (wrists are bent up and back so that the fingers are higher than the wrist joint) to support skilled finger movements
  • development of an awareness of the skill side of the hand (thumb, index and middle fingers for manipulating fine motor items)
  • development of an open index finger-thumb web space – the child is able to make an “O” with their thumb and index finger
  • development of skill in the small muscles of the hand

Children who are starting school should be developing their hands for a variety of activities in a variety of positions before they are expected to draw or write with a proper pencil grip.

Fine motor skill activities

The activities suggested in this resource are examples of how to encourage fine motor progression in your child.

Easel board activities

One of the most important items that you can provide for your child is a vertical or inclined surface to work on. The wrist is properly positioned to develop stability and skilful, balanced use of the finger muscles. Inclined surfaces support the development of arm and shoulder muscles and encourage the proper positioning of the arms and shoulders for work. When working on a flat surface children tend to straighten or bend their wrist which interferes with using the small muscles in the hand properly. Many activities can be adapted for use on an inclined surface by using book holders on a table, table top easels, or regular floor easels.

Here are a few examples of activities to do on an easel:

  • Stickers to make a picture
  • Felt boards for making pictures (Fuzzy Felt)
  • Chalkboards – use chunky chalks or ‘egg chalks’ to encourage and support an open web space (remember the ‘O’) between the thumb and index fingers
  • Sponge painting
  • Magna Doodle or Etch-A-Sketch


You can use playdough to develop fine motor skills in a number of ways:

  • encourage your child to mould and roll playdough into balls using the palms of their hands with their fingers curled slightly towards the palm
  • use the playdough balls to make playdough creatures
  • encourage your child to roll playdough into tiny balls by using only the finger tips of the skill fingers (thumb, index and middle fingers). Make a playdough pot to collect the balls
  • flatten the playdough with hands and poke small pegs into the dough to make a design
  • cut the dough with a plastic knife or plastic pizza wheel, encouraging your child to hold the knife or pizza wheel with the index finger positioned on the top of the knife or pizza wheel

Spray bottles

Spray bottles are great for developing strength to maintain an open web space. Make sure your child is using the index and middle fingers on the spray trigger with the ring and little fingers around the neck of the bottle. Use small spray bottles filled with water to spray plants. Fill with food colouring to make pictures in the snow or a little paint to make spray pictures.

Spray bottles can also be used for cleaning chalks off easels or ‘melting’ the pictures.


Tear newspaper into strips using the thumb, index and middle fingers (skill fingers) and crumple into a ball. The newspaper can then be used to make stuffed art creations such as animals and shapes. Use the newspaper balls to make a game of throwing the newspaper balls into a bin.

Over-sized tweezers and small tongs

Pick up small objects such as Cheerios or small cubes as part of a counting game. Clothes pegs make effective tweezers and you can have your child peg out the ‘washing’ with small things like flannels or socks.

Dice games

Many young children have difficulty cupping their hands to shake a dice. Teach your child to cup their hands to form a little ‘house’ for the dice when playing dice games. This will encourage development of the curved surface in the palm of the hand.

Lacing activities

Lacing activities provide an excellent challenge for children developing hand skills. Stringing beads and other small objects such as Cheerios onto pipe cleaners will also provide a fun activity for developing fine motor skills.

A few tips:

  • laces with small tips require the most skill, as do lacing cards with small holes
  • start big (Cheerios and pipe cleaners) and as your child’s fine motor skills progress, move on to narrower laces and smaller holes
  • large beads with large holes can be more difficult to thread than smaller beads — a large bead with a large hole will require sustained fine motor muscle movements to work the string all the way through the bead
  • a small bead, though harder to manipulate, will be easier to lace as one thrust of the lace will bring it all the way through the hole

Eye droppers and sponges

Fill a plastic eye dropper with a mix of water and food colouring and then make ‘dribble’ pictures on kitchen roll. You can also dip a sponge into water-based paint. Use the thumb, index and middle fingers to squeeze the sponge to make a ‘dribble’ picture. Eye droppers can also be used as bath time toys. Other bath time toys such as squirties are perfectly sized for little hands.

These activities will develop fine motor muscles in the thumb and index finger and encourage the development of an open web space.

Coins and buttons

Play coin and button games such as counting or matching with your child. Encouraging them to pick up or turn over the buttons without sliding them to the edge of the table. Also try making button pictures.

Tissue paper pictures

Roll scraps of tissue paper into small balls by using only the thumb, index and middle fingers. Glue the balls onto thick paper to make a picture. Encourage fine motor progression by drawing a simple outline such as an apple on thick paper and your child can make enough balls to fill the outline.

Cooking activities

Roll and press out cookie or pizza dough. Put sprinkles into bowls in order that your child has to pick them up with finger tips and sprinkle over cookies and buns. Make soft fruit skewers. Try making your own playdough

Colouring activities

Some children may show hand preference from as early a 12 months. However, hand preference generally develops gradually from 2 to 4 years of age and is apparent in tasks such as colouring. Children with OI who have hypermobile hands may initially use both hands with equal ability. Children with a weak grip perform better using short, fat crayons and markers as these support the open space between the thumb and index fingers.

Other things to consider

This is by no means a comprehensive list of all possible fine motor activities. Please do not be afraid of experimenting. You know your child better than anyone else.

Tips for success

  • Watch how your child performs the activities as precise and specific finger movements are required to develop fine motor skill
  • Adopt a low pressure, encouraging attitude with your child
  • Make activities fun!

Risk of choking warning

Young children learn about their world by putting things in their mouths. Left unsupervised, they may swallow things such as coins, marbles, beads and buttons.

It is important that all children remain supervised when carrying out the activities suggested in this resource.

If you see your child swallowing something, and you cannot stop it happening, or your child may have swallowed something, look for these signs that there could be a problem requiring emergency treatment:

  • trouble breathing, crying or talking
  • drooling coughing that does not clear the airways (the trachea or bronchi)
  • wheezing or noisy breathing
  • trouble swallowing
  • or bringing up saliva
  • loss of consciousness

If these happen, it may mean that your child’s airway is blocked. Call 999 for emergency help.

Contact us

If you have any further questions or concerns please contact the Rheumatology Occupational Therapist on 0114 271 7227.

Is something missing from this resource that you think should be included? Please let us know

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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