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Assessment and Treatment of Fine Motor Development (For parents, teachers, pediatricians, and other professionals)
By Rita Patterson OT/L
Part 1: Assessment of Fine Motor Development:
Many children with and without any type of diagnoses, may experience difficulties with fine motor skills. Delays or difficulties in fine motor skills can be caused by underlying difficulties. For instance, fine motor difficulties may be the result of: poor sensory processing, poor attention, poor motor sequencing, and/ or poor motor control, poor postural control, Fine motor skill development relies on the foundational skills of postural control, hand dominance and overall strength and muscle tone. Thus poor fine motor skills can be a result of one or many underlying factors. A thorough occupational therapy evaluation will help to determine where the weaknesses exist. Treatment utilizes therapeutic activities to enhance and address the underlying issues, opposed to focusing grossly on the end product of fine motor skills.
Poor fine motor skills can be due to a sensory processing disorder (www.sensory-processing-disorders.com ). (Please keep in mind, other neurological and / or other conditions may also result in poor development of fine motor skills, such as a co-existing “learning disability.” A more common example contributing to fine motor delays may be related to impaired sensory processing or poor sensory integration. If ‘tactile defensiveness’ is present, a child may avoid any activities he/ she needs to practice with their fingers and hands, thus perpetuating to the delay. If any sensory issues dominate a child’s behavior, fine motor difficulties can occur and can be difficult to self-remediate, due to the child’s tend to avoidance of what is most difficult for them. However, the relationship between what is the underlying problem and the fine motor difficulty may not be clear or apparent. The relationship between the surface problem and the underlying problem is typically not apparent to the lay person, without a thorough occupational therapy evaluation. For example if a child is avoiding fine motor activities due to poor postural control or a need for movement, it will appear that the child is being defiant as he/she seeks the movement they need to help sustain his/her posture for seated activities. If gravitational insecurity is present and a child has not had movement experiences to help him / her learn positional awareness. As a result, he or she may appear to not know where to place his pencil on the paper to begin to draw letters on the line. If movement issues are present, children will avoid the very activities they need, and will avoid gaining the experiences they need to facilitate the skills that are lacking. Consultation and evaluation by an occupational therapist can be instrumental to help to determine the reasons for the underlying factors when looking at fine motor and visual motor difficulties.
Part 2: Description of Types of Treatment Activities for Facilitating Fine Motor Skills
For purpose of this post, suggestions for fine motor activities are divided into two categories to stimulate development (Please refer to both lists provided):
1) Category 1: Activities to Facilitate Fine Motor Development. These activities are the most commonly used for stimulating fine motor skills and are typically found in preschools, day care centers, kindergarten classes, etc.
2) Category 2: Therapeutic Preparatory Activities for Fine Motor Development
These activities are typically used as part of an occupational therapy program and are focused on treating the underlying problems. These activities are to prepare the child for fine motor skills by enhancing the underlying neurology and muscle development. “Preparatory” activities prepare the central nervous system and the larger muscles of the body for more challenging tasks requiring higher level integration. These activities are therapeutic in that they build the foundational skills needed or pre-requisite skills needed for the development of fine motor skills.
Category 1. Activities to Facilitate Fine Motor Development
Category 2: Therapeutic Preparatory Activities to Stimulate Development of Fine Motor Skills
Occupational therapists trained and experienced in using sensory integration assessment and theory, sensory motor processing treatment, and neurodevelopmental treatment techniques utilize sensory integration theory, and theories related to motor learning, and neural plasticity to enhance all aspects of motor development. Occupational therapists trained in assessment and treatment of reflex integration and reflex development can be instrumental in making changes for children with poor fine motor and writing skills.
Examples of Therapeutic Preparatory Activities to Facilitate Fine Motor Development:
*Repeat activities as often as possible, as they become more and more integrative in nature to enhance neural plasticity in the brain and to re-inforce correct pathways as well as accurate postural mechanisms; allowing for further growth in the foundational skills needed for adequate skill development of fine motor skills.
Rita Patterson OT/L