What is Occupational Therapy?

The term “Occupational Therapy” may be confusing, as the word “occupation” conjures thoughts of an adult “work force”. However, at its core, Occupational Therapy works on activities of daily life. Activities of daily living may include dressing, toileting, eating, and hygiene skills.

Occupational Therapy helps your child reach their developmental milestones needed to engage in social emotional, fine motor, self-care activities. Occupational therapy may also address other pragmatic and regulatory skills needed for a child’s independent and healthy interaction with peers in the community, playground, and/or classroom.

Occupational Therapy also assists your child with oral motor and feeding skills, sensory integration, self-help skills, and visual motor skills.

Occupational Therapy often works on activities of daily living, such as dressing, toileting and hygiene skills.


What are fine motor skills?

Fine motor skills are the precise coordinated movements of the small muscles in our bodies. Examples of fine motor skills are hand writing skills, cutting, buttoning, zipping a zipper, turning pages, and eating.

Fine motor skill influences the quality of the task as well as the speed of a task. Efficient fine motor skills require a number of independent skills to work together to appropriately manipulate the object or perform the task.

Manipulation skills refer to the ability to move and position objects within one hand without the help of the other hand. Manipulation is used when holding a puzzle piece, buttoning, zipping, stacking blocks, writing or even cutting with scissors. Manipulation of objects are needed in the coordination of many skills for successful performance, including fine motor control, bilateral integration, coordination and hand-eye coordination.


What is Hand-Eye Coordination?

Hand-Eye (Eye-Hand) coordination is the coordinated control of eye movement with hand movement and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to guide the eyes. The small corrections that are needed to focus and look are considered a fine motor task in its self. The visual sense is the most utilized sense that humans depend on as they develop. Hand-Eye coordination is needed for the simple movements of stacking wooden blocks, brushing your teeth and using utensils to feed yourself. This skill is also needed for advanced skills such as archery, music reading, driving a car, computer gaming, copy-typing, It is part of the mechanisms of performing everyday tasks; in its absence, most people would be unable to carry out even the simplest of actions such as picking up a book from a table or maintaining general hygiene.

What is Bilateral Coordination/Integration?  How can an Occupational Therapist help?  CLICK HERE FOR MORE INFORMATION:


What are Feeding Skills?  How can an Occupational Therapist help?  CLICK HERE FOR MORE INFORMATION:



What are social emotional skills? How can an Occupational Therapist help CLICK HERE FOR MORE INFORMATION?


What are cognitive skills? How can an Occupational Therapist help CLICK HERE FOR MORE INFORMATION?



What is sensory processing? How can an Occupational Therapist help CLICK HERE FOR MORE INFORMATION?

Fine Motor Skills Checklist

If you’re concerned that your child is not meeting their milestones give us a call.

0 - 3 months
  • Holds head in midline when pulled to sit
  • Visually tracks a slow-moving object
  • Moves arms and legs when lying on back
  • Lifts head a little when laying on belly, can prop on elbows
  • Brings hands together when laying on back
  • Props on elbows in prone with neck extension
  • Rolls from their back to side
  • Grasps rattle when placed in hand
  • Likes looking at a human face more than other things
  • Responds with a smile when they are smiled at
  • Looks into caregiver’s face and eyes with interest
  • Hits at dangling objects with hands
4 - 6 months
  • Sits using hands for support. May start to sit independently
  • Grabs both feet and holds them when on back
  • Brings feet to mouth when on back
  • Reaches to a toy when playing on belly
  • Props on extended arms when on belly
  • Holds and shakes a toy
  • Puts fingers in mouth
  • Holds hands open, rather than in fists, at least half of the time
  • Smiles at self in front of mirror
7 - 9 months
  • Sitting by themselves without support.
  • Retrieves a toy in sitting and returns upright
  • Rolls to and from back <> tummy.
  • Combat -crawls with belly touching floor
  • Bangs a toy on the floor in front of them.
  • Passes a small object from one hand to the other
  • Plays peek-a-boo
  • Bangs toys together
  • Feeds self-finger foods
  • Starts to crawl on hands and knees
  • Pulls to stand at stable surfaces
  • Waves Bye-bye
  • Releases objects intentionally (plays the drop game)
  • Places objects into a container
10 - 12 months
  • Protecting reaction backward
  • Maintains sitting for 60 seconds while playing with a toy
  • Transitions to sitting from on belly
  • Bounces while holding onto your fingers
  • Takes 4 steps with support on your fingers
  • Plays in standing at a table
  • Stoops at table to retrieve object from floor
  • Cruising on and between furniture
  • Pivots in sitting
  • Standing for 5 seconds without support
  • Walks 4 steps with 1 hand held
  • Walks with a push toy
  • Pushes or rolls a ball
  • Drops small things, such as cheerios into a cup
  • Throws things just to see what happens
  • Removes socks
  • Transitions to stand using hands and feet (bear stance)
  • Walks 8 feet with one hand held
  • Walks 5 steps independently
  • Corrals a ball in sitting
  • Grasps thick crayon or pencil in fist as if to mark, but may not mark
  • Turns page of a cardboard book
  • Helps to pull off simple clothing and extends arms and legs to help with dressing
  • Puts objects into others, (puts blocks into a basket)
  • Pulls off shoes
  • Starting to drink from a straw
13 - 17 months
  • Rolls a ball 3 feet forward in sitting
  • Throws ball 2 feet forward overhand
  • Enjoys looking at pictures in books
  • Points at desired objects with index finger
  • Marks independently on paper with crayon or pencil
  • Pushes toy car along flat service
  • Brings filled spoon/fork to mouth
  • Drinks from cup without much spilling
  • Makes a stack of 2 blocks
  • Creeps downstairs independently
  • Puts something in and then gets it out of a container
  • Turns container over to pour or dump contents
  • Turns small knob
  • Selects and puts square or rectangular objects into respective receptacles
  • Puts large round pegs into pegboard
  • Helps dress and undress self
1 ½ – 2 years
  • Throws ball overhand a few feet
  • Drinks from cup independently
  • Turns light switches on and off
  • Looks independently at picture books and turns pages
  • Zips and unzips easy zippers
  • Plays individually, explores environment to learn, will play beside a peer with little interaction
  • Uses play dough, paint, and paper
  • Scribbles without going off paper
  • Builds a 4-6 block tower
2 – 2 ½ years
  • Throws ball underhand a few feet
  • Climbs up jungle gym ladder and negotiates a slide
  • Grasps thick crayon with thumb and fingers
  • Puts square, round, and triangular shapes into form board
  • Imitates drawing a vertical line
  • Spontaneously draws strokes, dots, circular shapes
  • Stacks 7-8 small blocks
  • Hand preference established
  • Presents arms and attempts to catch ball
  • Identifies 4 body parts on self
  • Makes small cuts (snips) on line with child-safe scissors and some help
  • Grasps spoon with fingers and rotates wrist to bring spoon to mouth
  • Washes hands by self
2 ½ – 3 years
  • Throws ball 7 feet underhand
  • Squeezes or pulls play dough apart
  • Grasps pencil with thumb and fingers instead of fist
  • Screws and unscrews jar lids
  • Sorts objects that vary in size only or color only when shown how
  • Undresses with help only for fasteners and pullovers with narrow necks
  • Matches blue, red, and yellow objects by color
  • Eats with a fork (with spillage)
  • Catches ball tossed gently from 5 feet
  • Completes a simple 3-piece puzzle of something familiar
  • Pours accurately from one container to another
  • Starting to play in a way that is more symbolic, dramatic, and interactive
3 – 3 ½ years
  • Makes continuous cuts with child-safe scissors
  • Copies a horizontal line and a circle
  • Builds a 9-block tower
  • Spoon/fork to mouth with no spillage
  • Dries hands
  • Plays by rules and in groups with increase in dramatic and imitative play
  • Completes an easy puzzle
  • Traces around the edges of basic shape templates
  • Cuts a piece of paper in half with scissors on a more or less straight line
  • Copies a vertical-horizontal cross
3 ½ – 4 years
  • Puts shoes on completely, on correct feet
  • Buttons and unbuttons large – quarter in buttons
  • Cuts on a line
  • Makes a flat, round cake by pressing and patting dough on table with fingers
  • Puts 3 things in order, such as hard to soft, full to empty
  • Traces and stays on (most of the time) a 3-inch, pencil-thick, horizontal line
  • Begins to copy some vertical/horizontal letters
4 – 4 ½ years
  • Performs a forward roll
  • Draws a person with 3 different body parts
  • Colors almost entirely within lines of 4-inch wide circle
  • Dresses and undresses when requested without much help
  • Copies a cross
  • Puts socks on correctly
4 ½ – 5 years
  • Pumps self on swing
  • Copies and cuts a square
  • Cuts easy foods with a knife
  • Copies color/shape sequence
  • Zips most zippers
  • Traces around own hand with a crayon
  • Completes simple dot to dot pictures
5 – 5 ½ years
  • Performs a few sit-ups
  • Skips
  • Performs jumping jacks
  • Moves fingers in fine, localized movements when writing with marker
  • Reads and writes numerals to 5
  • Matches letters in a group of different letters
  • Draws a face with mouth, nose, and eyes, and a person with 6 or more parts
  • Copies first name, although letters may be large, awkward, or reversed
  • Ties shoes (starts at 5, but may not be mastered until 6)
  • Prints a few capital letters without copying
  • Copies a triangle
5 ½ – 6 years
  • Performs several sit ups well
  • Performs several push-ups
  • Able to perform the monkey bars
  • Names most uppercase letters
  • Brushes or combs hair well
  • Uses simple tools, such as child’s screwdriver
  • Prints all numerals 0-9 and all letters without copying
6 – 7 years
  • Able to rollerblade or skate.
  • Completes a 6- to 12-piece interlocking puzzle
  • Plays simple card games, such as Go Fish
  • Competitive Play: Participates in team sports and activities that promote competition with structured rules