Program: Fine Motor

Today's post is about a program I usually write for children with impaired fine motor skills, motor problems, or difficulty with writing tasks.

'Fine motor' refers to using the hands and or fingers versus large (gross) motor which would be legs, arms, etc.

Problems with fine motor skills can show up in a variety of ways: The child might avoid certain activities, such as coloring, because they have weak fine motor abilities. The child might avoid, or be unable to, feed themselves, dress themselves, open doors, groom themselves, write, etc. Looking at it from a broader point of view, a child who is unable to grasp, point, make a fist, grab, or use a pincer grasp will struggle in a classroom setting, or during play and leisure time. Many toys require good fine motor ability to appropriately engage with the toy; the child must lift, push, pull, wind up, or shake the toy to get it to respond. This is why thorough assessment and evaluation are so important because skill deficits can "look like" challenging behaviors, if you don't know what to look for.

All of these skills can be worked on during ABA therapy sessions.

Typically, depending on the deficits a Fine Motor Imitation (FMI) program, or a Fine Motor Development (FMD) program, are a great place to start teaching.
A FMI program is teaching the child to imitate actions that the therapist must first model. The therapist can use shaping techniques to help the child get closer and closer to correctly imitating the fine motor action.  The program is more general, and teaches a variety of fine motor skills such as opening the hand, making a fist, making a peace sign, thumbs up, etc.

With a FMD program, this is more for a child with just a few fine motor tasks they struggle with, or cannot do. For example, an 8 year old who has difficulty writing his homework (homework is very sloppy or illegible), or a 6 year old who hasn't learned to tie shoes, and can only wear shoes that buckle or snap.

If you are a therapist or parent who has a relationship with an Occupational Therapist, they are a great resource for strategies to build fine motor muscle tone. Please see the list below for a few ideas to help your child with fine motor difficulties. Remember that if this is a deficit for your child, the skill has to be taught. You cant just buy these items and hand them to the child. Get on the floor and help them manipulate these items, encourage them to do activities they normally avoid (such as pulling up a zipper), and create multiple opportunities throughout the day for the child to practice:

 Toys

• Many simple toys can help to develop fine motor skills, including ring stackers, shape sorters and foam boards. These toys may have blinking lights, vibrate, play music or do all three as a naturally occurring reward when your child manipulates the toy correctly. This provides motivation to keep your child from becoming easily distracted. Many toys speak when certain buttons are pushed, helping your child to learn letters, numbers, colors and other concepts while also fine-tuning motor skills.

Play Dough

• Many fine motor skills can be developed with the use of play dough. Help your child mold large balls with her palms, small pea-sized balls with only her fingertips and long snake-like shapes between her hands or with her hands and a smooth surface. Many autistic children also enjoy squeezing things, which is great for improving forearm strength, so play dough is a perfect choice for this activity. Use tools to manipulate play dough as well. Cut with plastic knives or cookie cutters, make ridged designs with the flat side of a fork, press it onto buttons, fabric and other textures and show the child the designs he created.

Small Tools

• Teach your child to use tools such as plastic tweezers to pick up mini marshmallows, cheerios, and pennies. Use an eye-dropper to suck up colored water and then squeeze it out for painting.  Help your child use screwdrivers, such as those in an erector set, or give them undersized, silly items that require a firm grip, such as a small novelty pen.

Writing and Drawing

• Your child can begin to learn how to write and draw by finger painting, drawing lines, shapes, numbers and letters with their fingers. Use paints, or get out whipped cream and let your child have some fun. Magnet board drawing toys or large mats that change color with water-tipped pens can help your child learn to grasp and control a pencil.

Modified Toys and Activities

• If your child is easily frustrated by the toys she already has, consider creating similar toys with modifications so that she feels successful, then move on to the more difficult toys. Instead of a lacing board with many holes, make your own home made version out of cardboard, punching three to six holes instead of a dozen. Create your own peg board with plastic water bottles filled with water and glitter that fit into holes in a cardboard box. Fill some small boxes with sand and use these as blocks; they will be easier for your child to stack than regular blocks.