skip to Main Content

Red Flags for Fine Motor Skill Development

Are you concerned about your child’s fine motor development? 

Here are crucial steps in the development of good fine motor skills that may help guide you to determine whether or not your child would benefit from an occupational therapy screening or evaluation. 
Questions or concerns? Our occupational therapy experts are happy to assist. Email us at, or schedule an evaluation Here

Three Months

•  Tracks moving objects or people from left to right and right to left
•  Extends arms towards people or objects
•  Brings hands together at middle of body

Six Months

•  Extends only one arm towards a toy
•  Grasps and moves rattle or toy through space
•  Grasps a block with ring fingers, pinky fingers and palm
•  Transfers object between hands

Nine Months

•  Pokes or points with index finger
•  Grasps a block with thumb, index, and middle fingers
•  Uses a raking motion with fingers to pick up finger foods
•  Removes items from a container
•  Crumples paper with 1 or 2 hands
•  Claps hands

Twelve Months

•  Uses thumb and tip of index finger to pick up finger foods
•  Holds two blocks in one hand
•  Takes off socks
•  Opens board book and attempts to turn pages
•  Dumps things out and puts larger things in containers

Fifteen to Sixteen Months

•  Grasps a marker or crayon with fisted grasp and thumb and index finger towards paper to scribble
•  Puts small things in containers
•  Stacks 2-3 blocks

Twenty Months

•  Stacks 4-5 blocks
•  Turns board book pages 1 at a time
•  Feeds self with spoon and fork with spillage
•  Completes simple shape puzzles

Twenty-Four to Thirty Months

•  Imitates vertical and horizontal strokes with a crayon or marker
•  Stacks 8-10 blocks
•  Snips with scissors
•  Strings beads

Thirty-Six to Forty-Two Months

•  Shows a clear hand dominance
•  Grasps marker or crayon with thumb and pad of index finger, other 3 fingers are secure against palm
•  Feeds self with spoon and fork without spilling
•  Copies circle and plus signs
•  Unbuttons large buttons
•  Cuts on a thick line

Forty-Three to Fifty Months

•  Copies a square
•  Cuts out a circle
•  Begins to write name
•  Buttons and unbuttons large buttons on clothing
•  Engages zipper and zips coat

Red Flags


Contact us if your child is not moving both arms freely by 3 months, grasping objects by 6 months, using both hands in a coordinated manner by 9 months, finger feeding by 15 months, making purposeful marks on paper by 24 months, or does not have a hand dominance by 36 months.  Other red flags include using middle finger and thumb instead of index finger and thumb and persistence of fisted grasp on crayons or markers after 36 months.
By Nicole Torres
Back To Top

Patient Reviews

LLA Therapy

Patient Reviews

Crystal Scheibe

Great place, glad we found them. Been going to Medina over 2 months now and he loves Lauryn and Kyler. Wish they had more ABA therapy places available... live in Wooster and long drive everyday.

Karrie Swan LaRock

My 11 year old son has dyslexia and has made noticeable gains in working At LLA THERAPY. Katie is strong in her approach toward him and also keeps him comfortable enough to perform well. We will continue visiting both the Fairlawn and Hudson offices and recommend them highly.

Ron Monroe

My 9 year old just completed about 9 months of weekly speech sessions (due to his stuttering) with Matt Hagge at LLA and we are thrilled with the experience and results. What I thought might be a negative (what kid really wants to go to speech class?) was made very positive by Matt, and my son never hesitated or complained when we talked about class. He really enjoyed it and really took what Matt taught him to heart. His speech has been greatly improved and we definitely recommend LLA. Thank you so much!

Heather Dougherty-Pantoja

My son’s Occupational Therapist, Jess, is an amazing OT! She gives practical tips on working with my son at home and school!

Terri Apgar

I cannot say enough good things about LLA Therapy. My daughter was a client of Teal Simmons’ for approximately 2 years and was just released from speech therapy! She was diagnosed with Apraxia in 2015 and worked with Teal twice a week. Through Teal’s application of PROMPT therapy, my daughter had age-appropriate speech after one year. All of the staff we interacted with at LLA were absolutely wonderful. They really care about what they do and making sure your child achieves their goals.

Kelli Geisler Davisson

LLA Therapy has been an excellent experience for my son as well as my family! My son always asks, "When can I go see Ms. Jeannine again, is it Monday??" He has also made huge gains in only 5 months! I would highly recommend LLA and have already shared my experience with friends looking for services!

Victoria Hansford-Price

We are so grateful for our Speech Therapist Ms.Teal. We have seen a great improvement with our sons confidence and communication abilities since we have started "Prompt" therapy. What we love the most about LLA and Ms. Teal is that Kohl feels comfortable and relaxed which has played a critical role in his progress. Thank you Ms. Teal for all you have done.

Laura Lee Hogsett

They have helped in numerous ways. Speech, OT and behavioral. I've had numerous compliments on my son's progress thanks in very large part to LLA. I would recommend LLA before I recommend our local children's hospitals, though they are good, they don't have the staff that LLA does.

Amy Furukawa

We had a great experience with Matt Hagge at LLA! Our Middle School age son was becoming very conscious of his voice, which is nasal due to a cleft palate. Matt helped him to better form his sounds and project his voice in a way that makes the unavoidable nasality less noticeable.Our son is more confident and outgoing & even took on a speaking role in the church play. Matt has the perfect personality to relate with our son, and we would recommend him to anyone needing speech therapy services!

Jessica Havalotti

LLA Therapy has been an excellent experience for our daughter. I would highly recommend LLA. Miss Grace was so amazing and I can't believe how quickly our daughter showed improvement. Thank you!
Read More