Fine motor skills involve the body’s small muscles, especially those of the hands and fingers, and allow children to manipulate objects with their hands and develop hand-eye coordination. These skills are crucial to independent living, and as children gain greater control over their muscles, scribbling and playing with blocks will give way to more sophisticated tasks like drawing and writing, getting dressed, and eating with a knife and fork. A delay in this area of development could indicate certain health conditions, including cerebral palsy, Down syndrome, mental retardation, autism spectrum disorders, visual impairments, and developmental coordination disorder.

Below are some of the prominent milestones and possible signs of delay that are related to fine motor functioning. It’s important to keep in mind that milestones of this variety may be related or intertwined with milestones of other types, particularly gross motor skills, and that no two children will reach the same milestones in the same way or amount of time. If your child is behind on one milestone, it’s important to look for other potential delays. Only when a child falls drastically behind or misses several milestones does a parent need to worry about contacting a pediatrician.

Fine Motor Milestones:
3 months - The child can open and close his hands, grabs at dangling objects, grasps and shakes toys.
7 months - The child moves objects from one hand to the other, can use the raking grasp (opening hands and using a raking motion to grab objects).
1 year - The child can use the pincer grasp (picking up small objects between thumb and forefinger), bangs two objects together, puts objects into a container and takes them out again, can let go of objects, uses index finger to poke, starts to scribble.
2 years - The child scribbles, can turn over a container to dump out the contents, can build a tower out of at least four blocks, might begin using one hand more often than the other.
3 years - The child can use a crayon to make up-and-down, side-to-side, or circular lines, can turn book pages one at a time, can build a tower with more than six blocks, can hold a pencil in a writing position, can screw and unscrew nuts, bolts, and jar lids, can turn rotating handles.
4 years - The child can copy squares, draws circles and squares, can draw a person composed of two to four body parts, uses scissors, can form some capital letters.
5 years - The child can copy triangles and other shapes, draws people with bodies, prints some letters, gets dressed and undressed without help, can use a fork and spoon and maybe a table knife, usually does not need help when in the bathroom.

Possible Signs of Fine Motor Delays:
3 months - The child does not grasp and hold objects, does not reach for and grasp objects by 3 to 4 months.
3 years - The child cannot build a tower with at least four blocks, cannot easily manipulate small objects, cannot copy a circle.
4 years - The child cannot grasp a crayon between his thumb and forefinger, cannot scribble easily, cannot stack at least four blocks.
5 years - The child cannot build a tower using at least six to eight blocks, cannot comfortably hold a crayon, has trouble undressing, cannot efficiently brush teeth, cannot wash and dry hands.