Children's Emergency Department is now located in Children's Tower: 1001 E. Marshall Street.

Learn more
View alerts close
Fine motor skills: birth to 2 years

Fine motor skill development: Birth to 2 years 

What are fine motor skills?

Generally thought of as the movement and use of hands and upper extremities, fine motor skills include reaching, grasping and manipulating objects with your hands. Fine motor skills also involve vision, specifically visual motor skills, often referred to hand-eye coordination. Visual-motor skills are needed to coordinate hands, legs, and the rest of the body.

The difference between gross and fine motor skills pertains to the muscles being used. Gross motor skills refer to the large muscles and fine motor skills refer to the smaller muscles. Babies and toddlers need a lot of playtime and practice to develop those small muscles needed for fine motor control. Learn more about all developmental milestones by age.

Developmental milestones: Activities for infants and toddlers to build fine motor skills

This is a list of fine motor skills children should demonstrate between the ages of 0-2 years.  

0-3 months  

  • Brings hands to mouth
  • Moves arms
  • May swing arms at toys
  • Hands start to open more

3-6 months

  • Holds small object in hand (without thumb tucked in hand)
  • Holds hands together
  • Reaches for toys with both arms
  • Pushes up on arms when on tummy
  • Briefly holds a toy like a rattle
  • Follows objects with eyes in all directions 

6-9 months

  • Shakes and bangs rattles
  • Brings toys to mouth
  • Uses a raking grasp
  • Transfers objects from one hand to the other
  • Keeps hands open and relaxed most of the time
  • Starting to have the ability to pick up small foods like Cheerios

9-12 months

  • Able to release an object voluntarily 
  • Gives toy to a caregiver when asked 
  • Bangs two toys together
  • Turns pages of a book a few pages at a time
  • Begins to put objects into a container
  • Points to objects
  • Stacks 2 blocks

12-18 months

  • Claps hands together
  • Puts objects and toys into containers
  • Waves goodbye
  • Uses both hands to play 
  • Can isolate index finger with other fingers closed 
  • Scribbles with a crayon
  • Beginning to use a spoon and cup

18-24 months  

  • Can build a block tower using 3-4 blocks 
  • Puts rings on a ring stacker
  • Turns pages of a book one at a time
  • Begins holding crayons with finger tips and thumb

2 to 5 years

Additional ways to help infants develop fine motor skills

You can help your infant develop MOTOR SKILLS by: 

  • "Tummy Time"… An important concept in motor skills development for children ages 0-2 years is what is known as "prone skills." Prone refers to lying on your stomach; many therapists call this "tummy time." A young baby needs to spend playtime in "prone." Tummy time helps develop postural control and strength to provide stability for hands and fingers. This core stability helps support the development of fine motor skills. Foundational fine motor skills are developed through gross motor skills such as playing in prone, rolling over, sitting up, and crawling.

A 3-6-month-old learns to push up on their elbows in prone and eventually is able to push up onto their hands. These activities are the beginnings of shoulder stability and arch development in the hands, which are used later on for strength and coordination activities, such as pitching a ball, or precise activities, such as writing with a pencil.  

Tummy time also allows for floor time and limits time spent in equipment such as bouncers, infant seats, or swings.

As the development of vision and the sense of touch is important to the development of motor skills, children need to be able to see and feel what is in their hands in order to interact with or manipulate objects.  

Learn more about how tummy time can help your baby

Help your infant develop VISUAL SKILLS by: 

  • Getting close... Young babies like to look at faces. A parent's face is very expressive and possesses contrast which encourages babies to focus and use their visual skills. Position your face about 12" from your baby's face. Sing, talk and make silly faces!  
  • Choosing color... As babies get to be 3-6 months old they begin to enjoy objects with increasing color. Three-month-olds often like "cool colors"- lemon yellow, sky blue and lime green. Six-month-olds are getting ready for brighter colors - hot pink, red and orange.  
  • Exposing your baby to different and enriching visual environments... If you usually have an infant seat in the den, try other rooms so your baby can have different views. If you often carry your baby in a cradle hold through the house, alternate and carry your baby at your shoulder level so he/she can view the world with an upright head posture.  

Help your infant develop SENSORY SKILLS by: 

  • Incorporate multiple senses…When interacting with your baby remember all the senses: touch (tactile), movement (vestibular), body awareness (proprioceptive), sight, smell, hearing, and taste. Play mats with different textures and touch and feel books offer different tactile experiences. Rocking, swaying, and gentle bouncing provide varied movement experiences. As mentioned earlier using toys with different colors and playing in different environments offers different visual experiences. Using lightly scented lotions or letting you baby smell garden herbs can stimulate sense of smell. Listening to music and playing with instruments are good ways to provide auditory input. Once your baby is eating a variety of solid foods, at around five to six months of age, experimenting with a variety of tastes, textures, and colors is a great way to broaden her culinary (and sensory) horizons. 
  • Positioning... Our senses of vision, hearing, touch, taste and smell are all developing in a young infant. We also have a "positional sense"; this helps us to define if our body is moving, and where we are in space (sitting up or lying on our stomach). This positional sense is why babies like to be rocked. To help them have an enriched environment, alternate rocking with swaying, try different rocking chairs, and change the baby's position - swaddled in a blanket, upright on your shoulder, or lying on their stomach across your lap. Go for walks with your baby in a baby-wearing carrier or backpack for stimulation.  
  • Massaging... For development of touch sense or tactile awareness, provide your infant with massage to arms, legs and trunk. You can use baby lotion or oils if you like. Many YMCAs and other organizations offer classes for infant massage. This activity is great for bonding time with your child. 

How to improve your child’s fine motor skills

If your child is regularly missing development milestones, occupational therapy addresses challenges related to cognitive, daily living, motor, sensory processing, social and visual/perceptual skill development.  

Occupational therapists at CHoR can provide a comprehensive examination of your child’s strength, balance, coordination and fine motor skills in order to determine barriers to safe body movement. We provide therapeutic activities that are engaging and specific to a child’s age, cognitive status, ability level and interests. We strive to help a child and his or her family succeed through developing strategies unique to a child’s specific needs and abilities.

To make an appointment with a pediatric therapist, call one of these locations: 

Information provided by Sallie Tidman, OT/L, Director of Therapy Services, and occupational therapist's Katie BobbitMegan Stratton, and Melanie Koch