Signs & Symptoms


Is your child hating to work with tiny pieces?

If your child says, ‘these pieces are too tiny!,’ they probably are. What may be happening is that your child is struggling with the fine motor skills needed to manipulate the pieces.

This struggle may show up when learning to cook, tying shoes, buttoning or zipping during dressing tasks, when trying to build a lego set, in handwriting, while using a scissors, or when trying to pick up smaller objects with tweezers or tongs.

What’s happening here is that several skills are required to work well together, and any break in the chain can render these tasks difficult. The child needs to be able to ‘see’ what the model is supposed to look like, ‘feel’ the little pieces, ‘manipulate’ the pieces with fingers, and ‘move’ the pieces where they need to go. This combination of skills is called visual-motor integration.

What do challenges with Dexterity look like?

  • Saying, “these pieces are too tiny?”
  • Struggling with Legos or blocks?
  • Getting frustrated when putting things together?
  • Struggling with stringing beads or making friendship bracelets?
  • Having difficulty assembling a model from a picture?
  • Struggling as a toddler or preschooler to put shapes in a shape sorter?
  • Having trouble with classes like geography, architecture, or engineering?
  • Having difficulty grasping and holding daily objects?
  • Struggling using a scissors?
  • Avoiding activities requiring finger movements?

Why is Dexterity happening?

In order to effectively manipulate objects, a child has to have strong ‘visual perception skills,’ which is essentially making sense of what you’re seeing. Children are using visual perception when they can see a puzzle’s completion, imagine how a model will look when done, and plan out several moves ahead on a chessboard. Many components make up visual perception:

  • visual attention:  paying attention to what you are seeing
  • visual memory:  remembering the important elements of an object you have seen
  • visual discrimination:  being able to visually separate the different parts of an object 
  • spatial perception: seeing the correct position in space 
  • object form perception: understanding static properties of objects (form constancy), knowing how an incomplete figure will look when completed (visual closure), and seeing the difference between the object and the background (figure-ground recognition) 

As complex as this may sound, the idea is that kids who have trouble manipulating small objects may be actually ‘seeing’ it wrong. They may not know how to make things fit physically because they do not see them correctly first. In addition to visual perception skills, motor coordination is required for dexterity. Fine motor coordination is the ability to execute smooth and efficient movements with the hands and fingers. All of these skills need to work together for a child to have good dexterity. The eyes have to see it, the hands have to be able to do it, and the eyes and hands have to work together to get it done right. Children with challenges here may struggle with writing, drawing, puzzles, and building. 

How can I manage Dexterity at home?

If your child struggles with dexterity, an underlying visual-spatial deficit or fine motor weakness could be causing these problems. However, parents would want to consider whether or not these personal weaknesses are ‘getting in the way’ of every-day-life before they make a decision about further assessment or treatment.

For example, children with more significant struggles in these areas may have learning disabilities, particularly in writing; in that case, intervention or remediation would be required. Children with difficulties with their handwriting often respond well to occupational therapy and academic supports in the classroom. Other visual-motor challenges, such as building models and solving puzzles, may or may not be a major issue.

If not terribly troubling to your child, it may be that some ‘scaffolding’ is required in school. Scaffolding means having a teacher or parent provide supports through the task and then gradually pull away as the child becomes more independent.

In group work, in science or engineering, for example, it may be that your child’s teacher assigns a role to your child that is not as demanding in terms of motor dexterity. He could be the researcher, planner, or presenter rather than the one building the physical model. If these supports are needed, it may be helpful to consult with a school psychologist or learning specialist at your child’s school.

If, even with these supports in place, your child continues to struggle, you might consider a full evaluation and potentially occupational therapy. At home, you can use some fun strategies to help improve your child’s dexterity, visual-motor integration, and visual perception.


Activities to Help Strengthen Your Child’s Dexterity

Many fun activities can help further develop your child’s fine motor skills. Through crafts and games, it is easy for your child to work on these skills without even realizing it is ‘work.’ For example,


  1. Rolling paper: Rolling/crumpling tissue paper between the thumb, index, and middle finger and placing it on a pattern such as a snowman, rainbow, or favorite T.V./book character


  1. Board games: Perfection, games with tongs such as Bed Bugs, the Sneaky Snacky Squirrel Game, Don’t Spill the Beans, and you can utilize tongs during board games without tongs such as picking up Connect 4 pieces, Hi-Ho-Cherry-O


  1. Feed the Tennis Ball: Cutting a ‘mouth’ in a tennis ball and adding googly eyes, squeezing the sides to open the mouth and feeding it pennies, beads, or other small objects


  1. Coin Races: Race to see who can move a coin from the fingertips to the palm, back to the finger tips faster


  1. Hide the Object: Pick up a small object (beads, bean) and place it in the palm of your hand as if you’re ‘hiding it.’ See how many objects you can fit in your hand until you drop one!


  1. Coloring: Give your child lots of opportunities to practice coloring with different types of crayons, colored pencils, and markers. Coloring is great practice for fine motor dexterity


Activities to Help Visual-Motor Integration

  1. Mazes
  2. Word searches
  3. Lacing
  4. Playing catch with different sized balls
  5. String cheerios on a spaghetti noodle by picking up each cheerio with your thumb and index finger
  6. Copying Shapes
  7. Cutting—on lines, different shapes
  8. Lite Brite
  9. Balloon Activities (balloon tap, use rackets)


Activities to Help Visual Perception

  1. Puzzles
  2. Build a figure with blocks, and have them copy it
  3. Cut a cereal box picture, and have child put it back together
  4. Card game, ‘Set’ or ‘Spot It’
  5. Shape Sorters
  6. I-Spy, Highlights Magazines-spot the differences, Where’s Waldo
  7. Memory
  8. Partially hide toys or blocks, and have the child guess what the object is
  9. Walk through the house, and have the child point out objects that are circular

How can Clear Child Psychology help with Dexterity?

If your child is struggling with this symptom to the point that it is getting in the way of his or her learning, relationships, or happiness, it’s time to seek professional help.

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