Fine Motor Skills

Evidence 

https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.12297 

Arend F Bos, Koenraad N J A Van Braeckel, Marrit M Hitzert, Jozien C Tanis, Elise Roze 

Survival rates of preterm infants have improved during recent decades, and this tendency is continuing. During the same period, the prevalence of major impairments has remained relatively constant or even decreased, but the prevalence of milder dysfunctions is high, with a tendency to increase. This mainly appears to be the result of the increased survival of very preterm infants (gestational age <32wk), although more sensitive testing may also play a role. 

Cognitive, behavioural, and mild motor problems without major motor deficits are by now the most dominant neurodevelopmental sequelae in children born preterm, with prevalence’s reported up to 50 to 70%. These ‘high prevalence, low severity’ impairments often do not occur in isolation and may considerably hamper the children's functional abilities in daily life. 

Education 

Fine motor skills are the movements we make using the small muscles of the hands and fingers. They are required for many activities of daily living and from birth, babies use their hands to explore their own bodies and the world around them. Early tasks such as reaching, grasping, holding and manipulating objects, bringing items to the mouth to explore and self-feeding all require use of the hands. Strength of the larger muscles of the trunk/spine, neck, shoulders and arms and coordination of whole-body movements (gross motor skills) all develop prior to smaller hand and finger movements.  

Some babies born preterm may experience developmental delays in infancy and develop fine and gross motor skills slower. This means they may take longer than children born at term to achieve early motor milestones such as picking up objects, crawling and walking. 

Within the first year of life, your baby will develop critical motor skills that help them to hold up their head, roll, sit, crawl and stand, as well as picking up smaller objects with their thumb and finger. As a caregiver, there are many things you can do to encourage the development of bones and muscles to help them reach these milestones. Here are some ideas you could use to help your baby develop motor skills in their first year. 

Give them room to move. 

Babies need room to practice motor skills. The best place for your baby to explore movement and develop strength is on a play mat on the floor. Hanging soft toys above your baby while they are lying on their back, from a play frame or gym is a great way to build their vision and promote early arm movement including swiping, reaching and grasping. Try to limit the amount of time your baby spends in “equipment” such as bouncers, infant seats, and swings. Jumpers and baby walkers are not recommended as they can encourage a child to stand on their toes and may even delay walking (push toys are okay). Play pens and porta cots are great when you need a safe place to keep your baby contained.  

Tummy time – it’s never too early! 

Tummy time is the best way for your baby to develop the strength in their neck, shoulders, arms and trunk that they need to roll, crawl and walk. Even very young infants can do an easier version of tummy time by placing them on your chest while you are seated in a semi-reclined position. Once a baby has developed enough strength to lift their head, they can be placed on a flat surface or with a small towel roll placed under their upper chest, from armpit to armpit. Tummy time can be hard work for babies, so try keeping it fun and reduce their frustration by starting with very short sessions – less than a minute and gradually increase the time each day as they develop. Try placing a few colourful toys, a small mirror, or your face in front of them to help make it fun. 

Give your baby the “just right” challenge. 

Your baby may get upset or frustrated when first learning a new skill. Trial and error are very important for motor learning. While keeping your baby safe, give them lots of opportunity to practice skills on their own before jumping in to help them. Once your baby learns a skill, you can help them move on to the next step by making it just a little bit harder. For example, if your baby can sit on their own, encourage them to grab a toy held just out of reach to challenge their balance. If they can hold a rattle, challenge them to hold a toy that is slightly larger or heavier or give them two rattles to try and hold.

Make it fun! 

Babies learn through play, and they learn best when they are self-motivated and engaged. Find toys and activities that your baby finds exciting (try toys and objects with lots of different sounds, textures, and colours) and use them when practicing new skills. You can give your baby toys to explore throughout the day including nappy changes, bath time, rides in the pram and while lying or sitting on your lap. Allowing your baby to safely explore nature with their hands when outside (e.g. crumpling leaves, feeling grass and sand) and providing them with a variety of textured foods they can explore with their hands and get messy once they start solids is a great way for them to develop fine motor skills. Get siblings and other family members involved when you can. Babies also learn through imitation and love watching your facial expressions and hand movements. Using exaggerated natural gestures such as waving, clapping and blowing kisses, singing nursery rhymes and songs with hand actions, and reading and pointing to picture books together, are all simple ways to interact and bond with your baby, while helping develop their fine motor skills. Remember, your baby’s biggest motivator is you – so don’t forget to give them lots of praise and encouragement when they’re attempting something new! 

Empowerment 

Not all babies born preterm will experience developmental delay; research shows the risk may increase the more preterm a baby is born. Serious developmental disabilities are relatively uncommon, and most children born preterm will be able to participate and carry out daily activities such as finger feeding, basic undressing and dressing and washing their hands by the time they reach school age. 

Keep in mind that all babies are different, and every baby grows and develops milestones at their own pace. There's no precise timeline that skills appear and generally there is a perfectly normal variation in child development. It is helpful to watch and keep your eye on your child’s progress, rather than deadlines.  

If you have any concerns relating to your baby’s early hand skill/fine motor development, speak to your GP, paediatrician, physiotherapist, or occupational therapist.

Useful Links  

Raising Children 

https://raisingchildren.net.au/babies/play-learning/play-baby-development/movement-play-babies 

Miracle Babies Foundation 

https://www.miraclebabies.org.au/content/fine-motor-skills/gk9x5c 

Aussie Childcare Network 

https://aussiechildcarenetwork.com.au/articles/child-development/fine-motor-development-for-infants-0-12-months 

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