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Child writing

Developmental Milestones for Pre-Writing and Writing Skills

Our children use their fine motor skills countless times throughout the day. Anything from picking up the small pieces of cereal that fell to the floor during breakfast, to writing their name at the top of homework, to strumming the strings during guitar class, to painting a Picasso masterpiece incorporate different fine motor skills. Below is list of fine motor milestones to make sure that your child is up to speed with their skills:

Pre-Writing Skills

12-18 months: Children should typically be able to imitate spontaneous scribbles on a piece of paper with a thick marker.

19-24 months: Children should typically be able to imitate vertical strokes, horizontal strokes, and circles on a piece of paper.

2 ½ – 3 years:  Children should typically be able to accurately copy vertical lines, horizontal lines, and circles.

4-5 years: Children should typically be able to copy a cross, square, triangle and ‘x.’ This is also the age to begin practicing the formation of the letters in your child’s name.

5 years: Children should typically have their hand dominance established for fine motor activities.

Writing Skills

6 years: Typically, children should be able to copy or write their name. By 6 years of age, they should also be able to write the alphabet without omitting letters. Children should be able to write the alphabet in uppercase and lowercase letters without switching forms throughout.

7 years: Children should no longer reverse the letters of the alphabet while writing (example: ‘b’ versus ‘d’). They should also use appropriate capital letters and punctuation to write complete sentences.

Children develop their fine motor skills at different rates. If your child is delayed, it is not necessarily cause for concern but an occupational therapy evaluation may be warranted. Try to incorporate hand strengthening activities into your day to day routine (examples: swinging on monkey bars, coloring, playing in play dough) and offer your child a lot of praise for any attempts at novel or challenging fine motor activities.


 

What Is the Difference Between Occupational and Physical Therapy for Children?

Many of the parents I meet often ask why very few occupational therapist work with infants, or why an occupational therapist (OT) is seeing their child for toe-walking as opposed to a physical therapist (PT). They often wonder why one child who has balance or coordination issues would see a physical therapist while another with similar limitations would see an occupational therapist instead. Some parents think that occupational therapists only work on fine motor skills while physical therapists only work on gross motor skills.  Physical and occupational therapists work in a variety of settings, including hospitals, neonatal intensive care units, skilled nursing homes, outpatient clinics, schools, rehabilitation centers, and doctor’s offices.  Physical therapist and occupational therapist roles differ depending on the setting they work in and the medical diagnoses they work with.

In the outpatient clinic, some of these roles may overlap.  While there are some similarities between PTs and OTs in each setting, there are a few fundamental differences between OTs and PTs in the pediatric setting.

Pediatric Physical Therapy:

In the pediatric outpatient setting, physical therapists are often musculoskeletal and movement specialists. Parents can seek out evaluations when their babies are as young as 1 month old. Physical therapists have in-depth knowledge about human musculoskeletal, neuromuscular, integumentary, and cardiovascular systems. Based on our background in stages of development and biomechanics, we help children with mobility difficulties; whether they are behind on their gross motor milestones, recovering from injury/surgery, or not keeping up with other children.

Through all kinds of hands-on or play techniques, pediatric physical therapist work with children on the following:

  • Gross motor skills
  • Strength
  • Endurance
  • Balance and coordination
  • Motor control and motor planning
  • Body awareness
  • Pain relief
  • Flexibility
  • Gait mechanics
  • Orthotics training
  • Wound care

Our focus is for children to be as mobile and as independent as possible, while training their caregivers on all aspects of a child’s physical development. This includes anything that may affect a child’s quality of movement, posture, alignment, and safety.

Pediatric Occupational Therapy

Outpatient pediatric occupational therapists are trained to improve the quality of children’s participation in their daily functional tasks.  A child’s job is to play and take part in activities at school and at home. These include important endeavors such as paying attention in class, hand writing, dressing, feeding and grooming themselves, and being able to engage in age-appropriate games. Occupational therapists are also trained to help children organize and interpret information from the environment so that they can just be kids. This may include taste aversions that limit their food intake, or texture aversions that affect their clothing tolerance, or sound aversions that affect their mood.

OTs work with children on the following skills:

  • Sensory integration
  • Cognitive endurance
  • Fine motor skills
  • Hand function
  • Visual-spatial awareness
  • Hand-eye coordination
  • Attention
  • Social skills
  • Body awareness

Occupational therapists often educate parents and teachers on the best techniques to ensure children participate in learning, self-care, and play tasks.

Why do some children need both disciplines and some only need one?

So many factors can affect a child’s ability to participate in her daily life. A child may be experiencing frequent falls or may have trouble jumping due to a number of reasons.  No matter the diagnosis or underlying medical condition, any child who is having a hard time keeping up with his peers can benefit from a comprehensive evaluation by a pediatric specialist.