STADS Physiotherapy
Fine motor skills delay
Every child develops at their own pace; sometimes a little extra support helps.
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You notice that your child struggles with cutting, colouring, holding a pencil or doing up the buttons on a coat. Perhaps it’s slower than for other children their age, or your child quickly gets frustrated. On this page you can read what fine motor skills are, how a delay can develop, when it’s wise to seek help and what you can do at home.
What is a fine motor skills delay?
Fine motor skills are the small, precise movements of the hands and fingers. Think of grasping and letting go, holding a pen, cutting, tying a shoelace or eating with cutlery. For these movements, many things need to work together: strength and stability in the trunk, shoulder and wrist, feeling in the fingers, the eyes guiding the hand and the brain planning and coordinating it all.
Children learn these skills step by step, mostly through play and lots of practice. There’s a wide range: one child colours neatly inside the lines at four, another needs more time. That’s normal. We only speak of a delay when a child clearly and persistently struggles more than you’d expect at their age, and when that gets in the way of daily life, play or learning.
What signs might you notice?
- Your child holds a pencil or brush awkwardly or tensely and their hand tires quickly.
- Cutting, colouring inside the lines or drawing simple shapes is harder than for other children their age.
- Getting dressed takes a lot of effort, such as buttons, zips or laces.
- Eating with a knife and fork is difficult or very messy.
- Your child avoids crafts, puzzles or building with small blocks.
- At school, their handwriting is hard to read or writing is very slow.
One of these signs on its own says little. What matters is the overall picture and how your child feels about it.
What causes a fine motor skills delay?
Often there’s no single clear cause. Sometimes a child simply hasn’t had much experience yet with crafts, drawing or small objects, for example because they prefer running and climbing. With extra chances to practise, development then often picks up by itself.
The foundations play a part too. Fine motor skills build on gross motor skills: a child who can’t yet keep their trunk and shoulders stable has less control over their hands. Low muscle tone, flexible joints, difficulty processing touch or difficulty with eye-hand coordination can all make it harder.
In some children, a delay is linked to a broader developmental issue, such as DCD, a general motor delay, premature birth, attention or concentration problems or a neurological condition. Sensory processing can also play a part: some children dislike certain materials, such as clay or glue, and avoid them. As a result, they practise less. It’s good to map out these factors together, so the support fits what your child really needs.
How long does it take?
That varies greatly from child to child. In many children, fine motor skills catch up well over a few months with some extra attention and practice. Children learn best by doing, and young children’s brains are very good at that.
If the delay is linked to a broader developmental issue, it can take longer. The goal then isn’t always for your child to do everything exactly like their peers, but to be able to do the things that matter to them, perhaps with a handy adaptation or a clever way of working. We can’t say in advance how quickly it will go. But we regularly review with you and your child whether there’s progress and whether the approach is still right.
When should you see a paediatric physiotherapist or paediatric occupational therapist?
- Your child is clearly behind their peers in drawing, cutting or dressing, for longer than a few months.
- Their teacher is worried about their handwriting, writing speed or craft work.
- Your child gets frustrated, loses confidence or avoids activities that use their hands.
- Your child also struggles with gross motor skills, such as cycling, catching a ball or balance.
- The child health clinic (consultatiebureau) or youth doctor advises further assessment of their motor skills.
Can’t work it out on your own?
Our physiotherapists and occupational therapists are happy to help. In most cases you can come without a referral, in Eindhoven or Tilburg.
When should you see your GP or youth doctor?
Contact your GP, the child health clinic or the youth doctor if your child loses skills they could already do, if one hand or arm is clearly used less than the other, or if there are also concerns about speech, social contact, behaviour or overall development. With noticeable trembling, sudden weakness or frequent falls, it’s also wise to have a doctor take a look first.
How STADS helps with a fine motor skills delay
We start with a conversation with you as a parent. What do you see at home, what does school notice and what would your child like to be able to do? Then we observe your child during play and daily activities. Where needed, we carry out a standardised motor skills test, so we can compare their skills with those of their peers. We look not only at the hands, but also at posture, strength, balance and eye-hand coordination.
Then we explain in plain language what we see and what it means. Together with you and your child, we set concrete goals, such as zipping up their own coat or enjoying drawing. Small, achievable steps give a child confidence.
Treatment is playful and practical. Your child practises with real tasks and games that suit their age, and we gradually increase the difficulty. If it’s mainly about the foundations, such as posture, core stability and coordination, our paediatric physiotherapist will guide your child. If it’s mainly about daily activities such as dressing, eating and writing, or about adaptations at home and at school, paediatric occupational therapy may be a better fit. If sensory processing plays a part, sensory integration therapy can be a useful addition.
You’ll get concrete exercise and play ideas to use at home. With your permission, we coordinate with school, so your child gets the same support there.
What can you do yourself?
- Offer plenty of play materials that challenge the hands, such as clay, threading beads, clothes pegs, stickers, Lego and puzzles.
- Let your child help around the house: kneading dough, washing vegetables, laying the table or hanging out the washing with pegs.
- Make sure they sit well when drawing: feet on the floor or on a box, table at elbow height.
- Use thicker pencils or crayons if thin pencils are difficult.
- Let your child do as much as possible themselves when dressing and eating, even if it takes longer.
- Praise the effort, not just the result, and stop when your child gets tired or frustrated.
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Frequently asked questions
At what age can my child hold a pencil properly?
That varies per child. Toddlers usually still grab a crayon with their whole fist. Between the ages of 4 and 6, most children gradually develop a finer pencil grip with their fingers. A slightly unusual grip isn’t necessarily a problem, as long as your child can draw or write with it in a relaxed and legible way. If you’re worried, we’re happy to take a look.
What’s the difference between paediatric physiotherapy and paediatric occupational therapy for fine motor skills?
The paediatric physiotherapist mainly looks at the motor foundations: posture, core stability, strength, coordination and the movements themselves. The paediatric occupational therapist focuses mainly on daily activities such as dressing, eating, playing and writing, and on adaptations at home and at school. At STADS, both disciplines work together, so your child gets the support that best fits their needs.
Will my child grow out of it?
Sometimes, yes. Many children catch up with time and extra play experience. For some children it stays difficult without targeted support, and their self-confidence can suffer. If you’re unsure, an assessment will give clarity. Sometimes the advice is simply to wait and see, and play more at home.
Do I need a referral for paediatric physiotherapy?
No. In most cases you can come to us without a referral. We then start with a short screening to see whether paediatric physiotherapy suits your child’s needs. The same applies to paediatric occupational therapy. Sometimes we ask for information from the GP, youth doctor or specialist, for example if your child has been assessed before. That way we build on what’s already known.
Is the treatment covered by my insurance?
That depends on the insurance and any supplementary package. For children under 18, paediatric physiotherapy is often (partly) covered by the basic insurance, for a limited number of treatments per year. For some chronic conditions, a different arrangement applies. Paediatric occupational therapy is also often covered by the basic insurance for a number of hours per year. For more information, see reimbursements and rates or feel free to ask us.
Our locations
Two practices, one team
In Eindhoven and Tilburg, physiotherapists and occupational therapists work together under one roof. Choose the practice that’s easiest for you.
Eindhoven
Centrally located on Geldropseweg, with spacious treatment rooms and a large exercise room. Easy to reach by bike, public transport and car.
Address
Geldropseweg 28
5611 SJ Eindhoven
Free parking behind the building
Tilburg
Right in the heart of the Reeshof, close to the A58 exit. Also easy to reach from the surrounding villages.
Address
Reeshofweg 40
5036 BK Tilburg
Mon to Fri, 08.00–18.00
Questions first?
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