Children’s Occupational Therapy

Typical developmental milestones:

• Around age 3 – able to dress and undress themselves if helped with fastenings (buttons, zips) and helped to get clothes the right way around, need help to get shoes on the right feet
• Around age 4 – able to complete large buttons, needs help to fasten zips and may still need help getting shoes on the right feet.
• Around age 5 – dresses and undresses independently including smaller buttons, puts shoes on the right feet, may manage a large toothed open ended zip.

Tips and strategies to help your child develop their dressing skills

General strategies

• Practice dressing skills through play e.g. dressing up box, dressing dolls/toys, or musical chairs but when the music stops you have to put on and item of clothing
• Try to ensure your child knows their different body parts, you could play ‘Simon Says’ asking the child to touch/tap/tickle different parts of their body
• Ensure your child has a stable sitting position when they are practicing dressing e.g. sitting on a step stool or on the floor
• You may want to start with practicing undressing as this is easier than dressing
• You may want to start practicing with looser clothing e.g. pyjamas, which will be easier for your child to manage
• Describe actions and parts of the body as you are helping your child e.g. put one leg in, now your other leg, now stand up and pull up your trousers

Buttons

• Start by practicing posting pennies into a money box. Next, encourage your child to practice buttons whilst sitting at a table with the item of clothing on the table in front of them, teach them to ‘post’ the button into the hole just like they posted the coins.

Zips

• Practice using large toothed zips, initially put the zip into the shank for your child and ask them to practice pulling the zip up
• You can attach an extra-large zip pull or key ring onto the zip, so they have something chunky to grasp hold of

 Shoes

• If your child keeps getting their shoes on the wrong feet you could put stickers inside the shoes. Take a smiley face sticker, cut it in half and place one half inside each shoe, your child needs to place their shoes together to make the whole face, then they know which shoes goes on which foot.

Typical developmental milestones:

• Around age 3 – eats with a fork and spoon, drinks from a cup held with one hand, helps self to a drink from the tap, can help to set the table
• Around age 4 – eats skilfully with a spoon and fork, including liquids on a spoon, pours liquid from a jug
• Around age 5 – uses a knife and fork competently, gets own breakfast cereal, can use a knife to spread butter etc, can cut soft foods e.g. cutting a sandwich in half. 

Tips and strategies to help your child develop their self-feeding skills 

General strategies

• Children need a stable sitting position to master any fine motor skill. When sitting down for meals your child should have support under their feet, if their feet don’t reach the floor consider using a foot block. Your child should be sat high enough at the table that their elbows rest comfortably on the table top, if they are too low down consider adding a booster seat.
• Playing games which involve using the right and left hand together will help your child develop the bilateral (two handed) skills required for using cutlery. Games such as sweeping with a dustpan and brush, holding a bowl whilst mixing with a spoon, or tearing paper using two hands will all develop bilateral skills.

Having the right equipment

• Having a non-slip mat under the child’s bowl will stop it from slipping around
• Make sure cutlery is the right size for your child’s hands. Cutlery with a chunky handle is generally easier to grasp and control. If your child is practicing cutting make sure they have a serrated child’s knife (not plastic) so that it can actually cut.

Practicing spooning and scooping

• Encourage your child to practice scooping during play e.g. scooping dried rice/lentils/cereal from one container to another, provide them with a range of spoons e.g. tea spoon, serving spoon, ladle
• Encourage your child to pour water from one container to another in the bath

Practicing using a knife and fork together

• Practice cutting away from meal times, you could cut play dough, or make a fruit salad for the whole family and have your child cut the soft fruits.
• Children can find it difficult to apply to right amount of pressure, so try giving them a range of textures e.g. soft fish fingers with firm boiled potatoes, and talking about the fact that you need to press harder to cut through the firm potato.

Typical developmental milestones:

• Around age 3 – washes own hands but needs help with drying, can take self to the toilet independently but needs help wiping
• Around age 4 – washes and dries hands independently, independent taking self to the toilet
• Around age 5 – toilets, wipes, flushes and redresses self independently, able to wash and dry their hands and face independently.

Tips and strategies to help your child develop their toileting skills 

Potty training

• Most children will learn to use the toilet/potty between the ages of 2 and 3
• Signs that your child is ready to potty train include them being dry/clean for a couple of hours at a time, them being aware when they are having a wee or a poo, and them being interested in using the toilet
• Nappies are highly absorbent which can reduce your child’s ability to learn when they are wet, you could try putting a piece of kitchen towel in the nappy, or wearing pants under the nappy, to let them feel the sensation of being wet
• When you first start potty training try to sit your child on the potty at regular intervals e.g. every 2 hours. Aim for them to sit on the potty for 5-10 minutes whilst doing something fun e.g. looking at a story or blowing bubbles
• Talk to your child about what they are doing on the potty e.g. ‘waiting for a wee’, running a tap can help to encourage weeing

Learning to wipe

• Standing up to wipe is usually easier for children
• Guide their hand so they start to learn the action they are aiming for
• Some children find using wet wipes easier than toilet paper to start with, as they are able to feel where the wet wipe is on their skin more easily
• Encourage your child to look at the wipe before the flush it away to see if they are clean or not
• Some children will find it useful to practice wiping on a toy e.g. wiping squirty soap off dolly’s bottom, this allows them to visually see what you are asking them to do
• Some children benefit from practicing wiping in other activities e.g. squirt some moisturising cream onto a plastic plate and ask them to wipe it off

Typical developmental milestones:

• Around age 3 – starting to use a static tripod pencil grasp (thumb and index finger holding the pencil steady), able to copy a vertical line, horizontal line and a circle.
• Around age 4 – starting to use a dynamic tripod grasp (fine finger movements create controlled marks), able to copy a cross and an x
• Around age 5 – able to copy a triangle and square, draws lines with a ruler, prints own name

Tips and strategies to help your child develop their pencil skills 

General strategies

• Chunky pens and pencils are easier for your child to grasp
• Practice pencil skills in lots of different settings to keep it fun e.g. sitting at the table with pens and pencils, drawing with chalks on the garden path, or painting with water on the garden fence

Holding the pencil

• Encourage your child to hold their pencil between their thumb, index and middle fingers
• This can be encouraged by using a triangular pencil or a pencil grip

Learning to draw the basic shapes

• For your child to be able to form letters in the future, they first need to master drawing the basic shapes
• Play games involving shapes e.g. shape puzzles or shape sorters, and name the different shapes for your child
• Initially your child will need you to draw the shape so they can watch you and copy your movement, as their skills develop they will be able to copy just from a picture on the page
• Start by drawing shapes very large, so your child can feel the shape through their whole upper body and arm
• Practice drawing shapes on a vertical surface e.g. a blackboard or paper pinned up on the wall
• Start by practicing the most basic shapes (line, circle) then move to more complex shapes (cross, x) and when these are mastered move on to more complex shapes (square, triangle)
• Practice drawing shapes in flour/talc/sand/shaving foam/finger paint, to give your child lots of sensory feedback

Typical developmental milestones:

• Around age 3 – can snip forwards along a line
• Around age 4 – can cut along a straight or curved line, staying within about ¼” of the line, can cut out a circle staying within ½” of the line
• Around age 5 – can cut more complex shapes such as a square and triangle whilst staying within ½” of the line

Tips and strategies to help your child develop their scissor skills

General strategies

• Using scissors requires a ‘doing hand’ the hand which holds the scissors, and a ‘stabilising hand’ the hand which holds the paper. You can practice other games that have a doing hand and a stabilising hand e.g. opening jars, threading beads onto a string, drawing round a stencil

Getting the right equipment

• Ensure your child’s scissors are the right size for their hands
• Make sure you chose children’s scissors which have a metal blade that is actually able to cut. Your child will need supervision and a good sitting position to use scissors safely

Practicing with scissors

• Support your child to place their thumb and first two fingers into the scissor handles, they might need you to move their thumb and fingers into place initially whilst they are learning this hand position
• Start with practicing small snips round the edge of a piece of paper, then progress to cutting along a long straight line
• Make scissor skills fun e.g. snipping straws into 1” sections to make ‘beads’ to string onto a necklace, or snipping round the edge of a paper plate and then painting it to make a lion mask