Fine Motor Dev

Question 1

Newborn FMD

Answer 1

UE add and flexed with fisting of hands
Grasp reflex is predominate
Moves both arms randomly/reflexive and in total flx or ext
Beginning to visually “look” at things

Question 2

1 Month FMD

Answer 2

Moving arms, simultaneously in/out of flex
Thumbs in/out of palms
Hands fisted at rest
Involuntary grasp/release
No attempt to reach
Regards adult face

Question 3

2 Month FMD

Answer 3

ATNR
Make visual contact with hand face side
Prone-no neck, elbows behind shoulders, weight on forearms and ulna side of hands
Turns towards/away from familiar sounds
Loosely fisted—thumbs are coming untucked
Visually—regards and briefly follows adult face

Question 4

Up to 3 Month FMD

Answer 4

Interaction with environment is via visual inspection
Grasp reflex
Startle reflex
Begins to reach unilaterally—”bats” at objects

Question 5

3-4 Month FMD

Answer 5

Increase midline orientation of head –less ATNR
Hands come together over belly and held close into body
Fingers loosely flexed
Grasp reflex dropping out
Elbows moving under shoulders in prone, weight on forearms, hands loosely fisted, increased head control in prone

Question 6

4 Month in Prone

FMD

Answer 6

More desirable play position
Good head control in midline
Elbows under shoulders with increased weight on elbows not forearms
Can flex to get hand to mouth in prone and maybe a toy
Hands open with weight on palms of hands

Question 7

4 Months in Supine

FMD

Answer 7

Increase symmetry and increased ext with controlled neck/scapula flx get hands moving away from belly and body to more up and in front of eyes
Lots of hand to hand play, hand to mouth play and visual inspection of hands

Question 8

5 Months in Prone

FMD

Answer 8

Lots of prone play on flx and ext UE
Can grasp toys and get to mouth when on elbows
May reach for toy on ext elbows but any manipulation is done on elbows-not enough control yet on ext arms
Increase in neck and scapular stability get increase elbow stability
Weight on wrist and radial palmar sides of hands in prone
Elbows forward of shoulders

Question 9

5 Months in Supine

FMD

Answer 9

Lots of symmetry
Lots of hand to mouth play and toys in mouth
Lots of hand to knee and maybe feet play
Lots of elbow ext
Grasping and begin transfer object hand to hand by pulling
Using a palmar and ulnar grasp

Question 10

6 Months in Prone

FMD

Answer 10

Still will play in prone and be up on elbows and fully extended arms with weight on palms and radial side of hand
Can get toys and transfer but moving out of prone into sit to be more functional with play

Question 11

6 Months in Sit

FMD

Answer 11

Better ind sit so better position to play
See improved hand skills
Using more of a radial palmar grasp
Transfer starting w/o pull but placement into other hand (bilateral integration)
Not much time in supine

Question 12

7 Months

FMD

Answer 12

Play in a variety of positions
Using a radial digital grasp more
Thumb coming from add to abd to opp position
Begin controlled release

Question 13

8 Months

FMD

Answer 13

Lots of trans movements and differ play positions
This all results in increased rot, diag movements, weight shifting
Begin to pre-position fingers to grasp a medium size object
Uses radial digital and sometimes inferior
With small object still rakes to obtain

Question 14

8-9 Months

FMD

Answer 14

More pre-positioning of fingers to grasp (adjusts to size of object)
Radial digital grasp with wrist ext
Lots of releasing of objects (child engages in game of releasing and watch other person retrieve item)

Question 15

9-11 Months

FMD

Answer 15

More opp of thumb and inf pincer grasp
Refinement of release with slight wrist ext and rot of forearm-so child can see hand and place object
Decrease use of ulnar fingers
Begins poking with index finger
Able to hold one object in each hand and bang
Emerging ability to hold item in one hand and act on it with other hand

Question 16

12 Months

FMD

Answer 16

Emerging sup pincer grasp
Use of sup of forearm
Use of wrist ext
Release objects with control of shoulder, elbow and wrist
Works on releasing skills

Question 17

12-15 Months

FMD

Answer 17

Increasing control of intrinsic muscles so can now pick up and hold precisely flat objects
More refinement of bilateral skills
Scribbles with imitation
Stacks 1-2 cubes

Question 18

15-18 Months

FMD

Answer 18

stacks 3-4 blocs, scooping with a spoon—controlled supination

Question 19

17-18 Months

FMD

Answer 19

Starts to use one hand to stabilize while other manipulates
Pulls pop-beads apart
Scribbles spontaneously, might initiate a vertical stroke

Question 20

18 Months- 3 Years

FMD

Answer 20

Develops use of disk, cylinder, spherical, and lateral grasps
Increasing control with power grasp
Increasing control with release to enable ball throwing
Increasing use of simultaneous manipulation by both hands