What Causes Difficulty of Fine Motor Skills & How to Improve it?

Our body performs many movements while going through the daily chores of living. Among these movements, the movements which are small, coordinated and precise in nature, such as using our fingers to pick up a coin from the floor, are known as fine motor skills. In order to perform fine motor skills, it is important that there is coordination and balance of the skeletal, neurological and muscular function. If there is any disturbance in any of these, then it causes difficulty in performing fine motor skills. Individuals, after suffering from stroke, find it difficult to initiate and perform fine motor skills. Occupational therapists and physical therapists help in practicing and improving a person’s fine motor skills.

The main cause of problems or difficulty of fine motor skills is either over abundance or lack of muscle mass.¹ A person who has increased muscle tone will have problems with fine motor skills and can make mistakes due to over activation of the muscles. This results in sloppy or clumsy activities by the patient. Individuals or children with decreased muscle tone will find it difficult to perform even very normal and small activities, such as being unable to exert control of scissors or pencil. Even finger movements will be difficult and require a great deal of effort for a child/patient with decreased muscle tone.

Environmental and genetic factors can also contribute to difficulty with fine motor skills.² If a mother gets exposed to drugs and alcohol during her pregnancy, then it can affect the development of the baby. The neurons of the brain are directly affected by alcohol and there may be disturbance in the connection of the neurons in the brain of the baby if it is born prematurely. The risk of difficulty with fine motor skills increases with the prematurity of the baby. The baby can have difficulties with self-control or difficulty in his/her attention span. Smoking can also cause difficulty with fine motor skills.

An occupational therapist and a physical therapist help in improving fine motor skills of the patient. Proper guidance from an occupational therapist helps a great deal in developing and improving fine motor skills. It is believed that new pathways can be created in the brain to compensate for the affected regions. The important thing is to use the affected side such as the hand as much as possible and the activities/exercises need to be repeated multiple times daily.

Patients show a lot of improvement with constraint-induced movement therapy (CIMT), which is a type of rehabilitation program to improve fine motor skills in patients after a stroke.

A pediatric occupational therapist helps greatly in improving fine motor skills of a child. Two approaches can be adopted for the treatment, the first being a relatively general one, which deals with the assessment of the sensory development of the patient by seeing how the patient reacts and moves to a stimuli. Knowing the underlying factor will help in coming up with a second approach, which is specifically designed for fine tuning the manner in the more difficult tasks performed by the patient using their fine motor skills. Learning how to achieve and fine tune their fine motor skills will greatly help in improving the patient’s motor function.

An Occupational Therapist can also help a patient improve in the following areas:

• Overall grip and control over objects, such as pen, pencil etc.
• Finger and hand strength, hand stability and position.
• Finger movement.
• Control of the forearm and wrist.
• Letter formation and the spatial management of space.
• Dexterity and speed.
• The isolated movements, which are needed for using or holding scissors and tweezers.

It is important that parents take an active role in the treatment for continued improvement in their child’s fine motor skills. For children with difficulties in fine motor skills, the occupational therapist will make the patient perform some simple activities that can be done at home, such as drawing, paper cutting, coloring and making paper snowflakes. Drawing improves the neatness in which the child draws shapes and lines, which also improves the overall appearance of the shapes and letters. Coloring helps the eyes in determining where to stop by remaining inside the lines. One of the vital factors in fine motor skills is tracking movement. Various games and toys are also available for helping in improving the fine motor skills.

There are several exercises, which can be done to improve fine motor skills. Some of the exercises which include repeated activities using the affected hand and can be done at home include:

• Practice shooting marbles into a cardboard box multiple times a day using your affected hand.
• Practice putting pegs in a pegboard and then taking them out while timing yourself.
• Take a rubber ball and squeeze it with your affected hand multiple times in a day. This exercise will help in strengthening the affected hand.
• Rubber bands can also be used to exercise and strengthen the fingers. Keep your affected hand on the table and loop a rubber band around a finger. Next, using your unaffected hand, pull the rubber band up and down, which will give exercise to the affected finger.
• Start slowly with range-of-motion exercises, such as using your unaffected hand and raising/moving your affected arm up and down. You can also take the help of a caregiver.
• Focus on moving one finger at a time.
• Fan out your fingers daily.
• Push your affected hand and fingers against the mattress and release. Repeat this several times in a day. This will help in strengthening the hand and fingers.
• Daily practice making a fist.

Daily practicing these exercises is important. You won’t get results in a single day. Practice, patience and perseverance are required for improving fine motor skills. Every little twitch in the muscle or finger is a victory. Don’t get disheartened by lack of success in the beginning. Try doing something, which will stretch you every day and gradually you will see the results.

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