1. Fine Motor Checklist Student Name:_____________________________________Grade:_________ Gender:___________ Observed by:__________________________________________ Date:___________________ Age:____________ Use the corresponding intervention sheet for each area checked off.
Check areas you have seen difficulty with
Student does not cross middle of body with hands. Go to page 2.
Student does not have a hand preference (K-1 or after age 6). Go to page 3.
Student uses heavy or light pencil pressure (K-1 or after age 6). Go to page 4.
Student has incorrect grasp/poor writing position. Go to page 5 or 6 depending on age.
Problems with prewriting (pre-k and K). Student has difficulty drawing simple shapes such as a cross, circle or square. Go to page 7 and 8.
Student has difficulty with letter formation (K-1). Either letters are inconsistently formed or are not legible. Go to page 7 and 9.
Problems with spacing and alignment (grades 1-4). Student does not put space between letters/words, or letters go off the line. Go to page 7 and 10.
Check areas you have seen difficulty with
Difficulty using scissors. Student cannot load scissors into 1 hand and snip or cut along a line or for older students, cannot cut out complex shapes. Go to page 11.
Meltdowns (Difficulty switching activities, or transitioning between events). Go to page 12.
Low vision- Student needs accommodations because they have been diagnosed with low vision, or they need to be assessed for visual problems. Go to page 13.
Dysgraphia – Difficulty writing letters and words even after completing handwriting instruction. Go to page. 14
Hand Strengthening Activities. Go to page 15
Dislike playing with messy media (play dough, finger paints etc.)
Difficulty sitting still - constantly seeking movement.
Oral fixation- chews on everything (clothes, pencils)
Developed by Laura Hamilton, OTR (509)

2. Your Student Has Difficulty Crossing Midline
1. What to look for:
Child does not cross middle of body with hands (does not cross midline).
Child switches hands at midline to color/print
Child positions themselves so they do not have to reach across body.
3. Interventions to try
Check the ones you try
Set up table top activities that force the child to pick up an object with right hand and place it on left side of table and vice versa.
Ask the child to use one hand to reach across body to pick up items on the table or on the floor (blocks, Legos etc.)
Have the child draw large sideways figure eights on a vertical surface (i.e. on a whiteboard, chalkboard, or a big piece of paper taped to the wall)
Ball catching games (both hands)
Include a warm-up in your teaching routine that encourages students to do large movements that require crossing midline and diagonal patterns left hand to right foot etc.
____________________________
2. Why is it important?
The ability to cross midline demonstrates that the two halves of the brain are working together. It is also an important developmental precursor to developing hand dominance.
4. What did you try?
____________________________________________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

3. Facilitating Hand Dominance with your Students
1. What to look for:
Child switches hands to color/print.
Child does not consistently use the same hand to write, cut and eat
3. Interventions to try
Check the ones you try
Observe the child carefully and note what hand they use most often and for what. After identifying which hand is more skilled (dominant hand) have the child wear a bracelet or ring on that hand to encourage use.
Present items at midline. Let the child select the item with either hand, but have the child use that hand for the entire task without switching.
Maximize chances to use both hands (bilateral tasks). Activities to try: cutting, opening closing jars, stringing beads, placing stickers, pouring water or sand, play dough, lacing cards, throwing a ball, scooping or spooning into container, coins in bank or slotted, Nuts & Bolts game, or dry erase board/chalk board with sock eraser on non dominant hand.
____________________________
2. Why is it important?
Switching hands is part of normal childhood development and is generally not a problem at the preschool level. However, developing hand dominance is an important step towards more effective and efficient tool use. Children who do not develop hand dominance by age five are at greater risk for academic delays.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

4. Student’s Writing is too Dark or too Light
3. “Too Light” Interventions to try
Check the ones you try
Facilitate the correct pencil grasp (see intervention sheet on grasp)
Have child put carbon copy paper under their writing assignment. Does it copy to next page? The child now has something concrete to try.
Have child play with objects that help strengthen hands (clothespins, play dough, peg board, tweezers etc.)
1. What to look for:
Child’s writing is too light and difficult to see.
Child’s writing is very dark
Child complains of hand fatigue, pain, or cramping during writing tasks.
You see the child shaking hand in air or rubbing hand after writing or coloring
2. Why is it important?
Incorrect pencil pressure can effect legibility and cause the child to fatigue quickly when writing. Early correction of this problem can lead to more efficient legible writing and improve overall writing performance
3. “Too Heavy” Interventions to try
Check the ones you try
Pencil grip to relax grasp.
Carbon paper to provide feedback
Increase awareness of pressure by increasing the amount of feedback they get. For exp. Squeezing a ball or clapping, shacking and rubbing hands together before writing. Finger writing in shaving cream, sand, clay or on carpet square.
Mechanical pencil/try not to break led.
4. What did you try?
______________________________________________________________________________________________________________________________________________________________
What follow-up is needed? __________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

5. Encouraging a Correct Grasp with your Preschool – K Students
1. What to look for:
3. Interventions to try
Check the ones you try
Use slanted surface - slant board, 3 inch binder or easel to encourage correct position of the wrist.
Use short broken crayons or chalk to facilitate a correct “tripod gasp”.
Incorporate fine motor hand strengthening activities into your daily curriculum. Some ideas include: tweezer games, nuts and bolts, on/off lids, clothespin games, painting with eye droppers, lacing, and play-dough
5. What follow-up is needed?
___________________________________________________________________________________________________________________
2. Why is it important?
A correct grasp facilitates control for
coloring and pre-writing. However,
preschool children are too young to
force grasp because muscles are not
yet developed in hands
Grasps typical of 2-3 year-olds
Fisted grasp: The pencil is held in a
fisted hand with the point of the pencil
By the little finger.
Pronated grasp: The pencil is held
Across hand with the thumb and
index finger pointing toward paper.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

6. Encouraging Correct Grasp with Kids 6 and up
What to look for:
When learning to manage writing tools children progress developmentally from less efficient grasp patterns to more mature patterns. Children over 6 should have a tripod grip as shown here.
3. Interventions to try
Check the ones you try
Use slanted surface such as slant board (3 inch ring binder) or easel to encourage correct position of the wrist (wrist down on writing surface)
Provide pencil grip (6 yrs or older)
Use short broken crayons or chalk to facilitate a correct “tripod gasp”.
Incorporate fine motor hand strengthening activities into your daily curriculum (pegs, play dough)
Engage kids in tasks that copy the tripod grasp. Some ideas include: tweezer games, nuts and bolts, lids on/off, clothespin, eye dropper, lacing.
Child holds small object (penny) against palm with the ring and little finger leaving the other 3 free to grasp writing utensil.
If its not broke, don’t fix it! Many grasps look different than a tripod but they work for the student.
2. Why is it important?
A correct efficient grasp for writing facilitates control and coordination and can enhance legibility and writing speed.
Comments on what you tried:
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

7. Facilitating Good Writing Posture
What to look for:
The student is slumped on the desk
The student's feet dangle from the chair
The desk appears too high for the child.
The student does not choose to engage in large gross motor play at recess/PE
3. Interventions to try
Check the ones you try
Adjust seat and table height so that the students hips and knees are at 90 degrees, the students feet are flat on the floor, and that the table is two inches above the student’s elbow when arms are at sides.
Observe how the child is holding the pencil, does it look correct? Paper should be tipped right for left handed kids and left for right handed kids.
Add a morning warm up or group gross motor game (Simon says, duck, duck goose) to the daily routine.
Consider other ways for student to approach work – exp. Standing to do work at a higher surface, sitting on an exercise ball with a stand
Try using a wobbly cushion or sit and move cushion.
____________________________
2. Why is it important?
Good sitting posture is an important foundation skill for all table top fine motor skills. It gives the student a sturdy base of support to work from and accordingly increases writing control and precision.
When helping a student achieve good writing posture watch for signs of fatigue and build tolerance slowly.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

8. Facilitating Prewriting with Students
1. What to look for:
Can your student copy the following prewriting shapes?
׀ ― + □ ○ / \ ∆
3. Interventions to try
Check the ones you try
Progression to follow during prewriting activities: Imitate lines, Trace lines, Copy shapes
Right to left and top to bottom (directionality) problems
Highlight left and right margins (left with green for GO and right with red for STOP
Top/bottom directionality – colors to represent the top and bottom of a line
Do simple mazes and dot to dots
Do activities that encourage movement from left to right and that reinforces the movement with correct words (draw a rainbow and start on the left here and finish on the right over here)
Diagonal lines – boxes to make x’s in – emphasizing corner to corner
Formation – Fill in missing parts of pictures and letters, dot to dot, air writing with fingers, draw a mystery letter on back and have them guess.
2. Why is it important?
Children need to be able to draw all their prewriting shapes in the developmental sequence shown above before they start printing upper case letters. If they can draw all of them correctly it is a strong indicator of handwriting readiness. Incorporating a variety of fine motor activities in your curriculum will help children develop the muscles in their hands they need for writing.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

9. Facilitating Letter Formation with (K-1) Students
3. Interventions to try
Check the ones you try
First check the basics: see writing posture and pencil grip sheets for ideas.
When possible use a vertical surface for writing to facilitate wrist strength, positioning, and control
If possible determine where the problem is. Is it with concepts of directionality (right to left, top to bottom). Can they make diagonal lines? If they are copying from the board, can they see it? Move them closer or provide a near model.
Use a handwriting curriculum such as Handwriting Without Tears®
Arrange an in-service with Occupational Therapy to learn about a research based letter formation teaching progression
__________________________________________________________________________________________
What to look for:
the starting point is incorrect
the direction of the pencil strokes are incorrect
the sequence of the pencil strokes are incorrect
the control of the pencil is poor
letters are confused with each other
2. Why is it important?
Letter formation directly impacts legibility, speed and overall writing proficiency. Letter formation must be taught consistently and systematically for best results.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

10. Facilitating Size, Spacing, and Alignment (grades 1-4)
1. What to look for:
Child does not align letters on the guideline.
Child does not leave enough space between letters or words.
Letter size is inconsistent or inappropriate.
3. Interventions to try
Check the ones you try
Determine the type and size of lined paper that works best for the student and stick with it.
Use frequent verbal cues to “bump” or touch the line with all letters.
Use a systematic approach to teach hand writing such as Handwriting Without Tears®.
Use a spacer between words (popsicle stick, pointer finger)
Have student review work and self correct it. Is there space between words, are my letters on the line, are the tall letters tall and the long letter long, is there a capital at the beginning and punctuation at the end.
____________________________
2. Why is it important?
Size, spacing, and alignment of letters directly impacts legibility. Consistent performance in these areas develops throughout kindergarten and first grade, and is generally achieved in second grade.
4. What did you try?
______________________________________________________________________
Developed by Laura Hamilton, OTR (509)

11. Facilitating Correct Scissor Use
1. What to look for:
Observe how the child manages the scissors and the paper. Can the child put the scissors in one hand and snip? Are they cutting with the thumb pointing up? Does the child hold the paper with the other hand and rotate it?
3. Interventions to try
Check the ones you try
The correct cutting position is with the thumb in the top loop and two fingers in the bottom loop. Have the child hold the paper with the thumb on top.
When teaching children to cut it is important to provide hand over hand assistance until they master the correct positioning for cutting.
Hand strengthening activities like squeezing play dough and clothespin games will help children develop the hand muscles they need to use scissors.
Cutting Progression: Snipping paper, making forward consecutive cuts, cutting on a line, cutting out circles, cutting out shapes with corners, cutting out more complex shapes such as stars.
____________________________
2. Why is it important?
Correct loading and positioning of scissors is the first step in learning to cut effectively. Following the proper progression of learning to cut will help students feel more successful.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

12. Avoiding Meltdowns: Trouble with Transitions
1. What to look for:
Does your student have difficulty moving from one activity to the next, especially when it is a non-preferred activity? Is he or she throwing fits that are disrupting the rest of the class?
3. Interventions to try
Check the ones you try
Make a habit of giving a two minute warning whenever you are about to switch activities.
Keep a schedule for the day in plain view and announce it in the morning or have a daily picture schedule at the child’s desk.
Use “first / then” statements with your students and be consistent about enforcing them.
If the child begins to have a meltdown offer them two choices that are both appropriate and acceptable to you. This gives the student some control but only within your parameters.
Remain cool, calm, and assertive with children who are prone to meltdowns. Try not to get frustrated as this will escalate the situation.
Pick your battles. Is the child really asking for something unreasonable, or should you ignore and save energy for a more important situation?
2. Why is it important?
The ability to transition from one activity to the next is key for good functioning in the classroom as well as being a crucial life skill. Helping your students make smooth transitions will give you a break, cause less disruption to other students, and be key to the functional social development of your student.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

13. Tips for Students with Low Vision
1. What to look for:
Vision complaints from student
Frequent squinting at the board
Rubs eyes a lot
Closes or covers one eye
Tilts head or thrusts head forward
Inconsistent use of glasses
3. Interventions to try
Check the ones you try
Experiment with large bold fonts or use the copier to enlarge assignments.
Outline things you want the student to color or cut with a black wide tip felt marker.
If far vision is the problem, prepare near models for the student and move them closer to the front of the classroom.
Investigate the use of glasses. Obtaining a school pair may be necessary to ensure that the student always has access to glasses in the classroom.
Seek advice from the district’s low vision specialists at
____________________________
______________________________
2. Why is it important?
It goes without saying that a child needs to be able to see written material to function in a standard classroom. If you have a child with low vision it is important to consistently make all necessary accommodations to ensure that student’s success.
4. What did you try?
_________________________________________________________________________________________________________
Developed by Laura Hamilton, OTR (509)

14. Accommodate-Accommodate-Accommodate!!!
DYSGRAPHIA General term that covers many areas of visual-perception and fine-motor as they relate to handwriting
3. Interventions to try
Accommodate-Accommodate-Accommodate!!!
Focus on developing fine motor skills such as pencil grip and hand coordination
Develop motor-muscle memory. Ask the student to air write the letters with their eyes closed so they can go by “feel” and not what they “see”.
Reduce the amount they have to write. Allow them to dictate long assignments.
Write sentences for them and ask them to copy
Include a letter strip and a folder with high frequency words on their desk to refer to
Speech and occupational therapy referrals in the community (if they do not qualify for services within the school district) to help them develop the connections between letters, sounds, and words.
a Neuropsychologist is usually best to make this official diagnosis
Introduce keyboarding. Practice at least 5 min. a day with a type to learn program. There are many free programs on the web. Develop Motor Memory!
Introduce typing programs with word prediction
If typing is too difficult, try speech recognition programs (voice to text)
1. What to look for:
Diagnosed by a qualified professional
Intense dislike of writing/refusals to write
Continues with illegible printing even
after handwriting instruction
Mixes upper and lower case
Still has letter reversals after 3rd grade
Reads at grade level but cannot write
Unable to print more than a paragraph
Some students may also have difficulty with language processing and the connection between words and ideas they represent.
2. Why is it important? People with dysgraphia have much more difficulty with writing than others, but their abilities in many areas may be average or better. They are at-risk for being seen as lazy and careless with their work because of the frustration and fatigue they experience when completing seemingly easy tasks. Educators must provide positive learning experiences for them to help maintain their self-esteem and motivation.
Developed by Laura Hamilton, OTR (509)

15. Hand Strengthening Activities
What to look for:
Difficulty holding a pencil or manipulating items in the classroom such as game pieces
Difficulty opening and closing containers, buttoning or snapping clothing etc.
Complaints of hand pain or fatigue after writing or any other activity using their hands
3. Activities to try
Check the ones you try
Play Dough/Modeling Clay etc.
Hole Punch and Scissors– use on various thickness of paper until hands are tired
Screwing and unscrewing jar lids - grade strength by how tightly put on
Play tug of war with soft rope or rolled up towel or pull a friend on a towel
Carrying heavy tote bags
Cookie Press – squeeze play dough or cookie dough through press
Animal Walks – do different kinds of walking on hands (wheelbarrow, bear)
Hammer and pound golf tees or large headed nails into cork, Styrofoam, etc.
Sopping Sponge – use a sponge to sop up water and then squeeze into another container
2. Why is it important?
To be able to properly hold a pencil, the hand must be strong enough to maintain an open web space (between index finger and thumb). Strengthening activities will help develop the appropriate muscles allowing the child to gain control of hands and fingers for functional activities. When completing activities, make sure the thumb is grasped around the object and not placed along side of the index finger.
4. What did you try?
______________________________________________________________________
Developed by Laura Hamilton, OTR (509)