"Hi, I'd just like to know if you have any information on how to help my 4 year old son, who was just diagnosed with PDD-NOS, improve on his fine motor skills; such as shoelace tying, writing, snapping, zippering, etc. Thanks for your help." Sincerely, NR

Answer: Kelly Wilk, Occupational Therapist. (See more from Kelly at www.junctionof-ot-function.com)

Fine Motor 101: Some suggestions that have proven to be beneficial when trying to get a "jump start" on school readiness for fine motor skill development include:

1) Think big: When teaching fastener use (buttons, zippers, snaps) use very large fasteners. Little hands have an easier time trying to manipulate larger fasteners. Always teach unbuttoning first, using a big button. Developmentally it is easier to unbutton and the child feels successful. Zip up a zipper and let the child practice unzipping initially. Try using larger worn snaps, they are easier to manipulate.

2) Think simple: In other words break down the steps to any fine motor activity and keep the activity basic. Taking something apart is easier than putting it back together again! Remember that visual aides are vital. Hand over hand assistance helps the child "feel" the steps to any activity and is especially beneficial when there are motor planning difficulties.

3) Try to incorporate the activity into a child's daily routine: This makes the task meaningful to the child and they tend to absorb "functional activities" more readily!

4) Make it fun: Try to use a multi-sensory approach when teaching any skill and most importantly, BE PATIENT! Through daily practice, kids will learn. The key is in "How" we present the learning experience.

5) Break into steps: When teaching shoetying, break down the steps and do not move on until the child learns each step. Shoetying can be a huge undertaking, I know! When the steps are broken down, the child can build on each step and will be successful. The steps are a) the knot, b) making a bow, c) wrapping the lace around the loop, and d) pushing the lace through the hole to tie the bow.

6) Learn how to write through other modalities other than a pencil: A wonderful program is the Handwriting Without Tears program that uses wooden blocks to "build" letters. This is great and much less intimidating for a child that may already have fine motor delays. Teach top-to-bottom formations and again have fun and learn through play!

Site Links:
Shoe Tying made Simple
Handwriting without Tears
Red Lace, Yellow Lace