Kid-Eze Therapy Services

Motor Skills

A review of the current literature indicates:

Pedal walker

Visual-Motor Abilities

Visual motor coordination and fine motor skills are necessary for many functional and educational tasks. It is also an important variable in a child’s handwriting ability. In order to copy, a child must visualise the letterform or shape, assign a meaning to the form and then manipulate a writing tool to reproduce the same letterform or shape. Numerous researchers have found a relationship between poor visual-motor skills and handwriting. Visual motor coordination is also a necessary component for stroke control and accuracy in learning to colour, a skill required frequently in the primary grades. Colouring is also a precursor skill for the development of other, more advanced fine motor skills.

Hand Skills

Children with delayed in-hand manipulation skills (i.e. dexterity) often appear clumsy and demonstrate delayed use and manipulation of writing utensils, scissors, clothing fasteners and small objects. Exner (1996) and Pehoski, Henderson, and Tickle-Degnen (1997) suggested that the preschool period might be a particularly important time for the development of these skills. Pehoski (1998) reported that in-hand manipulation and visuomotor skills were the two skills directly related to the preschooler’s occupational performance. Cornhill & Case-Smith (1996) found a correlation between handwriting and poor in-hand manipulation skills; the scores for all the tests measuring hand skills were significantly higher in the children with good handwriting than in those with poor handwriting.

The development of dexterous hand skills also depends on the interaction of all joints in the upper limbs including the shoulder, elbow & wrist (Benbow, 1995).  When the stability of the arm is poor, hand control is compromised (Chapparo, 2002).

Pencil Grip and Pressure

Pencil grip in isolation does not necessitate treatment for handwriting difficulties, but should be remediated if fatigue is also a factor.  The variation of force of the pencil on the paper appears to have an impact on speed and legibility as well (Chapparo, 2002).


Pehoski (1998) found that occupational therapy intervention provided to preschool children with fine motor delays seems to narrow the gap between their performance and that of their peers without delays, and was particularly true for measures of in-hand manipulation and visuomotor skills. Case-Smith, Heaphy, Marr, Galvin, Koch, Good Ellis, & Perez (1998) also found that fine motor performance improves with intervention in preschool children.


Case-Smith, J., Heaphy, T., Marr, D., Galvin, B., Koch, v., Ellis, M. G. & Perez, I. (1998). Fine motor and functional performance outcomes in preschool children. American Journal of Occupational Therapy, 52, 788-796.

Cornhill, H. & Case-Smith, J. (1996). Factors that relate to good & poor handwriting. American Journal of Occupational Therapy, 50, 232-730.

Exner, C. (1996). Development of hand skills. In J. Case-Smith, A. Allen, & P. Pratt. (Eds.), Occupational Therapy for Children, 268-306. St. Louis, MO: Mosby.

Maeland, A. E. (1992). Handwriting and perceptual motor skills in clumsy, dysgraphic, and “normal” children. Perceptual and Motor Skills, 75, 1207-1217.

Pehoski, C. (1998). Clinical interpretation of “fine motor and functional performance outcomes in preschool children”. American Journal of Occupational, 52, 797-800.

Tseng, M. H. & Cermak, S. A. (1993). The influence of ergonomic factors and perceptual-motor abilities on handwriting performance. American Journal of Occupational Therapy, 47, 919-926.

Weintraub, N. & Graham, S. (2000). The contribution of gender, orthographic, finger function, and visual-motor processes to the prediction of handwriting status. American Journal of Occupational Therapy, 20, 121-202.

Weil, M. J. & Amundson, S. C. (1994). Relationship between visuomotor and handwriting skills of children in kindergarten. American Journal of Occupational Therapy, 48, 982-988