Fine motor development

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Original Author(s): Dr Louise Ingram and Hannah Murray
Last updated: 19th July 2018
Revisions: 18

Original Author(s): Dr Louise Ingram and Hannah Murray
Last updated: 19th July 2018
Revisions: 18

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Child development is the process by which the dependent infant matures into the independent adult, functioning within society. It is a complex interweaving of biology, psychology and environment where each skill builds on the ones that have come before and provides a foundation for those skills yet to develop.

Development in humans follows a predictable pattern and a rough schedule but no individual develops in exactly the same manner as any other. It follows an orderly pattern (unlike almost everything else regarding children); from top to bottom, central to outer and simple to complex. What is important, when considering normal development, is progress and parity; that children are moving forward in the different areas of development at roughly the same rate.

Disparity in progress between areas of the body (e.g. the right side and the left or the lower limbs and the upper limbs) or between domains of development (see below) is concerning, as is regression (i.e. loss of previously attained skills).

This article will outline the typical stages of development that children go through. The features typically seen at each age are described below.

Fine motor development

Fine motor development refers to the smaller movements, mostly concentrated in the hands, such as grip, manipulation of small objects, writing and using scissors. This area of development is important as these skills underpin many others; if you can’t hold and manipulate objects because there’s a problem with the muscles of your hands (fine motor skill), you won’t be able to feed yourself using a fork or spoon (social skill).

Age Feature
1 month Grasps a finger when placed in the palm
3 months Watches their own hands

Brings hands to their mouth

Holds a toy briefly

6 months Palmar grasp

Reaches for toys

Puts objects into mouth

9 months Passes toys from one hand to the other

May have a pincer grip

12 months Fine pincer grip

Points to objects of interest

Releases objects intentionally

15 months Imitates to and fro scribbles

Builds a tower of 2 cubes, when demonstrated

18 months Makes a tower of 3 blocks

24 months (2 years) Builds a tower of 6 blocks

Draws a horizontal line with preferred hand, may draw vertical lines

Turns pages of a book individually

30 months Can thread beads on a string

Makes a tower of 7 or more blocks

Holds a pencil with a tripod grip

36 months (3 years) Builds a bridge using blocks

Draws a circle

Draws a person with a head

 42 months (3.5 years) Draws a cross

48 months (4 years) Builds steps using blocks

Draws a square

Draws a person with head/face, arms and legs

60 months (5 years) Uses a knife and fork competently

Draws a triangle

Copies alphabet letters

One helpful way of remembering the age at which children draw certain shapes is the image above, a.k.a “Captain Development Person!”. You start with the hair and draw the person using each development milestone listed above. Try it out!



(1) Kapoor, Barnes, “Developmental Assessment”, Paediatrics, Edition 4, 2013
(2) Lissauer, W. Carroll, “Normal Child Development, Hearing and Vision”, Illustrated Textbook of Paediatrics, Edition 5, 2017
(3) Sheridan, M. D., From birth to five years; children’s developmental progress, 3rd edition revised and updated by A. Sharma and H. Cockerill, Routledge 2007
(6) Meggitt, C., Child development, an illustrated guide, 2nd edition, Heinemann 2006





1st draft: Trainee doctor Hannah Murray

Senior review: Dr Louise Ingram (Paediatric specialist registrar)