Pediatric Occupational Therapy

Understanding "Occupation"

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at Woman’s Center for Wellness


The word occupation refers to daily life activities. The role of Woman's Pediatric Occupational Therapists is to address the following age-appropriate skills and how they relate to play and function:

  • Perceptual motor skills: Perceptual-motor activities require children to use their brain and body together to accomplish tasks—for example, walking on a balance beam while reciting the alphabet.
  • Sensory motor skills: Sensory play includes any activity that stimulates your young child's senses: touch, smell, taste, movement, balance, sight and hearing. Sensory activities facilitate exploration and naturally encourage children to use scientific processes while they play, create, investigate and explore.
  • Fine motor skills: Feeding abilities and handwriting skills in school-aged children.

Personalized Evaluation

During your child's evaluation, your therapist will review:

  • Past medical history, pertinent lab results and current physical complaints
  • Range of motion and muscle strength
  • Functional abilities at home and at school
  • Level of pain
  • Need for additional services or equipment that will help them to improve their level of function
  • Understanding of their condition

Your child will be re-assessed regularly to see how they are progressing and to modify their treatment plan to help reach their goals.

Ask for a referral to Woman's Center for Wellness occupational therapists.

Fine motor skills are finger and hand skills such as writing, cutting, opening lunch boxes, and tying shoelaces. The development of these skills relies upon the age appropriate development of physical skills (such as core trunk control and shoulder strength) providing the stable base from which the arm and hand can then move with control.

Note: Each stage of development assumes that the preceding stages have been successfully achieved.

How to use this chart: Review the skills demonstrated by the child up to their current age. If you notice skills that have not been met below their current age contact Woman's Pediatric Therapy at 225-924-8450.

 Age  Developmental Milestones  Possible implications if milestones not achieved
 0-6 months
  • Reflexive grasp (at birth)
  • Global ineffective reach for objects (3 months)
  • Voluntary grasp (3 months)
  • 2 handed palmar grasp (3 months)
  • 1 handed palmar grasp (5 months)
  • Controlled reach (6 months)
  • Poor muscle development and control
  • Delayed ability to play independently
  • Delayed sensory development due to delayed interaction with toys and other sensory objects
 6-12 months
  • Reaches, grasps, puts object in mouth
  • Controlled release of objects
  • Static Pincer grasp (thumb and one finger)
  • Picks things up with pincer grasp (thumb and one finger)
  • Transfers objects from one hand to another
  • Drops and picks up toys
  • Poor development of hand and finger strength
  • Poor manipulation of objects resulting in delayed play skills
  • Delayed sensory development due to lack of sensory play experiences
 1-2 years
  • Builds tower of three small blocks
  • Puts four rings on stick
  • Places five pegs in pegboard
  • Turns pages two or three of a book at a time
  • Scribbles
  • Turns knobs
  • Paints with whole arm movement, shifts hands, makes strokes
  • Self-feeds with minimal assistance
  • Able to use signing to communicate
  • Brings spoon to mouth
  • Holds and drinks from cup independently
  • Poor development of hand and finger strength
  • Delayed independent play skills
  • Delayed development of self care skills (such as eating)
  • Delayed manipulation skills
 2-3 years
  • Strings four large beads
  • Turns single pages of a book
  • Snips with scissors
  • Holds crayon with thumb and fingers (not fist)
  • Uses one hand consistently in most activities
  • Imitates circular, vertical, and horizontal strokes
  • Paints with some wrist action, makes dots, lines, circular strokes
  • Rolls, pounds, squeezes, and pulls playdough
  • Eats without assistance
  • Delayed self-care skills (such as eating)
  • Delayed pre-writing skill development
  • Delayed manipulation of small objects such as toys, pencils and scissors
  • Frustration when manipulating small toys and objects
 3-4 years
  • Builds tower of nine small blocks
  • Copies circle
  • Imitates cross
  • Manipulates clay material (rolls balls, makes snakes, cookies)
  • Uses non-dominant hand to assist and stabilize the use of objects
  • Snips paper using scissors
  • Delayed pre-writing skill development
  • Frustration and/or avoidance of pencil based tasks
  • Poor pencil grasp and pencil control
  • Poor self-care skills (such as eating)
  • Delayed drawing skills
 4-5 years
  • Cuts on line continuously
  • Copies cross
  • Copies square
  • Writes name
  • Writes numbers 1-5
  • Copies letters
  • Handedness is well established
  • Dresses and undresses independently
  • Difficulties holding and manipulating a pencil
  • Difficulties learning to write name and other letters of the alphabet
  • Dependence on caregivers for every day activities such as dressing
  • Frustration and/or avoidance of pencil based tasks
 5-6 years
  • Cuts out simple shapes
  • Copies triangle
  • Colors within lines
  • Uses a 3 fingered grasp of pencil and uses fingers to generate movement
  • Pastes and glues appropriately
  • Can draw basic pictures
  • Difficulties learning to form letters and numbers correctly
  • Poor handwriting
  • Difficulties demonstrating academic ability on paper
  • Fatigue during pencil based tasks
  • Frustration and/or avoidance of pencil based tasks
 6-7 years
  • Forms most letters and numbers correctly
  • Writes consistently on the lines
  • Demonstrates controlled pencil movement
  • Good endurance for writing
  • Can build Lego, K’nex and other blocks independently
  • Ties shoelaces independently
  • Difficulties getting ideas down on paper
  • Experiences fatigue during handwriting tasks
  • Difficulty keeping up in class due to slow handwriting speed
  • Poor legibility of handwriting
  • May impact on self-esteem when comparing work to peers
  • Possible frustration and/or behavior difficulties due to avoidance of pencil based tasks 
 7-8 years
  • Maintains legibility of handwriting for entirety of a story
  • Difficulty completing handwriting tasks in a timely manner
  • Experiencing fatigue during handwriting tasks
  • Poor academic achievement due to difficulty getting ideas down on paper
  • Difficulties due to avoidance of pencil based tasks 


This chart was designed to serve as a functional screening of developmental skills per age group.  It does not constitute an assessment nor reflect strictly standardized research.