Information provided by Paediatric Neurology Service and Occupational Therapy Service from KK Women's and Children's Hospital (KKH), a member of the SingHealth group.

Children with neuro-developmental conditions may face challenges in carrying out dexterous tasks in play and functional activities as these require the ability to manipulate tools/toys or items with precise and coordinated movements of the hand. You may be able to help your child work on his/her hand and finger coordination through some common play activities at home. Some of these activities are listed below.

If your child presents with neuro-developmental concerns affecting hand dexterity / coordination, please consult your occupational therapist for specific hand function goals and relevant recommended activities before getting started. Your occupational therapist will also be able to advise on the suitability of activities in accordance to your child’s developmental level.

Safety precautions

  • Ensure your child is well supported and seated/standing in a stable position.

  • Start with an easy task before progressing to something more challenging.

  • When introducing a new activity, demonstrate the task especially during the first few attempts. Provide hand over hand assistance or consider breaking up the activities into simple steps where necessary.

  • Allow your child time to practise and feel comfortable in the presented activity.

  • Praise your child for his attempts and successes to reinforce his efforts and encourage participation!

Provide supervision during activities to ensure safety, especially when learning to use tools or sharps, or when introducing small manipulatives. If your child is in the mouthing phase, choose larger-sized, developmentally appropriate toys and manipulatives.

Activity ideas to promote hand coordination

1. Play-dough/ Therapeutic putty 

  • Create small balls, long rolls, or pretend pancakes

    • Using one hand and rolling the dough/putty on the table

    • Rolling dough/putty between both hands

    • Using thumb, index and middle finger to roll dough/putty into small ball

    • Using finger pads to squeeze the dough/putty

  • Manipulate dough/putty with fingers or simple tools to create objects/figurines e.g. snake, sausage, snowman, etc

  • Pulling apart dough/putty to find hidden “treasures” (e.g. beads, beans, buttons)

  • Drawing in flattened play-dough using tools such as chopsticks, dough cutter, pencil

2. Stringing or lacing activities

  • String large rings through shoelace

  • String large wooden beads

  • String small beads

  • Lace board or cards

3. Finger isolation activities

  • Eye droppers: Use as part of table top art activity, or during bath time. Water can be mixed with food colouring to make “dribble pictures”.

  • Coins and buttons: Pick up coins/ buttons as part of counting/ matching/ sorting game, making designs with buttons. Turn over pieces without bringing over edge of table.

  • Pick up small objects with thumb and index finger (e.g. raisins, crumbs, pegboard pins, beads, beans).

  • Finger puppet play

  • Flicking games (e.g. marbles, clay balls, rolled-up paper balls, finger soccer)

4. Constructional play/ puzzles

  • Wooden inset puzzles with varying sizes of knobs/ pegs atop puzzle pieces

  • Jigsaw puzzles with puzzle pieces in varying shapes/sizes

  • 3-D constructional puzzles

  • Bolts and nuts

  • Lego/Duplo

5. Tweezers, tongs, and pegs

  • Experiment with different sizes and stiffness of tweezers, tongs or pegs to pick up items

  • Pick up different objects, graded by texture, size and shape

6. Craft activities

  • Scissors skills

  • Craftwork with scissors and glue

  • Paint shapes/ figures using paintbrush, string, sponge, toothbrush

  • Finger painting using fingers, fingers, fist or hand

  • Paper folding or origami (e.g. into a fan, boat, box, paper chain)

  • Stickers play

7. Daily activities at home

  • Dressing up and managing own or doll’s buttons, zips, shoelaces

  • Pouring water into containers with openings of various sizes (e.g. mugs, bottles)

  • Turning taps on/ off

  • Baking fun: Using rolling pin, cookie-cutting, simple cake/biscuit decorating

  • Food preparation: Spreading butter/ jam on bread, stirring drinks, grating cheese/ carrot, peeling fruits, making meatballs, fishcakes or anything that has to be rolled/ shaped

Ref: K21