Brain injury - Fine motor skills

  • What are fine motor skills?

    Fine motor skills help us pick up, use and let go of objects such as a pen or cutlery, and they help us manipulate objects in our hands.

    Fine motor activities include drawing, cutting, doing up buttons and shoe laces. After a brain injury, a child may have difficulty using their muscles (including those in their hands) because of changes to the signals that come from the brain to the muscles.

    How can fine motor skills be affected following brain injury?

    Either one or both hands can be affected in a number of ways, including:

    • muscles may be stiff and difficult to move
    • movement may be jerky or clumsy and difficult to coordinate
    • muscles may become paralysed or difficult to move quickly when the brain 'tells them to'
    • planning and executing movements may become difficult

    A child's ability to perform fine motor skills depends on a number of things, including muscle strength and coordination. A brain injury may also affect sensation which could then affect the ability to perform fine motor activities. Children who have had a brain injury can have long-term difficulties with fine motor skills.

    What is the treatment?

    An occupational therapist can assess children's fine motor skills and provide:

    • exercises and specific activities to help children re-learn how to hold and let go of things, hold a pen, etc.
    • casts, splints and stretching exercises are helpful if muscles have shortened
    • training to deal with difficult tasks. For example, they can teach how to tie shoelaces with one hand
    • special equipment to help with fine motor skills. For example, a weighted ruler or spring-loaded scissors

    Key points to remember

    • Fine motor skills are skills that are used to help us manipulate and use objects with our hands.
    • Following a brain injury, a child's ability to use their muscles may be affected due to altered brain signals.
    • An occupational therapist can assess fine motor skills and provide recommendations for ways to improve or manage the difficulty.
    • Children who have had a brain injury can have long-term difficulties with fine motor skills.

    For more information


    Developed by The Royal Children's Hospital Paediatric Rehabilitation Service based on information from the Brain Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH consumers and carers.

    Reviewed September 2020.

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