Welcome to Toddlerhood: Vision and Fine Motor Skills Development 12 - 24 months

Have you ever cut or burnt your index finger or thumb, on your dominant hand, and had to wear a Band-Aid? If so you’ll know how important fine motor skills are for doing the simplest of tasks, from doing up a button to using scissors, through to typing on your laptop. Fine motor skills are those involving the refined use of the small muscles in the hands, fingers, and thumbs. These skills, developed from infancy, go on to be crucial for play, writing, drawing, eating, dressing, using electronic devices and tools, self-care and many other activities of daily living.

Good vision and visual perceptual development affect fine motor skills, gross motor skills, and cognitive development, according to The American Optometric Association. At birth, your baby could only see highly contrasted images, 8 to 10 inches from her face. In the early months her vision rapidly improved, as her eyes started working together, she began to focus on, and follow objects. Color vision, hand-eye, and body-eye coordination skills improved through the middle months of the first year. She gradually began to be able to distinguish small objects like bricks and pick them up. By her first birthday, she was able to judge distances and throw an object overarm. Improving vision between 12 and 24 months will help your child improve her fine motor skills. Any problems with vision will hinder this development and will need to be investigated and treated promptly.

Fine motor milestones

By his first birthday, your baby will have mastered shaking a rattle, hold a cube (thumb and palm grip) and transferring it from hand to hand. Grip will be transitioning from thumb and palm to thumb and fingers and onto thumb and index finger (fine pincer grip), allowing him to precisely touch and pick up a small object like a piece of cereal.

12 - 18 months fine motor skills

Around the 12 month mark, give or take 2 months, he can pick up and brick and purposefully drop it into a cup, or throw it onto the floor, which causes hours of entertainment, watching grown-ups chase around picking things up! He will learn to feed himself finger foods and hold a bottle. In the next three months, he will begin to use a spoon and drink from an open cup and build a tower of 2 blocks.

18 - 24 months fine motor skills

By 18 months the towers are getting up to the 4 brick level and are even more fun to knock over. He may be removing clothing (socks being a particular favorite for many), walking around with toys in hand, and scribbling (with fist grip). Heading towards his second birthday he may show signs hand dominance, he may use a fork for some of his eating, build a tower of up to 6 bricks, insert shapes in a shape sorter, and scribble back and forth and round in circles. Around his second birthday, he will also master opening doorknobs and sucking through a straw. He may start to remove other buttonless clothes, including the diaper, brush his teeth with your help and wash his hands.

Please note

Children born prematurely will usually reach milestones based on their due date, rather than their birth date. All milestones have a broad range of ages at which they are achieved. If you would like further information the CDC has a good summary of all developmental milestones.

Helping Your Toddler Develop Visual and Fine Motor Skills

Providing a safe environment is the best place to start. Get down to her level and look for dangers. Small objects become a choking or injury risk, as soon as your child is mobile and able to grab things.

Mastery of skills takes much trial and error and it is best if you can ignore mistakes and praise successes. Try not to interfere too much in play and don’t be afraid to let her get a little frustrated, she needs to learn to persist.

Occupational Therapist Patty Bunce, of the Penfield Children’s Centre, recommends several activities that will help your child develop her fine motor skills. These include:

• Finger Feeding: helps improve pincer grip and hand-mouth coordination. Also, let her play with a baby spoon and fork,
• Playing with small toys: like bricks, puzzles, instruments, stacking cups and shape-sorters,
• Reading board books together,
• Playdough: is a great way to strengthen those bendy little fingers,
• Finger Painting and drawing: with an age-appropriate paint, crayons and pencils. Yes, I’m afraid things are about to get very messy!

When to call your doctor

The American Academy of Pediatrics suggests developmental checks at 9 months, 18 months and 24 or 30 months. Children who were premature, low birth weight or have other health problems may be screened more frequently. If you are worried you can request an assessment at any time.

If you think your child is showing unusual signs don’t panic, there may be a very simple reason, every child is different. Signs to report to your doctor include:

• Squint (misaligned eye) or lazy eye,
• Tilts head when watching TV or looking at a book,
• Rubs eyes when not tired or blinks excessively,
• Delay in reaching milestone of 2 months or more,
• Avoids using one hand,
• Muscles that are unusually stiff or loose,
• Loss of skills previously gained (regression),
• Unusual movements or twitches.

It is recommended that you keep a record of your child’s development: if you are concerned it may help reassure you that your child is, in fact, progressing and if the need arises it will provide useful information for your doctor.