12 great fine motor activities for children with cerebral palsy – diplegia or hemiplegia

1. Lots of children enjoy sorting games. Start by organising larger toys – like cars or Duplo blocks – into different coloured piles.

2. Move onto sorting smaller items by type, shape or colour. Try different pasta shapes, paper clips, pens and pencils, lego bricks or coins. 

3. If this works well try even smaller items. Mixing different dried foods can work well: for example mixing rice with lentils and dried beans or chick peas. This activity can be made more engaging by dyeing the food bright colours prior to play (see our messy play to find details of how to dye different foods).

4. To make this task more challenging, try offering a pair of tweezers to pick the items up – or suggest they use their less dominant hand.  

5. Once your child has sorted their small objects, you can suggest an additional activity using the items they’ve sorted.  For example, they could make a necklace out of the tube pasta, or make a picture using glue and the dried food items. This will keep your child motivated to keep sorting and is another great way to work their fine motor skills. 

6. You could make this a little more challenging by creating a Laser Quest game in a box. See our video for details of how this can work.

1. Drawing can be practiced with a hand, finger or with an implement.  

2. Start your child drawing with their fingers or hands. This could be during messy play (e.g. in sand or shaving foam) or using a tablet. To show them the way, you could draw a line for them to copy or follow in the path you have made. 

3. Move on to trying drawing with implements. Large pieces of chalk or crayons need less fine motor skills than smaller implements. To begin with any grip is fine, as holding the grasp as well as keeping pressure can be a great challenge in itself. 

4. To begin with, encourage any kind of mark making on the page or on a chalk board. As their skills develop, encourage them to draw lines: up and down, side to side or diagonal. Curved lines are more complicated, with circles being the most tricky drawing movement. 

5. Here’s a helpful tip to help your child hold a pen: take a regular clothes peg and clip it round the end of the pen. If this looks comfortable for them, your child can now be helped to hold across the peg and with their index finger around the other side of the pen.

6. It’s also usually easier to make marks on an angled surface.  You can rest or stick paper onto a lever arch file, or prop a board onto something to tilt it. Ikea have inexpensive laptop supports that work really well for this.  

7. As your child improves, move on to thinner crayons or pens.  

Music is a motivating way to improve fine motor skills, and there are lots of options depending on skill level.

1. Your child can just use their hand to hit a keyboard or a drum as an easy way to get some cause and effect without needing high levels of fine motor skill. 

2. The next step of difficulty is to use a hand-held implement in to make music. Using a stick to hit a drum or shaking a rattle or tambourine are all good ways to practice grasping.

3. Fine motor skills can be further refined by just using the index (pointing) finger. Practice pressing a keyboard key with this finger, pressing buttons on musical toys or using the pointing finger for games on a tablet. 

4. If you don’t have any instruments at home you can make your own using objects in the home. A wooden spoon and upside down saucepan can become a drum and drumstick, a plastic bottle with some rice in it becomes a shaker. This blog offers some other easy ways to make musical instruments from everyday objects.

Playing with stickers is a great way to practice fine motor skills.

1. Peeling stickers off their backing uses as much (if not more!) skill as sticking them down  

2. You can sticking easier by peeling most of the sticker off its back. Your child can use their fingers to take the rest off and then stick to a piece of paper or part of their body. 

3. Try using stickers to ‘colour in’ a shape – or draw a shape with the stickers. You could always give stickers as a reward for great effort or behaviour – they won’t even know they are still working! 

1. Start with putting soft toys or rolling large balls into an open container. Use brightly coloured containers such as bright pink stain remover tub, or items with metal bases to give “noisy” feedback e.g. hot choc tub or Pringles tube. Thanks to @brightcolourfulkids for the picture of their posting game!

2. Progress to smaller toys into a smaller container. You could combine this with a matching game, like putting the red objects into the red container. 

3. Shape sorter games are fantastic for working fine motor skills. If you don’t have a shape sorter, cut a circular hole in the lid of a plastic pot and post small objects.  

4. As your child gets more accurate, cut smaller circles or slits and post smaller objects such as coins, pebbles or buttons. You could cut different sizes of slits for different sizes of objects so they have to work out sizes as they post.

1. Start with threading pipe cleaner through the holes of a colander. Your child could make lines across to make a bridge for their cars. Or keep to the side of the colander and just go freestyle and make some lovely patterns.

2. You could also stick a piece of uncooked spaghetti in some play-dough or blue tack on the table so it is sticking right up. Your child could then thread tube pasta onto the spaghetti.  

3. As their skills improve, use laces (with the taped end) to thread paper. Use a hole punch to make holes along the edge of a piece of card. Or try making necklaces with laces and tube pasta.  

4. As they improve, use string, or ribbon or even some thread on a needle for threading games.  They could add colour to a basket by adding ribbon through the holes, have fun re-lacing the shoes in your house or cut some straws into small tubes to lace into a necklace. 

1. Start with simple paper weaving. Cut some coloured paper into 1 inch strips. Cut a different piece of paper into 1 inch slits but leave an inch uncut at the end so the paper is still attached at the top. Your child can then slip 1 loose strip over and under the main paper. Start nearest to the end which is still in one piece. The next piece goes over and under (the opposite from the first strip). 

2. You could try this with smaller strips of paper to make it more difficult. 

3. Move on to weaving knitting wool. This video shows how you can weave just using a piece of cardboard.
   

4. Move onto shapes. This video shows how to make cool patterns on a paper plate but you could use any cardboard you have (old cereal boxes etc) instead. You could even write out your child’s name. 

5. Here is a lovely video which shows how to make a simple Pom Pom. This is a lovely exercise to use repetitive use of your child’s hands to strengthen and improve their endurance.

6. Knitting is a great progression to weaving and brilliant for developing those more advanced fine motor skills. Finger knitting is straight forward and a good way to start and you only need some wool to try it. This video gives a lovely demonstration.

7. Knitting with knitting needles is an even more advanced fine motor skill. This video demonstrates nicely how to do this. You will need knitting needles and wool. 

Puzzles are lovely for making children match up shapes and work their fine motor skills. Some children will try to use force instead of turning the puzzle piece to make it fit so start with easy puzzles where they can be more successful to teach them about turning the puzzle piece (or turning the board if they can’t turn their hand as well). 

1. Puzzles with pegs on them are often the best place to start if children don’t have full fine motor control.   

2. Move onto regular flat puzzles as skills improve. 

3. Use smaller pieces as skills improve. 

4. If you don’t have puzzles at home, find a pretty page from a magazine and cut it into a few pieces. Your child can piece the pieces back together. 

1. Building towers requires a steady hand and precision in placement of the next block.  

2. Start with bigger objects to stack, such as cushions and pillows, books or empty cans. This works well as a 2 handed activity – great for bringing in a weaker hand.  

3. As they get more accurate, try smaller stacking such as coins, Lego, or blocks. They can build all sorts of scenes and structures with building toys and piecing the pieces together is great for their fine motor skills. 

4. If they get really good, try to challenge them to find things to stack – use flat pebbles, cars, or soft toys.  

5. Another great thing with this game is that they get to knock it all down at the end. 

1. If you don’t have play-dough there are plenty of different ways to make dough at home. See our video for how to make dough and how to play with it if you have less refined fine motor skills. 

2. Make the dough with your child for an extra opportunity to strengthen hands and fingers.  

3. Kneading the dough, rolling it with a rolling pin, squashing dough balls, squeezing it through their fingers, pushing items into the dough – with a full hand or with a pointing finger – are all great ways to work your child’s fine motor and hand skills. 

4. You can also put different objects into dough or other soft play mixtures – things they need to find or things to play with e.g. cars or plastic animals/ dinosaurs/ figurines. 

5. Hiding marbles in your play-dough will work their manipulation skills brilliantly. 

1. Use paper clips to make a chain. 

2. Start with large paper clips and get smaller as they master the skill.