What is the best course of action for a 12-month-old with a fine motor skills delay?

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Last updated: June 18, 2025View editorial policy

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From the Guidelines

For a 12-month-old with a fine motor skills delay, the best course of action is to seek an evaluation from a pediatrician or developmental specialist as soon as possible, and then refer the patient to early intervention or special education resources, as well as physical and/or occupational therapists, as recommended by 1. Early intervention is crucial and can significantly improve outcomes. Once evaluated, a tailored therapy plan typically includes regular sessions with an occupational therapist who specializes in pediatric development. At home, parents should incorporate simple activities that promote fine motor skills, such as:

  • Stacking blocks
  • Playing with shape sorters
  • Practicing finger foods
  • Encouraging the child to pick up small objects (under supervision) Using toys with different textures, sizes, and weights can help develop grip strength and coordination. Consistency is key—these activities should be incorporated into daily routines for 10-15 minutes several times a day. Developmental delays can often improve with appropriate intervention because the young brain is highly plastic and responsive to stimulation, as noted in 1. While some delays may resolve with therapy, it's essential to continue regular follow-ups with healthcare providers to monitor progress and adjust interventions as needed, and consider referrals to specialists such as neurologists, developmental pediatricians, geneticists, physiatrists, or orthopedists, as recommended by 1. Additionally, the child's cognitive and behavioral development should be assessed, and referrals to speech and language therapy, behavioral therapy, and other services may be necessary, as outlined in 1.

From the Research

Referral Options for a 12-Month-Old with Fine Motor Skills Delay

  • A pediatric neurologist or a developmental pediatrician can assess the child's overall development and provide guidance on the best course of action 2.
  • An occupational therapist (OT) can evaluate the child's fine motor skills and provide targeted interventions to improve their development 3, 4.
  • A physical therapist (PT) can also be involved in the child's care, particularly if they have gross motor delays or other physical limitations 3, 4, 5, 6.

Considerations for Referral

  • A thorough clinical history is essential in establishing a diagnosis and guiding management decisions 2.
  • The physical examination and investigations may not always be influential in management decisions, but can provide valuable information in some cases 2.
  • A multidisciplinary approach, involving OT, PT, and other healthcare professionals, may be necessary to address the child's complex needs 3, 4, 5, 6.

Potential Interventions

  • Functional training based on principles of motor learning may be an effective approach in promoting gross motor skill acquisition in children with cerebral palsy 5.
  • The START-Play intervention, which focuses on enhancing cognitive and motor outcomes, shows promise for children with severe motor impairments 6.
  • Other approaches, such as manual stimulation of position and movements, addressing environmental factors, and conceptual methods, may also be used as supplements to the main approach 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Physical therapy clinical management recommendations for children with cerebral palsy - spastic diplegia: achieving functional mobility outcomes.

Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 2006

Research

Current Physical Therapy Practice in Norway for Children With Cerebral Palsy.

Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 2021

Research

A Physical Therapy Intervention to Advance Cognitive and Motor Skills: A Single Subject Study of a Young Child With Cerebral Palsy.

Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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