Parents always notice the early motor development milestones of their children. When and how child takes their first wobbly steps or how easily they can offer a careful grip on a crayon can tell parents and Occupational Therapists how the childs fine motor skills are developing. Motor skills keep mattering as a child grows. If your child is finding fine motor skills tricky (handwriting, buttons, small tools), falling more than their classmates, or shying away from sport, a paediatric Occupational Therapy, or a BOT-2 assessment can give you a clearer picture of what is going on and if any futher intervention is required.
01 · The basics
What are fine motor skills and gross motor skills, and why they matter
Motor skills are the movements a child uses to interact with the world. Australian paediatric Occupational Therapy practice groups them into two broad families.
Gross motor skills are the big movements that use large muscle groups: running, jumping, climbing, kicking and catching a ball, balancing on one leg, riding a bike, swimming. These depend on core strength, balance, coordination, and the ability to plan a movement before doing it.
Fine motor skills are the small, precise movements of the hands and fingers: holding a pencil, using scissors, doing up buttons and zippers, threading beads, using cutlery, typing. These depend on hand strength, finger control, in-hand manipulation, and the eye-hand coordination that lets the eyes guide the hands.
Both groups underpin everyday life. Gross motor skills shape play, sport, school readiness, and independence in self-care like dressing. Fine motor skills shape handwriting, drawing, eating, and the school-day tasks that quietly add up over a long year. When one group is harder than expected for a child’s age, daily life can feel heavier than it needs to.
02 · Milestones by age
Motor milestones by age, and what to watch for
Motor development follows a broadly predictable sequence, but the timing varies from child to child. The Australian Government-funded Raising Children Network sets out an age-banded picture that is useful for parents.
- Toddlers (1 to 3 years). Walking and running steady up. Climbing onto furniture. Stacking blocks. Scribbling with a fisted grip. Drinking from a cup.
- Preschool (3 to 5 years). Hopping on one foot. Catching a large ball. Pedalling a tricycle. Using scissors with help. Drawing simple shapes. Holding a pencil with a tripod grip towards the end of this band.
- Early primary (6 to 8 years). Skipping. Riding a two-wheel bike. Catching and throwing with control. Writing legibly. Tying shoelaces. Using cutlery independently.
- Mid-to-late primary (9 to 11 years). Refining sport skills. Handwriting fluency. Using small tools like rulers and compasses. Independent self-care for most daily tasks.
These are guides, not deadlines. Children move through the bands at their own pace, and a child a little slower in one area is not a sign of trouble. What matters is the overall picture across several settings, and whether a child can take part in the everyday tasks the world is asking of them.
03 · When to ask
When to ask for an Occupational Therapy assessment
Most variation in motor development is healthy. Some patterns are worth a conversation with your GP, your child’s teacher, or a paediatric Occupational Therapist. Concerns about gross motor skills or fine motor skills are the most common reasons families seek an assessment. Common reasons include:
- Handwriting is much slower or messier than peers, or the child avoids writing tasks.
- The child trips or falls more often than classmates, or struggles with stairs, playground equipment, or sport.
- Buttons, zippers, shoelaces, or cutlery stay hard well past the expected age.
- A teacher, paediatrician, or early childhood educator has flagged a concern.
- The child has a diagnosis (such as autism, developmental coordination disorder, cerebral palsy, or intellectual disability) that affects movement.
- The family wants a baseline picture before starting school, or before an NDIS planning conversation.
An Occupational Therapy assessment is not a diagnostic label. It is a structured picture of where a child sits, what they find tricky, and what practical strategies may help at home and school. If gross motor concerns are dominant, or there are questions about how a child walks, our Physiotherapy team may also be involved.
04 · The assessment
How an Occupational Therapist assesses motor skills, and how the BOT-2 works
A paediatric Occupational Therapy motor skills assessment combines three sources: a standardised test, clinical observation, and a conversation with parents and, where appropriate, teachers.
The standardised test. Our Occupational Therapy team most often uses the BOT-2, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. The BOT-2 is standardised for children and young people aged 4 to 21, and it is administered one-to-one. The full test has 53 items grouped into 8 subtests:
- Fine motor precision
- Fine motor integration
- Manual dexterity
- Upper-limb coordination
- Bilateral coordination
- Balance
- Running speed and agility
- Strength
The BOT-2 is a well-studied measure. Research in children with an intellectual disability has found it highly reliable from one testing session to the next, and responsive enough to pick up change over time.
Scoring. The BOT-2 produces standard scores, percentile ranks, and age equivalents. The Occupational Therapist turns these into a clear, descriptive picture in each motor area, from well below average through to well above average, so the numbers mean something for daily life rather than sitting on a page.
Clinical observation. Numbers tell part of the story. The Occupational Therapist also notes what the test alone does not capture: how the child approaches a new task, their attention and focus, how they manage frustration, posture and trunk control, and whether they understand and remember instructions. These observations often shape the practical recommendations more than the scores do.
Parent and teacher input. A motor profile in clinic is not the same as a motor profile at home or at school. The Occupational Therapist asks parents, and sometimes teachers, about everyday tasks like dressing, mealtimes, handwriting, sport, and playground play, to see how the findings line up with daily life.
The report puts these three sources into one document the family can keep, share with the school, or share with their paediatrician or GP.
A motor profile in clinic is not the same as a motor profile at home or at school.
05 · What happens next
How the results support your child
The assessment is the starting point, not the end. The Occupational Therapist uses the results to set goals with the family, then plans the practical work that follows.
Goal setting. Goals are written in everyday language and measured in everyday tasks. A child identified as below average in balance might work towards “hop ten times on each leg without putting the other foot down” or “walk along the playground beam without holding on”. A child with fine motor goals might work towards “write a full sentence legibly within two minutes” or “do up the buttons on a school shirt independently”.
Therapy planning. Sessions usually combine targeted activity (strength work, balance work, fine motor games, handwriting tasks) with home practice and, where it helps, recommendations for the classroom. The work tends to look a lot like play.
Re-assessment. A repeat BOT-2 is usually suggested around twelve months after the first one, so the family and the therapist can see what has changed and what to focus on next. Where progress has been strong, sessions ease back. Where it has been slower than hoped, the plan is revisited.
It can feel unsettling to learn that your child’s motor skills are tracking below expectations. The work itself is practical: a structured assessment, plain-language goals, sessions that look like play, and a clear picture of progress over time. We work alongside families and schools, and link in with the wider clinical team where it helps.
Further reading
- Pre-linguistic skills and early language covers the foundations before first words.
- How drawing can help children express feelings and emotions links fine motor skills and emotional expression.
- Speech and language development sets out communication milestones from one to five years.
- Occupational Therapy approaches to executive function covers the thinking-and-doing skills that support learning.
