Fine Motor Development

The Two Sides of the Hand and Their Role in Fine Motor Development

Ever wonder how children develop refined hand skills? 

Children’s hand skills begin to develop at birth. In the beginning, movements are gross and as a child develops their upper extremity strength and stability, hand precision evolves.  Once this occurs, a child begins to have the ability to use their smaller muscles in their hands to perform play skills and self-care skills more independently, such as eating, building with blocks, stringing beads, writing, cutting, getting dressed, etc.

Did you know that your hand has two sides? 

We have the radial side which consists of the thumb, index, and third finger. This side of the hand is usually the side that performs the skill of picking up a toy, holding a crayon, etc.  The ulnar side of the hand is the 4th and 5th fingers.  This side of the hand acts as a stabilizer.  While the radial side of the hand moves to manipulate toys or a tool, the ulnar side is tucked inward providing stability and thus allowing for more precise movements to occur.  This process starts to develop as an infant.  Have you ever seen a baby crawl while holding a toy in their hand?  They may be holding it on the radial side of the hand while weight bearing on the ulnar side of the hand.  These are the beginning steps to the development of the two sides of the hand!

Separation of the hand begins to develop as early as infancy. Separation of the hand becomes more refined as children grow and develop.  Poor separation of the hand can affect a child’s ability to perform activities expected for their age.  It can affect how a child holds a writing utensil, as they may present with a gross or fisted grasp on their pencil.  In return, the child will resort to moving their whole arm to write versus utilizing smooth controlled dynamic movements of the pencil with the radial side of their hand.  Their writing may appear large and with poor legibility.  A child with poor separation of their hand may also have difficulty utilizing other functional tools, such as scissors.   Cutting skills will be gross and uncoordinated.  As a child gets older, self-care tasks such as manipulating fasteners and tying shoes could be impacted as well.

How do I help my child develop the two sides of their hand?

help my child develop the two sides of their hand

There are many fun games and activities to do with your child that will aid in the development of the two sides of their hand.  Here are just a few:

  • Placing coins into a piggy bank or slotted container (start with large checker chips for 2 to 3-year-old children and then challenge older children with standard-size coins.
  • Completing a fun craft while the child is tearing paper builds hand strength and the use of the radial side of the hand (ages 2 and up).
  •  Using spray bottles to water flowers or help clean the table or a toy while only using the thumb, 2nd, and 3rd finger to spray. You can color the water and paint the snow.  (ages 2 and up).
  • Stringing beads, macaroni or lacing kits encourage the refined use of the radial side of the hand (ages 3 and up).
  • Using broken crayons to color a picture.  This requires the child to use the radial side of their hand to hold the crayon (ages 3 and up).
  • Using tongs to pick up pom poms, cotton balls or marshmallows.  Playing games such as Bed Bugs, Noodle Knock Out or Feed the Monkey.  These are fun tong games that encourage this fine motor development (ages 3 and up).
  • Placing pegs into a foam pegboard or playing Lite Brite will help to encourage using the radial side of the hand.  You can challenge your child by placing a small Lite Brite peg in the ulnar side of their hand and have them hold it in there while their radial side of the hand works to create their Lite Brite picture (ages 4 and up).
  • Playing games that have small pieces such as a travel size Connect Four or Hi Ho Cheerio and utilizing the same strategy as above, encouraging stabilization of one small piece in the ulnar side of hand while playing the game using the radial side of their hand (ages 4 and up).

Building these skills in the early years of childhood is crucial for hand development.  Development of these skills are the building blocks to dexterity and could prevent the frustration that may occur with increased demands and motor expectations as a child ages.


Healthline. 2021. Fine Motor Skills for Toddlers and Preschoolers: Tips and Activities. [online] Available here [Accessed 29 December 2021].

Verywell Family. 2021. Fine Motor Skills for Toddlers and Preschoolers. [online] Available here [Accessed 29 December 2021].

Beck, b., 2021. Easy Ideas for Motoric Separation of the Hand in Fine Motor Skills – The OT Toolbox. [online] The OT Toolbox. Available here [Accessed 29 December 2021].


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