In today’s blog post, we’re talking all things manual dexterity goals. Fine motor IEP goals, or goals designed to target manual dexterity needs can be identified based on dexterity weaknesses that impact participation in the educational environment. You’ll also find many manual dexterity activities in this blog post, including this dexterity activity.
Be sure to read about IEP and 504 plans for information on where to begin with these processes. Another resource you’ll want to check out is our self regulation IEP goals and identifying student strengths for IEP writing.
Goals, goals, and more goals! It seems all therapists do is create, work on, and document about goals. Occupational therapy is about play. Where is the fun in that? Unfortunately, therapists are driven by measurable data and reimbursement.
That being noted, the focus on progress and goals will continue. Writing goals and measuring them can feel overwhelming at times. Today we will focus just on manual dexterity goals.
Manual dexterity or precision in fine motor skills, has many underlying factors that impacts graded coordination in functional tasks.
manual dexterity goals
Before churning out a dozen goals, it is important to review the basic framework and structure of excellent goals. A
s much as I dislike all of the documentation involved in providing therapy, having great measurable goals makes it a little easier. When goals are SMART, they are specific, measurable, attainable, relevant, and timebound.
The key to successful goal writing is to incorporate all five of these elements into each goal. Check out this post on Breaking Down Goals for more information.
what are manual dexterity skills?
Manual dexterity refers to the ability to use your hands in a skillful, coordinated way to grasp and manipulate objects and demonstrate small, precise movements. Manual dexterity is one of the components of fine motor skills.
Other fine motor skills include: speed and precision, visual motor skills, and strength. These skills allow for manual dexterity, or coordinated precision, to happen. Those skills listed out are:
- separation of the sides of the hand
- open thumb web space
- neat pincer grasp
- arch strength and development
- bilateral coordination
- finger isolation
- hand strength
- finger strength
- in hand manipulation, including translation, shift, and rotation
There are tons of articles and ideas in the OT Toolbox Archives under “manual dexterity” to help gather ideas of what to be watching for when evaluating a student for fine motor skills.
Manual Dexterity Examples
Manual dexterity goals are going to be related to manipulating objects with the hands, rather than the visual motor goals of copying shapes, writing letters, coloring, and cutting.
Examples of these from the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT™-2) include the following five items measured in fifteen second intervals:
- transferring pennies (total pennies into box after fifteen seconds)
- sorting cards
- making dots in circles
- placing pegs into a pegboard
- and stringing blocks
Other manual dexterity measurements might include; the Purdue Peg Board, 9 Hole Peg Test, Jebson Hand Function Test, Functional Dexterity Test, and the Box and Block Test.
It’s important to know about fine motor milestones when assessing these results in order to create fine motor goals.
Specific examples of fine motor, manual dexterity activities include many components of every day activities. There are many fine motor skills required in the school environment. At home there are just as many!
It would be hard to list out every single manual dexterity example, but here are some listed below. Some of these are related to the school environment and may be incorporated into IEP goals based on manual dexterity needs in the school-based OT environment. Others are more ADL or IADL based and do not impact education. These dexterity goals may be covered in outpatient or medical model of occupational therapy.
- Typing on a keyboard
- Handwriting, holding a pencil
- Coloring in lines
- Writing in a given space
- Buttoning clothes
- Zipping a zipper
- Snapping a clothing snap
- Tying shoelaces
- Threading a needle
- Cutting with scissors
- Using chopsticks
- Turning a key in a lock
- Playing a musical instrument
- Operating small tools (e.g., screwdrivers)
- Applying makeup
- Drawing and coloring
- Pressing buttons on a device
- Sculpting with clay or manipulating play dough
- Braiding hair
- Flipping a coin
- Manage money
- Stringing beads
- Assembling puzzles
- Crafts
- Tearing paper
- Playing board games
- Painting miniatures or models
- Using a combination lock
- Applying nail polish
- Playing jigsaw puzzles
- Building with LEGO bricks
- Weaving paper crafts
- Operating a computer mouse
- Folding origami
- Stacking small items like Jenga game pieces
- Cutting food with a knife
- Putting on jewelry
- Playing cards
- Folding paper
- Flipping a light switch
- Opening a door handle
- Turning a faucet
- Opening containers like a toothpaste lid
- Sealing plastic sandwich bags
- Using a spoof and Fork
- Pouring liquid from a container
- Applying lotion or cream
- Turning the pages of a book
- Using a stapler
- Playing with building blocks
- Playing with small toys
- Using tweezers
- Using fingernail clippers
- Flossing teeth
- Turn a pencil sharpener
- Turn a watch dial
- Put on a watch
not so great manual dexterity goals
How do you translate the data you gathered in a standardized assessment into SMART goals? One strategy is not to be to vague. This is one of the first goals I pulled up when searching for “manual dexterity goals”:
The student will improve fine motor dexterity skills to manipulate small objects, use tools, or engage in activities that require precise hand movements.
This goal is missing several components. It is not specific, measurable, attainable (how will you know when the student has improved?), or timebound. While it IS relevant to therapy, it is missing all of the other components that make it a usable goal.
How about this one?
In six months, the student will improve manual dexterity skills by improving score on the BOT2 test from 11 to 18 points in 3 of 4 trials.
There is a big part of me that likes this goal. It has all of the components of a SMART goal. The drawback is you will be constantly teaching and reviewing the specific items on the test, which will nullify the results the next time you retest. Also, school based therapists can not use standardized assessments each time they measure and report on goals.
Another thing to consider about writing fine motor goals based on the results of standardized testing; This goal is a “no no” in the school system (I found out the hard way this year). Maybe there is a way to tweak it in a long term goal, while having several different short term goals. After all, your ultimate measurement for progress and discharge may be those results from updated standardized testing!
manual dexterity goals – framework
The goals I tend to write have several similar components (as dictated by the school district or governing body):
- In TIME FRAME (one, three, six, 12 months)
- student will improve manual dexterity skills
- by…
- as measured by clinical observation and data collection by occupational therapist
- 3 of 4 trials, 8 of 10 opportunities, 4 of 5 sessions. I prefer this to percentages because it feels more specific than “75% of opportunities”.
measurable manual dexterity goals
The following is a list of goal ideas to get you started. It is by no means an all inclusive list, because students are as different as snowflakes.
To use an activity in goals, you can add time frames, percentages, number of seconds, assistance, or whatever modifications you need.
For example, to write a fine motor goal based on a specific fine motor task, follow this format:
In 12 months (specify date), the student will demonstrate improved manual dexterity skills by:
- stringing 3 half inch beads on a lace within 15 seconds, stringing one at a time
- place 9, 1/4 inch pegs into a 5 inch pegboard using dominant hand within 30 seconds
- pick up and hold 10 pennies without dropping any, using dominant hand only, and a pincer grasp to pick up
- find 10 quarter inch beads in medium green theraputty using a pincer grasp (this can include picking off the extra strings of dough)
- independently button/unbutton 4/4 one inch buttons on a standard button strip
- rotate a pencil in hand from the lead side to use the eraser using one hand only
- rip one inch pieces of construction paper using finger tips
- crumple pieces of tissue paper using one hand to reduce to 1/4 the original size
- independently open screw top containers and replace
- roll 10 one inch balls of playdough and place them in one inch circles
- pick up 10 pennies and place into a vertical slotted container in 30 seconds
- place 15 clothespins accurately on the edge of a plastic container, using dominant hand to squeeze clothespins
- flip 10 quarters on a horizontal surface using in hand manipulation, without sliding quarters off of table
- lace a shoe lace through holes x6 holes (does not have to be in correct order)
Manual Dexterity Activities
Remember when writing and using goals, these are just the items you are measuring for documentation. This does not mean these are the only manual dexterity activities you do during your treatment sessions. It would be next to impossible to list all of the possible activities you will be measuring in your goals.
You may end up with 27 goals this way! I often add 3-4 challenges within the goal, as I feel that one item might not be enough to accurately represent my student.
Manual dexterity intervention strategies can (and will!) include the list of 50 examples of dexterity that we shared above. After all, occupational therapy is all about functional tasks as a tool and a goal. However, some more manual dexterity examples can be rooted in play and the interests of the individual.
Some dexterity activities to try include:
- String beads
- Play with play dough
- Copy designs on a geoboard
- Make strings of paper clips
- Deal and play games with playing cards
- Play with tangrams
- Build puzzles
- Play with LEGO
- Stack craft sticks
- Tearing paper crafts
- Play with water droppers
- Use tweezers to pick up and manipulate small items
- Use a pickle picker to pick up small items
- Cut food with a knife
- Use toothpicks to create art
- Finger painting
- Cross stitch or making plastic sheeting art
- Lacing cards
- Cut out shapes
- Work on typing speed
- Work on clothing fasteners
- Practice flossing teeth
- Crumble paper art
- Pushpin art
- Use the activities in our Fine Motor Kits
Working on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, or scissor skills? Our Fine Motor Kits cover all of these areas and more.
Check out the seasonal Fine Motor Kits that kids love:
Or, grab one of our themed Fine Motor Kits to target skills with fun themes:
- Frogs Fine Motor Kit
- Unicorns Fine Motor Kit
- Vehicles Fine Motor Kit
- Apple Fine Motor Kit
- Back to School Kit
- Sports Fine Motor Kit
- Outer Space Fine Motor Kit
- Fairytale Fine Motor Kit
- Plus more in our shop!
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Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
