Teletherapy fine motor activities

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Teletherapy fine motor activities? Is this possible? This entry covers activities to address fine motor development in telehealth occupational therapy. Interventions covered include: Origami; drawing; beading; stickers; putty; tongs; mazes and coloring; messy play; and building blocks.

Fine motor skills are essential to many functional activities in our lives. From cooking to playing a game, getting dressed to taking down a phone number, fine motor skills are utilized all of the time. So how do we, as occupational therapists, address these physical skills through an online therapy platform (via teletherapy mode) ? Read on to learn about specific ideas for addressing fine motor skills in a teletherapy setting.


An activity that can be graded from simple to challenging, origami can be tailored to suit many different client needs. Origami originates from Japan and is the art of folding paper to create representational designs. Origami is a natural choice for teletherapy as all your client needs is a sheet or two of paper. You can share your screen to provide visuals for sequencing the steps. For clients at a beginner level, simply introduce how to fold the paper in half and crease it. Clients with more advanced fine motor skills may be motivated to create a favorite shape or animal. You can also show a YouTube video during your online session with origami instructions and pause the video once in a while to make sure that the child can follow along. TheraPlatform (EMR and teletherapy in One), for example allows users to organize YouTube videos into folders right on their platform and then they can watch them during video call with their clients.


Another teletherapy motor fine activity involves drawing. If your client hasn’t developed a functional grasp, keep writing utensils small with broken crayons, bits of chalk, or golf pencils. This encourages use of the skilled side of the hand. To encourage wrist extension, direct your client to tape the paper to a wall or another vertical surface. Could your client use forearm stability and benefit from shoulder girdle strengthening? Try drawing in prone position (as tolerated) with their forearms stabilized. Bonus: Drawing representational pictures is also an excellent way to address visual motor skills.


Beading is a fine and visual motor activity that can be easily adapted based on your client’s skills and available materials. It is a skill that requires fine motor precision similar to zipping up a jacket or lacing a button. This is a great activity for teletherapy because you can adapt whatever the client has available. This might be cheerios and pipe cleaners, pony beads and uncooked spaghetti, or shoelaces and play doh beads you constructed earlier in the session.


Stickers are well loved by clients in many ages and stages of life and are now made to be appealing to adults as well as children. The process of peeling stickers requires your client to stabilize the sheet of paper in one hand and use their pincer grasp to peel the sticker off of the paper. To make the activity easier, use stickers with either a larger surface area or puffy stickers. Direct your client to cross the midline by having them place the stickers on one side of their body and the paper on the other.

Resistive Putty

Putty is an excellent choice for clients who need to build strength and endurance for fine motor skills. Roll ‘spaghetti and meatballs’ to develop the arches of the hand. Hide small manipulatives inside and then find them again. Make tiny figures (cakes are a favorite) to work on isolating the radial side of the hand. Ripping putty to make small pieces of ‘confetti’ also addresses separation of the sides of the hand and is great practice for a client who is refining their scissor skills.

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Here is another teletherapy fine motor activity that involves tongs. They are an excellent tool for developing strength and dexterity on the skilled side of the hand. Ask your client if they have tweezers or small kitchen tongs available. If not, they can be easily DIYed using two popsicle sticks, a pom-pom, and a small elastic. You can make it in your session as a therapeutic activity in itself. Then use the tongs to pick up pom-poms, cotton balls, counting bears, and other small manipulatives your client has handy.

Mazes and Coloring

The smaller the maze, the more precise your client will have to be with their fine motor control to be successful. In a teletherapy session, send the maze you will be working on ahead of the session for printing, or screenshare and have your client create their own copy and trace the maze by holding a paper up to their own computer. Fine motor precision is also necessary for coloring in tiny details. Use an adult coloring book or have your client scale to a smaller size when printing an online coloring page. TheraPlatform allows users to upload PDFs and send them to families via their client’s portal.

Get Messy!

For a fun and engaging activity, allow your client to get a washable item messy. This could look like covering an animal figurine in flour or painting a toy car with pudding. After your client enjoys this process, direct them to wash the item off with a tiny sponge or wash cloth. In order to be successful they will need to use bilateral coordination, squeeze the mess out of the sponge, and manipulate items in both hands. Although you are addressing several skills, this one will not feel like work for many pediatric clients.

Building Blocks

Building blocks tend to be the perfect shape and size for younger kids who are just beginning to develop hand skills. Developmentally, this client may not have developed a consistent pincer grasp yet. However, there is a reason that building a tower of blocks is often noted as a developmental milestone. As the child experiments with holding the blocks they may start with a palmar grasp. With more experience and exposure to the materials the child starts moving the block to the skilled side of the hand for more control. Building a tower gives excellent feedback regarding grasp, proprioception, and visual motor skills.


Here are more OT teletherapy ideas

What fine motor activity is the most popular among your clients? Comment below to share!

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