Tracking infant hand (fine motor) and communication skills: birth - 6 months

Within weeks newborn infants start to reach, for and explore with their hands, and interesting objects that catch their attention and by 8 months when they start to sit they have developed quite sophisticated ability for sustained attention to a task and the ability to manipulate toys using a full range of hand actions.

This development of sustained attention and visual and manual exploration of toys is strongly influenced by the infant’s social environment.  A responsive and rich environment which provides many opportunities that are just right for the infant’s level of development promotes optimal development of attention and fine motor skills.

This is particularly true for infants who are born preterm and those who are risk for developmental delay. For these infants early and responsive intervention to promote social, attention and fine motor skills is very important for ensuring optimal development.

Why it is very important to pay attention to the development of hand (fine motor) abilities

Long term follow up studies have shown that preterm infants have a greater risk of developing attention and fine motor problems when they enter school. This is true even for infants who are only 5-6 weeks preterm (often referred to as later preterm). Early intervention has been shown to reduce this risk. 

Early intervention has also been shown to improve hand function (fine motor control) in Infants at risk for developing cerebral palsy (hemiplegia) 

Below I have provided a list of the social and hand (fine motor) abilities as they appear during the first year.  Use this to track your infant's progress. 

More information fine motor development 

How infants use their hands to grow their brains

How an enriched environment promotes optimal development 

Importance of face-to-face conversations

From birth infants are able to imitate other people’s mouth movements and soon start to mirror the expressions on their caregiver’s faces.

Infants love to have conversations with their caregivers. Mothers are very good at setting up turn taking in these conversations: they say something and then give the infant a chance to respond. By 3-4 months infants are adding their own voice to the conversation as they coo and gurgle in response. These conversations provide the infant with their first experience of sustaining their attention on a task for minutes at a time.

Newborn looking 2_2.jpg

Reaching, grasping and manipulation

Within weeks newborn infants start to reach towards their carer’s faces and interesting objects within reach. Early reaching is a bit of a hit and miss affair, but soon the infant manages to grasp and explore toys that are suspended within easy reach.

At 3-4 months infants are able to hold the head steady in the midline and bring the hands together to hold and explore toys.  What is quite remarkable is how, by this age, infants have developed the ability to pay careful and sustained attention to what they are doing with their hands: they prod, grasp, pull, and push the toy.

This exploration of toys teaches them a great deal about the relationship between what things look like, how they feel and how they respond to being manipulated.

Lots of experience with manipulating toys also provides the brain and the hand muscles with the experience they needs to control the movements of the fingers for the basic grasping actions

W 4m playing hands in bouncy chair.jpg

Early action: newborn to sitting 

Newborn moments of repose and visual contact

Hands lightly fisted when lying quietly.  
Looks intently at interesting objects - this is sometimes called visual reaching. 
Visually tracks moving toy.

Newborn repose W 5w.jpg    Newborn looking 2.jpg    

Looks with interest at caregivers face 

Responds to caregivers voice.  Will imitate mouth movements if prompted by caregiver. 

 W 5w conversation_1.jpg

Swipes at toys in reaching distance

Fingers are extended. 
Sometimes manages to grasp toy.

Will 5w swiping 2.jpg    Will 5w swiping 4.jpg  

Looks at own hands with great interest 

Also watches hands of social companion. 

W 4m hands to midline.jpg   T 13 w watching hands 1.jpg

Brings both hands to mouth

From 2-3 months infants can hold their heads steady in the mid-ling and bring their hands to their mouths. 

W 4m hands to mouth.jpg

Watches and reaches towards caregiver's face 

Faces interest infants. Infants love to have conversations with caregivers. 

 T 18w reachinh face.jpg

Reaches  for, feels and grasps toys with two hands 

From about 3 months infants start to reach for toys within easy reaching distance. Hand not shaped to match the toy. Grasp is still hit and miss. 

 W 4m 22 feb grasp skills 1_1.jpg    W 4m 22 feb grasp skills 2.jpg 

Uses fingers to explore a toy 

Watches own actions carefully - this helps the infant to make connections in the brain between what he sees and what he feels. 

W 4m playing hands in bouncy chair.jpg

Holds a toy in one hand briefly

Will hold and shake a rattle when it is placed in the hand. Grip is not secure. Drops toy quickly. 

 W 4m hold and shakes rattle.jpg

Sitting provides new opportunities 

Inspecting and exploring toys

Opens and closes hands repeatedly when exploring a toy

Infants take particular delight in playing with flaps and labels on toys.

   R hand opening and closing 19.jpg    R hand opening and closing 18.jpg

Grips small flat objects between thumb and forefinger 

Notice how Roan (9 months) carefully positions the hand in readiness for grasping the flap on the toy. 

    R hand opening and closing 14.jpg    R hand opening and closing 15.jpg

Spends time exploring a new toy using two hands 

Infants take time to inspect a new toy using both hands. They turn the toy over, turn it around, shake it and bang it on hard surface, taste it. 

They also watch their own hand actions and visually inspect the toy with sustained attention. 

will hands 9m.jpg    R 9m graband pull 4.jpg

Visually inspects a toy - turns it over and around 

The infant looks at the toy with great interest , turning it around and inspecting it from all angles. 

This visual exploration is important for making the connections in the brain that link what the infant sees to how the toy feels and behaves and also to the hand movement that are used to grasp and move the toy. 

   will 9m turn toys over 1.jpg      will 9m turn toys over.jpg

Adjusts shape and position of hand ready for grasping 

Here you see how Will aged 10 months opens the fingers and aligns the hand in readiness for grasping the toy with the left hand. 

At this age the hand will still open  a lot more than needed for the action. 

    will 9m shape hand to toy 1.jpg     will hands 9m 4.jpg

Shakes a toy to discover if it makes a noise 

If the toy does not make a noise, the infant will usually stop the shaking action. 

If the toy does make a noise, the infant will shake it several times before continuing to explore the toy in different ways. 

will 9m grasp and bang.jpg      T shaking toy 2.jpg

Mouths a toy briefly to explore texture and taste

At 8 - 10  months the infant will still spend a little time exploring the taste and texture of a toy with the mouth. However this is usually quite brief and the infant quickly moves on the exploring the toy in different ways. 

 W 8m mouthing a toy_1.jpg

Passes toy from one hand to the other 

Infants pass toys from one hand to the other repeatedly. 

This is important for learning to use the two hands together, including moving the hands to the right place at the tight time. 

    will 9m paasess to to other hand.jpg      will 9m paasess to to other hand 1.jpg

Approaches and picks up larger object with two hands 

Infant quickly learn when an object needs two hands for lifting. 

W 8m grasping with two hands.jpg    W 8m grasping with two hands 1.jpg

Shaking, banging and drumming 

Shakes a toy that makes a noise  

Spends time shaking the toy in different ways to explore how different movements change the sound that is produced by the shaking action.

Stops and starts, speeds up, slows down and changes the direction of movements, changes hands. 

T shaking toy 2.jpg  

Bangs toys on a hard surface

Vigorously bangs toys on a hard surface to discover if it makes a noise. Toys that produce a satisfying sound are banged repeatedly. 

 T 11 m banging tin 5.jpg      T 11 m banging tin 4.jpg

Bangs two blocks together 

Picks up small hard toys such as blocks and bangs them together repeatedly. 

The accuracy of the banging action improves over tome. 

winterhands in action 6.jpg    winterhands in action 6.jpg

Drums with hands on hard surfaces that make a pleasing noise. 

Bangs an open hand against a flat surface that produces an interesting sound. Explores drumming with one hand or both hands together. 

Drumming is usually done in response to a demonstration by a play partner. 

T 11 m banging tin.jpg    W 8m drumming 1.jpg

Takes turns in a drumming game with a play partner 

The infant watches and copies the actions of a play partner who initiates the game. Infants are  sensitive to turn taking. 

 T 11 m banging tin 2.jpg

Knocking over and building towers 

Knocks over towers and other tall toys

T 12 m knocks over a tower.jpg    T 12 m knocks over a tower 2.jpg

Stacks two or three blocks or tubs to make a tower

W 18m tub tower 1.jpg

Drop, throw, hide and look

Drops toys over side of feeding chair - watches them land.

This action teaches the infant a great deal about what happens when a toy falls onto a hard surface: What sort  of noise does it make, does it bounce and roll? 

W 8m knocks jar off table.jpg    W 8m looks for fallen toy.jpg

Throws toys backwards and then looks for them 

This seems to be a favorite game for infants.

T throw and watch 2.jpg     T throw and watch 2.jpg

Tipping out and unpacking 

Reaches into a container to retrieve a toy

T 11m tin and blocks 7.jpg    T unpacking bucket.jpg

Tips  toys out of a box or tub

T 12 m tipping toys out of box 5.jpg   T tipping a tub.jpg    

Packing in and posting 

Packs toys into a container

Holds toy over the opening and releases it. 

T 11m tin and blocks 5.jpg   T 12 m tipping toys out of box 3.jpg  


Posts a ball through a round hole in a box 

Infants love posting games. 

T 11 m Posting ball.jpg 

Posts a  rod into a hole

This is more difficult than posting a ball into a round hole. The stick needs to aligned at right angles to the hole to fit through. Short rods are easier than longer rods. 

   W posting rod.jpg   T 16m posting long rod 1.jpg

Taking things apart and fitting them together 

Takes lids off and puts them on again

T 16m closing honey jar.jpg    T 16m closing honey jar 1.jpg

Takes apart a toy egg or tub

This requires a strong grip and forceful pulling action.  Fitting them together again requires precision in matching the pieces. 

         T 24m pulling apart.jpg   T 24m pulling apart 1.jpg

Grasp and pull 

Pulls toys apart

Knows how to grasp firmly and pull hard to pull a toy apart. 

12m pulls toys apart.jpg

Pulls on a cloth to bring a toy nearer 

R 10m pulling blanket.jpg

Imitation and following instructions 

Copies simple arm action

Imitates caregiver's everyday actions 

Pretends to talk on the phone. Uses a lid as a hat.

R 12m stick is a tel.jpg   R 12m lid on head.jpg

Watches a demonstration and copies the action

W 8m copying simple action.jpg         

Copies a complex action on a toy.

Here I show Roan how to pull a toy apart. 

 R 12m watching a demo.jpg   R 12m pulls apart after demo.jpg

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Tracking Attention, Communication and Hand Function Charts