Blog Posts

Fine Motor Development

Fine Motor Development

What are Fine Motor Skills?


Fine motor skills rely on our ability to use the small muscles in the hand to control our fingers, hands, and wrist to manipulate objects and complete tasks. Fine motor skills are essential for many activities in childhood and through to adulthood, such as printing, buttoning shirts, zipping zippers, or tying shoelaces, and are frequently an area of focus in occupational therapy interventions. 

How Fine Motor Skills develop

Fine motor skill development begins at birth and develops throughout childhood. Children must learn and develop the foundations of motor control before being able to successfully engage in fine motor tasks such as printing, doing up buttons, or tying shoelaces.

“Much like an amateur runner who cannot run a marathon without proper training, a child cannot master the art of conventional writing without the proper foundation of muscle development” (Huffman & Fortenberry, 2011, pp. 100).

Fine motor development begins by first engaging in gross motor tasks, such as activities which engage the trunk and core muscles. Research has shown that gross motor activities are crucial in improving fine motor control for activities such as printing and handwriting. Core strength and posture have strong implications for handwriting and fine motor control, as our trunk serves as the base of support for the movements required to print. Once trunk control and core strength have been improved upon, we can move our attention to the arm and shoulder. From the shoulder, the fine motor development continues to develop through to focussing on the whole hand. From the whole hand, we arrive at the final stage of fine motor development which accomplishes the pincher and pincer grasp which are most commonly associated with printing and handwriting skills. 

Why is core strength so important in handwriting?

The development of core strength is essential in improving and addressing handwriting in children for several reasons. One of the main reasons why core strength is so important to develop before addressing handwriting, is ensuring that children can maintain the proper posture while seated. This requires adequate trunk strength to be seated for an extended period of time (in class taking notes, for example). Without proper posture, handwriting is typically messy, as children who are slouching are not able to support the paper they are writing on with their helper hand. As such, they cannot keep the paper still as they write, which leads to illegible handwriting. In addition, a slouched posture leads to over extension in the arm while writing, which takes a great deal of energy to sustain. This can lead to messy handwriting, but can also lead to lack of stamina while writing, or being unable to write for long periods of time (Occupational Therapy: Helping Children, 2023).

Since the core is the foundation of the strength in the rest of our body, it must be
strengthened first, before the focus can be turned to the shoulder, the arm, the hand, and the fingers. 

Blog post written by occupational therapy student Charlotte Inthof-Barrett

Key Resources:

Occupational Therapy: Helping Children. (2023). Motor Development.

Huffman, J.M., & Fortenberry, C. (2011). Helping preschoolers prepare for writing:

Developing fine motor skills. Young Children, 66(5), 100-103.

Online Booking Now Available

Creative Therapy is happy to announce that we now have the ability for clients to manage their bookings online at

This system provides our clients with the ability to book many of their appointments online based on therapist availability.  Automated reminders for booked appointments will be sent to you via text or email based on your preference.  You will also be able to access your account details online.

You can still call us to book your appointments if you prefer and some appointment types, like initial assessments,  require that you call us to book a time so that we can have a more thorough discussion of your needs.

Feel free to reach out to us at 519-954-5026 or if you have further questions.


Camps and Classes 2022-23

Sliding Into September 2023: 

Registration Closed -Camp Fully Booked

This camp is designed to help children transition from their summer routines back into the more scheduled environment of a typical school day.  A series of structured activities have been developed by an Occupational Therapist to help children enhance individual skills as well as group interactions.  Problem solving, emotional regulation and motor skills development are all part of the curriculum.  The  camp runs from August 28 through to September 1, 2022 from 9 AM  to 3 PM.    If you have any questions please call us at 519-954-5026 or email  Please click this link to register online.

PD Day Camps for 2022-23 School Year

We offer PD day camps for your child that correspond with the elementary school PD day schedule.  Please see our PD Day Camp Schedule for more details, including activities, dates, times, costs and registration.

Printing Groups

We offer group sessions designed to help your child with the fine motor controls required to improve their printing skills.  Please see our Printing Groups page for more details or register online.


PD Day Camp Schedule 2022-23

Creative Therapy Health Services offers PD Day camps for Elementary School participants.

Elementary School Camps:

Monday October 24, 2022
Friday November 18, 2022
Friday January 20, 2023
Friday April 21, 2023
Friday June 2, 2023

Where: Creative Therapy Health Services at 136 Moore Ave. South, Waterloo ON

Cost: $200 for each full day (9 AM to 3 PM). 

Registration and Questions: You can pre-register online for this event or email or call 519-954-5026 to get your questions answered about whether this program is suitable for your child.

After Hours Care: If your child requires additional before or after hours care please contact us prior to the camp to discuss your needs so that special arrangements can be made and costs can be discussed.

What Is It?:

Creative therapy offers PD day camps that coincide with the Waterloo Regional District School Board and Waterloo Catholic School Board calendars. Each of the elementary school camps is based on a fun theme, like “Superheros”, “Outer Space” or “Going to the Beach”. These camps provide a fun and safe experience designed and led by an Occupational Therapist. Children work on a variety of fine and gross motor skills while developing appropriate social skills. A high ratio of counselors to participants ensures that your child receives the attention necessary to ensure they have a fantastic experience. Camps are structured around “Activity Stations”, where groups of children transition from one activity to another. The activities will help the children develop confidence in sequencing, planning, fine motor and other requisite skills while having fun and socializing.

 For information about all our camps and classes please have a look at our camps and classes schedule page or contact us to discuss your unique needs.

Nature Based Occupational Therapy

What is nature based Occupational Therapy?

Nature based occupational therapy utilizes the outdoors to foster children’s skills and abilities. Outdoor play provides a sensory rich environment to learn a wide variety of skills.

Why should I consider nature based OT for my child?

Our children have shown decreases in active free play outdoors. This play promotes optimal sensory and motor development in children. Children learn how to problem solve, take risks, take turns, regulate their emotions, etc. With increased scheduling of extracurricular activities and appointments after school hours this doesn’t often leave much time for kids to use their imagination and have fun outdoors. Nature based OT will use a mix of structured and unstructured activities to let your child’s imagination run wild while meeting their therapy goals.

What can my child learn through nature based OT?

  • Gross motor skills
  • Fine motor skills
  • Visual spatial skills
  • Sensory processing
  • Emotional regulation
  • Flexible thinking
  • Social skills
  • Cognitive skills (problem solving, attention, planning, impulse control, etc.)
  • Mindfulness and coping skills

What would a nature OT session look like?

The occupational therapist will first complete an assessment and work collaboratively with you and your child to set goals.

The occupational therapist or occupational therapy assistant will then meet with you and your child at a local park. The occupational therapist will prepare various structured and unstructured activities to complete with your child outdoors.

It could look like completing a nature scavenger hunt in the forest to work on planning, attention, organization, flexible and critical thinking, fine and gross motor skills, visual perceptual skills and sensory processing.

It could also look like creating an insect sanctuary to work on bilateral coordination, hand eye coordination, motor planning, visual motor skills, grasp, sensory processing, attention and planning.

Camps And Classes 2022

Schedule of Events for 2022

We are again scheduling group activities at Creative Therapy.  Please subscribe to our Facebook or Twitter feeds to keep up with the latest news. 

Currently Available Groups:

Printing Group:

This is a small group of up to 6 pediatric participants that is facilitated by an Occupational Therapist. This weekly group consists of 6 sessions meeting from 6 to 7 PM every Tuesday from April 5 through to May 10 2022.  Total cost for the 6 sessions is $200.  For more information please call us at 519-954-5026 or email  Please click this link to register online.

Soaring Back To School: 

Sorry: Registration is Closed – Camp Is Fully Booked

This camp is designed to help children transition from their summer routines back into the more scheduled environment of a typical school day.  A series of structured activities have been developed by an Occupational Therapist to help children enhance individual skills as well as group interactions.  Problem solving, emotional regulation and motor skills development are all part of the curriculum.  The  camp runs from August 29 through to September 2, 2022 from 9 AM  to Noon.  Total cost is $500 per child for the week.  If you have any questions please call us at 519-954-5026 or email  Please click this link to register online.


Welcome To New Team Member Brad Thomas

Creative Therapy is happy to welcome Occupational Therapist Brad Thomas to the team!  Brad will be working with our Pediatric clients and brings with him an awesome energy and enthusiasm.  Prior to starting his Masters in Occupational Therapy, Brad had been a volunteer at Creative Therapy so he is very familiar with our approach to working with kids and helping them achieve their full potential.

Creative Connections

Creative Therapy is excited to offer a virtual group “Creative Connections” that is designed to allow teenagers to connect with each other virtually. This group will focus on helping your teenager build social relationships while exploring emotional regulation themes through fun, social and interactive games. This group will be facilitated by Patricia Nguyen, whose positive energy is infectious!!!

Virtual Zoom sessions will be held at 7 PM to 8 PM  on Tuesdays from January 26’th  to March 2’nd 2021 (6 sessions total) at a cost of $180. We will also have volunteers to help prompt and encourage your teenager to participate and understand the concepts that are being presented.

Register online for this event or email or call 519-954-5026 to get your questions answered about whether this program is suitable for your child.

All Group Activities On Hold

After very careful consideration we have decided to put all group activities at Creative Therapy on hold at this time. We discussed the possible ways we could continue to offer camps while maintaining all the necessary COVID restrictions and determined that the challenges outweighed the benefits.  That said, we are continuing to think of creative ways to re-introduce group activities while meeting the needs of our clients and COVID safety requirements.  We’ll be updating the website with any developments on this front.

We have been successfully seeing individual clients at the clinic for well over a month now which has been fantastic and well received by both clients and staff.  This has provided us with a tremendous learning opportunity to adapt our treatment methodologies, especially for clients who have specific issues with PPE.  We will bring this experience to any group activities we hope to introduce in the future. Live, Learn & Adapt!

Clinic Office Re-Opening

Status as of June 1, 2020

Creative Therapy Health Services is excited to announce the re-opening of our physical space for client appointments starting on Monday June 8, 2020.

Plans for Physical Re-opening

Like all business across Ontario, we are anxious to serve our clients in the safest and most effective way possible.  We are following the guidelines put forth by the Government of Ontario as well as the regulatory bodies governing Occupational Therapy to best manage the safety of our clients and our staff.  Given the nature of Occupational Therapy and the the fact that many of our clients fall into the vulnerable sector of the population we are being very diligent in implementing procedures which include:

  • Screening clients before appointments
  • Screening anyone entering our physical office
  • PPE procedures for clients and staff
  • Limiting the number of clients and caregivers in the office to optimize social distancing
  • Sanitizing all equipment used by a client prior to the next client appointment
  • Sanitizing common areas including the bathroom, handrails, door handles etc.
  • Creating posters and visual reminders for all our clients

Further details about how we are handling client appointments at our clinic offices can be found here.

Pediatric Clients

While we are re-opening our physical space and we really enjoy working one on one with our pediatric clients we recognize that many of those children or their family members may fall into a high risk population for COVID.  We will continue to offer virtual treatment sessions allowing you to choose what suits best for your situation.  Click here For more information.

Motor Vehicle Accident Clients

Our Motor Vehicle Accident clients present a unique challenge and we are being as flexible as possible in delivering the services needed without introducing unnecessary risk to anyone involved.  While we are more than happy now to be able to meet with clients in our physical clinic space we recognize that MVA clients may be at higher risk for COVID.  We are fully equipped to deliver services to  clients using virtual technologies, sometimes utilising other health care practitioners already on site with the client to help facilitate our work.  Please contact your therapist directly or, if you are a new client, our office at email:  phone: 519-954-5026.

Group Sessions

Creative Therapy has cancelled all on-site group sessions until further notice.  This includes Printing Group, Music Therapy and Yoga. 

Post-concussion Yoga sessions are being delivered fully online via Zoom.

If you have questions about your upcoming appointment please contact us at 519-954-5026.