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How Occupational Therapy Can Support Children with Motor Skill Difficulties

When a child struggles with motor skills—whether it’s tying shoelaces, catching a ball, or writing neatly—these challenges can ripple out into many parts of their daily life. That’s where paediatric occupational therapy (OT) comes in, offering tailored, playful, and evidence-based support. This blog explores what motor skill difficulties can look like, what occupational therapists do, and what you should be looking for if you think your child might benefit.

What do we mean by “motor skill difficulties”?

Motor skill development divides broadly into two categories:

• Gross motor skills: These involve large muscle groups and movements such as running, jumping, climbing, balancing.

• Fine motor skills: These involve smaller, precise movements — e.g., using scissors, holding a pencil, buttoning a shirt.

Children with motor skill difficulties may show signs such as:

• Frequent trips, falls or awkward coordination (gross motor).

• Struggling with things like handwriting, tying shoelaces, using utensils.

• Difficulty with motor planning (sequencing and organising movement), e.g., they may know what to do but find initiating or organising the movement challenging.

• Delays in reaching motor milestones or significant differences compared to peers.

• Impact on everyday tasks: dressing, self-care, participating in games or classroom activities.

It’s worth emphasising that motor skill difficulties can affect a child’s confidence, participation in play, school performance, self-care, and social interactions.

What does occupational therapy do for children with motor skill difficulties?

Here’s how a paediatric occupational therapist might support a child:

1.  Assessment & identifying underlying factors

An OT will assess not just the task difficulty (e.g., writing) but also underlying components: strength, posture, sensory processing, body awareness, coordination, motor planning.

For example, if a child tires quickly when sitting at a desk, the therapist might look at core stability and posture, not just pencil grip.

2.  Individualised intervention & play-based activities

Therapy is made fun, meaningful, and embedded in real tasks. For example, obstacle courses, ball games, balance beams, beanbags, climbing — all with a goal and structured challenge.

By positioning tasks in a playful context, children often engage more and generalise skills into their daily lives.

3.  Sensory integration and motor planning support

Many children with motor skill difficulties also have sensory processing or body-awareness challenges. OT uses strategies like tactile play and movement through space to help children better organise movement and respond to sensory input.

Motor planning (the ability to sequence and coordinate movements) is also supported via structured activities with increasing complexity.

4.  Adaptive tools and environmental modifications

OTs may recommend adaptive equipment (e.g., pencil grips, slanted writing surfaces, spring-loaded scissors) or adjust the environment to lessen barriers.

This means the child can succeed in tasks while still working on underlying skills — which supports motivation and independence.

5.  Working with families, schools & embedding practice

Therapy is not only about the clinic; the OT will collaborate with parents, caregivers and teachers to make sure skills transfer into home and school environments.

They may provide home-activity ideas, routines, and advise on how to integrate practice in everyday life.

Why is this especially important?

• Children who struggle with motor skills may avoid physical play or tasks where they feel challenged — which can limit their participation socially and affect self-esteem.

• If left unaddressed, motor skill issues can lead to secondary problems: poor posture, fatigue, avoidance of new tasks, social withdrawal.

• By improving motor skills, children gain independence for self-care (dressing, feeding), better engagement in school (handwriting, classroom tasks) and more opportunities for play and friends.

When should you seek an occupational therapy referral?

It’s usually worth getting an OT assessment if:

• Your child significantly lags behind peers in coordination, balance, self-care tasks.

• The difficulties impact daily life: school tasks, play, self-care, social participation.

• There is persistent clumsiness, frequent dropping of objects, avoiding tasks requiring motor skills.

• You’ve tried home strategies and seen limited progress, or you’re unsure how to help.

• You’d like personalised assessment and support from a trained OT.

Here at the St Andrews Practice we offer occupational therapy assessments and intervention to support children with motor difficulties. See the link below to learn more:

https://thestandrewspractice.com/our-services/child-and-young-people-services-cyp/motor-skills