Is your child hating to work with tiny pieces?

Is your child:

  • Saying, “these pieces are too tiny?”
  • Struggling with Legos or blocks?
  • Getting frustrated when putting things together?
  • Struggling with stringing beads or making friendship bracelets?
  • Having difficulty assembling a model from a picture?
  • Struggling as a toddler or preschooler to put shapes in a shape sorter?
  • Having trouble with classes like geography, architecture, or engineering?
  • Having difficulty grasping and holding daily objects?
  • Struggling using a scissors?
  • Avoiding activities requiring finger movements?


If your child says, ‘these pieces are too tiny!,’ they probably are. What may be happening is that your child is struggling with the fine motor skills needed to manipulate the pieces.

This struggle may show up when learning to cook, tying shoes, buttoning or zipping during dressing tasks, when trying to build a lego set, in handwriting, while using a scissors, or when trying to pick up smaller objects with tweezers or tongs.

What’s happening here is that several skills are required to work well together, and any break in the chain can render these tasks difficult. The child needs to be able to ‘see’ what the model is supposed to look like, ‘feel’ the little pieces, ‘manipulate’ the pieces with fingers, and ‘move’ the pieces where they need to go. This combination of skills is called visual-motor integration.


Children who have difficulties solving puzzles or building things may be struggling with some of the visual perception or visual-motor integration. These skills are required to follow the directions when assembling Ikea furniture or building a Lego set or a block tower. In order to effectively manipulate objects, a child has to have strong ‘visual perception skills,’

“defined as the total process responsible for the reception (sensory functions) and cognition (special mental functions) of visual stimuli [1].

In other words, visual perception is making sense of what you are seeing.

Many components make up visual perception

Children are using visual perception when they are see a puzzle’s completion, imagine how a model will look when done, or plan out several moves ahead on a chess board.

  • visual attention: paying attention to what you are seeing
  • visual memory: remembering the important elements of an object you have seen
  • spatial perception: seeing’ the correct position in space, understanding where things go (visual-spatial orientation), seeing how far away something is (depth perception), and reading a map or physical model (topographic orientation
  • object form perception: understanding static properties of objects (form constancy), knowing how an incomplete figure will look when completed (visual closure), and seeing the difference between the object and the background (figure-ground recognition)
  • visual imagery:  creating a mental picture or a moving picture gallery in the mind

Taken together, the eyes have to see it, the hands have to be able to do it, and the eyes and hands have to work together to get it done right. Children with poor visual-motor integration will may struggle with writing, drawing, puzzles, and building.


If your child struggles with dexterity, an underlying visual-spatial deficit or fine motor weakness could be causing these problems. However, parents would want to consider whether or not these personal weaknesses are ‘getting in the way’ of every-day-life before they make a decision about further assessment or treatment.

For example, children with more significant struggles in these areas may have learning disabilities, particularly in writing; in that case, intervention or remediation would be required. Children with difficulties with their handwriting often respond well to occupational therapy and academic supports in the classroom. Other visual-motor challenges, such as building models and solving puzzles, may or may not be a major issue.

If not terribly troubling to your child, it may be that some ‘scaffolding’ is required in school. Scaffolding means having a teacher or parent provide supports through the task and then gradually pull away as the child becomes more independent.

In group work, in science or engineering, for example, it may be that your child’s teacher assigns a role to your child that is not as demanding in terms of motor dexterity. He could be the researcher, planner, or presenter rather than the one building the physical model. If these supports are needed, it may be helpful to consult with a school psychologist or learning specialist at your child’s school.

If, even with these supports in place, your child continues to struggle, you might consider a full evaluation and potentially occupational therapy. At home, you can use some fun strategies to help improve your child’s dexterity, visual-motor integration, and visual perception.


Activities to Help Strengthen Your Child’s Dexterity

Many fun activities can help further develop your child’s fine motor skills. Through crafts and games, it is easy for your child to work on these skills without even realizing it is ‘work.’ For example,


  1. Rolling paper: Rolling/crumpling tissue paper between the thumb, index, and middle finger and placing it on a pattern such as a snowman, rainbow, or favorite T.V./book character


  1. Board games: Perfection, games with tongs such as Bed Bugs, the Sneaky Snacky Squirrel Game, Don’t Spill the Beans, and you can utilize tongs during board games without tongs such as picking up Connect 4 pieces, Hi-Ho-Cherry-O


  1. Feed the Tennis Ball: Cutting a ‘mouth’ in a tennis ball and adding googly eyes, squeezing the sides to open the mouth and feeding it pennies, beads, or other small objects


  1. Coin Races: Race to see who can move a coin from the fingertips to the palm, back to the finger tips faster


  1. Hide the Object: Pick up a small object (beads, bean) and place it in the palm of your hand as if you’re ‘hiding it.’ See how many objects you can fit in your hand until you drop one!


  1. Coloring: Give your child lots of opportunities to practice coloring with different types of crayons, colored pencils, and markers. Coloring is great practice for fine motor dexterity


Activities to Help Visual-Motor Integration

  1. Mazes
  2. Word searches
  3. Lacing
  4. Playing catch with different sized balls
  5. String cheerios on a spaghetti noodle by picking up each cheerio with your thumb and index finger
  6. Copying Shapes
  7. Cutting—on lines, different shapes
  8. Lite Brite
  9. Balloon Activities (balloon tap, use rackets)


Activities to Help Visual Perception

  1. Puzzles
  2. Build a figure with blocks, and have them copy it
  3. Cut a cereal box picture, and have child put it back together
  4. Card game, ‘Set’ or ‘Spot It’
  5. Shape Sorters
  6. I-Spy, Highlights Magazines-spot the differences, Where’s Waldo
  7. Memory
  8. Partially hide toys or blocks, and have the child guess what the object is
  9. Walk through the house, and have the child point out objects that are circular


If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

  • Coordination (gross motor movement): problems with dexterity may be related to challenges with running, walking; catching or kicking a ball, clumsiness
  • Handwriting: problems with dexterity may be closely related to sloppy writing may be due to trouble visualizing how a letter should look
  • Depth Perception: problems with dexterity may be related to judging how far away something is
  • Learning problems (Learning): problems with dexterity could be related to challenges with reading or writing
  • Vision challenges: problems with dexterity may be due to eye problems


Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

  • Developmental Coordination Disorder: challenges with fine motor, likely including poor handwriting
  • Dyslexia (Specific Learning Disability in Reading – Educationally Identified Disabilities, may be diagnosed clinically as well): challenges with reading that have underlying visual processing deficits
  • Dysgraphia (Specific Learning Disability in Writing – Educationally Identified Disabilities, may be diagnosed clinically as well): challenges with writing due to visual or motor processing deficits


If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

  • CLEAR Child Psychology: to obtain a customized profile of concerns for your child or to consult live with a psychologist
  • Physical Therapist: to assess and treat gross motor coordination; to help with large muscle groups and movement
  • Occupational Therapist: to assess and treat fine motor skills and sensory integration needs
  • Psychologist or Neuropsychologist: to consider symptoms in context; may be related to visual spatial problems, attention, or learning

These professionals may recommend or administer the following tests for this symptom:

  • MVPT-4: test of visual perception, including
    • visual closure– what would a partially drawn object look like completed
    • visual figure ground– locating a visual figure in a distracting visual image or an object that is altered to be smaller, larger, or darker
    • visual memory– recalling a picture presented a moment before among distracting objects
  • Beery VMI sequence: test of visual-motor integration, visual perception and motor coordination
  • WISC-V: test of intelligence. Using tasks of block design, coding, symbol search and cancellation, examiners can look specifically at visual tracking and visual motor (IQ test)
  • DAS-2: test of cognitive ability. Provides a spatial index score consisting of block design and a copying or recalling designs subtest depending on participant age. Concerns with writing or fine motor can be assessed using the spatial index (IQ/Cognitive test)
  • Grooved Pegboard: test of fine motor dexterity
  • TOVA: continuous performance test of sustained attention in the absence of immediate reinforcement. Often, children with significant challenges with sustained attention have poor handwriting. Ruling out a diagnosis of AD/HD will be important if sustained attention/ hyperactivity or impulsivity are challenges
  • WIAT-III: test of academic achievement for related concerns in reading, writing, or math (academic test)
  • WJ-IV: test of academic achievement for related concerns in reading, writing, or math (academic test)
  • TOWL: test of written language, provides standard, age and grade equivalent scores for writing only (academic test)
  • Writing Samples: assessments of handwriting samples from your student’s language arts class are helpful to assess legibility (academic test)


[1] Schneck, C. (2010). Visual perception. In Case-Smith, J., & O’Brien, J. (Eds.). Occupational therapy for children (373-403). St. Louis: Mosby.

[2] Debrabant, Julie; Vingerhoets, Guy; Van Waelvelde, Hilde; Leemans, Alexander; Taymans, Tom; Caeyenberghs, Karen. Brain Connectomics of Visual-Motor Deficits in Children with Developmental Coordination Disorder. The Journal of Pediatrics, Volume 169, 21 – 27. e2.


[3] Peacock, Gretchen Gimpel & Collett, Brent (2010). Collaborative home/school interventions: Evidence-based solutions for emotional, behavioral, and academic problems.

[4] Trawick-Smith, Jeffrey (2013). Early childhood development: A multicultural perspective.


Image Credit:
Description: Kids playing with toys
Image ID: #514767996 (iStock)
By: Kikovic
Previously Licensed on: May 13, 2017
Stylized by Katie Harwood exclusively for Clear Child Psychology

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