It really depends where you live (like most things) I can refer our pupils directly but in some areas it goes through the child's GP.
An OT would assess what is causing the difficulty and put together an exercise programme.
Fine Motor Skills
Things to remember:
Upright working surfaces promote fine motor skills. Examples of these are: vertical
chalkboards; easels for painting; flannel boards; lite bright; magnet boards (or
fridge); windows and mirrors; white boards, etc. Children can also make sticker
pictures; do rubber ink-stamping; use reuseable stickers to make pictures; complete
puzzles with thick knobs; use magna-doodle and etch-a-sketch as well. The benefits
for these include: having the child's wrist positioned to develop good thumb
movements; they help develop good fine motor muscles; the child is using the arm
and shoulder muscles.
Fine Motor Activities
Moulding and rolling play dough into balls - using the palms of the
hands facing each other and with fingers curled slightly towards the palm.
Rolling play dough into tiny balls (peas) using only the finger tips.
Using pegs or toothpicks to make designs in play dough.
Cutting play dough with a plastic knife or with a pizza wheel by holding
the implement in a diagonal volar grasp.
Tearing newspaper into strips and then crumpling them into balls. Use
to stuff scarecrow or other art creation.
Scrunching up 1 sheet of newspaper in one hand. This is a super
strength builder.
Using a plant sprayer to spray plants, (indoors, outdoors) to spray snow
(mix food colouring with water so that the snow can be painted), or melt
"monsters". (Draw monster pictures with markers and the colours will run
when sprayed.)
Primary
Picking up objects using large tweezers such as those found in the
"Bedbugs" game. This can be adapted by picking up Cheerios, small cubes,
small marshmallows, pennies, etc., in counting games.
Shaking dice by cupping the hands together, forming an empty air space
between the palms.
Using small-sized screwdrivers like those found in an erector set.
Lacing and sewing activities such as stringing beads, Cheerios,
macaroni, etc.
Using eye droppers to "pick up" coloured water for colour mixing or
to make artistic designs on paper.
Rolling small balls out of tissue paper, then gluing the balls onto
construction paper to form pictures or designs.
Turning over cards, coins, checkers, or buttons, without bringing them to
the edge of the table.
Making pictures using stickers or self-sticking paper reinforcements.
Playing games with the "puppet fingers" -the thumb, index, and middle
fingers. At circle time have each child's puppet fingers tell about what
happened over the weekend, or use them in songs and finger plays.
Place a variety of forms (eg. blocks, felt, paper, string, yarn, cereal,
cotton) on outlines
Match shapes, colour, or pictures to a page and paste them within the
outlines
Primary
Self-Care Skills
Buttoning
Lacing
Tying
Fastening Snaps
Zipping
Carrying
Using a screwdriver
Locking and unlocking a door
Winding a clock
Opening and closing jars
Rolling out dough or other simple cooking activities
Washing plastic dishes
Primary
Sweeping the floor
Dressing
Scissor Activities
When scissors are held correctly, and when they fit a child's hand well, cutting
activities will exercise the very same muscles which are needed to manipulate a pencil
in a mature tripod grasp. The correct scissor position is with the thumb and middle
finger in the handles of the scissors, the index finger on the outside of the handle to
stabilize, with fingers four and five curled into the palm.
Cutting junk mail, particularly the kind of paper used in magazine
subscription cards.
Making fringe on the edge of a piece of construction paper.
Cutting play dough or clay with scissors.
Cutting straws or shredded paper.
Cutting
Use a thick black line to guide cutting the following:
A fringe from a piece of paper
Cut off corners of a piece of paper
Cut along curved lines
Cut lines with a variety of angles
Primary
Cut figures with curves and angles
Sensory Activities
The following activities ought to be done frequently to increase postural muscle
strength and endurance. These activities also strengthen the child's awareness of
his/her hands.
Wheelbarrow walking, crab walking
Clapping games (loud/quiet, on knees together, etc.)
Catching (clapping) bubbles between hands
Pulling off pieces of thera-putty with individual fingers and thumb
Drawing in a tactile medium such as wet sand, salt, rice, or "goop".
Make "goop" by adding water to cornstarch until you have a mixture similar
in consistency to toothpaste. The "drag" of this mixture provides feedback to
the muscle and joint receptors, thus facilitating visual motor control.
Picking out small objects like pegs, beads, coins, etc., from a tray of salt,
sand, rice, or putty. Try it with eyes closed too. This helps develop sensory
awareness in the hands.
Midline Crossing
Establishment of hand dominance is still developing at this point. The following
activities will facilitate midline crossing:
Encourage reaching across the body for materials with each hand. It
may be necessary to engage the other hand in an activity to prevent
switching hands at midline.
Primary
Refrain specifically from discouraging a child from using the left hand
for any activity. Allow for the natural development of hand dominance by
presenting activities at midline, and allowing the child to choose freely.
Start making the child aware of the left and right sides of his body
through spontaneous comments like, "kick the ball with your right leg." Play
imitation posture games like "Simon Says" with across the body movements.
When painting at easel, encourage the child to paint a continuous line
across the entire paper- also from diagonal to diagonal.