Occupational Therapy
Pre-Referral Interventions For Classroom Difficulties
Fine Motor Tasks
Please try as many of the following interventions as possible for a period
of 4-6 weeks. Your student may demonstrate the following difficulties
in isolation or in combination with others.
Pre-Writing:

Have the student fold paper (orgami is great!). If a student has difficulty folding
paper in half, place a colored dot on each corner so the student can match corners.

Outline pictures with bright colors or use templates or stencils to help the student
remain within the boundaries while coloring.

Draw/write in a variety of media, such as shaving cream or sand.

Place glue around the outline of an area as a boundary, giving it time to dry, and
have the student color inside the boundaries. Cut out a design or picture to color,
glue it on dark paper, copy it to block out the background area.

Play games such as picking up small items with tweezers, coloring, sewing cards,
cutting, painting, shaping with clay, stringing beads, painting with cotton balls or
make-up sponges.

Work on a vertical surface, such as an easel, slant board, chalkboard, or paper
taped to the wall.
Handwriting Warm-Ups:

Make large circles with arms in a backward motion.

Extend arms forward with backs of hands together, then make slow circular arm
motions.

Make a fist with both hands, tensing muscles of the entire arm and hand as hard as
possible. Hold for 3 seconds for 5 repetitions.

Crinkle up a sheet of newspaper into a ball with one hand, then unwrinkled and
straighten it out as much as possible. Repeat with the other hand.

Place palm of one hand on the desk and raise each finger off the desk. Repeat
with other hand.

Place a small object in the palm of one hand (paper clip, button, coin, etc..). Use
fingertips and place onto the desk. Repeat with the other hand, and then do the
activity with both hands at the same time.
Handwriting:

Highlight margins with markers (green for left margin to “go” and red for the
right margin to “stop” at the red line).

Try various lined papers. Some students do better with wide-rule paper, while
others are more successful with narrow, college-rule paper.

When letters/words are up and down, use lined paper rather than plain paper in
order to assist with organization of words on the page.

If a student has difficulty lining up math problems, use graph paper or turn lined
paper sideways to create columns. Graph paper can also be used to help a student
with difficulty spacing between words.

Tape a strip to the student’s desk with a model of the manuscript or cursive upper
and lower case alphabet, numbers, and the student’s cursive signature.

Clear the desk of all clutter.

Have the student write on strips of paper rather than on an entire sheet of paper.

For students who have difficulty copying from the board, provide a model at their
desk, or keep an open desk at the front of the room that they can come up and use
while copying.

Keep worksheets clear and uncluttered, use half worksheets, prepare worksheets
with only one problem on a sheet, or have worksheets with short-answer blanks
only.

Cut out a window in a piece of cardboard and place it over a worksheet (or book)
so that only relevant information is showing through the window. This may only
be one line at a time or one section of the worksheet at a time.

Have the student practice writing with his/her eyes closed. This encourages
“feeling” how the letters are formed so that writing becomes more automatic.

Check writing position. Make sure the student’s feet are on the floor and the desk
height is not too high or too low. Desk height should be approximately even with
the student’s bent elbow.

Ideas for modifications: shorten writing assignments, allow extra time, use a
computer with word prediction software, use a tape recorder for note-taking, or
have another student copy his/her notes.
Pencil Grasp:

If the student cannot make a tripod grasp after many attempts over a period of
time, teach an adapted tripod grasp. (Place pencil in the “V” between the index
and middle fingers, then bring the tips of these two fingers to meet the tip of the
thumb around the pencil)

Use short pencils, crayons, and chalk to encourage correct position

Try various types of pencil grips

When all fingers are used to hold a pencil, have last two fingers hold small object
against palm in order to isolate thumb, index finger and middle finger to hold
pencil.
Scissor Use:
Pre-cutting skills:

Have student open and close scissors without cutting anything

Cut play dough “snakes”, straws, old playing cards, index cards, magazine inserts,
etc…

Cut firmer paper, such as construction paper, tag board, sand paper, etc…
Cutting skills:

Begin with snips, then straight lines, then curved lines. Provide a lot of practice at
each level.

The student should hold the paper to be cut using non-dominant hand, and thumbs
of both hands up.

Try having student place both elbow on the desk while cutting

If student cuts too rapidly, place a rubber band around the blades of the scissors,
near the loops, to give some resistance.

An adult can cut close to the shape to minimize the amount of paper the student is
working with.

To enhance the cutting line and reinforce it as a cutting boundary, trace over it
with a thick, black marker or glue the outline ahead of time so that student can cut
just outside the dried glue or line.
ALTERNATIVE TYPES OF SCISSORS

Spring-loaded scissors for students with poor strength or motor planning

Loop scissors for students unable to put finger and thumb in loops, but able to
squeeze scissors

Scissors designed for left-handed students will usually yield better results for the
left-handed student. Some brands are designed to be used right and left- handed.