The integrity and balance of the small muscles and joints of the hand work together to achieve refined finger movements and precision in grasp and release. The typical preschool child utilizes their fine motor skills for drawing and, eventually, for use of scissors. Early childhood is an important time for learning fine motor skills. Developmental milestones such as dexterity, bilateral coordination, and eye/hand coordination are acquired in early childhood.

A functional grasp of the pencil begins to develop at 5 years of age with the pencil held in the tips of the thumb and neighboring two fingers. The movement of the pencil is powered through the fingers. Drawing skills progress in the following sequence: vertical line (2 years), horizontal line (3 years), cross (4 years), and diagonal line (5 years). A development of scissor skills follows other tool use. Mature use of scissors is not achieved until 5-6 years of age because it requires isolated finger use.

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