Abby Barnes, M.S., CCC-SLP
Once children start school, they keep on growing and developing. Not only do they learn new skills, they also keep improving the skills they have. Occupational therapists (OTs) can help kids who need support with their fine motor and visual motor skills, emotional and sensory regulation, self-care skills, and more. Here are the milestones to watch for in your school-age child, as well as what to do if they need some extra help.
Key takeaways
Occupational therapists can support children’s fine motor and visual skills; social, emotional, and play skills; regulation and sensory needs; cognitive skills; and self-care skills.
Fine motor skills help children do things with their hands more precisely, such as writing in school and buttoning clothes.
Social, emotional, and play milestones are important as kids are around their peers more often. Examples include cooperating with friends, being aware of others’ feelings, and managing conflicts in social situations.
Regulation and sensory milestones relate to how well a child tolerates things such as loud sounds, a distracting space, and the need to sit for extended periods of time.
Cognitive skills include the ability to solve problems and follow longer, more detailed sets of directions.
Self-care skills are important for growing independence. These include dressing, bathing, and keeping track of personal and school items.
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Get startedWhat do occupational therapists assess and treat in children?
Occupational therapy can help with several areas of childhood development:
Fine motor and visual motor skills
Social and play skills
Cognitive development
Regulatory and sensory organization
Self-care
Fine motor and visual development is how kids use their hands and eyes together to interact with items and their environment. This might include holding a pencil correctly or writing with appropriate spacing.
Social, emotional, and play skills are how kids learn to engage with others, such as through social interactions or playing sports.
Cognitive growth includes problem-solving skills, following multistep directions, and organizational skills. Cognitive skills show just how much your child is learning every year.
Regulation and sensory organization is how kids respond to sensory input like touch, sound, movement, or visual stimuli. There are lots of sounds, sights, and other sensory input in school and other situations that may be new to your child. Having good regulation skills help kids handle these transitions, experiences, and day-to-day routines more easily.
Self-care relates to skills children start doing themselves as they become more independent. School-age kids can do most hygiene and self-care tasks themselves, such as brushing their teeth and tying their shoes.
For more about what to expect at this age, see our speech and language milestone checklists for school-age kids.
Learn the communication milestones to look for in kids ages 6-10, along with signs that your child may have a speech or language disorder.
Fine motor and visual milestones for kids ages 6-12
Fine motor and visual perceptual skills are very important for school-age kids, as they write, cut with scissors, and use other classroom tools. In one study, depending on their grade, students in kindergarten through 4th grade spent between 37% and 60% of the school day performing fine motor activities. Take a look at some of the expected skills for school-age kids:
Writes clearly with appropriate spacing
Uses the tripod grasp (three-finger) consistently with pencils, pens, and markers
Cuts complex shapes and along lines accurately
Colors in the lines with control
Has good visual tracking for reading and writing at 6-8 years old
Around ages 7-8, starts cursive writing
Around ages 7-9, can copy from the board to paper accurately
Around ages 8-10, improves speed of handwriting
Around ages 8-10, draws detailed pictures with proportion and perspective
Can complete puzzles with lots of pieces
Shows good spatial awareness
Fine motor skills are the small hand and finger movements we use for everyday tasks. Learn examples, activities, and how to support your child’s development at home.
Regulation and sensory milestones for kids ages 6-12
Strong regulation and sensory organization skills help kids succeed in school.
For example, students have to sit for structured periods of time, whether they’re at their desk or sitting in a school assembly.
School-age kids have to regulate how active they are in different settings. For example, they need to understand that it’s OK to run around during recess, but not in the classroom.
There can be a lot of sensory input in the classroom, such as bright lights, a loud air conditioner, or noise from other kids. Students have to adapt to this sensory input and stay regulated, even if it’s distracting. At the same time, they have to learn to keep their attention on their school tasks. All of this may take a little bit of time and practice!
Learn what causes attention problems in children, such as ADHD, and how to help your child with their attention and concentration at home.
Cognitive milestones for kids ages 6-12
Your child keeps learning as they grow! You should see the following cognitive skills taking shape in your school-age child:
Follows multistep directions (example: “Put your lunchbox away, get a pencil, sit down, and wait quietly for class to start.”)
Can solve problems with less support from adults
Shows a better attention span
Around ages 7-10, uses organizational strategies for school tasks, such as using a planner or making a list
By ages 8-12, begins to understand time management skills
Strong executive function skills help your child succeed in school. Find easy ways to help your child plan, organize, and stay focused.
Social, emotional, and play milestones for kids ages 6-12
As you can imagine, social and emotional skills are important for school-age children. They’re now in an environment with lots of other kids, learning to interact with each other.
School-age children should be able to play and interact cooperatively. Taking turns and following game rules should be more natural and “standard” for them.
They also will start to understand other kids' perspectives. For example, if a child’s turn accidentally gets skipped in a game, other kids should be able to think, “That would make me upset, too,” and try to help the situation.
They may need a little support from teachers or a parent, but they should be able to manage simple conflicts with friends.
Kids are also starting to form real friendships. These are often based on similar interests. Let’s say two kids really enjoy playing soccer at recess, or they both like a certain TV show. They’re likely to bond and form a friendship over this.
Some kids need a little help in making friends. Here’s what parents can do to help their child learn social communication skills.
Self-care milestones for kids ages 6-12
Kids at this age should be independent in self-care tasks. They might need reminders from you: “Don’t forget to brush your teeth” or “Tonight you need to take a shower.” But in general, they will be doing many of these tasks themselves:
Independently dresses and undresses
Can manage fasteners like buttons and zippers
Can tie their shoes
Brushes their teeth independently
Uses utensils properly during meals
Around ages 7-9, prepares easy snacks for themselves
By ages 8-10, manages personal hygiene routines with very little help
Organizes belongings like backpack, notebook, pencils, and other school materials
By ages 8-10, can do their morning and bedtime routines mostly on their own
Activities of daily living (ADLs) are key self-care skills. Learn when kids develop them, common delays, and how occupational therapy helps.
What if your child isn’t meeting developmental milestones?
If you notice that your child is missing some of these milestones, talk with your pediatrician or an occupational therapist. Starting any needed therapy sooner will lead to faster growth for your kiddo—and help them feel more confident and successful both in everyday life and in school.
Here at Expressable, we provide personalized, virtual occupational therapy designed to fit your child’s needs. Reach out to us to schedule an OT evaluation and get your questions answered.
Frequently asked questions (FAQs)
Sensory issues in children can include difficulty with loud sounds, busy spaces, certain textures of clothing, picky eating, or regulating their emotions.
Making arts and crafts (beading, weaving, clay, and more!), building with Legos, and playing games with small pieces are fun and motivating fine motor activities for school-age kids. Writing practice is also a great activity for fine motor skills that also supports handwriting development.
An 8-year-old is typically able to do most self-care routines by themselves. They should be able to dress themselves, use the toilet, wash their hands, and brush their teeth on their own. They can also prepare some simple snacks themselves. Eight-year-olds may need general reminders—for example, “Don’t forget you need to wash your hair tonight.” But they should be able to complete the tasks themself.
Eleven-year-olds should be learning concepts like time management and organization. They should know how to keep track of their belongings and school materials. They are typically able to pay attention, follow detailed directions, and stay regulated at school and during structured activities. Kids this age should also be independent with self-care and personal hygiene. They may need reminders from you, such as when to wear deodorant or take a shower. But they should be able to complete these tasks without help.
An occupational therapist (OT) can help kids with sensory processing and emotional regulation. This relates to their ability to stay calm in different situations. OTs can also support school-age children with social skills, fine motor skills needed for school and everyday tasks, and cognitive growth. OTs will assess these areas of development to determine specific skills to target in therapy.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
