Introduce yourself to the child and parent and state the object of the visit or encounter. For example; my name is Mary and I have been asked to see how good you are with doing things with your hands. Ask the parent if they have any concerns with their child's vision and ensure that they wear appropriate visual aids.

Introduce one test item at a time. Crowding your examination table will confuse the child, you and maybe the examiner.

Bricks may be a safe starting point.
• Build a tower with bricks and ask the child to copy what you have just done
• Build a bridge, a train, stairs/steps and a gate and see if the child can copy it or build it from scratch
• If a child cannot make a tower with bricks they may not be able to build a bridge or steps.

Comment on their skills, - finger thumb apposition , accurate placement, hand eye coordination, ability to copy and their ability to build from scratch.
 

Remove the bricks and offer the child a book.
• Can they open it?
• How many pages do they turn at a time?

Comment on their finger thumb apposition and accuracy

Offer the child  a pencil and a paper and test their pencil skills
• Can they copy a line?
• Can they imitate strokes or a circle, or a square or a cross, or a diamond or triangle?
• Ask the child to draw a man(3years and above), say themselves, their mother or father and assess their ability to draw a man.
 

Start with  age appropriate  activities for the child and work your way to more or less advanced skills depending on the child's performance.  For example if the child is 3 years old,  test their ability to draw a circle then move to a square or line depending on their performance.

Demonstrate threading beads to the child and see if they can do the same. Start with large beads then small beads.

Test the child's ability to use a scissors (31/2 to 4 years). Demonstrate cutting a piece of paper using a scissors and ask  the child to do the  same

If allowed you can also asked their parent about the child's ability to put on their shoes, undo and do buttons.

Summarise your finding and present them  to the examiner. Remember that you may not be able to assess all the above points. Propose a management plan and know when to involve different members of community team.

Remember that you may not have beads, or a scissors during the examination. Use whatever you have available to come to a conclusion.

The following fine motor skills are expected at:
 
2 years  
Tower of six cubes
Turns pages of a book one at a time
Puts on shoes(may be on the wrong foot)
Circular scribbles
 

3years 
Draws a circle
Tower of nine cubes
Bridge with three cubes
Can undo buttons
Can imitate a bridge
 

4years 
Copies a square
Copy 3 steps
Copy a cross at 31/2 years
Can use a scissors

5 years 
Copies a triangle and a diamond

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