A-Z List


Perceptual/Fine Motor

Visual Focusing - 0-2 mos.

Short-term Goal: Child will focus on an object placed 10-12 inches in front of his eyes (midline).

At various times during the day, position yourself where the child can see you. Sing to the child and make interesting noises. Change your facial expression in a positively reinforcing way when child indicates he can see you.

Shake a colorful noisemaker in front of the child’s face to gain her attention and to promote focusing of eyes.

Place a musical toy in the child’s crib so that he will have something on which to focus his eyes.

NOTE: If the child’s eyes do not focus on the object, move her head to face the object.

*Visually Impaired: Give the child an opportunity to listen to a variety of sounds such as noise makers, records, and voices. Cessation of activity or increase of activity is indicative that she is hearing the sounds. Later he will begin to locate the sounds. Later she will begin to locate the sounds of his environment.


Visual Tracking - 0-2 mos.

Short-term goal: Child’s eyes will follow objects that are moving horizontally in front of her (horizontal tracking).

While the child is looking at you, move your head from side to side to the beat of any music which the child enjoys. Encourage the child to follow you with her eyes.

Hold a puppet approximately 2 inches from the child’s face. Slowly move it from side to side to make it dance to the beat of the music. Be sure the child’s eyes are focusing on the object. Gradually increase the distance of the object from side to side.

Place finger cymbals or hand castanets on your thumb and index finger and click them together as you move your hand across the midline in front of the child’s face, encouraging him to follow visually.

Hang a musical mobile above the child’s crib. Hang it so it swings horizontally. Encourage the child to follow its swing.

When the child’s eyes are focusing forward, present a maraca to the side of the child’s face. Shake it slightly and try to attract the child’ s attention. When the child turns to focus on the object, move it horizontally across the child’s midline in a slow continuous movement, encouraging the child to follow it visually. Repeat to both sides. This activity may help to develop the child’s peripheral vision.

*Visually Impaired: Encourage the child to follow the sounds of a moving noise maker, musical instrument, or your voice as you move about the room. Reward her with praise and physical contact.


Visual Focusing - 0-2 mos.

Short-term Goal: Child’s eyes will alternately (and rapidly) focusing on two objects separated by some distance.

By the left side of the child’s head, hold a pair of maracas in one hand, and at the right side of her head hold a pair of castanets in your other hand. Alternate playing the instruments. When the child focuses on one instrument, play the other one. Continue to alternately play the instruments in both hands and reward the child when she is able to change her focus on both sides alternately.

*Visually Impaired: Encourage the child to turn her head to follow sounds that change position, i.e., near, behind and in front of her.


Visual Tracking - 0-2 mos.

Short-term Goal: Child’s eyes will follow an object moving vertically and obliquely in front of her (vertical and oblique tracking).

Use the sequence of activities described for horizontal tracking and apply them to vertical tracking. Once the child successfully tracks a vertically moving object, repeat the sequence of activities for oblique (diagonal) tracking.

*Visually Impaired: Move musical objects in various directions in front of the child. Encourage her to listen by asking “Where is it now?”.


Visual Tracking - 3-5 mos.

Short-term Goal: Child will move his head to track a moving object through a 180’ arc.

Attract the child’s attention with a musical instrument. Slowly move the instrument to one side until the child stops following it; then move it in the opposite direction past the midline, for as long as she will follow it (tracking game). Repeat the tracking game until the child follows a moving object with smooth, well coordinated eye and a head movements in both directions. Gently help the child turn his head if only her eyes move.

Continue to increase the distance the musical instrument moves from side to side until the child turns his head and eyes to follow the instrument through a complete semicircle.

NOTE: Do above activities when the child is a variety of positions (back, stomach, sitting up).

*Motorically Involved: If the child has a strong tendency to assume the asymmetrical tonic neck reflex position (fencer’s position with head turned to one side), make sure the child’s arms are in front of her. Hold them across her chest if necessary.


Eye-Hand Coordination - 3-5 mos.

Short-term Goal: Child will reach for dangling musical instrument

Place a musical instruments in a place where the child’s arm will make contact with it when she moves her arms.

Shake maracas or jingle bells beside the child. Encourage him t reach for the instrument. Reward her when she does.

Place a musical mobile above the child’s crib and encourage her to reach for it.

Dangle the child’s favorite musical instrument above her crib low enough for her to reach it and encourage her to do so.

*Motorically Involved: Present the object at midline and guide the child’s arm towards the toy.

Hands in Midline - 3-5 mos.

Short-term Goal: Child will bring her hands together in front of her body (at the midline).

Hold out a pair of cymbals in front of the child at midline. When he reaches for them, hold her hand and guide her in playing the cymbals, bringing her hands close together.

Play pat-a-cake with the child. Move her arm through the actions, pausing to help her feel her other hand at the midline. Use her finger tips to feel her palm and other fingers.

*Motorically Involved: If the child does not voluntarily move her arms and hands to the midline, it will be necessary for you to frequently move her hands and arms to the midline. Use her finger tips to feel his palm and other fingers.


Grasp - 3-5 mos.

Short-term Goal: Child will hold a object placed in his hand.

Give the child a musical instrument such as a shaker or a jingle bell to hold in her hand. Encourage her to close her fingers around the instrument. Gradually decrease your assistance.

*Motorically Involved: If the child has weak muscle tone, support her wrist before placing an instrument in her hand. If the child’s fist is closed due to spasticity, drop the wrist before placing the instrument in her palm. The fingers should open when the wrist drops. Place the instruments in the child’s hand and slowly straighten her wrist.


Grasp - 3-5 mos.

Short-term Goal: Child will voluntarily grasp an object in her palm using only his pinkie, ring and middle finger (ulnar- palm prehention).

Give the child musical instruments to hold onto. Decrease your assistance until the child can grasp the instrument by herself.

*Motorically Involved: If the first is closed due to stiffness, drop the wrist to a relaxed position offering the object.

Supporting the child on your lap in front of a table, or sitting on the floor and place the child between your legs for support. Help the child explore musical instruments which have been placed in front of her. Close her hand over the instruments. Later encourage her to explore the surface in front of her and grasp her own.


Visual Focusing - 3-5 mos.

Short-term Goal: Child will look at her hands.

Bring the child’s hands into her field of vision and move them to make them clap or reach for musical instruments.

Tie small bells to the child’s hands so they will ring when she moves them.

*Visually Impaired: Use bells to call child’s attention to her hands.

Grasp - 3-5 mos.

Short-term Goal: Child will hold an object in her palm using her thumb and index finger (radial-palmar prehension).

Let the child grasp a musical instrument and encourage her to use her thumb and index finger.

Gradually give the child smaller instruments until she can hold surfaces as small as 1 inch in diameter using her thumb and index finger.

*Motorically Involved: If you hold the instrument in your hand or with your fingers, the child will be less apt to use an ulnar grasp or a raking motion when she grasps it. If the fist is closed due to spasticity, gently shake the child’s arm or pat the child’s fist on the floor or on your lap to get her to open her hand.


Eye- Hand Coordination - 3-5 mos.

Short-term Goal: Child will accurately reach for and grasp an object.

Play a musical instrument which you are holding close to the child. Hold it directly in front of her. Reward her when she touches it.

*Motorically Involved: If the child has cerebral palsy, position the child on her side before you encourage her to reach for the object.

*Visually Impaired: It is essential that blind children learn to reach on sound cue in order to establish a foundation for later gross motor development. Place instruments just slightly out of the child’s reach. Over time, increase the distance the child must reach to obtain the object. Help the child reach out to feel your mouth and larynx whenever you talk or sing to her.

Bimanual - 3-5mos.

Short-term Goal: Child will transfer an object from hand to hand.

Present the child an instrument alternately from her right, then left side so that she will eventually reach and grasp with either hand. Let her play with the instrument when you present it.

Present a musical instrument from the child’s left side. Gently restrain her left hand until her right hand comes across her body to grasp the instrument. Repeat, having the left arm cross over her body. Once the child has grasped the instrument with one hand, allow her to play with it.

When the child is holding the instrument with one hand, help her transfer it from one hand to the other. Gradually decrease you assistance until she can transfer the instrument on her own.

*Motorically Involved: If the child has one side more effected than the other, place the instrument in the hand which will be used to stabilize the instrument (the affected side). Encourage her to use her non-affected hand to remove it. Consult a therapist regarding ways to get the child to move her affected arm.

NOTE: A motorically impaired child may have decreased sensation and may not feel the object in her hand. Make sure the child sees it.


Eye-Hand Coordination - 6-8 mos.

Short-term Goal: Child will purposefully reach for and act upon an object.

Hold out musical instruments such as bells, shakers, etc., and encourage the child to play them by shaking them.

Demonstrate playing a drum and encourage the child to imitate.

*Motorically Involved: It may be necessary to move the child’s arms through the motions so that she gets a ‘feel ‘ for the desires movement.

*Visually Impaired: Move the child through the motions of the activities until she does them on her own.


Grasp - 6-8 mos.

Short-term Goal: Child will pick up a small object by scooping or raking.

Place rhythm instruments near the child in a box placed on its side and encourage the child to retrieve the instrument by scooping or raking.

NOTE: The child may pick up the instrument by scooping it up with her whole hand (hand will rest on surface with her thumb pointing towards the ceiling) or by raking (palm down with fingers straight, then curling around the instrument).

*Motorically Involved: The child may develop this form of grasp earlier than others as she does not have to isolate a finger to do so. Help her to close her hand over the objects by holding her wrist in a relaxed position.

*Visually Impaired: Let the child feel the object before moving her arm through the desired motion.


Grasp - 6-8 mos.

Short-term Goal: Child will hold an object between her thumb and first two fingers (thumb-finger opposition).

Hand the child instruments which gradually decrease in size to diameters as small as one inch. Encourage her to grasp and hold them with her thumb and first two fingers.

NOTE: The child will develop this grasp quicker if instruments are handed to her rather than on a flat surface.

*Motorically Involved: Hold the child’s wrist in a relaxed position to aid in grasp.


Manipulation - 6-8 mos.

Short-term Goal: Child will manipulate an object with her hands and fingers.

Demonstrate playing several musical instruments (i.e. playing rhythm instruments, piano, strumming guitar, etc.). Encourage the child to imitate.

*Motorically Involved: If the child’s hands are often fisted, gently shake the child’s wrist to help in relaxing her spasticity. As she is performing the activity, firmly push down on her wrist to loosen and relax the fingers.

*Visually Impaired: Help the child to feel all of the instruments.


Grasp - 9-11 mos.

Short-term Goal: Child will isolate movement of her index finger from all other finger movements.

Present the child with a set of finger cymbals or finger castanets. Demonstrate how to play them and encourage her to imitate. It may be necessary to manipulate the child’s fingers at first.

*Motorically Involved: If the child’s hands are often fisted, gently shake the child’s wrist to help in relaxing spasticity. As she is performing the activity, firmly push down on her wrist to loosen and relax the fingers. Help her isolate the index finger by gently holding down the other fingers.


Eye-Hand Coordination - 9-11 mos.

Short-term Goal: Child will purposefully release an object.

Demonstrate placing the musical instruments in a basket. Encourage the child to imitate.

NOTE: If the child has trouble releasing instruments, help him by stabilizing her wrist against the container.

*Motorically Involved: Stabilize the child’s wrist in a relaxed position (in line with the fore arm) to make sure that the release is active and not reflexive (wrists drops, and fingers open). Decrease your assistance as the child gains skill.

*Visually Impaired: At first, guide the child’s hand over to the basket to make sure the instruments make a noise as they drop into the basket. Decrease your assistance as the child gains in her skills.


Pincer Grasp - 9-11 mos.

Short-term Goal: Child will hold an object between her thumb and index finger (tip of thumb and index finger should oppose each other).

Give the child a guitar or an autoharp pick. Demonstrate how to strum and encourage her to imitate.

NOTE: The child may start by picking up the pick between her thumb and the side of her index finger. This is an inferior pincer grasp. Continue to work on grasp until the child demonstrates real pincer grasp with complete opposition.

*Motorically Involved: Hold the wrist straight to ensure active grasp

*Visually Impaired: Manipulate the child through the activity a number of times.


Bimanual - 12-15 mos.

Short-term Goal: Child will use both hands to perform same action.

Give the child two mallets, one for each hand, and show her how to pay a xylophone. Both hands will initially move simultaneously so the mallets hit the xylophone at the same time.

Encourage the child to imitate clapping hands.

Give the child a set of maracas. Demonstrate how to play with one in each hand and encourage her to shake them both.

Give the child a set of bongo drums. Demonstrate how to play with both hands and encourage the child to imitate.

Present the child with a basket of instruments and encourage her to use both hands to remove them one by one and then place them back in the basket.

*Motorically Involved: Encourage the child with one-sided involvement to also use his affected hand.


Bimanual - 12-15 mos.

Short-term Goal: Child will stabilize an object with one hand and manipulate it with the other hand.

Have the child hold a tambourine or drum with one hand and hit it with the other.

Give the child a musical toy which plays music when a string is pulled. Demonstrate how to make it play by pulling the string. Encourage the child to imitate by holding the toy steady with one hand while he manipulates it with the other hand.

Give the child a triangle. Demonstrate how to play it and encourage her to imitate by holding it steady with one hand while striking it with the other hand.

Encourage the child to stabilize an autoharp by pressing down a button on the autoharp as he strums with the other hand.

*Motorically Involved: Place your hands over the child’s hands and manipulate her through the activity many times. Gradually decrease the amount of assistance you give. When she is able to perform the task with minimal assistance, guide her from the elbow.


Eye-Hand Coordination - 16-19 mos.

Short-term Goal: Child will guide a object to hit a target.

Give the child a drum and a drumstick or a xylophone and a mallet. Show her how to hit the drum or play the xylophone. Encourage her to imitate you.

Give the child two rhythm sticks and show her how to hit them together to make a sound.


Eye-Hand Coordination - 16-19 mos.

Short-term Goal: Child will purposefully and accurately put an object in the appropriate place.

Demonstrate how to place the holding loop of the triangle around the triangle in order to hold it up. Encourage her to imitate.

Demonstrate how to place a xylophone in its case and encourage her to do the same.

Demonstrate how to place several rhythm instruments in a basket or box. Encourage the child to imitate.


Bimanual - 20-23 mos.

Short-term Goal: Child will perform activities in which one hand moves in the opposite direction from the other hand.

Play the drum or xylophone with one hand first and then with the other. Encourage the child to imitate.

Crash the cymbals together by moving one hand up as the other hand moves down. Encourage the child to imitate.

Grasp - 20-23 mos.

Short-term Goal: Child will manipulate an object using only her fingers

Have the child grasp an autoharp or guitar pick and strum the autoharp or guitar by moving the pick up or down.

Give the child a small hand organ. Help her turn the crank or handle until she can do it in her own.


Directionality - 24-27 mos.

Short-term Goal: Child will differentiate between vertical and horizontal directions.

Demonstrate directions by moving up and down to the music and by swaying from side to side. Encourage the child to imitate. Verbally identify up and down, and across.


Manipulation - 32-35 mos.

Short-term Goal: Child will successfully manipulate increasingly difficult objects

Let the child play a piano or organ. Show her how to manipulate it with only one finger at a time. Encourage her to participate.

Give the child a toy flute which is made of two pieces together. Demonstrate how to twist the two pieces together. Encourage the child to imitate.


Form Discrimination - 32-35 mos.

Short-term Goal: Child will identify an object by feeling it.

Show the child several rhythm instruments with which she is familiar enough to know their names. Verbally review the names of each instrument. Place the instruments in a box. Ask the child to close her eyes (or blindfold her) and reach into the box, pulling out one instrument at a time and identifying each instrument by name. Have the child open her eyes each time to verify her identification. Encourage her to correct herself when she has made a mistake.

*Visually Impaired: Encourage the child to verify her identification by listening to the sound of the instrument.