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Developmental Red Flags
20-24 Months
An early childhood intervention/ development therapy referral
may be appropriate if your child is exhibiting any of these red
flag symptoms:
- Not imitating a drawing of a vertical line by 24 months
of age
- Excessive mouthing
- By 24 months, most toddlers will pick up crayons with
pads of fingers to make marks and scribbles, manipulate
shapes and puzzle pieces to place into forms, and self-feed
with a spoon.
Therapy Options

Thankfully, there are many ways to deal with delays in child
development and behaviors.
These include in-home services, outpatient (you take your child
to a clinic), inpatient (following injury or surgery) and school
based services. Which type of therapy should you choose?
Visit our Therapy
Options area to learn more.
Ask a Therapist

We understand developmental milestones and the challenges of
Special Needs children. We spend a great deal of time with
families understanding the inner workings of childhood routines
and interactions. Ask us about your child today!
Ask a Therapist
Fine Motor Skills for Toddlers
20-24 Months
Fine motor skills will be refining at this level.
Your toddler is able to make circular scribbles and imitate vertical
lines.
Crayons are held between thumb and fingers. During play, he or she
manipulates shapes and large puzzle pieces, building with blocks,
and scooping independently.
Most Two Year Olds can:
- Build a tower of three small blocks
- Put four rings on a stick
- Place five pegs in a pegboard
- Turn pages two or three at a time
- Scribble
- Turn knobs
- Throw a small ball
- Paint with whole arm movement, shifting hands, making strokes
- Build a tower with 4-6 blocks
- Fold paper (randomly)
- Imitate a circle when scribbling (not accurate)
- Begin to use scissors and string beads
- Use zippers
- Open doors using knobs
- Help with simple household tasks
Parenting Tips for Fine Motor Skills:
You can help with baby developmental milestones. Suggested play to help
a toddler 20 to 24 months of age develop fine motor skills:
- To encourage drawing a line (vertical or horizontal), draw a line
with finger in wet sand or finger paint, demonstrate making a line, and
offer your toddler a chance to imitate you.
- To promote circular scribbles, practice stirring with a bowl. Make
circles in wet sand with your finger or a stick. Sit next to your
toddler while you demonstrate.
- Make jewelry. Stringing beads, macaroni, or large cereal will help
your child learn how to use two hands at the same time. Remember to put
tape at the end of the shoelace or string.
- Puzzles are fun. This is a great age to introduce simple puzzles.
You can even make your own by cutting a cereal box into three or four
large pieces.
- Create a photo album. Make a small picture book just for your
toddler with photos of family, friends, and pets. Your toddler will
enjoy helping you put the book together. Later, you can look at the book
and talk about the people, again and again!
- Make a fruit salad. By using a plastic picnic knife or even a
Popsicle stick, your baby can cut up soft fruit like bananas or peaches.
He or she can sprinkle raisins on top and stir it all together.
- Write a store list. While you're making a shopping list, give your
child paper and a crayon and have him or her 'write' their own list.
Fine Motor Skills by Age Group
'Fine motor' refers to the development of small muscle movements of the
hands. Fine motor skills develop as your child's whole body gains mobility,
stability, cognitive, and emotional/social development. Fine motor skills
that come to mind are shoe tying, writing, and cutting paper with scissors.
Contact Information
Find Early Intervention
Support contacts in your State. If you have a question or comment for
us, please visit our Contact page.
Early Intervention Helps with Developmental Delay
For children with Special Needs, intervention in early childhood
development means finding specific ways to help a child become as functional
as possible.
Learn more on our Parenting
Tips
page.
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