Handwriting and pencil control
Grip, posture, letter formation and strength in the small muscles of the hand, practised on sloped boards, chalk walls and tracing games.
When pencils, buttons or busy rooms get in the way
Small Hands is a paediatric occupational therapy practice for children aged 3 to 12. We watch how your child writes, dresses, eats and copes with noise and touch, explain what we see in words that make sense at the kitchen table, then agree a few small goals with you.
90 minutesfor the first assessment, mostly play
Ages 3 to 12with a parent in every session
10 working daysuntil your written report arrives
Things parents tell us they have noticed
Most families get in touch about one stubborn everyday struggle rather than a label. Any of these is a fair reason to ask us.
- Handwriting that tires the hand after a few lines
- Avoids buttons, zips or shoelaces
- Covers both ears at hand dryers or parties
- Will only wear certain socks or clothes
- Finds a knife and fork hard to manage
- Bumps into things and tires quickly in PE
- Takes a long time to settle after school
- Struggles to cut along a line
Spotting one of these does not mean something is wrong, because children develop at different speeds. If your child's general health, growth or development worries you, talk to your family doctor as well, since an occupational therapist does not diagnose medical conditions.
What sessions work on
A session might involve dough, tweezers, a swing or a treasure hunt. Each activity is there for a reason, and the therapist tells you what it is as you watch.
Cutting, cutlery and tools
Snipping, cutting along a line, spreading butter and using a knife and fork, built up from steps your child can already manage.
Dressing and getting ready
Buttons, zips, socks and coats broken into small steps, practised with the clothes your child really wears to school.
Sensory needs
Children who seek out or avoid noise, touch, movement or certain textures, with calm routines planned for home and the classroom.
Coordination and play
Balance, ball skills, climbing and planning a sequence of movements, for playground games, PE lessons and riding a bike.
Routines and organisation
Packing a school bag, following morning steps and moving between activities, using picture lists that suit your child.
We work alongside your child's doctor, teacher and other therapists, never instead of them. Our therapists do not diagnose conditions such as autism or ADHD; if an assessment raises a question like that, we explain who can look into it.
The first assessment, in plain words
The first appointment lasts about 90 minutes in our therapy room, and you stay in the room throughout. For your child it feels like a morning of games: drawing, threading, building, balancing and a little writing. For the therapist it is a chance to see how they hold a pencil, plan a movement and react to sound and touch.
Some of the games are standardised tests. That simply means every child does the same tasks in the same way, so a score can be compared with children of the same age. Beforehand you fill in a short questionnaire about everyday life, often called a sensory profile, because you see things at home that nobody can see in one morning.
- A chat with you first, while your child settles
- Play based tasks, with breaks whenever needed
- What we noticed, explained before you leave
- A written report within 10 working days
Words in the report, and what they mean
Reports use a few professional terms because schools and doctors expect them. This is what the most common ones mean at home.
| Word you may read | What it means | Where you might see it |
|---|---|---|
| Fine motor skills | Small, precise movements of the hands and fingers | Doing up buttons, holding a pencil, picking up peas |
| Gross motor skills | Big movements that use the whole body | Climbing stairs, catching a ball, riding a scooter |
| Motor planning | Working out and ordering the steps of a new movement | Learning a new playground game, dressing in the right order |
| Visual perception | Making sense of what the eyes take in | Copying from the board, finding one shoe in a busy cupboard |
| Sensory processing | How the brain notices and answers sound, touch, movement and taste | Bothered by labels, or always climbing and crashing |
| Bilateral coordination | Both hands, or both sides of the body, working together | Holding the paper still while cutting, or skipping |
If a word in your report is still unclear, ask us. We would rather explain twice than leave you guessing.
What each appointment costs
Every child starts with the first assessment. After it we suggest a block of sessions with a review at the end, and you pay for each one on the day.
First assessment
fixed fee$260
- Questionnaire for parents beforehand
- Play based tasks and standardised tests
- Written report within 10 working days
Therapy session
per session$95
- Goals from the report worked on through play
- Five minutes at the end to show you the home game
- Progress reviewed after six sessions
School visit
per visit$180
- Your child seen in class and at play
- A short talk with the teacher
- Classroom ideas written up for the school
Fees are paid to the practice on the day. Whether an insurer, a school or a public scheme pays towards children's therapy depends on where you live and on that funder's terms, so check before the first visit if you hope to claim. A late cancellation, under 48 hours before the start, costs the full fee unless your child is unwell.
A look around the therapy room
A swing, a writing corner and a quiet tent, so every session can move between busy and calm.
From parents after a block of sessions (example reviews)
The report explained every score in words that made sense, and the school picked up the same ideas the following week. Mornings with buttons and coats are calmer now.
Our son thought he was coming to play, and he was. The therapist showed us a five minute game for the evenings, and he now asks for it before bed.
Hand dryers used to end every trip out. Together we planned ahead with ear defenders and a countdown, and outings feel manageable again.
Ask for a first appointment
Tell us your child's age, what you have noticed and the days that fit around school. Within two working days a therapist rings to hear more and to agree a time with you.
Nobody reads this form outside opening hours. A child who is unwell or hurt needs their own doctor, and for anything that cannot wait, ring your local emergency number.
- You stay in the room for every session
- First assessment about 90 minutes, $260
- Report in plain words within 10 working days
Parents ask us
Does my child need a diagnosis before coming?
No. Many children we see have no diagnosis at all, just an everyday task that has become a struggle. Some insurers and schemes want a doctor's referral before they pay, and that differs between countries, so check first if you plan to claim.
Will my child know it is therapy?
Younger children usually think they are simply playing. Older children like to know why, so we explain the goals in their own words and let them choose some of the games.
What is a sensory profile?
A questionnaire for parents about how your child responds to sounds, touch, movement, tastes and sights in daily life. It takes about twenty minutes and shows us what one appointment cannot.
Can you promise my child's handwriting will improve?
Nobody can promise that. What we can do is find out what makes writing hard, practise the parts that can be practised, suggest changes at school and review progress with you honestly after six sessions.
How much practice is there at home?
Usually one short game a day using things you already own, such as dough, pegs or a ball. If a week gets busy, skipping it is fine, and we never send worksheets.
What should we bring to the first visit?
Comfortable clothes, any glasses your child wears, a few pieces of recent schoolwork and any reports from other professionals.
Where to find us
Phone during opening hours, or email and a therapist replies within two working days.
Phone and email
A ground floor therapy room beside the primary school playing fields, with space for buggies and a quiet waiting corner
Opening hours
| Monday and Tuesday | 08:30 to 18:00 |
| Wednesday | 08:30 to 13:00 |
| Thursday | 08:30 to 18:30 |
| Friday | 08:30 to 16:00 |
| Every other Saturday | 09:00 to 12:30 |
| Sunday | Closed |
For teachers and nurseries
With a parent's written consent, we share ideas with your child's teacher and can visit the classroom. Teachers are welcome to email us with the parent copied in.