In addition to specifically targeting sensory integration issues, the occupational therapist may work with your child to improve fine motor skills. Just as “fine” can mean sharp and exact and “gross” can mean large and all-encompassing, “fine motor” means movements that are small and require careful coordinated control — writing, cutting, or picking up small objects — and “gross motor” means movements that are large and involve coordination of multiple body parts — running, jumping, skipping, or throwing. Your child may be delayed in one or both of these areas, and sensory integration therapy will, even indirectly, help with both.

Children with sensory integration disorder are often delayed in skills like writing or using eating utensils, and techniques that take a sensory integration approach to those abilities can be very effective.

Your child will likely sit at a table with the therapist to do this work, and some of these items may be employed:

• Pencil weight: A weight slipped around the barrel of a pencil can give your child additional information about where his hand is as he writes, improving accuracy and making him more comfortable.

• Vibrating pen: Although it makes funny squiggly letters instead of neat ones, a vibrating pen gives your child good information about the movements that he's making to form those letters.

• Wikki Stix: Pieces of string made stiff with wax, these toys can be formed into letters and shapes to increase your child's fine motor control. The slightly sticky feel may be pleasing to kids who crave different tactile experiences.

• Wind-up toys: Turning the knob on a wind-up toy requires fine motor control and offers a big pay-off to motivate your child.

• Tops: The spinning toys also require fine motor coordination to function and give a child a pleasing result to his action.

• Geoboards: These flat plastic boards with pegs offer a canvas on which your child can stretch colored rubber bands to make designs. The stretching requires fine motor strength and planning.

• Lace-up cards: Getting a lace through a hole in a piece of cardboard takes good planning and control.

• Pick-up sticks: Your child picks out one thin stick from a pile and removes it without disturbing the others.

All these activities, plus others that include cutting, coloring, hole-punching, and picking up items with chopstick-like tweezers, will strengthen your child's fine motor ability while also providing strong sensory input. Don't be surprised if your child brings home artwork from school that he did in OT. Making designs with different substances is a great tactile workout, too.