Kids Born 2015–2020 Have a Motor Skills Problem. Pediatric Therapists Are Alarmed.

Occupational therapists started noticing it around 2022. Kids coming in for evaluations couldn’t hold scissors properly. Five-year-olds who should have had functional pencil grips didn’t. Six-year-olds struggled to button their shirts. Seven-year-olds who hadn’t learned to tie shoes — not because nobody taught them, but because the fine motor foundation wasn’t there yet.

These weren’t isolated cases. OT clinics across the country began reporting the same thing: the pandemic generation, kids born between roughly 2015 and 2020, was arriving at kindergarten and first grade with measurable motor skill gaps compared to pre-pandemic cohorts. And the waitlists to see a pediatric occupational therapist — always long — had ballooned to 12, 14, sometimes 18 months in major metro areas.

This matters for more than handwriting. Motor competence in early childhood is one of the strongest predictors of physical activity habits, academic readiness, and social participation through elementary school. When that foundation is delayed, the effects compound.

What Pediatric OTs Are Seeing Since 2022 — the Numbers

The clearest signal isn’t the research papers — it’s the OT waitlists themselves. In 2019, many pediatric OT clinics had 4–8 week waits. By 2022, surveys of occupational therapy practices in the United States reported waits of 6–18 months as the new norm. The American Occupational Therapy Association (AOTA) flagged a workforce shortage compounding the demand surge, but therapists in the field consistently report that the referral volume — not just the shortage — has driven the backlog.

What’s generating those referrals? In clinical observations published by the AOTA and in parent surveys, the most frequently flagged concerns for the 2015–2020 birth cohort include:

• Weak pencil grip and poor letter formation entering kindergarten
• Difficulty with scissors, snaps, and buttons
• Poor bilateral coordination (the ability to use both hands together purposefully)
• Reduced core strength affecting seated posture for classroom work
• Delayed ball-throwing and catching compared to age-matched pre-pandemic norms

These aren’t subjective impressions. Standardized assessments like the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) and the Movement Assessment Battery for Children (MABC-2) are showing it quantitatively. Clinicians report that scores in the 5th–15th percentile — which would have been moderate concerns in 2018 — are now appearing with enough frequency to strain the interpretation of what constitutes “below average.”

Why the 2015–2020 Cohort Is Uniquely Affected

To understand why this particular birth cohort shows more pronounced delays than slightly older or younger kids, you have to map the ages they were during the pandemic.

A child born in 2017 was 2–3 years old in 2020. The period from ages 2–5 is the primary developmental window for foundational gross and fine motor skills — when running, jumping, climbing, throwing, drawing, and manipulating small objects build the neural architecture for movement control. Lockdowns hit this cohort during that precise window.

Playgrounds closed. Play dates stopped. Preschool and daycare programs shuttered. The sensory-rich, peer-interactive physical environments that drive motor development were replaced, abruptly, with indoor sedentary environments where screens became the primary activity for much of the day.

A 2022 study by Holloway, Stoodley, and Sheridan in Preventive Medicine Reports analyzed physical activity levels in children ages 3–10 during COVID-19 restrictions. They found that structured and unstructured physical activity decreased by 60–80% in the early months of lockdown. For the youngest children in the sample — ages 3–5 — the reduction was most severe and most sustained. Screen time increased correspondingly, with the largest increases in passive viewing (rather than interactive or educational screen use) concentrated in the youngest age groups.

The 2015–2020 cohort didn’t just miss a year of physical play. They missed 12–18 months of the specific developmental window when motor competence is most rapidly built — and most sensitive to deprivation.

Children born in 2013 or 2014 were already 6 or 7 in 2020. Their motor foundations were substantially established before the disruption. Children born in 2021 and later grew up in an environment that was more open by the time their motor development window opened. The 2015–2020 cohort sits squarely in the gap.

Which Motor Skills Are Most Delayed — and What the Data Shows

Not all motor skills are equally affected. The research and clinical reports consistently point to fine motor skills and functional movement patterns that depend on the kind of repeated, varied physical manipulation that indoor screen time doesn’t provide.

Motor Skill Domain	Pre-Pandemic Benchmark (ages 5–6)	Post-Pandemic Observations	Primary Concern
Pencil grip	Functional tripod grip typical by age 5	Immature grips (fisted, lateral pinch) more common at kindergarten entry	Handwriting readiness
Scissor use	Basic cutting by age 5, curved lines by age 6	Delayed scissor control; grip strength inadequate	Fine motor coordination
Bilateral coordination	Catching with two hands, stringing beads by age 5	Reduced two-hand integration; asymmetric movement patterns	Reading, musical instruments
Gross motor — throwing	Overhand throw with trunk rotation by age 5	Delayed arm/body coordination; limited throwing distance	Physical ed, social play
Gross motor — balance	Hop on one foot 3–5 times by age 5	Balance delays more common; affects stair negotiation	Core strength, posture
Postural endurance	Seated upright in class for 20+ min typical	Slouching and fatigue during seated tasks flagged more frequently	Classroom participation

Sources: Ketcheson et al. (2021), Holloway et al. (2022), AAP (2022), clinical BOT-2/MABC-2 norm comparisons.

Ketcheson, Mackintosh, and Linde (2021) published a systematic review in the Journal of Motor Learning and Development examining motor competence during the COVID-19 pandemic. Across the studies they reviewed, children with high screen time and low physical activity showed significantly lower motor competence scores, particularly in object-control skills (throwing, catching, kicking) and locomotor skills (running, jumping, galloping). The effect was more pronounced in children under age 6 than in older children — consistent with the developmental window argument.

The fine motor picture is particularly concerning from an educational standpoint because handwriting, drawing, and cutting are the manual foundation for early literacy and numeracy instruction. A child who enters kindergarten without functional fine motor skills is already behind before the academic content starts.

What Motor Skill Delays Mean for School Performance

The connection between motor competence and academic outcomes isn’t intuitive, but it’s well-established in the developmental literature. It runs through several pathways.

The most direct is physical. A child who can’t hold a pencil properly produces letter formation slowly and painfully. The cognitive effort going into the physical act of writing leaves less available for the content of what’s being written. This is one reason why fine motor skill in kindergarten predicts reading and math outcomes years later — not because writing is reading, but because motor automaticity frees up working memory for higher-order thinking.

The indirect pathways involve physical activity’s effects on attention and executive function. When a child’s gross motor competence is low, they tend to avoid physical play. Less physical play means less exercise. Less exercise has documented effects on attention, impulse control, and mood regulation — all of which affect classroom performance.

A 2010 study by Grissmer and colleagues in Developmental Psychology found that fine motor skills at kindergarten entry were among the strongest predictors of academic achievement at age 8 — stronger than attention, social skills, or knowledge of numbers and letters. This result replicated in multiple cohorts and has been cited extensively in the subsequent motor-academic outcomes literature.

For the pandemic cohort entering kindergarten in 2022–2025, the implications are direct: a cohort arriving with delayed fine motor skills is arriving with reduced academic readiness, through no fault of their own or their parents’.

What Parents Can Do at Home Without a Therapist

Most families in the 2022–2025 OT waitlist situation face the same question: we know there’s a concern, we can’t get an appointment for 14 months, so what can we actually do? The evidence on home-based motor intervention is genuinely encouraging.

Use playdough, clay, and kinetic sand daily

Squeezing, rolling, flattening, and cutting playdough directly builds intrinsic hand muscle strength and fine motor control. It’s not a substitute for therapy, but it addresses the foundational hand strength deficit that underlies most fine motor delays. Aim for 10–15 minutes daily. The resistance the material provides mimics the kind of hand muscle loading that comes from manipulation of physical objects.

Bring back puzzles, LEGOs, and building toys

These activities require bilateral hand coordination, finger dexterity, and sustained visual-motor control. A 100-piece puzzle a day for a 5-year-old is a solid fine motor workout. LEGO provides progressive challenge — start with Duplo for younger kids and move to standard brick sets. The manipulation involved in snapping and separating bricks is exactly the kind of activity the pandemic cohort missed. For more on why building activities matter developmentally, see our piece on why kids who build and draw outperform peers in STEM.

Prioritize outdoor unstructured play with variable surfaces

Running on grass, climbing on playground equipment, navigating uneven ground — these build the gross motor foundations and postural stability that indoor sedentary time doesn’t. The goal isn’t organized sport. It’s unstructured physical exploration. Aim for 60 minutes of outdoor active play daily. The WHO and AAP both cite this figure for ages 3–17.

Bring back handwriting practice — with pencils, not tablets

For school-age kids, 10 minutes of daily handwriting with an actual pencil (not a stylus) builds pencil grip strength, letter formation memory, and visual-motor integration simultaneously. If grip is immature, start by building grip strength with the playdough and clay approaches above before focusing on letter formation.

Cutting practice

Give your 4–6 year old safety scissors and paper to cut. Let them cut junk mail. Cut along straight lines, then wavy lines, then simple shapes. The muscle patterning involved in scissor use directly supports pencil grip development. It seems trivial. The therapists who specialize in this area say it’s not.

When to Seek a Professional Evaluation

Home activities help significantly with mild delays. But some children need formal evaluation, and waiting to see if the delays resolve on their own can be costly.

Seek a referral to a pediatric occupational therapist if:

• Your kindergartner (age 5–6) cannot hold a pencil with any kind of functional grip after several months of practice
• Your child’s gross motor delays are affecting their ability or willingness to participate in physical play with peers
• Your child’s teacher flags specific concerns about classroom motor performance (writing, cutting, posture)
• Your child shows asymmetric motor patterns — consistently favoring one side in tasks that should use both hands
• Fine motor delays are affecting self-care (dressing, fastening, feeding)

You don’t need a diagnosis to request an OT evaluation. A pediatrician referral is usually sufficient to start the process. Given current wait times, making that referral at the first sign of concern — rather than waiting to see if the child “grows out of it” — is the pragmatic choice. The next article in this series covers how to navigate the OT waitlist situation in detail.

FAQ

How do I know if my child’s motor development is delayed versus just slower than average?

Developmental ranges are wide, and normal variation is real. A useful threshold: if your child is more than 25–30% behind the typical age benchmark for a specific skill (e.g., most kids catch a ball by age 5, but yours can’t at age 6.5), that warrants a conversation with your pediatrician. Single skill gaps are less concerning than multiple delays across skill domains.

My child was born in 2018 and seems fine. Should I still be concerned?

Not necessarily. The 2015–2020 cohort shows delays at the population level — not every individual child is affected. If your child has had regular physical play, varied manipulation activities, and no school concerns flagged, there may be nothing to act on. The research describes group-level patterns, not individual predictions.

Can screens really prevent motor development, or is this overstated?

Screens don’t directly cause motor delays. The mechanism is displacement: time on screens is time not spent in physical manipulation, outdoor play, and hands-on activity. Ketcheson et al. (2021) and Holloway et al. (2022) both found that it’s the reduction in physical activity, not screen exposure per se, that predicts lower motor competence scores. If a child has 60 minutes of vigorous outdoor play daily plus some screen time, the risk is lower than for a child with three hours of passive viewing and minimal physical activity.

Is occupational therapy really necessary, or will kids catch up on their own?

For mild delays — one skill behind by 6 months — natural catch-up with targeted home activities is plausible and documented. For children with multiple delays, classroom functional concerns, or delays that have persisted for a year without improvement, OT evaluation is warranted. “Waiting to see” makes sense for a month or two. It stops making sense when the child is entering second grade still struggling with kindergarten-level fine motor tasks.

What should I tell my child’s kindergarten teacher?

Be specific. Instead of “we’re worried about motor skills,” say: “We’ve noticed she has trouble with scissors and her pencil grip looks immature. We’re on an OT waitlist. We’d appreciate knowing if you see the same in class, and if the school has any OT services we should know about.” That framing opens the door to school-based services, which are a significant resource most parents don’t know to ask about. For more on navigating school-based OT, see our guide to OT waitlists and school-based services.

Are boys more affected than girls?

The evidence is mixed. Some studies find boys show more frequent motor delays overall, but the pandemic effect doesn’t appear to be significantly gendered — the cohort-level delays are documented across both sexes. Individual variation within each group is much larger than the average difference between groups.

Key Takeaways

• Kids born 2015–2020 hit their primary motor development window (ages 2–5) during pandemic lockdowns, missing 12–18 months of physical play that cannot be fully replaced by indoor activity
• OT waitlists of 12–18 months in major cities are the most visible signal of how widespread the referral surge has been since 2022
• Fine motor delays (pencil grip, scissors, bilateral coordination) are more consistently documented than gross motor delays and have the most direct effect on kindergarten academic readiness
• Grissmer et al. (2010) found fine motor skills at kindergarten entry predict academic achievement at age 8 more strongly than attention, social skills, or early academic knowledge
• Playdough, building toys, cutting practice, and 60 minutes of daily outdoor play address the most common deficit patterns and have evidence-based support
• Don’t wait 18 months for the OT appointment before starting a home program; home activities make a measurable difference for mild delays
• Request a school-based OT evaluation via your child’s school — it’s a separate track from private OT and covered under IDEA

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About the author

Ricky Flores is the founder of HiWave Makers and an electrical engineer with 15+ years of experience building consumer technology at Apple, Samsung, and Texas Instruments. He writes about how kids learn to build, think, and create in a tech-saturated world. Read more at hiwavemakers.com.

Sources

1. Ketcheson, L., Mackintosh, K., & Linde, M. (2021). “Motor competence during the COVID-19 pandemic.” Journal of Motor Learning and Development, 9(2), 177–193. https://doi.org/10.1123/jmld.2020-0070
2. Holloway, J., Stoodley, N., & Sheridan, A. (2022). “Physical activity and screen time in children during COVID-19.” Preventive Medicine Reports, 25, 101685. https://doi.org/10.1016/j.pmedr.2021.101685
3. Grissmer, D., Grimm, K. J., Aiyer, S. M., Murrah, W. M., & Steele, J. S. (2010). “Fine motor skills and early comprehension of the world.” Developmental Psychology, 46(5), 1008–1017. https://doi.org/10.1037/a0020104
4. American Academy of Pediatrics. (2022). “COVID-19 and developmental concerns: What pediatricians need to know.” AAP.org. https://www.aap.org/en/news-room/news-releases/aap/2022/
5. Barnett, L. M., Stodden, D., Cohen, K. E., et al. (2016). “Fundamental movement skills: An important focus.” Journal of Teaching in Physical Education, 35(3), 219–225. https://doi.org/10.1123/jtpe.2014-0209
6. American Occupational Therapy Association. (2024). “OT workforce data and trends.” AOTA.org. https://www.aota.org/practice/workforce
7. World Health Organization. (2020). “Guidelines on physical activity and sedentary behaviour.” WHO.int. https://www.who.int/publications/i/item/9789240015128