Eye-Hand Coordination — A Team That Works Together To Get The Job Done

By Barbara Greenspan OT, pediatric occupational therapist

Many of us think eye-hand coordination is something the ‘big-kids’ need to play team sports like baseball and tennis. But actually, eye-hand coordination begins developing in early infancy. In order to achieve proper coordination, the hands and eyes must work together in smooth and efficient patterns. This is achieved through effective control of the head and neck, which enables the eyes to monitor the work of the hands.

The Eyes: Nature has it set up so that controlled eye movements developmentally precede controlled hand movements. That is why babies use their eyes before they master the use of their hands. As infants, eyes develop in a clear developmental sequence as follows:

• From birth to 3 months is something called ‘localization’ –where infants locate a visual target like mom or a toy


• At four months is ‘Fixation’ where the baby can maintain a stationary gaze (stare at an object)


• At five months is ‘Ocular Pursuit’ typically starts. Where the baby can smoothly track an object with the eyes (follow a toy as it moves, watch mom move around the room)


• At six months ‘Gaze Shifting’ begins. This is when the child quickly and accurately shifts her gaze, moving independently from the head (watch a moving toy while keeping the head still)

The Hands: Just like the eyes develop in a sequence designed for function, so do the hands.

• First the baby learns to grasp an object.


• Next they grasp and release objects (think of dropping food from the high chair).


• The baby then learns to move an object within the hand (in-hand manipulation) and then use two hands together to play or hold an object (bilateral hand skills).


• All this hand development is done through playing with objects and toys.

Mastery of reaching for objects requires good postural control of the head, neck, trunk and upper arms. These areas must be strong before good hand manipulation occurs. Think of a tree-the trunk must be strong in order to support the branches (so much goes in to this eye-hand coordination!).

The first “tool” for eye-hand: When the hands are developing they progress from a simple grasp-release pattern through using tools and objects. The first real “tool” introduced to the hand is the spoon for self-feeding. The hand holds it and the eyes watch the spoon to direct it from the food on the plate to the mouth. As the child grows, they use more refined tools like crayons (use small, broken ones to fit the little hands!) and the eyes are watching as the hand moves the crayon. As the child gets older, he or she can begin to follow mazes and use the eyes to lead the hand in the right direction. In pre-school at 3 or 4 years old, he or she begin to cut with scissors and use the eyes to direct their hands.

Ways to work on eye-hand:

• Playing ball is a great way to work on eye-hand coordination. Start rolling a ball to your baby and watch his or her eyes follow the ball.


• Playing with a balloon (filled with air) is a great way to get the eyes to follow a moving object because a balloon moves so slowly, it is easy to follow.


• As your child grows you can work on throwing and catching with a playground ball and progress to a smaller ball. Tennis balls are great fun to catch and throw for 4 and 5 year olds. Warm these kids up with a big ball and progress to a smaller ball when they are successful.


• Dribbling is also a great activity to develop eye-hand coordination. Four, five and six year olds feel so good about themselves when they can dribble with one hand and then progress to alternating hands!

Eye-hand coordination is something that begins to develop at birth and continues throughout childhood. It is a skill children use daily in their occupations as students and athletes - and for just plain fun! So enjoy, and notice how much you use your eyes to direct your hands! You will be amazed!