There are many applications you can find on iPad and iPhone that work on fine motor skills, handwriting, visual discrimination, visual perception, visual memory, etc… Based on my research, but mostly experience, I have come up with the best app to use in occupational therapy.
My all-time favorite app is Dexteria! It has great reviews and users love it (including me!). What’s great about this app is that it allows the child to develop his fine motor skills while allowing the parents or therapist to track and email progress reports. Dexteria works on three areas of fine motor skills: tapping, pinching, and writing.
Tapping is the first section where the child places his thumb on the thumb spot while his fingertips tap on the correct color dots as they appear in different places on the screen. This requires the child to flex his digits to varying degrees depending on the colored spot. Different levels adjust for the speed of which the child has to tap on the dots. I sometimes find this activity hard for younger children because they tend to want to move their whole hand instead of only their digits. In this case Dexteria Jr. may be a better choice to begin with.
Pinching, requires the child to pinch the tip of his thumb to the tip of his index in order to pinch the crab as they slowly move across the screen. This section works on finger and hand movements for fine motor control and manipulation. It may be hard at the beginning for the child to understand what to do, so practice pinching before starting this game on the iPad. One creative way to adapt this activity is to use iPad chopsticks. Although the objective of the activity is lost (no more pinching), it is another way to work on fine motor control and precision.
The last section is the writing activity. The child has to trace letters (upper and lower case) and numbers following the sequence as shown. It allows the child to practice letter and number formation as well as precision. For this writing section, I strongly suggest using a stylus instead of the index finger to trace the letters/numbers in order to achieve proper pencil grasp. The one I found to work best with children is the thick AluPen or the Griffen Crayola . 
All in all, this app can be used as an evaluation tool and is a definite must get in occupational therapy. Current cost $3.99. Also available from the same company:
- LetterReflex-Overcoming Letter Reversals & Backwards Writing in Early Childhood Development & Dyslexic Children
- P.O.V.-Spatial Reasoning Skills Development
Stay tuned for the second part of my blog post on my top 5 apps to use with children in occupational therapy!