As Fort Myers occupational therapists, one of the most rewarding moments for us is when a child successfully zips their own jacket for the first time. The pride that lights up their face tells a story that goes far beyond just fastening clothing. It’s about independence, confidence, and the foundation for lifelong self-care skills.

But we understand getting to that point is tough for a lot of our patients. Those buttons and zippers become sources of frustration. Morning routines turn into battles. Your child often becomes upset or resistant during dressing time. It’s essential to understand in those moments that behavior is communication. Your child isn’t being difficult; they’re very likely struggling with the complex motor skills that dressing demands. The good news is our Fort Myers occupational therapists can help.

The Hidden Complexity Behind Simple Tasks

Most parents don’t realize just how sophisticated buttoning a shirt or zipping a jacket actually is. These everyday tasks require an intricate coordination of multiple skill areas working together simultaneously. According to the Centers for Disease Control and Prevention, developmental milestones show what most children (75% or more) can do by specific ages, helping parents and professionals identify when additional support may be needed.

When we break down what’s happening during dressing activities, children must coordinate:

• Fine Motor Skills: The small, precise movements of fingers and hands necessary for grasping buttons, pinching zippers, and manipulating fasteners
• Bilateral Coordination: Using both hands together in a synchronized way—one hand holds the fabric steady while the other threads the button through the hole
• Visual Motor Integration: Eyes and hands must work together to guide the zipper pull into the chamber or align the button with the buttonhole
• Motor Planning: The brain must sequence the steps in the correct order and execute them smoothly
• Sensory Processing: Tolerating the feel of different fabrics, the pressure of clothing against skin, and managing the body awareness needed to know where clothing items are in space
• Core Stability and Posture: Strong trunk muscles provide the stable foundation needed for hands to work with precision

Research confirms that developing fine motor skills through activities like buttoning, zipping, and fastening is crucial for accomplishing daily life activities. When children struggle with these foundational skills, it can affect not just their ability to dress independently, but also their self-esteem, peer relationships, and readiness for school tasks like writing and using scissors.

Developmental Milestones: What to Expect and When

Understanding typical development helps parents recognize when their child might benefit from additional support. Here’s what occupational therapists generally expect to see:

• 12-18 months: Babies help with dressing by pushing arms through sleeves or lifting feet for shoes. They may start removing simple items like socks or loose hats.
• 2 years: Children can find armholes in shirts, remove unfastened coats, and pull down pants with assistance. They’re beginning to show interest in dressing themselves but need lots of help.
• 3 years: Kids can put on loose shirts with minimal help, manage large buttons, and work zippers once the hook is already engaged. They can remove pants with elastic waistbands independently.
• 4 years: Children consistently identify front from back on clothing, can insert the zipper hook and zip their coat, and put shoes and socks on correctly (though they may still need help with laces).
• 5 years: Most children can dress themselves independently with age-appropriate clothing, though complex fasteners may still require practice.

According to the CDC, approximately 1 in 6 children in the United States has a developmental delay, disorder, or disability. Early identification through developmental monitoring and screening creates opportunities for timely intervention when motor skill challenges affect daily functioning.

When Dressing Becomes Frustrating: Understanding the Behavior

If your child melts down every morning during dressing time, refuses to wear certain types of clothing, or seems to avoid tasks involving buttons and zippers, their behavior is telling you something important. As Fort Myers occupational therapists, we understand that what looks like defiance or lack of motivation often stems from genuine skill deficits or sensory challenges.

Children may exhibit challenging behaviors during dressing for several reasons:

• The Task Feels Impossible: When fine motor skills are delayed, buttoning can feel as difficult as trying to thread a needle while wearing mittens. Frustration is a natural response.
• Sensory Overwhelm: Some children have heightened sensitivity to clothing textures, tags, or the feeling of fabric against their skin. For these children, getting dressed involves managing uncomfortable sensory input.
• Lack of Success History: If a child has repeatedly failed at dressing tasks, they may develop learned helplessness or anxiety around these activities.
• Limited Motor Planning Ability: Children who struggle with sequencing may forget steps or become confused about what comes next.

Understanding the function of your child’s behavior—whether it’s avoidance, seeking help, or communicating discomfort—is the first step in addressing it effectively.

OT Strategies: The Practical Scoop on Success

At FOCUS Therapy in Fort Myers, our experienced occupational therapists use evidence-based strategies to help children master dressing skills while building confidence. Here are some of our most effective approaches:

1. Backward Chaining: Starting with Success

We often teach dressing skills using backward chaining, where parents complete most of the task and the child finishes the last step independently. For example, with buttoning, you might button all but the last button, allowing your child to complete that final success. Gradually, you’ll have them do the last two buttons, then three, until they’re completing the entire task. This approach ensures each practice session ends with achievement, building confidence along the way.

2. Making It Visible: Visual Supports and Modifications

Sometimes the challenge isn’t motor skills but visual guidance. Simple modifications can make a huge difference:

• Use stickers or markers to show exactly where hands should grip the zipper or button
• Highlight buttonholes with washable marker for easier matching
• Color-code buttons and corresponding holes so children can match them correctly
• Practice on clothing laid flat on a table first, removing the challenge of managing body positioning simultaneously
• Start with oversized buttons on loose fabrics before progressing to smaller, tighter fasteners

3. Strengthening the Foundation: Preparatory Activities

Before children can manage tiny buttons, they need strong hands and coordinated fingers. Fort Myers occupational therapists at FOCUS Therapy incorporate fun activities that build these prerequisite skills:

• Play-dough manipulation: Pinching, rolling, and squeezing strengthens hand muscles
• Clothespin games: Opening and closing clothespins builds the same pincer grasp needed for buttoning
• Lacing activities: Threading shoelaces through large holes develops hand-eye coordination
• Pop bead necklaces: Connecting and disconnecting beads practices bilateral coordination
• Tong activities: Picking up small objects with kitchen tongs builds hand strength

4. Practice Through Play: Making It Fun

Children learn best through play. Instead of only practicing on actual clothing (which carries the pressure of getting dressed “on time”), create opportunities for practice during play:

• Dress dolls or stuffed animals with various fasteners
• Create button boards or zipper walls
• Play dress-up with oversized clothing featuring large, easy fasteners
• Set up “dressing relay races” where kids help each other practice
• Use apps or online games that simulate fastening activities

5. The Right Clothing Makes a Difference

While we want children to eventually manage all types of fasteners, selecting appropriate clothing during the learning phase reduces frustration:

• Begin with loose-fitting garments that have some give
• Choose clothing with larger buttons (at least 1 inch in diameter) and contrasting buttonholes
• Look for zippers with large pulls or attached rings/tabs for easier gripping
• Consider temporarily using adaptive clothing with magnetic closures or Velcro while building skills
• Select fabrics that aren’t slippery or too stiff

6. Environmental Setup: Positioning for Success

Where and how children practice matters tremendously. Occupational therapists pay attention to these details:

• Practice sitting down first, which provides trunk stability
• Use a mirror so children can see what their hands are doing
• Ensure good lighting so visual details are clear
• Allow plenty of time without rushing
• Practice when your child is alert and regulated, not when they’re tired or hungry

7. Addressing Sensory Needs

For children with sensory sensitivities, dressing challenges may have little to do with motor skills. Our Fort Myers occupational therapists assess sensory processing and provide individualized strategies:

• Gradually introduce new textures through sensory play before requiring them in clothing
• Remove tags and choose seamless options when possible
• Allow children to select clothing within appropriate choices, giving them some control
• Use compression garments underneath if deep pressure is calming
• Consider the order of dressing (sometimes putting socks on last reduces tactile defensiveness)

When to Seek Professional Help

While many children develop dressing skills with time and practice, some benefit significantly from occupational therapy intervention. Consider reaching out to Fort Myers occupational therapists if your child:

• Is significantly behind age-expected milestones (for example, a 5-year-old who cannot button or zip at all)
• Shows extreme frustration or emotional distress during dressing routines
• Avoids participating in activities because of clothing fasteners (won’t wear certain types of clothes to school)
• Has accompanying difficulties with other fine motor tasks like drawing, cutting with scissors, or using utensils
• Has been diagnosed with conditions that affect motor skills, such as developmental coordination disorder, cerebral palsy, or autism spectrum disorder
• Exhibits sensory sensitivities that significantly impact daily functioning

The FOCUS Therapy Difference

At FOCUS Therapy in Fort Myers, our multidisciplinary team understands that dressing independence is about more than just putting on clothes. It’s about fostering self-reliance, dignity, and confidence in young children. Our experienced, compassionate Fort Myers occupational therapists take a holistic approach, considering not just the motor components but also the sensory, cognitive, and emotional factors that influence success.

We work closely with families, providing:

• Comprehensive Evaluation: Detailed assessment of fine motor skills, visual motor integration, bilateral coordination, sensory processing, and motor planning abilities
• Individualized Treatment Plans: Goal-oriented therapy sessions tailored to your child’s specific needs and interests
• Family Education and Coaching: Teaching parents practical strategies to support skill development at home
• Collaborative Care: Working alongside other therapists (physical therapy, speech therapy) when children have multiple areas of need
• Progress Monitoring: Regular reassessment to ensure interventions are effective and adjusting approaches as your child grows

Building Independence, One Zipper at a Time

The journey to dressing independence doesn’t happen overnight, and that’s okay. Every child develops at their own pace, and what matters most is providing the right support at the right time. When children receive appropriate intervention from skilled Fort Myers occupational therapists, they don’t just learn to button and zip—they develop problem-solving skills, persistence, and the confidence that comes from mastering challenging tasks.

If you’re concerned about your child’s dressing skills or overall fine motor development, the compassionate team at FOCUS Therapy in Fort Myers is here to help. We believe every child deserves the opportunity to participate fully in their daily routines, and we’re committed to providing the evidence-based, family-centered care that makes independence possible.

Remember, challenging behavior during dressing time isn’t defiance—it’s communication. And with the right understanding, strategies, and support, those struggles can transform into moments of pride and accomplishment.

FOCUS offers pediatric occupational therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Effect of Occupational Therapy Based Activities on Fine Motor Skills of Children With Intellectual Disability, 2024, By T. Jegadeesan and Dr. P. Nagalaskhmi, Journal for ReAttach Therapy and Developmental Diversities

More Blog Entries:

Everyday Activities to Build Fine Motor Skills for Toddlers & Preschoolers: Fort Myers Occupational Therapy Tips