A couple months ago, Miles' preschool teacher mentioned to me that he had difficulty with holding his pencil. Even when he did grip his pencil correctly, he had difficulty applying enough pressure to get the pencil to write. She suggested we consider occupational therapy.
My first step was to take him to Project Enlightenment. A child psychologist did a full evaluation of him there, everything from vision to hearing to fine motor skills to social development to problem solving. The results of that were that he was doing fine in all areas.
After that, I took him to a private physical therapy office (that also does occupational therapy) for an evaluation. They determined that he does have a minor delay in fine motor skills, and that his delay is related to a deficiency in upper body and core strength. I was surprised to hear this, considering how much time we spend outside running and jumping and playing on playgrounds. This also spurred my memory of his pediatrician saying that he had "low tone" when he was about 6 months old. His therapist, Abby, said that this is probably related to that.
Now, once a week, we take him to therapy. He absolutely loves it. He gets to roll down the hall on their scooter board, play games and make crafts with Abby. She is a gem, and she says that he has already made lots of progress.
We need to spend more time doing wheelbarrows and crab walks and practicing with our pencils, but he has already made strides. Abby said that he probably would only need about 6-8 weeks of therapy, which would have us ending some time in January.