The best therapy exercises are the ones where the child doesn't know it's an exercise, which is why every pediatric speech and occupational therapist's "bag of tricks" is mostly full of toys and games and other fun activities.
Play dough is one of these staple activities. There are endless possibilities of what you can do with it, one of which is creating a "birthday cake" for imaginary play and to work on fine motor skills.
So, let's throw a birthday party!
• Be enthusiastic and involve the child in every step of the process. Ask him/her who's coming to their party, what kinds of games they'll play, where it will be hosted, etc.
• If you have more than one color of play dough, let him/her choose the "flavor" of the cake. Then form a rounded "cake" shape out of the dough (this will also work with putty that holds its shape).
• For the candles, use small pieces from other games (in the picture above we're using pegs from a peg board set). You can use as many as you'd like, or match the number to their age to make it more personal / relevant.
• Then have the child put the "birthday candles" on the play dough "cake." Encourage him/her to use only the thumb and pointer finger, without letting the other fingers / hand assist. To that end, "candles" that are about 1 to 1.5 inches tall are about the right size, as this will make it harder for their other fingers to have room to help.
• Once the child has placed some candles on the cake, have him/her use the opposite hand as well. You can say something like "oh no! Your other hand is so lonely! We need to let it have some fun, too!"
• To make the exercise more difficult, have the child make his/her own "candles" by cutting a straw into smaller pieces. Not only does this add a cutting component, but it also practices bilateral coordination as well. And since straws are more delicate, the child will have to have more control over their finger pressure.
• Once all of the straw candles are in place, blow out the candles and sing Happy Birthday. And don't stop there - have the child pull out all of the candles and help you put the putty / dough back in its container.
For some children, it may help to have a Grabber or another sensory chew tool handy in the case the child needs help re-focusing. Chewing can be very calming and regulating and helpful with focusing, so oral motor chew breaks may be in order. And if the child holds a Grabber in one hand, he/she may be less likely to use that hand to assist with the fine motor work the other hand needs to do.