My kids love using the hole punch or any punchers I have. They can sit and just punch a random piece of paper for a long time so I decided to try a heart shape  and incorporate the pattern to punch.  Even though they themselves are not making or even saying the pattern, they are visually seeing a pattern so it counts! And…it is AMAZING for fine motor work (small hand movements by getting the paper between the punches all while squeezing the puncher and holding the paper). 

I used dot stickers to make the outside color pattern but you could use markers too (you could also have your child color the pattern themselves for an added step). If you don’t have punchers you could have them put stickers over the pattern to match colors or poke the pattern with qtip and paint.