Posts Tagged ‘occupational therapy’

Top OT Ideas for Kindergarten Readiness

Monday, August 15th, 2016

For many families, kindergarten marks the start of “real school”. Whether your children attended full day preschool, a part-time program, or had no formal experience, the start of kindergarten is a major milestone. Over the past decade in American schools, there has been an increased academic demand placed on young children, starting with strict curriculum and expectations in kindergarten, and continuing on as they face state testing as early as age 8. This trend appears to be a result of many factors, including increased pressure on teachers and admistrators, parental expectations, a national awareness of America’s lagging behind other nations with regards to math and science, and legislation including No Child Left Behind. Whatever the reasons, many people are stating that “Kindergarten is the new first grade”.

As an occupational therapist, developmentalist, and parent, I am in favor of keeping play and exploration at the heart of the kindergarten experience.  (Our family has been blessed to be part of a progressive, public school in Brooklyn, where my son just completed a wonderful year of inquiry, community field trips, and project-based learning.) Whether you have chosen a play-based setting, a more academically-focused kindergarten, or something in between, there are several foundation skills that will help make the year successful for your student. This article will explain the various motor, perceptual, and social skills that can help prepare your child for the school year ahead.  Games and activities that you can do at home are provided under each area of developmental. If your child is lagging behind significantly in any of these areas, please consult your pediatrician, OT, PT, or SLP to determine if professional intervention is needed.

  1. Promote a mature pencil grasp

As children enter kindergarten, most are at the age where they should have a fairly mature grasp on a writing tool (crayon, marker, pencil).  For a 5-year old child, Occupational Therapists expect to see a dynamic, tripod grasp (the pencil held with the thumb, index and middle finger; other fingers tucked under; wrist movement used in lieu of whole arm movements). A typical progression of grasps is seen here:

Young children's pencil grips

If your child is stuck in one of the earlier developmental grasps, below are some activities you can do to help facilitate a mature grasp. (NOTE: if your child is utilizing an alternative grasp, it could be indicative of hand weakness or delayed dexterity; you should consult an Occupational Therapist to explore).

  • Color with small pieces of crayon (broken crayons are great for this).  Put the paper on a vertical or inclined surface (tape to a wall, use an easel, or attach to a large 3-ring binder to make a “slant desk”).  Together, the incline and the small crayons will encourage a child to use a finger grasp and hand muscles, instead of relying on using the whole arm to color.
  • Tear paper into little pieces (as part of a craft project) and/or wad paper into balls.
  • Coloring in a confined space (the smaller the space, the harder it is, the more strengthening it is).
  • Use a hole punch on various thickness of paper. Fiskars makes a “Teeny Tiny Cassette Punch” with exchangeable cassettes that children find fun to punch out various shapes.
  • Use a squirt bottle filled with water to water plants, “clean” the table, or “melt” shaving cream from the tub wall; ensure that the child is using the index and middle finger to pump while the other fingers are stabilized on the bottle. Tug-o-war with a towel
  • “Finger” tug-o-war with a popsicle stick or coffee stirrer; make sure child maintains grasp by pinching pad of thumb and pad of index on the stick (don’t let him use a lateral “key grasp” with thumb on top)
  • Games with tweezers or grabbers:  Caterpillar Scramble, Bed Bugs, Gumball Grab,
  1. Let them work (but not run!) with scissors

Many children enter kindergarten without ever having held a pair of scissors.  Parental fears and our protective nature are often the culprit, since it is developmentally appropriate for children to learn to hold and snip with scissors by age 25 months, and be able to cut a paper in half by 37 months.  By age five, accurate cutting on a line and cutting simple shapes (circle, square, and triangle) are emerging. Scissor cutting should play a big part in preschool and kindergarten activities, because learning how to use scissors correctly can also help with developing pencil control skills. Some key points to know about the development of good scissor use: Scissors should be held with the thumb in the top loop, with the middle finger in the bottom loop.  The index finger is placed on the outside to be free to guide the hand around curves. Holding the scissors in this way enables the tripod fingers to work together well. You can help your child keep the ring and little fingers tucked away by putting a little piece of paper under them. If the child’s fingers are very small and/or if the finger hole is large, it is acceptable to put the index and middle fingers through the same hole.

Snipping

  • Plastic straws:  then string up the pieces to make a necklace
  • Styrofoam packing peanuts
  • Playdoh and putty
  • Dandelion (or other flower) stems and leaves
  • Edges of paper plates, Styrofoam plates and cup
  • Edges of index cards

Cutting straight lines

  • Place 2 rows of stickers or dots on a card or paper; practice cutting in between  the rows
  • Draw a wide lines (1/8 to 1/4 inch thick) to cut short strips of paper to make a paper chain
  • Cut up junk mail in strip
  • Cut along straight lines to cut out coupons
  1. Feed their senses

All those wonderful sensory table activities are not just for preschoolers!  Your rising kindergartener still enjoys getting their hands messy, and they are gaining valuable experience from it, too. A child’s tactile skills continue to develop well into their school-age years.  Through tactile exploration of water play, Playdoh, clay, sand, and dried rice and beans, kids are learning about the qualities of objects and how they interact, working on vocabulary to describe tactile materials, and improving their tactile discrimination skills.  All the input to their hands helps kids improve their “stereognosis”, which is the ability to perceive the form of an object by touch alone. Some activities you can do at home include:

  • Make a mystery bag of common objects (bottle cap, quarter, eraser, penny, button, etc.) and see if your child can identify the object without looking at it
  • Make a sensory bin for the home (use a 5 gallon plastic bin with a lid).  Fill with dried rice and/or beans, bird seed, sand (beach or kinetic or “moon” sand), instant snow, water beads, etc.  You can hide small “treasures” for your child to find, or puzzle pieces that she has to seek and then complete the puzzle.
  • Sensory materials such as playdoh, modeling clay, theraputty, and model magic are all great materials for hand strengthening as well as tactile play.
  • Practice copying lines, shapes, and drawing faces in shaving cream on the bathtub wall.
  • Practice writing their name in sand or salt on a cookie sheet.
  1. Body awareness

Peek into any kindergarten classroom at circle time (aka “morning meeting” or “rug time”) and you will likely see several children in some alternative position to the teacher-requested cross-legged position. I would even venture to say that several children would be sitting on, leaning on, flopping over, or in some other way touching their nearest neighbor(s).  Besides being adorable, sweet, and cuddly…many kindergarteners often have underdeveloped body and spatial awareness. Some ways that you can help your child improve this “hidden sense” are:

  • Animal walks (crab walk, bear walk, slitter like a snake, hop like a bunny, etc.)
  • Wheelbarrow walking for good weight bearing on the arms and core strengthening
  • Whole body activities such as swimming, yoga poses, karate, dance and gymnastics
  • Obstacle courses, where they child needs to change their position to move through the challenges.  If you’re ok with making a little mess at home, you can set up obstacle courses using couch cushions to walk over, chairs to crawl under, broom handles to jump over, etc.
  • Push and push weighted objects.  This could mean pulling a sibling on a blanket, pushing stuffed animals in a laundry basket, or helping carry in the groceries.
  1. Listening skills

Ask any kindergarten teacher and this is probably the biggest request.  They’d like their students to be better listeners.  Good kindergarten teachers employ a multi-sensory approach to getting kids attention in a noisy active room (meaning that raising your voice is not the best practice).  She will often ring a bell, flash the lights, do a call-response, or raise up two fingers….all ways to tap into a child’s other senses, when that pesky kindergartener auditory system is not responding as it should.  You can help improve your child’s ability to listen and follow directions (wouldn’t that be great?!) through several fun activities and games.

  • Do-it-yourself listening games:  Simon says, Follow the leader, Hokey pokey, Red Light Green Light, Yoga poses, and drumming, tapping, or clapping rhythms and patterns (parent does a pattern, child repeats it)
  • Play the games “20 questions”: Players try to guess the person, place, or object that another player is thinking about. Participants must pay attention to deduct the final answer.  You can only ask “yes/no” questions. The player who figures out the answer with the least amount of questions wins. In my family, we call this game “Is it metal?” since that was always my stepson’s first question.
  • Treasure Hunt:  Hide a “prize” (or maybe a favorite stuffed animal) somewhere in the house. Give your child directions to follow to find the treasure.  You can start with simple one-step clues, such as “check in the kitchen”, but then you can add more fun and silly steps as they improve, such as “march to the kitchen, jump three times, and then open the fridge”.  Children will find it funny and will be building their multi-step direction skills!
  • Commercial games:  Hullabaloo, Diggety Dog, Whack-a-mole, BopIt!, Cat in the Hat I can do it game
  1. Self-help skills: buttons, snaps and zippers oh my!

A really meaningful way in which you can ready your child for school is to give them the confidence to know that they can take care of their own body and belongings.  As caring parents, we want to help our children any way we can (or we are just so busy and want to get out the door!)  Either way, after the age of four, we are actually NOT helping our child if we are helping them too much.  They need to develop good self-care skills, from eating, to toileting, to dressing and grooming.  One of my son’s fears going into kindergarten was that he’d have a bathroom accident if he couldn’t’ unbutton or unzip in time. His solution was to ask for only elastic-waist pants. I’ve found that preschool teachers are often quite involved in helping kids with managing their backpacks, lunches, and coats. There is typically a higher teacher to student ratio in preK which gives teachers (and kids) this luxury. A lot changes come kindergarten!  In my son’s school this year, he had 24 classmates and one teacher!  She did not have the time to help each child unzip their backpack, take off their coat, take out their lunch, and put their folder in the bin.  The bathroom was down the hall, and kids were expected to be fully independent with their clothing fasteners, toilet hygiene, and hand washing.  As your child prepares to enter kindergarten, you should be preparing him or her for the important job of being in charge of his/her body and belongings.  You can practice buttons, zippers and snaps on dolls, on stuffed animals, or on a younger sibling…but there is no substitute for practicing on themselves.  It is not only a fine motor task, but also great confidence builder for our growing kids.

  1. Visual-Perceptual skills

Good visual-perception is a foundation skill needed for reading, writing, and math.  There are many ways that you can help your child hone their skills in this area of development.  Visual perception is the ability to see and interpret (analyze and give meaning to) the visual information that surrounds us.  Visual-perception has several areas, including the following which are key to success in school:

  • Visual discrimination: The ability to determine differences or similarities in objects or forms based on size, color, shape, etc.  The school skill this helps with is a child’s ability to tell the letter “b” from “d”, or differentiate a circle from an oval.
  • Visual closure:The ability to recognize a form or object even when the whole picture of it isn’t available.  This relates to a child’s ability to read sight words.
  • Visual memory: The ability to recall visual traits of a form or object.  This is related to recall skills during reading, as well as copying from a book or the board.
  • Figure-ground discrimination: The ability to locate something in a cluttered or busy background.  School-wise, this has many implications, from finding their backpack in a big pile, to being able to the ability to focus in on important information on a busy worksheet or book.
  • Form constancy: The ability to know that a form or shape is the same, even if it has been rotated, made smaller/larger, or observed from up close or far away.  With regards to reading, this is a child’s ability to know that the letter “A” is an “A” whether it’s printed in a book, written on a board, on a billboard or sign, or made out of sticks.
  • Visual spatial relations: Understanding the relationships of objects within the environment.  This skills help kids develop their gross motor skills and safely navigate the environment.  It also helps develop right/left awareness, reading a map/chart/graph, and figure out if it’s a 6 or 9, p or q.

Some fun, play-based ways to help your child improve visual-perceptual skills include:

  • Sorting objects:  sort by different characteristics of the items (size, color, shape, etc.); some fun things to sort are different types of pasta or cereal, buttons, blocks, Lego pieces, and playing cards.
  • Complete age-level puzzles.  A 5-year old child should be working on interlocking (not inset) puzzles.  Puzzles of 12 to 24 pieces are appropriate for this age.
  • Copying block designs (you build a structure, ask the child to copy); Following visual directions that come with Lego sets.
  • Working on patterns.  Introduce the concept of a pattern to your child when stacking blocks, stringing beads, coloring, etc.
  • Playing the memory/matching game.  This refers to the commercially available game “Memory”, which comes in many varieties now (SpongeBob, Disney, Minions, baby animals, Dory, etc.).  You can also make your own matching game by using cards from a standard deck of cards (start by using about 10 pairs; from a deck of 52 cards, take two 2’s, two 3’s, two 4’s, etc….then you will have your own matching game ready to go).  Another way to make your own is with index cards (you can write letters, numbers, shapes, or use stickers).  To play:  Mix up the cards and place them face down in rows.  Each player is allowed to turn over two cards and see if they are a match.  If not, put them back in the same spot to help work on visual memory.  My family plays that you get another turn if you get a match.
  • Playing Lotto or Bingo games with pictures or letters
  • Play “What’s different?”  Put three things on the table, have the child close his eyes, and then change one.  Have the child tell you which one is different.  Use more objects as he gets more skilled
  • Place a covered tray with a dozen or so objects on a table, let the child look at it for 30 seconds, cover the tray, and have the child tell you everything that he remembers.  Alterative:  take one item away and have him guess what is missing.
  • Other good games you can purchase:  Eye-spy books and games, Where’s Waldo books, Tangos, Guess Who?, Rush Hour Jr., Colorforms, Highlights magazine, Busy Town I Found It game
  1. Social Skills

Children will learn many new social skills throughout the kindergarten year.  It is a time of huge growth, independence, and confidence building for these young learners.  By the end of the school year, my son was much better at expressing his needs and emotions, and negotiating with peers (without getting upset or immediately asking for an adult to intervene).  There are many things that parents can do at home and in the community to help your child have some of the key social skills to be ready for Kindergarten.  As an OT, we address play skills in our daily practice, since play is a child’s main “occupation”.

  • Taking turns:  A key factor in many games and activities is turn-taking.  Before entering Kindergarten, you can support your child by teaching the concept of taking turns, including the fact that he or she does not always get to “go first!”
  • Being a good sport:  This is also called having a good winning-losing response.  Kids often need to be taught what to say in this situation, since most people do not like to lose.  “Good game, maybe I’ll win next time”, “Nice playing with you”, “It was fun, even though I didn’t win” are some phrases that parents can model for our children, so that they will see and hear an example of being a “good sport” and hopefully mimic our words.
  • Problem-solving:  OTs frequently address this “executive function” skill during therapy session, and parents can do much to support their child’s ability to identify and solve problems on their own.  As parents, we are often quick to jump in and “fix it” for our kids; whether it’s a mediating a squabble over a toy, or asserting (for them) that they were next in line.  To help prepare your child for school, you can model the language they can use in such situations while at home, but encourage your child to come up with their own solutions when issues arise.

My final words of wisdom as an OT and the parent of a kindergarten “graduate” are:  Enjoy this exciting time!  Each school year will bring its own challenges.  Making the kindergarten year fun and enjoyable can help set a positive tone for years to come.  If we as parents can maintain a healthy attitude towards school, our children will see this example.  If we give them the building blocks for education from an early age, they can succeed in school.  It is important to include math and literacy in fun activities, this will instill a love of learning much more than doing worksheets, math problems, or pushing reading skills on them too early.  And finally, if you have any concerns about your child’s development (whether it is fine motor, visual-perception, language or social skills), seek professional help from the appropriate provider as early as possible to ensure your child has the foundation skills she/he needs to thrive.

Lynn-Marie Herlihy is an Occupational Therapist in private practice in Park Slope, Brooklyn. She has over 12 years experience treating children from birth to school-age, with a variety of sensory and motor deficits, developmental delays, and learning issues. You can also visit her website at www.ParkSlopeOT.com.

Tags: , ,

Handwriting Matters
By Lynn Herlihy, MS, OTR/L

Saturday, November 15th, 2014

“So, whandwritinghy does my child even need to write neatly? We all type everything now anyway!”

This is a quote from a parent of a second grader who recently contacted me (at the urging of the boy’s teachers), due to illegible handwriting. The boy is struggling in school due to his messy and slowly produced written work. He is feeling frustrated and bad about himself. The teacher does not have time to give him the individual help he needs. The parents were told he wouldn’t qualify for support in the school, because it was “just handwriting”.

In my work as an Occupational Therapist, I have heard first-hand from parents and educators (and even the kids themselves) their assertion that handwriting is becoming unnecessary in this digital age. There is a debate among teachers, parents, and those who develop curriculum around whether or not schools should spend any of their valuable time teaching students to write properly. As a firm believer in the importance of handwriting, I was very excited to see a recent article in The New York Times (“What’s lost as handwriting fades” by Maria Konnikova) highlighting the importance of handwriting for a child’s development. Konnikova provides some very though-provoking information about scientific research, which counters the increasingly popular argument that handwriting is no longer needed. It cannot be overlooked that, regardless of what the future classroom may look like, at this point in time and with our current education model, handwriting remains one of the primary means by which students express themselves and demonstrate understanding of what they have learned. Furthermore, the research shows that it is an important part of early literacy for children, and can even continue to help us encode information as adults.

As an OT in private practice, I receive many referrals for students with poor handwriting, starting as early as Kindergarten and as late as fourth or fifth grade. I can honestly say, with over 15 years’ experience in the field, that handwriting does matter. Research has shown that students who write with poor quality are very likely to receive lower grades than a student with neat handwriting, despite compositional quality. Although they try to be objective, it is hard for teachers to separate content from presentation. Not only does handwriting influence how a teacher sees a child’s work, but the kids are judging themselves (and each other). From very early on, kids know who has “nice writing” and who is messy. I have encountered many children who struggle with writing, and it almost always takes a toll on their self-esteem, their confidence as a student, and the amount of writing they are willing to do.

Complexity of Handwriting

Handwriting is a very complex task. Those of us who are fluent at it do not tend to think of everything that goes into the process of writing. A child must have adequate core strength to maintain an upright posture, shoulder stability to hold their hand in place, wrist stability to hold the pencil, and hand strength to grasp the pencil. And that is just the physical demands! There are also visual demands (converging and tracking with the eyes, perceptually leaving enough space between words, adhering to the margins and baseline), and cognitive factors (memory to recall letters and spelling, sequencing the letters and words, formulating a cohesive sentence). Some students who struggle with handwriting in school may spend so much time on the mechanical aspects of writing that they are less able to express what they have learned. Others have so much to say, but lack the visual-spatial and visual-motor skills to produce it in a way that is legible to others. Most schools still include conventional handwriting instruction in their primary-grade curriculum, but today that amounts to just over an hour a week (according to Zaner-Bloser Inc., one of the nation’s largest handwriting-curriculum publishers).

In my opinion, switching a child with poor handwriting (or any other child) to typing at a young age is not the answer. Not only do we still need to be able to write to function in society, but there are also key learning benefits to the act of writing. Konnikova sites research in her article from two psychologists (Pam A. Mueller of Princeton and Daniel M. Oppenheimer of UCLA). These researchers found that “students learn better when they take notes by hand than when they type on a keyboard”. It appears that writing by hand lets a student process a lecture’s contents and reframe it in their notes; and it is this process of reflection and manipulation through writing that can lead to the student’s overall better understanding and improved memory encoding. Konnikova also sited psychologist Karin James at Indiana University whose study found that the “doing” part of drawing letters by hand increases activity in three areas of a child’s brain that adults use when they read and write.

Future of Handwriting

It is my hope that educators will continue to devote instructional time to handwriting (both manuscript and cursive) so that children continue to reap the developmental benefits of writing. As adults, we can reinforce the importance of writing by pointing out to our kids when and where we still need to write by hand (e.g., filling out forms such as the doctor’s office, writing a quick note or grocery list, sending a card or letter to a loved one, signing a check or legal document). If a child continues to struggle with legible writing, despite school and home-based instruction, then an occupational therapist may be able to determine the underlying cause of the difficulties. An OT can evaluate the child and recommend either intervention or more targeted activities/programs for work on at home.

Lynn-Marie Herlihy is an Occupational Therapist in private practice in Park Slope, Brooklyn. She has over 12 years experience treating children from birth to school-age, with a variety of sensory and motor deficits, developmental delays, and learning issues. You can also visit her website at http://www.ParkSlopeOT.com/

 

Tags: , , , , , , , , , , ,

Exploring and Engaging Purposefully in Everyday Activities, by Neeha Patel, OTD, OTR/L, Occupational Therapist

Sunday, August 26th, 2012

Development during early childhood is driven towards exploring and engaging in everyday activities in order to learn about the world. Children explore the world through their sensory systems (touch, movement, body awareness, hearing, seeing, smelling, etc). Once a child gains interest in an activity or toy, children then are asked to manipulate and further explore the object in order to learn more about how to utilize the item, toy, or object. Once these steps have been mastered, children are able to engage purposefully with an object or toy. An example of this can be when a 1-year-old child picks up two rings. First the child will explore it and manipulate it by touching it, moving it, visually inspecting it, and figure out what they may be able to do with the rings. Then the child may manipulate it further by banging it on a tabletop or banging the rings together at midline. Lastly, a child can engage in play with the rings in a purposeful manner, like bringing the rings together to make noise when listening to music. The skills needed for this process are highly driven by motor planning skills.

Motor planning is a large skill that includes our body’s ability to figure out what to do and how to do everyday activities. Difficulties with motor planning can lead to difficulties with learning and difficulties with mastering everyday activities.

Here are a few examples of motor planning tasks:
-Figuring out how to ride a bike
-Learning how to drive a car
-Learning how to walk, crawl, walk up/down stairs
-Learning how to use tools (i.e. scissors, crayons, etc) in a purposeful manner
-Learning how to kick a ball
-Figuring out how to use a spoon to feed oneself
-Learning how to write
-Learning how to organize day to day life

When a child has difficulty with motor planning, it can impact the child’s ability to learn how to interact with objects and activities in their world. In addition, difficulties with learning how to explore and engage with toys in novel ways can impact the child’s ability to learn in the school setting, play with peers, and function when changes or disruptions occur in their everyday activities. Here is an example of difficulties coming up with new ways to play with toys: If a child is having difficulty figuring out how to come up with new ways to play with their toys, they will prefer to play with their toys in the same way and have difficulty expanding on that. An example of this could be a child always pushing their cars or trains along a path on a table, and having difficulty taking that same toy and pushing it along a collection of pillows that create “hills”.

Here are just a few examples of what you may see if your child is having difficulties with motor planning skills:

-Difficulty figuring out a new way to play with a toy.
-Difficulties figuring out what to do with tools like scissors, spoons, forks, pencils, etc.
-Difficulty expanding on a play routine
-Difficulty coordinating the two sides of the body together to complete tasks like holding paper while coloring, stringing beads, riding a bike, playing catch and throw, etc.
-Difficulty with multi-step activities – obstacle courses, dressing, self feeding, etc.
-Difficulty learning how to complete prewriting shapes (vertical line, horizontal line, circle, square, triangle, oblique lines, etc) or difficulty learning how to form letters.

Here are a few questions to consider when looking at motor planning skills and determining whether difficulties with these skills are contributing to your child’s learning potential and development:

-Does your child have difficulty with expanding on their play routines?
-Does your child choose to play with the same toy in the same way?
-Does your child have difficulty dressing oneself?
-Does your child have difficulty feeding oneself without spilling a lot of the food?
-Can your child figure out how to assume simple yoga positions when you model it for them? (i.e. downward dog, child’s pose)
-Does your child have difficulty coordinating the two sides of their body to manipulate fasteners on their clothing, string beads, hold paper while cutting or coloring, etc.?
-Does your child have difficulty following multi step directions or multi step activities?
-Does your child seem to get lost while completing a task, and require modeling and verbal cues to help them figure out how to complete the task?
-Does your child get upset when they are asked to come up with new ways of playing with a toy?
-Does your child have difficulty with prewriting or handwriting skills?

These are only a few questions related to possible motor planning difficulties. If difficulties with motor planning are impacting daily life and your child’s ability to participate in age related activities to their fullest potential, an occupational therapy consultation or evaluation might be beneficial. Occupational therapy can assess a child’s individual motor skills, motor planning skills, and overall sensory processing capacity to assist with increase in functional independence.

Here are a few examples that an occupational therapist could utilize to assist you and your child with their motor planning:

-Completing an evaluation using the Sensory Integration and Praxis Test (SIPT), the gold standard for evaluating praxis (motor planning) related difficulties. This battery of 17 tests provides specific information in regards to sensory processing that directly impacts praxis skills. The test can be completed on children ages 4 through 8 years, 11 months.
-Determining what areas of sensory processing are delayed and impacting motor planning skills and focus intervention and home programming to increase those skills.
Determining adaptive techniques to assist with increased independence at home during motor tasks that are typically challenging for the child. An example could be to create a visual schedule or visual chart breaking a task down into simple steps with visual cues.

Dr. Neeha Patel is a licensed occupational therapist who offers a holistic approach to therapy, drawing from evidenced-based practice techniques, sensory integration theory, neurodevelopmental treatment, family-centered care, and a play-based approach. She is Sensory Integration and Praxis Tests (SIPT) certified, and has extensive experience helping children from birth to 16 years old with sensory processing delays, fine and visual motor delays, social skills, pre-writing and handwriting skills, as well as in their primary activities of daily life. She has worked with varying diagnoses including autism spectrum disorders, learning disabilities, developmental delays, developmental coordination disorder, cerebral palsy, disruptive behavior disorder, and down syndrome. Neeha has special interest and completed her doctoral work in the area of cultural sensitivity when working with children and their families. Neeha offers home, school, or community visits in Manhattan (Upper West Side, Midtown, Chelsea, Clinton, West Village, Soho, Tribeca, Union Square, Murray Hill, Gramercy Park, Upper East Side).

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Summer Occupational Therapy: Fun Ways to Increase Hand Strength, by Lynn-Marie Herlihy, M.S., OTR/L, Occupational Therapist

Tuesday, July 10th, 2012

If summer vacation means that your child has the summer off from Occupational Therapy (or if you just think he/she could use a little work-out for those growing muscles), here are some of my favorite ways to improve grasp and hand strength. Improved hand strength can translate to improved handwriting, better endurance while writing and cutting, and better fine motor and self-care skills. These are fun ways to improve skills (without it feeling like “work”).

Playdoh, Clay, or Silly Putty
• A good clay is Crayola Model Magic. Squeezing with the whole hand to soften the dough increases overall hand strength. Be sure to switch back and forth between hands. Hide “treasures” that the child has to find.
• Roll the dough on a table to make snakes, using one hand and then the other, and then both together.
• Practice pinching off pieces of the snake, using thumb and index finger. Roll dough into a ball, then squish it flat like a pizza between fingers and thumb. Poke holes in the dough using index finger.
• Wrap a rubber band or silly putty around the student’s flexed fingers. As he straightens them, have him spread them apart against the resistance.

Tennis Ball “Monkey”
Parents can use a knife to cut a 2-inch slit in a tennis ball for the mouth and draw eyes with permanent marker. Then, have the child use one hand to squeeze and hold the mouth open, and the other hand to feed monkey pennies, beads, small buttons, etc.

Movement Ideas
• Doing gross motor play while weight-bearing the hands is great for strengthening the shoulder, wrists and hands. Some suggestions are: wheelbarrow walking, tug-o-war (with a towel or blanket), crawling through a tunnel, sustaining a grasp while hanging from monkey bars, climbing ladders/playground structures, and rock climbing walls. Even biking and scooters can help with hand strength.

Water Play
• Squirt guns are great for strengthening fingers.
• Plastic turkey basters are good for strengthening the whole hand.
• Squeeze sponges or squeeze out a wet washcloth.

Games
• Don’t Break the Ice
• Lite Bright
• Whack-a-Mole

Paper Play
• Tear paper into little pieces (as part of a craft project) and/or wad paper into balls.
• Cut thick paper (e.g. cardboard, index cards, several sheets of construction paper).
• Coloring in a confined space (the smaller the space, the harder it is and the more strengthening it is).
• Color with small pieces of crayon (broken crayons are great for this). Put the paper on a vertical or inclined surface (tape to a wall, use an easel, or attach to a large 3-ring binder to make a “slant desk”). Together, the incline and the small crayons will encourage a child to use a finger grasp and hand muscles, instead of relying on using the whole arm to color.

Lynn-Marie Herlihy is an Occupational Therapist in private practice in Park Slope, Brooklyn. She has over 12 years experience treating children from birth to school-age, with a variety of sensory and motor deficits, developmental delays, and learning issues. You can also visit her website at http://www.ParkSlopeOT.com/.

Tags: , , , , , , , , , , ,

Regulating Our Bodies For Optimal Learning, by Neeha Patel, OTD, OTR/L, Occupational Therapist

Monday, January 23rd, 2012

Self-regulation is critical to a child’s learning and development. Self-regulation is a person’s ability to maintain their arousal level and a level of alertness that is appropriate for the demands of the environment. Children and adults use various strategies and techniques to maintain self-regulation throughout their daily lives. Many of these strategies are sensory based and help our nervous systems sustain physiological regulation in order to participate in social activities, daily living activities, and other age appropriate activities. Sensory processing is a key ingredient to a child’s self-regulation.

Sensory information that our bodies process includes:

• Proprioceptive input: Gives our bodies information of body position and where our body is in space.
• Vestibular input: Provides information to our body about movement and changes in head position.
• Tactile input: Sense of touch through our bodies, hands, and mouth; allowing us to interpret what we feel.
• Auditory input: Sense of hearing, allowing us to interpret what we hear.
• Visual input: Sense of vision, allowing us to interpret what we see.

Our bodies take in sensory information from the environment and process that information, resulting in a behavior in response to the environment. When children have difficulty processing sensory information or have difficulty adequately registering the sensory information, difficulties in self-regulation can result.

Just a few examples of how adults sustain regulation on a daily basis using sensory strategies include:

• Chewing gum to help sustain attention.
• Going out for a massage or engaging in physical exercise when feeling stressed.
• Lying under a heavy blanket when relaxing and falling asleep.
When a child has difficulty with self-regulation, it can impact the child’s ability to participate in school activities, in activities of daily living, social activities, etc. For example, if a child has difficulty sustaining an optimal level of arousal and is very active they will potentially have difficulty listening to classroom instruction, difficulty following the classroom routine, etc. Another example is a toddler who has difficulty tolerating transitions and difficulty self-soothing. This toddler may have difficulty utilizing tools or strategies to assist with self calming, like engaging in a calming movement activity, getting a hug for comfort, knowing what to expect through a visual schedule, etc.

Here are a few questions to consider when looking at a child’s functioning and determining whether difficulties with self-regulation may be contributing to your child’s learning potential:

• Does your child have difficulty staying seated or sitting still during tabletop tasks?
• Does your child have difficulty transitioning between activities?
• Does your child have difficulty sustaining attention to a conversation, activity, or task?
• Does your child have difficulty self-soothing when upset?
• Does your child have difficulty filtering excessive noise resulting in difficulty sustaining attention?
• Does your child have difficulty following multi-step directions or multi-step activities without requiring assistance?
• Does your child have a low activity level?
• Does your child seem to get lost while completing a task, delaying his/her ability to complete it in a timely manner?

These are only a few questions related to possible self-regulation difficulties. If difficulties with self-regulating is impacting daily life and your child’s ability to participate in age related activities to their fullest potential, an occupational therapy consultation or evaluation may be beneficial. Occupational therapy can assess a child’s individual sensory needs and self-regulation capacity to assist with increase in functional independence.

Here are a few examples of techniques that an occupational therapist could utilize to assist you and your child with their self-regulation:

• Create social stories: creating a story about the child and identifying their arousal level (our bodies move slow, just right, and fast).
• Creating a sensory diet that is specific to the child’s sensory system and needs, to help provide needed sensory input to maintain regulation.
• Increasing a child’s self-awareness and ability to identify their own arousal level.
• Providing sensory rich experiences for the child to engage in to increase opportunities for the child to receive the sensory input that they may need.
• Engaging in sensory based community activities that provide the sensory information that the individual child may benefit from.

Dr. Neeha Patel is a licensed occupational therapist who offers a holistic approach to therapy, drawing from evidenced-based practice techniques, sensory integration theory, neurodevelopmental treatment, family-centered care, and a play-based approach. She is Sensory Integration and Praxis Tests (SIPT) certified, and has extensive experience helping children from birth to 16 years old with sensory processing delays, fine and visual motor delays, social skills, pre-writing and handwriting skills, as well as in their primary activities of daily life. She has worked with varying diagnoses including autism spectrum disorders, learning disabilities, developmental delays, developmental coordination disorder, cerebral palsy, disruptive behavior disorder, and down syndrome. Neeha has special interest and completed her doctoral work in the area of cultural sensitivity when working with children and their families. Neeha offers home, school, or community visits in Brooklyn and Manhattan (Upper West Side, Midtown, Chelsea, Clinton, West Village, Soho, Tribeca, Union Square, Murray Hill, Gramercy Park, Upper East Side).

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,


Enable Javascript