Have a Snow Ball Fight!!!

I know some people have real snow on the ground and are able to send the kids outside to have a real snow ball fight, but others do not have snow right now.  So, have an indoor snow ball fight!  Have the kids rip paper and crumble it into "snow balls".  Then have them throw these balls at each other!  It's a fun and safe snow ball fight.

Hand print Reindeer

Here's a cute idea for a holiday craft.  Trace your child's hand (or have them trace their own) then have your child, if able, cut it out.  Next, have your child draw a heart and a circle and cut them out.  Glue on the parts and have your child draw, or glue on, the eyes and mouth and they have a cute reindeer!

Edible Christmas Tree

Make an edible Christmas Tree- it's simple.  Cover an ice cream cone with green icing (add green food color to white icing) and turn upside down.  Have your child use a butter knife to spread the icing.  Then have your child put assorted candy onto the "tree" as ornaments.  The biggest challenge of this project is keeping your child from eating the candy before the tree is decorated!

Make a Candy Cane

Need more tree decorations?  Have your kids make candy canes.  All you need is a pipe cleaner and red and white beads.  Bunch up one end to prevent the beads from falling off, then have your child string the beads in a red-white-red-white pattern.  When they are done, fold down the top of the pipe cleaner and form it into a "U". 

Candy Nativity

Try this for a twist on the gingerbread house!
Make a stable:
Break a graham cracker in half, then use a serrated knife to cut off one edge on each one at an angle.  Use icing to make these stand up on a paper plate.  Then use a full graham cracker to make the rooftop.  Crush frosted mini-wheats around to look like snowy hay!

Make the nativity figures:
Each figure is made with a tootsie roll, gumdrop, and a piece of fruit roll-up... use icing to put the gumdrop head onto the tootsie roll.  Then use a strip of fruit roll up to drape over the head and wrap around the tootsie roll body.  Use a mini candy cane to turn one of your people into a shepherd!

Make a marshmallow sheep:
Poke 5 holes in a large marshmallow, one on the side for the head and four for legs.  Cut a piece of black licorice into 5 pieces and poke them into the holes in the marshmallow.

Other stable animals:
Use icing to make other stable animals standing around using animal crackers.

Set this up and wait for baby Jesus to be born!  Parents, try using a small gingerbread cookie as baby Jesus, place him in the stable on Christmas eve for a special night.

Santa Picture

Here is an easy, but cute, craft to have your kids make.  Find a picture of Santa, have them color in the picture and then glue cotton balls for the beard. For increased fine motor benefit, have them pull the cotton balls apart before gluing them onto the picture.

Alphabet Bus

Here's another gift idea- an alphabet bus.  These buses are fun for the kids as well as provide educational benefits.  The children isolate their fingers to push the alphabet letters.  These buses usually have songs and say the letters as your child pushes them, thereby teaching your child his/her letters.

Fidgety Kids Part 2

Here's some more ideas to help your child focus through homework sessions:
Chew gum, or fruit snacks, i.e. one per row of math problems correct...
Wear wrist and/or ankle weights to help ground them...
Wrap a stretchy exercise band around the front chair legs so the child can bounce his heels against it, or slide his feet between the bands and try to swing his legs - this one's great for those who crave deep pressure...
Break up your session with movement, i.e. one run up and down the stairs after X amount of work, or try somersaults, push ups, or jumping jacks...
Attach a finger puppet to the end of the pencil and tell the child to take him for a ride...
Allow the child to stand at an easel instead of sitting for some of the homework...
Send them on an errand in between assignments, i.e. put away laundry, walk the dog, help unload the dishwasher... something that will increase feeling of self-worth while feeding the need to move...
Encourage your child by providing leading questions, ones that help teach the concept but don't provide the exact answer... this can improve a child's self-esteem and view of homework in general if they achieve success themselves.

Stay tuned for more ideas in a future post!

Social Story for Nap Time

Here's an example of the use of a social story for a child I see in the HeadStart environment (I removed the pictures for privacy).  He is wiggly at best and disruptive at worst during naptime.  The thing is, he really NEEDS the sleep!  We are going to try this intervention next week sometimes it can be helpful to use a story like this to prep the child before a change.  This idea has worked in the past for other kids!  Also, try noise canceling headphones, a weighted blanket under the direction of an OT, or placing the child's cot under a classroom table with a sheet draped over to give him a feeling of enclosure.  Simple words and clear pictures help the child understand exactly what's going to happen and what's expected of him.  Happy napping!

This is Nap Time

Miss Chelsea is bringing me a tunnel and sleeping bag for nap time on Wednesday.
(picture of tunnel)

When I do not stay on my mat during nap time my friends cannot sleep.

Then they are very tired.
(picture of tired child)

Everyone needs to rest during nap time so everyone can be ready to play, even me!(picture of children resting on their mats)

First I will get ready for nap time by giving myself five bear hugs.
(picture of child hugging self)

Then I will crawl into the tunnel and lay down inside the sleeping bag.
(picture of child getting in sleeping bag)

I will let Miss Barb or Miss Kelly zip me up in the sleeping bag.

Then I will rest quietly.  No more talking.  No more singing.  No more moving around.
(picture of boy with resting on elbows with hand over his mouth)

I can look through the tunnel windows quietly.  I can close my eyes and remember something that was fun.  I can be as still as a statue and as quiet as a mouse.

I might even fall asleep.

That’s OK because Miss Kelly and Miss Barb will let me know when it’s time to get up.
(picture of classroom clock)

Then I can roll up the sleeping bag until the next nap time.
(picture of rolled up sleeping bag)

Everyone is happy because everyone got some rest, even me!
(picture of 5 smiling kids)

Make an Ornament

Here is a way to let your kids personalize your Christmas tree- make their own ornaments.  It's simple, and fun. All you need is apple sauce and cinnamon.  Use equal parts of each and have your child stir them together.  It should become a thick paste, so you may need to add more cinnamon to thicken it if it is too thin.  Once you have a paste, give your child a ball and have him/her flatten it with their hand and use cookie cutters to form the ornaments.  Then, use a pencil to make a hole to hang the ornaments.  (It is important that you put the hole in the ornament before it hardens)  Let the ornament dry and it is ready to go!  Remember to turn them over every day so the edges don't curl too badly.  Try watering down glue and painting it over the ornament, then sprinkle on some glitter.  You could even tinge the watery-glue with food coloring!

Taste/Smell and Visual Sensitivity

A continuation of a previous post, now focusing on ideas for taste/smell and visual systems:


Taste/Smell Sensitivity

• Crunchy cereal, firm fruit (apples)
• Vibrating toothbrush or massager
• Whistles to help decrease a child putting his/her tongue into an open cup
• Drawing shapes and letters in pudding
• Gradually increasing willingness to taste a certain food

• Tolerating the food on the table
• Tolerating the food near his/her plate
• Tolerating the smell of the food near his/her nose
• Tolerating the food on his/her lips
• Tolerating the food on his tongue
• Tolerating one bite

Visual Sensitivity/Developing the Visual System

• Allowing your child to wear sunglasses or a hat when outside
• Making letters or shapes in different craft media (i.e. clay, playdough, shaving cream, string, pudding, popsicle sticks, sand paper)
• Cutting on a straight or curved line
• Tracking activities such as following clouds, birds, squirrels or airplanes move with your eyes
• Ball play making sure to follow the ball with your eyes
• Playing with a streamer on stick and following it with your eyes
• Whistles that have an eye following component
• Flashlight play 

Tickle Me Tunnel

OK here's another quick tip on a great holiday gift for those sensory seekers on your list... and Amazon has it for $32.99 and FREE shipping now... best price on the web!

http://www.amazon.com/Pacific-Play-Tents-Tickle-Tunnel/dp/B003DQ6E3K

This company also makes a variety of other tents and tunnels, perfect for secret getaways, rolling around in for proprioceptive input, and even during nap time!  If you've got a wiggly one in Head Start or preschool that has trouble staying on their mat during rest time, try a sleeping bag in a tunnel!  It's worked on more that one occasion for me... or try pushing a therapy ball through the tunnel for deep pressure input!

Toys for Christmas

It's almost that time of year- can you believe how fast this year has gone?  The kids are starting to get excited for Christmas and the parents are worrying about what to get them.  So, this month is a good month to make some toy suggestions that are both fun for the kids, but also work on educational skills.  Our first suggestion is a simple toy that has been around, and well-liked, for years; the Magna Doodle.  Kids love being able to draw and then erase.  Parents can have the child work on drawing shapes and letters.  Do math problems on them.  There are many differen varieties, and sizes, of Magna Doodles, so get one that would interest your particular child (ex. one with Princesses on it).

More Circle/Carpet Time Strategies

-incorporate animal walks (frog, bear, crab, snake etc.) as a way to transition to circle or seated activity

-incorporate reward system (small piece of gummy or crunchy candy, stickers, stamp to hand, high five, verbal praise) intermittently for appropriate behavior.  Be sure to simply explain appropriate behavior (good sitting, etc.).

-massage, tight squeezes, bear hugs, or deep pressure onto shoulders as needed

-textured objects taped under chair or table that the child can quietly feel during circle or work time

Strategies to help kids focus at school

I had a teacher ask for ideas for those kids that find it difficult to sit still during structured circle time.  The teacher wanted strategies to help these kids increase their attention, while not disturbing the other kids in the classroom.  Here are a few ideas to try.  Keep in mind that it takes a lot of trial and error to find the right solution as there is no "one fits all" answer to this question.  Every child is unique and each responds to different strategies.
Have the child:

-hold squeeze toys, silky fabrics, vibrating toy, small amount of play doh

-sit on a ball, rocking chair, bean bag, sit-fit, or almost-fully deflated beach ball on a chair

-allow child to lie on stomach on floor

-do chair push ups while sitting (place palms on seat of chair and push  body upward)

-hold objects with weight (books, cans) in lap

-if seated on chair, put long sleeve shirt over the chair back, tie the bottom of the sleeves and fill with rice, sand, etc.  Have the child put the shirt arms over legs for calming input.

-tape a circle on the floor or use a carpet square as a visual cue as to where the child is to sit

- have child push or carry chair to circle area

These are just a few strategies.  So as not to overwhelm with a long list, I will post more in a later post.  Remember, it usually takes more than 1 try to assess whether a strategy is working.  Also remember, a strategy may work great for a couple of weeks and then become less effective.  At that point, it is time to try other strategies. 

I would love to hear of any effective strategies that others use in the classroom.  Feel free to comment with other ideas!

Sensory Based Activities for Young Children

This list has been compiled over time from a number of different occupational therapists that work with young children.  We have organized the list by area of sensory processing.  Our hope is that these ideas will be helpful to you and increase your child’s success at school and at home.  A good starting out book is The Out-of-Sync Child by Carol Stock Kranowitz.  Also, the sequel, The Out-of-Sync Child has Fun is available.  This author explains the neurology behind sensory processing difficulties in an easy to understand manner and she may give you some additional ideas to try with your child.  These books and others are available through Amazon.com, major bookstores, and local library systems.  Contact your OT for additional resources.

I will post ideas following the categories presented in the Short Sensory profile, an evaluation tool we use to assess the degree to which sensory processing issues affect the daily life of the child.

Here's #1 - Activities to address Tactile Sensitivity

• Increase tactile discrimination – finding toys in putty
• Reduce tactile defensiveness – sensory table filled with dry noodles, rice, beans, birdseed, sand, water, mashed potato flakes, snow, ice (pour, touch, mix)
• Play in shaving or whipped cream, fingerpaint, etc., have a car/doll wash, encourage but don’t force, encourage line drawing and tracing
• Fill Ziploc bags with shaving cream, pudding, ketchup, etc. if child is not willing to touch messy textures or have them wear gloves initially
• Rub-a-dub-dub rub in the tub a variety of textures (different types of soaps, oatmeal soap, shaving cream, lotion soap, loofa sponges, thick washcloths, foam pot-scrubbers, plastic brushes)
• Water play pouring, sponges, toy water pumps
• Bury items in the sand encourage finding
• Feelie box –insert item and guess what you have
• Hands on cooking
• Handling pets
• Swaddling – roll up in a blanket
• Back rub—deep firm pressure
• Dress up with different texture clothing
• Secret hideaway, make it fun by adding a variety of toys with texture in a large cardboard box or tent

Thanksgiving head band

Here's a cute idea for the kids to make and wear for Thanksgiving (or any time).  It's a turkey head band.  Cut a paper plate in half for the turkey's body and have your kids color the feathers.  Cut out, or let your kids cut out,  a yellow circle for the head and a half circle for the body.  Cut out the eyes and a triangle nose.  Take 2 strips of orange paper and fold them accordian style and glue everything together.  Glue the turkey onto a band of paper fit to the child's head.

Hand Turkey

 

Here's an idea to do for Thanksgiving: use an outline of your child's hand to make a turkey.  Trace your child's hand on a brown piece of paper (or have your child trace their own hand, if they are able).  Have your child do at least some of the cutting to make their turkey. Then, decorate the "turkey".  We used crumbled pieces of tissue paper to make ours colorful, but you could use colored feathers, or simply color or paint the feathers.  Either draw or glue on an eye, and your child has their own turkey!

Elmo cupcakes

This is a cute idea for birthday cupcakes!  Elmo!  Simply use red frosting for his fur, an m&m for his nose, white chocolate discs for his eyes and a half of one wafer of an oreo for the mouth. Kids love these!

Pick corn

Have left over corn or maze?  Have your kids pick off the kernels, it's a really good fine motor activity!  They can then glue them onto a piece of paper do design a picture.

Pumpkin painting

Don't know what to do with the pumpkins now that Halloween is over?  Let the kids paint silly faces on them.  They can use paint, or just markers.  Let them be creative!

Potato Painting

Here's yet another fun way to get the kids painting.  Use a cut potato, or apple, to make circles on paper.  Have the kids make designs with the potatos. 

IEP or 504?

Here in Pennsylvania, we have IEPs (Individualized Education Plans) and 504 plans in our education system.  IEPs help your child through specially designed instruction that can take the form of direct treatment, consultation and/or observation.  Your child is seen for therapy sessions with a service provider.  504 plans can support your child with what they need to be successful in school without the need for direct intervention, i.e. attention/focus supporting strategies, transportation or self-care supports, or adaptive equipment/modification needs.  Children with 504 plans are not showing any developmental delays, but may be struggling physically or academically anyway.  I'd like to open the comments section here with your experiences with 504 plans.  My older son has one to support his needs related to attention and focus, and I have to say it's working out very well this year in 4th grade.

Coffee or tea squirrel craft

Here's another fun, easy craft involving lots of senses!  Print out a squirrel outline, paint him all sticky with glue and sprinkle tea or coffee grinds on for his fur.  If your child dumps out the whole tea bag in one spot, more fun using pincer grasp to spread it out.  Not to mention all the fine motor work picking those little pesky tea spots off your hands!

A wall worthy fall leaf craft!

Easy to do and the process is a lot of fun!  Put some shaving cream in a tray and squirt a blob of paint in it, let the kids swirl it into the shaving cream with a paintbrush or popsicle stick, the more fall colors, the better!  Then take a cut out paper leaf (tagboard works really well) and press it lightly into the mix... if it's tempera paint, it will come out kind of like sponge painting, if you're brave and it's acrylic paint, it will come out more swirly.  The tricky part is then gluing them onto a piece of construction paper...

Fall craft

Since there are lots of leaves falling outside, here is a fun craft to do with the leaves.  Have you child color, or draw if your child is able,  a tree and glue on real leaves!  It's cute, and works on fine motor control and school readiness skills.

More painting

Yet another fun way to paint- use yarn to make stripes on paper.  Here, we use a picture of a zebra and black paint to make it's stripes, but you can use any color paint, or many different colors, to make fun designs.

Paint with Q-tips

Kids love to paint.  So, switch it up a bit and give them Q-tips to paint with.  It is fun and works on their fine motor control.

Pancake fun

My good friend, and fellow OT, Tamara, shared this creative idea with me.  Add food coloring to pancake batter and have fun!  Make smiley faces, make circles or other shapes.  Have your kids be creative!  Put the batter in squirt bottles and let your kids squeeze out the designs- they will love it!

Upper extremity weight bearing

To have good fine motor skills, including hand writing, it's important for children to have stability in the should girdle. As the saying goes, "proximal stability for distal mobility". So, it's important for children to do upper body strengthening (although not with weights).  Weight bearing through the upper extremity is good to improve shoulder strength and stability.  Young children should not lift weights as their joints are not yet able to handle the stress.  If you have access to an exercise ball, have your child lay on his stomach and roll forward so that his/her hands touch the floor.  He/she can then rock back and forth by using his hands.  (This is also good for core strength and stability). 

Movement to increase brain function

We are going to continue to talk about ways to increase the attention and focus of children in school.  One thing that we advocate is movement.  Aerobic exercise is shown to stimulate the brain for optimal learning.  One elementary school near us has all the students, and teachers, walk around the perimeter of the school prior to school each day.  Another has 15 minutes of exercise before begining their day.  Children, especially elementary and preschool children, function best after movement.  Many teachers use taking away recess as punishment for bad behavior.  This only makes it harder for the child to learn, as he/she did not get the necessary gross motor play.  In essence, this teacher has punished herself/himself as the children will have even more difficulty focusing for the rest of the day.  The younger the child, the more movement breaks they need.  Have the children crawl to circle. Have them hop to their desks or to the bathroom.  15-20 minutes/day of aerobic activity is recommended for optimal learning.

Fidgety kids

Have a child that has difficulty paying attention and focusing?  One that is constantly slouching or needing redirection?  Or, a child that has difficulty sitting still to complete his/her homework?  Try having the child sit on an exercise ball.  Studies have shown improved attention and focus when a child sits on a ball.  Students have reported a difference in their ability to concentrate.  And, sitting on an exercise ball works on core strength.  It is best if the child's feet touch the floor and it is important to remind the child that there is no bouncing or rolling the ball.  Most children like using the ball, so taking the ball away when the child bounces or rolls is usually a good way to reinforce the rule.  We don't recommend using the ball for more than 15-20 minute sessions so as not to incur back aches or poor posture.

All about me

Preschools typically have an "all about me" theme to get the children to become aware of themselves.  Body parts are identified and families are discussed.  Here is an art project for the children to complete.  Have your child use different color yarn to make hair depending on the color of their hair.  If their hair is blond- yellow yarn, brown hair- brown yarn.  Have your child pick out his/her own yarn, "what color is your hair?".  Glue the yarn on the head.  Have your child color the person to match what they are wearing.  Then, either glue eyes on the face, or have your child draw the entire face. 

Bubble wrap

Don't throw away the bubble wrap that comes in boxes!  It's not only fun for the kids to pop, it's a great fine motor activity!  It takes finger dexterity and strength to pop the bubbles.  Lay it on a hard, flat surface and have the kids use one finger to try to pop it or have him/her hold it in one hand to pop.  Have him/her slap his/her hand onto the wrap to see how many bubbles he/she can pop at one time.  Lay it on the ground and have your child jump on it.  There are lots of fun ways to enjoy bubble wrap!

Let's go fishing

Make an aquarium in your child's room.  Take a paper plate, cut out a triangle for the tail and have your child color, or paint, his fish!  The older child should do his/her own cutting and gluing, including opening/closing the glue.  The younger child can do the gluing, and attempt to do the cutting, with close supervision.  Glue the fish on a blue piece of paper, add some "seaweed" and you have an aquarium.  Add as many fish as your child wants.

Egg carton School Bus

For back to school, have your child make a school bus made from an egg carton.  Simply have your child color or paint the carton yellow.  (A cardboard carton works best)  For the older child, have him/her look through magazines and have him/her cut out pictures of children and glue them on the inside of the carton so that the faces are seen through the holes of the carton.  For younger children, simply have them glue the children in place.  Cut circles from black construction paper (again, the older child can cut these) and glue for wheels.  Another idea for wheels- use bottle caps and paint them black.  Then write "school" on the carton, and your child has his/her very own school bus.

Sit for school

Here's another tip to prepare your kids for school.  Start having your kids sit at the table, or at a desk, to do table top tasks.  Summer is full of fun, sun and lots of gross motor activities.  School is full of sitting and completing fine motor activities. Your child needs to start practicing being able to sit and complete fine motor activities.  Have your child color, or write a story.  Play board games to practice taking turns. Have your child increase the time he/she is able to sit so that he/ she will be ready when school starts.

It's School Time!!!

It's that time of year again- back to school time!  While most parents are ready to send their little ones back to school, it's important to make sure the kids are ready, as well.  Aside from the hand writing, scissor skills, spelling, reading, etc., kids need to be physically ready for school.  Working in the school environment, we hear all the time about the importance of kids getting enough sleep.  A tired child is not as able to learn as easily as a well rested child.  Think of your productivity at the office when you didn't get enough sleep the night before- it is not up to par.  Same goes for a child in school.  We know the summer brings a relaxed schedule, with later bedtimes.  If your child has not yet started the school year, start now by having your child go to bed earlier each night until he/she is at school bedtime.  Practice getting up earlier, too, so your child is able to do so for school.  Remember, consistency is key.  Children love routines and their bodies flourish by having them. Get an alarm clock, many different, and inexpensive models found at stores like Target and Walmart, and Kohls.  Have your child work on waking up to the alarm clock.

Sea shell creatures

Wondering what to do with the shells you collected at the beach this summer?  Here is a cute idea.  Take one shell and glue it to a piece of wood.  Add eyes which you can make from tiny marshmallows or can buy at a craft store.  Glue another shell to the first shell to make seashell creatures! If the kids want, they can paint the shells first to make colorful creatures!

Here is a cute craft idea to do with the kids this summer.  Cut a paper plate in half and paint it into a watermelon.  You can use just paint to make the watermelon, or, you can use actual watermelon seeds.  To do this, make sure the red paint is pretty thick and the kids can put the seeds right onto the paint- no glue needed.  Once the paint dries, the seeds will stay on the paper!

Fine Motor on Vacation

Having just got back from the beach (a four hour car ride for us) I look back at how natural it can be to introduce kids to essential motor skills while on vacation!  If you're headed to the ocean try these activities:

• In the car, try playing small car bingo games with the little doors that slide open and closed, or find books with flaps to open.  Also, using a cookie sheet or tray with a lip can be helpful to position crafts and books.  Try placing a sheet of thick shelf liner or Dycem to help hold things in place.
• In the hotel or house, bring new foam or interlocking puzzles from the Dollar Store for a quick surprise, sometimes novelty gains attention!  Kids can help fold towels or arrange everyone's shoes for helpful movement and sorting activities.
• At the beach there are plenty of things to do that help improve motor and dexterity skills!  In the sand, practice using those tools, pinching up sand crabs you find to help place them in wet sand to burrow was one of our favorites this year.  You can find rocks and shells in the ocean to sort into holes you dig or bury your child's hand and tell them to raise out on finger at a time.
• The ocean provides plenty of sensory input, from walking in different sands (wet and dry), to the sound of the waves, to the rush of the water over their ankles.  Depending on your child's abilities, swimming in, jumping over, diving through, and body boarding with the ocean's waves provide tons of sensory input and heavy work, playing against resistance.

Hope this helps you think of some new ideas next time you get a chance to get away!

Learning letters

Recently, I have had a few parents of kindergarten going kids ask for different ways to teach their kids to recognize letters. I always find that kids, especially little boys, like gross motor activities. So, a few suggestions: play hop scotch with letters, but tell the kids which letter to jump onto (good for numbers, as well). Make paper "targets" with letters on them and have the child throw a ball at them. You can put them on your wall, garage or even on the driveway and have them throw at the letter you state. I recommend focusing on a few letters at a time. Once these are mastered, add some more (maybe 2-3). It's a good idea to teach both upper and lower case letter recognition at the same time. Learning is easier when the kids are having fun!

Play Ball!

Being a nice day today, the preschool class in which I was working decided to go to the playground to play.  I brought a ball outside to throw and roll to the kids to work on their eye-hand coordination and strengthen their arms. Very few of the kids were able to trap a ball thrown slowly at them.  Most of the kids did nto even watch the ball as it was coming at them. In speaking to the teacher and aide, we all agreed that kids these days don't spend enough time outside doing these types of activities.   It is so important that kids get outside for gross motor play!  Catching and throwing a ball works on many skills, including eye-hand coordination, bilateral hand use, sequencing, motor planning and attention.  All kids can benefit from playing with a ball.  Get outside and play ball!

Chalk is fun

Chalk is a fun, outside activity that kids enjoy doing.  Give them a piece of chalk and the driveway and let them be creative!  Have them draw shapes, people, hop scotch, houses, etc.  Practice writing their letters and numbers.  This is a great way to help them learn to write and draw.

Potty Training Tips

OK here's a good topic, one everyone's talking about these days, potty training!  A must and full of trials and tribulations, it's a path many a parent and I have discussed.  This post will cover just the tip of the iceberg and will be meant to get the ball rolling on comments that may help us help each other!  While many of these tips are useful for children of all abilities, some can be especially useful to kids with autism spectrum disorders.  Happy toilet-teering!

Beginnings
Begin at whatever age your child begins to follow you into the bathroom (not everyone enjoys the open door policy, but it can be a teaching moment) or when your child begins to dislike being wet or soiled.  At first, you may see fleeting moments of interest and occasional intermittent voiding in the toilet.  Celebrate these successes, but don't expect the mind and body to connect all at once!

Books and Movies
Media can be helpful, there are a ton out there on the subject.  My top favs of each are the Once Upon a Potty book (two versions are available, one for girls, one for boys) and the Bear in the Big Blue House DVD 'Potty Time with Bear'.  It has 3 episodes dealing with the subject.  Both my sons loved these.  Social stories specifically geared towards issues like fear of the toilet or toilet flush, can be particularly useful.  Make your own with personalized words and pictures, talk to your OT.

Doll
One of the first things you might try is a doll that wets after you give it some water.  There are a bunch of dolls out there as well, they can be both anatomically correct and pricey.  Honestly, a cheaper version that is not necessarily anatomically correct does the job just fine.  Play with it a lot.

Communication
With children who have speech delays, sometimes a motor action or picture card will do the trick.  Teach him the sign for potty (put your thumb up through your index finger and middle finger with your hand fisted and rotate your forearm back and forth - like the Miss America wave) or use a PECS card.  PECS stands for Picture Exchange Communication System and consists of small laminated cards that are usually used on a velcro strip.  Print out a bunch of picture cards and make them available throughout the house.  Sometimes with the additional easy motor action kids will be able to communicate quickly and effective enough to be successful.  At first they may rely on the card, but just reinforce talking with the use of the card and eventually they will begin to use the word as well, or replace the card completely with the word.

Visual Schedules
If your child is a visual learner, often kids on the autism spectrum are, try using a picture schedule (sequence strip) for the routine.  Visuals can help any child organize the activity!  First add the potty into your child's daily schedule at particular times, i.e. morning, evening, and anytime you're going to leave the house.  In the beginning, you may want to up the opportunities to as many as once per hour.  Also put up a mini-schedule right near the potty that shows pictures of the steps such as:

1. Pants Down
2. Sit on Potty
3. Toilet Paper
4. Flush
5. Pants Up
6. Wash Hands

Over at the sink, you could place one for the hand washing or tooth brushing routines.  One of my favorite sites on the web for picture schedules is http://do2learn.com.

Behavior Reward System
While potty training can exist without the use of these, some children who respond well to positive reinforcement for behaviors, or who are in ABA programming, need consistent motivation in a predictable manner.  First kind of chart would be a piece of the puzzle kind of thing that included a box that says "I am working for".  You can velcro a picture of whatever it is (a toy, trip to McDonald's, hugs and kisses, extra book at bedtime, whatever) in that box.  It helps if this chart is in picture form.  One of my favorite ways is to have an outline of a train.  Each time the child uses the potty he earns a train car, when the train is complete he earns what's in the box.  This kind of chart is good to begin with, I would start with no more than 5 train cars.

Once you have that down and you feel your child is ready for more, you can go to a grid chart.  Each step of the potty routine is pictured above the top row.  Each time he completes a step independently he gets to put a sticker or mark in the grid under that step.  You decide how frequently you want to reward - whether they have to complete X number of rows or columns or fill in the whole grid.  You can use stickers, stamps, velcro PECS, whatever motivates your child.

Diapers or Training Pants or Underwear?
I'm a big fan of real underwear.  When children are in diapers or disposable training pants they do nothing to allow the child to feel the discomfort of being wet, unless they're really really wet.  With both my boys I found that when they were in either, they would freely pee and poop in it.  In fact, with one of them, the first time he initiated peeing on his potty was when we left him naked with a t-shirt while we were camping.  You saw that look on his face when he had to go like, "where do I PUT this?"  We told him quickly, "Find your potty!"  By the end of the weekend he had peeing down.  Pooping took a little longer.  We found that keeping both boys in underwear increased their independent trials of the potty.

If you're in a pinch and/or don't want to have a mess when you're out, try putting on a pull-up over the underwear.  Kids with sensory issues can have big issues with underwear.  Some prefer the traditional character underwear, but for some the tight waistband can drive them nuts.  Some kids are more comfortable in boxers or even the old school padded cotton Gerber training pants.  Don't stress about using disposable training pants overnight or when you're going to be out for a long time.  A combination of disposable pants and underwear will not hurt.  And eventually you will find that the disposable pants will be dry too!

As you can see, there are a lot of things you can try to help your child become successful using the potty.  Don't let anyone tell you you child cannot be trained.  Some kids may take much longer than others, but it is worth trying.  It is a major life skill that will help them be integrated into school and society!

Flowers made from melted crayons

This is a cute craft that kids love to create.  Items needed are: crayon shavings (I use scissors to scrape off pieces of crayon), wax paper, an iron, a green pipe cleaner and paper.   Have your child draw a large flower on a piece of paper (or you can draw it if the child is not yet able).  Then, if able, have your child cut out the flower shape (or you cut it out).  Next, have your child sprinkle some of the crayon shavings on the paper.  Cover the paper and crayon with the wax paper and roll the heated iron over the paper until the crayon has melted. Have your child poke the pipe cleaner through the center of the flower (once it is cool) and bend it to make a stem.   Your child can make a few of these to make a bouquet!

Caterpillars

Here is a cute craft activity.  Take an egg carton and cut it so that you have three cups.  Have your child paint it as they like.  Then, take pipe cleaners and push them through the bottom of the egg carton and through to the other side.  This can be very difficult so you may need to poke a hole through with a pen or something first.  Have your child push the pipe cleaner through.  Draw on some eyes, and your child has made a caterpillar!

Wheelbarrow races!

It's nice outside so get the kids out there and excercise!  One great idea is to have the kids have wheelbarrow races.  This is great for strengthening the upper extremities and helps both children gain control of their movements.  The kids will have a blast trying not to land on each other or take headers into the grass!  This is an activity that should be done on a soft surface such as grass.  Get the neighbors and have races.

Muscle strengthening and sports

So, I just got back from seeing a pediatric sports medicine doctor for my 12 year old daughter. Turns out she has loose shoulder joints causing the right shoulder to pop out of joint (sublux) for no reason. This happens during simple movements such as raising her hand during class. The appointment today inspired me to post about other aspects of Occupational Therapy that are important to children and their overall development. The physician said that with proper shoulder and back exercises, my daughter's shoulders would become stronger and would, thereby, pop out less. Now, I feel that I should mention that my daughter is a soccer player and does summer swimming, so she is a somewhat athletic child. She is not the perverbial couch potato. She just happens to have hyper mobile shoulder joints and needs to focus on exercises that strengthen her shoulders. Soccer, does not provide a lot of opportunities to strengthen the shoulders. It is important for children to be active. Sports, whether organized or not, provide great opportunities for children to increase their strength, endurance, balance and overall well being. It is, however, important for children to be well rounded in their sports playing, for many reasons. Focusing on one sport at an early age, and playing only that sport year round can lead to overuse injuries. Focusing on one sport, focuses on certain muscle groups and can lead to injury. It is beneficial to switch sports throughout the year. For example, do soccer in fall and spring, swimming in winter and summer. That way, your child will use different muscle groups allowing the others to take a break between seasons. When switching sports, it is important for your child to "ease" into the new sport, allowing his/her muscles to adapt to the new movements. In the next couple posts, we will provide fun, safe, movement activities and games for children to do to maintain a strong, healthy body.

Left-handed cutting

Now let's talk about the left-handed child and cutting.  Most classrooms provide right-handed scissors for the children to use.  What does it matter if a left-handed child uses right-handed scissors?  Right-handed scissors are designed to fit naturally within the curve of a right-handed thumb and fingers.  When used by a left-handed child, it is difficult to produce smooth, even cuts.  One might notice uneven, jerky lines when observing something that a left-handed child has cut.  It may not be lack of scissor skills, but that the child is using scissors intended for use by a right-handed child. The earlier a child uses the correct scissors, the more likely he/she will develop good cutting habits. When a left-handed child uses right-handed scissors,it is difficult for him/her to see the lines he/she is cutting, thereby causing the jerky, uneven cuts.  So, it is important that left-handed children are provided with scissors intended for left-handed children.  Speak to your child's teacher about designating a pair for your child's use and keeping them separate from the other scissors for easy identification.

Left-hand dominant children and writing

We’ve had a request to address children who are left-hand dominant and the difficulties that they face when learning to write.   As we know, left-hand dominant children make up a small minority of children.  Typical classrooms are right-hand oriented, presenting unnecessary difficulties for the left-hand dominant child.  Left-hand dominant children have additional challenges when learning to write.  As their hand progresses across the paper, they cover the letters that they have already written, presenting spacing problems as well as possible smearing of previously written letters.  These children will not have the visual guidance of being able to see the letters that they have already written in order to form a word.  Some of these children will develop strange grip patterns in an attempt to see what it is that they have already written. 

So, how do you, as parents or practitioners, assist the child to develop good writing skills using their left hand?  First, try repositioning the paper so that he/she will use a good grip while being able to see the letters that were previously written.  Practice prewriting lines and shapes using this paper positioning.  Have the child draw squiggly lines and shapes. 

Here is one way of positioning the paper for a left-handed child.  Note that the letters written are visible for the child. Smaller children may need the paper to be taped to the table to prevent it from moving from this position.  It is important to monitor for good grip patterns when a left-handed child first begins to write so that he/she becomes comfortable with the grip.

Lastly, remember, it is important not to force a child to be right-handed.  Allow the child to naturally pick the hand that is more comfortable for him/her to write.  We realize that there are children that, for pathological reasons, use their left hand to write, sometimes in an awkward manner.  These are not the children that we are referring to.  Those children may need to seek out the professional assistance of an Occupational Therapist. 

Please feel free to post questions regarding this, or, to post ideas/solutions that have worked for you. 

Finger strengthening

Here's a cute project to work on finger strengthening.  Give your child some cotton balls and tell him/her to pull them apart.  Print a picture of a sheep and have him/her glue the cotton on to make the sheep "fluffy".  Be sure to allow your child to open/close the Elmer's glue and squeeze the glue onto the paper.  You will probably have to assist with guiding the glue since most children will simply squeeze the glue, making one big glob of glue.

Coffee filter coloring:  Take a coffee filter and put it on a plate or on paper.  Get some food coloring.  Have your child use an eye dropper get the coloring and drop it on the coffee filter.  You can use different colors to make a colorful design.  By lifting the filter up by an end, the food coloring will run to create neat designs.  When dry, use an unfolded paper clip to poke through the filter.  Tie the other end to a string and hang it from your child's ceiling.  Your child will love that he/she is helping decorate his/her bedroom!

Flower Pots- get ready for summer

Here's a fun activity for both you and your child.  Get Terra Cotta pots (any size will do) and have your child paint them.  You will want to use water proof paint if you are planning on using it outside this summer.  Have you child paint the pot any way he/she likes.  Once dry, have your child scoop some potting soil into the pot.  You can decide whether you want to plant seeds or a flower.  Have your child put the seeds or flower into the pot, pat the soil around it and then water it.  He/she can take care of it all summer and watch it grow!

Let's Try Scissors

Let's take a little break from writing. We want to start with scissor skills. We can't tell you how many parents tell us that their child is not allowed to use scissors at home. There are many reasons; the parent's fear of injury, a younger sibling in the house, etc. Parents: IT IS OK FOR YOUR CHILD TO USE SCISSORS (under close supervision, of course)! We like child-sized scissors as they fit better on small hands and are easier to open/close than adult scissors. For those parents afraid of a finger being cut of(which almost never happens- just kidding- never saw it happen), there are rounded-edged varieties. There are also adapted varieties if your child is unable, after practice, to use regular, children's scissors. For these, you should contact an OT to assess which best fits your child's needs. Ok, so, let's begin with proper scissor use. Children should have their thumb in one hole and their index and middle fingers in another hole. Thumb should be up when cutting. One trick to remind children to keep their thumb up is to put a sticker, or draw a smiley face, on their thumb nail. Tell you child he/she should always be able to see it when cutting. Start by just snipping paper. You can prompt your child by saying "open/close". You can also help your child hold the paper with his other hand by placing your hand over his/her hand. It is important, though, that you do not hold the paper for your child, as he needs to get used to holding it on his/her own. Once your child is a pro-snipper, start to progress his/her scissors across a paper. Next, have him/her cut on top of lines, then cut out shapes. Cutting takes LOTS of practice to perfect. Have him/her "help" you cut out coupons (of course, not ones you actually need, unless he/she is a pro). Cut play doh. Kids usually enjoy using scissors, so allow them many opportunities to practice.

Pencil Grasp Tricks

Although there are a variety of useful pencils grips out there sometimes we can encourage kids to grasp it correctly without fancy adaptations.  Sometimes though that extra support of a specialized grip or weighted pencil is needed.  Try these suggestions first to see which road you need to take!

1. The Lizard Trick - Have your child make an L with his/her dominant hand using thumb and pointer finger then tell them to pinch the pencil.  I call it the lizard trick because I tell my kids L is for lizard and place a little lizard finger puppet over the eraser of the pencil so they can 'take him for a ride'.
2. The Pinch and Flip Trick - Try placing the pencil down on the table with the point facing towards your child.  Tell him/her pinch the pencil then use the other hand to flip it up into writing position.  This allows the child to start with his other fingers tucked into the palm.

In addition to either of these techniques, you can try having the child hold a small object like a marble in their palm while writing to help keep their fingers tucked.  As long as the object itself isn't too motivating and distracts from the writing activity!  If additional supports are needed, talk to us or your own pediatric OT for recommendations!

April is OT month!

Just thought I'd like to take a step back and give a good general description of how we pediatric OTs help families and children.  Sometimes I'm asked how can children get occupational therapy?  They don't have jobs!  The 'occupations' of children are school, play, and self-care.  Here are just some of the areas of development we assess and treat:

• fine motor dexterity, the way your child is able to use his/her hands
• eye-hand coordination
• balance and coordination
• ability to complete self-care tasks like bathing, toileting, and tooth-brushing
• sensory needs, like touching messy things, eating a variety of foods, exhibiting the ability to pay attention and keep hands to self
• play and social interaction skills

We OTs tend to have a good ability to sense the need of the whole child, taking into account strengths, developmental needs, and environmental implications.  Please consider using our Ask the OT section to gain additional knowledge about your child (privacy please) and guide our post topics.

To learn more about the field of occupational therapy in the United States, try this link:
The American Occupational Therapy Association

Pencil Control

Pencil Control: Let's start getting better pencil control for writing. Frequently, I have a parent of a child, who is not yet able to imitate horizontal or vertical lines, or draw a circle, complain to me that their child is not able to write his/her name. The parent inevitably wants me to focus on teaching their child how to form the letters of his/her name. I try to patiently explain that their child is not yet ready for that, that there are foundation steps to master prior to the ability to write letters. An Olympic ice skater doesn't start out learning the difficult jumps that everyone wants to see. First she has to master the basic skill of being able to stay upright on the ice. There are multiple other skills to master prior to her ever even trying the difficult jumps. Same thing with writing.
Today's OT Strategy: Start by having your child learn to draw controlled horizontal and vertical lines.
You can have him/her draw on paper.
Set up an easel and have him/her use a paint brush.
Go outside and use chalk on the driveway to draw long lines.
Put shaving cream/whipped cream on a cookie sheet and have him/her use his/her index finger to draw lines.
Draw around the edges of a chalkboard.
Any OTs/Teachers out there with any other ideas?  Feel free to share them.

Finger Manipulation

Ok, so we are still working towards getting kids ready for kindergarten.  We talked about pencil grip and gave a strategy to achieve a more mature grasp.  But to effectively use a pencil to form letters and shapes, we first need to have stabilization at the shoulder, finger strength and be able to use our fingers for manipulation.  Here is a spring art activity that will work on your child's finger skills.  Cut tissue paper into small squares.  Have your child crumple the pieces into little balls.  Have him/her use only one hand, if able, if not have him/her use only the finger tips of both hands.  Allow your child to open the glue and squeeze it onto a flower picture (some children will need adult assistance to move the glue around the paper so as not to have one big clump of glue). Have your child pick up one "ball" of tissue paper at a time and place it onto a glue dot.