Archive for April, 2013

Making Time for Play

Between soccer practice, karate, homework, therapies, PPT meetings, family commitments, home exercise programs, sensory diets and swim lessons, are you feeling like every waking moment is scheduled? It can be hard, but try to find a few minutes to play just for fun. Give your child a break from critique of their grasp patterns, articulation or other therapy objectives, get down on the floor or go outside together (without technology!) and just play. Feeling stuck for ideas?

Here’s a list of 75+ quick and easy activities to play, from Parenting Magazine.

Another great resource is Unplugged Play by Bobbi Conner. This book is full of 710 screen-free, cord-free, developmentally appropriate and fun activities for toddlers, preschoolers and elementary school aged children.

Have FUN!

Apps We Love: Mr. Potato Head

App Name: Mr. Potato Head

Why We Love It:

This engaging app brings the classic Mr. and Mrs. Potato Head to life.  The app recently changed its interface and got rid of the need for in-app purchases.  Your child can pick from 26 different outfits and 13 different play scenes.  Just like the real mr potato headMr. Potato Head, your child must choose where to place the body parts to assemble the character.  After the characters are built, your child picks the scene where she can make the Potato Head characters jump, dance and interact with the scenery by pressing buttons on the screen. This app reinforces correct placement of facial features and symmetry in body scheme.  The child can work on finger isolation when dragging and dropping the body parts on to the character.  To practice correct pencil grasp, have your child use a stylus intended for a touch screen device.

Why Kids Love It:

The variety of options for outfits is a major draw.  The characters’ antics within the play scenes maintains a child’s attention, and they love the option to take a “snapshot” of their Potato Head in action.

Available: iTunes FREE

On Our Bookshelf: The Hidden Curriculum

On Our Bookshelf: The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situations, by Brenda Smith Myles, Melissa Trautman, and Ronda Schelvan

Audience: Parents and caregivers of individuals with autism, Aspergers or other difficulties in social interactions

From the introduction of The Hidden Curriculum: “The hidden curriculum refers to the set of rules or guidelines that are often not directly taught but are assumed to be known. The hidden curriculum contains items that impact social interactions, school performance, and sometimes safety. The hidden curriculum also includes idioms, metaphors, and slang – things most people “just pick up” or lean through observation or subtle cues, including body language.” hidden-curriculum book

Many children on the autism spectrum find it hard to understand the hidden curriculum that peers seem to naturally follow. For example, young adults will typically speak more formally to a grandparent, while they may use more “colorful” language around peers. During an elementary school band concert, most children will not proclaim loudly their opinion that the musicians sound horrible. While everyone in the audience may indeed be thinking the same thing, the hidden curriculum protocol for this situation is to sit quietly and congratulate the musicians on their hard work, rather than offer a critique. Many of our culture’s social expectations depend on the context at hand: it may be appropriate to greet a favorite cousin with a fist bump at the park, but not at a funeral. These concepts are typically not directly taught, and the majority of children will follow along, or respond to subtle cues, such as a parent pursing their lips and raising their eyebrows to indicate disapproval. Children on the autism spectrum have difficulty noticing and interpreting these types of social cues. They require more specific lessons regarding the hidden curriculum.

The Hidden Curriculum offers parents and caregivers a look into the complexity of social protocols, and presents lists of potential challenges in topics from personal hygiene, rules for different types of restaurants, and classroom guidelines. It also includes a list of common idioms and the meaning behind them (e.g. “You’re killing me” really means to make another person laugh, not actually kill them).

Available from major booksellers and the Autism Asperger Publishing Company.

Helpful Hints for Shoe Tying

boy tying shoes

Learning to tie shoe laces is an important but difficult milestone for many children. For some of our clients, just the mention of shoe tying is enough to bring on tears. Here are some ways to help break down the process for your child.

  • First of all, shoe tying should be practiced when there is time to practice. The last five minutes before the bus arrives is not the most opportune time for a child to feel focused and relaxed to attempt a new skill. Some families have found that sticking with slip-on or Velcro closure shoes for the school day and saving the lace up sneakers for afternoons and weekends works for them.
  • Contrast laces can help your child differentiate which lace is which. Get a black lace and a white lace (or two of your child’s favorite colors) and cut each lace in half. Tie the two shortened laces together and lace up a sneaker. Now when your child is learning the motor plan of how to manipulate the laces, you can use directions such as “Make a loop with the black lace”, rather than diving into right vs. left.
  • If your child is having trouble manipulating the laces due to decreased fine motor skills, try using a jump rope wrapped around their foot. The increased diameter of the rope makes it easier for you to fit your hands into the process and help your child. For some children, the simple fact that the rope is not a shoe helps to lessen hesitancy to try. Other children enjoy pretending to tie an elephant’s or a dinosaur’s shoe.
  • Talk to your child’s OT about which method of tying laces may be best for your child. In general, children who struggle with motor planning may benefit from the “two bunny ear” approach, as the steps are repetitive. Children who have difficulty with fine motor dexterity or bilateral coordination may do better with the “one bunny ear” approach. Once you pick a method, stick with it for a good length of time so that your child settles into the consistency of the steps.
    • A word about that “bunny ear”. Most children try to form a bunny ear, but end up with a small balloon-like loop at the very end of the lace; this results in the lace slipping through too far when trying to pull the laces tight at the end of the task. We have found that teaching the child to grasp the “middle of the lace”, then “bring the middle down to the bottom” results in a good-sized loop with enough extra lace at the end to allow for success when pulling the laces tight.
  • Visuals are key! Try a book with step by step pictures, take a video of yourself tying shoes or try an app.
    Shoe Tying app

    Shoe Tying

    Tie Your Shoes app

    Tie Your Shoes

    There are two apps we have found to be useful: Tie Your Shoes and Shoe Tying. Tie Your Shoes breaks the activity down into short steps and gives the option to have black and white laces, or two white laces. The app itself is easy to navigate and allows the user to repeat a step if needed. The video is narrated by a clown, however, even our older children at the clinic don’t seem to mind. (Note: if you are searching for Tie Your Shoes in the App Store, it is listed as an iPhone app, not an iPad app, but the video quality remains clear on an iPad.) Shoe Tying is a little harder to navigate and only shows white laces, but may be appropriate for an older child who finds Tie Your Shoes to be juvenile.

  • Help your child gain confidence by asking them to do part of the task. Have your child complete just the first step (cross the laces), or just the last step (pull the loops tight), then work your way towards completing the whole activity. By celebrating the small successes, your child will gain interest and pride in their accomplishment.

Why Childhood Games Matter: Tag

In an age of electronic entertainment and plugged-in play, many classic childhood games are being pushed aside. However, these classic games provide key benefits for child development. In this series of posts, we will explore how these “unplugged” activities are more than just child’s play.



Marco Polo, Sharks and Minnows, Blob Tag, Freeze Tag or just plain old Tag, we’ve all played it.  But did you realize the many benefits of this category of games?  Children playing tag are receiving proprioceptive feedback from their muscles and joints as they run, as well as vestibular input from the movement and changing of direction.  Sensory input that is controlled by the child is typically more readily processed than movement imposed by another person. Studies have shown that proprioceptive input causes the release of neurochemicals such as serotonin (involved in mood, sleep and appetite) and dopamine (involved in the sleep/wake cycle). Tag provides a natural motivation to challenge one’s endurance, an area in which many of our clients at the clinic demonstrate difficulty.  Balance and coordination are required to make fast changes in direction and the visual system must fluidly track the movement of other players.  Social reciprocity skills are also practiced as children take turns being “It”.   Time to lace up those sneakers!

Movement Breaks for Coloring and Writing

Many children with vestibular and proprioceptive processing difficulties find it very challenging to sit and attend to fine motor tasks such as coloring, cutting and writing. A child who is under responsive to sensory input and constantly seeks movement may expend so much energy and attention keeping their body relatively still that he is not focused on the task at hand.  Another child who is a passive under responder may slump in her chair, have a hard time using the correct amount of force on her tools and seem like she is not paying attention.  So what can you do to make homework time more effective and enjoyable for everyone involved?  Pair table top activities with movement.  This will provide your child with the sensory input they need while also giving natural breaks and rewards for tackling a challenging task.  Studies have shown a positive link between movement and learning, retrieval abilities and arousal level. Here are some ways to put this into practice this week.crayons

  • Practice spelling words while tossing a ball back and forth.
  • Complete jumps or jumping jacks next to his chair after completing a number of problems or after a given amount of time.
  • Log roll or do an animal walk across the living room to collect crayons one at a time for a coloring project.
  • Print or purchase pictures of simple yoga positions to imitate between worksheets.
  • Hold a vibrating massager or sit on a vibrating pillow when reading. (*Note that vibration should not be used with children who have a history of seizures*)
  • Do wall push-ups or chair push ups after writing a sentence or a paragraph.
  • Sit on a small yoga ball – knees should be at 90 degrees and feet flat on the floor.

April is National OT Month

What is occupational therapy?OT month

Occupational therapy is a client-centered service that enables performance in activities and greater social participation through occupation.   Intervention in occupational therapy can include the process of occupation (the DOING of something meaningful), as well as adapting the environment or altering the task demands to allow for occupation to occur.  Intervention can be directly with the child, or via consultation with significant persons in the child’s life (parents, siblings, teachers).

What does the term occupation mean?

Occupation means all the things humans do that have meaning to us.  Work, self-care and leisure are the primary adult occupations.   For children, occupation includes school tasks, play and self-care.  OTs use occupation in treatment to restore or improve function.   Therefore, we often use play activities to help develop skills and we also play in order to improve the child’s ability to play.  We choose and modify activities carefully through a process called task analysis, and alter the amount of challenge the activity provides so that the “just right challenge” is obtained.  The child should be challenged but not to the point of frustration.  The activity typically will also have components that address specific skill areas we want to target (eye-hand coordination, in-hand manipulation, strengthening etc.).  If we do our job well, the child will look to others like he or she is just playing and having a good time

What is our background and knowledge base? 

Occupational therapists are trained to understand and promote human occupation. We possess a knowledge base of neurological, sensory motor and motor development as well as a theoretical base of both occupational therapy theory and theory from fields such as psychology, anthropology and sociology.  We have been trained to be careful observers of behavior and analyzers of activity.  We are able to provide information, activity ideas, intervention and adaptations to promote the development of certain skills or skill components that may be lacking.  We can assist in modifying environments or activities to allow for greater success.  Overall, our goal is to promote occupation and occupational performance in the children we see.

Want to know more?

Check out the American Occupational Therapy Association (AOTA) website for more information about OT’s role with children. AOTA: Children and Youth