Posts tagged ‘middle school’





Geocaching is a great way to get the whole family working together for a common goal, get active and have fun at the same time. Think of it as a hiking scavenger hunt. First, you log on to and choose a geocache to search for. Next, use your GPS (or GPS enabled phone) to navigate to the location. A geocache (or cache) is a container that holds a log book to track the people who have found it in the past as well as small treasures or trinkets that you may take as a memento of your find. Then you leave a treasure for the next person and replace the cache just as you found it. Congratulations, you’re a geocacher!


So, why geocaching? While some children with decreased endurance and muscle tone may hesitate to go on a hike for the sake of hiking, they may be more engaged in a treasure hunt. Because the website gives valuable information regarding difficulty of the terrain, length of the hike, and size of the cache, you can tailor your family’s outing to the time you have available and the endurance levels of your family members. The website also provides a hint as to where the item is hidden (e.g. look near the fence). Beyond the physical benefits of exercise, research has shown that children with ADHD and autism spectrum disorders, as well as typically developing children benefit from exercise with regard to increasing attention and on-task behaviors and decreasing maladaptive behaviors. An activity like geocaching can provide the physical outlet and sensory input that your child needs, while giving the whole family an opportunity to participate in a fun bonding activity together.


Check out a short video about geocaching here, or jump right into searching for your first cache! Have fun!



Pencil Grips

Many children we see at the clinic have difficulty assuming and maintaining a functional pencil grasp, which impacts their ability to write. What do we mean by “a functional pencil grasp”? Here are a few grasp patterns that we encourage:

Tripod Grasp – this is often seen as the “gold standard” for pencil grasp, however it is not the only tripodfunctional and efficient way to hold a pencil. The pencil is held between the thumb and index finger and rests on the side of the middle finger. The ring and pinkie fingers are tucked into the palm while the shaft of the pencil rests in the open webspace formed by the thumb and index fingers. This pattern requires strong intrinsic hand muscles and good stability at the joints.

Quadrupod Grasp – this pattern is closely related to the tripod grasp, however, the pencil is held by the thumb, quadindex and middle finger and it rests on the side of the ring finger. The pinkie is tucked into the palm and the pencil shaft rests in the open webspace just like a tripod grasp. This pattern provides slightly more stability but does not sacrifice control or joint positions.

Modified Tripod Grasp – Although this pattern looks quite a bit different than a standard mod triptripod grasp pattern, the pencil is held the same way by the tips of the thumb and index finger. The difference is that the shaft of the pencil rests between the index and middle fingers. This pattern may be beneficial for children who lack stability of their webspace and arches of the hand. The movement of the pencil remains unimpeded and the joint positions are ergonomically correct.

Chances are if you are reading this article, your child does not use one of the patterns listed above. Some children tuck their thumbs under their index fingers, which is referred to as a thumb tuck.

thumb tuck

Others place their thumb on top of their index fingers for added stability, which is referred to as a thumb wrap.

thumb wrap

Then there are a wide variety of other dysfunctional grasp patterns like this one:

five finger

Perhaps a teacher or other professional has suggested the use of a pencil grip but with so many different grips available, how do you know which one is right for your child? Speak with your occupational therapist to investigate the need for a grip. Here are some of the common grips available. Click on the pictures below for a larger image.

A Word of Caution Regarding Any Pencil Grips:

  • Whenever exploring the potential use of a pencil grip, the following must be considered:
    • Does the grip support participation in handwriting tasks or does it cause more of a distraction?
    • Can the child consistently place their fingers correctly on the grip or do they need assistance each time they pick up the pencil?
    • Is the child willing to use the grip or will they hide it in their desk or “lose” it?
    • Is the child working to develop the intrinsic musculature of the hand in order to transition away from needing a grip?
    • What are the other factors impacting their writing? How is their trunk control? Are the seat and desk heights appropriately matched for the child? How is their proximal stability at their shoulder? What is their wrist position? Does the child efficiently separate movement between the two sides of the hand? How do their visual perceptual skills impact their writing? How does their regulation impact their attention and ability to sit long enough to master grip and graphomotor skills?
  • Before a child enters Kindergarten, there is little need to use pencils or grips. Encourage the use of short crayons or pieces of chalk instead. A child’s grasp patterns continue to develop into a “mature” pattern around the age of 5-6 years old, so it is not uncommon to see a child alternate between functional and less functional grasp patterns up until this time.

Is It Picky Eating? Or Something More?

Are you concerned about your child’s eating habits?  Avoidance of new foods is a typical part of child development, most often seen in 2-3 year olds, but for some children, this pattern continues further into childhood. How do you know if your child is a just a picky eater or if there is a need to seek out assistance in this area?   Here are some brief guidelines to help differentiate between picky eaters and problem feeders:

Picky Eaters:

  • Are reluctant to try new foods, but can typically tolerate them being nearby, touching them or looking at them.
  • Have at least 30 accepted foods.
  • Will typically accept the food again after a break from eating it for a period of time
  • Will eat at least some food from most food groups or texture groups.
  • May frequently eat a different meal than the rest of the family, but typically sit with the family at mealtime.
  • May slowly “warm up” to a new food after 10 or more presentations.
  • May eventually agree to try a new food if they are hungry enough.

Problem Feeders:

  • Become excessively distressed when a new food is presented – may gag, vomit or cry after looking at a new food.
  • Have a significantly limited food repertoire – typically less than 20 foods.
  • Will not accept a food again once a food is lost from the diet, even after a break.
  • Avoid whole categories of food groups or texture groups.
  • Are frequently unable to join the family for mealtime.
  • Continue to have strong negative reactions to foods even after 10 or more presentations.
  • Will ignore hunger cues from their body and refuse to eat a non-desired food, even if this results in malnutrition or dehydration.

If you are concerned about your child’s diet, talk to your pediatrician about nutritional concerns and to rule out physical or medical reasons for feeding difficulties, such as swallowing difficulty, food allergies/sensitivities or reflux. Your occupational therapist can also help by examining your child’s food preferences for patterns in texture, flavor or other factors, and help make suggestions about how to introduce new foods into your child’s diet.

The Four Food Groups


sleepingHow much sleep does my child need? Here are some general guidelines for the amount of sleep children should be getting.

3-6 Years Old: 10 – 12 hours per day

7-12 Years Old: 10 – 11 hours per day

12-18 Years Old: 8 – 9 hours per day

What are some signs my child is not getting enough sleep?

  • Difficulty waking in the morning.
  • Awakening in an irritable mood
  • Decreased attentiveness and alertness during the day.
  • Frequently falling asleep during the day outside of normal napping hours, or frequently falling asleep during the day after naps are no longer part of the daily routine.
  • Taking more than 30 minutes to fall asleep at night.

How can I help my child improve their sleep patterns?

  • Studies have shown that children (and adults) who watch TV, play video games or use other electronics before bed took a longer time to fall asleep than those who avoided screen time.  It’s always easier said than done, but try to avoid screen time 1-2 hours before bedtime.
  • Dim the lights.  Turn off some of the lights or use table lamps in the 30 minutes before bed.
  • Create a bedtime routine that can be completed in 30 minutes or less.  Give your child some control over the routine, such as choosing a book to read or what PJs to wear.
  • Provide calming and organizing sensory input.  Taking a bath, getting a lotion massage, or providing deep pressure via “pillow squishes” can help a child with a high arousal level transition to sleep.  To safely do pillow squishes, have your child lay on a solid but comfortable surface on their belly.  With a couch cushion, large body pillow or several smaller pillows, provide firm pressure to their back, arms and legs for the duration your child desires.  Always be sure his face is not covered and his breathing is not impeded.
  • Some children benefit from a supplement called Melatonin.  If your child is still having sleep difficulties after trying bedtime routines and sensory strategies, you may wish to discuss potential use of Melatonin with your pediatrician.

Making a Homework Zone

homework zone

School has started and the homework is coming at full force. Here are some things to consider when making homework area for your child.

  • Look at the potential distractions present near the homework zone. Is your child easily distracted by auditory input? An area away from the TV or a noisy window may help. What are the visual distractions? Sit in your child’s seat and see what she will see.
  • Keep the homework zone stocked with supplies. Try to keep pencils, erasers, scissors, rulers or any other items typically needed for your child’s homework assignments handy in this area.
  • Lighting is very important. Use a desk lamp at eye level rather than overhead lighting to reduce glare.
  • Consider seating options. If your child has a hard time keeping an upright posture, he may benefit from a chair with arms and a solid surface to place his feet on. Other children may enjoy sitting on a small yoga ball. Ideally for all children, the table surface should be 2” below the height of bent elbows.
  •  For children who tend to wiggle and fidget, provide opportunity for controlled movement that does not interfere with the completion of homework. Tie a length of theraband across the legs of the chair for her feet to push on. Affix a material with texture your child likes on the underside of the desk – try the fuzzy or bumpy side of Velcro, a small piece of corduroy or something squishable, like an icepack at room temperature or a water-filled teething toy. This will provide your child with a textured fidget toy, without the chance of it becoming lost or getting in the way.

Tips for Middle School

The transition from elementary school to middle school can be a challenge. Here are some quick tips to consider before the school year starts.

  • Combination locks are often difficult for children with motor planning difficulties.

o       Some children benefit from using a padlock with a key rather than a traditional combinationword-lock lock.  Others may prefer to use a lock with a code, such as this.

speed dial combination locko      Another option is the “Speed Dial” lock that uses a slider that moves up, down, left and right and can be set with the combination of your choice. (Please note this style of lock is larger than traditional combination locks and we have found that it does not fit on all lockers.)

o       If your child’s school locker has a combination lock built in, your child could ask permission to place a discrete sticker on the right side of the lock to help him recall which direction to spin the lock first.

  • Begin a color-coding system with your child.  This system can last him through the middle school, high school and college years.  Have your child pick a color for each subject (e.g. math is the red folder).  Label the outside of the folder “Math” and label the pocket on the inside “To Do” and “Finished”.  If your child can get in the habit of always placing homework and completed assignments in the proper colored folder, there will be fewer misplaced papers and less stress for all involved.
  • Purchase or print out calendar pages for your child to keep by their homework area in order to track long-term projects.  As soon as assignment dates are given, teach your child to put them on the calendar.  Use colored stickers or markers to reinforce the color-coding system for each subject.

Back to School Tips

school busSummer has flown by and once again it is time to head back to school. Here are some ideas to help with this transition.

  • Get back to school-year bedtimes and wake-up times at least a week before school starts.  Although this may not be popular with older children, it will be worth it during the first weeks of school.
  • If your child is bothered by the feeling of new clothing, do not push them to wear a brand new outfit on the first day of school.  Wearing comfortable clothing will reduce the sensory demands on your child when in a new classroom with unfamiliar sensory stimuli.
  • Use a calendar to set up after school routines.  Having a visual aid as well as the comfort of knowing what to expect is helpful to many children.
  • If your child has fine motor or motor planning difficulties, food and beverage packages may be a challenge at snack and lunch time.  Give your child a chance to master these packages at home before going back to school.  You can even serve snacks and lunch in your child’s lunch box to practice the motor sequences from start to finish.