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How Does Play Help Meet a Child’s Therapy Goals?

Occupational therapists often use play as a means of helping achieve our clients’ goals. Many times, it may not look like our sessions are working on your child’s areas of need; however, when we are working with children, we often try to adapt play activities in order to help your child meet his goals. Play is a very motivating activity for a child to engage in with the therapist and work on some of his goals. Play may also mask the fact that children are working on a difficult skill by introducing fun into the activity. For example, if one of the child’s goals is to improve his handwriting skills, you could play a game that involves writing, such as Boggle, Scattergories, or crossword puzzles.

Therapist and child at Gym

Here are some play activities that OT’s use to help your child meet his goals:

  1. If your child needs to work on balance and coordination, we may play basketball while standing on top of a bosu ball (imagine standing on the rounded part of a ball cut in half).
  2. A child who needs to work on core and upper extremity strength could meet these goals by playing a game while lying on his stomach over a therapy ball, while balancing with his arms on the ground.
  3. In order to improve self-regulation for a child who has sensory concerns, we may start our session by playing on the gym equipment in order to help regulate his nervous system.
  4. To work on bilateral coordination and fine motor skills with a child who does not like drawing, we often use play-doh and have him trace shapes and cut them out with scissors.
  5. Another way to work on gross motor coordination is to practice climbing a rock wall, climbing a ladder, or swinging on the monkey bars.

Sometimes, however, it may be difficult to adapt the activity and make it fun for the child. In this case, the therapist may have the child participate in an activity to work on the skills he needs to improve, but use a play activity as a reward.  From the first example in which the child’s goal is to improve handwriting, the child may still not want to play the games that involve handwriting. Then, the therapist may tell the child that after handwriting, he can do an activity of his choice.

Hopefully, this blog provides a bit more insight into the therapist’s mindset while working with your child. The therapist is constantly thinking and problem solving about how to make an activity therapeutic and how to make it easier or harder based on the child’s ability to succeed at the tasks. If the therapist is successful, the child will not even realize the activities are working on their areas of need and will want to come to therapy every session!

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Low Muscle Tone Revealed

Muscle tone refers to the muscle’s ability to sustain a contraction. It is different than muscle strength, which refers the muscles’ power. A child with low muscle tone is often observed to sit with a slouched posture, may have difficulty holding their head upright when sitting at a desk and may be observed to prop their head up with their hand. Mother and child with balance ballOther observations include having difficulty sitting for extended periods of time, particularly without back support or w-sitting, where the legs are splayed out to the side in the shape of a ‘w’ when sitting on the ground.

Muscle tone cannot actually be changed, though through occupational or physical therapy, muscles will become stronger and compensate for the low muscle tone to help support your child through his/her daily tasks.

Here are five activities to help address strength, endurance and low muscle tone at home and in the community:

  1. At the park, have your child lie on his belly on the slide and pull himself up the slide using only his arms.
  2. Complete yoga poses that work on balance and core strength, like down dog or plank.
  3. Using a weighted ball or BOSU ball, have your child lift the ball overhead with both arms, lower it to the floor and balance his hands on the ball while he jumps his feet backwards into a plank position. Repeat these steps 10 times.
  4. Have your child lie on his back on the floor. With his legs raised off the floor and knees bent, have him weave a ball between his legs.
  5. Encourage your child to use the monkey bars or hang from the zip-line when at the park.

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How to Teach your Child with Sensory Processing Difficulties How to Ride a Bike

Learning to ride a bike can be a scary and overwhelming adventure for both the parents and the child involved!  There are many components required for bike riding, such as motor planning, body awareness, trunk control, balance, self-confidence, following directions, safety awareness, timing, and sequencing.  However, one of the best things about bike riding is that the child is typically very motivated and excited to do it, as he sees his friends or other children in the neighborhood doing so already.

SPD Child riding a bike

Below are several strategies on how to get started:

  • Practice lots of balance activities:  balance is a huge part of bike riding; therefore, it is important to strengthen these skills by challenging your child’s ability to maintain various positions including standing on one leg, sustaining yoga poses, walking across balance beams, or kneeling on an unstable surface such as the bosu ball.
  • Incorporate a variety of activities with wheels:  while being able to ride a bike independently might be the ultimate goal, it is beneficial to incorporate other similar skill sets into your child’s play experience.  This will help you and your child to take the emphasis off of the fact that he does not know how to ride a bike and help to focus on the excitement of trying new things (e.g. scooter, skate board, tricycle, roller skates, etc.).  Similarly, your child might really excel at one of these activities, in which this activity can then be used as a confidence booster when the child has already mastered it.
  • Practice inside:  have your child practice simply balancing on the bike/sitting on the bike in a safe environment, such as inside (e.g. basement or playroom/living room if appropriate).  Place large pillows/beanbags next to the bike so the child feels secure, and if he falls, he will crash into the pillows.
  • Involve different family members/friends:  bike riding can be a very complex task; therefore, it can be extremely beneficial to involve different family members/friends to help with the process. Different people have different strategies and ways of motivating and sometimes one strategy will really hit home for your child.  Similarly, then the same parent and child won’t get so frustrated with one another.
  • Visual schedule:  help your child to make a visual schedule/calendar to illustrate when the child will start practicing and what skill he will work on each day (e.g. getting onto bike; peddling with both legs; ride to the corner etc); then the child can put an “x” or a sticker on the chart when he completes a day of practice, or practices a skill etc.  Visual schedules can be motivating for the child, and provide structure.
  • Take the pedals off:  taking the pedals off of the bike helps initially with learning the feel of the bike/balance. Take the bike to a small hill and have the child ride down without the pedals, this provides an introduction to moving and balancing on the bike without needing the coordination to pedal.

Learning a novel activity can be intimidating for a child, as it is a totally new experience and requires a significant amount of following directions and motor planning.  Similarly, teaching  novel activities can be nerve wracking for the parents, especially if it is a skill they have not taught before, like bike riding.  As parents, it is important to keep in mind that every child learns differently and requires different levels of support when learning a new skill.  Make sure to constantly praise your child during this challenging activity, even if it seems like the tiniest accomplishment (e.g. buckling bike helmet independently; putting kickstand down independently).  As always, feel free to talk with an occupational therapist or physical therapist if you need more individualized strategies or have other gross motor concerns for your child.

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10 Activities to Improve Balance

Balance is a great skill to help your child progress with their gross motor skills, leisure activities, and activities of daily living.

The following activities are various ways you can work on improving static and dynamic balance for improved performance in activities such as sports, games, self-care, and many more!

  1. Stand with one foot on the ground while the other foot is resting on a stool in front of the other foot. This is the primary skill in working towards balancing on one foot. If this is too easy, replace the stool with a ball that your child has to rest his or her foot on. Then, progress to just standing on one leg. To make it more challenging play a game (such as catch, zoom ball or balloon tennis) while balancing.
  2. Stand on top of a bosu ball. A bosu ball is an exercise ball cut in half with a flat plastic surface on the bottom. If your child gets really good at standing on top of the bosu ball, turn it upside down so that the ball is underneath and he or she is standing on the flat side. Once this is mastered, play catch while standing on the bosu ball.
  3. Stand on a balance board. A balance board is a flat surface made of wood or hard plastic that has a rounded or curved underside. This can be a very challenging activity just to stay upright!
  4. Simply stand on one foot! Make this into a contest with the whole family and see who can maintain their balance the longest.The person who wins gets to pick a family activity.
  5. Put two lines of tape on the ground and practice walking on a pretend balance beam. The space between the two pieces of tape could start large (6 inches) and progress to 4 inches apart. If your child steps out of bounds, he or she has to start again. By employing a balance beam that is flush with the ground, this will decrease any possible fear of falling. Once this becomes easier, utilize a real balance beam to work on more challenging balance skills.
  6. Sit on an exercise ball while playing a board game at the table. Don’t let your child put his or her feet on the ground while playing unless they need to make sure they don’t fall.
  7. Play hopscotch only while jumping on one foot. No switching feet is allowed! This makes the game slightly more challenging.
  8. Sit, kneel, or stand on a flat platform swing. Once you child can simply balance, play catch, zoomball, or balloon volleyball while sitting, kneeling, or standing.
  9. Stand on a trampoline with just one leg on the surface. To make this even more challenging, invite someone else to walk on the trampoline (or jump) while trying to keep your balance!
  10. Try any of the above activities with your eyes closed. Balancing with your eyes closed is significantly harder than having your eyes open. Therefore, if your child has mastered all of the above activities, make it one step harder to keep them challenged!

The possibilities are endless! Get creative and make these activities easier or harder depending on your child’s progression of skills.  By working on balance, your child will learn to use their muscles properly in order to adjust to changes in movement. This will set them up for success in playing games and sports with their peers! As always, ensuring your child’s safety during these activities is very important. Utilize pillows, mats, and adult supervision when practicing these activities.

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