Thursday, November 29, 2012

Kneeling during table work

When you come into my occupational therapy studio or classroom, you'll find that all the tables are coffee table height and without chairs.  This seems to puzzle the kids I work with.

So, why no chairs?  Well, I found out that little kids really have a hard time sitting in chairs.  They fall out of the chairs, they wiggle in the chairs, they rock them back and forth..they do anything but stay in chairs.  Kids don't want to sit !  They need to move.   While we are working on fine motor or handwriting, we sit at my "kneeling tables".  While working, the kids have the freedom for movement AND for working on trunk stability and core strength via long kneeling.  So, bring out the kneeling tables and see better developmental skills!

Wednesday, November 28, 2012

Preschool fine motor and handwriting development

Today in our Mini Charmer's Pre-K class, we continued our focus on numbers.  Our class contains ten gifted kiddos ready to learn formal handwriting prior to kindergarden.

After spending the first several months on uppercase letters, working on numbers is a nice change of pace.   Boys especially like numbers as they relate to numbers often better than girls ( girls often have an easier time with letters).

Our first activity is for the kids to find the numbered gingerbread men in the gym.  Each child is assigned a number to find.

This format helps kids to increase skills in visual perceptual, visual memory, and number recognition.  This also helped with team building, as we heard "Jack, here is your number!", "thanks!", and so on.   Next we took all of the numbers and laid them out on the floor one by one.  I asked "is a 4 bigger or smaller than a 12?".   As we continued this process we ordered them from 1-20 on the floor and then counted forward and backwards.  Many kids this age do not consistently recognize numbers in the teens and so this repetition is great for them.  

After some good gross motor action in the gym, we settled in the classroom and did centers that warm up and increase fine motor skills. 

Wind up toys were a big hit. Wind up toys help so much with translation (stabilizing something with one part of your hand and mobilizing with the other part) as well grip strength. 

Pop beads were another center.  These pop beads are quite hard, but the kids had no trouble at all with it!
Pop beads of this size are super because they force a child to utilize a stable pincer grasp while using strength in pushing together.   This carries over into grasping a pencil correctly.  

Another fun center was the textured stencil and rubbings of dinosaurs and sea creatures.  This would also be a super Christmas gift (kids love these).  They are made by Melissa and Doug and can be found at Toys and Company, whom we partner with.  The stencils are two part-  they first can be used to stencil amazing animals, insects or dinosaurs and then they can be used as a rubbing plate.  

In this picture, he is completing the stencil side.  Next, he will put the textured stencil under the paper and then rub the crayon to make the drawing come to life.  As an occupational therapist, this is one of my all time favorite activities to develop hand and handwriting skills WITHOUT doing handwriting.  Great fun for all.  My 11 year old even likes doing these stencils.  

Lastly, I teach the direct skill of writing numbers.   We use our Handwriting Without Tears book and the kids lay on their stomachs (it works on core strength but also makes sure that the wrists are stabilized appropriately).  

I give everyone a slate chalkboard and demonstrate how to write each number 1-3 today and then each child practices it.  I was truly amazed at how well they did and they were so proud of their accomplishment.  It is a wonderful experience to see children learn to love handwriting and to gain such confidence.  

Sunday, July 22, 2012

Sit still, keep hands to yourself, & stop bumping into me!

Children often get in trouble at school for being "wiggly", not keeping hands to themselves or for personal boundary issues.  In late pre-k and kindergarten it becomes more important for students to learn these concepts.  When children do not master these concepts, they often get in trouble more and more and may start to dislike school.   Why do some children have problems in these areas?

Any of these issues may stem from a number of non-behavioral reasons. These are the major ones that I see:

Core Strength:  this affects sitting still in line, staying seated in a chair, and sitting upright in the floor during circle time.  Our core strength is a perfect synergy between our extensor muscles (in our back) and our flexor muscles (in our stomach).  When one, or both of those muscles do not have good enough strength to maintain an upright position for sustained activities, then a student will basically tire out.  The child may lean on others, attempt to lay in the floor, change positions, fall out of their chair, and be "wiggly".  In addition, kids with less than adequate core strength will often have reduced endurance and may be quite fatigued after an elementary school day.

Proprioception: this is one of our body's sensory systems that allows us to sense our body's position in space.  Our joints, tendons, and muscles contain the receptors that allow for accurate proprioceptive feedback.  When you lift weights, you feel each muscle that is being exercised.  If you work out well, you'll have awareness of those muscles long after your workout is over.  During and after this workout, you have a keen sense of where these sore muscles are.  In fact, if you close your eyes, you could likely point right to the place that you are the most sore.  This is proprioception (and maybe some lactic acid setting in too!).  Everyone has different thresholds for senses.  Kids that seem to be a bull in a china store most likely have very high thresholds for proprioceptive input.... meaning that their nervous system needs much more input before it can register the input. Kids that may have a high threshold for proprioceptive input are the ones that bump into everything, seem to be accident prone or clumsy, constantly seem to touch others, may hug or play too rough, or may crave  jumping/bouncing.

What to do?  For core strength, swimming, karate, and yoga are great activities that help.  You have to stay after it so that you can build on the core strengthening.   For proprioception, a sensory diet works wonders.  Activities that allow a child to get this input prior to school will help the child to succeed.  Sensory diets have to be allowed during and after the school day too.  They don't have to be obvious activities though.   A sensory diet activity can be carrying books in a crate to the library, jumping on a trampoline for 20 minutes prior to school, monkey bars,  sitting and bouncing on a yoga ball, climbing up a rope,  and other heavy work activities. 

If you need help, then get a pediatric occupational therapist involved.  Often, it is helpful for the connection at school as an O.T. can explain why a child's behavior is an attempt to activate the nervous system, not an attempt to drive the teacher crazy.  :-)

Friday, July 13, 2012

Executive Skills- had to practice what I teach

NOTE:  not for the weak at heart or for parents that don't like to see messy rooms.  

Executive skills coaching /therapy takes a child's strengths and weakness's in mind when working toward the ultimate goal of improved achievement at home and at school.  Executive skills are those frontal lobe skills.  In children with ADHD, studies have found that executive skills may lag by as much as 5 years.  Wow.   Here is the list of executive skills.  Want the definitions?

Response Inhibition   
Working Memory          
Emotional Control
Sustained Attention
Task Initiation
Time Management
Goal-directed persistence
I got a good dose of using my training last week when my son got really upset at me and completely wrecked his room.  He threw everything off the bed and shelves and threw in the floor.
a wrecked room for sure

Sunday, June 17, 2012

Brain Training at Learning Charms..and a little vent

"Brain Training" (also called cognitive training) is a hot topic of interest for parents of children who are struggling in school, or who have  ADHD, learning disabilities, attention/focus issues and sensory processing difficulties.  There are many franchises that offer brain training.  Brain training is not new, but is a new "hot word".  Occupational therapists have been helping clients to rewire their brains for decades.  We just called it "occupational therapy".   Occupational therapy increases achievement of students by working on the underlying and foundation issues of development, such as core strength, sensory processing, bilateral use, fluency, motor planning and so on.  Therapists practice increasing left and right brain integration every day because that is part of therapy. This increase in foundation skills increases academic performance.   In the past several decades, new high tech systems (such as Interactive Metronome) have come along that can assist therapists with improving and refining areas of focus, attention and timing.

So, my clients have asked me about these brain training franchises and what they do. I cannot say that I can personally review their effectiveness.  But I will share some insight.  I recently met a student that worked at one of the franchises and I asked what she did there.

Tuesday, May 22, 2012

Jumping rope in occupational therapy

Why do we jump rope in O.T. and handwriting tutoring?

My students always want to know why I make them jump rope so much.  If you come to see me at Learning Charms then you'll definitely be leaving being much better at jumping rope. 

Why is it important?  Jumping rope is beneficial mostly for fluency.  Fluency is part of motor praxis (meaning "planning") and is basically the ability to keep a steady pace and rhythm. It can be seen in reading fluency, math fluency, and even fluency in independent working pace.  I especially like jumping rope for children with ADD/ADHD.   Fluency is an executive function of the brain, meaning that it is a high level skill.  I teach jump rope to kids as young as 3 years.  As they get older, we learn to jump rope backwards, one footed, with rhymes, and counting backwards by 2's or 3"s.  Jumping rope helps with academic skills, timing, sensory processing and motor coordination too.  Bring out the jump rope this summer!

Friday, May 4, 2012

Occupational therapy for poor handwriting: why it works

Most of our clients come to us to improve some component of handwriting or writing skill.  Parents often question why occupational therapists work with handwriting so much.  Handwriting is a very complicated neurological and anatomical process.  Usually poor or inefficient handwriting or penmanship is simply the symptom of a developmental process that is not functioning smoothly.   When a well trained pediatric occupational therapist evaluates handwriting issues, they should be evaluating specific developmental areas. 

Optimal handwriting skills also require fundamental skills such as:
core strength
sensory processing
fluency praxis
processing speed
trunk stability
bilateral integration
upper body strength
visual motor integration (also known as eye hand coordination)
visual perception (vision to brain processing)
pencil grasp, finger strength and
postural stability

This is why traditional handwriting tutoring by someone other than an occupational therapist may not give your child the improvement that they need.  Once a trained occupational therapist has helped a child to improve these underlying fundamental skill sets, then a child's handwriting will quickly improve.