Friday, December 12, 2014

Coil Stringing

This activity provides visual stimulation while individuals watch the rings spiral downward. They are encouraged to reach above their eye level to develop better postural control while also using both hands together to attach the rings. The coil is half of a hose that I came across, its a really nice tube that stays  coiled up up after it is pulled upward. Pulling it provides wonderful proprioceptive stimulation to muscles and joins and is just fun to feel the springiness as it moves up and down. I attached a bag of sand to the bottom of one of these to help keep the bottom of it on the floor. Then I realized that if I attached a sock to the bottom of another one, the individual could stand on it and work on balancing while reaching to take more rings. It was quite the challenge for some of them to sequence these steps and it certainly worked on body awareness and motor planning !!
 

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Friday, December 5, 2014

Vibrating Candy Cane Shaped ring Stack


 
 
I have been using candy cane ring stacks for many years with young children to develop hand skills and give sensory input. You can attach it to a motor such as the massager shown in the photo. It helps children and adults to visually attend and be more aware of their hands. Children with autism have especially loved it, although adults with developmental disabilities have also been motivated to use their hands to place rings and feel the vibration. 
 
 If you use pieces of swimming noodle to push down a candy cane so that it requires force, the child receives sensory stimulation to muscles and joints.
 
The candy cane is bright and seasonal!  Its easy to find or purchase many different types of candy canes.....
 
I found this one at a hippotherapy farm around the holidays. It was thrown out after holding pony edible treats. I punched holes in the bottom and wrapped string in and out of the holes and legs on the blue massager until it felt pretty secure. these massagers are commonly sold in department stores and pharmacies.  The child shown in the photo is sitting on top of a horse. When finished placing the rings she will be rewarded with a trot- a very nice example of sensory reinforcement....
 
 I cut the rings out of plastic bottles and lids. This activity is very difficult to use with only one hand since it is shaking so it really encourages using both hands. The first person shown in the video has very good manipulation skills but he tends to do everything with his fingertips avoiding touch to his palms. I think that he found this fun and it gave good sensory input to his palms.
 
 
The second person shown in the video is really enjoying the sensory aspects of the vibration and pushing the rings downward. He is legally blind and seemed to especially respond well to the tactile aspects. The last person shown very briefly because i had a difficult time avoiding his face while filming shows how he has difficulty motor planning how to position the ring to fit over the hook of the candy cane shape. He also has motor control challenges so this activity works on developing many skills- eye hand coordination, bilateral hand use, motor planning and attention. 

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Wednesday, November 26, 2014

Adapted Cup Holder



This adaptation was spontaneous and effective. The client tends to sit and stand hunched over. She does not want her dining equipment raised higher on a platform. I happened to have a cardboard tube from some packaging in my office and the cup fit inside it perfectly so that she can grasp the tube while eating. This set up is promoting a nice erect posture. I will be prettying up the tube with contact paper.

Wednesday, November 19, 2014

Reaching to String Words or Pictures


I designed this activity for an individual who is able to read and write. I wrote simple phrases on cards that I laminated and cut slits in the center for stringing.

There are 2 different products shown in the photos. One  has the end of the   cord attached to the top of a book stand using duct tape. I cut the flat plastic cord out of a shampoo bottle. There is another bottle attached to the board with black felt where the words are stored.

 Since the book stands that I ordered came with battery powered lights that clipped on, I added a few so that the activity can be performed in a room darkened for relaxation. 

The other photo shows the end of the cord attached to a green bottle handled so that he can tuck the end of the cord into it when finished. I just used the recycled materials, felt and duct tape that I had handy and this is how it turned out. You can use string or cord and make round holes in the word cards, but I have lots of plastic bottles available to use and these do not fray.

I love that he enjoyed reading the words. His eye hand coordination is pretty good so actually  stringing, although fun was not as important as the fact that he raised his arms repeatedly to strengthen his upper extremities and neck muscles. 

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Wednesday, November 5, 2014

Weaving Loom made out of Book Stand


I feel like a super occupational therapist when i do weaving activities!!!

 I made this loom by attaching the fabric pieces to a very large book stand. The book stand can have the angle adjusted but it is positioned vertically even though it doesn't look that way in the video. If you don't have such a fancy books tand try cuttinb a heavy duty box and folding to create a triangular frame.

 I happened to have a lot of sticky back felt that was provided by a recycling center program. It is green and I used it to hold the red fabric strands in place. I also got the red felt (not sticky back) from the same recycling center. I sewed each red strand to a horizontal strip of fabric and taped securely in place across the top of the stand. You can't see it because it is covered by the green  felt. The blue plastic is cut from the bottom of an old tent. 

I wasn't sure whether to work on weaving from top to bottom or left to right  but working top to bottom seemed easiest to make and use.

 My goals were to improve visual attention, manipulation skills, learn  over and under concepts to weave and most importantly to sit up erect and reach upward for strengthening and to improve posture.

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This is a great way to teach weaving concepts since the fabric won't rip easily like the paper place mats do. Once your clients learn weaving concepts, they can engage in a variety of crafts that require this skill. 

Tuesday, October 28, 2014

Light Box Insertion Activity

 These light boxes are great. The handle can be adjusted to make the light surface flat or various angles. Unfortunately, the nurses told me not to use them because the  bright lights might cause a seizure.

I made this insertion activity hoping that the light would not be too bright but bright enough to be fun and attract attention to the box opening during a simple insertion task.  

The nurses approved!! Hooray !!

The top photo shows how I covered a box with sticky back felt and used velcro to attach to the light box.

The other photos show a white box that still needs to be covered with felt to create some color contrast. But you can see the inside light is covered with some translucent stickers. I cut openings on the bottom and top of the box so that the light shows through.   

The man in the video is legally blind but he turns his head toward light so I think that this adaptation helps him to  find the box opening.

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Wednesday, October 22, 2014

Enlarging Handle for person with Spasiticity



I recently adapted this cup holder for an elderly lady with spasticity. She was unable to open her hand enough to grasp the cup and was gripping it by the rim instead.  So I am sharing a simple adaptation that involves attaching a handle cut from a detergent bottle to a  cup-like plastic container that the drinking cup is inserted inside. The client drinks out of the regular red drinking cup. The white cup that holds it is a bottle used for contact lens solution. I have no idea whether that white plastic container is safe for consumable liquids but the white cup holder never touches her lips.

I also show a sponge holder that I made years ago so that people with spasticity can grasp the handle to paint.

I cut into the green handle to make the cup holder- in the same way I cut the tab shown in the yellow handle below. I cut a notch into the white bottle (holding the red cup) and pushed the green tab through it and secured with the gray duct tape. It works quite nicely and nothing wiggles while she drinks.


The tab of the sponge holder is pushed through 2 notches in the sponge.

The last picture shows another way to attach a handle to a plastic container like the green coffee one. I cut long notches to insert the handle flaps into and secure inside with tape. I use these in a variety of ways for insertion tasks with very young children and all ages of adults with developmental disabilities.
I use a variety of lids with different types of openings to create shape sorters.


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Tuesday, October 7, 2014

Sensory Play with Light Box


I recently received these wonderful light boxes to use at work but the nurse said that I should not use the lights because they can cause seizures. First she said that I should just not use it with people who have a seizure disorder but then decided it was too risky because even if a person without a disorder used it someone else can walk over and look at it.

So I am looking at ways to use it without any batteries, electricity or lights.... I like how the carrying handle moves to change the viewing angle. The light box cover is this white plastic and pretty bright even though not lit up. It looks cool when I put the striped plastic sheet over it.

 I  cut the plastic fruits to have an extended piece on the bottom that can be pushed into slits cut into the striped plastic. I am still experimenting with how I will use this.


But the fun news is that I was in a program room all set up for a 
Holloween sensory activity with cute  skeletons and pumpkins and other things to touch and look at, including  a container of goopy stuff (looks like blood)..... Nobody wanted to touch it until I put clumps on the light box screen. The video shows one of the individuals enjoying using it in a fine motor task of removing it to put in the container. He needed the structured way of manipulating it rather than just holding it in his hand to feel.



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Tuesday, September 30, 2014

Bilateral Bean Bag Activity

 I have been working with a young man who avoids using his right hand. He has limited hand skills and attention and he typically transfers objects to his left hand to insert into a container. He has been working on this for a long time.

I decided that since he is relatively successful at grasping and moving bean bags I would make something similar that would require using both hands because it is too long, awkward and heavy to lift with only his left hand. I filled an old long socks with a plastic bag in the center and  small bags of sand inside each end of the long sock.

Then I sewed the smaller socks onto each end to create some color contrast. As you see in the video I am trying to have him grasp the 2 small sock ends one in each hand. The video is choppy because I edited out his face. I am also talking constantly int he video because I don't want the voices of other clients heard, to protect their privacy. You do hear one other staff person directing him to do the task. He did really well and its exciting to find a new skill we can develop that  is within his potential given the cognitive limitations.
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Friday, September 26, 2014

Making an Adapted Spoon



I have been thinking for a while that I should be able to make enlarged spoon handles using the handles from detergent bottles. The ones that are sold in therapy catalogs get lost- often.

I have been working with a young man who is able to grasp the handle and bring the spoon to his mouth but he often drops or throws it and then tries to eat with his hands. I also want him to learn to scoop.  I  had purchased a spoon for $25.00 (can't remember the name of it) but it had a very long and flexible handle that wrapped around the arm. I thought that I could grasp that long handle while he ate to encourage him to bring his hand down to the plate to scoop.
That spoon broke while figuring out how to use it!!

So here are photos and a video of some attempts to make built up handles. The maroon spoon fit inside the foam but all got quite soggy during the meal . I think that the green handle over the foam feels better.

I found the long blue tube on the beach. It looks like it might have been part of a tent pole. I ran it through the dish washer and it survived nicely!  


I discovered during this process that a heat gun makes the plastic soft enough to squeeze with pliers. If you can't get the end to clamp tightly onto the inserted spoon you can use duct tape to make it more secure.   

My favorite photo is on the bottom showing my client eating. He has learned not to throw the spoon and getting the kinesthetic  experience of grasping and scooping while the staff guides the movements.


























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Monday, September 15, 2014

Ring stack adapted for patient with Hemiplegia


This client is a lady who had a brain injury. Her left hand is contracted and flexed tightly against her body. I found that she is limited in any type of hand use (except for eating) but was willing to put rings on a stack. The top picture shows the adapted ring stack laying on the table. She used her functional right hand to push the orange cones onto the tube.   She refused to use her left hand at all.

I don't have a photo of her using the revised adapted ring stack shown below. I had the blue massage pillow at home. It was broken and did not vibrate anymore. I pushed the tube into where the batteries were supposed to go and attached a blue detergent bottle cap on top to create color contrast.  I thought that the soapy aroma that lingered would be pleasant. Finally I did a little sewing to the blue cushion so that the part with the tube used as a ring stack actually stayed upright all by itself.  I showed her how to lay her typically flexed left arm  on top of the blue cushion to keep it upright while stacking the rings.  She seems to like it for brief periods, so we are working on increasing the time she tolerates hand activities, especially stabilizing with her weaker side.......


 

Friday, August 29, 2014

Adapting Sensory Items on Frame



 I am working with a severely developmentally delayed woman who has low vision and is very tactile defensive. She does not want to be touched and had made this known over the past 40 plus years after numerous sensory-based OT programs.

She actually finds it calming to pull on soft objects suspended from a frame that is attached to her wheelchair. She had an objective to knock objects off a board attached to a wall. The objects were attached with Velcro. She has met that goal so I have been working hard to think of a new skill to teach her.
She does not grasp objects unless physically assisted and then she clearly does not enjoy either the physical assistance nor the grasping.

The top picture shows the 3 stuffed animal toys that I originally found attached to the frame with string. The first thing I did was reattach the objects with some stretchy material so that there is give when it is pulled.

My client already has the skill to pull on these objects, so I decided to up the challenge so that she needs to pull them out of containers and her reward will be that the containers will fall away and she can engage in her preferred activity of pulling

I found enough clear plastic containers that the tennis balls come in and I also used a vitamin bottle and bottle for contact lens solution. Shampoo bottles would also work well. I cut around the top and added the red duct tape to create color contrast. However, she really didn't look toward the objects, so this didn't particularly matter when using with her.


The stuffed bear shown on the left is too large to fit inside any container so I just left it in place and it can easily be pushed off the frame out of view.

I suspended a long red microfiber sock filled with supermarket bags and sewn closed. It feels really good.

The photo above shows a sock filled with sand attached to the cord. I put an extra blue sock over it so that it can be washed.

You also see the Brainy Baby toy.  When pulled it vibrates and she seems to like it. There was a rabbit that can be pulled to activate music (shown in the first picture) and I left it on the frame but it is too large to fit inside any of my bottles.   However, I love the idea of using the toys that can be pulled to activate music or vibration.

 The last 3 photos show my client pulling trying to get rid of the bottles. I realize that  I should start out having her work at this for only about 5 seconds and then remove the bottle myself so that she does not get mad. I am hoping that over time she will connect the idea that removing the bottles will enable her to get to the fun part of grasping the soft materials. As you can see she prefers using her left hand and avoids the right hand, so part of my goal is that she use both hands either together (preferably or alternate).

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Monday, August 18, 2014

Straws for Motor Planning

I found 6  crazy straws in a package at a dollar store and knew that I would put them to good use....

 It was very easy to make these motor planning ring stacks. I stuffed an oatmeal container with a bottle of water and fabric scraps. One can use anything, sand, gravel etc. just so that the container is full . Then when you poke the straw through the lid it will press against something and not need to go down. Next, decorate with contact paper and secure with duct tape.

I cut the little circles out of detergent bottles and punched holes in the center.

The  lady in the top photo is completely blind and I like how she had to pay close attention to feel as she moved the rings downward. I originally gave her the container with 2 straws but then decided since she is blind I would make one for her with only one straw.

The lady in lower photo and video is using the single straw ring stack and I realized that she would have enjoyed some color matching. So you can adapt this to meet your client's needs....so that they can color matching as part of the process of motor planning the movements of circles downward.

I think that this can function somewhat as a fidget tool. The straw feels nice and smooth as one moves the pieces upward or downward....


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Monday, August 11, 2014

Tummy Time Blog Hop and Baby's First Year


Welcome to the Therapy Bloggers blog Hop !!!!

We are all writing about the importance of tummy time:



Below you will Find all the posts in the Tummy Time therapy blogger blog hop. So many great ideas and thoughts on tummy time from Occupational Therapist and Physical Therapists.
The Importance of Tummy Time for Babies - Golden Reflections Blog



5 Awesome Toys for Tummy Time! - The Inspired Treehouse
Tummy Time : The Basics - Therapy Fun Zone
Tummy Time Tips - Pedatric OT Tips
Tummy Time Just Isn't For Babies - Your Therapy Source
Tummy Time Never Gets Old - Playapy Platform


 
 
My baby 26 years ago.... before I heard about "Tummy time" !!!


I also recommend that you also check out the tummy time tips in my book:  From Rattles to Writing: A Parent's Guide to Hand Skills





Occupational therapist Masume Marjani from Iran has shared these photographs of her beautiful baby Mitra. Let's take a look at how tummy time has helped Mitra to develop her gross and fine motor skills during her first year of life.


Parents may introduce tummy time for just a couple of minutes soon after  birth.  Its important to keep the "tummy times" brief, fun and frequent so that baby becomes used to this position at an early age.

Try placing a small rolled up towel under baby's chest to make this easier and more comfortable.

Then as your baby gets older try using a small bolster or Boppy pillow. The goal is to make baby comfortable while playing on her tummy so that she focuses on having fun rather than whether or not she likes position. After a while she won't need to use a towel, cushion or any other positioning assistance because she will be strong enough to hold herself up all by herself.....

Prone (on tummy) position helps baby to gradually develop head control and experience the pull of gravity as she begins to move and lift her head to look at loved ones and objects.


These days babies spend a lot of time on their backs because pediatricians recommend supine sleeping to hopefully prevent SIDs (sudden infant death syndrome). Babies these days also spend a lot of time in carriers, car seats and other positioning devices that interfere with developing important gross motor skills such as rolling over.

Encourage your baby to roll from back to tummy by placing some exciting toys to her right and left sides. Also position your own smiling, laughing face to motivate turning. You can assist by flexing baby's higher leg at the knee and giving a little push at the hips and shoulders .







Rolling over back to front and then front to belly teaches Mitra how to control her own body. It develops body awareness- as she learns that she can roll either to the left or right. Rolling develops coordination between the right and left sides of the body.

Shoulder and hip rotation experienced during rolling develops the flexibility babies needs to crawl, stand and transition back and forth between standing and sitting. 



Make the "tummy time" moments special with toys and even books. Its never to early to show babies how we adults love BOOKS!!  


  

 
As baby Mitra brings her hands together over her face she is experiencing wonderful tactile stimulation to her skin and proprioceptive stimulation to her muscles and joints.  Babies explore their fingers, toes and toys by putting them in their mouths. So encourage your baby to do this while on her belly.

Arms out like an airplane !!! Mitra demonstrates good muscle tone, head control and coordination between right and left sides of her body.....





Occupational therapists love to see babies fly either on the floor or in the air with arms and legs out like an airplane.




I love how Mitra attends to the musical toy in the video, she is enjoying her Tummy time !!!




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Toys can be positioned flat on the floor or a bit higher such as this toy piano that Mitra is playing. She props herself up on her elbows to help control her hands reaching to activate the music. this position makes it easy for her to look directly at what her hands are doing and at the same time she is strengthening her shoulders and ocular (eye) muscles.





Reaching upward to touch the water toy is fun so it motivates Mitra to explore. She is feeling the new sensation of water moving under her arms.

Mitra can visually track the toys inside the water bag. She is shifting her body weight between left and right sides of her body as she explores reaching with one side and then the other. Mitra is developing many skills.....



Spending time on the belly prepares Mitra to coordinate rocking forward and backward on her hands and knees. This rocking provides vestibular stimulation as the liquid in the inner ears moves.

Early tactile touch), vestibular (movement) and proprioceptive (stimulation to muscles and joints that tell Mitra where her body parts are and how they are moving)  sensory stimulation helps baby to  develop body awareness and abilities to process sensory information such as how things feel, fit together and how to suck on one's toes. 


Mitra is learning about her body as her bum goes up and down, her arms and legs shift weight from left and right sides as her body moves forward to crawl. At the same time, the weight of her body strengthens her shoulders, arms and hands in preparation for complex manipulations such as scribbling. 



Beautiful reach and eye-hand coordination, Mitra!

This will help her develop the coordination to shift her balance reaching toward her right and left sides so that she can throw and catch a balls and bean bags.












Crawling under, over and around obstacles teaches Mitra about the spatial relationships between her body and large objects. This knowledge will help develop an understanding of how small objects fit together- objects like ring stacks and nesting cups. 















Crawling downward from pool to floor helps Mitra put even more weight onto her palms.




























As Mitra develops the coordination and strength to stand she continues to reach for toys on the floor and toys located at different heights.


Transitioning between standing and sitting and climbing onto the toy car helps Mitra to develop the balance and coordination she will need in order to walk. 







I love how Mitra is weight bearing with her hands on the steering wheel. All that "Tummy Time" is paying off as she uses her strong body.

















Now Mitra can continue to bear weight on the same piano she used during "Tummy Time" as she practices standing and squatting up
and down..... while making music!!














  










 Of course, Mitra is thrilled to walk!! However, she continues to  develop motor skills while crawling, squatting and sitting.....














Develop grasping skills with objects that  feel great and fit comfortably inside the hands..... encouraging transferring the toys between hands and grasping 2 toys at the same time....




















Mitra explores the holes in a strainer while squatting.....








Mitra can play piano now with her sticks!












Toys such as nesting cups teach Mitra how smaller objects fit inside larger ones and that she needs to use her 2 hands together to manipulate them. 



Play dough not only teaches Mitra about different textures and shapes,but is helping her develop finger isolation. I love her little pointer finger going into that dough!






 




A ball can also be grasped with 2 hands or poked with an isolated index finger.


Index finger isolation, poking, pointing and pushing will help Mitra to develop the motor control she will need to scribble and eventually write.

Child development is truly all about the transitions between  big body movements - prone (tummy time) to standing and fine-motor development From Rattles to Writing...... 









 















   

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