Saturday, March 17, 2018

Simple Sensory Motor Activities that Help Individuals with Autism Spectrum Disorders

Children and adults on the autism spectrum frequently seek deep pressure and movement sensory stimulation. We see this when they are running, jumping, twirling, rocking, swaying, crashing into things and burying themselves under  blankets and cushions.  These are the individuals who are "sensory seeking" and they are attempting to self-regulate or soothe themselves, decrease anxiety or agitation or in other words, make their brains function at a more comfortable state for optimal focus and learning.  Some therapists describe the brain as an engine that may be running too high or too low.  Sensory diets are designed to help make "engines" run- just right.

Parents with young children may see these types of sensory seeking behaviors, but it does not necessarily mean that their children have an autism spectrum disorder. Many children with a sensory processing disorder (SPD) have atypical responses to sensory stimuli (what they see, hear, taste, feel, smell,  feel and how they move), yet do not manifest the social/communication impairments associated with the autism diagnosis. In my book From Flapping to function; A Parent's Guide to Autism and Hand Skills, I describe in great detail the types of SPD, the impact on children on the autism spectrum and strategies that help promote attention, learning and hand skills.

In this post, I share a few strategies that help bring the person with a very active brain or "engine" to an optimal state for learning. These strategies may help decrease the anxiety that leads to agitation and the agitation that contributes to maladaptive  behaviors such as biting ones hand or having a meltdown.

Lets start by exploring a variety of seating options that allow movement  (such as ball chairs and seat cushions) and use of weighted lap pads, vests, shoulder pads, etc.  My client shown in the photo is sitting on a large canvass bag I found, stuffed with foam, fabric, squeaky dog toys, bubble wrap and other items. He likes to stand and sit in order to make the squeaky toys, squeak. He also likes the weighted collar.

Its not expensive to explore strategies. Try filling a large sock with plastic bags of sand. If you use them outside you can omit the plastic bags, but the socks will leak. In any case, these feel great around the shoulders, lap or just to hold in the hands.
Now let's get moving! The young lady in this photo is enjoying the tight squeeze of my old life jacket. You can also try commercial weighted or pressure vests or fill an old vest with pockets with little bags of sand. Young children may enjoy the tight swimming garments or shirts that are so small they squeeze the body. Many children love layers of clothing in order to get that tight feeling and some prefer no clothing at all! So of course, use lots of trial and error and your experience to design adaptations....

The woman wearing the red vest is pushing a heavy cart loaded with bottles filled with sand. She is walking down the hallway at her program removing one at a time to place on the floor along the walls. Moving up and down or high/low provides vestibular stimulation, as does pushing the cart across the room. This vestibular stimulation is not as powerful as swinging or spinning but it is safe in this environment and does not take any special skill on the part of the staff to implement these strategies throughout the day.

I took the socks filled with sand and sewed the ends together to make weighted rings. I placed a pile of the rings on a tall cart so that the client shown in the picture needs to  reaching high into it. The rings may be placed on the floor or across the room to provide other types of movement as the client retrieves them and adds to a ring stack.

Parents with children at home may try hiding these rings under cushions or other heavy objects so that they use lots of muscle power to find them. Perhaps you can set up a large cardboard box to throw heavy bags or the rings into. The child can gather rings from inside the house or yard and place them on their arms or around their waist  if they fit before bringing them over to toss into the box.

This will be even more fun if you place a big vibrating massager inside the box so that it shakes. After your child inserts the weighted bags, it might be a great time to take advantage of the calm and focus and show them how to form shapes, letters, numbers or words on the cardboard box or just scribble if your child is at that level.

In the following video you will see my high energy clients travelling across the room to take an object and then use it in a different part of the room. Here are a few ideas...
1) place rings on one side of the room, or hide under cushions or inside containers to open and bring them one at a time to stack on a tall ring stack on the other side of the room.
2) Place a container of golf balls on top of a vibrating cushion so that the child takes one ball at a time and brings it across the room to push into a small opening in a lid. I have taught clients to take the objects one at a time so that the activity lasts longer. Pushing the balls through a tight lid is very sensory in itself because it takes force to push them.
3) Set up a large number of heavy bean bags or socks filled with sand on one side of the room to bring to a large container on the other side. Try using a very large container with a small opening so that they need to push the bags inside. Then when the activity is finished your child might enjoy having the bags dropped on them while sprawled on the couch or floor.
4) Create an obstacle course with trampolines, boxes to step in and out of or bolsters to crawl over as they move the weighted objects.
5) Set up so that objects are moved back and forth from the floor to higher surfaces in order to provide that high/low vestibular stimulation.
6) Provide a shoulder bag or backpack to help gather the objects and bring back to the container for insertion. You can see in the video that that can be quite challenging in and of itself!
6) Try counting the weighted objects or attach pictures, letters numbers or words  on them to identify or read.  Sensory motor activities are a great time to teach academic concepts!

Source: Sensory-Motor Activities for Individuals with Autism by RecyclingOT

Remember: It does not require a lot of space or money to create a fun sensory environment! Learn more at

Wednesday, March 14, 2018

"Success-Only Activities" Help Develop Hand Skills

I describe in my book From Flapping to Function: A Parent's Guide to Autism and Hand Skills, a teaching strategy that I call "Success-Only Activities".  This means that the activity will work only when done correctly. Many years ago, I started a position at a day program training adults with developmental disabilities and noticed that some of the clients had goals such as naming or matching colors.... for years if not decades!!!! I immediately set about creating realistic goals given the client's cognitive level and sensory motor skills.
I designed the ring stacks shown above so that the red rectangular shapes only fit over the red rectangular stack and the blue triangular shapes only fit over the blue triangular stack. This is a 'success only activity" because the shapes will only fit and go down when the shapes are matched AND the colors will automatically be correct. The user may or may not learn color matching, but this is a great way to introduce the concept.  This illustration and a more detailed description is found in my book: The Recycling Occupational Therapist. 

Here are a few more example of easy to make shape sorters and ring stacks that require the child or adult to correctly orient the pieces to fit. Notice that the little boy is only working at orienting the blocks rather than using a traditional baby shape sorter. He has visual-perceptual delays and the shape sorters sold for babies have too many shapes and openings to match up. It was challenging enough to work on only the square shape.  Next he worked on fitting dominoes into a rectangular opening. This was a bit more challenging than inserting a cube shape.

The little boy in the photo below must orient the rectangular rings to fit over the sword. I cut the rings out of detergent bottles. I bought the sword at the dollar store. Notice how he has such nice visual attention while using his hands together to stabilize the sword.

The ring stack with the triangular shape was made by using triangular shaped cardboard packaging and covering it with contact paper. I cut out lots of red circular and blue square shaped rings but only the yellow triangular rings will fit on the stack. Therefore, children will be automatically correctly matching yellow if they are able to push the yellow rings down the yellow stack.

The coin insertion bottle shown below is designed to teach coin discrimination. I provided a pile of quarters, pennies and nickels. The slot in the bottle is large enough for the pennies to fit inside. The quarters and nickels are too large to fit and there are no dimes since they are  small enough to fit. This is a great way to teach children to think about the size of the coin before attempting to fit them into the slot and to discriminate pennies- the only coins that are a coppery color. After children learn to select and hopefully identify pennies, try providing only nickels and quarters with an opening just large enough for the nickels to fit through.

I have used this "success only" adaptation with a woman with developmental disabilities who rapidly pushes objects into openings without considering size, shape or color.

The picture at the bottom of this post shows a pile of pennies and little green plastic rings. I punched holes in the rings. The green rings can be strung onto the cord and are too large to fit inside the slit in the bottle. The pennies obviously cannot be strung!

I used this "success only task" to teach the client to slow down and think about whether to push the round object into the container slot or string it onto the cord.

 I provided enough assistance with point cues so that she would not get frustrated during the learning process. then she was able to work on this independently, allowing the activity rather than me to give feedback on what works and what needs to be tried a different way. This nonverbal aspect of using success only activities is often very appealing to individuals on the autism spectrum who perhaps prefer visual cues.  

We can also set up situations to teach cognitive concepts. For example,  provide an egg carton with 12 egg sections. Provide a large bowl of plastic Easter eggs or other objects. Then ask the child to count out 12 objects while placing each in a section. The child may have difficulty counting correctly to 12 but after filling each section, will automatically be successful at counting out 12 objects.  Provide lots of praise for this success!

Now its video time! The children in the video must position the cones correctly in order to succeed in stacking them......

Source: Occupational Therapy Cone Activities * by RecyclingOT

Source: Occupational Therapy Cone Activities * by RecyclingOT              

The child must choose the correct shape opening in order for the shapes to fit. Notice how effect it is to use with a motor inside!

Source: Velcro Bottles for Individuals with Developmental Disabilities by RecyclingOT

After unscrewing the covers, the individual must match the sizes correctly in order to insert them in the round and oblong slots.

Source: Matching Lids Sensory Activity by RecyclingOT

Source: Matching Lids Sensory Activity by RecyclingOT

The clients are matching pictures, but they also have the physical cues to help them. The pictures will only fit inside the matching rectangular, round or square form board openings. This is a fun way to teach picture matching.

Source: Form Board Picture Activity for Individuals with Developmental Disabilities by RecyclingOT

Tuesday, February 27, 2018

Strengthening the Tripod Fingers for Handwriting

The Tripod Grasp, as the name implies involves grasping a writing tool using three fingers, which likens it to the three-legged device that stabilizes a camera. The tripod grasp is considered the most efficient for pencil control and endurance. However, developing the tripod grasp is a gradual process beginning with fine-motor activities that strengthen the "tripod fingers"- the index, middle fingers and thumb. 

Typically developing children between 1 and 1 1/2 year grasp a pencil inside the palm. Between 2 and 3 years of age they begin grasping it with all the fingers and thumb facing downward. By 3 years of age they typically begin grasping near the pencil point between the index and middle fingers and thumb- forming a tripod. Over the next years of practice the tripod grasp refines so that the pencil is held with greater precise and control.

Strengthening the "Tripod Fingers"

Here are just a few activities that  develop coordination and finger strength as children  press or squeeze between these fingers.

1) Pushing pennies or buttons into a slot in container lid or opening in a tennis ball
2) Pushing pegs into a Lite Brite Board
3) Removing tiny objects from putty or clay.
4) squeezing clothes pins or chip clips. The little girl in the photo is removing squeeze pins from a horse's mane.
5)  Use of tongs to pick up small objects, the game Operation uses tongs.

One of the easiest strategies is to provide thick, short crayons to grasp. The child will have to grasp using the fingers as opposed to grasping a marker inside the palm. Wiping a dry erase board with a small rag and erasing pencil marks with a kneeded eraser also strengthen the tripod fingers.

The following videos demonstrate a few of my home made manipulation tasks that strengthen the "tripod fingers".  But there are also lots of activities and toys on the market that develop these skills.  Here are a few more:
1) Dressing dolls with fasteners
2) Coloring with a small crayon over sandpaper or raised textures. It will take force to make the textures show up on the paper.
3) Weaving, lacing and stringing beads
4) Screwing/unscrewing nuts and bolts or containers with caps
5)  Legos, Tinker Toys, Knex and other construction toys
7) ripping paper or fabric for arts and crafts projects

Source: Strengthening the Tripod Grasp Fingers by RecyclingOT

Source: Strengthening the Tripod Grasp Fingers by RecyclingOT

Source: Make-Your-Own Lacing Cord Activities by RecyclingOT

Working in the Vertical Plane

One easy strategy that occupational therapists frequently recommend is to adapt activities to play and work on vertical surfaces. You can see in the above photo that the Lite Brite toy is perfect for this.  Coloring and writing on vertical surfaces puts the wrist in the best anatomical position (wrist extension) for pencil control.  Here are a few, fun vertical plane activities for young children:
1) coloring on a large, refrigerator size box
2) use of white and black, felt boards on the wall.
3) attach a Lego board to the wall
4) Paint on large easel or paper on wall
5) bathtub paint to use on tub walls
6) paint the house, shed or garage with water and brush

Source: Bottle Coloring and Erasing to Develop Pencil Control by RecyclingOT

Source: Recycling Occupational Therapist demonstrates Fidget Spinner by RecyclingOT

Friday, February 23, 2018

Adapting Ring Stacks with Small variations Builds Fine-Motor Skills

Rings stacks can be extremely simple, yet adapted to teach many skills. Typically developing babies often play with the popular nesting ring stacks during their first year.  A ring stack can be as simple as a tube wedged inside a container so that rings can be placed on top and not fall off.  I have used my own arm as a ring stack during therapy and the Princess Wand shown below. I love using the wand with children because after they release the ring, I can activate it to flash lights, make sounds and vibrate. These types of sensory rewards can be very motivating when trying to engage children with attention challenges.
I cut the ring shown in the photo out of a detergent bottle.

The ring stacks shown below demonstrate just a few ways the common ring stack can vary.....
1) they may require nesting by size, largest to smallest or not require size discrimination at all because the rings are the same size
2) the rings and stack may be made out of plastic, wood, soft vinyl or fabric-providing different tactile  sensory experiences.
3)The rings may be designed to squeak when squeezed
4) made out of a material safe for a baby to mouth and
5) the ring stacks may vary in the number of rings nested; of course the greater the number of rings- the more complex.

Ring stacks teach spatial relationships-how objects fit together and children build on these skills as they fit complex shapes into shape sorters and fit their feet into shoes. I have found it very helpful to explore adaptations to ring stacks when working with children and adults with disabilities. I can make rings to be as large as necessary to compensate for decreased eye hand coordination.  The little boy in the photo is placing rings on top of a cat toy. The mouse is on a spring and squeaks when moved. He was motivated to engage in order to hear the mouse.

The ring stack made out of a toy sword (I bought this one at a Dollar store)  requires stabilizing with one hand while placing the rings. The child in this photo is visually attending better than usual because  he is reaching and stretching, getting some movement sensory stimulation while engaged in stacking the ring.

In addition, I cut these rings in a rectangular shape so that he must orient the shapes to fit onto the sword. this adds a higher level cognitive demand.

I often adapt tall ring stacks to use with adults to promote visual attention and an upright posture.  The following videos demonstrate a few more variations. The Frisbee Ring Stack requires using force, so the resistance provides sensory stimulation and builds strength.

Source: Sensory Frisbee Ring Stack by RecyclingOT

The bilateral ring stack encourages people to use both hands together, developing bilateral coordination. The one shown in the video makes a beep when they press down hard. I attached a squeaky toy to the bottle so that they have to push down using force to make it squeak. Many children and adults with developmental disabilities, including autism spectrum disorders enjoy the proprioceptive sensory stimulation to muscles and joints as they use force.

Source: Bilateral Ring Stack for Individuals with Developmental Disabilities by RecyclingOT

The stretchy cord ring stack requires pulling the ring shapes that are attached to cord and then stacking them onto the stacking piece in the center. It provides a great deal of sensory stimulation as they pull and even more when the ring stack consists of a motorized toothbrush.

Source: Stretchy Cord Ring Stack for Individuals with Developmental Disabilities by RecyclingOT

The Twirly ring stack takes a great deal of motor control to place and release the rings. Many of my clients with autism enjoy watching the shapes spiral downward.

Source: Visual Stimulation Ring Stack for Individuals with Autism by RecyclingOT

The curvy ring stack made out of a bird mister provide a different type of visual sensory stimulation, reaching and requires using hands together to coordinate placement.

Source: How to make this helpful toy for children with autism by RecyclingOT

Ring stacks can be straight or curve such as the  "candy cane " ring stack shown in this video. It vibrates making it especially motivational fun and sensory based.

Source: How to Make Vibrating Candy Cane Ring Stacks for Children with Autism by RecyclingOT

Many of my clients with developmental disabilities love the paint roller ring stack. It feels great to roll between placements. It also develops motor planning skills because it can be tricky to make the rectangular shapes fit and go down this ring stack.

Source: Paint Roller Ring Stack for Children with Autism by RecyclingOT

This is just a sampling of some adaptations I have made by using the simple, familiar skill of placing a ring over a stack and adding challenges that motivate, meet sensory needs and build hand skills. Check out my books to learn more.....

Saturday, February 17, 2018

Visual Stimulation Activities that Help Individuals on the Autism Spectrum

Children and Adults on the autism spectrum often love visual stimulation. They may seek it out by staring at moving lights or flapping their hands near their face. The following  activities are designed to provide visual sensory stimulation that people seek while at the same time promote
1) using hands together (bilateral coordination)
2) visual skills such as tracking or convergence
3) Motor control
4) social skills when used with a partner

Fidget Spinners

Fidget spinners have been very popular over the past year. Some children find them calming and since they are motivating, they can be used as a reinforce (a reward) after completing a task... perhaps homework or a chore.

The video demonstrates a few ideas on how to utilize this motivating toy to develop grasps to effectively use scissors and pencil.  At the same time children receive the pleasure of visual stimulation as they watch it spin...

Zoom Ball 

Zoom ball develop coordination and motor planning as players alternate moving arms apart and together. As players maintain their gaze on the moving "ball" their visual system is stimulated. Their eyes converge as the ball moves toward the face and diverge as the ball moves away from the face. Developing these visual skills help children to keep their eyes on a ball and other objects during sports games.  The video demonstrates how to make this game. 

Spiral Ring Stack 

This is a fun visual activity that also develops motor control. The rings are positioned at the top of a spiral shape and then when released they rapidly spiral downward.

These are easy to make but you have to buy the helicopter toy (see amazon link below) to get the plastic piece that the rings spiral down. Wedge the spiral piece inside the top of a bottle. You may need to cut a small hole inside the bottle cap and then wedge it inside and secure with tape. 
Cut lots of pretty, colorful plastic shapes from containers or lids and then cut a small notch in the center. 

Some individuals who seek visual stimulation really like this- it meets their sensory needs....

Source: Visual Stimulation Ring Stack for Individuals with Autism by RecyclingOT
Source: Visual Stimulation Ring Stack for Individuals with Autism by RecyclingOT

Spiral Ring Stringing

The young man shown in the photo is stringing small rings onto the tip of a water hose coil. He enjoys watching them spiral downward.  I attached a bean bag to the bottom so that he can stand on it while pulling the coil upward. The pulling upward provides additional sensory stimulation to his muscles and joints and develops balance. 
He really enjoys watching the rings spiral down. This seems to be relaxing and decrease agitation. 

Source: Sensory Processing Disorder Activity: Stringing Coiled Hose by RecyclingOT

There are lots of tracking tube toys on the market. I made this one by twisting a coat hanger into a spiral shape. I pushed the hanger through the clear plastic tube, added some marbles and covered the two ends. This makes a cool sound as well as providing visual stimulation. In addition, if you wedge the tube inside a box or bottle you can use it as a ring stack.

I bought this tube at a hardware store. They were sold to hold the long florescent light bulbs and were only a couple of dollars.

I include a few Amazon links to products described in this post. If you order on AMAZON through my links, I make a few pennies....


Tuesday, February 6, 2018

Simple Weaving Shapes for Children with Autism or other Disabilities

Weaving is the process of interlacing threads by going over and under each other. I use a similar process when I cut slits in a plastic shape and "weave" a longer strip through it. This photo shows my son holding one I made over 20 years ago!

I realized that if I make one end a bit bigger, the insertion strips will look like lollipops and when pulled in place tightly, won't slip through the notches and come out easily.

This activity continues to be easy to make and beneficial when used at work with adults with developmental disabilities. However,  young children with or without disabilities will reap the benefits of watching you make this manipulation activity to use at home or for therapy.

Weaving the shapes together
  • strengthens hands and fingers
  • promotes bilateral hand use
  • develops eye-hand coordination 
  • teaches the spatial relationships of going in and out, over and under... 
  • may involve color and/or size matching
  • provides a repetitive fine- motor task that some individuals will find relaxing
Taking the pieces apart is easier than putting them together and some individuals may only learn this aspect of the task.  Use thicker, stiffer plastic if you want th
e person to use force.  This makes the activity "resistive" and provides sensory stimulation to muscles and joints. Try using the vibrant, strong plastic from coffee containers, plus it smell great! See the Amazon links below.

One of my clients loves to rip paper, especially cardboard. Pulling these shapes apart to push into a small container lid opening appears to meet her sensory needs.
For some clients-I may choose to use a container with a large opening so that insertion is easy. Over time I may add a lid with a large slot opening and eventually use a more challenging lid with a thin opening so that force is required to push the shape inside.

Notice that the individual in the video must pull the pieces apart or they will NOT fit into the slot. There is some built-in problem-solving required in order to be successful.

Also notice that I positioned the container next to the pink vibrating cushion so that he can feel the vibration while working.  You may choose to put some type of vibrating object inside the container. Either way vibration often motivates children or adults with disabilities to engage in hand activities.   

Source: Simple Weaving Shapes for Children with Autism by RecyclingOT

 Placing or removing the worms from the apples works on similar fine-motor skills. However, the openings are quite large and force is not required.... Fall is a great time to incorporate this pretend play into your hand activities.....
Source: Make Your Own Apple Toys for Preschoolers by RecyclingOT

Another option is to attach or remove arrows from valentines. I love the creative options when creating my own materials and your children or clients will, too ❤

Source: Make-your-own Valentine Hearts and Arrows by RecyclingOT

Don't have time to make toys?

Saturday, January 27, 2018

Sensory Pill Bottle

 I discovered that pill bottles fit nicely into the openings of desk file organizers. In fact, they fit perfectly, requiring some force to push them all the way in or pull out. Using force means that this activity is "resistive" and many individuals with developmental disabilities respond well to the sensory stimulation to muscles and joints when there is resistance.

This activity develops coordination,  hand strength and motor planning skills. Notice how one client in the video is using trial and error to figure out how to get the bottles out.

Another client brought the materials close to his face because he is visually impaired and he liked shaking and tapping the bottles  in order to hear the contents.

I put various auditory objects inside such as marbles, pennies, beads, dried lentils etc. Then closed them well (they are after all medication bottles) and secured again with duct tape. This was a great activity for the clients who rush through tasks ... they need to focus and persist in order to complete this task.

Source: Pill Bottle Sensory Activity by RecyclingOT on Rumble

The organizers I used look somewhat like this but check to see if your pill bottles can be inserted......

Tuesday, January 9, 2018

Make- It- Yourself Zoomball

"Zoom Ball" also known as "Forward Pass" is a commercially available toy that involves 2 players.  Each player grasps a handle in each hand alternating opening arms apart and bringing them together. When player A moves arms apart the "ball" shoots across to player B who has hands together. Then player B moves arms apart so that the "ball" shoots across to player A (who has hands together). The players repeat as long as strength holds up and they are having fun...   This is what the commercial toys look like.....

I prefer to make my own because:
1) I can use any length cord I choose; the shorter the cord the easier to play
2) I think that the handles are much more comfortable
3) It is recycling something plastic
4) and of course, it is FREE !!!!

Materials used are:
1) nylon cord
2) 4 detergent bottle handles
3) 2 soda bottles
4) duct tape

I demonstrate how to make a zoom ball the video. You may also like to simply use what I call a "batter". After connecting the 2 soda bottles,  one player may use it to push a ball across the room or bat at a suspended ball.  The soda bottle spouts function as handles.
The boy in the photo is actually on top of a scooter board that you can't see and he pushes the ball, scoots toward it and repeats. We did this during an occupational therapy session. Two players can turn this into a back and forth push the ball game......

The bottom photo shows a close up of the cord attached to a handle. 

A few of the many therapeutic benefits of Zoom Ball: It promotes

1) visual attention, tracking, convergence and divergence
2) bilateral coordination
3) strong shoulders, neck, arms and grasp
4) sensory stimulation as played in a variety of positions
5) motor planning, rhythm
6) social skills, working with a partner, turn taking
7) endurance and persistence as player recites the alphabet  or counts to 100.
8)  exercise......

1)Play while kneeling
2) use feet instead of hands
3) face away from each other.....

Source: Make Zoom Ball for Individuals with Autism by RecyclingOT on Rumble