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Monday, November 26, 2018

Children with Sensory Processing Disorders and Hand Preference

Excerpt from From Flapping to Function: A Parent's Guide to Autism and Hand Skills. 

Most typically developing children show a preference for one hand or the other by the time they enter kindergarten, although it is not abnormal to develop hand dominance as late as six or seven years of age.
  •     Hand dominance is the result of brain specialization so that the hand opposite the dominant brain hemisphere develops great skill. 
  Children develop coordination between the right and left sides of the body when the right and left halves of their brain- called the brain hemispheres- are communicating efficiently.  Many children with Sensory Processing Disorders (SPD), especially those with dyspraxia, have difficulty with coordinating the two sides of their body, especially to perform complex tasks such as braiding hair or knitting. Because the right and left halves of their brain may not communicate well, these children may develop hand dominance (right-or left-handedness) at an older age than is typical, or not at all.  

Let's take a brief look at the relationship between brain hemispheres and hand dominance. Each hemisphere controls the opposite side of the body-the left hemisphere controls the right side, and vice versa. One hemisphere of the brain is typically dominant and people develop greater skill on the body side opposite the dominant hemisphere. Thus, someone with a dominant right hemisphere is typically left-handed. Most people are right-handed, have greater skill on the right side of the body and have a dominant left hemisphere. 

The person reaching for pictures in the top photograph demonstrates a  right hand preference because she consistently uses it to reach across her midline and to perform skilled tasks such as fitting shapes into form boards.  She also tends to avoid using her non-dominant left hand unless she really must-another characteristic sometimes seen in people with SPD. 

  • Midline  is an imaginary line that runs down the center of the body, dividing it into left and right halves or sides.  
The term hand preference is sometimes used to mean hand dominance. However, hand dominance is the result of brain specialization. This means that certain skills- like language- develop in one hemisphere rather than the other and that one hemisphere becomes dominant with the opposite side of the body becoming more skilled. 

  • The term hand preference is sometimes used to mean hand dominance. 

The preferred or dominant hand is often stronger, as well as more skilled at performing tasks such as controlling pens, scissors, tweezers or a sewing needle. 

There are other reasons why a child may prefer one hand over the other. For example, Thomas may be left-handed but use his right hand to cut because he was given right-handed scissors or he imitated his right-handed teacher.  Some children switch hands when one hand gets tired or when they are searching for a more comfortable way to grasp a tool. Modifying tasks may help them to use their dominant hand consistently. For example a fat piece of chalk that is easier to grasp may reduce hand switching due to fatigue.  

It is important to develop hand dominance because using the same hand consistently for specific  tasks helps develop proficiency. Try writing with your non-preferred hand and you can see what I mean! 

Some children develop what is called crossed or mixed dominance. This means that they use different hands for specific skills. For example, Claude became adept at using his right hand to write and his left hand to throw a ball. This was not a problem because he practiced each skill consistently with the same hand. Thus, he became very good at throwing with the left hand and writing with the right.  

Many children with SPD  also avoid reaching across midline, or even bringing their hands together at midline.  Learn why this is an important skill to develop in my post...  The Importance of Crossing Midline for Children with Sensory Processing Disorders

Children with poor coordination between the right and left sides of the body may also have difficulty using their hands together to stabilize materials and to discriminate right from left.

The following videos demonstrate a few strategies to
  • promote right left side coordination
  • promote crossing midline
  • learn to discriminate right and left  
  • develop an awareness of which hand feels stronger, more coordinated and comfortable  
Velcro bottles are difficult to use unless stabilized with one hand, usually the non-preferred hand.  Pulling Velcro objects off backings requires force and using force provides proprioceptive sensory stimulation to muscles and joints. Encourage your child to use the same hand consistently to remove the objects and the other hand to stabilize.

Source: Velcro Bottles for Individuals with Developmental Disabilities by RecyclingOT

As this video demonstrates, children pull using force and using force provides sensory stimulation. Ask your child to think about which hand is stronger while pulling and which hand gets tired more quickly.

Source: Sensory Pull Bottle Helps Children with Autism or sensory Processing Disorders by RecyclingOT

Talk to your child about the "worker hand" and the "helper hand" and refer to them as either right or left respectively. Position materials so that they cross midline to retrieve them with the hand identified as the more comfortable "worker hand".  

Don't forget to make Developing Hand Skills Fun !

Source: Recycling Occupational Therapist demonstrates Fidget Spinner by RecyclingOT

Tuesday, November 13, 2018

Screw Cover matching Activities that Develop Fine-Motor Skills

Screwing and unscrewing covers to bottles and other containers is a great way to develop manipulation skills!

There is an unlimited supply of plastic containers from detergent, dishwasher soap and juice bottles available to make these activities.

I cut around the threaded pouring spouts and saved the lids so that young children with or without disabilities or adults with developmental disabilities can match by size and then screw the pieces together.

The yellow covers shown in the photo screw onto white threaded  containers used for Thick-it. Many of my clients have their drinks thickened with this product. Sometimes the threaded pieces are the same color as the caps so that children can match both size and color at the same time.


This activity may be used as a simple single- step matching cover to threaded piece activity without inserting them into containers.

 It is generally easier to motor plan the motions to unscrew than to screw the pieces together. So you may set the activity up to separate them before teaching how to screw them together.

Create a 2 step task by requiring the child to insert the covers into container openings.  The threaded pieces may function as rings to stack on a ring stack. .

At first, choose larger materials that are easier to manipulate. As skill develops use smaller caps and threaded pieces... perhaps from juice bottles.

You may choose to have only 2 or 3 different types of  sizes to match and then increase the challenge as skill develops.

The client removing the yellow covers has limited visual perceptual skills, so I provided a container with only one opening and all of the yellow covers can fit inside.

 In the following video, there are so many different sizes that even I found it a challenge to match them! So I numbered the covers to match the threaded pieces and it turned out to be a hit!

I discovered that my clients really enjoyed having the threaded pieces organized on a long strand of fabric or cord.

Cut 2 holes in the threaded pieces to string these in sequence. Children can work on matching and sequencing skills as they develop eye-hand coordination.

You may choose to match and sequence these in alphabetical rather than numerical order. Some children or clients m ay best match simple shapes or pictures drawn or glued onto materials.

Source: Matching Numbers Screw Cap Activity to Develop Fine- Motor Skills by RecyclingOT

This activity may also be adapted to be performed while sitting, standing or moving across the room to retrieve materials. Moving from high to low and back provides not only aerobic exercise but vestibular sensory stimulation. Many children or adults with sensory processing disorders will appreciate the movement sensory stimulation that may decrease anxiety or agitation.

Reaching high up is great for developing posture and visual attention since the materials are right in front of the person's face.

The individual in the green shirt has cerebral palsy and avoids using his left hand. However, he was so motivated to work on matching and unscrewing - he stabilized the threaded pieces - and worked with a smile!

Source: Unscrewing Bottle Caps to Insert or Stack by RecyclingOT

This gentleman is blind and enjoyed working on a book stand that has the threaded pieces attached. A maintenance man at work drilled holes into the bookstand so that I could attach string to tie pieces onto.

A container with  2 different shape openings turns this into a simple shape sorter after the covers are unscrewed.....

Another option is two attach materials to the sides of a large container used for cat litter a bucket.

Source: Matching Lids Sensory Activity by RecyclingOT

I share the links to demonstrate the products that come in the containers I like. If you shop on Amazon through any of these links, I earn a few pennies.....

However, obviously, I prefer to recycle!