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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).

I include my affiliate Amazon link, so if you start out shopping from the page below, I earn a few pennies.... how nice !

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 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....

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 !!!

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...... 




Wednesday, August 6, 2014

Pushing Ball to hit Beeper

I love this adapted bowling alley. I don't have pins to knock over but I recently added a switch that makes a beep. I use balls that make sounds, vibrate or look cool, attach them to Velcro so that individuals with minimal motor control can give them a push....

Source: Bowling for Children Who are Unable to Grasp by RecyclingOT

Monday, August 4, 2014

Motor Planning Ring Stack made using Silly Straws

These crazy straws add fun and challenge to people who have pretty good fine-motor control. This woman is blind and has very good motor control.  I thought that she would find this too easy or childish and I know that she prefers to simply socialize..... but she liked it.                                                                                                     I put a couple of water bottles inside an oatmeal container to make it heavier and stable. Pushed a couple of straws inside and taped all in place. I originally made this for someone who might like to color match the red and green circles to the straws.But since she can't see, I will make another one for her with only one straw.  The straws cost 6 for a dollar, so I can make several of these activities for pennies.....

Motor Planning

Friday, August 1, 2014

Activities For Person who has Tremors

My company was given some fantastic large book stands.

 I made the button board from an old tent was husband was about to throw away. I cut the blue tarp from the tent, folded it and taped on the edges so that it slips over the book stand. I placed small pieces of Velcro near the bottom to keep it all in place.

I cut the "buttons" from container lids and detergent bottles and then punched the holes and sewed them onto the blue tarp. The last step is to cut some fabric pieces with slits to button or unbutton on the board.

I am working with a man who has tremors and better motor control when pushing or pulling against a stable surface.  He seemed to enjoy removing the fabric pieces and pushing them into a container. He was also able to press down on the hole puncher as shown in the video. Of course, I am also exploring use of a weighted spoon, wrist weights and other materials that are resistive, but wanted to share these...

 It took me about 1 1/2 hours to sew the circles onto the blue tarp but it saved me about 1,000 calories of snacking.

Source: Fun Activities that Develop Buttoning Skills by RecyclingOT