Tuesday, January 29, 2013

Sporting Opportunities at School for Students with Disabilities

The US Department of Education, Office of Civil Rights, has issued a letter based on a report performed by the United States Government Accountability Office (GAO) which highlighted that access to, and participation in, extracurricular athletic opportunities provide important health and social benefits to all students, particularly those with disabilities. The letter provides an overview of the obligations of public elementary and secondary schools under Section 504 and the Department’s Section 504 regulations including:
  • an overview of Section 504 requirements
  • informs school districts not to act on stereotypes or generalizations
  • provide equal opportunity for participation
  • offer separate or different extracurricular activities if necessary
You can read the entire letter at the Department of Education

Here is my summary on the letter:
1.  Coaches are not allowed to exclude a student due to a disability based on the coaches stereotype or generalization of how a certain disability presents itself.

2.  Schools must make reasonable modifications.  If aids and services are necessary to ensure an equal opportunity to participate the school district must allow it.  The exception is if the school district can show that doing so would be a fundamental alteration to its program.

3.  Schools do not have to include all students on any team.  But, if the student has the skills to make the team you can not exclude the student based on a disability.  Basically the school has to make reasonable accommodations if necessary for the student to participate. 

4.  If a student with a disability can not participate in the school's extracurricular programs even with modifications, a school district should offer students with disabilities opportunities for athletic activities that are separate or different from those offered to students without disabilities. These athletic opportunities provided by school districts should be supported equally, as with a school district’s other athletic activities.

5.  Recommendations to collaborate to create regional teams, male/female teams or unified sports teams (teams including students with and without disabilities).

Do any of the schools where you work or live pay for extracurricular activities for students with disabilities for those that can not participate on the school team even with modifications? 

Reference:Seth M. Galanter, Acting Assistant Secretary for Civil Rights. Dear Colleague Letter. Retrieved from the web on 1/28/2013 at http://www2.ed.gov/about/offices/list/ocr/letters/colleague-201301-504.html 

Monday, January 28, 2013

Fingertip Tripod Grip Dot Markers


Make these resusable fingertip dot markers for about $2 using furniture tips and small sponges.  The furniture tips come in different diameters so you can vary the size based on the child's abilities and hand size.  Watch the video on how to make them and see them in action at YourTherapySource.  The printed sheets in the video are from DOT Letters and Shapes ebook.   

Friday, January 25, 2013

Disorganization, Coordination Disorder and ADHD


The Journal of Child Neurology published research on the association of attention deficit and disorganization in boys with and without specific developmental disorder of motor function. The study included four groups of 120 boys ages 7-12: 1.) disorganization plus coordination 2.) coordination disorder 3.) disorganization 4.) control.

 The results indicated a significantly increased rate of attention deficit in children with organizational deficit. Attention deficit in children with specific motor disorder was exclusively associated with an organizational deficit.

Reference: Nirit Lifshitz, Naomi Josman, and Emanuel Tirosh Disorganization as Related to Discoordination and Attention Deficit J Child Neurol 0883073812469295, first published on December 26, 2012 doi:10.1177/0883073812469295

Thursday, January 24, 2013

Achondroplasia and Gross Motor Skill Development


The Journal of Paediatrics and Child Health published research on the gross motor skill development of children with achondroplasia.  A population based study was done on children with achondroplasia ages 12 months to 48 months in Australia and New Zealand from 2000 through 2009.

The results indicated that children with achondroplasia exhibit delays in gross motor skill acquisition although within group differences in height, weight and head circumference (or relationships between these factors) do not appear to influence gross motor skill development before 5 years of age. The only exception was supine to sit transitioning, which appears likely to occur earlier if the child is taller and heavier at 12 months, and later if the child has significant head-to-body disproportion.

 Reference: Penelope Jane Ireland, Robert S Ware, Samantha Donaghey, James McGill, Andreas Zankl, Verity Pacey, Jenny Ault, Ravi Savarirayan, David Sillence, Elizabeth Thompson, Sharron Townshend and Leanne M Johnston The effect of height, weight and head circumference on gross motor development in achondroplasia. Journal of Paediatrics and Child Health. Article first published online: 22 JAN 2013 | DOI: 10.1111/jpc.12078

Tuesday, January 22, 2013

Exercise Program for Non Ambulatory Children with CP


Clinical Rehabilitation published research on 35 children with a gross motor classification system levels IV-V who participated in a 6 week exercise program.  The subjects were randomly placed to participate in a stationary bike group, treadmill group or control group.

After the 6 week intervention significant differences were found in GMFM-88D scores between the bike group and the control group, and the treadmill group and the control group. No significant differences were found for GMFM-66 or GMFM-88E scores between the bike group and control group, or the treadmill group and control group, although improvements were noted for both exercise groups. No improvements were seen during the follow up period.

The researchers concluded that exercising on a bike or a treadmill may produce short term improvements in gross motor skills for children GMFCS Levels IV-V.

 Reference: Elizabeth Bryant, Terry Pountney, Heather Williams, and Natalie Edelman Can a six-week exercise intervention improve gross motor function for non-ambulant children with cerebral palsy? A pilot randomized controlled trial Clin Rehabil February 2013 27: 150-159, first published on July 30, 2012 doi:10.1177/0269215512453061

Monday, January 21, 2013

Free Football Game for OT, PT or Speech Activities

Here is a fun, football themed activity for some therapy carry over or during a session.  Create your own 6 activities to see who will win the game.  Download the printable, blank footballs and directions at Your Therapy Source Inc.

Thursday, January 17, 2013

Wiihab and Balance

A recent study was published in Developmental Neurorehabilitation regarding the use of the Nintendo Wii to improve balance, motivation and function in children participating in acute rehabilitation following acquired  brain injury.

A multiple baseline, single study research design was used with three subjects who received daily Wii balance training.  The results indicated that two participants were equally motivated by traditional balance training and one participant was more motivated using the Wii.  Improvements were seen in dynamic balance and functional ability.  The results for static balance were inconclusive.

The researchers concluded that using the Wii is a safe and motivating tool for balance therapy for children with acquired brain injury.  Further research was recommended  regarding the use of the Wii for balance therapy.

Do you use the Wii in therapy sessions?  I have before and wish I could bring one with me for so many students that I see, particularly older students.

Here are the positives:

  • The motivation level is high
  • there is wonderful visual and occasionally tactile feedback
  • challenges motor planning skills
  • excellent feedback for weight shifting of the lower extremities
The negatives are:

  • motor planning skills can be very challenging for some children on certain games
  • difficult to travel with as a school based therapist
  • cost for the entire system is a bit pricey if you are paying out of your own pocket
I have considered putting together a Wii kit to include a small television or monitor, the Wii and the Wii Fit balance board.  If I tossed it into a small suitcase on wheels I could transport it to different schools.  Perhaps I will look for a second hand television set and Wii (now that the WiiU has come out I am sure there are plenty of people willing to unload the old Wii for cheap).  The Wii can be set up in a snap (unlike the Kinect that takes some time to calibrate to the room you are playing the game in).  I will be keeping my eyes out.

So back to the question do you use the Nintendo Wii in therapy sessions?      

Reference:Wii-habilitation as balance therapy for children with acquired brain injury Sandy K. Tatla, Anna Radomski, Jessica Cheung, Melissa Maron, and Tal Jarus Developmental Neurorehabilitation 0 0:0, 1-15 doi=10.3109%2F17518423.2012.740508

Wednesday, January 16, 2013

Weighted Vest and Challenging Behaviors

Developmental Neurorehabilitation published a single case study that analyzed the effects of a weighted vest on the aggressive and self-injurious behavior of a young boy with autism. An ABAB design was used where the boy wore a 5 pound weighted vest or no vest. The results indicated that the weighted vest had no marked effect on levels of aggression and self-injurious behavior in the young boy with autism.

This study caused some interesting discussion across some social media outlets.  Some therapists felt it adds to the growing body of evidence that weighted vests are not an effective tool for sensory motor or behavioral outcomes.

Other therapists felt that using a weighted vest is beneficial for some children as indicated by increase in attention to task or a decrease  in certain behaviors.  Just as this study was a single case study design some therapists have seen success with certain students.

What is your opinion?  Do certain children benefit from the use of weighted vests?    

Reference: Tonya N. Davis, Sharon Dacus, Erica Strickland, Daelynn Copeland, Jeffrey Michael Chan, Kara Blenden, Rachel Scalzo, Staci Osborn, Kellsye Wells, and Krisann Christian. The effects of a weighted vest on aggressive and self-injurious behavior in a child with autism.  Developmental Neurorehabilitation 0 0:0, 1-6 doi=10.3109%2F17518423.2012.753955

Tuesday, January 15, 2013

Strength, Balance and Mobility in Children

Gait and Posture published research regarding the relationship between lower extremity muscle strength, balance and mobility in 21 children ages 7-10.  Each child's isometric and dynamic strength was tested in addition to their steady-state, proactive, and reactive balance and mobility (single and dual task conditions).  The results indicated the following:

  • significant positive correlations between dynamic and isometric lower extremity muscle strength
  • hardly any association was found between variables of strength and balance/mobility and between measures of steady-state, proactive, and reactive balance
  • no significant correlations were detected between balance/mobility tests performed under single and dual task conditions.
The researchers concluded that balance and mobility performance is task specific. In addition, strength and balance/mobility as well as balance under single and dual task conditions may be independent of each other. Therefore, strength and balance/mobility may have to be tested and trained together.

Reference: Thomas Muehlbauer, Carmen Besemer, Anja Wehrle, Albert Gollhofer, Urs Granacher. Relationship between strength, balance and mobility in children aged 7–10 years. Gait & Posture - January 2013 (Vol. 37, Issue 1, Pages 108-112, DOI: 10.1016/j.gaitpost.2012.06.022) 

Monday, January 14, 2013

Conversation Heart Clothes Pins

Check out these cute conversation heart clothes pins for Valentine's Day!  You can download the printable for free at YourTherapySource.

Friday, January 11, 2013

Development and Plagiocephaly


Pediatrics has published research comparing the developmental skills of children at 36 months with and without developmental plagiocephaly.  Over 400 children were studied by pediatricians and were assessed with the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). The results indicated the following:


  • children with developmental plagiocephaly scored lower across all scales including cognition, language, adaptive behavior and motor skills
  • the smallest difference was seen in motor skills when comparing the two groups
The researchers concluded that since preschoolers with developmental plagiocephaly continue to exhibit deficits pediatricians should screen children for developmental plagiocephaly to encourage early intervention.

Reference:    Brent R. Collett, Kristen E. Gray, Jacqueline R. Starr, Carrie L. Heike, Michael L. Cunningham, and Matthew L. Speltz.  Development at Age 36 Months in Children With Deformational Plagiocephaly Pediatrics 2013; 131:1 e109-e115; published ahead of print December 24, 2012, doi:10.1542/peds.2012-1779

Wednesday, January 9, 2013

Participate in National Handwriting Day


National Handwriting Day in January 23, 2013 so why not participate with a special project for the day.  Here are a few suggestions:

1.  Create some handwriting art - Practice writing your signature on one piece of paper using various mediums such as crayons, pencil, colored pencil, pens, markers and watercolors.  Want to work on more handwriting than just your signature?  Copy a favorite quote in your best handwriting and frame it.  Give it as a gift.

2. Print and hang up this infographic (http://www.coursehero.com/blog/2011/10/19/infographic-write-it-down/) in your school on why it is still important to write things down when taking notes in school. This will help to educate school staff on the benefits of handwriting.

3.  Give a quick presentation on the brain based benefits of handwriting.  There is plenty of information to start with in this article from the Wall Street Journal - http://online.wsj.com/article/SB10001424052748704631504575531932754922518.html

4.  Need more inspiration for a presentation?  Read this essay also from the Wall Street Journal (http://online.wsj.com/article/SB10001424127887323530404578203970519252566.html) written by Philip Hensher the author of the Missing Ink.

5.  Participate in Handwriting Without Tears Mail to the Chief campaign.  They have free printables based on grade level (http://www.hwtears.com/sites/default/lpform/mttc2012form.php?pc=website) to help get a classroom or student started on writing a letter to the President.  It needs to be mailed by January 15, 2013.

Need more ideas?  Read a previous blog post from 2010 with ideas for National Handwriting Day.

Monday, January 7, 2013

Handwriting Practice and Visual Perceptual Motor Practice


The American Journal of Occupational Therapy published research that compared two different handwriting interventions.  Seventy two first and second grade students either received intensive handwriting practice or visual perceptual motor activities during a handwriting club for 12 weeks.  The post test results indicated the following:
  • the intensive handwriting practice group demonstrated significant improvements in handwriting legibility 
  • neither group showed significant effects on handwriting speed and visual–motor skills
The researchers concluded that the handwriting club model can be an effective short term intervention for RTI Tier II.

Reference: Tsu-Hsin Howe,Karen Laurie Roston,Ching-Fan Sheu,and Jim Hinojosa. Assessing Handwriting Intervention Effectiveness in Elementary School Students: A Two-Group Controlled Study Am J Occup Ther January 2013 67:19-26; doi:10.5014/ajot.2013.005470  

Wednesday, January 2, 2013

Helping Children with Healthy Resolutions


Here are some ideas to help children create some healthy new year resolutions:

1.  Help children identify a habit or routine that they would like to change.  Only pick one habit or action to focus on that they would like to change.  Perhaps it is to reduce the number of times they participate in a bad habit.  For example, instead of watching television for 2 hours straight without moving, reduce the amount of time to one hour of television.

2.  Encourage children to define a new, healthy goal to achieve during the new year.  Offer some suggestions such as: participating in 30 extra minutes of physical activity per day, eating an additional serving of vegetables per day, exercise during commercials, etc.

3.  Try a new leisure activity that will increase their physical activity time weekly.  Try to think of an activity they can complete on their own without adult.  Use the local library or school library as a resource to teach themselves a new skill.  Rent a video or watch You Tube to learn a new skill such as yoga, tai chi or Zumba.  If available at your school, suggest joining intramurals to test out a new sport.

4.  Create a collaborative poster of healthy resolution ideas.  Print and add to the poster at YourTherapySource.com pictured above.  Children can add their own resolutions or write their names next to ones that are already on the paper.  Save it and see how everyone does when next year rolls around.

  

Tuesday, January 1, 2013

School Based Therapy Resolutions

Since I posted these last year and certainly did not accomplish them all I though it was worth repeating below for 2013.  As I reflect on 2012 some goals were easier to reach than others - as for myself I was able to accomplish #3, #5, #6 and #7.  I definitely need to work on taking the time to observe, #2.  I frequently rush to get to the "meat and potatoes" of a treatment session rather than slowing down and fine tuning my observation skills (this is a bad habit).  So obviously I am not great about being patient, #4 - I tend to jam pack therapy sessions with too many activities.  I really need to slow down and let children problem solve more rather than rush along to the next activity.  I am getting better at this. 

Below are the goals I posted last year - How about setting some basic goals yourself to accomplish in 2013. Here are a few suggestions:

1. Realistic Home/Classroom Programs - I will make every effort to provide parents and teachers with activities that are easy to carry out in the home or classroom.

2. Take the time to observe - I will take the time to just observe. I will document observations in the classroom or home in writing or with photographs. It is very difficult to determine needs if you do not have an idea of baseline issues.

3. Make the children part of the therapy process - I will incorporate the children in each therapy session by allowing them to make choices. I will discuss goal setting with each child.

4. Be patient - I will encourage children to think critically and problem solve independently by allowing them enough time to form a motor response without interfering. Therapy sessions usually only last 30 minutes and we want to jam pack them with activities. Slow down and let the children respond - quality is better than quantity. Let me re-phrase that...independence is better than dependence (regardless of quality at times).

5. Document correctly in a timely manner - I will document therapy sessions immediately following the session so that the documentation is accurate.

6. Set a goal for each therapy session - I will set small, realistic goals for each therapy session.

7. Keep it fun, fun, fun!!!! - I will keep therapy sessions fun. Some children have to attend therapy sessions for years, keep it novel, motivating and fun.

Care to add to the list with your goals for 2013?  I plan on focusing more on #2 and 4 which means I have to be more patient.  Hopefully I do not repeat myself again next year!
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