Thursday, February 28, 2013

Reflective Questions for Motor Learning

How do you provide feedback to children regarding their performance on a motor skill?  Do you provide constructive criticism, positive praise, additional motor commands, additional demonstrations or more trials? Why not ask the child to verbally plan or review their own performance on a motor task.  For example, once you request a motor task to be completed ask an open ended question such as:
  • What do you plan to do? 
Then once the motor skill has been completed ask more open ended question(s) such as:
  • How did you think you did?
  • What could you have done differently?
  • Could you have done anything better?
  • Did you accomplish what you planned to do?
If necessary provide more detailed question(s) such as the following examples:
  • Did you perform the skill fast enough?
  • Did you stay on the line?
  • Did the ball go into the basket?
  • Did you avoid the obstacles?
  • Did you climb to the top?
And don't forget to allow the children 5-10 seconds to answer the question.  

By involving the children in planning and feedback it provides additional input during motor learning trials.

Wednesday, February 27, 2013

Slow Motion - Muscle Strengthening Game

Here is a fun, simple strengthening exercise that requires no equipment - slow motion.  When you slow down a motion it requires more muscle control and a longer muscle contraction.  Pretend to act out the following activities in s-l-o-w motion:

  1. Running a race
  2. Shooting a basketball
  3. Walking up or down stairs
  4. Bicycle riding laying on your back
  5. Ballet dancing
  6. Zumba!
  7. Karate kicks
  8. Boxing
  9. Jumping rope
  10. Hopscotch
Try to create a group dance where you all perform synchronized movements in slow motion!




Need more ideas to promote muscle strengthening through play?

Check out our ebook - Play Strong.

Tuesday, February 26, 2013

10 Simple Ways to Work on Balance

Here are 10 simple ways for children to work on balance skills throughout the day:

1.  Walk up and down stairs or curbs - each time you take a step you are balancing on one foot.

2.  Ride a bicycle - this task requires postural control and balance

3.  Ride a scooter - obviously three wheeled scooters are easier than two wheeled scooters

4.  Walk on uneven terrain - walk on grass, rocks or dirt.  Wet, thick, mud is a big challenge.  Walk on uneven terrain with no shoes on for a bigger challenge ie sand.

5.  Play a game of kickball or soccer.  You need to stand on one foot to kick the ball.

6.  Play follow the leader practicing walking fast, slow, backwards and sideways.

7.  Pretend to be a tight rope walker - Walk heel to toe along any line, try on your toes or your heels.

8.  Try putting on your pants in standing - this is a real balance challenge to stand on one foot while putting the other leg in pants.  Want to make it harder? Try putting socks on in standing without falling.

9.  Walk along curbs or balance beams at the park.

10.  Go on a hike searching out some logs or big rocks to climb.  




Check out What? Why? and How? Series 1 for 10 forms that explain the what, why and how of physical activity in children, locomotor skills, trunk muscles, equilibrium reactions and more.

Monday, February 25, 2013

Limited Functional Capacity in Very Low Birth Weight Premature Children

A cross sectional study was performed comparing 6-9 year old children born before 37 weeks gestation weighing less than 1500 grams and children born full term.  Each group of children participated in the 6 minute walk test and the 10 minute shuttle walk test.  The results indicated the following:
  • the premature children walked shorter distances in the 6 minute walk test
  • both groups walked similar distances in the 10 minute shuttle walk test
  • walking distance was associated with height and oxygen dependency at 28 days in both the 6 and the 10 minute test
The researchers concluded that children born prematurely with very low birth weight, especially those who had bronchopulmonary dysplasia may present with limited functional capacity during exercise.

Reference: Tsopanoglou, S. P., Davidson, J., Goulart, A. L., de Moraes Barros, M. C. and dos Santos, A. M. N. (2013), Functional capacity during exercise in very-low-birth-weight premature children. Pediatr. Pulmonol.. doi: 10.1002/ppul.22754

Friday, February 22, 2013

Wait for a Motor Response

Tip of the day:  Do you always remember to wait for a child's motor response following directions?  I know I do not.  A simple tip is to countdown from 5 (or even 10 for some children) to wait each time you give a specific motor direction.  Whether it be about picking up small objects, playing hopscotch or completing a handwriting assignment children need time to process the information in order to form a motor response.

In addition, by giving them time to form the response you get a clearer picture of how they interpreted the verbal directions.  If we fire off another verbal motor command before they act on the first direction, then it is hard to determine what information they actually required to complete the task.

So try this challenge - every verbal motor command that you request count to five slowly after each one.  See if you notice a difference in the child's independent output.   

Thursday, February 21, 2013

Homemade Hurdles

These homemade hurdles can be made in different heights or reconfigured for other activities to practice jumping skills, balance, motor planning and body awareness.  You can get more info and watch the video at YourTherapySource.  

Wednesday, February 20, 2013

Rehab Services and Youth with CP

Child: Care, Health and Development published research on rehabilitation services and youth with cerebral palsy (CP) in Canada.  A questionnaire on rehabilitation and educational resources (OT, PT, Speech, Psychology and special education) received within the last 6 months was completed by the parents of 91 school-age children and 167 adolescents with CP. More than half of the students were in regular schools with 41% of this group receiving special education services. The results indicated the following:
  • almost 85% of the children were receiving at least one rehabilitation service and this decreased to 68% in adolescents. 
  • the most common rehabilitation services were PT and OT mostly provided in the school setting. 
  • children who had greater motor limitations, lower IQ and greater activity limitations were more likely to receive OT, PT, SLP or special education.
  • students in segregated schools were significantly more likely to receive rehabilitation services, when compared with children in regular schools.
  • adolescents were less likely to receive services and if they did they were more likely to be consultative services.
Reference: A. Majnemer, K. Shikako-Thomas, L. Lach, M. Shevell, M. Law, N. Schmitz and C. Poulin, QUALA Group. Rehabilitation service utilization in children and youth with cerebral palsy. Child: Care, Health and Development. Article first published online: 30 JAN 2013 | DOI: 10.1111/cch.12026 

Tuesday, February 19, 2013

Feeding Difficulties and Autism

The Journal of Autism and Developmental Disorders has published an analysis of the research related to feeding problems and autism.  The review indicated the following:
  • significantly more feeding problems in children with autism versus their peers
  • examination of dietary nutrients showed significantly lower intake of calcium and protein in children with autism
The researchers recommend that children with autism should receive:
  • screenings for feeding concerns and nutritional deficits/excesses 
  • measurements of gross anthropometric parameters as part of routine medical evaluations
  • healthcare providers who review the potential consequences of pursuing an elimination diet taking into account the child's unique feeding and nutritional presentation.
Reference:  Emory University (2013, February 4). Children with autism at significant risk for feeding problems and nutritional deficits. ScienceDaily. Retrieved February 19, 2013, from http://www.sciencedaily.com­ /releases/2013/02/130204184625.htm

Monday, February 18, 2013

Saturday, February 16, 2013

Sitting and Walking Predicts Vocabulary

Infant Behavior and Development published research on the attainment of sitting and walking and the development of productive vocabulary between ages 16 and 28 months. This longitudinal study found that the earlier the age of unsupported sitting predicted a larger productive vocabulary. In addition, an earlier age of walking predicted a faster rate of growth in productive vocabulary. The researchers concluded that the achievement of motor milestones enhance linguistic development.

It may help to add this research to justify adaptive equipment such as supportive seating or gait trainers.

Reference: Ora Oudgenoeg-Paz, M. (Chiel) J.M. Volman, Paul P.M. Leseman. Attainment of sitting and walking predicts development of productive vocabulary between ages 16 and 28 months. Infant Behavior and Development. Volume 35, Issue 4, December 2012, Pages 733–736.

Wednesday, February 13, 2013

Presleep Activities and Time of Sleep Onset


Pediatrics published research on a survey completed by 2017 children ages 5-18 regarding activities reported during the 90 minutes before sleep time.  The results indicated that television watching was the most commonly reported activity before sleep time.  The participants who had a greater engagement in screen time  had a later sleep onset.  Participants who reported significantly greater time spent in nonscreen sedentary activities and self care had an earlier sleep onset.

Reference:   Louise S. Foley, Ralph Maddison, Yannan Jiang, Samantha Marsh, Timothy Olds, and Kate Ridley Presleep Activities and Time of Sleep Onset in Children. Pediatrics 2013; 131:2 276-282; published ahead of print January 14, 2013, doi:10.1542/peds.2012-1651

Tuesday, February 12, 2013

Rug Gripper and Gross Motor Skills


I have found that visual cues can really help children when practicing gross motor skills.  Things like poly spots or cones are great for some kids but sometimes you need a little something extra.  Pictured above are the feet from Proprioceptive Poems.  These feet are great to provide that extra visual cue as to where you need children to place their feet.  Once you laminate them or any other picture of feet, use a hot glue gun to secure rug gripper to the back of the page.  A roll of rug gripper is $1 at the dollar store.  One roll covers about 7 pieces of regular sized paper.  Once that rug gripper is on there, the laminated sheets are not sliding on the floor (just like a poly spot).  Practice jumping, hopping or walking from one page to the next.

In addition, the possibilities are endless to combine movement with learning.  Print out sight words, vocabulary words, letters, colors, numbers, etc and get moving. 

Monday, February 11, 2013

Interventions for Developmental Coordination Disorder


Developmental Medicine and Child Neurology published a research review on the efficacy of interventions to improve motor performance in children with developmental coordination disorder (DCD).  Twenty six studies were included in the review.  Interventions were placed into four different types: 1) task-oriented intervention, (2) traditional physical therapy and occupational therapy, (3) process-oriented therapies, and (4) chemical supplements. The results indicated the following:
  • strong effects were seen with task oriented intervention and traditional physical and occupational therapy
  • weak effect with process oriented interventions
  • the evidence for chemical supplements for children with DCD was insufficient for a recommendation
Overall, the researchers concluded that task oriented intervention produced stronger effects.  Process oriented interventions are not recommended to improve the motor performance of children with DCD. 

Process oriented interventions are broad based and target an underlying process that the child has not developed sufficiently.  An example of this would be to improve kinesthetic function which in turn may improve functional motor performance.

Task oriented interventions focus on the task itself.  Working with the child's skills, the task is usually taught directly or broken down into component parts.  In general, a task oriented approach has been more successful for children with DCD.

References:

Bouwien, C M  et al.  Efficacy of interventions to improve motor performance in children with developmental coordination disorder: a combined systematic review and meta-analysis. Developmental Medicine & Child Neurology. Volume 55, Issue 3, pages 229–237, March 2013.

Kirby, A. and Sugden, D. Children with developmental coordination disorders. J R Soc Med. 2007 April; 100(4): 182–186.




Thursday, February 7, 2013

Tabata Timer App to Get Moving


If you follow this blog at all you know I am always on the look out for apps that get kids and adults moving.  I have been use this free Tabata Timer app for quite some time now and really like it.  Tabata is an exercise protocol based on the work of a Japanese scientist named Izumi Tabat and his colleagues on high intensity interval training.  Basically you exercise for 4 minutes going as hard as you can for 20 seconds followed by a 10 second break repeating this 8 times.  I have had great success with children combining the Tabata 4 minute exercise routine with physical activity cards.

Start out by selecting at least 4 exercises to complete (you can repeat each one twice) or pick 8 different exercises.  I use exercise cards for the children to choose the activities from.  I usually pick through the cards for what each specific child needs to work on and then allow the child to choose from that pile.  Once the exercises are chosen, if they are new I teach the child the exercise first.  If not, we get started.  Place the cards on the table and start the Tabata Timer app.  It will count down to start with three beeps.  Begin the first exercise.  As the 20 seconds counts down the timer also provides a visual image of the time elapsing along with the number count down.  For the last 3 seconds it beeps.  You then rest for 10 seconds.  Turn the first card over.  Get ready for the 2nd exercise for 20 seconds.  Repeat the process until all 8 exercises are completed in 4 minutes.

Here is what is so great about this app:
1.  Kids are much more motivated to complete the exercises.  There is a start and stop time.
2.  The visual timer of the time elapsing let's the child see that the exercise is almost completed.
3.  The rest period is just short enough for the child to be ready for the next exercise.
4.  Kids who are very hesitant to complete aerobic exercise are completing this 4 minute work out without complaint.  If I asked them to run for 4 minutes or jump rope for 4 minutes some children just would not participate. 
5.  Great little app to build endurance.  Start a session out with the 4 minute workout and finish up with a 4 minute work out. 

If you need physical activity cards, check out Physical Activity Cards and Games , Move Cards and Games and Action Alphabet. 

Wednesday, February 6, 2013

Giving Meaning to Sensory Play


The Journal of Occupational Therapy, Schools and Early Intervention published a small study of eight participants with sensory sensitivities according to the Sensory Profile. The participants engaged in messy play either with a pretend theme or without. When pretend play was incorporated with the messy play, the participants showed improvements in the initiation of pretend play.

In the testing conditions the researchers provided meaning to the sensory materials - ie glue the sticky cotton balls onto the bunny picture, make a shaving cream mustache on the smiley face, etc. 

Here are 5 other suggestions to provide meaning to messy play though pretend play:
1.  Use baking materials such a cupcake pans to pretend to bake cupcakes with your sensory materials
2.  Make pretend cupcakes using cupcake lines, play dough, cotton for icing and beads for sprinkles
3.  Use the hands to put shaving cream on a doll and shave it off with a pretend shaver or popsicle stick.
4.  Use sand to make a small playscape for Lego figures
5.  Wash up dolls or plastic animals with sudsy soap and wash clothes.

What are your favorite pretend sensory play ideas?

Reference: Kristin R. S. Miller OTDOTR/L & Alexia E. Metz PhDOTR/L Pretending Enhances Engagement in Messy Play for Children with Sensory Sensitivity. Journal of Occupational Therapy, Schools, & Early Intervention. Volume 5, Issue 3-4, 2012  

Tuesday, February 5, 2013

Ankle Ligaments in Children with Hemiplegia


The Journal of Ultrasound in Medicine published research comparing lateral ankle ligaments between the unaffected and affected leg in children with spastic hemiplegia cerebral palsy. Eight children with a mean age of 5.2 years old underwent sonograms of the anterior talofibular ligament and calcaneofibular ligament and the anterior talofibular/calcaneofibular ligament thickness ratio was calculated. In addition, the modified Ashworth scale was used and passive ankle dorsiflexion was evaluated. The results indicated the following:

  • anterior talofibular ligament thickness in the affected legs was significantly greater than that in the unaffected legs
  • calcaneofibular ligament thickness in the affected legs was significantly less than that in the unaffected legs
  • anterior talofibular/calcaneofibular ligament thickness ratio in the affected legs was significantly greater than that in unaffected legs (ratio was positively correlated with the modified Ashworth scale and age but negatively correlated with the passive ankle dorsiflexion angle in the affected legs).
The researchers concluded that there is an increased anterior talofibular ligament thickness and a decreased calcaneofibular ligament thickness in the affected legs compared with the unaffected legs. This discrepancy between the lateral ankle ligaments may play a role in the equinovarus deformity of the ankle together with spastic leg muscles in children with spastic hemiplegic cerebral palsy.

Reference: Kwon DR, Park GY. Differences in lateral ankle ligaments between affected and unaffected legs in children with spastic hemiplegic cerebral palsy. J Ultrasound Med. 2013 Feb;32(2):313-7.  

Saturday, February 2, 2013

Online Pediatric Occupational Therapy


Online occupational therapy, in particular, for whatever reason remains to be a hard topic for schools and the special education community to grasp. To address these concerns, Rosemarie Helton participated in a brief Q&A with Your Therapy Source about online occupational therapy and online therapy in general.

Rosemarie Helton is a registered and licensed Occupational Therapist part. She graduated from Colorado State University with a Bachelor of Science degree. She has been an Occupational Therapist for over 10 years and has worked in a variety of therapy settings including virtual settings. In providing online therapy Rosemarie is part of a network of speech language pathologists and occupational therapists working with Presence Learning, a provider of online therapy services. 


1.  How are you providing online OT in the schools? ie special computer programs, video conferencing, etc.
I provide online occupational therapy services using an internet platform by PresenceLearning. This internet platform delivers online therapy services such as online speech therapy and online occupational therapy. The PresenceLearning platform allows me to use audio, video and interactive activities all in one location.  

2.  Is the recommended services the same whether online or not? ie you follow IEP recommendations
Yes, the services provided are from the IEP.

3.  Does the school district provide a teacher's assistant to help the student receiving services?
I currently work with students in a virtual school setting. The need for a support person is based on the students abilities, age and the focus of their therapy sessions.

4.  What types of activities do you offer?  All computer games or some hands on activities?  How do you ensure that materials are available?
I offer a variety of activities based on the students needs and the focus of their therapy goals. I use computer based games/activities and hands-on activities that I create or find in the PresenceLearning content library within the internet platform. I occasionally send materials and equipment as needed for each students.

5.  Is the cost of online therapy cheaper?
The overall cost of online therapy is cheaper. Online therapy allows for cost savings in the areas of travel time, therapist recruiting, training and retention and the use of digital and common household materials. Online therapy has some start up costs such as headset, webcam and internet service but those costs are not enormous and most people already have some or all of the this equipment and/or service.

6.  Can you offer group sessions?
Yes, group online therapy sessions are available and based on the individual students needs.   

7.  How many school districts currently use online OT or have you seen growth in this area?
There is huge growth in the area of virtual schools. Currently, 40 states have virtual schools and 30 states have statewide full-time online schools. Approximately, 12% of the over half a million students who are enrolled in virtual schools receive special education services including OT. This is a huge population and growing rapidly. 

8.  Are you involved in IEP writing and goal setting?
Yes, I am involved in IEP writing and goal setting. In the virtual school setting IEP's are held by phone and I am part of the team that attends the meeting and reviews the document to ensure it is appropriate and accurate. 

9. One more - how do you document if schools use specific IEP tracking programs like IEP Direct or Clear Track?  Do they grant access to those programs for you?
Yes, I am given access to this IEP tracking application provided by PresenceLearning called the “SLP Portal.” The SLP Portal is a custom online application that allows me to document my therapy sessions, review therapy notes and track progress. 


To learn more about online occupational therapy and hear insight from special education leaders, sign-up for a free webinar hosted byRosemarie Helton and PresenceLearning on February 5, 2013. 


What is your opinion on providing virtual OT in the schools? I personally find this a very interesting topic. I think it can be an effective way to deliver services in areas that are difficult to staff and in the virtual school setting. Perhaps not a good fit for every student but definitely see a role for it. What do you think? Would love to hear from therapists, parents or teachers who have utilized this service.
Related Posts Plugin for WordPress, Blogger...