Wednesday, September 28, 2016

Task Analysis – Independent Bathing in Children

independent-bathing-step-by-step-analysisThe majority of individuals shower or bathe independently for personal hygiene reasons and as a stress reliever.  The calm, peaceful warm shower or tub can be very relaxing and purposeful.  When motor skill deficits are present in children, bathing can be a very complicated, arduous task.  When you stop and think about bathing and showering, you start to realize it requires extensive fine motor, gross motor, sensory processing and visual perceptual skills.  In order to for children to accomplish independence with bathing, breaking the skills down into a step by step analysis can be beneficial to determine where certain skills need to be practiced or modified.  Here are 4 different task analysis for independent bathing in children.



  1. Get a towel – walk and carry a towel
  2. Get undressed – removing clothing requires balance and coordination skills
  3. Turn on water – reaches forward while maintaining balance
  4. Transfer into shower or tub – lifts leg high enough to clear tub, balance on one foot and step over the tub
  5. Stand in shower – maintains balance on wet surface
  6. Sit in tub – lowers body down into tub and positions legs
  7. Clean body with soap – reaches down and around to clean body while maintaining balance
  8. Rinse body clean – turns body in shower or lowers extremities in tub to rinse
  9. Wash hair – raises arms up overhead to wash hair and maintains balance while eyes are closed
  10. Rinse hair clean – extends neck to rinse out shampoo
  11. Transfer out of shower – lifts leg high enough to clear tub, balance on one foot and step over tub
  12. Dry off with towel – reaches down and around to dry off body without losing balance
  13. Get dressed – maintains balance and coordinates getting dressed (see previous post on gross motor skills and dressing)



  1.  Get undressed – manipulate any fasteners on clothing
  2. Turn on water – rotation of the hand to turn the faucet on
  3. Pick up soap – grasp the soap so it does not slip out of the hand
  4. Hold soap – grasps soap while washing body
  5. Open shampoo – isolate the muscles in the fingers to open a flip lid or rotation to unscrew a cap
  6. Hold shampoo bottle – contract the muscles in the hand to hold the weight of the bottle
  7. Squeeze shampoo out – has the strength and graded muscle control in the hands to squeeze an appropriate amount of shampoo out
  8. Rubs shampoo into hair – isolates fingertips to rub shampoo into hair and scalp
  9. Rinse shampoo out – opens hands to rinse shampoo out
  10. Wash with wash cloth – wrings out wash cloth to wipe face
  11. Hold wash cloth – grasps wash cloth while wiping face and/or body
  12. Turn off water – rotates faucet off



  1. Turn on water to proper temperature – determines hot versus cold
  2. Hear water running – auditory system tolerates the sounds of running water
  3. Wash body – tolerates tactile input of soap
  4. Smells shampoo or soap – olfactory system tolerates the smells of shampoo and soap
  5. Use wash cloth – tolerates tactile input on skin of wash cloth
  6. Leans head back to wash hair – vestibular system tolerates head being tilted back
  7. Wash hair – tolerates water on head and over face
  8. Wash face – tolerates tactile input to face and closes mouth to avoid soap in mouth (sensation of taste)
  9. Towel dry – tolerates the feel of the towel over the body



  1. Find hand soap, shampoo, washcloth and towel – visually locates all items necessary for bathing
  2. Turn on/off water – uses eye hand coordination to reach for faucet
  3. Step into shower or tub – visual spatial skills needed to gauge how high to step over tub
  4. Reach for shampoo, soap or wash cloth – requires eye hand coordination skills
  5. Use shampoo or conditioner – requires visual discrimination skills to determine which bottle is which
  6. Get dressed – requires extensive visual perceptual skills (read more about visual perceptual skills and dressing here)

READ MORE about tips and strategies to facilitate independent showering and bathing for a child with special needs.

Check out Personal Hygiene Rubrics (includes bathing and showering rubrics) for assessment at initial evaluation and annual reviews, progress reports, establishing entrance or exit criteria for therapy and creating measurable goals.

This post is part of the Functional Skills for Kids series is on personal hygiene.  This series is a 12-month long series written by occupational and physical therapy bloggers on the development of 12 functional skills for children.  Stop by to see what the other occupational therapists and physical therapists in the Functional Skills for Kids series have written on the school day functions.


Tips and Tricks for Teaching Hand Washing with Kids  | Growing Hands-On Kids

I can brush my teeth! Tips for Tooth Brushing and Oral Care!  | Your Kids OT

Screen Free Quiet Time When Daytime Naps are History  | Kids Play Space

Tips to Help Kids Learn How to Blow Their Nose | Sugar Aunts

Tips to Help Kids Who Hate Haircuts | Mama OT

Sensory Friendly Tips for Kids Who Have Trouble Sleeping  |  The Inspired Treehouse

Your Child With Special Needs: How to Conquer Showering Independently | Miss Jaime OT

Adolescent Hygiene Challenges  | Therapy Fun Zone


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Tuesday, September 27, 2016

5 Gross Motor Activities to Help with Dressing Skills


Gross motor activities that focus on postural control, trunk rotation, bilateral coordination, eye hand coordination, motor planning and balance skills are beneficial when it comes to developing independence with dressing. Here are 5 suggested activities:

  1.  Play games where the child has to reach outside of his/her base of support without falling over. Practice in sitting or standing depending upon the child’s skill level. For example, try batting a balloon in the air with your hands but do not move your feet. The child will be practicing trunk rotation, eye hand coordination skills and balance skills.
  2. Squatting activities while the child is holding an object. Put a hula hoop on the floor. Can the child squat down, pick up the hula hoop and reach it overhead? Put it back on the floor in front of the child and repeat. Can you get across the whole room only stepping in the hula hoop? Roll a large ball to the child. The child can squat down, pick it up with two hands and push it back.
  3. Body awareness game such as Simon Says adding in directions such as “Simon says touch your both hands to your left foot” or “Simon says squat down and touch the floor”. If Simon Says is difficult for the child play a game of Match Me. Move your body a certain way ie reach your right arm behind your back and the child tries to match your actions exactly.
  4. Play catch or kick a ball to each other. Simple games of catching, throwing and kicking include many of the underlying skills necessary for learning how to get dressed. When catching a ball a child brings his/her hands to midline (skill needed for unzipping, buttoning, etc). When throwing a ball, a child rotates the trunk and brings the arm across midline during the follow through phase (skill needed to reach for socks and shoes). When kicking a ball, a child has to momentarily stand on one foot while the other side of the body is moving (skill needed for getting pants on and off in standing).
  5. Set up obstacles courses that require the child to motor plan different activities. Include activities related to dressing ie. put on bigger shoes and walk several feet forward without losing your balance, pick up a small hula hoop or ring with your left hand and slide it up your right arm (mimics putting on a shirt), hide an object in a zippered bag for the child to rescue at the end of the obstacle course. Try relay races including getting dressed in bigger clothes. Set up two teams, run to the pile of clothes, put on large shorts, front open shirt and big shoes. Take them all off and run back to the starting line. Not enough kids to make teams? Just time one child and see if they can beat his/her record and get it done as fast as possible.

The post 5 Gross Motor Activities to Help with Dressing Skills appeared first on Your Therapy Source.

Monday, September 26, 2016

5 Activity Ideas to Practice Motor Planning


Here are 5 activity ideas to practice motor planning skills:

Ninja Clothes Pin ClipsNinja Clothes Pin Clip Activity – find the matching Ninja, move your body like the Ninja and clip the Ninja to the circle. Download the Ninja Free Activity.

Motor Planning with Pool Noodles from Planning with Pool Noodles – here is a super easy set up but challenging activity to encourage motor planning skills, coordination and body awareness. Cut up pool noodles lengthwise and lay them on the floor in different directions. Ask the child to jump from noodle to noodle keeping the pool noodle between the feet.  Watch a video of it in action.

Box_Balance-214x190Box Balance Game – Watch the video at YourTherapySource to see how to play the Box Balance game to encourage balance skills, motor planning, body awareness, eye foot coordination and right/left discrimination.

Simon Says FreebieHere is a fun, new freebie from the latest download, Simon Says.  Print off these 9 cards to play a quick game of Simon Says.  Can the children copy the body poses exactly?  These are 9 samples cards from the HUGE collection of body position cards from the complete Simon Says download.

rhythmic-timing-and-motor-planning-videoTry this rhythmic timing and motor planning activity with a small group.  Trickier than it looks!

The post 5 Activity Ideas to Practice Motor Planning appeared first on Your Therapy Source.

Sunday, September 25, 2016

8 Playtime Modifications for Children with Disabilities


Whether it be at home, daycare, school or extracurricular activities, children with disabilities may benefit from modifications during playtime. Here are 8 questions to ask when assessing a child’s needs during playtime:

  1. Does the environment need to be modified? If the physical environment is adapted perhaps the child will be able to be more independent during playtime. For example, move toys down to lower shelves to allow the child to access the toy without asking for help.
  2. Do the play materials need to be adapted? For example, build up a handle on a toy so a child can grasp it independently or use a larger ball so a child can catch it.
  3. Do you need to make the activity easier? For example, change the rules of the game to shorten the length of time to play or simplify the steps of a game.
  4. Do you need to make the play time more motivating for the child? Perhaps the child is not engaging in play because he/she is not interested in the toy or activity. Try using what a child enjoys playing with in different situations to expand his/her repertoire of play.
  5. Do you need to provide adaptive equipment? For example, use a chair with more support to provide additional postural control so the child can use his/her arms and hands more efficiently.
  6. Do you need to provide prompts to encourage appropriate play? Try modeling the activity or providing occasional verbal prompts for suggested uses of the toys.
  7. Do you need to partner the child with a friend? Try teaming the child up with a friend to model play activities or turn taking to complete a game.
  8. Do you need to provide step by step visual directions? Try placing visual step by step photographs in the play area for reminders of suggested play activities.

Play - Move - Develop

Play Move Develop is a collection of 100 reproducible sensory motor activities to encourage motor skill development and learning.  Find out more information.

Reference: Sandall, S. Play Modifications for Children with Disabilities. Young Children Journal. Retrieved from the web on 9/23/16 at

Read more on Gross Motor Skills and the Development of Play here.

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Thursday, September 22, 2016

3 FUN Elephant Activities to Practice Fine, Gross and Visual Motor Skills


Here are 3 fun elephant activities to play to practice fine motor, gross motor and visual motor skills.  Big bonus – It is actually Elephant Appreciation Day!  Who knew?  Me! Only because I just heard it on the radio.  Haha!  But it did spark a few ideas for the blog.  So here we go:


Copy the Elephant – download this activity to practice visual motor skills.  There are two versions – easy: copy the entire elephant and hard: complete the elephant picture.  There are more spatial reasoning activities included in the Grid Drawing download (or just grab another freebie).


Elephant Fine Motor Game – download this activity to practice fine motor skills, math skills and finger strengthening if you use play dough.

Elephant Gross Motor Activity – here is a fun brain break from Just Dance Kids.  It starts off with a monkey dance but keep dancing and you will soon be acting like an elephant.  Need more brain breaks?  Check out Your Therapy Source.

The post 3 FUN Elephant Activities to Practice Fine, Gross and Visual Motor Skills appeared first on Your Therapy Source.

Tuesday, September 20, 2016

3 Strategies to Help Children Initiate and Plan Motor Skills


Children who struggle with executive functioning deficits may have difficulties learning how to initiate and plan motor skills.  Here are 3 strategies to help initiate and plan when learning a new motor skill:

  1. Work with children to establish the end goal.  By asking open ended or more direct questions to the child, determine specifically what the end goal is for him or her.  sample-completed-pages-my-goal-trackerPictured above is just an example of how to guide the student perhaps they want to learn how to catch a ball in gym class?  Climb the playground equipment? Write faster?  Learn self calming techniques? Maintain personal space?  Complete assignments quicker?  By establishing a specific end goal, children will understand the clear intent of why they are learning the skill which will hopefully drive intrinsic motivation.
  2. Break down the goal into a series of steps.  Help the child to determine what steps need to be taken to achieve the goal ie practice sessions, modifications, etc.  Let the student help map out how to break up the skill.  Try using this four square idea to get started. 4-stepsAsk questions to help prompt the child if necessary but do not just provide the solution to the problem. If the student is able, write down a timeline of when each part will be completed. For example, if the student is learning how to climb stairs in a crowded stairwell, then the timeline could include activities such as climb the stairs independently with visual distractions in the stairwell, climb the stairs independently with one other student in the stairwell and finally climbing the stairs with many students in the stairwell. Set dates for each skill to be accomplished. If the student is tackling a big academic project, encourage him/her to set specific dates with specific directions for each part of the project.
  3. Stop, reflect and review.  When you are moving through each “piece” of the overall goal stop, reflect and review. To encourage staying on task, the student can self talk asking “is what I am working on now going to help me achieve the goal?”.   Review and check if the student is able to repeat what was previously learned and show 100% achievement of that “piece”? Ask the student if they need to change the timeline or any strategies that are being used. Encourage the student to reflect on what, if anything, could be done to improve it to do it better the next time?

My Goal Tracker


My Goal Tracker: This is an electronic book of data collection forms for students to track their own progress. The student can track his/her goals over time, by monitoring the skills over the course of a day, week, month or quarter. This allows the student to get a visual picture of improvement, decline or maintenance of different skills.

Find out more information here.

The post 3 Strategies to Help Children Initiate and Plan Motor Skills appeared first on Your Therapy Source.

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