Tuesday, July 25, 2017

AFOs, Walking and Cerebral Palsy

AFOs Walking and Cerebral Palsy

The Annals of Physical Medicine and Rehabilitation published a systemic review on ankle foot orthotics AFOs, walking and cerebral palsy. The purpose of the study was to complete a systematic review of the literature to determine if AFOs produce a more normal gait pattern by positioning joints in the proper position to reduce pathological reflex or spasticity in children with cerebral palsy.

An article search was performed from 2007 to 2015 of studies of children with CP wearing the following AFOs: hinged (HAFO), solid (SAFO), floor reaction (FRO), posterior leaf spring (PLS) and dynamic (DAFO) to determine if there was a change in gait pattern and walking ability.

Seventeen studies were included with a total of 1139 children with CP. The PEDro score was poor for most studies (3/10) with only 4 randomized controlled studies with an appropriate level of evidence.

The results indicated the following:

  • overall the use of AFOs improved speed and stride length.
  • the HAFO was effective for improving stride length, speed of walking, single limb support and gait symmetry and decreasing energy expenditure with hemiplegic CP as compared with the barefoot condition.
  • the plastic SAFO and FRO were effective in reducing energy expenditure with diplegic CP.
  • for children with diplegic CP, the HAFO and SAFO improved gross motor function.

The researchers concluded that for children with hemiplegic CP, certain AFOs improved gait parameters, including ankle and knee range of motion, walking speed and stride length. AFOs reduced energy expenditure in children with spastic and hemiplegic CP. The researchers recommend further studies with improved PEDro scores for more conclusive evidence regarding the effectiveness of AFOs in children with CP.

Reference:  Aboutorabi, A., Arazpour, M., Bani, M. A., Saeedi, H., & Head, J. S. (2017). Efficacy of ankle foot orthoses types on walking in children with cerebral palsy: A systematic review. Annals of Physical and Rehabilitation Medicine.

Therapeutic Play Activities for Children Download

Therapeutic Play Activities for Children digital download includes 100 play activity pages and 12 tip sheets. The play activities encourage the development of fine motor skills, bimanual skills, rolling, crawling, tall kneeling, standing balance and cruising with a strong focus on children with cerebral palsy.  FIND OUT MORE INFORMATION.

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Monday, July 24, 2017

Unicorn Find and Color – Visual Perceptual Skills

Unicorn Find and Color

This unicorn find and color activity is a freebie from the Unicorn Sensory Motor Packet.  Children can practice visual discrimination skills, visual scanning and visual motor skills with this printable.


Unicorn Sensory Motor Packet

Check out the complete Unicorn Sensory Motor Packet – This digital download includes 20+ games, activities and puzzles to encourage playtime, visual perceptual skills, fine motor skills, and physical activity.  FIND OUT MORE.

Unicorn Find and Color

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Sunday, July 23, 2017

Free Find and Follow ABCs

Free Find and Follow ABCsChallenge visual motor, visual scanning and more with these free find and follow ABCs.  You can download this 3-page freebie from the Find and Follow complete packets that include every uppercase letter and numbers 0 through 9.

The great thing about this freebie is it requires no prep – just print and it is ready to go.  Bonus – it is all in black and white therefore inexpensive to print.

These free find and follows ABCs are perfect for handwriting warm ups, letter review, and visual scanning.

DOWNLOAD YOUR FREE FIND AND FOLLOW ABCsFind and Follow Alphabet Numbers hunts and mazes

Here are more details about the complete Find and Follow: Alphabet and Number Hunts and Mazes digital download includes mazes and hunts for every letter of the alphabet and numbers 0-9.  Challenge visual scanning, visual motor and visual spatial skills with this fun, black and white packet.  On each page, you need to find and circle the upper case letter or number and follow the path through the maze. packet.

Find and Follow ABCs

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Thursday, July 20, 2017

Color Cut Glue Shark Freebie – Just in Time for Shark Week!

Color Cut Glue Shark

All right, I admit it… I definitely get sucked into the whole shark week thing.  And super ashamed to say that I will be tuning into to see if Michael Phelps beats the shark.  It is all such ridiculous and mindless television but I do enjoy to zone out once in awhile.  Last night, I decided since everyone LOVED the free Spring and Summer Color Cut and Glue projects why not create a shark.  Download your free copy at the end of the post.

This is a simple one page black and white activity to practice coloring, cutting out simple shapes, planning out where to glue the pieces (the trickiest part) and then paste the shapes together to create the shark.  Just print and it is all set to go.

This activity encourages:

  • scissor skills practice
  • eye hand coordination
  • bilateral coordination
  • motor planning
  • sequencing

So look at that – all in the name of Shark Week and you can have fun practicing those skills.  Haha!  Remember to get your free copy by signing up for our newsletter at the bottom of the post.

Looking for more scissor activities?  Here is a collection of three activity downloads for scissor practice.

Scissors Bundle from Your Therapy Source

If you need more specific information on the development of scissor skills, check out The Scissor Skills Book.  This digital download is a huge resource for anyone who works on scissor skills with children. Written by the Functional Skills for Kids (FSFK) team of 10 pediatric physical and occupational therapists with years of experience in the field, The Scissor Skills Book is the ultimate resource for tips, strategies, suggestions, and information to support scissor skill development in children.

Color Cut Glue Shark

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Wednesday, July 19, 2017

5 Simple Tips to Help Children Reach Their Goals

5 Simple Tips to Help Children Reach Their Goals

Do you ever feel like a child you are working with is in a rut or having trouble reaching their goals?  Maybe you just want to give them an extra push to accomplish a task.  Here are 5 simple tips  to help encourage children:

1.  Change up the tools, toys or activities that you are doing.  It may be just as simple as approaching the skill using a different tool or material.

2.  Change the environment.  Perhaps trying accomplishing the skill outdoors, in a quiet room or with a peer.

3.  Be positive.  If you assure the student that they have the ability to accomplish the goal you will provide them with the ability to believe in themselves.  The power of positive feelings can go a long way.  Check out Positive Affirmation Posters and Cards to provide your students with a visual reminder.

4.  Change your teaching style.  If you are only providing verbal directions, perhaps offer a demonstration or a visual picture of what the student needs to accomplish.  If you are always offering verbal feedback, perhaps try diminishing how often you provide feedback to see if that makes a difference.

5.  Offer rewards.  Some students respond very well to a reward system.  You can read more on rewards and motivation in previous blog posts:

Encourage students to track their own progress with My Goal Tracker.

My Goal Tracker student data collection

TitleMy 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.

Included in this download is the following: samples of completed forms, goals setting worksheet, improvement ideas worksheet, goal tracking cards (for trials or percentage) and graphs to complete for daily, weekly, monthly or quarterly progress (number of trials out of 10, percentage or minutes). There is also one blank form for you to label if you are monitoring goals in a different manner. Complete the goal worksheet, print the necessary forms and place in a binder. The student can then graph his/her progress accordingly.
By having the students track their own goals they will take ownership of their progress. It doesn’t get any easier than this to track progress. Find out more.

5 Simple Tips to Help Children Reach Their Goals



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Monday, July 17, 2017

Right or Left Hand Poster

Teaching children right from left can be a difficult concept.  The ability to determine whether you are using your right or left hand requires higher level spatial awareness, body awareness and motor planning skills.  This right or left hand poster is from the Right or Left Games packet.  You can download it for free (see below).

Here are some ideas for the right or left hand poster:

  1. Color it reinforcing which is the right and left hand
  2. Hang it on the wall for visual reinforcement throughout the day
  3. Hi- 5 Hands: Hang it on the wall.  Smack the right hand and say out loud “right hand” repeat with the left hand.
  4. Wall Presses:  Hang it on the wall.  Put your hands over the correct hands and perform wall presses for proprioceptive feedback to provide extra sensory feedback regarding which is the right or left hand.


Check out the complete Right or Left Games packet.

Right or Left Games

The Right or Left Games packet helps children to practice right and left discrimination, bilateral coordination, fine motor skills, balance skills, body awareness, motor planning and visual spatial skills.  The Right or Left Games Packet includes the following:

  • one page handout on tips to teach children right from left
  • 18 right and left hand action cards
  • 45 right and left sides of the body action cards
  • one game board
  • 18 cards to move along the game board ie move 2 spaces to the right, move 1 space to the left and one space up, etc.


If you need more activities to practice visual spatial skills and body awareness check out these titles:

Simon Says

Which Way?

Move Like Me

Personal Space Journey

25+ Bilateral Coordination Exercises

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Sunday, July 16, 2017

Weighted Pencils and Handwriting – What Does the Evidence Say?

Weighted Pencils and Handwr

Pediatric occupational therapists sometimes recommend a weighted pencil to improve handwriting legibility and increase pencil pressure but what does the evidence say?  Not much…  I found one recent study on the use of weighted pencils and handwriting.  In theory, the purpose of the weighted pencil is to provide extra proprioceptive input in the fingers and hand to help provide extra feedback.  A recent study in the Journal of Occupational Therapy, Schools, & Early Intervention discussed three case studies of children who were unable to form their letters. Following the use of a weighted pencil, all 3 children demonstrated marked improvement in their ability to write.

If you are aware of other research studies on the use of weighted pencils, please send me an email.

Read more on ways to increase pencil pressure.

If you decide to recommend the use of a weighted pencil to improve handwriting legibility don’t forget to follow up after you implement the strategy.  Read 6 follow up questions to ask regarding the use of adaptive equipment in the classroom.

Read more on Proprioception and Handwriting.

Reference:  Brown, M. J. (2017). Use of weighted pencils to improve handwriting legibility. Journal of Occupational Therapy, Schools, & Early Intervention10(1), 52-68.

Need to check if the weighted pencil is affecting handwriting skills?  Try using a handwriting rubric.

Handwriting Rubrics

Handwriting Rubrics – This is an electronic book of 26 rubrics to assess handwriting. A rubric is a scoring guide to judge performance on a specific task. Have you ever wanted to quantify handwriting skills such as letter formation, speed or copying? Handwriting Rubrics can be used as assessment tools to quantify an individual’s written productivity. By using the rubric, each individual can be scored based on the same criteria.   FIND OUT MORE.

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