10 Tips for Transitions

Do you have students who have difficulty transitioning from one activity to another?  Maybe they have a hard time transitioning from the classroom to the therapy room. 

Here are some tips to help make transitions easier:

1.  Establish a consistent schedule or routine for the student to follow.  Provide visual picture symbols if necessary for the student to follow. 
2.  Allow the student enough time to experience the activity before moving on to the next activity.
3.  Make sure the student understands what the directions are or what is expected of him/her.  Some students will need to be taught how to follow the routine.  This takes practice and time.
4.  Provide verbal and physical cues that a transition is approaching.  There are plenty of visual timers that can be used to provide warnings for transitions. 
5.  Modify schedules to have the least amount of transitions possible.  For example, if a student is already out of class to go to the nurse or another related service it may be a good time to schedule therapy to reduce the number of transitions in and out of the classroom.  Another option would be to provide push in therapy services to avoid transitioning in and out of the room.
6.  Sing songs or chants to signal transitions.  Use the same songs each time so children can anticipate what is to happen next.
7.  Provide feedback about transitions.  If a student does a good job transitioning explain to him/her what they did correct.  If changes need to be made offer suggestions of how to improve the transition the next time.
8.  As the student's skills improve during transitions, encourage the student to transition independently.
9.  Keep it simple with directions for the transition.  One or two step motor commands should be effective and concise.
10.  Provide positive reinforcement for other students who complete transitions successfully.  Students will learn from each other and model other behaviors.

Check out Cut and Paste Sensory Diet to use picture symbols for sensory diet activities during transitions.

Fine Motor Charades

Here is a fun game to play - Fine Motor Charades.  Can you guess what was created in the pictures above?  Head to YourTherapySource for how to play Fine Motor Charades and the answers. 

24 Hour Positioning

School based therapists are frequently involved in monitoring sitting and standing postures in order for students to access the educational curriculum without compromising range of motion.  It is the pediatric therapists job to ensure that deformities are avoided through proper positioning.  Obviously, this can be monitored and followed during the school day.  But what happens when the student goes home.  If a student is positioned properly at school whether in a wheelchair or adaptive seating and then goes home to sit slumped on a couch not much will be accomplished.  Or perhaps a student goes home and remains seated or standing with appropriate posture but then goes to sleep for 10 hours in a misaligned position.  

Although school based therapists only work in the school, educational goals may not be met if a program is not also followed through at home.  Consider the following when creating a positioning program and offer suggestions to help supplement proper positioning at home:

1. Is the child positioned properly before school and during transport?
2. Is the child positioned properly in each classroom setting ie homeroom, library, music, art, etc?
3. Does the child have appropriate posture during meal times?
4. Is the child positioned properly after school?
5. Is the child positioned properly during sleep time? (here is an informative article on sleep positioning - http://www.atgrehab.com/clinician/articles/LOJSampleSleepPositioningEquipment.pdf )

 

Long Term Benefits of Selective Dorsal Rhizotomy

The Journal of Neurosurgery published research on the long term benefits of selective dorsal rhizotomy (SDR) in children with cerebral palsy.  The participants in the study included 102 children with spastic CP who underwent SDR between the ages of 3 and 10 years and were evaluated by a multidisciplinary team before surgery and periodically afterward. After evaluating the data the following results were seen:

• statistically significant improvements in lower-limb muscle tone, gross motor function, and the ability to perform activities of daily living in the majority of patients.
• the improvements lasted throughout adolescence and into early adulthood 
• children performed better who had better preoperative gross motor function (GMFCS Groups I through III), spasticity involved only two limbs, rather than three or four and spasticity involved the adductor muscles of the hip only moderately (Ashworth score lower than 3)
• following SDR children were less likely to need adjunct orthopedic surgeries or Botox injections to control spasticity

Reference: Dudley RWR, Parolin M, Gagnon B, Saluja R, Yap R, Montpetit K, Ruck J, Poulin C, Cantin MA, Benaroch, TE, Farmer JP. Long-term functional benefits of selective dorsal rhizotomy for spastic cerebral palsy. Clinical article. Journal of Neurosurgery: Pediatrics, published online, ahead of print, May 28, 2013; DOI: 10.3171/2013.4.PEDS12539

Top 10 Benefits of Physical Activity for Children

Here are 10 benefits of physical activity for children:

10.  Improves children's overall physical fitness

9.  Practice motor skills

8.  Healthy competition when active in sports

7.  Improves self confidence

6.  Encourages socialization when physically active with friends

5.  Reduces obesity

4.  Improves the mood

3.  Helps with self regulation

2.  Encourages setting and acheiving goals

1.  BRAIN BOOSTER!!!!!!!  The positive benefits of physical activity include cognitive skills (executive functioning, attention span, memory and verbal comprehension), higher academic test scores, motor planning and impulse control.

Need ideas to get kids moving? 

Check out the following:

freebie page for gross motor activities -  http://yourtherapysource.com/freestuff.html

50 Sensory Motor Activities for Kids -  http://yourtherapysource.com/50book.html

Mini Movement Breaks - http://yourtherapysource.com/minimove.html

Play Move Develop - http://yourtherapysource.com/playmove.html

New Handwriting App - StartDOT

Here is a new handwriting app for the iPad, StartDOT, that is worth checking out.  According to the website it was developed by an occupational therapist with 20 years experience and it shows.  There is a variety of handwriting instruction methods incorporated into this app.  I only tested the lite version of 6 letters but I was impressed.  

Here is what it offers:
1.  Written and verbal instructions of how to form the letters
2.  Kinesthetic order or alphabetical order to learn the letters (you can choose either order but you must go in order, you can not choose a specific letter on the lite version)
3.  Uses sky grass dirt method and visual cues
4.  Offers different levels of cues gradually decreased the cues each practice time

5.  Can do rainbow writing using repetition to practice letter formation
6.  Keeps track of what letters a student has practiced (tracks up to 6 students)

7.  Offers free, printable worksheets to compliment the app.  This is my favorite feature.  To help with carry over to pencil and paper, you can download worksheets that compliment the app to practice on actual paper!   

Has anyone else checked out this latest handwriting app? 

Printing a Prosthetic Hand

How cool is this?  Using a 3D printer, there is the capability to make prosthetic hands.  Watch this video to see how it came to fruition and how they made it all happen.   The last few minutes of the video show some children in action using their robohands.

I happen to be highly interested in 3D printing.  Imagine the possibilities 3D printing has for all the children that we work with in terms of personalized adaptive equipment, prosthetics and orthotics!  I hypothesize that 3D printing will be the next great thing that hits our technology world.  What an amazing world we live in.

Curious to know is anyone using a 3D printer with any adaptive equipment, prosthetics or orthotics?  Would love to hear about your experiences.