Monday, September 28, 2009

Go hiking!

Just finished reading an excellent article in Advance for PT/PTA's entitled Through the Trees. This is the story of identical twins who have autism and their experiences with hiking. You can view the entire article on their digital edition at Advance For PT/PTA's. The article offers some excellent benefits on hiking for children with developmental disabilities and their families.

Here were some of my favorite points:
1. Hiking is free.

2. The whole family benefits from the exercise - stress reduction, mood elevator and physical benefits of exercise.

3. Does not require intense social interaction.

4. Does not require a significant amount of coordination depending upon types of trails.

5. Sense of accomplishment.

Take the time to read the article - well worth it!

Reference: Mayer, R. (2009) Through the Trees. Advance for PT and PTAs. Sept 21, 2009 Vol 20 (19):11-13.

Saturday, September 26, 2009

Sensory Motor Video Idea - Indoor Ladder Path

Here is an activity idea that encourages fine motor and gross motor skill development. Great for an indoor movement activity. You will need low adhesion painter's tape. This is available at painting or hardware stores. It comes up easily from the floor or rugs (would not use it on any type of expensive flooring though just in case but it has always come up for me no problem).

Wednesday, September 23, 2009

Teaching Action Verbs - Get Moving!

A recent study caught my eye that television is not working when it comes to teaching action verbs to young children. Funny, but I could have told them that. Not sure why anyone would want to use a television set to teach a young child anything. To use it as a babysitter for a few minutes - guilty as charged but not as a teacher. The research did indicate that if an adult interacts with them they can learn the action verbs. Well great, but I can think of so many more ways to learn action verbs instead of watching a television set. How about do the actions. Now there is a novel idea. Children can perform action verbs and adults interact by using words to describe the actions. If a young child has a disability that precludes them from performing the action perhaps a peer or adult can demonstrate it. Provide physical assistance to the child to perform the action verb if necessary. Anyone else have any ideas?

Try creating our Mini Action Books to encourage literacy regarding action words.

Reference: Roseberry et al. Live Action: Can Young Children Learn Verbs From Video? Child Development, 2009; 80 (5): 1360 DOI: 10.1111/j.1467-8624.2009.01338.x

Tuesday, September 22, 2009

Visual and Auditory Input

Here is a simple and free assistive technology to read the words on the web or text. At you can type and have the text read to you in various voices. The voices sound quite clear and are available in male and female. This is a great free tool to help children with comprehending material. In addition, this website can take written and scanned documents (i.e. Word document) and convert it to a audio file. Put it on a mp3 player and you can review class notes, listen to textbooks and more. If you can not think of a student who would benefit from this how about yourself? Take journal articles, create the audio file and listen to it during your commute or work out. You can even create an audio file from an RSS feed like this blog! What a great idea. Here is a video explaining how Read the Words can help.

Monday, September 21, 2009

How To Get Your Child to Fall Asleep Faster...

Wanted to grab your attention with the title - hope it worked. So I am sure you are wondering what you can do to get a child to fall asleep faster...

How about a guess -

A. Warm milk and cookies
B. TV before bed
C. Sleeping in Mom's bed
D. Increase activity.

If you answered D you are correct. A recent study in Archives of Disease in Childhood found that the more activity 7 year olds got during the day the faster they fell asleep. Five hundred ninety one seven year olds wore actigraphs to determine activity levels. In addition, the amount of time it took the child to fall asleep was measured (sleep onset latency). Children who were more active (vigorous activity for one hour throughout the day) fell asleep 6 minutes faster. Another bonus was that the children who fell asleep faster slept for longer periods.

One more reason to encourage your children to be active for your own sake! I would love to see research on the amount of time spent outdoors during wake time and its effects on sleep onset latency. My humble hypothesis, fresh air wears you out and you fall asleep faster.

Reference: Nixon GM, Thompson JM, Han DY, Becroft DM, Clark PM, Robinson E, Waldie KE, Wild CJ, Black PN, Mitchell EA Falling asleep: the determinants of sleep latency. Arch Dis Child. 2009 Sep;94(9):686-9.

Friday, September 18, 2009

Autism, Motor Skills and Vision

Recently, there have been more studies on autism and motor skill development. Many children with autism exhibit delays in motor skill acquisition. Some research has shown deficits in the following areas:

1. dynamic balance and diadochokinesis (rapid pronation/supination of forearms)
2. fine motor skills with regards to timed movements
3. increased variability to perform simple movements
4. performing timed tasks
5. slower initiation of movements.

In addition, research has shown a correlation between the degree of motor deficit and the degree of social withdrawal and severity of autism. There is limited research on eye hand coordination and autism.

In a recent study, 13 young people with autism were compared to 15 young people without autism in tasks that used vision and proprioception to land on one of two targets. In this study, young people with autism exhibited longer planning and execution of the manual reaching movements. There was great variability of the eye hand movements in the young people with autism. If the task required greater visual proprioceptive integration the amount of time required to perform the movement was increased.

Do you find these trends to hold true in your daily practice of therapy? For example, do you find variability in the day to day execution of motor skills in children with autism? What about the correlation between the degree of motor deficit and the severity of autism? How do you take these factors into account when setting goals?

More information on autism and proprioception.

Reference: Glazebrook, C, Gonzalez, D. Hansen, S., Elliott, D. (2009) The Role of Vision for Online Control of Manual Aiming Movements in Persons with Autism Spectrum Disorders. Autism 13 (4): 411-433.

Thursday, September 17, 2009

Proprioceptive, Tactile and Fine Motor Painting Activity

Here is a simple activity that you can modify depending upon the skill level of the child. We chose to do a name but you could make this activity much more simple by just doing lines or random designs. It could also be done on a canvas bag to make a great tote bag gift for someone special.

Purpose of activity: Encourage fine motor skill development, upper extremity muscle strengthening and proprioceptive/tactile input.

Materials: painter's tape (low adhesion), paint and paper. Easel is optional or you could do the activity on the floor.

Step 1: Put painter's tape (low adhesion) on a large piece of paper in a design or create a name.

Optional: If able have the child help to tear the tape to encourage fine motor skill development.

Step 2: When design is completed paint the palms of the child's hands. The child will then press hard on the picture with flat hands.

Step 3: When the paint has dried completely remove the painter's tape to reveal the design.

Looking for more sensory motor development ideas? Go to for free activities, electronic books, monthly newsletter and more.

Wednesday, September 16, 2009

Robotic Therapy and Cerebral Palsy

Heard about this from @pediastaff on Twitter. Watch this news story about what Shriner's Hospital is doing with children who have cerebral palsy.

Tuesday, September 15, 2009

COORE - Cooperative of Occupation Related Evidence

Heard about this new venture on Twitter from @willwade. COORE (Co-operative of Occupational Related Evidence) is an open access journal for Occupational Therapy and Science evidence. The goal is to create a peer reviewed online, FREE journal to gain more evidence to support occupational therapy. The creators are looking for OT's to help out with peer reviews and submitting research. For more information regarding COORE check out the blog. Help to spread the word regarding this online journal - tell all your OT students, colleagues and professors.

Sunday, September 13, 2009

Observing and Guiding Children's Play

Play for young children is crucial to healthy development. Pediatric therapists who work in early childhood education know the importance of play and how to use it to reach IEP goals that are set for specific children. When a child is evaluated for therapy services, the therapist observes the child in the classroom setting. Therapists will then often consult with teachers and school staff on using different toys, activities and centers to encourage practice of motor skills and sensory development. Here are several tips to fine tune your observation skills and to guide children's play in the classroom.

1. Observe the environment.
Can the child access all the toys and activities? Are activities practiced in different environments to encourage generalization of skills?

2. Observe what the child does during free play.
What toys does the child like to play with the most? During free play what centers does the child spend the most time in?

3. Observe what toys or activities the child prefers.
Just like learning styles in older children, you can assess learning styles in little ones by what toys they prefer. Does a child prefer visual, auditory, tactile or kinesthetic activities?

Once these questions are answered use the gathered information to create a plan of action. Make sure that if possible all of the toys are accessible for the children. Provide the classroom staff with specific ways to generalize skills across different centers. After determining a child's toy preferences use that knowledge to make suggestions regarding toy placement. If a child dislikes a certain center, try adding favorite toys into that center to initially engage the child. After these ideas have been tried and a child is still not engaging in certain centers, provide prompting by adults in the classroom. Make sure that the adults provide the least amount of prompting that is necessary. Prompting can be done along a continuum such as:
1. Present the activity to the child
2. Provide a verbal request to play.
3. The adult can model how to play.
4. The adult uses hand over hand to assist with play.
At each stage of prompting the adult should wait several seconds for the child to interact following the prompt before moving on the the next level of prompting.

Each time that you observe a child in a natural setting, remember to observe closely to ensure that the environment is suitable for developmentally appropriate play. What do you find works best to engage children in play? Do you have any other observation tips? Would love to hear what works for you...

Reference: DiCarlo, C., Vagianos, L. (2009) Using Child Preferences to Increase Play Across Interest Centers in Inclusive Early Childhood Classrooms. Young Exceptional Children 12:4 (31-39).

Saturday, September 12, 2009

Including Samuel - Documentary on Inclusion

This seems like a very interesting upcoming documentary to watch on PBS stations entitled Including Samuel. It is the story of a family's quest to include Samuel, a nine year old boy with cerebral palsy, in all aspects of their lives. It describes the successes and trials over 4 years of Samuel's family and 4 other individuals with disabilities. This looks like one to watch. Go to the website to see the schedule of when the documentary will be airing in your area.

Friday, September 11, 2009

Free Resource for the Assistive Technology Process

This is a free, download of a electronic workbook that allows students to help guide the assistive technology process. This is full of great information and questionnaires for the students to fill out. It is entitled Hey Can I Try That? A Student Handbook for Choosing and Using Assistive Technology. Just click on the title to download the book.

Tuesday, September 8, 2009

Spasticity and Gross Motor Function

Spasticity levels were measured using the Modified Tardieu Scale in 50 children with cerebral palsy (GMFCS I-V)aged 18 months. The children followed for one year and gross motor function was assessed with the GMFM-66. The researchers concluded that spasticity has a small relationship with gross motor function but other factors also need to be considered.

Reference: Jan Willem Gorter , Olaf Verschuren , Laura Van Riel and Marjolijn Ketelaar (2009) The relationship between spasticity in young children (18 months of age) with cerebral palsy and their gross motor function development BMC Musculoskeletal Disorders 2009, 10:108doi:10.1186/1471-2474-10-108

Monday, September 7, 2009

Great Video on "Extreme Recess" for Kids with Disabilities

Extreme Recess! Summer 09 For Health Week from Abby Kritzler on Vimeo.

Twitter for Therapists

Twitter is an excellent platform to learn about: therapy ideas, therapy practices all over the world, research, assistive technology and more. Many people use to twitter to enhance their personal learning network (PLN). For those of you who are new to Twitter it is a short messaging service where you can follow other peoples messages or create your own 140 word character tweets. Because the messages (other wise known as "tweets") have to be so short they must be concise and to the point. This allows you to read through a significant amount of information in a short amount of time.

Here are 5 steps to getting started with Twitter:

1. Create an account. Go to and create an account.

2. Organize tweets. If you plan on following many people I recommend that you use a tool like TweetDeck or Hootsuite. These tools allow you to follow many tweets and manage them. It can be become very difficult to read all the interesting information that comes in if it is not organized. You can create columns of different topics i.e. OT, PT, assistive technology, autism, ADHD, etc. This makes all the "tweets" more manageable to read and follow. If you want more than one Twitter account, for example personal and professional, you may want HootSuite to manage those accounts.

3. Send a message. Type your 140 character or less message in the box at the top of the page and hit update or enter. If you are referencing a website you have to include http:// before the www part of an Internet address. Most people shorten the web address to leave more room for the message. To do this you can create a tiny url right in TweetDeck. Paste in the full web address and hit the shorten button.

4. Find people to follow. This can be a slow process. You can search keywords in Twitter via TweetDeck or Twitter Search. For example, type in the keyword occupational therapy and see what comes up. If you find any interesting tweets, choose to follow that person. To perform a more specific search use a hash tag. A hash tag in twitter is the # sign. You put that before words when you want to tag a tweet. For example, we frequently use the hash tags #OT, #PT, #ADHD and #autism to mark our tweets on specific topics. This allows people to track the topics easier.
Another way to find people to follow is to find one person who shares your interests (we recommend @YTherapySource - that is us!) Then check who we follow and who follows us. Many of these people will also have common interests.

Here are 2 great Twitter accounts that I recommend to follow for pediatric therapy topics:
@YTherapySource - pediatric occupational and physical therapy news, research, ideas and activities.
@pediastaff - more pediatric OT, PT and speech news stories, research and tips.

5. Retweet, Reply or Direct Message. Here is some Twitter lingo to review. When you retweet a message, you can resend a message to all of your followers that you think is important. For example, you read a post that we wrote and you want to share it with others. You can just click on the retweet button in TweetDeck or type in RT@YTherapySource and paste the message.

You can reply to any message by simply typing in the twitter account name with the @ sign before it i.e.@YTherapySource - thanks for all the great information.

If you want to send someone a message but do not want all of your followers to view it, you can direct message someone or DM. You can click on the direct message button in TweetDeck or type in D@YTherapySource followed by your message. This tweet will only be seen by the person you are sending it to.

From personal experience, I have found Twitter to be a great networking source of information. Give it a try! If you would like to recommend someone to follow regarding pediatric therapy post a comment.

Sunday, September 6, 2009

Navigate Web with Keyboard

Key Surf was released by CanAssist in June 2009. It allows users to navigate the web using they keyboard instead of a mouse. It also remembers your web history making it faster to use each time. This free download may be helpful to any client who is unable to use a mouse. It is compatible with a standard keyboard, intellikeys, on screen keyboards and speech recognition. It is in beta format so they are looking for feedback. You do need the Firefox web browser.

Friday, September 4, 2009

Visual Motor, Eye Hand Coordination and Handwriting

The Journal of Occupational Therapy, Schools and Early Intervention published research on 75 second graders who were evaluated using the Concise Assessment Scale for Children's Handwriting, the Developmental Test of Visual Perception-2 and the manual dexterity section of the Movement Assessment Battery for Children. Results indicated that visual motor integration and eye hand coordination are predictive of the quality of a student's handwriting.

Reference: Marie-Laure Kaiser; Jean-Michel Albaret; Pierre-Andr Doudin (2009) Relationship Between Visual-Motor Integration, Eye-Hand Coordination, and Quality of Handwriting. Journal of Occupational Therapy, Schools, & Early Intervention, Volume 2, Issue 2 April 2009 , pages 87 - 95.

Wednesday, September 2, 2009

NDT, SI or Perceptual Motor Approach for Children with Mild MR

The American Journal of Occupational Therapy published research on the effects of neurodevelopmental treatment (NDT), sensory integrative therapy (SI) and perceptual motor (PM) therapy for children with mild mental retardation. One hundred sixty children were randomly assigned to one of four groups: NDT group, SI group, PM group and control group. After interventions, the three groups all performed better than the control group on most measures. The children in the SI group showed greater improvements in: upper limb coordination, fine motor skills and SI functioning. The children in the PM group showed greater improvements in gross motor skills. The NDT group exhibited the smallest changes.

Reference: Yee-Pay Wuang-PhD, OTR, Chih-Chung Wang-MA, OTR, Mao-Hsiung Huang-PhD, MD, Chwen-Yng Su-PhD, OTR (2009) Prospective Study of the Effect of Sensory Integration, Neurodevelopmental Treatment, and Perceptual--Motor Therapy on the Sensorimotor Performance in Children With Mild Mental Retardation AJOT 63 (4) Abstract.
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