Wednesday, October 31, 2012

More Hula Hoop Ideas

There is a previous blog post here on hula hoop ideas that was extremely popular entitled 3 Simple Group Games with a Hula Hoop.  I just came across a great video from Barbara Smith, The Recycling OT, with some more fun ideas to use a hula hoop.  I especially liked her ideas to put the rings on the hoop.  You can watch the video below.


Pencil Grasp, Legibility and Speed of Handwriting

Recent research completed video analysis on 120 typically developing fourth grade students performing a handwriting task.  The pencil grasps were categorized into six groups (four mature, one immature and one alternating grasp).  Speed and legibility of handwriting was evaluated.  The results indicated that there was no significant effect for mature pencil grasps on speed or legibility.

Reference: Heidi Schwellnus,Heather Carnahan,Azadeh Kushki,Helene Polatajko,Cheryl Missiuna and Tom Chau. Effect of Pencil Grasp on the Speed and Legibility of Handwriting in Children. American Journal of Occupational Therapy November/December 2012 vol. 66 no. 6 718-726. doi: 10.5014/ajot.2012.004515

Tuesday, October 30, 2012

Limb Length Discrepancies

A recent study in Pediatric Physical Therapy evaluated limb length discrepancies in 105 typically developing children ages 8- to 12-years-old. Limb length measurements were taken from the anterior superior iliac spine to the medial malleolus and umbilicus to medial malleolus using the direct method. The results indicated that 7 of the 105 children exhibited a limb length dicrepancy of 2cm or more.

Reference: Drnach, Mark PT, MBA, PCS; Kreger, Alison PT, DPT, PCS, CKTP; Corliss, Charles PT, DPT; Kocher, Derek PT, DPT. Limb Length Discrepancies Among 8- to 12-Year-Old Children Who Are Developing Typically. Pediatric Physical Therapy: Winter 2012 - Volume 24 - Issue 4 - p 334–337. doi: 10.1097/PEP.0b013e3182691c48

Monday, October 29, 2012

Balance and Motor Memory Video Activity Idea

Practice balance skills, coordination, jumping skills, motor planning and motor memory all with some duct tape and rope!  Watch the video for all the details at 

Thursday, October 25, 2012

Stair Climbing App Review

Here is a fun, free app to add to your iPhone or iTouch - Monumental.  It keeps track of how many stairs you climb using the phones accelerometer.  Holding the iPhone at your hip, you hit the GO button.  Start climbing the stairs. It will keep track of how many steps you climb.  When you have climbed the correct number of steps you reach the top of your destination and then you can see the view.  The first level is the Museum of Art in Philadelphia (Rocky Movie stairs).  So when you reach that level it shows you a view from the top.

This adds a little bit of extra fun to stair climbing.  Since many children work on stair climbing during therapy sessions this freebie app can help keep track of their progress over time.  

I give this app a huge thumbs up.  I have tested it out with some kids and they were motivated by it especially to get to the next level.  Personally, I enjoyed checking out the views but the kids seemed to want to just achieve the next level.  You can share your status on the social networking sites although I did not use the app in this manner.  The only downfall is that I wish you could create different accounts.  I have the kids just adding on to eachother's accomplishments rather than each climbing their own monuments.  The feature of counting the steps is still convenient though to track progress in therapy session notes. 

Why not give it a try?  Can't beat free and maybe one of the children (or yourself) will be motivated to climb the monuments of the World.  Hey this even relates to the Common Core Standards right? More on that another time.

Wednesday, October 24, 2012

Super Simple Brain Break Tip

While many of us know that increased physical activity levels are associated with higher academic scores, it can be hard to implement more exercise time during the school day.

Here is a simple tip -  suggest to the teachers to squeeze in a super quick movement break every hour on the hour no matter what they are doing.

Just take two minutes to drop the pencils, stand up and move around.  It can be as simple as doing the same activity every hour ie. stretch and marching in place or as varied as changing the activity every hour or every day.  You could even provide suggestions to perform the movement breaks sitting down.  With kids in school for about 6 hours that would total up to an additional 12 minutes towards the 60 minutes of physical activity per day that is recommended.  Not to mention shake those wiggles out and get kids ready to work.  I know this can not work in every class room but for some it might be another idea to add into the school day.

Need ideas?  Check out 10 Simple Activities to Encourage Physical Activity,    Mini Movement Breaks (print this out to give to teachers to change the activities up - super easy and the breaks require no equipment), go on a quick Imagination Action Journey,  or perform activities from Roll Some Fun (print and throw the dice to determine what activities to perform). 

Tuesday, October 23, 2012

Lined Paper and Letter Formation in First Graders

A recent study in the Journal of Occupational Therapy, Schools, & Early Intervention assessed two groups of first grade students with the Minnesota Handwriting Assessment. The first group printed on a four-lined writing grid that included top, middle, base, and descender guidelines. The second group printed on double lined paper that provided middle and base guidelines only.

The results indicated the following:
  • no difference between groups for legibility, form, alignment, and space as measured by the Minnesota Handwriting Assessment. 
  • a statistical difference noted between the two groups for size 
  • sizing errors showed that 55% of the students in the double-lined paper group used the middle guideline as a top guideline 
The researchers recommend using paper with a top and bottom guideline for first graders to encourage proper letter sizing.

Reference:  Whitney Reidlinger MAOTR/L, Catherine Candler PhDOTRBCP & Marsha Neville PhDOT. Comparison of Differently Lined Paper on Letter Production Quality in First Graders. Journal of Occupational Therapy, Schools, & Early Intervention Volume 5, Issue 2, 2012 pgs 155-164 DOI:10.1080/19411243.2012.701544

Sunday, October 21, 2012

Halloween Sensory Motor Group Game

Play this Halloween sensory motor group game to encourage locomotor and listening skills.  You can view or download the lesson plan at YourTherapySource.

Saturday, October 20, 2012

Loopz Motor Planning Game and App Review

There are more and more active games coming out on the market.  LoopzTM is a toy available in stores ranging from $35 to $50 (Walmart, Target, ToysRUs, etc) and online that is a great tool to practice motor planning and coordination skills.  It is a set of four arches that has lights in each arch.  There are different ways to play with Loopz and motion sensors detect your movement as your wave your hands through the matching loops.  Some of the games start out with you using one hand to follow the lights and then progress to two hands.  In addition you can make music by turning on and off the loops, which the teenagers enjoy.

This has been a great toy to add to my PT bag.  The children can play on all fours, over the therapy ball or even in standing.  Motor planning skills, reflexes, balance and coordination skills are challenged as the children have to follow the patterns of the lights.  My favorites are Repeat the Beat and Reflex Master.  Repeat the Beat is where you have to repeat an increasing number of lights.  Reflex Master challenges you to wave as many lights as you can before time runs out.  Have to admit the kids don't love playing in standing (although I do) because it challenges their balance and they really just want to play the game.  I usually have them try it and reward them with a turn on all fours which is still beneficial.  When the game progresses to requiring the player to use two hands at a time it can become difficult for many children since it challenges bilateral coordination skills and timing.       

The Loopz app ($0.99 full version but a free version is available) is also a fun addition to challenge students reflexes, motor planning, bilateral coordination and timing.  I prefer the "real" game to the app from a physical therapy perspective but I am sure OTs would love to try out the app.  There are also more options on the app to create music by tapping the Loopz.  I think a bargain for $0.99.    

Has anyone else tried out this game?

Friday, October 19, 2012

Toothpick Pincer Grasp Activity

Here is a super simple and super economical activity to encourage the pincer grasp.  Recycle and clean a Styrofoam tray.  Draw some simple shapes, letters, numbers or just let the child make a free form sculpture.  Put the toothpicks next to the tray in a container.  Poke the toothpicks into the tray around the shapes as pictured or anywhere.

Try using other objects to poke the tray like a dull pencil or the back of a paint brush.

This would make a nice sensory break as well that incorporates fine motor skills, proprioception and visual perceptual skills.

Want to add another element to your sculpture?  Put colored straws next to the tray.  The child can place the colored straws over the toothpicks to make the sculpture taller and colorful.  Be careful not to knock over the toothpicks as you put the straws on - takes a lot of graded muscle control. 

Thursday, October 18, 2012

ADHD, Exercise and Learning

A new study published in the Journal of Pediatrics recognizes the benefits of exercise to improve academic abilities in children with ADHD.  In this study, 40 children total (20 with ADHD 20 without ADHD), ages 8 -10 years old spent 20 minutes walking briskly on a treadmill or 20 minutes reading.  This was followed by a reading comprehension test, math exam and a computer game (goal of computer game was to ignore visual stimuli).  The results indicated that all of the children scored better following the bout of exercise.  In addition, following exercise the children with ADHD did a better job at slowing down after making an error to avoid repeat mistakes.  The researchers concluded that children need more physical activity throughout the day.

This is an excellent tip to offer to teachers before the next state exams, especially with all the new APPR requirements and test score results - take a brisk walk for 20 minutes right before the exams.  Free, healthy and super simple to carry out.

Need ideas to squeeze physical activity in throughout the school day?  Check out the following -
Classroom Activity Posters, Mini Movement Breaks, Roll Some Fun, Dancing with the Owls and Educational Sensory Motor Activities.

Reference: Michigan State University. Exercise may lead to better school performance for kids with ADHD. Retrieved from the web on 10/17/12 at

Wednesday, October 17, 2012

Pediatric OT and PT for Children with Cerebral Palsy

Research will be published on the focus and amount of pediatric occupational and physical therapy services for 399 children, ages 2-6 years old, with cerebral palsy.  Parents completed a questionnaire over the telephone with therapists reporting the child's Gross Motor Function Classification System (GMFCS) level.  The results indicated the following regarding the amount of services:
  • children who received educational and clinical services had greater mean minutes per month for OT and PT services
  • mean minutes per month of OT and PT were greater for children GMFCS Levels IV and V than Level I
  • mean minutes per month of OT and PT were higher in the US than Canada
Parents reported that pediatric therapy services focused on the following:
  • moderate to great extent on primary impairments, secondary impairments, activity, and structured play activities 
  • moderate extent on environmental modifications and equipment 
  • moderate to small extent on self-care routines

Reference:  Palisano RJ, Begnoche DM, Chiarello LA, Bartlett DJ, McCoy SW, Chang HJ. Amount and Focus of Physical Therapy and Occupational Therapy for Young Children with Cerebral Palsy. Phys Occup Ther Pediatr. 2012 Sep 7. [Epub ahead of print]

Monday, October 15, 2012

Postural Control and Ankle Foot Orthotics

Recent research studied the effects of ankle foot orthotics on trunk postural control and lower limb coordination in 20 children (ages 4-12) with and without cerebral palsy.  The results of tridimensional trunk kinematics and thigh, shank, and foot elevation angles while walking barefoot and with ankle foot orthotics indicated the following:
  • significantly greater trunk excursions in children with cerebral palsy compared to
    typically developing children in both conditions
  • when wearing ankle foot orthotics, increased trunk frontal angular velocity was seen in children with cerebral palsy whereas typically developing children showed increased trunk frontal displacement
  • no significant changes in trunk displacement and angular velocity were recorded in the sagittal plane in either group
  • significant changes in shank and foot elevation was seen in both groups when wearing the ankle foot orthotics
Reference: Degelean M, De Borre L, Salvia P, Pelc K, Kerckhofs E, De Meirleir L, Cheron G, Dan B. Effect of ankle-foot orthoses on trunk sway and lower limb intersegmental coordination in children with bilateral cerebral palsy. J Pediatr Rehabil Med. 2012 Jan 1;5(3):171-9.

Thursday, October 11, 2012

Visual Monitoring and Handwriting

The Edie Neurolearning Blog posted information on some research on the brain basis of dysgraphia.  It appears to be very interesting although there is not a reference.  It confirms what many pediatric therapists observe - many children require extensive visual monitoring of letter formation.  Functional MRI's compared "good writers" with "bad writers".  The testing revealed that "bad writers"  had much more active visual areas of the cortex than the primary motor-sensory areas around the central gyrus.  In addition, cerebellar activation was stronger in midline structures ie trunk more than the fingers.

Reference:  Edie Neurolearning Blog.  Retrieved on 10/10/12 from

Tuesday, October 9, 2012

Immersion in the Skill

Here is something to try that does not have to necessarily do with swimming - immersion in one particular motor skill.  When we are teaching a child a new motor skill or perhaps working on refining a motor skill, try bombarding the child with the skill.  Here are some examples:
  • The goal is to write a circle.  Overload the child with circles during the therapy session.  For example, cardboard tube slices, tub tops, jar lids, paper plate stencils, hot glue rubbings, salt tray, etc all to practice manipulating and writing circles.  
  •  The goal is to jump forward 6 inches with two feet together.  Overload jumping skills with watching videos of children jumping, model the proper jump, play a game with frogs who jump, jump on a trampoline and more.
  • The goal is to perform a sit to stand transfer with verbal cues.  Practice sit to stand transfers in many different chairs, video tape the sit to stand transfer and watch it, practice manipulating action figures or Barbie type dolls moving from sitting to standing, etc.
Take the time to discuss with the child the importance of the skill.  By providing all the opportunities and examples of the skill will hopefully teach the child how important the skill is and to help provide the child with internal motivation to achieve the goal.

What do you do to "overload" a child to learn or refine a motor skill?  

Monday, October 8, 2012

Bean Bag Tunes on You Tube

Came across these fun YouTube videos to use as a quick brain break for teachers in class or some activities during a therapy session.  It reinforces learning right side from the left side, bilateral coordination, body awareness and following directions.

Here is the BeanBag Beatbox #1:

Here is Beanbag Beatbox #2:

If you need more movement to music ideas check out all the great titles for sale at

Thursday, October 4, 2012

Relationship Between IQ and Motor Skills

Pediatrics published research on the relationship of IQ to motor skills.  Data on motor skills and IQ was assessed on 460 children in educational and clinic settings.  The results of the data analysis indicated that typical and atypical motor skills were seen at all levels of IQ.  In addition the following was seen:
"for each SD lower IQ, a mean loss of 10 percentile motor points should be expected".
 Overall, children in the study with a lower IQ showed poorer motor performance more often than children with a higher IQ.  

Reference:  Bouwien Smits-Engelsman and Elisabeth L. Hill. The Relationship Between Motor Coordination and Intelligence Across the IQ Range. Pediatrics 2012; 130:4 e950-e956; published ahead of print September 17, 2012, doi:10.1542/peds.2011-3712

Wednesday, October 3, 2012

Pincer Grasp on iPad

Here is the tip of the day when using an iPad - use a mini sponge.  A regular cellulose sponge cut up into a small piece will encourage the child to use a pincer grasp when using the iPad.  In the pictures above, you can see the pincer grasp on the mini sponge.  Now you can "write" directly on the iPad using the sponge instead of just the fingertips.  This is wonderful for visual motor activities (ie Visual Motor Workbook in pdf format opened in an app that allows you to mark up pdf documents).  It works on regular apps as well.  Tested it out on Letter School and it worked perfectly.  Hopefully, encouraging the pincer grasp with the mini sponge when forming letters or visual motor tasks on the iPad will result in be better carry over to actual handwriting compared to just using pad of the index finger.  Thanks OT with Apps for the idea!

Tuesday, October 2, 2012

Dynamic Tripod Grip

We have recently published What? Why? How? Series 2 which is a collection of 11 hand outs to describe what something is, why it is important and how you can help. Series 2 has a focus on fine motor skill development. You can download a free sample page on the dynamic tripod grip.

Monday, October 1, 2012

October 2012 Digital Magazine for Pediatric OT and PT

The latest issue of Your Therapy Source's digital magazine for pediatric occupational and physical therapists is now available for free. It includes articles on motor skill practice, sensory processing and lots of freebies. If you can not view the document below go to to download a pdf copy.
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