Many pediatric occupational and physical therapists work with children who exhibit decreased sensory processing such as decreased body awareness, motor planning and proprioception. These difficulties of sensing where a child is in space can interfere with motor skill development, peer interaction and safety. We are all familiar with therapy sessions that focus on proprioceptive input, following motor commands and activities that encourage the children to learn where their body is in space. One additional activity to consider is fully exploring the environment where the functional skills are to be learned.
Let’s take this goal for example: Johnny will negotiate the classroom without bumping into stationary objects 100% of the time. As stated previously, therapy may consist of body awareness activities, proprioceptive input (heavy work activities) and motor planning skills. If it is pull out therapy all of this takes place outside of the true environment. If it is push in therapy perhaps skills are practiced during recess, physical education or sometimes in the classroom. BUT do you remember to explore and practice skills in the actual environment?
Remember to not only practice activities but how about really exploring the area where “Johnny” is having difficulties. When the classroom is empty, go inside and have Johnny walk in and around the desks and chairs. Johnny can crawl under desks, kneel down and sit in different locations in the classroom. Add in games or activities to keep it novel. Provide verbal cues as Johnny walks by items ie. this desk is wide or this aisle is narrow. This exploration allows Johnny to develop a motor map of his surroundings with him in it. He can develop a better sense of how big desks are, how tall are the chairs, how wide is the carpet and how far is the bathroom.
This can apply to different areas of the school or home. How about the cafeteria? Let a child explore it to help define a motor map for in between cafeteria tables, on the cafeteria line and around garbage cans. At home, if furniture is changed around allow time to just explore the new areas and obstacles without adding in the stressors of different goals. Now when you do start to add in the actual functional tasks that needs to be accomplished, Johnny should have a much better idea of what you are expecting of him.
In summary, keep it simple sometimes and start out with just simply exploring the surroundings without adding in any other functional tasks to help build a strong foundation.