Helping our students build and develop the small muscles of their hands so they can be successful with their daily routines both at home and while at work is very important. Here are some of my favorite hand strengthening treatment ideas!

• Theraputty or Playdough: You can roll it, knead it, turn it into a pancake. I love to hide items, such as beads or coins inside to have the students try to find them.
• Rip Paper and Crumble: Work on using two hands together to rip paper. The thicker the paper the harder to rip! Take those ripped pieces and roll them into a ball so you can use those materials to create a craft.
• Cookie Cutters: Use cookie cutters with the playdough, or take small elastic bands and try to have students stretch them around the cookie cutter
• Tennis Ball Mouth: Make a small incision in the tennis ball, and draw on some eyes. Squeeze the tennis ball to open the mouth and feed it some pompoms or beads.
• Clothes Pin or Tweezers: Both are great manipulation tools
• Pompoms in a Wiffle Ball: Try picking up and pushing pom-poms through the holes of a wiffle ball. This is also great for in hand manipulation by passing the pom-poms from the palm of a hand to the fingertips.
• Beads: Take small beads and slide them onto a pipe cleaner. Combine these beads with the theraputty or playdough for further hand strengthening
• Using a Spray bottle is a great way to target the open web space and graded pressure.
• Classroom materials such as hole punchers, squeeze glue, and a stapler are all beneficial for building hand strength and bilateral coordination
• Wheelbarrow Walks: This also includes any other weight bearing exercises where your students are pushing through their arms
• Squigz: The suction of Squigz provides good resistance for hand strength. Combine this with using a scooter board. Have students use the Squigz on a tile floor to propel themselves forward.
• Pegs: Foam Pegboards also provide resistance when trying to insert the pegs. Incorporate color matching to build with the pegs for targeting additional skills.

By Andrea Doumar, Pediatric OT @ot_room

Advice to New Pediatric OTs

In honor of Occupational Therapy Month, let’s talk about lessons learned! I definitely wish I knew these tips when I was a new graduate.

A Very Important Reminder

It’s not that you’re bad at this, you are NEW at this. Transitions, even positive ones, can be difficult. Know that it can take time to navigate new documentation systems, establish relationships with new clients, and manage treatment plans. Every client, every family is unique, so make space for that!

Be honest with your needs and areas of growth. Ask about the pace of the setting that you plan to work in, common diagnoses, mentorship & learning opportunities, as well as expectation on hours & scheduling. Do you enjoy setting your own hours, prefer an established schedule, or able to be on the go & change routine quickly? These are great areas to consider.

Take opportunities to learn about feeding interventions, sensory processing, emotional regulation & executive functioning. It will be helpful in the long run!

Listen & Be Intentional. Ask about caregiver and client concerns, and check in periodically to make sure that everyone is on the same page. Pediatric therapies can be completely new and at times stressful for families, so don’t assume that everything will make sense the first time. Present yourself as a support for families and not as a sole expert. Even strategies that work in a clinical or school setting, may be more difficult to implement at home, so work together to find feasible and applicable interventions. As you listen and get to know different families, you’ll learn how to collaborate and interact with different parenting styles as well!

If it’s not a matter of ethics or safety, don’t take negative or constructive feedback too personal. Families may switch therapists or leave altogether. It happens and it isn’t just you.Learn how you can improve for future clients, or just simply know that everyone has personal preferences and different personalities, and that’s ok. It’s truly important to have a growth mindset in this profession!

Always Continue Learning! Collaborate and learn from other therapists and work together when you can! Take continuing education courses and attend conferences. Seek mentorship and community with other peers, even if they are not in the area! Learn about community resources that can be helpful for families and therapists, like the disability application process and related waivers, local inclusive recreation programs, parent support groups, therapy resources and handouts to provide, and more.

Finally model occupational balance and take to learn something unrelated to occupational therapy and clinical skills. Burn-out is real and can happen at any point in your career. Take time for self-care and be intentional with your wellbeing & overall wellness - physical & mental.

By Dr. Diamond E. Rashad, OTD, OTR/L @adimeofot

In this post, I'm going to personally compare and contrast the outdoor playground with the new kid on the block, the sensory gym. On the surface, they appear similar, yet when we dive deeper into their purpose they couldn't be more different.

"It is a happy talent to know how to play" – Ralph Waldo Emerson

In this article, I do a deep dive into the origins of the outdoor playground and the sensory gym. What they are, their original purpose, their benefits, and what they aren't. So make sure to read to the end so you can be fully informed on which one is best for your child and when.

Within each I compare:

• Origins
• Purpose
• Benefits
• What they aren't
• How they're both effective in their own way

So make sure to read to the end so you can be fully informed on which one is best for your child and when.

Personal Overview

Before I get into the article myself, my name is Mason Pfefferle. I've been involved in designing, installing, and marketing sensory gyms for over 10 years. I'm a father of three sons, and a daily frequenter of the local outdoor playground.

Origins of the outdoor playground

The outdoor playground was a local oddity when it first appeared on the public stage. Initially known as "sand gardens" in Germany in 1885, the United States saw its first playground appear at Golden Gate Park in San Francisco in 1887. The first government-funded playground wasn't built until 1903. Shortly after the first government-funded playground was installed, the Official Playground Association of America was founded in 1906.

In 1907 President Theodore Roosevelt called for the construction of playgrounds as a way to protect children from playing dangerous, unsupervised games in the hot city streets. Interestingly, in 1912 climbing structures were banned from New York playgrounds. Two years later it was made a crime to play in the streets as many believed this led to truant behavior.

The first industrial revolution took place in England during the 18th and 19th centuries. The United States was still a fledgling nation at the time. It was only a matter of time before British industrialists would take advantage of the many opportunities the United States presented. One of the first large-scale textile mills to open in the United States was done so by Englishmen Samuel Slater in 1793.

Urbanization in the United States

The second industrial revolution often referred to as the American Industrial Revolution began in the second half of the 19th century. After the absolute carnage of the civil war, the United States was in a period of reconstruction. At the same time as rebuilding, the United States saw a massive influx of job-searching European Immigrants. Most of these jobs would be in factories which were located in industrial cities.

According to Hofstra University historian, Alan Singer, "Cities grew because industrial factories required large workforces and workers and their families needed places to live near their jobs. Factories and cities attracted millions of immigrants looking for work and a better life in the United States."

As urban populations grew, so to did the stress on public welfare. Cities suffered from poor air quality, cramped living quarters, and social isolation. This led to the spread of epidemic diseases such as tuberculosis.

A place to be a child

Most children living in urban areas in the 19th and 20th centuries played on the curb or in the streets. This presented a constant danger to the safety of the children. Many children sought out "play streets" these streets saw minimal vehicle traffic. The initial concept of the playground was to alleviate the everyday burdens of urban life on children. With purpose-built play structures in urban areas, children were able to practice healthy play routines, develop social skills, keep themselves from engaging in troubling street activities, and just be children.

Soren Carl Theodor Sorenson was a Danish landscape architect who is considered to be one of the greatest landscape architects of the 20th century. Soren is best known for designing the first Adventure Playground for children in Copenhagen. Adventure playgrounds were playgrounds modeled on the empty lots that children sought out for play. These playgrounds contained tires and other "junk" material, with a few existing play structures, that would allow children to build and create their own unique play area. Well-maintained adventure playgrounds could be unique and enjoyable spaces, but many became a repository for unwanted material. There remains a movement today to reintroduce adventure playgrounds as a viable concept for schoolyard play.

Outdoor Playground Benefits

Many of my most cherished memories as a child can be traced back to playgrounds. It's where I met some of my closest friends, where I learned to vent my frustrations in a subliminal manner, and where I learned to be patient and respectful of others' abilities. Encouragement was always in high supply as we cheered for each other to complete the monkey bars or walk across the balancing pole without falling onto the woodchips.

Some of the incredible benefits of the outdoor playground include:

1. Reduced Risk of Nearsightedness:

• Outdoor play can reduce a child’s risk of becoming nearsighted. There are of course genetic factors that are also at play, however, many studies continue to show links between outdoor play time and myopia. Here is a study for your convenience

2. Lowered Risk of Behavioral Issues:

• There's a strong link between a child's connection with nature and behavioral problems. Researchers have found that nature connected-kids were better behaved and more likely to behave kindly to others. The study is available here.

3. Facilitates Group Interaction:

• Friends to play with and peers to meet! Playing games, collaborating to play games, or taking turns to go down the slide are all working to foster a child's social skills. When children learn the rules of a game and use them to play with other kids, they're working on akey executive function skill,

4. Sensory Development:

• Swinging, spinning, sliding, and climbing all provide children's brains with complex vestibular andproprioceptiveinformation. When properly analyzed, this information helps a child orient themselves through proper body positioning and posture in space and time. Should I increase speed or decrease speed? These are questions addressed by vestibular and proprioceptive input.

5. Builds Muscle Strength:

• When children play they're warding off disease. Outdoor play improves immune system function, promotes a healthy heart and lung function, and lowers the risk of obesity and diabetes. When children swing they're working their core and leg muscles as well as shoulders. Almost every activity on the playground promotes healthy physical development.

Of course, there are way more than five benefits to playing on an outdoor playground. I wanted to touch briefly on the top five benefits. It's no secret that outdoor play fosters healthy cognitive and physical developmental growth in children.

On the surface, playgrounds may appear as mere fun. However, you'll see that these activities and obstacles are definitely providing your child with a full workout. My fiancé and I personally love taking our son to the park two hours before bed. This helps regulate his energy allowing for a full night of sleep.

The CDC recommends children should have at least60 minutes of moderate to vigorous physical activity every day. What better place to achieve this than by frequenting the outdoor playground? Frequenting the playground also creates a routine of exercise that we hope will carry over into our children's adult lives.

What An Outdoor Playground Isn't

Historically, outdoor playgrounds haven't always been accommodating or accessible to children with special needs or handicap needs. It wasn't until the passage of the Americans with Disabilities Act (ADA) in 1990 that we started seeing more inclusive playgrounds.

Even in 2022, it can be difficult to find local playgrounds that are handicap accessible. As I stated previously, many of my most cherished memories can be traced back to my time on outdoor playgrounds. But for children whose disabilities keep them from using playgrounds, those opportunities can be lost.

Many of the advancements we've seen take place around more inclusive outdoor playgrounds haven't come from the federal government but rather from parents and advocates. Inclusive playgrounds are much more expensive than traditional playgrounds which aren't accessible to children with disabilities. This means many local governments are having a hard time affording these projects.

These inclusive playgrounds allow children with disabilities to play shoulder to shoulder with their peers. Eve Hill a civil rights attorney with the Justice Department stated that "Play areas are not just places where kids have fun, they are places where kids learn to interact with the world, and with each other."

Outdoor playgrounds can also be overwhelming for children with special needs. Sensory Processing Disorderis a condition in which the brain has trouble receiving and responding to information that comes in through the senses. Children with SPD may have a hard time telling where their limbs are in space, bump into things, be uncoordinated, or find difficulty engaging in conversation or play. Because the symptoms of SPD are on a spectrum, many children may experience it differently.

Although children with SPD seem to generally prefer the same types of play as their typically developing peers (Cosbey et al., 2010), they may need explicit instruction in strategies to manage their sensory over-responsiveness and under-responsiveness and may need structured play situations while they are developing the ability to use strategies independently (Case-Smith & Miller-Kuhaneck, 2008).

This leads me to my analysis of sensory gyms

What is a sensory gym?

(Pictured is a Fun Factory Sensory Gym)

In its most basic definition, a sensory gym is a room or place that encourages sensory play or sensory activities. What do we consider a sensory activity? A sensory activity is any type of play or action that gives stimulation to our senses. There are a total of 8 senses.Sensory gyms provide a supervised environment in which sensory development is fostered through open-play and structured play situations. Structured play situations allow therapists and parents to isolate external factors while working to develop the sensory system.

It's this development in a safe setting that helps children develop their physical and cognitive abilities. This translates into increased confidence and self-esteem.

Before I get too far ahead of myself I want to give a brief history of the sensory gym. It's hard to believe that 15-20 years ago these lifelines that we now call sensory gyms were virtually nonexistent. In 2007 It's a Sensory World (ISW) became the first sensory gym in the state of Texas and only the second in the entire nation.

As I mentioned previously in the article, children with special needs and disabilities prior to the passage of the 1990 Americans With Disabilities Act and the advent of the sensory gym, either had to try and figure out a way to play on the outdoor playgrounds or avoid them altogether.

This lack of inclusion in outdoor playground design led many parents and therapists to begin creating their own sensory spaces. Many of these early sensory spaces included swings from the ceiling, balls, and mini trampolines. It wasn't until 2007 and 2010 that we started seeing the actual incorporation of outdoor playground features make their way into the sensory space scene.

The original designer of the sensory gym is Troy Pfefferle (founder of Playaway Toy Company and Fun Factory Sensory Gym.) Troy still holds patents on the indoor support bar which was one of the first indoor swinging apparatuses ever invented. He is also the founder of Fun Factory Sensory Gym, the first company to incorporate outdoor playground design into sensory gyms. Troy felt that early sensory spaces were limited by their equipment and design. Most early sensory gym designs weren't entirely purposeful.

There was equipment scattered about but the design lacked flow and functionality. Many of the sensory gyms you see today have quite a few components that were taken from the outdoor playground. These include:

• Monkey bars
• Zip-lines
• Swings
• Rock climbing walls
• Play structures
• Stairs
• Slides
• Foam-cube pits

More Than Just a Play Room

Just as the outdoor playground has tremendous benefits, so too does the sensory gym. You will see obvious similarities between the two given their shared design and equipment. When most people hear the word gym they immediately might think of treadmills, dumbbells, and Stairmasters.

These purpose-built sensory gyms are more than just playrooms. They're structured environments in which active play on intent-based equipment stimulates the senses of children. This includes equipment that addresses vestibular as well as proprioceptive needs. These sensory environments give individuals with autism and other sensory needs access to the equipment they need for sensory regulation in a non-threatening environment.

The structured nature of these sensory environments helps foster increased engagement by creating a calm setting. This calmness helps children focus and can minimize tantrums and meltdowns.

Sensory Gym Benefits

Although all children can use and enjoy a sensory gym, they're typically used in hospitals and therapy centers.

1. Enhanced Therapy:

• Sensory gyms in their own right provide many of the same physical fitness benefits. Many children with special needs require services such as occupational therapy, or speech therapy. Sensory gyms are not meant to replace these types of therapy, however, they will help amplify the effects of the therapy. Sensory gyms help foster engagement, when a child is engaged they're more likely to participate attentively in their therapy sessions.

2. Encourages Motor Planning:

• Because many sensory gyms have various pieces of equipment, they're tremendous for assisting children in motor planning. For example, when a child is navigating a rock wall they must conceive, plan, and carry out a skilled, non-habitual motor act in the correct sequence. This involves firstly generating an idea (ideation) deciding how to go about it (motor planning) and then carrying out that plan.

3. Cognitive Development:

• Sensory play helps developing brains bridge nerve connections. New and frequent experiences create connections that improve a child's ability to do more complex learning activities.

4. Problem-solving, creativity, exploration:

• Sensory gyms come with limited expectations. It is a place where a child can push the boundaries of their abilities while figuring out how to navigate certain sensory stimuli in a safe environment. Children can be creative with how they're going to use problem-solving to navigate the rock wall or jump into the foam cube pit.

5. Builds Muscle Strength:

• When children play they're warding off disease. Outdoor play improves immune system function, promotes a healthy heart and lung function, and lowers the risk of obesity and diabetes. When children swing they're working their core and leg muscles as well as shoulders. Almost every activity on the playground promotes healthy physical development. This is critical for children with special needs who have higher rates of obesity than their neurotypical counterparts. According to the CDC, 20% of children 10 through 17 years of age who have special health care needs are obese compared to 15% of children of the same ages without special health care needs.

Important Note

Sensory gyms do not exist to replace outdoor play. They exist to assist children in developing their sensory skills in hopes that this development will carry over into their everyday lives. From putting on their clothes to brushing their teeth to navigating a rock wall. Outdoor play is irreplaceable. However, as we discussed previously, traditional outdoor playgrounds for various reasons haven't always been accessible to children with special needs. There is also much more awareness around special needs today than there was 20 years ago. There are still tremendous strides to be made in regard to special needs awareness.

In Conclusion

Children of all ages and developmental stages can benefit from both an outdoor playground and a sensory gym. The sensory gym is a structured environment in which a child can develop their sensory systems. The outdoor playground also benefits a child's sensory system, however, the environment isn't structured and can be dangerous to children with special needs who may lack the required sensory processing abilities to effectively participate. Hence, the sensory gym!

I truly hope this article helped spell out the major differences between outdoor playgrounds and sensory gyms. They're both incredibly effective in how well they assist in the overall development of children.

Is there something I missed? Please let me know your thoughts. I look forward to engaging with my readers and getting to know everyone.

What is Neurodiversity? Neurodiversity recognizes and accepts the value of brain diversity. This includes autism too! Honoring and recognizing strengths, differences, and barriers.

Why Autism Acceptance Month? It’s important to not just stop at awareness, but also continue to support acceptance and inclusion. Listening to Autistic voices and diversifying your feed is essential to do all year long! Here are some additional(non-exhaustive) resources and books that can help to learn and take on new perspectives.

Podcasts:

• The Sensory W.I.S.E. Solutions - Laura Petix (The OT Butterfly)
• Two Sides of the Spectrum - Meg Proctor (Learn, Play, Thrive)

Books to Explore:

• NeuroTribes: The Legacy of Autism and the Future of Neurodiversity - Steve Silberman
• Uniquely Human: A Different Way of Seeing Autism - Barry M. Prizant and Tom Fields-Meyer
• I Will Die on This Hill - Megan Ashburn and Jules Edwards
• Sincerely, Your Autistic Child: What People on the Autism Spectrum Wish Their Parents Knew About Growing Up, Acceptance, and Identity
• Unmasking Autism: Discovering the New Faces of Neurodiversity - Devon Price

Picture Books:

• Spencer’s Noisy Mixer - Paige Amanda
• A Day With No Words - Tiffany Hammond
• Meneos, Pisotones, Y Apretones Para Calmar Mi Cosquilleo (Wiggles, Stomps, and Squeezes Calm My Jitters Down) - Lindsey Rowe Parker
• Liam’s First Cut - Taye Jones

Organizations & Sites:

• Neuroclastic - https://neuroclastic.com/
• Autistic Self Advocacy Network - https://autisticadvocacy.org/
• Autistic Women &Nonbinary Network - https://awnnetwork.org/
• Yellow Ladybugs - https://www.yellowladybugs.com.au/

By Dr. Diamond E. Rashad, OTD, OTR/L @adimeofot

Welcome to another edition of Therapy Talk with Fun Factory Sensory Gym. APRIL is Autism Acceptance Month, so I wanted to give you a rundown of what Autism is and what types of characteristics you might see with this condition.

Autism is a neurodevelopmental disorder, typically first identified in children, usually around 2-3 years of age (depending on early signs/symptoms and appropriate/timely referrals). Autism is best described, in my opinion, as a brain difference! Autism is very much a combination of characteristics, including, differences in social and language skills, alongside repetitive actions, special interests, and sensory differences, as well. Now, a child with Autism may present with challenges in just one, two, or any total combination of these areas.

Now, let's break down these characteristics:

Social Differences:

1. May prefer to play alone and to not interact with peers

2. Decreased environmental awareness or attention to personal space

3. Decreased or inconsistent use of eye contact

4. Difficulty maintaining focus on conversation to participate in communication with peers or adults

5. Decreased pragmatic skills

Language Differences:

1. Language delays

2. Echolalic speech (repeating others)

3. Scripting (reciting words or phrases they have previously heard, but are now out of context)

4. May be able to label pictures, but difficulty with asking for needs or wants

5. Regression in language skills (loss of words)

Repetitive Actions:

1. Preferred topics, toys/objects, and special interests

2. Perseveration on same activity

3. May prefer to play in the same way with all toys, such as lining up or rolling objects on the floor, or picking up and dropping over and over again

4. Prefer routine, difficulty with change

Sensory Differences:

1. Aversions to certain textures, tags in clothes, shoes on feet, grass, soap on hands, food on fingers or face, etc.

2. Sensitivity to loud noises and covering ears

3. Hand flapping and repetitive jumping

4. Sensory seeking (likes spinning, being flipped upside down, crashing into things, pushing feet into surfaces or parents, squeezing)

Now, remember, these are only SOME of the characteristics that you MIGHT see in children with Autism. My main goal is that you have gained a better understanding of what Autism is with this blog post. If you have any concerns that your child may have some challenges or differences in any of these areas, it does not mean that they will be diagnosed with Autism Spectrum Disorder. However, it is worth bringing up to your pediatrician if you notice any of these characteristics beginning to develop in your little one. They may be appropriate for further follow up testing to rule out this developmental disorder. Go with your gut...you know your child best!

If you have any further questions, feel free to follow me on Instagram at @tips_and_pediatricks and send me a DM with your questions. I'd be more than happy to answer!

By Dr. Darcy Fass, PT, DPT @tips_and_pediatricks

Therapy Talk featuring Sarah Stevens @theotmethod

🌸 Sarah Stevens, MSOT, OTR/L, is a pediatric occupational therapist in the Greater Philadelphia Area. Sarah has experience in pediatric acute care, rehab and early intervention settings. Sarah specializes in pediatric cardiology with expertise in infant handling, neurodevelopment, physical rehabilitation and stroke recovery. She loves utilizing a holistic approach to provide her clients, patients and families with the best possible care and support.

✅ Social-emotional skills are the foundation for building connection, social interaction, empathy, and emotional intelligence.
But first—it’s important to understand expectations at each developmental level to help your child soar on the social-emotional front and to give them opportunities to be successful!

Follow and share @funfactorysensorygym for useful tips and advice on all things related to therapy and more!

Did you just secure your first OT job? 🎉 Are you feeling nervous, anxious, oroverwhelmed? Here are my top tips and advice to help you thrive and be the best OT you can be! 💯

1. You are not expected to, nor will you, know everything. And that’s OK.

This is a hard one for us to wrap our brains around. Even as a clinician for 4 years, I still get frustrated with myself when I don’t know all the answers. But one of the best things you can do when you don’t know the answer is to go find it. It takes courage to admit when you don’t know something, especially when you’re first starting out. Be a sponge! Absorb everything you can, find a mentor, and take control of your learning. Self-initiation will take you far!

Tip: Keep a log of terms and definitions, treatment/evaluation components, and/or anything else you want to brush up on. Don’t overdo it though! Limit yourself to 5 items per week. Babysteps!

2. Ask Questions

This is how you will learn! It can feel daunting, especially when first starting out, but taking the leap and asking all your questions will not only help you develop clinical decision-making skills, but also build confidence over time.

3. Get to know your teammates and other integral members of your team

This does not mean you have to be close friends with everyone. But you do want to introduce yourself, get to know your teammates, and familiarize yourself with people that work near or around you. You never know when you might need assistance or help, and it’s beneficial to have others in your back pocket to be able to reach out to! Seeking out a mentor will also do wonders!

4. Set small goals

We all want to achieve our big goals, do all the things, and be successful. But that amount of stress and pressure we put on our end goal makes achieving that goal more difficult. As OTs, we are trained in goal writing and goal management. We are the kings and queens of breaking up long-term goals into short term goals to achieve the bigger picture—so apply this to yourself! Set smaller daily, weekly, or monthly goals to meet (whichever you prefer!). This will make your bigger goals digestible and allow you to have small successes along the way.

5. Be patient with yourself

Set your goals, absorb everything you can, ask questions, and above all else, be patient with yourself! You will get to where you want to be. Give yourself grace, hold yourself accountable, and never stop holding faith that what you want will happen. It may take some work to get there but mixing the practical work with a good mindset will certainly help you get to your destination sooner. You got this—good luck!

Happy OT Month!

By Sarah Stevens, OTR/L @theotmethod 🌸

Regulation....why is my therapist always using that word?

Regulation or the state of being regulated has been a highly used descriptor despite it being a highly misunderstood concept. Regulation is the ability to change energy in the body to MATCH the energy level required for the activity/task that is being completed.

Are you bouncing off the walls in the trampoline park? Regulated.

Are you bouncing off the walls in the classroom during a math test? Dysregulated.

Nothing is as simple as the example above, but it gives us a starting point. To be regulated does not mean that you are ALWAYS calm, slow, and using a quiet voice….just as dysregulated doesn't mean that you’ve got loads of energy. Regulation is directly related to the context.

Children are not born knowing how to regulate themselves and as much as we want to be autonomous, even as adults we have a hard time self-regulating sometimes.

Regulation can be broken down in 2 stages: co-regulation and self-regulation. Co-regulation is when the child is regulated through a relationship with the caregiver where the caregiver is providing tools and input to meet the child’s needs. Self-regulation is when the child is able to independently match their energy levels/status to that required to the activity or task.

Activity ideas:

• Check out the energy meters provided on AutismLevelUp.com and ask yourself does your energy level meet the energy level the activity needs?
• Reflect on what skills you have taught your child to assist in their regulation.
• Write a list of 3 strategies that you, as the adult, use to regulate yourself to different acitivties.

By Emily Noldin, OTR @otandemily

Words matter: the language we use can shape our mindset and attitude towards learning and growth. By reframing negative self-talk, you can help your children approach challenges with a more positive and growth-oriented mindset.

Pediatric Occupational Therapy Services can be provided across a continuum of settings and a variety of different ages including toddlers, children, and young adults. It is important to note that in all of these settings the activities and sessions will be play driven which optimizes motivation to complete functional tasks. Even though the child may just be sitting playing with a toy, in the larger picture that one toy may be targeting a plethora of other motor skills to assist with development. Pediatric Occupational Therapists can work in many different settings, and assist children in becoming as independent as possible within their daily routines.

School Based Services:

A child may qualify for school based related services as soon as they age out of Early Intervention, which would be three years of age. A child may be referred to the Child Study Team, where they may be evaluated by a team of professionals to see if they are eligible for special education. If they are eligible, then the IEP (Individualized Education Plan) process would begin to determine what services may be needed, as well as, to support the child within their least restrictive environment. In the school setting, related services may include Occupational Therapy, Physical Therapy and Speech Therapy. In terms of Occupational Therapy, the mandate and duration of sessions would all be determined based on standardized assessments and clinical observation. A child would receive services through an IEP or a 504 Plan.

School settings for related services follow an educational model, whereas an outpatient clinic may follow a medical model of the therapy. School Based Occupational Therapists look at a child’s skills to see where the educational impact is. Therapy services are provided to assist students to become independent and participate throughout the school day. Some areas that are targeted during the school day may include fine motor skills, visual motor skills, self-help, such as unpacking and packing their belongings, classroom organization, attention to task,handwriting skills, and/or prevocational skills. A school setting may allow for job training, and transition programs for ages 18 to 21. The school setting allows for additional collaboration between the therapists, teachers, and child study team for greater carryover of skills and to meet the needs of the child within their school day.

Outpatient Clinic Based:

Outpatient Therapy is usually in a clinic or a sensory gym. This setting typically follows a medical model of therapy. Following a medical model, therapists may work on additional skill sets that may not be addressed through school based services, whereas in the school, it always relates back to the specific educational impact. A medical model looks at the child’s skill to help them become successful in their daily life at home and within the community.

Outpatient Therapy is sometimes covered by insurance or can also be self-pay. Outpatient Clinics may also have additional equipment and tools that a school based room may not have, such as large sensory gyms including swings, mats, and climbing equipment. Outpatient Occupational Therapy services may also include fine motor and visual motor skills.They may also work on gross motor skills, overall muscle strengthening, sensory integration, and feeding therapy. Clinics focus on a child’s skill within all environments; therefore, can target a wide variety of tasks with specific one on one time with the therapist. It is important to note that outpatient services may be provided after the child's school day or on weekends. It is also important to consider that a child may behave differently after the school day if they are exhausted from a full day of school with little break before more therapy after school.

Early Intervention:

Early Intervention is available for infants up to three years of age. Many parents do not know that their child may be eligible for Early Intervention services. Early Intervention is to help assist babies and toddlers develop basic skills and hit their developmental milestones. A child may receive Early Intervention if they are delayed in their milestones or have a developmental disability. Some skills that may be addressed through Early Intervention may include walking, crawling, talking, playing, eating and sensory processing. Therapists will often use the toys that the child specifically has in their own home during the sessions to target their skills. A big part of Early Intervention is Caregiver and Parent Education. Early Intervention is done in the home setting where it is most natural for the child. It also allows the parents to be involved in the process so they can continue to reinforce skills when the therapist is not there.

Home Based Therapy:

Home based Occupational Therapy services may be provided to children who are unable to return or attend school based on their conditions or diagnosis. It allows for the child to receive their services that are necessary within their home environment. Treatment planning can be tailored to their needs within their home, and how a child can be independent within their own natural environment. Home based services may also be provided for children with more severe diagnoses such as those who are immoble. A therapy session for them may include parent education and assisting the family with learning passive range of motion for preventive care, such as contractures and bed sores. Similar to Early Intervention, there is a big emphasison on Family Education, and having the family and caregivers a part of the process. A parent can also hire a pediatric OT to come to their home for additional support even if the child does not qualify for services elsewhere or may not have the resources to drive them to a clinic.

Acute Care:

Acute care is another setting where Occupational Therapists often work especially with babies, children and young adults. Acute Care Occupational Therapists may see the children right after they have had surgery or may be battling a chronic diagnosis. Children may be referred for Occupational Therapy services in the hospital for a variety of reasons which may even include potential for developmental delays based on prolonged hospital visits. Skills addressed may include strengthening, mobility, and activities of daily living performance.

By Andrea Doumar, Pediatric OT @ot_room

Andrea Doumar is a Pediatric Occupational Therapist, who graduated from Seton Hall University for both her undergraduate and graduate degrees. She has always been passionate about working with children and helping them reach their full potential. She is very creative and loves sharing all of her craft and activity ideas. When she is not being an OT, you can find her at the beach, traveling, or DIYing.

First things first—what is weightbearing and how can it benefit your child?

Weightbearing is when a person puts some or all oftheir own body weight through a certain part oftheir body such as an arm or a leg. Examples of weightbearing may be leaning through your arm in side-sit, using your arms to push up from a chair, or standing on one or both feet.

Now that we have the basics down, let’s talk about what it can do:

• Helps strengthen muscles and improves joint and bone integrity
• Improves coordination and balance
• Strengthens proximal muscles to facilitate better movement from distal musculature (proximalstability = distal mobility-this helps with building fine motor skills!)
• Reduces tone and improved range of motion
• Elicits sensory awareness
• Provides proprioceptive input (this allows your child to move around space, play, and participatein everyday activities in a morecoordinated way!)
• Assist in reflex integration
• Calming down the nervous systems to help improve attentionto facilitate cognitivedevelopment

You’re probably thinking “OK great! But now what? How can I work this into how I play with my child?”

No need to worry! There are so many easy, time-efficient, and low-cost ways to incorporateweightbearing into your everyday routines and during play. Here are some of my favorite activities:

• Animal walks
• Yoga poses
• Hanging on monkey bars/playing on the jungle gym
• Assisting with chores (pushing vacuum cleaner or grocery cart)
• Tummy time propped on forearms
• Tunnel crawls
• Extending elbows on a therapy ball
• Climbing up slides
• Pushing heavy objects across the floor (fill up a laundry basket with heavy items and haveraces!)
• Any type of isometric holding: wall push-ups, planks, pushing against heavy objects

By Sarah Stevens, OTR/L @theotmethod

Sarah Stevens, MSOT, OTR/L is a pediatric occupational therapist in the Greater Philadelphia Area. Sarah has experience in pediatric acute care, rehab and early intervention settings. Sarah specialises in pediatric cardiology with expertise in infant handling, neurodevelopment, physical rehabilitation and stroke recovery. She loves utilizing a holistic approach to provide her clients, patients and families the best possible care and support.

The Hidden Sense You Need to Find!

Has your occupational therapist talked with you or your child about interoception? Interoception is one of our three hidden senses and helps us understand and recognize what we are feeling internally. The others are “vestibular” and “proprioceptive” (a story for another time). These three hidden sentences add in with our five more well known senses of sight, hearing, touch, taste, and smell for a total of eight senses.

These internal feelings can come on quickly and be difficult to understand. A person may not understand what is needed when their muscles begin to get heavy, eyelids feel weighted, and their brain feels slow. I’ve learned that for me this feeling is exhaustion and depending on the time of day I either need to drink some chai tea or slide into bed for a nap. For the children I work with it can be tricky to differentiate between a stomach ache from hunger and needing to use the bathroom, or both! This is where interoception comes in. Many therapists use the Interoception Curriculum created by occupational therapist Kelly Mahler to introduce experiments and activities that target various body parts to elicit a stronger response for easier identification.

If your child does not see an occupational therapist or have access to the interoception curriculum a great place to start is with the free printable resources and videos on Kelly Mahler's website: www.kelly-mahler.com.

Start discussing interoception with your kids today!

Activity ideas:

• When your child asks for a snack, ask where they feel the hunger in their bodies? Is there stomach grumbling? Do they feel shaky or tired?
• While washing your hands in the sink talk about the temperature of the water and how it feels on their hands, what do their hands feel like when they use the soap? What about when they dry them off on the towel or flap them to air dry?
• Running around the house? How fast is their breathing? Can they feel their heart?
• Identify your own internal feelings out loud! “My eyes are starting to get heavy, I’m feeling tired” “this soap makes my hand feel slippery and soft".

By Emily Noldin, OTR @otandemily

Emily is a Midwest occupational therapist who loves hiking, hot tea and listening to podcasts. She's passionate about providing neurodiversity affirming care to all of her patients.

Being a mom is one of the most rewarding yet challenging jobs in the world. From the moment you hold your newborn baby in your arms, you're responsible for their well-being and growth. It's a role that requires patience, sacrifice, and resilience, and sometimes it can feel overwhelming.

As a mom, you may sometimes doubt yourself, wondering if you're doing everything right. You may feel exhausted from sleepless nights and endless chores, and you may question if you have what it takes to handle everything that comes your way. But here's the thing: you are exactly who your kids need. You are capable of amazing things, and you've already survived hardships that have made you stronger than you realize.

It's okay to feel tired and worn out, because it means you're doing your very best. Motherhood is not about perfection; it's about doing your best with the resources you have. Your kids don't need a perfect mom, they need you – flaws and all.

So, to all the moms out there, we want to say: don't worry, don't doubt, don't be afraid. You're doing great! Keep showing up for your kids, keep giving them love and support, and keep believing in yourself. You are a superhero, and your kids are lucky to have you.

Kids with sensory disorders can suffer from nutritional deficiencies, as they can get overwhelmed by the smells, textures and taste of certain types of foods. This can create a challenge for them to maintain a nutritional diet. Here are some tips on how to work around these challenges.

Thanksgiving is just around the corner and the best way to celebrate it is by making fun festive crafts! There are so many amazing Thanksgiving crafts that you can do at home, but what’s better than making Turkey Thanksgiving crafts! Making turkey crafts is the perfect theme for your child to celebrate and understand Thanksgiving. I picked out some of my favorite turkey crafts that I think you and your child will be thankful for. Gobble gobble!

1. Thanksgiving Turkey Dough Craft from Tools to Grow OT – This is the perfect tactile recipe that will allow you and your child to explore and create your very own turkey! Your child will be exposed to great sensory benefits such as tactile, proprioception, following verbal and written directions, tool usage, hand strengthening, and praxis.

2. Soda Bottle Turkey Fine Motor Activity from Stir the Wonder – What’s better than getting into the holiday spirit by making a big motor turkey! Here your child can decorate their turkey with large colorful feathers, googly eyes, and some brown paint. Instructions here

3. Turkey Juice Box Cover from Sugar Aunts - If you’re looking for a cup holder for your child for Thanksgiving dinner, here is the perfect craft you can make at home. Just grab some colored feathers, googly eyes, some crafting scarps, and a cardboard tube that can be made into a turkey cupholder.

4. Clothespin Feathers Turkey from Stir the Wonder - Making this fun craft is a great way to work on your child’s fine motor skills, hand-eye coordination, and bilateral coordination. Your child can match the colored feathers to where they belong on the turkey.

5. Turkey Fine Motor Activity and Craft from Fantastic Fun and Learning – Working on scissor skills and cutting the toilet paper roll is the perfect way to help strengthen your child’s fine motor skills. Also, placing the feathers into small holes of the turkey makes perfect practice for fine motor skills and visual skills.

6. Feed the Turkey from Mama OT – Sometimes the simplest crafts are the best! Work on bilateral coordination, pincer grasp, hand-eye coordination, and in-hand manipulation, and then decorate your turkey. Take it up a notch by adding in some tongs and placing the turkey on one side of your child and the noodle on the other side to promote crossing the midline.

7. Play Dough Toothpick Turkey from Mama OT – Roll up some playdough or Theraputty to make a toothpick turkey. Work on building up pincer grasp, tripod grasp, strengthening fingers and webspace, separation of the two sides of the hand, bilateral coordination, and hand-eye coordination. This super simple turkey craft is easy and fun!

8. Clothespin Toilet Paper Roll Turkey from Mama OT – This fun activity provides a great way for your child to work on their fine motor skills. The clothespins are the perfect item to help your child work on their pincer grasp, strengthening their fingers/hands/webspace, and bilateral coordination.

9. Button the Feathers on the Turkey from Mama OT – This turkey craft uses buttons and other creating pre-buttoning activities to help your child develop their fine motor and self-dressing skills. Work on your child’s pincer grasp, bilateral coordination, hand-eye coordination, and button/self-help skills when doing this activity.

10. Thankful Turkey Craft from Kids Activities Blog – Using this step-by-step tutorial by Kids Activities Blog is a great way for children to share what they are thankful for and to work on their visual skills!

11. Turkey Felt Board Feather Matching from Teach Beside Me – Working on bilateral coordination, hand-eye coordination, and fine motor skills is best when making a craft for Thanksgiving. This activity is fun because it allows your child to work on color recognition and pattern.

12. Feather Color Sorting and Fine Motor Activity from Fantastic Fun and Learning - To get started with this craft, gather some colorful playdough, feathers, googly eyes, and small foam triangles to work on color sorting and recognition. This is the perfect activity to help your child learn how to sort colors and work on their fine motor skills at the same time!

13. Thanksgiving Handwriting Craft from Tools to Grow – Work on fine motor skills, bilateral integration, visual-motor coordination, praxis, and hand-writing skills by making this Thanksgiving Handwriting Craft. Such a great turkey craft to do with your child to show what they are thankful for!

14. Watercolor Coffee Filter Turkey from Typically Simple – Cutting along the edges of the coffee filter, adding color with a marker, and drawing a turkey face on the front is a fun creative craft to do before Thanksgiving. Typically Simple shares a craft to work on scissor skills and fine motor skills.

15. Leaf Turkey from Toddler Approved – Grabbing some leaves from outside is a fun fall and Thanksgiving craft. This is another great fine motor skills craft to work on with your child.

If you have any suggestions on fun Thanksgiving activities that are more sensory-related please share with us!

Thank you for reading our 15 Fun Turkey Crafts for Thanksgiving article!

Gross motor skills in children grow at varying rates. However, when young children struggle with those abilities, it can be challenging for them to engage in gross motor activities like running, jumping, and throwing. Try these entertaining exercises if your child's gross motor skills require a little extra help.

Apps for Handwriting Skills and Letter Formation

• Shelby’s Quest - $4.99 – This app was created and designed by an occupational therapist who wanted to give children a fun way to practice their fine motor skills and visual perception skills. Each activity found on the app allows your child to work on their visual motor, visual matching, fine motor, and visual-motor integration at 3 different levels.
• iWrite Words – $2.99 - This app can help improve your child’s fine motor skills and handwriting skills. It is one of the best letter tracing apps around that has many activities that can help teach your child how to write. While your child is on the app, it gives back auditory and visual feedback, telling your children to stay on the lines. You can download this amazing app on the iTunes store.
• iTrace - $3.99 - This handwriting app allows your child to work on their visual-motor skills and letter formation. There are many different activities that can help your child learn how to trace letters, numbers, words, and shapes.
• Writing Wizard – $4.99 - This app allows your child to trace letters along with a visual guide. There are several different fonts that your child can trace. Check out this app on the Google Play Store.
• Start Dot – $1.99 - This letter formation app allows your child to trace the words using visual, auditory, and movement cues. It allows your child to use accuracy and independence when tracing the letter.

Apps for Visual Perception

• iDoodle Card - $0.99 – This fun app allows your child to work on their visual motor and visual perception skills using just 54 drawing activities such as mazes, coloring, drawing, and freehand. Your child can practice their skills by picking from 6 different colored markers. Users can save their masterpieces with screenshots by referring to them from outside the app.
• Highlights Hidden Pictures - $2.99 – On this app, there are over 50 hidden picture activities that can help work on figure-ground skills. As your child finds the hidden figures and touches them, the figures turn from black to white into color. After they finish the puzzle, the entire picture turns from black to white into color.
• Chocolate Fix – Free – This app is great to help develop your child’s problem solving, planning, visual motor, and visual perception skills. Your child can play this game at any time of the day!
• Visual Attention Therapy - $9.99 - This app was designed to help your child visual scanning from left to right, making it the perfect app to practice your child’s pre-reading skill. Your child can practice their scanning activities as they play 10 different levels.
• Gloop – Free – This app is a fun visual stimulation app your child can download from the iTunes store. Your child can move the “gloop” around the screen with their fingers. They can also set up it the way they want to by changing the colors, density, and even more!
• Little Finder – Free – This app allows for two kids to play against each other and battle it out for some points to find hidden objects. It is the perfect way to get some playtime with your family!
• My Little Suitcase – Free – This visual memory game allows for 4 players to play. The players need to find the matches for all of the items they are going to pack in their suitcase and then guess where they are going to be traveling based on what they packed!
• Fluidity – Free- This cool app is like a virtual lava lamp; it can calm and soothe your child while they are using the app. You can control the flow and change the color as you please with just the tips of your hands. It is the perfect combination to practice for visual stimulation and fine motor skills. So cool!

Apps for Fine Motor Skills

• Ready to Print - $9.99 – Even though this app is pricey, it is the perfect app to work on your child’s pre-writing skills. This app was created by an occupational therapist with over 25 years of experience with working children. It has 13 different activities so that your child can master their visual motor, visual perception, and fine motor skills that are necessary for correcting printing patterns.
• Dexteria - $3.99 – This app allows your child to work on 3 different activities, such as finger isolation activity, an activity that encourages grasping, and a writing/tracing activity. On the app, there is an option that allows several users to store and track their progress and data.
• Slide and Spin - $2.99 - This app was designed for toddlers ages 18 months and up. It works on the basics of fine motor skills: turning, sliding, spinning, and pushing a button. Check out this fun app on the iTunes store!
• Dot to Dot Game – Connect the dots ABC Kids Games – Free – This app is perfect for young children who need help with working on precision, dexterity, and fine motor skills. It works primarily on letter formation.
• Tiny Roads – Free- This app allows your child to connect items while working on precision and finger isolation. You can download this app on the Google Play Store.

Apps for Auditory Skills

• Annoying Sounds App – Free – This auditory app can be found on both the Google Play Store and iTunes store. If your child is bothered or distracted by some sound, then this app may help your child. With this app, your child can listen to different sounds and control the volume as they please.
• Songify – Free – You can download this app for free on Google Play Store. This app allows your child to turn everyday phrases and words into songs! It has the perfect tools to work on improving your child’s speech and language.
• Sleep Pillow - $1.99 – This auditory app is the perfect app to use when you are trying to calm down your child. On this app, there can several different white noises and calming sound options, such as waves, thunderstorms, and a crackling fire. White noise is the best for providing a calming auditory background noise at home, in therapy, and in the classroom.
• Beat Box – Free – You can download this auditory sensory app on your iPad to give your child some extra noise and sound to stay on track!
• Drum Kit – Free – This fun awesome app is great for an auditory sensory break. Your child can discover what a drum kit sounds like!
• I Hear Ewe – Free – This app has 3 pages of picture cards that your child can tap to hear animal and vehicle sounds. You can use this app for an auditory break between activities or use it as a sound guessing game.

What apps do you use in your therapy practice, the classroom, or at your home? Feel free to share what apps you use.

For more information, click on the following websites.

• https://theinspiredtreehouse.com/occupational-therapy-best-apps-for-kids/
• https://theinspiredtreehouse.com/occupational-therapy-best-apps-for-kids/
• https://txsource.com/2017/01/20/must-apps-pediatric-occupational-therapists/