Christmas is a wonderful time of the year!

This year I have collated a collection of previous printables that I have released over the years together with some new colouring pages in one huge pack! There are over 35 pages of activities from visual motor, handwriting, colouring, craft and more!  You can download this printable pack HERE.

I am always looking for simple achieveable activities to incorporate into OT sessions. With only a couple of weeks left, it is time to incorporate some festive cheer.  This year we will be making some Christmas ornaments that are achievable for kids! Here are 5 variations.

1. Paper Circle Bauble 
* Cut out 6 circle shapes on festive paper.
* Fold each circle in half.
* Glue the half-circles together until you reach the last two half-circles.
* Create a hanging ring with some pipe-cleaner, tinsel or wool. Place that between the last two half-circles and fix with sticky tape. 
* Glue the last two half-circles together. 

2. Christmas Tree ornament with washi tape decoration.
* Create a Christmas tree from a toilet paper roll.  
* Cut out green paper and glue this onto the tree shape toilet paper roll.
* Decorate with washi tape.

3. Christmas Tree ornament with sticker decorations.
*  Create a Christmas tree from a toilet paper roll.  
* Cut out green paper and glue this onto the tree shape toilet paper roll.
* Decorate with coloured stickers.

4. Styrofoam pipecleaner bauble.
* Cut down pipe cleaners into small pieces. 
* Poke one end of the pipe cleaner into the top of the styrofoam ball and the other end into the base. 
* Repeat until you reach the desired look.

5. Styrofoam cellophane bauble.
* Cut down cellophane paper into small pieces.
* Glue on cellophane to the styrofoam ball. 
Hint: you may need to wash (or wet) your hands regularly as the cellophane will begin to stick to your fingers rather than the ball. 

Watch the video to see how each or these ornaments are made HERE. 

Don't forget to download the huge FREE Christmas Printable Pack! 
​

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. â€‹â€‹â€‹
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A quick trick for pencil grasp!

Create a "stabiliser" by using a felt strip.  I use felt strips approximately 2.5 cm wide x 5 cm long (but the size doesn't really matter). Sew a button to one end of the felt strip and place a small slit at the other end.  Place your pencil through the hole create in the felt.  

Ask your child to hold the button end of the felt strip so that it is hidden into the palm of their hand whilst holding the pencil with the thumb and index finger. Rest the third finger behind the pencil. 

This felt strip helps to work on the "separation of the two sides of the hand".  The fourth and fifth fingers holding the button are stabilising the hand so that the other fingers (thumb, index and third fingers) can move the pencil.  A pencil grip can also support the fingers to hold the pencil. 

For some children, the pencil grip and felt strip create a "superhero costume" for the pencil (a mask and cape). The pencil is then given super hero powers to help with writing on the line, staying in control of the pencil for formation, not rushing, remembering the size of letters ... or anything else you need help with! 

Watch me put this simple felt strip into action... HERE

A side note that these felt strips have been used for buttoning practice! Create a chain of buttoned strips to form a daisy chain!

​Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. â€‹â€‹â€‹
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
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​

t seems like an old fashion idea now.

Writing a letter. Mailing it. Receiving a letter. 

These days with emails and text messages, the need for "physical mail" seems unnecessary.  

...and yet, the benefits of writing in this way as a form of communication are really wonderful! 

Did you ever have a penpal when you were a child? I remember writing to a girl in the UK and looking forward to a new letter in the mailbox.  I remember receiving postcards and even a tea towel! 

About once a year, I introduce a penpal program amongst my OT children.  I keep it just between the children I work with and match children from different schools of the same age and gender. I supervise the letter writing and deliver the letters.  There is no pressure on parents to find envelopes and stamps. 

Why include a penpal program during occupational therapy sessions? 

Benefits of program.
Social skills

•  communication skills
• knowing what to share of one's self
• being socially curious (wondering) about others
• considering someone else's perspective
• developing a positive relationship
• feeling special with having a new friend and making a connection
• feeling heard/listened to 

Writing 

• Motivation for writing  so that it can be read by someone else.
• We can work on legibility, use of capital letters, punctuation and sentence structures. 

When it ends
*  I will generally run the penpal program for a school term (approximately 10 weeks in Australia), however I leave it up to families if they want to continue contact or meet in person.  Some of my current clients are enjoying the program this term so we may even continue!
* Some children don't make a connection and that is fine too.  
* Some children will not be motivated with the handwriting aspect. The challenge may be too difficult or it doesn't engage their interest in making friends. 

NOTES:
* I have found that children 8 years and older benefit most from this program. I have also done this with slightly younger children. When the child is younger (ie. 6- 7 years), we keep the letters brief, focusing more on a drawing or craft inclusion. 
* I tend to repeat a craft that I do with one child so that each child makes and receives the same craft. Sometimes I change it up so that it is not always the same child "starting" the craft, so that they are surprised by the letter content too! 

To help you get started with a penpal program, I've created a printable pack of some of the resources that I use.  This printable pack includes:
* Writing paper (letter writing pages fold to create an envelope)
* All about me page
* Topic cards
* Printable craft and game templates 
* More craft ideas. 

This penpal printable pack is currently FREE for a limited time (Sept 25- Oct 25th 2023)! So it is a perfect time to give penpals a try in term 4 (Australians will understand this reference). 

Download your FREE copy of the Penpal Printable pack from the Your Kids OT shop! 

Keep an eye on your inbox over the next few weeks as I have more freebies and new products to tell you about! 
 

​Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
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Sit up, don't slouch!

Why are you lying on the floor?

You don't need to hold up your head. 

Postural instability is a common reason we see children slouched, or propping themselves up or falling over.  There may be other reasons too but today let's talk about postural stability...

We talk about core muscle strength as being "the sturdy central link in the chain connecting your upper and lower body".    Core muscles describe both the muscles which assist with stability as well as those which enable trunk movement. 

In order for our children (and us) to use our limbs (arms and legs) we also need those joints connecting to the trunk (ie. the shoulder for arms and the hips/pelvis for legs) to be strong.  We need stability for mobility.

We need to be able to use our arms and legs separately and together. Individually as well as cooperatively.  This involves bilateral coordination as well as a established trunk rotation and crossing the midline  A separation of the upper body from the lower body is needed too.

We need to move and sustain our movements against gravity. In self care, our arms need to be raised so that we put on a jumper.  Our legs need be raised individually to put on or take off pants.  These actions work against gravity whilst keeping the body stable. 

Balance and coordination also come into play with postural stability. Mature balance and equilibrium responses also minimize the need for primitive reflexes.

Controlled movements of our arms and legs then develop into controlled movements of our hands and feet.  We then look at the stability and strength from our elbow and wrists for fine finger movements.  We look at stability from the knees and ankles for our feet and toes.

We also gradually reduce the base of the support (eg. legs wide apart to shoulder width apart).  This helps a child to reduce the need for abduction and external rotation at the hips and shoulders.  In turn, this helps with controlled movements. 

To SUM up... to achieve postural stability and strength, we need to be placing our body in different positions whilst we play or work! 

Yoga is highly valued for mindfulness as well as gentle stretching to work on stability and mobility. It is an excellent way to incorporate a change of body positions throughout the day. 

 We can also intentionally try a variety of positions that can have therapeutic benefits! Here is a list below. 

Body Positions!
When choosing a body position, also consider your placement of toys or activities.  You may place toys or items on the floor, a low height table, a high table or on a vertical surface.  Perhaps you have items placed on two different surfaces to allow for movement between boday positions. 

Also take caution that these positions are not recommended for babies under 12 months old. Older toddlers should also be supervised.  These recommendations are for preschool and school aged children. 

Single leg or Tall Kneeling. 

• This position encourages an elongation of the back and trunk, activating core muscles.
• This position stretches the pelvis into a neutral position. 
• This position encourages use of the upper limbs with a stable base. 

​Adults have long used kneeling chairs to work with at a desk. Some find this position more comfortable than sitting or standing. 

Four Point Kneeling.

• This is the "get ready for crawling" or quadruped position. 
• Crawling is a wonderful way to build bilateral coordination whilst developing strength, however if we stay in the four-point kneeling position for activities, there are also many benefits. 
• In this position the weight can be distributed between the arms and lower body with hands and knees planted on the ground.  Rocking forward and backwards can also be calming as weight is transferred. 
• In this position the core muscles are activated to maintain your back straight against gravity (back not too arched and tummy not too rounded). 
• In this position the knees are aligned under the pelvis (and not too wide apart). 
• In this position the shoulder and neck muscles are activated with stability and strength. 
• In this position the head and neck can turn from side to side, up and down; working against gravity.
• As your child gains stability in the position, you can increase the difficulty with one hand and the one leg lifting from the ground.  You can try the opposite arm and leg (eg. right arm and left leg). This will challenge stability and strength. 

Long sitting.

• Long sitting allows for a wide base of support with legs extended during sitting. 
• Gradually bring the legs from spread far apart closer together, reducing the base of support and developing balance skills. 
• Encourage use of the arms and hands whilst sitting in the position. 
• Encourage midline play and trunk rotation to reach objects. 
• Avoid leaning back on one arm. Rather lean forward to align the head over the trunk. 

Side sitting.

• Side sitting is an alternative body position that does require good balance and trunk control. 
• The position places the body in asymmetry (not symmetrical) which encourages more upper body movement. 
• Encourage use of the arms and hands whilst sitting in this position. 

Squat to stand

• Maintaining a squat position can be difficult to encourage a squat to stand by positioning items at different heights.
• Squatting can help to develop bone density.
• Squatting can relieve the pressure on knees and ankles, whilst building leg and hip strength. 
• Encourage an upright head and chest. 
• Discourage leaning forward and avoid the knees going over the toes.
• Modify this position by doing a squat against a wall (wall sit). 

Standing

• Standing engages the back, core and leg muscles and can improve posture. 
• Standing encourages placement of activities on a vertical surface which can build shoulder and arm stability. 
• Standing can encourage crossing the midline with trunk rotation. Discourage shuffling of feet or leaning to one side. 
• Encourage a small base of support with feet shoulder width apart.  

Prone 

• Prone or the "tummy time" position will strengthen neck, shoulder, arm and trunk (front and back) muscles.
• This position encourages reaching and pivoting skills.
• The elbows are can be points of contact for stability, freeing the hands for play. 
• This position can be achieved with the use of equipment such as a scooter board, gym ball or even a rolled up towel. 

You may have heard that children should avoid "W sitting"! 

This position is often used with very young children to gain a wide base of support. It is not problematic if they also move into other positions voluntarily. 

However, if the "W sitting" extends beyong toddler years, there can be associated difficulties.  They continue to need this wide base of support to compensate for weakness in joints, mucles and bones.  Read more about "W sitting" with this excellent infographic by North Shore Pediatric Therapy. 

How?? 

• Start with short time periods with a preferred activity. 
• Try the position together! Lead by example.
• Try multiple positions in one day (or during one therapy session). 
• Incoporate the position into a natural choice. 

Which positions are you going to try today? 

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
Instagram: https://www.instagram.com/yourkidsot/
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​

The latest printable resource available from the Your Kids OT Shop!

"Word Search Spot It" is a printable resource designed for children to develop early literacy skills, handwriting, spelling, visual perceptual skills and copying skills.

This printable resource contains pages focusing on CVC words, general words, nouns, verbs, adjectives, adverbs and emotions.

The words are situated within circles to help children to focus on a small area at a time when searching for a matching word. This promotes skills in switching and dividing attention whilst developing visual scanning and figure ground skills.

This printable resource also contains word searches based on themes with matching pictures.

A blank template page also enables the user to design words to suit the indivdiual child or a class.

Words have Australian spelling.

Watch a preview of this product on You-tube. Select a playback speed of 2X to watch it a little faster! 

Does pencil grasp matter? !

Well the short answer is yes. Yes it does matter. 

Occupational therapists have a role in identifying when it is important to address it! 

There has been a lot of talk recently, actually probably since 2012 when Schwellenus et al published their article in the Australian Occupational Therapy Journal (reference below).  Their article report the four pencil grasps found to not affect legibility amongst their small sample.  Changing pencil grasp has been seen as unnecessary and unneeded as long as function is obtained. 

If you are a long time follower, you will have read some my previous articles on grasp.  I do agree that function is the aim of the game when it comes to writing. Pencil grasp is just one aspect that we consider. If you are new to Your Kids OT, you may want to head over to read here with reference to the above article for "Dynamic Pencil Grasp Why Do We teach it?". I discuss the Schwellenus article here as well as the question about when grasp has not yet been established.   I also address "What if my child can't use a normal grasp? Should I change it?"  taking into consideration when fatigue, pain, endurance and legibility are affected. 

Occupational therapists use their clinical reasoning all the time to work out what needs to change, what can remain the same, what skills can be taught or how to do we compensate? 

When we look at pencil grasp,  there are lots of things to consider but one of the main things is actually "pencil control".

Where is control of the pencil coming from?  The shoulder? The elbow? The wrist? The fingers?

What if the child looks like they are using one of the four pencil grasps that are seen as "efficient" but really they don't actually have a hold of the pencil? Pencil slips rather than a good pencil grip?! 

As a clinician and a blogger (and not a researcher), I can only share what I see in my own practice, my own experiences and how I make clinical decisions.  I'm seeing an increasing number of children (of all ages) who allow the pencil to slip whilst they are using it. Their fingers touch the pencil but do they actually have a "grasp" or "hold" of it.  Are they controlling the pencil or is the pencil controlling their movements? 

The pencil might slide so that the webspace of the hand closes up. The fingers might slide so that they end up very close to the nib of the pencil (or up too far away from the nib).  The pencil may even slide so that it ends up pointing backwards rather than forwards.  If we look closely are fingers touching fingers rather than the pencil? 

The affect of this, is loss of pencil control. Loss of pencil control can then lead to wobbly lines for some, poor legibility, fatigue or less writing than others of the same age. 

So what do we do about it? 
In these situations, a silicon pencil grip is very helpful! They allow the fingers to be positioned on the pencil for maximum support.  Silicon pencil grips can relieve a child with fine motor skill difficulties to concentrate on the marks being made on the page (ie. drawing and writing). Many of the children (but not all) we see also struggle with the motor planning and thinking skills to make visual motor connections on the page.  You can head over to this article "From Scribble to Drawing and Writing" if this is also a concern. 

At the same time, we continue to work on fine motor skills and hand strength (with lots of the activities that OTs are fabulous at incorporating into sessions).  You can find browse a few ideas from the YKOT Fine Motor Page or Instagram Page. 
​
I've recently shared a few ideas to bring physical awareness to the important fingers needed or grasping in a video.  My OT children have loved "pencil wars"! The "Losing Pencil Control Video" is also available on You tube HERE. 
​

Did you find this article helpful? Let me know if you have noticed an increase in "pencil slips" !

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
Instagram: https://www.instagram.com/yourkidsot/
Pinterest: https://www.pinterest.com.au/yourkidsot/
​
Reference: ​Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting after a 10-minute copy task in Grade 4 children. Australian Occupational Therapy Journal, 59(3), 180-187. http://dx.doi.org/10.1111/j.1440-1630.2012.01014.x

To be honest... it scares me.  

The world is changing and artificial intelligence is here to stay. 

There has been so much talk about AI recently; taking over our society, doing our jobs, creating everything from recipes to songs…. I’ve been reflecting on the impact for OT.

I have heard of AI being used by OTs with grammar checks, program development and report writing. 

As I said, it scares me. 

OT is a fundamentally “human” profession that is built on relationship and connection. It is a two way process of engagement, function and collaboration. There would be so much missed if Ai is substituted into our process.  

So here is my list of why AI will never replace OT…

* Empathy
* Critical Thinking
* Therapeutic Use of Self
* Kindness
* Compassion
* Flexibility
* Client Centred
* Emotional Intelligence
* Creative ways to address goals
* Good communicator
* Ability to form real connections
* Ability to help clients develop sense of self
* Ability to motivate
* Ability to pivot during therapy session
* Ability to work in a team
* Ability to build rapport
* Ability to be culturally sensitive
* Ability to adapt/stretch boundaries like time and place
* Ability to think on the spot and make quick decisions
* Ability to know when to be light-hearted and went to be serious

From discussing this with others...  I would also add lived experience, expert opinion, human warmth and the ability to build trust. 

What would you add to this list?

​

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
Instagram: https://www.instagram.com/yourkidsot/
Pinterest: https://www.pinterest.com.au/yourkidsot/
​

Have you ever thought about how much help you are providing your child? Do you feel like you are always repeating yourself? Does your child have difficulty learning new skills?

The prompt hierarchy is something that OTs (and other therapists) use to consider the level of support a child needs.  Sometimes we prompt from most to least.  At other times we will prompt from least to most. More on that later in the article. 
​
​Prompts and cues are provided for additional support during learning of tasks to develop and acquire skills. Prompts and cues can assist with preventing mistakes, improving performance, reducing frustation, maximising learning potential, motor planning, reinforcing sequencing of steps and aiding memory.

Prompts can assist with kinesthetic learning through movement and muscle memory for long term independence.

A combination of prompts can provide a multi-sensory approach where movement, visual and verbal cues are provided simultaneously.

So what types of prompts are there? 

PHYSICAL ASSISTANCE - The adult provides physical help by holding the child and guiding movement.
Example 1: The adult's provides "hand over hand" assistance by holding the child's hand to move a pencil to form a letter.
Example 2: The adult holds the child's waist and lifts them up to facilitate jumping.
Example 3: The adult holds down the child's forearm on the table during a writing activity.

PARTIAL ASSISTANCE - The adult provides partial physical assistance by using their body (usually hands) to direct movement.
Example 1: The adult uses their finger on the page to provide a physical barrier to direct the size of letters formed.
Example 2: The adult positions hand for child to place foot on top (of adult's hand) to encourage balance on one leg.
Example 3: The adult taps the child's wrist as a reminder to place it on the table.

MOST TO LEAST HIERARCHY

• A "most to least" approach is more restrictive and intrusive on the individual.
• Full or partial physical assistance may be beneficial for safety reasons.
• Consent (where possible) should be sought before providing physical assistance, respecting an individual's personal space.
• This approach can help to prevent errors.
• This approach can be beneficial in the early stages of learning a new skill.
• Should be used with caution as it may reduce the child's need to think about the actions invovled with a task.

LEAST TO MOST HIERARCHY

• A "least to most" approach is less restrictive and intrusive on the individual.
• This increases the need fo the child to "think" and use cognitive strategies.
• It can be difficult to prevent errors and the child may learn incorrect steps.
• This may be useful during an assessment process when determining a child's strengths and difficulties.
• This may be useful when a child has practised a skill and is almost indepedent.
• Prompts are ideally faded with skill acquistion so that a child does not become depenedent on the prompts.

The level of prompting provided may be determinded by the general approach to skill acquisition. Is the approach directive, investigative, exploratory, reflective or goal directed?

Some children will always require additional prompts due to a cognitive, developmental or physical delay. Some children may require a task modification and/or environmental modification. This level of independence with the most suitable level of support should be celebrated as functional.

For those of you who are occupational therapists (or other therapists) you may be interested in this resource that I've designed with the prompt hierarchy in mind. The "PROMPT HIERARCHY GOAL AND RECORD SHEETS" may be used as part of an asssesment, to record progress or the use of prompts.

The "PROMPT HIERARCHY GOAL AND RECORD SHEETS"  include:

• Prompt Hierarchy Visual
• Explanation pages x 2
  
• Occupational therapy goal and progress sheet.
• Therapy goal and progress sheeT.
• Lowercase letter formation attainment checklist.
• Uppercase letter formation attainment checklist.
• Numeral formation attainment checklist

These unique pages will assist with report writing! 

Have you considered how much support your child needs? How much help? How much can they do independently? 

You can also read more on the JUST RIGHT CHALLENGE where I explain how the child, activity and environment are a balancing act!

Until next time,
​

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
Instagram: https://www.instagram.com/yourkidsot/
Pinterest: https://www.pinterest.com.au/yourkidsot/
​

As OTs we are often promoting activities that encourage weight bearing on the hands. This means that weight is transferred from the rest of the body and the child supports their own weight through their upper bodies (shoulders, elbows, wrists and hands).  There are wonderful benefits to weight bearing on the hands including increasing proprioceptive and vestibular input (the last few blogs have focused on this) and building upper body strength (shoulder, elbow, wrist and hands). 

But what does this look like? What are we aiming for? Can we be doing it wrong? 

Can you spot the differences in the photographs above? 

1. Arms extended, hands forward, wrists extended, palms flat. (Top left photograph)

This is a great way to build strength and provide sensory input through yoga poses, animal walks, prone activities, crawling, etc. This is what we are aiming for when we are encouraging weight bearing. 

2. Arms extended, supination of forearm leading to external rotation of wrists, fingers pointing away from midline. (Top right photograph)

Things to check: ability to support forearm and wrist on table during writing, extension of wrist for writing, wrist stability. 

Some children will rotate their forearms to use their shoulder and/or elbow muscles for stability.  This is often a way to compensate for weak wrist muscles.  However, suspending one's whole arm can become tiring and also means that only big movements are possible.  Finer more controlled movements of the hand (fine motor skills) are best achieved with the dynamic movement of the hand and finger muscles. 

3. Arms extended, wrists extended, fingers curled at DIP joints. (Bottom left photograph)

Things to check: tactile defensiveness, low tone, shortening/tight finger extensors, retained reflexes (palmar, STNR), wrist strength and stability, development of palmar arches.

This is not a fully fisted hand.  Rather the fingers are curled over at the Distal Interphalangeal Joint of the fingers (the joint closest to the palm). 

In my practice as an OT, I'm observing an increasing number of children with this presentation.  Some say that it is due to less active children with less exposure to gross motor movements.  Some say that retained primitive reflexes need to be addressed as they have not been integrated.  Some say that it is an over use of devices that leads to shortening and tightening of the finger muscles. 

We need to remember that in all movements, children are seeking stability.  They do things automatically to protect themselves and to be comfortable. 

4. Arms extended, wrists extended, fingers and palms slightly arched.

This could be normal protective reflex patterns. This could also reflect strong palmar arches needed for fine motor skills. If so, no change needed.

Also check: tactile defensiveness, wrist strength, elbow strength or collapses.
​

​Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
Instagram: https://www.instagram.com/yourkidsot/
Pinterest: https://www.pinterest.com.au/yourkidsot/
 

Lycra is the not-so-secret tool in the OT's tool box!

Bear hug? 
Deep pressure massage?
Lying in a hammock?
Sitting in a soft bean bag?

For children who enjoy these sensations, the stretch of lycra can provide propioceptive input to the body as the child moves by pushing and pulling it.  They may get the same benefits from using a stretchy resistance band.

There are many commercially available products made from lycra (or nylon spandex) including body socks, lyrca tunnels and lycra bed sheets.  These are fabulous and I've seen many children benefit from these. 

Today I want to share with you some new ideas for using just a square of lycra (although if you look closely, you will see that I'm missing a corner)... of approximately 1.4m x 1.4m. You can change the size of your material depending on the size of your child. 

Watch these ideas below or use the following You-tube link:  youtu.be/b0ODU-KhymY
​

Lycra activities

1. Sit and pull
2. Tie to chair legs - Sit and stretch, running legs, read a book, spin
3. Tie to a hoola hoop - Stand and stretch, stand and jump, stand and turn, stand and twist, sit and drive, sit and move legs, sit and hide

You could also use a large lycra piece as a hammock or swing.  Be very careful where about how you tie this lycra. For weight bearing activities such as these, you may require multiple pieces of lycra, load bearing hooks and attachments. Please seek professional advice if you are making any suspension or weight bearing activities and be aware of potential choking hazards.  Use with supervision and caution always! 

​For more on the benefits of sensory based activities, read the blog from last week (link HERE). 

Let me know if you use any of these ideas or if you have other ways that you use a lycra sheet!
​
​

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
Amazon Store: https://www.amazon.com/shop/yourkidsot
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot
You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured
Facebook: https://www.facebook.com/yourkidsot
Instagram: https://www.instagram.com/yourkidsot/
Pinterest: https://www.pinterest.com.au/yourkidsot/
​