🎄 End-of-Year OT Poem 🎄
The school year’s nearly over — OTs far and wide agree,
We’re a mix of tired, wired, overjoyed… and dreaming to be free!
Some are finishing reports, eyes twitching from the strain,
Some are stuffing last-minute resources into any box they can contain.

Some are buzzing with excitement — “HOLIDAYS ARE NEAR!”
While others whisper softly, “I just need one more week this year…”
Some are overwhelmed and buried in assessments they forgot,
And one is daydreaming beach trips… (okay fine, that’s all of us. A lot.)

A few are already celebrating — tinsel wrapped around their head,
And one heroic OT proclaims, “My paperwork is done!”
… The rest glare in dread.

But through the chaos, laughs, and coffee cups that never end,
We’re grateful for our kiddos — every moment we got to spend.

For progress, patience, teamwork, and each family we hold dear--
Thank you for the memories.
Merry Christmas, and cheers to next year! 🎄✨

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. 
​​​​
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
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If I asked you what makes handwriting readable, what would you say? 

Writing on the line? 
Recognisable letters?
Spacing between letters?
Spacing between words? 

Would you include punctuation? Capitalisation? Spelling?

As an OT, we are often asked about functional handwriting.  What does that really mean? 

It can mean scribble on the page for a toddler. 
Writing one's own name for a child who is learning their own identity. 
It can mean completing a form so that the letters stay in the small boxes provided.
It can mean keeping up with classmates to write a story of suitable length and within a set time frame.
It can mean taking notes while the teacher is explaining new information. 
It can mean writing adequately under exam pressures.  

There is lot of literature that report higher grades for students who have more readable writing.  But what about the early years when a child is learning to hand write? Is it important?

What is "orthography" and why do we need to know about it?

Mathwin, K., Chapparo, C., & Challita, J. (2024) define orthography to encompass all features children learn when writing sentences by hand.  They include adherences to the rules for the correct use of the symbols (alphabet-letters) so that others can read and understand the writer's message.  These rules include:

• visual shape
• placement
• spelling
• word break
• the conventions of punctuation and capitalization

Orthrographic representation of letter(s) requires knowledge of the alphabet (ie. letter recognition for upper and lower case, letter name, sound-letter representations).  There is value in having alphabet knowledge prior to handwriting, integrating phonics instruction with handwriting, including spelling instruction with handwriting, using multisensory strategies and in using cognitive strategies (mental practice, self monitoring, self evaluation).  

Handwriting is cognitively demanding!

Cognitive load theory (CLT) provides a framework and information processing theory of the cognitive demands during classroom writing tasks and includes intrinsic CL (task complexity), extraneous CL (instructional design) and germane CL (motivation and mental effort required by the learner).  When the cognitive load is too high, the ability to access and add information to long term memory is compromised.  (Sweller, Ayres & Kaluga, 2011 cited in Staats, Oakley & Marais, 2019).

Handwriting requires the retrieval of orthograhic representations from long term memory, holding the information in working memory, applying the motor plan, establishing the size and placement of the letter and then doing the actual handwriting.  There is a hierarchy of handwriting tasks which can affect legibility. Pairwise comparison of writing tasks with differing cognitive loads for the same student can reveal potential challenges so this is useful as part of a handwriting assessment. 

Automatic access to  organised schemas can be developed wtih deliberate practice, allowing working memory to be accessed for understanding and learning new information. 

"Automaticity" refers to the effortless execution and absence of conscious awareness in teh component skills necessary to free up cognitive resources for higher-order process (Malpique, A. A., Valcan, D., Pino-Pasternak, D., Ledger, S. & KelsoMarsh, B. (2023).
​ 
Poor legibility reflects a lack of automaticity (Fogel, Rosenblum, Barnett, 2022). 

Limited handwriting automaticity constrains focus on other complex aspects of writing (eg. ideation and word selection) and can predict writing performance (Malpique, A., Pino-Pasternack, D., Ledger, S., Valcan, D., Asil, M. (2024).

What are the practical implications for OTs and others supporting children with handwriting?!

Occupational therapy intervention has traditonally worked on many aspects of handwriting, integrating fine motor skills, visual motor integration, motor planning, multi-sensory strategies with cognitive strategies.  Executive functioning skills are promoted including self evaluation and monitoring.   Phonics and spelling instructions are often referred to our speech therapist and teacher colleagues. 

​A "just right challenge" of cognitive load can help to maintain legibility when a student is learning to handwrite (Stats, Oakley & Marais, 2019). Copying is less cognitive demanding that dictation which in turn is less demanding than composition.  This heirarchy can be considered when assisting a student to maintain legibility.  Occupational therapists also consider the prompt hierarchy for levels of support. 

There is value in teaching subsets of handwriting legibility to match their cognitive load capacity.  Here are a couple more suggestions.
Top Tip Handwriting: Bump the line!
Handwriting Size and Spacing
​
At the end of this article, I have listed the references used.  This is not a systematic review of the literacture and presents a quick overview of this topic. ​

Introducing “Legibility Legends”-  a series of handwriting books created to focus on key aspects of legible writing, including staying on the writing line, using correct spacing between letters and words, recognising letter sizes, and applying capital letters and punctuation correctly. Friendly legends such as robots and unicorns guide children through these skills. Each book also includes a progress record sheet, handwriting checklists, and a range of multi-sensory and guided activities.

In this NEW book "Unicorns are Neat", join unicorns Lucy (who loves lines), Sofia ("Don't skip Letter sizes."), Cupcake ("Capital letters count!"), Pippa ("Punctuation Please") and Sweetheart ("Don't be a space invader.") as they help your children with neat writing through a series of guided activities

The workbook contains:

• Handwriting legibility progress sheet
• One page “Unicorns are Neat Checklist”
• Eight desk sized “Unicorns are Neat Checklists”
• Over 100 pages of guided activities (writing, cutting)
• Multisensory strategies
• NSW foundation font

114 pages

INTRODUCTORY OFFER INCLUDES FREE COPY OF "ROBOTS ROCK WRITING"!
Please note: Robots Rock Writing has been updated with corrections and new activities after being first published in 2024 (an increase from 76  to 114 pages).

Offer ends 1st December 2025. No need for a code, simply purchase "Unicorns are Neat" for both products. 

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. ​​​
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 List:
Fogel Y, Rosenblum S, Barnett AL. Handwriting legibility across different writing tasks in school-aged children. Hong Kong Journal of Occupational Therapy. 2022;35(1):44-51. doi:10.1177/15691861221075709

Malpique, A. A., Valcan, D., Pino-Pasternak, D., Ledger, S. & KelsoMarsh, B. (2023). Shaping young children's handwriting and keyboarding performance: Individual and contextual-level factors. Issues in Educational Research, 33(4), 1441-1460. http://www.iier.org.au/iier33/malpique.pdf

Malpique, A., Pino-Pasternak, D., Ledger, S., Valcan, D., & Asil, M. (2024). The effects of automaticity in paper and keyboard-based text composing: An exploratory study. Computers and Composition, 72, 102848. https://doi.org/10.1016/j.compcom.2024.102848

Mathwin, K., Chapparo, C., & Challita, J. (2024). Handwriting accuracy of beginning writers and its impact on the readability of their sentences. Journal of Occupational Therapy, Schools, & Early Intervention, 18(1), 59–81. https://doi.org/10.1080/19411243.2024.2315582

Staats, C., Oakley, G. & Marais, I. (2019). A legibility scale for early primary handwriting: Authentic task and cognitive load influences. Issues in Educational Research, 29(2), 537-561. http://www.iier.org.au/iier29/staats.pdf​

Getting dressed. Feeding ourselves. Toileting. Brushing our teeth.

These self-care tasks require coordinated fine and gross motor movements.

Using pencils and crayons to draw.  Cutting paper with scissors.

These tasks with “tools” require coordinated fine and gross motor movements.

Playing football. Dancing, Completing puzzles. Playing a board game.

These leisure activities require coordinated fine and gross motor movements.

We need to move our bodies in a coordinated way to perform fine and gross motor tasks, at home, at school and in the community.   

When considering fine and gross motor movements, we can look at how the body works as a whole.  This might include using both legs together for jumping, eyes and hands together for catching and throwing, hands and eyes together for drawing, left and right hand together to manipulate paper for cutting.  We may also focus on smaller components like the hand and fingers to move a small item into a container.

When choosing an occupational therapy assessment, we consider several factors including the age of the child, the reason for testing and reporting, standardised or criterion-referenced tests, skills-based or functional focus, observations by parents and teachers and practical considerations (eg. time, child’s attention, environment, training, access, online administration and scoring).

Sometimes it is difficult to make a choice.

A real comparison is only possible through experience and knowledge of several assessments.  It is also guided by the population of children (or adults) that you currently serve.  Your decision may change with these factors. 

​The Bruininks-Oseretsky Test of Motor Proficiency – Third edition (BOT-3) and the Movement Assessment Battery for Children – Third edition (MABC-3) are two popular motor-based assessments.  In this article, we compare these assessments to help therapists to make an informed decision about which to use. I provide an objective and subjective comparison. 

The BOT-3 and MABC-3 are well-known and respected standardised tests.  They each have important functions to guide clinical reporting and decision making. Both assessments include goal directed tasks and some test items are very similar. There are also some significant differences between the tests.

I particularly like the comprehensive in-depth analysis of fine and gross motor skills of the BOT-3.  There are more pencil and paper tasks as well as scissor skills task which the MABC 3 does not have.  This is explained as the authors of the MABC 3 were instrumental in the development of the Detailed Assessment of Speed of Handwriting (DASH-2) which has also been standardised on the same population as the MABC 3, bringing these instruments closer together. Therefore, if I require information about an individual’s pencil control, I would choose the BOT-3 or use a supplementary test with the MABC 3 to make these observations.

The BOT-3 includes subtests with specific examination of bilateral coordination – same side and opposite side synchronization as well as crossing the midline. This is valuable information about an individual’s movement patterns. Strength subtests also include familiar (dare I say “classic”) measurements of prone extension and supine flexion, which have been recognised as important indicators of motor skills.

Both the BOT-3 and MABC 3 acknowledge that there are non-motor factors that affect motor performance.  The BOT-3 includes subtests which provide information about motor planning and coordination.  Examiners can also record background and behavioural observations, considerations, accommodations, attention, fluidity of movement, effort and understanding.   The MABC 3’s record form provides for specific qualitative observations of posture/body control (ie. posture, grip/grasp, coordination, consistency of hand use, fluency), adaptations to task requirements (ie. space, time, force) and fourteen non-motor factors (such as attention, impulsivity, anxiety, persistence, etc) that might affect movement. The prompts provided are helpful, especially to those who are new to assessment observations. Significant recording of non-motor factors may also prompt consideration of further testing of executive functioning skills.

The MABC 3 checklists are unique in providing parent, educator or self-reporting of movement and coordination.  These checklists include observations/reporting of manual dexterity related to personal care, home and classroom participation, drawing/writing/keyboarding.  They also include aiming/catching and balance/locomotion information.  It is useful to know the functional implications of fine and gross motor difficulties and may inform future goals for OT. Similarly to the MABC 3 Test, the checklists ask the person completing to make comment on the fourteen non-motor factors that may also affect movement. The self-reporting for older children and adults can be especially valuable information gathered with the MABC 3.  This can help identify personal insights about strengths and weaknesses.

The MABC 3 has been designed with practicality in mind.  The provision of the pre-measured walking lines makes set up simple and the rolling trolley bag with compartments has been thoughtfully considered. It makes transporting the assessment from one site to another ergonomic and compact.  This compares with the BOT-3 which requires you to bring a suitable tape measure and painter’s tape to prepare the area for testing. As a mobile therapist, I appreciate the ease of setting up the MABC-3, however if I had a clinic this would be a moot point as either test could be prepared for multiple clients in the one space. The BOT-3 is considerably more light weight than the BOT-2 as the heavy balance beam is no longer needed, although it can also still be used if you have it already. 

​The MABC 3 would be my choice for younger children and those with known difficulties with attention, language and behavioural considerations. As the test items have been designed for specific age groups, they are more engaging and there are less multiple-step tasks. Each subtest does not require a lot of verbal instruction. Set up and modelling is easy to do and the activities themselves are engaging.  The manipulatives are different sizes to suit the different age ranges. Colour coding is helpful to know which record forms and checklists to use.  The “drawing circles” response sheet also needs to match with the correct age band. Consequently, there needs to be familiarity with differences in administering the correct subtests according to age and different items used within the kit.   
​
The BOT-3 items are administered to all age groups. This makes administration simple with one response booklet, one record form and one set of items to become familiar with conducting. I am personally very familiar with the BOT-2 so learning the BOT-3 was not a big jump.  I reach for the BOT-3 particularly for school age children where I want to assess and report on their motor skills. The manipulative fine motor skills tasks are easy to administer. The children themselves loved the timed challenges, often determined to beat their own scores.  The visual motor integration information is useful when considering the implication for school functions such as copying from the board, reading and writing. Some of the bilateral coordination and gross motor tasks may be more difficult for younger children to follow, especially if they have language delays or inattention. 

The BOT-3 and MABC 3 are both important motor skills assessments.  As discussed, making the choice between the assessments will depend on the factors that are most important to you and your clients.   I recommend that you have both assesssments in your OT toolkit to provide you with choice when you need it. Consider the population that you serve (especially as it may be different to mine).

The BOT-3 and MABC 3 are available from Pearson Assessments.  

For more information on the BOT-3, please visit PearsonAssessments.com/BOT3.
For more information on the MABC 3, please visit PearsonAssessments.com/MABC3.

This is a sponsored article.  All opinions are my own and drawn from experience using both assessments in occupational therapy practice. If you are a therapist, save this one for reference or share the article with your colleagues to help them with a side by side comparison of these assessments. 

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. ​​​
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/
​

What happens when you ask a child to take deep breaths? 

Do they sound like they are hyperventaliting? Do they take one breath and say that's enough? Do they take a shallow breath? 

We know that breathing is an important regulation tool.  It helps to lower one's heart rate, blood pressure, reduce stress hormones, improve oxegnation to the body. 

These sensory based activities were designed to engage your child with breathing for regulation and calming affects.  The movement activities also activate sensory signals to the body via proprioceptive and vestibular input.  Information may be highlighted about where our body is in space, help us to feel grounded and balanced.  We may also bring alertness to parts of the body through deep pressure (squeezing, clenching) or stretching.  

There are 8 sealife regulation activities.
1. Puffer Fish Puff
2. Clam Cuddle
3. Turtle Tongue
4. Star fish Stretch
5. Shark Scowl
6. Blobfish Bob
7. Jellyfish Jiggle
8. Seal Showtime

This printable was first released in 2016 for newsletter subscribers and contained the first four animals.  It has now been updated and contains a variety of  visual prompts for individual and classroom use. 

• Single page summary
• Two page spread of the 8 activities
• Single page with each of the individual activities
• Two pages of palm-sized cards
• Two colouring pages
• Two matching pages

I'm making an early start with Australian OT week 2025 celebrations with the release of this FREE updated printable! 

We are also in the final days for you to get a FREE ticket to the 2025 Sensory Summit:Unpacking Sensory Needs, One Case at a Time (hosted by Precision CPD).  This online conference is being held next week Oct 27-29 (Eastern Standard Time)! 

It is your last chance to grab the Early Bird VIP rate. Three days of learning is inspiring, but it can also be overwhelming. And once the summit ends, it’s easy for strategies to slip away in the busyness of life.
The VIP Ticket is the best way to make the most of the Sensory Summit.
Here’s what you get:

•  Accredited (for US readers) CEUs for OTs, PTs, SLPs, and EI providers (10 contact hours) 
•  Podcast access for flexible listening
•  Printable workbook + bonuses
•  Lifetime access to all sessions

 Early Bird VIP pricing ends Oct 26 (midnight EST).
Register free — or upgrade now before it’s too late.

Note: Pricing for the VIP ticket is in $US. I earn a small commission from sales of this ticket. 

Until next week when we will continue (since I've already started) to celebrate OT week!
​

Cindy is a registered occupational therapist practising in Sydney, Australia.  Cindy's children are a constant source of inspiration and learning.  She 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. ​​​
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/

OTs value every child as an individual.

OTs value learning at an individual’s own pace.

OTs value a child achieving their own milestones.

There is also value in comparing a child’s strengths and challenges with others or with developmental expectations. Choosing the right standardised occupational therapy assessment can be an important step in understanding a child. The best assessment is not just about picking a well-known test—it’s about matching the tool to the child, the purpose of assessment, and the context.
​
Whether you are a therapist reading this, a parent or educator - this article may help to inform you through the process of why we choose certain assessments over others.  If you make it to the end of the article, I will also give you a hint about what is coming next. 

1. Age and Developmental Stage
Most assessments have specific age ranges they are designed for.

• Younger children (0–5 years): Assessments may focus on developmental milestones, play skills, sensory processing, and early motor development.
• School-aged children: Assessment tools may also focus sensory processing, participation in daily activities, classroom participation, fine motor skills, visual-motor integration, handwriting, attention, executive functioning skills, social emotional development and self-care.
• Teens and adults: Assessments may continue to test the same areas as younger children and they may also focus on functional daily living skills, vocational readiness, or independent living.

​
2. Reason for Testing and Reporting.
An OT assessment should be driven by the why. Some of the reasons for testing include:

• Identifying developmental delays
• Supporting diagnosis (e.g., autism spectrum disorder, developmental coordination disorder)
• Recording a baseline and tracking progress over time
• Guiding therapy goals and intervention
• Providing evidence for funding or school support plans
• Research purposes

Establishing a clear purpose ensures the assessment chosen will provide the right type of information. There should also be a clear understanding about who will receive results of the assessment reporting.  Is the audience a funding body, parent, education or medical staff? Will multiple people be reading the report information? 

3. Standardised vs Criterion-Referenced

• Standardised (Norm-Referenced): Compares a child’s performance to a large group of peers the same age. This is helpful for identifying whether skills are above, below, or on par with age expectations.
• Criterion-Referenced: Measures a child’s performance against a set standard or skill list, without comparing to peers. This is useful for tracking progress or measuring mastery of specific skills over time.

4. Skills-Based or Functional Focus
Some assessments measure underlying skills, such as:

• Fine motor control (e.g., grasp, dexterity, handwriting)
• Gross motor skills (e.g., balance, coordination)
• Visual-motor integration (how eyes and hands work together)
• Sensory Processing (eg. how a child responds to sensory input)
• Executive functioning (eg. how a child perceives, plans, recalls and performs)

Some assessments evaluate a child’s functional participation, looking at how skills are applied in daily life (e.g., dressing, feeding, school tasks).  

OTs will choose the assessment depending on whether the goal is to understand how a child performs, how well they participate or how much assistance they may need.

5. Observations from Parents, Teachers, Caregivers and Therapists
Standardised assessments provide structured information, but they don’t capture everything about a child’s everyday functioning. This is where questionnaires and interviews are invaluable.

• Parent/teacher questionnaires help understand behaviour, sensory preferences, participation, and independence in real-life settings.
• Observations can highlight differences between structured testing situations and natural environments.
• Observations between home and school can also reveal how the child is participating in these environments. 
• Observations by therapists can provide insight into functional participation, sensory processing, environmental factors, accomodations already in place, social impact, social skills, non-motor factors (eg. motivation, regulation, perseverance, attention). 

6. Practical Considerations
Sometimes the “right” assessment is influenced by practical factors:

• Time available: Some assessments take 10 minutes, others over an hour.
• Child’s attention and tolerance: The tool should suit the child’s energy, mood, and regulation levels. The option to present the assessment in small segments may be considered.
• Environment: Space, equipment, and quiet may be necessary.
• Training requirements: Some assessments require specialised training or certification.
• Access to the assessment tool: It is not feasible for every assessment to be available, and an OT may need to choose the best from what is accessible.
• Online reporting: Some assessments may now be conducted online via a link or a shared screen. Some reports may be generated online. 

​ 7. Combining Multiple Tools
No single assessment will answer every question. OTs often combine:

• A standardised motor skill test
• A criterion-referenced functional checklist
• Parent/teacher questionnaires
• Interviews
• Clinical observation in natural settings

This combination provides a richer, more accurate understanding of the child’s abilities and needs.

In choosing assessments, occupational therapists consider the whole child —developmental stage, assessment purpose, skill type, and the child’s real-world participation—before selecting the most appropriate combination of tools.

The ultimate goal? We don’t just want a score, but we are looking for meaningful insights that guide intervention and help children thrive in the activities that matter most.

If you found this article helpful, you may also like to read this application of the occupational performance model. 
 
If you made it to the end of this article, well done! You may want to save it for future reference. It may be particularly helpful if you are a new graduate or student OT.  A little teaser for next week where I do a deep dive comparing two popular assessment tools - the BOT-3 and the MABC 3. There may be some extra "sensory" content coming your way too . 

Until then,

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. ​​​
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/

Sensory. 

When you hear the word "sensory", what do you think of? Do you think of rice, sand or shaving cream?  These things may provide sensory experiences but "sensory" is much than that!

We all interact with the world around us. Taking in sensory information, interacting with it and managing a balance to perform our daily activities. 

Or do we? 

Some of the children we see, struggle with this. 

What is a neurological threshold? Are we trying to reach it or not? Why? 

What is the self-regulation continuum? 

Last year, I shared information about the Winnie Dunn's Sensory Profile framework (keep reading as I'm also giving you an overview in this article), but I feel like we need to go back to the beginning... well the theoretical background.  Dunn describes this framework as an explanation of the "interplay between neurological thresholds and self-regulatory behavioural responses to explain how we process sensory information".  

The "neurological threshold" is the nervous system's responsiveness to stimuli.  A "low" threshold means that only a low amount or intensity of stimuli is needed as they nervous system is easily activated for awareness and response.  This child may be seen as hyperresponsive.  A "high" threshold means that more intense stimuli is needed before the nervous system responds. A child may be seen as hyporesponsive. 

Sensitization is the process that enhances the awareness of important stimuli, screening anticipated harm or danger in the environment while engaged in play or learning. We need to be able to respond quickly to risky situations that could hurt us.

Habituation is the process of recognising familiar stimuli that does not require further attention, allowing focused attention of the task at hand without becoming distracted, agitated or inattentive. There is comfort and security found in familiar sights, sounds, people, routines, textures, schedules and expectations that reassure us.

Modulation is the balance of activation needed so that a child can be alert to selected information while screening out other stimuli in order for functional participation in everyday life. The child selects the appropriate responses to environmental cues.

The children we see for occupational therapy may have difficulty processing sensory information … eg. could be alert to sensory information that interferes with tasks, could be unaware of sensory information, may perceive something as dangerous when it isn’t, or can’t get enough sensory information.

Winnie Dunn's sensory profile framework looks at the interplay between the neurological threshold and the self-regulation continuum to bring you four profiles.  These profiles can be further divided into "under responsive" and "over responsive" but that information is for another day.  

When a child responds much more than others in these profiles we see the following:

• The "bystander" may miss sensory cues, has a high threshold (takes a lot for them to notice) and passive response (may need help to interact with stimuli). 
• The "sensor" reacts more quickly and more intensely to sensory cues, has a low threshold (high level of awareness of their environment (may need help to cope with stimuli).
• The "seeker" is busier and more engaged in sensory experiences, has a high threshold (manages more input than others but is difficult to satisfy) and actively pursues these experiences. 
• The "avoider" is more likely to retreat from unfamilar situations, has a low threshold (prefers activities or environments with limited sensory experiences)  and may actively withdraw, be disruptive or try to control their environment. 

We may also see a combination of these responses. 

I am currently working on creating a guidebook with more information about sensory profiling and intervention strategies.  This continues to be a work in progress, however it is progressing! Stay tuned! Thank you for those of you who periodically email to check if it is still coming - :) 

If you love learning about sensory processing, then make sure that you have obtained your FREE ticket to the upcoming SENSORY SUMMIT. I'm not presenting, however the speakers are very engaging and experienced. They bring you practical case studies this year with examples of how to implement strategies for every day life.  I've been told that there are already 5000 registrants! Don't miss out!

The FREE event is being held October 27-29 (Northern Hemisphere dates).  

If you want the most out of the experience, the VIP ticket ($US) is at a discount before the event begins. I receive a commission from any VIP tickets that you purchase using my link. 

The VIP Ticket includes:

• Accredited CEUS for OTs, PTs, SLPs, and EI providers (10 contact hours)
• Private podcast feed for flexible listening
• Workbook and speaker bonuses
• Lifetime access to all sessions.

Register and upgrade HERE!

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. ​​​
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Linear vestibular input can be categorised into three groups. Here are examples of activities within these categories.
* Forward and backward movements

• Swing (traditional, hammock, platform, tyre)
• Flying fox, zip line
• Slide, monkey bars, 
• Jogging, walking
• Crawling
• Bike riding, scootering
• Swimming
• Rocking horse, rocking chair
• Facilitated movements with a gym ball, scooter board

* Up and Down movements

• Hopper ball (bouncing on a gym ball)
• Jumping, jumping on a trampoline, jump rope (skipping)
• Seesaw
• Pogo stick
• Sit ups

* Side to Side movements

• Rocker boards, balance board, 
• Dancing
• Side stretches
• Side steps
• Crab walks sideways
• Rocked by parent side to side

​Rotary vestibular input includes spinning around and turning the head (and fluid in the inner ear). This type of input is generally alerting and stimulating, helping with balance, muscle tone and body awareness. 

It differs from linear vestibular input and can be either organising or disorganising depending on the indiidual's sensory needs. Excessive or intense input can lead to overstimulation, while some children with sensory processing challenges may be under-responsive and seek this input.  Combining vestibular and proprioceptive input can be regulating. 

Vestibular rotary activities can vary with an individual rolling (forward, backward, log), turning (like a spinning topy), orbital (like a merry-go-round) on an axis and upside down/inversion (like cartwheel). It can vary intensity system is very powerful and input should be closely supervised, especially sensory seekers who may not know their own limits. 

Alerting or arousing vestibular movements may include a change in head position, speed change, direction change or rotary head movements. These movements increase arousal for an activity, helping to elevate or keep adequate alertness throughout the task. 

Discriminating or mapping vestibular movements help a child to develop anticipation of a task sequence and reduce distraction from the task.  Routines can provide a sensory pattern so that the child knows what is occuring and what will come next  (expectations).  Linear and repetitive head movements  can support body awareness in space and calm a child who is overstimulated. 

Signs of sensory overload should be closely monitored. These may include nausea, dizziness or disorientation. 

I am sharing more sensory information this month!  

In the meanwhile, if you are looking for more information and expertise on sensory processing, I want to let you know about the upcoming Sensory Summit: Unpacking Sensory Needs, One Case at a Time, hosted by Precision CPD.

This event is designed for professionals working with kids who want to move beyond quick fixes and build real clinical reasoning skills for sensory practice across the whole multidisciplinary team. The speakers will use case studies to provide practical applications that will inspire you, whether you are an experienced therapist or just starting out. 

The FREE event is being held October 27-29 (Northern Hemisphere dates). Register for the FREE TICKET HERE!
If you want the most out of the experience, the VIP ticket ($US) is at a major discount before the event begins.
The VIP Ticket includes:

• Accredited CEUS for OTs, PTs, SLPs, and EI providers (10 contact hours)
• Private podcast feed for flexible listening
• Workbook and speaker bonuses
• Lifetime access to all sessions.

Register and upgrade HERE!

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. ​​​
YKOT shop:  https://www.yourkidsot.com/store/c1/Featured_Products.html
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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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​

A natural part of every body's daily life!

Toilet training is a massive milestone when it is achieved. 
 
There are so many factors that can affect a child's ability to use the toilet consistently.  Whether they are developing at a typical rate or not, we can use a range of strategies to help with the process. 

As an occupational therapist, we consider forward and backward chaining, the prompt hierarchy, the child's environment and the level of support they need. In this article, I have collated some practical resources that you can use to assist with teaching toilet training. Keep reading to find out about a free printable to support body awareness and interoception. 

1. Toilet training Book - by the Functional Skills Therapy Team 
The Toileting Book is a comprehensive resource covering every aspect of toilet training.  I was a contributing author to this book. 

• Written by a team of experienced pediatric occupational therapists and physical therapists with decades of experience  
• Packed with information on toilet training readiness and achievement of toileting success
• Includes Toilet Training Guides for special populations (children with fine or gross motor needs, behavioral or cognitive challenges, physical disabilities, etc.) including Sensory Processing Disorder, Trauma-Informed Needs, Autism Spectrum Disorder, Cerebral Palsy, Spina Bifida, Spinal Cord Injuries
• Provides information on interoception and the role this sensory system plays in potty training
• Discusses common toileting equipment and special needs toileting tools
• Includes tips and suggestions for individualized toilet training 

This book is available in digital, e-book format AND in a physical, soft-cover book format. Purchase the physcial, soft-cover book HERE

2. Videos with stories and songs
There are range of videos and songs that I use to assist with teaching toileting skills.  Here are some of my favourites. 

• Tom's Toilet triumph 
• Princess Polly's Potty
• Pirate Pete's Potty
• Push the Poopy out
• Baby Shark's Potty song
• Peppa Pig's Potty Training
• The Toilet Song by the Wiggles
• Constipation in Kids: What your poo is telling you
• A Journey Inside your body
• What if you hold your poop for too long? 
• What if you hold your urine for too long?

3. Social stories 
We use social stories with simple text and pictures (or photographs) to talk about the steps needed to use the toilet. The visual sequence can help with ordering and organisation skills.  It can help to develop routine and expectations.  Toileting can be broken down into component parts such as identifying body signals, sitting on the toilet, using the toilet, using toilet paper, cleaning oneself, flushing the toilet, washing and drying hands.  There is a social story in the book mentioned above.  Here are a few more resources. 

• Poop goes to Poopland
• I can push out my poos!
• Toileting social story
• Going to the toilet social situation (Twinkl)
• Social Story Potty Training girl and Social Story Potty Training Boy
• Using the bathroom at school
• Potty training editable boy and girl
• How to use the urinal
• Flushing is loud social story
• Using the bathroom visual aids
• Using the bathroom social story​​

4. Visual Supports
Similarly to social stories ... we use visual supports to help with understanding concepts, provide consistent information and promote independence. 

To support interoception skills for toileting, I have developed these visual supports which provide information about body signals before toiletting, a narrative that the child could say to themselves before they go, the actions they can complete and how they may feel afterwards.  There is a page for boys, girls and a third page for older children/teens. To get your free resource, use the form below to subscribe to the Your Kids OT emails.  You will be the first to know of future resources. If you already subscribe, you will only be on the list once! 
​

5. Picture books - Here are just a few!

•  No more nappies by Marion Cocklico
• Ms Rachel: Potty time with Bean
• Poo Poo Bum Bum Wee Wee by Stephen Cowell
• P is for Potty (Sesame Street lift the flap)
• Usborne Why do we need a potty?
• I pooped inthe potty today! by Dillan Slobodian
• Are you feeling cold Yuki? by Kay Al-Ghani
• Little Mousey has that Potty feeling by Didi Dragon

This contains Amazon Affliate links.

Did you notice the resources that I didn't provide? 

Reward charts. 

While I think there is a place for reward charts with some children, we are moving away from these in every day practice.  It is more helpful to help your children to recognise their body signals and respond to them. For more information about interoception and body awareness, read this article "Body scan check: Interoceptive awareness for children". 
​

I would love to hear what your favourite toilet training resources are! Let me know and don't forget to download your free printable visual aids!

​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. ​​​
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/
 

Fun!
Engages a child's imagination!
Physical movement!
Core strength and gross motor skill development!
Sensory motor input to the muscles and joints!
Regulatory benefits!

No prep! 

Every therapist, teacher and parents should have "animal walks" in their toolkit to use with individual children and groups (even classes). 

There are so many benefits to participating in animal walks and some of them are harder than they seem. Add a timer (such as a visual classroom timer) or roll a die (dice) to determine how long to do each movement.  You can determine how many different animal walks to do each time. 

Animal walks are so important that I am giving you a FREE printable to use them in as part of your repertoire of activities. You can print out the visual prompts, cut and laminate them to use in a number of ways.  More on how you can recieve this free printable later in this article. 

Firstly here are 10 ways you can include animal walks into your routine. .

1.  Warm up or alerting activity.  
Choose an animal walk to start a session, or as a brain break in the classroom.  

2. Hallway or transition activity. 
Choose an animal walk to move from one room to another.  Do this individually or as a group. 

At home, you could incorporate animal walks from one part of the house to another (eg. let's bear walk from your bedroom to the kitchen). 

3. Follow the leader. 
Have a child choose an animal walk and the rest of the group follow behind. This is a great activity to do within a classroom in and around tables and chairs. 

4. Make an animal walk plan (for executive functioning skills). 
Have a child choose a few (I start with three) animal walks to make a plan.  Place these in a sequence and then carry out the sequence.  The child can keep track of what they are up to by checking (ticking off) the walks they have done.  

By creating a plan, sequencing and carrying out the plan -  your child is developing executive functioning skills with a motivating task.  This process can be carried over to help them to break down larger tasks that may seem more overwhelming (eg. getting ready in the morning).  Read more about executive functioning skills HERE and HERE. 

5. Obstacle course or circuit.
Position the animal walk prompts strategically around a room (or playground).  Have your child start with one animal walk towards the next and so forth until they complete the circuit. This is a great activity to do when inside sport is needed in a hall or gym. 

6. Relay race. 
Divide your group into teams. Position them for a relay race (could be back and forth in the same area).  Determine the sequence of animal walks. This is also a great activity for inside wet weather sport days. 

Have the first person to do the first animal walk toward the next person in their team. Have the next person do the second animal walk and so forth. 

7. Active listening in the classroom. 
When your students know the animal walks well, you can call out an animal for a "drop and do" action at any time during the day.  You could determine the time for this (eg. 1 minute).  Even a 10 second movement activity will help with alertness and engage participation.  To add another twist, call out "zoo" for the children to determine the animal themselves. 

8. Add props!
While animal walks can be done without any props and any preparation, you could also consider adding a few things to create more interest over time. 
a) Obstacles such as hoola hoops, cones or even furniture could be used to guide a route. 
b) Motor planning props such as an agility ladder and sensory tiles could be used to help with spatial awareness. 
c) Bean bags or weighted products could be transported from one place to another with an animal walk. 
d) Dress up items such as a hat, scarf or face masks could be used to develop animal characters. 

9) Themes!
Use each animal as a separate theme for further activities in therapy sessions, the classroom or at home.  You could add a craft, read a book, create a writing activity, make a puppet, draw a picture or more! 

Here are some animal themed products and activities that you could use!
* 10 week animal themed preschool program.
* Scissors skills zoo
* Guess my answer writing pages (the first one is animal).
* Frog activites

10) Practice fast, slow and stop (impulse control and regulation)! 
Faster speeds will be more alerting and slower speeds will help to calm the body. Some children need the faster speeds to help with regulation too.  These movements connect the body with the brain (as they need to think about what they are doing). 
a) Have your children listen to the speed they should perform their animal walk as you call out- fast, slow or stop. 
b) Use a metronome to listen to the speed and vary this up or slow down.  
c) You could play musical animals where the children perform an animal walk while the music is playing and freeze when the music stops. 

Animals walks are a great example of a "people game".  Doing these animal walks alongside, together, collaboratively - you are building connection with your child.  Can you do the animal walk towards each other?  Can you do it without laughing? Can you do them with a silly sound?  Can you make it a guessing game with younger children?  Can you challenge your children to think of more animal walks (eg. How does an axolotl move?)?  For more examples of "people games"  and a reminder that your child's best toy is you (READ THIS). 
​
Receive this free ANIMAL WALK PRINTABLE as an email subscriber to Your Kids OT. Don't worry, if you are already a subscriber, you will only be listed once.  Fill in the form below to receive your copy!  

I hope that you keep "animal walks" in your regular repertoire and incorporate some variations that I've shared above! Send your friends, clients and colleagues here to receive their own copy of animals walks. 

​

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. ​​​
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/
​

I almost failed. 

Importantly, I didn't fail. I tried again. I succeeded. 

I wish I had paid more attention in that first semester of OT school. ​

Neurobiology.

Ironically, the study of the brain and how it works  - was hard on my brain! The fact that I could learn new things, make mistakes and try again is so important for life-long learning.  It is the neuroplasticity of our brains that helps us to keep growing (developing skills, resilience and knowledge) and keep going (adjusting to challenges, recovering from difficulties, and maintaining function over time). 

I have been reflecting on this recently with the neurodivergent children that I see. Why are some aspects of learning so hard? What if neurobiology helps us to explain why? What are the links to brain structure? What is the impact on every day activities?  Does OT really help when it seems like an uphill struggle sometimes? 

Now, these questions could form the basis of a Phd ...and sorry I don't have the time or know-how for that...  but I thought I would do a little digging into the research to find a (simplified) answer for myself.  I hope this brief dive is helpful for some of you too - making connections between neurobiology, neuroplasticity and neurodiversity! 

Neurobiology is the study of how the brain and nervous system are structured and how they function. It provides the foundation for understanding sensory processing, motor control, attention, memory, and emotional regulation (see, I knew I should have paid more attention in OT school!).

The brain is divided into two hemispheres, each with specialized roles:

• The left hemisphere is generally associated with language, sequencing, logic, and fine motor control.
• The right hemisphere plays a stronger role in visual-spatial processing, creativity, emotional understanding, and holistic thinking.

For everyday activities, both hemispheres need to work together. For example, writing requires the left hemisphere for sequencing letters and words, while the right hemisphere manages spatial awareness on the page. 

The corpus callosum is a thick band of nerve fibers that connects the left and right hemispheres, enabling communication between them. When the corpus callosum is underactive or not fully developed, children may struggle with coordination, problem-solving, or transferring information between sides of the body (Hinkley et al., 2016).  Research has shown that individuals with autism may present with differences in corpus callosum size and connectivity, which can influence how information is processed across hemispheres and contribute to the diversity of learning and developmental profiles. These neurobiological variations highlight the importance of understanding neurodiversity not as a deficit, but as a spectrum of brain-based differences that shape how skills are acquired and expressed. By acknowledging and supporting these unique neurological pathways, therapists, educators, and families can foster meaningful skill development in ways that are affirming and individualized (Prigge et al., 2013).​

OT activities that use both sides of the body—like clapping games, ball throwing, or bilateral drawing—help strengthen these inter-hemispheric connections.

Crossing the midline refers to moving a hand, foot, or eye across the invisible line dividing the body into left and right halves. This seemingly simple action is vital for building neural pathways between the hemispheres through the corpus callosum.

In OT, we are often encouraging midline crossing through posture and positioning.  We ask the child to sit or stand in a certain position, separating the upper body from the lower body but also crossing from one side to other. 

For example:

• A child sits cross legged on the floor and reaches across their body to grab puzzle pieces.
• A child standing at a whiteboard, without moving their feet, they draw a “figure 8” (infinity symbol) repeatedly.
• A child sits at a table, with trunk rotation, plays with  items to move from one side to other. 

These activities strengthen communication between brain hemispheres and lay the foundation for skills like handwriting, reading, dressing, and sports. Repetition of cross-lateral movements has been shown to support neuroplastic changes that enhance interhemispheric integration and higher-order learning (Ocklenburg S, Guo ZV., 2024).

Neuroplasticity is the brain’s ability to reorganize and create new neural connections in response to experiences, learning, or injury. This is the reason therapy works—the brain is not fixed, but adaptable, flexible ... learning.
​
From an OT perspective:

• Every therapy session provides opportunities for practice and repetition that strengthen new skills.
• Engaging in meaningful, motivating activities enhances neuroplastic changes because the brain is more likely to “rewire” when tasks are purposeful.
• Early intervention harnesses neuroplasticity during critical developmental periods, but change remains possible across the lifespan (Kolb & Gibb, 2014). So even when say that habits are formed or things are "locked in", there is still the potential for change and learning. (You can teach an old dog new tricks). 

We use strategies such as multi-sensory learning, task analysis, finding the "just right challenge", appropriate grading and support.  We encourage embedding learning in every-day activities, hands on learning, learning through play and "making learning fun"! 

The CO-OP approach (Cognitive Orientation to daily Occupational Performance) empowers children to set their own goals, problem-solve strategies, and practice until skills become automatic. This process strengthens the brain through neuroplasticity. Goal setting, practice, strategy, and reflection drive neuroplasticity. Skills carry over best when they are meaningful to the child and practiced in real-life contexts.
​

Neurodiversity is the concept that natural variations in the human brain—such as autism, ADHD, dyslexia, and dyspraxia—are not deficits but differences that bring both strengths and challenges (Armstrong, 2010).
​
From an OT perspective:

• Neurodiversity shifts the focus from “fixing” a child to supporting participation and promoting self-advocacy.
• Therapy emphasizes strength-based approaches, recognizing creativity, problem-solving, and unique perspectives (Dwyer. P. et al, 2024).
• Environmental modifications and accommodations are just as important as skill development.
• Neurodiversity-affirming practice means respecting stimming, sensory needs, and alternative communication, and avoiding interventions that push masking or compliance.
• “How can we adapt the environment or activity so this child can thrive? How can we support the child?

These three concepts are not separate—they overlap in ways that shape occupational therapy practice:

• Neurobiology helps us understand the mechanisms behind skill development and challenges.
• Neuroplasticity gives hope and evidence that change is possible through meaningful practice.
• Neurodiversity ensures we affirm individuality, valuing strengths while supporting challenges.

Together, they guide OT practice toward more compassionate, effective, and empowering therapy.

​As therapists we can consider to: 

• Use neurobiology to understand sensory, motor, and cognitive foundations, and design activities that cross midline to support interhemispheric integration.
• Build neuroplasticity with meaningful and goal directed  tasks.
• Practice neurodiversity-affirming care: value differences, avoid compliance-based goals, and prioritize participation, autonomy, and strengths.

As parents we can remember:

• Your child’s brain can change! With practice, problem-solving, and support, new skills can grow over time.
• Focus on what matters to your child—skills are more likely to  carry over when they are meaningful.
• Celebrate your child’s strengths and differences. Being neurodivergent is not something to “fix”—therapy is about helping them thrive in their own way.
• Partner with your OT: share your child’s goals, celebrate progress, and advocate for approaches that respect your child’s individuality.

​Do you have more questions about neurobiology, neuroplasticity and neurodiversity? I do! Let's keep learning together!  Let me know your reflections and questions!

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. ​​​
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/
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