Colleen Beck OTR/L

Colleen Beck, OTR/L is a pediatric occupational therapist and the owner and author of The OT Toolbox website. She manages all of The OT Toolbox social media accounts and runs the popular newsletter. Read about Colleen's experience and career as an occupational therapist, including how The OT Toolbox began on our About The OT Toolbox page: https://www.theottoolbox.com/about-us/ Colleen created The OT Toolbox in 2011 and since then has written thousands of blog posts designed to support therapy providers, educators, parents, counselors, admin, and caregivers in promoting the healthy development of kids. Check out Colleen's blog posts below:

The Size of The Problem Activity Ideas

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In this blog post, we’re sharing a fun way to work on problem solving skills and overwhelm in kids. The kids we’ve worked with on executive functioning skills love The Size of the Problem Activity strategies for a few reasons. It helps them to understand just how big various daily problems actually are…so they can come up with a game plan to fix the issue at hand.

The size of the problem activity might sound like a quirky game, but it’s actually a combination of self-regulation, executive function, and metacognition that helps kids understand the magnitude of the problems they encounter and to cope with them….all while knowing that it’s ok to have problems, it’s ok to have big feelings, and it’s ok to not know what to do about them. After all, emotional regulation and executive functioning skills go hand in hand.

One way that I’ve done this in the past is with a few fun and engaging activity ideas. These activities can be used with different ages.

size of the problem curriculum

What Is “the Size of the Problem”?

Have you heard of a Size of the Problem concept? It’s a tool to help kids picture how bit their problems are.

Size of the Problem is a social-emotional learning concept that helps children recognize the actual size of the problem they are facing and match it with an appropriate response. The goal is to teach children that not every challenge requires the same level of emotion or reaction.

For example, dropping a crayon during art class may be a small problem that requires a quick solution and a calm response. On the other hand, a significant event such as a family emergency or a big change in a child’s life may be a large problem that requires additional support and coping skills.

Many children who struggle with emotional regulation may become very upset by small problems or have difficulty determining which situations require larger reactions. Teaching Size of the Problem helps children develop perspective-taking, self-awareness, and problem-solving skills.

The concept of “Size of the Problem” activity is often used in educational and therapeutic settings. It essentially helps the child to categorizing problems into different sizes based on their level of seriousness or impact. 

The goal is to teach individuals, especially kids, to match their reactions to the size of the problem, promoting emotional regulation and effective problem-solving.

Helping kids to identify problems by size can help them with skills like:

Remember that this can be a tricky skill to learn and then to use! Executive function develops over a long period of time and identifying problems, finding a regulation strategy, and then using it takes time, too!

How Does the size of the problem activity Work?

Now, let’s take a closer look at how this activity works:

  • Identification: Kids are guided to recognize and express their feelings about a particular situation or issue. You can prompt them with questions like “How does this make you feel?” or “Why is this bothering you?” 
  • Categorization: Once the problem is identified, it is categorized based on its size:
    • Small problems: Minor issues that can be managed independently.
    • Medium problems: Require more effort, support, or coping strategies to address.
    • Big problems: Significantly impactful challenges that may necessitate assistance from adults or professionals.
  • Understanding Impact: By assigning a size to the problem, kids can better understand how it relates to their overall well-being and differentiate between minor frustrations and more substantial issues.
  • Applying Coping Strategies: Once the size of the problem is determined, appropriate coping strategies can be introduced. For instance, small problems may be addressed with simple self-soothing techniques, while bigger problems might require more complex problem-solving skills or external support.

How to Introduce the Size of the Problem to Kids?

Introducing the concept of the Size of the Problem to kids should be done in a simple manner. Here’s how you can make the introduction effective and relatable:

  • Start with Simple Language: Begin by explaining the concept in language that suits the age group. Use examples they can relate to, like misplacing a favorite toy, having a disagreement with a friend, or not understanding a homework assignment.
  • Use Visual Aids: Create a visual chart or use images to represent problems of varying sizes. This can be a spectrum ranging from small to large, helping kids visualize the different magnitudes of problems.
  • Open Communication: Encourage conversation by asking them questions. For example, “Can you think of a time when something bothered you? Was it a small, medium, or big problem?” This prompts reflection and allows the child to connect the concept to their own experiences.
  • Relate It to Emotions: Discuss how different-sized problems can make us feel various emotions. Connect emotions like frustration, sadness, or worry to specific examples. This helps children link the concept to their own emotional experiences.
  • Model the Concept: Model the behavior by sharing your own experiences and categorizing problems based on their size. This helps children see real-life applications of the concept.

How to Teach Size of the Problem

Teaching Size of the Problem works best when children are given repeated opportunities to compare situations, discuss feelings, and practice matching responses to different scenarios.

Start by introducing categories such as:

Small Problems

Small problems are inconveniences that can usually be solved quickly and independently.

Examples:

  • A pencil breaks
  • A crayon rolls off the table
  • Someone sits in your favorite chair
  • You lose a turn in a game

These situations typically call for small reactions and simple problem-solving strategies.

Medium Problems

Medium problems are situations that may require help from an adult or a friend but are not emergencies.

Examples:

  • An argument with a friend
  • Forgetting homework at home
  • Missing part of a special activity
  • A disagreement during recess

These situations may cause someone to feel disappointed, frustrated, or upset, but they can often be resolved with support and communication.

Big Problems

Big problems involve safety concerns, emergencies, or significant life events.

Examples:

  • A serious injury
  • A natural disaster
  • A family crisis
  • A major big change in a child’s life

These situations may require adult assistance, emotional support, and more intensive coping strategies.

Using the Size of the Problem Activity in Different Settings

So, how does this play out in real life? Whether you’re at home, in school, or in a therapy session, the Size of the Problem activity is adaptable. It’s all part of emotional intelligence, but there are different problems that arise in different settings.

Let’s take a quick look at how it can be used in different settings:

Size of the Problem Scenarios At Home

So, you can help kids to understand that different problems come in different sizes by talking through the everyday problems that come up in the day to day at home.

We’ve all experienced issues that derail our plans, and this is true for sure, at home. For example, just this week in our house, we lost a bathing suit that is needed for swim class. A problem like this means that without her bathing suit, my daughter can’t swim in her swim class at school. She will have to either find her bathing suit in the laundry bins/stuffed in a bag/lost under the bed/etc. or she will sit out in swim class. She would then receive a zero for the day.

On the scale of small/medium/large problems, this one is pretty big because it means she would miss swim class each day until the bathing suit is found.

At home, parents play a huge role in the co-regulation that needs to occur as part of development. We can talk with our kids about mood and affect, emotions, and problem solving.

Other “size of the problem” scenarios that might happen at home include:

You need milk or another ingredient for making a meal. This problem is pretty small because there are easy options to solve the problem (ask a neighbor for a cup of milk, go to the store to get milk, make a different recipe that doesn’t require milk). However, if you need milk because a baby or toddler needs that as their primary source of nutrients, then the problem is bigger. It’s more of an immediate need. Some ways you could talk about this problem to support skill building might be:

  • Make a family meal plan so you can see what ingredients are needed. This works on planning and working memory skills.
  • Keep a checklist of ingredients that you need to pick up from the store. Getting kids involved with this (they can add items when they see the house has run out, too!). This can help kids with working memory, problem solving, and planning skills.

Everyone got up late and now you’re running late for the school bus. This is a larger problem because it has immediate, significant consequences like being marked tardy for school and then work for the adults. It requires a more urgent and structured response (driving to school). Strategies to address this problem could include:

  • Teaching time management skills, such as setting alarms or creating a morning routine checklist.
  • Problem-solving skills to identify what caused the delay and how to prevent it in the future.
  • Emotional regulation skills to manage the stress or anxiety that might arise from running late.

You are unable to find the remote control. This is a smaller problem. It may cause frustration or inconvenience (especially when a favorite show is on tv) but lacks significant or long-lasting consequences. The approach to this issue is more about managing disappointment or frustration and finding creative solutions. This small problem is actually a great way to teach skills to our kids, that they can use for other problems.

  • Encouraging the child to express their feelings in a constructive manner, and use self regulation strategies.
  • Teaching organizational skills or systematic ways to look for lost items.
  • Highlighting the difference in the scale of reactions appropriate for small problems versus big problems.

The list could go on and on (and on)! Problems are part of day to day life, because nothing is exactly like we might predict it to be. But, as parents, we can use these problems to help our kids develop real and essential skills.

Some ways to talk about and come up with tools to “go with the flow” when problems arise at home (and they will):

  • Family Discussions: Gather the family and initiate casual discussions about daily experiences. Ask questions like, “What happened today that made you happy, and was there anything that bothered you?” Encourage kids to share and categorize problems based on their size.
  • Visual Aids: Create a visible chart or poster at home depicting the Size of the Problem spectrum. Include pictures or symbols to represent different-sized problems. This serves as a daily reminder and facilitates ongoing conversations about emotions.
  • Family Coping Strategies: Introduce and practice coping strategies as a family. Emphasize that everyone has different ways of dealing with problems, and it’s okay to seek support from one another. Make it a collaborative effort to build a positive and supportive home environment.

Size of the Problem Scenarios In School

You can probably see that identifying problem size and coping with that problem is actually a life skill. It makes sense that as parents we can help our kids develop these skill and that the home is a great place to work on them.

But, we all know that problems will arise at school too! You can even include some of these concepts and ideas in a calm down area in the school. For example, using an emotions check in activity or a feelings check in activities can help with this ability.

For example, some ways that size of the problem activities can be done at school include:

The student is missing a school assignment. This is a larger problem in the school context because it has direct consequences on the child’s grades. Things do come up, though so missing assignments are not always going to be a big issue, and it’s up to the teacher to decide on that. How big of a problem it is might depend on if the student consistently misses assignments, or other considerations.

This type of problem also provides an important learning opportunity about responsibility and time management.

Addressing this problem could involve:

  • Helping the child understand the importance of deadlines and how missing them can impact their grades.
  • Developing time management and organizational skills, such as using a planner or setting reminders.
  • Working with the child to communicate with the teacher about the missed deadline and to understand the consequences and responsibility.

The student has a disagreement with a friend at recess. This is a smaller problem (in most cases), with less long-term consequences, but it’s an important opportunity to develop social skills.

Addressing this issue can involve:

  • Teaching the child to express their feelings and listen to others’ perspectives, fostering empathy and communication skills.
  • Encouraging problem-solving strategies to resolve disagreements, such as finding a compromise or seeking help from a teacher or peer mediator.
  • Highlighting the importance of resilience and the ability to bounce back from minor social conflicts.

Some ways to help address various size of the problem scenarios at school include:

  • Visual Aids in Classrooms: Teachers can display visual aids representing the Size of the Problem spectrum in the classroom.
  • Role-Playing Exercises: Classroom activities can include role-playing exercises where students act out scenarios and categorize problems. This hands-on approach fosters a deeper understanding of the concept and encourages peer-to-peer discussions.
  • Classroom Coping Strategies: Integrate coping strategies into the classroom routine. You can also incorporate self-regulation strategies. Teach students various coping mechanisms and encourage them to apply these strategies based on the size of the problem they encounter.

Teaching Size of the Problem Supports Social-Emotional Learning

Size of the Problem is an important social-emotional learning skill because it helps children understand how emotions, thoughts, and behaviors are connected.

Children learn:

  • Perspective-taking
  • Emotional regulation
  • Flexible thinking
  • Problem-solving
  • Self-monitoring
  • Communication skills

These skills support success in the classroom, at home, and in social situations.

Build Emotional Vocabulary Through Problem Solving

A strong emotional vocabulary helps children accurately describe their feelings and experiences.

Instead of simply saying they are mad, children can learn words such as:

  • Frustrated
  • Disappointed
  • Worried
  • Nervous
  • Embarrassed
  • Angry
  • Overwhelmed

Expanding emotional vocabulary allows children to better communicate their needs and select appropriate coping strategies.

Size of the Problem activities

We covered some size of the problem strategies in the scenarios above, and these ideas can be applied to a bunch of different situations.

Now, let’s look at some strategies that align with the Size of the Problem activities. The idea is to match the intensity of the coping strategy with the size of the problem. 

These can be great self regulation group activities for a small group in schools.

We do have a few printable resources that can be used:

  • For small, medium, or large problems, you can also help students to use a goal ladder to help them identify steps they need to take to reach their goals when it comes to problems.
  • Another tool is our resource to help kids break down goals.
  • Another printable resource is our drawing mind map exercises. You can use them to help kids figure out different responses and what to do about problems.

The thing to remember is that problems mean responses. What seems like a small problem to one person might actually be a huge problem to the person actually experiencing it! And that’s totally ok! I like to think about it like the Zones of Regulation where it’s ok to not be in the green zone all of the time. It’s OK to feel emotions and have big feelings to things like losing the remote!

As therapy providers, and as parents and educators, it’s actually our job to not argue about how much a child should be responding to a problem, but to accept those feelings and then to offer solutions. Maybe some ideas for what to do next, or what to do next time can help!

One way to do this is with sorting problems, much like our measuring activities, only in this case, we’re helping kids to measure out the size of an issue they might be experiencing.

Small Problems

Small problems can use different tools that support small needs. A student can use these ideas to help.

  • Breathing Exercises: Teach deep breathing exercises for small problems. A few mindful breaths can bring a sense of calm and perspective.
  • Using a Stress Ball or Fidget Toy: Provide a small stress-relief tool. Squeezing a stress ball or using a fidget toy can be a quick and effective way to release tension.
  • Taking a Short Break: Suggest a short break from the situation. Sometimes stepping away briefly can reset their emotions for small problems.

Medium Problems

  • Journaling: Introduce journaling as a coping strategy. Writing about their feelings and thoughts can help kids process medium-sized challenges.
  • Problem-Solving Techniques: Teach basic problem-solving skills. Guide them in breaking down the issue into smaller parts and brainstorming possible solutions.
  • Positive Self-Talk: Encourage positive self-talk. Help children develop phrases like “I can handle this” or “It’s just a small bump in the road” for minor issues.

Large Problems

  • Seek Adult Guidance: Encourage reaching out to trusted adults. For larger problems, seeking guidance from parents, teachers, or counselors is an appropriate and essential step.
  • Create a Plan: Work together to create a plan. Break down the larger problem into manageable steps, helping kids feel more in control.
  • Professional Support: Emphasize the importance of professional support. For significant challenges, seeking help from a therapist or counselor can provide the necessary tools and guidance.
Size of the Problem books for teaching kids about the size of problems

Size of the Problem Books

One way to help kids with problem solving and identifying what problems they are having…and then what to do about it…is with books. Some of the ones that I’ve used in the past (and love) include:

When reading these books with kids, you can help them to pay attention to the problems and what the characters in the books did about them.

Different Strategies for Different Problems

Not every problem should be handled the same way. Teaching children to choose different strategies based on the situation helps build independence and resilience.

Possible strategies include:

  • Taking a deep breath
  • Asking for help
  • Talking to a friend
  • Taking a break
  • Using positive self-talk
  • Problem-solving independently

When children learn multiple coping tools, they are more likely to respond successfully to challenges as they experience life and encounter new situations.

How Can you help kids with size of the problem

Hopefully, these ideas gave you something to think about. The important thing to take from these ideas is that identifying the size of a problem isn’t meant to dismiss feelings we have about a problem. It’s actually normal to “feel” no matter what the problem’s size is. Helping kids to identify a problem by size is simply a tool that shapes the way kids understand and handle their emotions.

It helps them to use the regulation strategies that work for them. And it helps them work through those emotions.

I like that we can support kids, no matter what emotions they feel about a specific problem, and give them tools to meet those needs.

So, if you are a therapy provider working on social and emotional regulation skills with kids, know that the curriculum isn’t always cut and dry. That part comes with skilled therapy experience. We can equip our kiddos with the skills needed to assess, understand, and effectively manage challenges. This is part of function!

Teaching Size of the Problem as a Lesson

Teaching the size of the problem concept is an important lesson that helps children match the size of the reaction to the situation they are experiencing. This skill supports self-regulation, social participation, and problem-solving across school and home environments.

In this lesson, students learn to identify whether a problem is small, medium, or big, and then choose an appropriate reaction. Using a common language around problems and reactions helps children build consistency and confidence when navigating challenges.

This approach is especially helpful for younger students, children at the elementary level, and learners who benefit from explicit teaching, including ELL students and those receiving school-based counseling or occupational therapy support.

We made this size of the problem visual to support executive functioning skills. It can help to teach kids how to sort problems into small, medium, or large concepts. This is great for life skills and helping with safety awareness.

Size of the Problem Visual

To help kids learn about abstract concepts, you can use visuals to teach kids as well!

A strong size of the problem visual helps children understand abstract concepts in a concrete way. Visual supports often include categories such as small, medium, and big problems, along with matching reactions.

You might use:

  • Different buckets labeled small, medium, and big
  • A visual scale showing escalating problem sizes
  • Icons or pictures that represent each level

Students can sort problem examples into the correct category and match them with an appropriate response. For example:

  • A broken pencil might go in a small problem bucket
  • Losing a turn at recess may be a medium problem
  • A serious event like a tornado or thunderstorm would be considered a big problem

These visuals help children begin to recognize that not all problems require the same level of response.

Size of the Problem Scenarios

Using size of the problem scenarios allows students to practice applying the concept to real-life situations. Presenting different scenarios helps children learn to think through their reactions and build flexibility in their responses.

Examples of scenarios include:

  • Someone cuts in line on the playground
  • A best friend doesn’t want to play
  • A game doesn’t go as expected
  • A larger life event such as a family divorce

Students can discuss each students problem, determine its size, and decide on the size of the reaction that would be expected. This type of practice builds awareness and supports generalization across environments.

Using Task Cards and Hands-On Activities

Task cards are a great way to reinforce learning through structured practice. Each card can include a scenario, and students can sort it into the corresponding bucket or category.

Hands-on activities make this concept more engaging. Try:

  • Sorting strips of paper with problem scenarios
  • Tossing scenario cards into labeled bins in a basketball game
  • Using visuals inspired by familiar themes like Incredibles characters

These types of activities encourage participation while reinforcing learning in a meaningful way.

Supporting Sized Reactions

A key goal of this lesson is helping children develop a sized reaction that matches the problem. Some children may demonstrate big reactions to small problems or have difficulty identifying when a situation requires a larger response.

Teaching strategies include:

  • Modeling calm and appropriate responses
  • Practicing matching problem size with reaction size
  • Discussing alternative ways to respond
  • Encouraging reflection on their own problems

This helps children move toward more flexible thinking and improved self-regulation.

Activities for Younger Students

For younger students, it can be helpful to simplify the concept using visuals, movement, and repetition. Use clear categories and provide frequent opportunities to practice.

Ideas include:

  • Acting out scenarios with role play
  • Sorting pictures into problem categories
  • Using simple language like “small problem, small reaction”
  • Practicing in real-life situations throughout the day

These strategies help build understanding over time and support carryover into daily routines.

Size of the Problem Worksheets

Inside The OT Toolbox, we have Size of the Problem worksheets to help with this skill.

Occupational Therapy Perspective: Why Size of the Problem Matters

From an occupational therapy perspective, Size of the Problem is about more than behavior. It involves executive functioning, emotional regulation, perspective-taking, and self-monitoring skills. When children can accurately identify the size of a problem and choose an appropriate response, they are better able to participate in school, maintain friendships, manage frustration, and navigate daily challenges with confidence.

As children gain these skills, they become more flexible thinkers and more successful problem-solvers in all areas of life.

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

Free Anger Thermometer Printable

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Anger thermometer

Next up in our free printable series is this Free Anger Thermometer Printable for occupational therapy. An anger meter is not a new concept. However, we wanted to take this visual imagery to support areas that impact daily functional performance and the underlying areas we address in occupational therapy sessions that do impact occupational participation: Emotional regulation, Executive functioning, Self-awareness, Social participation, Impulse control, Conflict resolution, Interoception, and of course, Occupational performance.

anger thermometer worksheets

Measuring Anger with an Anger Thermometer

Anger is a normal human emotion. Everyone experiences frustration, irritation, disappointment, and anger at times. The challenge is how we recognize those feelings and respond to them. Without self-awareness and regulation strategies, anger can interfere with relationships, school performance, work participation, daily routines, and overall well-being.

This free anger thermometer printable helps children, teens, and adults identify their emotional intensity, recognize warning signs, and develop a plan for responding to anger in healthier ways. By visualizing emotions along a thermometer scale, individuals can begin to notice when feelings are building and practice stopping, thinking, and choosing an appropriate response before reaching a breaking point.

The anger thermometer can be used as a self-monitoring tool, an emotional regulation activity, or an executive functioning support that helps individuals build greater awareness of how emotions affect participation in daily life.

For our some clients, we need to work on naming emotions and this thermometer tool is a great way to do that.

What Is an Anger Thermometer?

Ok, let’s break this down. An anger thermometer is a visual tool that helps individuals identify the intensity of their emotions. Similar to how a thermometer measures temperature, an anger thermometer measures emotional intensity from calm to overwhelmed.

Instead of viewing emotions as simply “good” or “bad,” the anger thermometer teaches that emotions occur along a continuum. This visual representation helps individuals recognize that anger often builds gradually rather than appearing suddenly.

For example, we like to use numbers on the thermometer to grade levels of feelings:

  • Calm (0–2)
  • Irritated (3–4)
  • Agitated (5–6)
  • Angry (7–8)
  • Overwhelmed or Rage (9–10)

Recognizing these levels helps individuals develop emotional awareness and identify opportunities to use coping strategies before reaching the highest levels of distress.

It’s another option to naming how we feel in the moment, a lot like using the levels of how our engine is running in the Alert Program. Another example is the red, yellow, blue, or green colors of the Zones of Regulation. The difference is that with this particular emotions thermometer, we are talking about anger.

Why Self-Awareness Matters

One of the most important components of emotional regulation is self-awareness.

Many children, teens, and adults do not recognize early signs of anger until emotions become overwhelming. They may notice the emotion only after yelling, arguing, shutting down, withdrawing, or engaging in impulsive behaviors.

The anger thermometer encourages individuals to pause and ask:

  • How am I feeling right now?
  • What is happening in my body?
  • What thoughts am I having?
  • What behaviors do I want to do?
  • What choices can I make instead?

This process develops metacognition, or the ability to think about one’s own thoughts and actions.

The Executive Functioning Connection

The anger thermometer is also a powerful executive functioning tool.

Executive functioning skills help individuals monitor emotions, control impulses, solve problems, and make thoughtful decisions. When emotions become intense, executive functioning skills often become less efficient.

The anger thermometer supports:

Self-Monitoring– Recognizing changes in emotional intensity.

Inhibitory Control– Stopping before reacting impulsively.

Emotional Control- Managing strong feelings appropriately.

Cognitive Flexibility- Considering alternative responses.

Metacognition– Reflecting on thoughts, behaviors, and reactions.

Problem Solving– Choosing strategies that help improve a situation.

For many individuals, emotional regulation difficulties are closely tied to executive functioning challenges. Teaching children and adults to monitor emotional intensity helps strengthen these important cognitive skills.

Understanding Body Clues

Anger often appears in the body before it appears in behavior.

The anger thermometer encourages individuals to identify physical warning signs that occur as emotions increase.

Examples may include:

  • Tight muscles
  • Clenched fists
  • Jaw tension
  • Increased heart rate
  • Feeling hot
  • Stomach discomfort
  • Restlessness
  • Rapid breathing

These body clues act as early warning signals that emotions are beginning to escalate.

When individuals learn to recognize these signals, they can begin using coping tools sooner.

Identifying Triggers

Triggers are situations, demands, interactions, or experiences that increase emotional intensity.

Common triggers may include:

  • Conflict with peers
  • Changes in routine
  • Academic demands
  • Sensory overload
  • Feeling misunderstood
  • Being corrected
  • Waiting
  • Transitions
  • Difficult conversations
  • Work-related stress

The anger thermometer worksheet includes space to identify personal triggers and reflect on patterns that contribute to emotional escalation.

This awareness helps individuals prepare for situations that may require additional coping supports.

Coping Strategies for Anger

Once individuals recognize their anger level, the next step is choosing an appropriate coping strategy.

The most effective coping tools are often used before anger reaches the highest levels.

Strategies may include:

The goal is not to eliminate anger. The goal is to respond in a way that supports participation and prevents negative consequences.

How Occupational Therapists Use an Anger Thermometer

Occupational therapists frequently address emotional regulation because emotions influence participation across occupations.

The Occupational Therapy Practice Framework, Fourth Edition (OTPF-4), recognizes that emotional regulation, social interaction skills, and environmental factors influence occupational performance.

The anger thermometer can support intervention in:

Social Participation

Managing peer interactions, friendships, family relationships, and community participation.

Education

Following classroom expectations, handling frustration, participating in learning activities, and managing transitions.

Work

Maintaining professional relationships, accepting feedback, managing stress, and responding appropriately to workplace demands.

Activities of Daily Living

Completing self-care tasks despite frustration or emotional challenges.

Instrumental Activities of Daily Living

Managing IADL responsibilities, household routines, finances, and community participation.

By helping clients recognize emotional intensity and develop regulation strategies, occupational therapists can support improved participation across daily activities.

Anger and Social Interaction Skills

Strong emotions can significantly impact social relationships.

When anger increases, individuals may:

  • Interrupt others
  • Argue
  • Withdraw
  • Blame others
  • Become defensive
  • Avoid problem-solving
  • Misinterpret social situations

The anger thermometer provides a framework for discussing social situations and helping individuals identify alternative responses.

It can be especially helpful during social skills groups, counseling sessions, school-based occupational therapy, and executive functioning interventions.

Reflecting on Occupational Performance

One of the most valuable sections of the anger thermometer worksheet asks individuals to self-reflect on how anger affects participation in meaningful activities.

Questions may include:

How does anger affect my:

  • Relationships?
  • School performance?
  • Work responsibilities?
  • Daily routines?
  • Community participation?
  • Health and well-being?

These reflections help individuals connect emotions with real-life participation and identify areas where additional supports may be helpful.

Creating an Anger Action Plan

The worksheet also includes an anger action plan that helps individuals prepare coping strategies before they are needed.

For example:

When my anger is at a 3–4:

I will take a short break and use deep breathing.

When my anger is at a 5–6:

I will step away and talk to a trusted adult.

When my anger is at a 7–8:

I will use my coping toolbox and avoid making important decisions.

When my anger is at a 9–10:

I will move to a safe space and seek support.

Planning ahead increases the likelihood that coping strategies will be used successfully during emotionally challenging situations.

Building Lifelong Emotional Regulation Skills

The free anger thermometer printable helps individuals develop self-awareness, executive functioning skills, emotional regulation strategies, and problem-solving abilities that support participation across daily occupations.

Whether used in occupational therapy, counseling, school settings, mental health programs, or at home, this tool encourages individuals to pause, recognize their emotions, and make thoughtful choices that support meaningful participation in everyday life.

Learning to recognize emotions before they become overwhelming is a skill that can strengthen relationships, improve school and work performance, and promote greater independence throughout the lifespan.

This printable is in the OT Toolbox Membership Level 1 and in the Level 2 membership, we have a version just for teens/college age students/adults.

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

Coping Skills for Anxiety

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Today we are covering a list of coping skills for anxiety. This includes a printable strategies list to help you or the person you are working with in a professional manner find strategies that really help. We decided to create this coping strategies list specifically to target coping for anxiety after working on a side project, our Daily Cup Reset Project, a social media tool for simple strategies for nervous system regulation and self regulation. You can find this on Facebook, Instagram, and integrated into our TikTok account.

coping skills for anxiety

Coping Skills for Anxiety

Anxiety looks different for every person. Some people experience racing thoughts and difficulty concentrating. Others notice physical symptoms such as muscle tension, headaches, stomach discomfort, restlessness, or fatigue. Anxiety can affect sleep, social participation, work performance, executive functioning, and daily routines. Because anxiety can present differently from person to person, coping strategies that work for one individual may not work for another.

This free coping skills for anxiety printable is designed to help individuals explore strategies, trial them intentionally, and document what actually works.

Rather than trying random techniques and hoping something helps, this worksheet encourages a more structured approach. It allows you to identify strategies you have tried, notice patterns, and create a personalized coping toolbox.

For occupational therapists, counselors, educators, and adults using the worksheet independently, this printable can become a practical tool for self-reflection and emotional regulation.

Why Coping Skills Matter

Coping skills are actions, routines, and strategies that help manage stress responses and support regulation. Effective coping skills do not eliminate anxiety completely. Instead, they can help lower the intensity of symptoms and improve participation in meaningful activities.

Coping strategies can support:

  • Emotional regulation
  • Executive functioning
  • Self-awareness
  • Interoception
  • Sleep routines
  • Attention and concentration
  • Stress management
  • Social participation
  • Daily functioning

The goal is building awareness of what helps your body and mind function at their best.

Grounding and Mindfulness Strategies

Grounding strategies help bring attention back to the present moment. Anxiety often pulls thoughts into future worries or repetitive thinking patterns, and grounding activities can interrupt that cycle.

Deep breathing helps regulate the autonomic nervous system and may reduce physical symptoms associated with stress responses. You could add in any other relaxation breathing techniques as well.

The 5-4-3-2-1 grounding technique asks individuals to identify:

  • 5 things you see
  • 4 things you feel
  • 3 things you hear
  • 2 things you smell
  • 1 thing you taste

This technique works because it redirects attention toward sensory information and away from racing thoughts.

Mindfulness activities encourage awareness without judgment and can help individuals notice emotions and body signals before they become overwhelming.

Movement and Physical Well-Being Strategies

Physical movement influences emotional regulation and nervous system functioning.

Exercise increases endorphins and may reduce physical tension associated with stress. Movement does not have to mean intense exercise. Walking, stretching, yoga, or even changing environments can provide regulation support.

Movement strategies may include:

Heavy work activities can be particularly helpful because they provide proprioceptive input that often supports calming and body awareness.

These are types of things that can be used then within a sensory lifestyle or sensory diet.

Thinking and Emotional Regulation Strategies

Anxiety frequently affects thinking patterns, or mindset. Individuals may experience catastrophizing, repetitive worries, negative self-talk, or difficulty shifting attention. All of this is part of emotional regulation. We use these tools to improve a growth mindset.

Journaling can help organize thoughts and externalize worries. Writing often reduces the mental effort required to hold multiple thoughts at one time.

Positive self-talk helps challenge automatic negative thinking.

Gratitude exercises can shift attention toward positive experiences and strengths.

Cognitive reframing involves asking:

  • Is this thought completely true?
  • What evidence supports this?
  • Is there another way to view this situation?

Social and Support Strategies

Humans regulate through relationships. Supportive social connections can reduce emotional load and increase feelings of safety.

Strategies may include:

  • Talking with a trusted person
  • Asking for help
  • Setting boundaries
  • Spending time with supportive people
  • Joining support groups

Many adults feel pressure to handle stress independently, but social support remains one of the strongest protective factors for emotional well-being.

Lifestyle and Self-Care Strategies

Daily routines significantly affect anxiety symptoms.

Sleep patterns, hydration, nutrition, and routines all influence nervous system functioning.

Strategies might include:

  • Consistent sleep routines
  • Balanced meals
  • Drinking enough water
  • Limiting caffeine
  • Creating bedtime routines
  • Building regular movement into the day

These routines may appear simple, but foundational habits often create meaningful improvements over time.

Trialing Strategies: How Long Should You Try Them?

One of the most common challenges is trying a strategy once and deciding it does not work.

Some coping tools provide immediate effects, while others need repeated practice before benefits become noticeable.

Immediate strategies often include:

  • Deep breathing
  • Grounding activities
  • Movement breaks
  • Sensory tools

These may create changes within minutes.

Other strategies often require repeated use:

  • Journaling
  • Mindfulness
  • Exercise routines
  • Sleep routines
  • Gratitude practices

For longer-term strategies, trialing for approximately one to two weeks may provide more useful information before deciding whether the strategy helps.

Consistency matters. A strategy used once during an overwhelming moment may feel ineffective even if it could become helpful through repeated practice.

What to Notice While Trialing Coping Strategies

As individuals trial strategies, encourage them to notice both emotional and functional changes.

Questions to consider include:

  • Did I feel calmer afterward?
  • Did I focus better?
  • Did I fall asleep more easily?
  • Did I feel less overwhelmed?
  • Did my body feel different?
  • Did I recover from stress more quickly?
  • Did I complete daily tasks more easily?
  • Did I participate more comfortably in work, school, or social situations?

Sometimes the effects are subtle.

A strategy may not remove anxiety entirely but may help someone feel slightly more regulated, more focused, or more able to continue participating in daily activities.

How to Document Results on the Printable

The Results/Notes section of the worksheet helps transform the printable into a personalized data collection tool.

Instead of writing:

“It helped.”

Encourage specific observations such as:

“Felt calmer after five minutes.”

“Still worried but I focused better afterward.”

“Felt less tension in my shoulders.”

“Helped me fall asleep faster.”

“Did not notice much change.”

“Worked better when I paired it with walking.”

Over time, patterns begin to emerge. Individuals may discover that movement strategies help more than breathing techniques, or that sensory tools work better than journaling.

The goal is to build an individualized coping toolbox based on real experiences rather than guessing.

Free Coping Skills Strategy Tool

There is no single coping strategy that works for everyone. Emotional regulation and anxiety management often involve exploration, flexibility, and self-awareness.

This coping skills for anxiety printable provides a structured way to try strategies, notice patterns, and build a personalized toolbox that supports participation in daily life.

Use it in therapy sessions, counseling, classrooms, or independently. This printable can help transform coping strategies from a long list of ideas into meaningful tools that support emotional well-being and everyday functioning.

This is one of the tools in our Coping Skills Toolbox.

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

Heavy Work Activities

by
Heavy work activities for Summer

Did you know the important role that heavy work activities play in our ability to learn, focus, attend, and participate in everyday tasks? It’s true. We all need calming and organizing sensory input in the form of heavy work tasks that provide proprioceptive input through the muscles and joints. Here, we’ll cover what heavy work is, when heavy work is needed, and specific heavy work strategies that kids of all ages can do at home, in the classroom, or in their therapy session.

Heavy work is a powerful support for organizing input in self-regulation. The heavy work resources here can be added to your self regulation strategies.

TABLE OF CONTENTS

Heavy Work Activities

WHAT is HEAVY WORK?

WHEN TO DO HEAVY WORK

Why Heavy Work?

How to use heavy work activities

Pushing Heavy Work Activities

Pulling Heavy Work activities

Jumping heavy work Activities

Lifting heavy work strategies

Chewing and Sucking heavy work input

More Heavy Work Tools

Free Heavy Work Activities Printable

FREE Information Packet on Heavy Work Activities

WordPress Table of Contents by Topic
heavy work ideas for calming and regulation

Heavy work can be so many things! Below you’ll find ideas for pushing, pulling, lifting, jumping, chewing, and other ideas for adding organizing proprioceptive input.

Want printable versions of these activities to use at home, in the classroom, or therapy? Try our Heavy Work Activity Cards for easy access to movement-based sensory input.

Heavy Work Activities

In a different world children would be ready to learn at all times. In an alternate universe children would not have temper tantrums or meltdowns in shopping centers. In another time and place all of us would be well-regulated all day and all night!

But that’s not how things work and anyone spending time with children will know that there are moments when they are out-of-sync and not quite with the program.

We all experience dysregulation at one point or another! We cover more on this in our recent blog on on the Alert program, which also has ideas for heavy work input.

And that’s all part of their journey of growing, developing and learning. You will be happy to know that when you are faced with these rather challenging times there is a powerful tool you can use to help children become more regulated…heavy work!

heavy work

You can rely on heavy work to help you out to organize a dysregulated nervous system.

WHAT is HEAVY WORK?

Heavy work is activity that requires effort from our muscles and these tasks usually involve activation of the muscles and joints of the body through the proprioceptive system by movements such as pushing, pulling or lifting. The movement activities create resistance input to the muscles and this feedback is ultimately what calms and regulates the sensory system.

The sensory system that is activated during heavy work activities is called the proprioceptive system. The proprioceptive system receives messages when the muscles move to do work. These messages flow back and forth to the brain. The brain decides how much force a muscle should use based on the task at hand.

This allows children to use the correct amount of force when they need to hold something gently or when they need to lift something heavy.

It’s a complex system that is constantly adjusting to make sure the brain is getting the right information from all the joints and muscles in the body and as well as making sure the muscle output is appropriate to the task. This concept is also known as body awareness and allows us to know where our body is in space and how to move our body.

The take away message about the proprioceptive system is that it is a universal and powerful regulator.

By working with the proprioceptive system you can even out disturbances in other sensory systems. You can increase energy levels if you need to and you can reduce high energy levels to help children reach a calm, comfortable space to interact with the world.

Heavy work activities for kids to impact self-regulation, attention, and functioning.

So when is heavy work appropriate to support learning and participation in daily tasks?

WHEN TO DO HEAVY WORK

The beauty of heavy work is that they are really easy to incorporate at home, in the classroom and in therapy settings. Adding heavy work to a child’s daily routine will contribute to the development of their sensory processing.

Children will also gain valuable tools that they can use when the feel that they need to regulate themselves. How often you use heavy work input will depend on the individual child. Be guided by the child’s enjoyment and response to the activity that you introduce.

Consider including a heavy work activity in the morning before going to school and again in the afternoon when children arrive home from school. Heavy work can also be incorporated into bedtime routines to help the sensory system feel calm and restful.

At school, heavy sensory input for the whole class can be incorporated at regular intervals during the day. Incorporating heavy work (and other sensory system input) into daily functional tasks, or setting up a sensory lifestyle, are all concepts covered in the book The Sensory Lifestyle Handbook.

Here is more information on proprioception, or heavy work and it’s impact on attention and learning.

Strategies like pushing a ball or heavy basket, or wall push ups and chair push ups are some examples of heavy work. Heavy work offers effort from the muscles and joints and requires the proprioceptive sensory system. The resistance provides feedback through the receptors in the muscles, joints, and ligaments. This is what is calming and regulating because the movements are organizing.

Why Heavy Work?

If you look at the iceberg image above, you’ll notice that the image depicts an iceberg with activity words above the water level. These tasks depict the heavy work actions that we see in action.

Heavy work may include:

  • Pushing
  • Pulling
  • Lifting
  • Carrying
  • Chewing
  • Jumping
  • Carrying
  • Squeezing
  • Climbing
  • Pinching
  • Brushing
  • Any other actions that use the muscles and joints with weight of the body or object

Under the water level, you’ll notice words and phrases that depict underlying skills. These are the components of heavy work that you might not “see” in action, but they are occurring with and through heavy work.

These are skills that we need for everyday tasks. Heavy work involves these components, and are what makes body awareness and movement happen. These are the skills that contribute to the organizing and regulating capacity of heavy work. The potential of these underlying components to contribute to the effectiveness of heavy work activities.

These underlying components include:

We like to say that it’s like the chicken and the egg saying. The underlying and contributing factors of heavy work contribute to the heavy work actions and the heavy work actions contribute to the underlying contributing factors.

How to use heavy work activities

Now you are ready to use heavy work sensory input to create happy, well regulated children!

Specific children may be given opportunities to engage in additional heavy
work activities during the day if they are struggling with sensory processing and attention the classroom.

Some deep pressure work activities require no equipment and very little space. Others may require some props and a bit of space. Select your heavy work activity according to the space and items available to you.

And have a few options available. Each child has a different sensory make up and preference and will respond differently to the heavy work input that you introduce. You will soon discover the activities that they enjoy and the activities that help them to feel calmer and more regulated.

heavy work pushing activities like wall push ups and chair push ups.

Pushing Heavy Work Activities

Pushing or pulling heavy objects, like a wagon, a weighted sled, or a suitcase, engages the muscles and joints of the proximal leg joints and the large muscle groups of the legs. These activities also engage the proximal joints and shoulder girdle of the upper extremity, as well as core strength and stability.

  • Wall push ups- stand an arm’s length away from a wall and place both hands on the wall at shoulder height. Bend your elbows and lean into the wall until your nose is touching the wall. Return to the original position. Repeat ten times.
  • Chair push ups- sit in a chair with you palms on the seat of the chair at either side of you. Push on your arms and lift your bottom and legs off the seat of the chair for a few seconds.
  • Pushing a box across the room- fill a box with books or toys and kneel in front of it. Push the box across the room.
  • Fill a laundry basket with laundry and ask your child to push it through the house.
  • Push a large therapy ball or medicine ball along the floor and up the wall as high as you can go
  • Push a wheelbarrow or trolley
  • Wheelbarrow walking
  • Pulling a wagon or sled
  • Pushing someone on a swing
  • Pushing off a wall or object while on a sensory swing
Pulling heavy work activities include yoga, tug of war, pull ups, and more.

Pulling heavy work activities include activities like some yoga moves, playing tug of war, doing pull ups, and more.

Pulling Heavy Work activities

Closely related to pushing, pulling heavy work uses the upper and lower extremities and the core.

  • Pulling on a rope- tie a rope to a tree, pole or secure door handle. Hold the rope and see how far you can lean back while pulling on the rope. You only need one person for this tug-of-war game!
  • Tug of war- if two or more children are available have a game of tug of war
  • Pull up bar- it may be tricky for children to perform pull ups but just hanging from a bar is great work for muscles.
  • Pulling and stretching a piece of theraband or stretchy material.
  • Wall push-Ups- Have children perform wall push-ups by pushing against a wall with their hands. This provides resistance and helps build upper body strength.
  • Chair push-ups- Seated push ups from the seat of a chair. This is a nice sensory strategy for the classroom.
Jumping heavy work activities include playing on a trampoline, jumping jacks, star jumps, and other jumping games.

Jumping is a great organizing heavy work activity and ideas include using a trampoline, doing jumping jacks, rocket jumps, or star jumps, and other jumping games.

Jumping heavy work Activities

Jumping activities add heavy work through the hips, knees, and feet.

  • Trampoline- this provides endless hours of heavy work activity. Wonderful proprioceptive input while children enjoy the pleasure of jumping.
  • Jumping on a mattress on the floor or couch cushions placed on the floor.
  • Rocket jumps- crouch down and place your hands on the floor next to you. Count down from ten and leap into the air raising both hands up to the sky. Repeat the rocket launch a few times.
  • Star jumps / jumping jacks are great for co-ordination and heavy work.
  • Sitting on a small therapy ball and bouncing up and down.
  • Hopper balls with handles are also a fun way to bounce around.
Lifting heavy work activities include carrying a stack of books, doing laundry, and yoga.

Lifting heavy work activities include carrying a weighted backpack or stack of books, doing laundry, and yoga.

Lifting heavy work strategies

Lifting weighted items or carrying heavy objects such as books, backpacks, or baskets of laundry offer heavy work. In addition to holding weighted items, lifting can involve the body weight as well.

  • Carrying bags- allow children opportunities to carry bags of groceries or laundry at home
  • Weighted backpack- place a few magazines in a backpack and encourage your child to walk around with the backpack for a few minutes.
  • A message could be placed in the backpack and your child could deliver this message to a family member at home or to another teacher at school.
  • Carry a stack of books
  • Carry a full laundry basket
  • Carry a full tote bag
  • Weighted stuffed animal
  • Leg lifts, raising arms over head, holding a bridge position
  • Yoga positions use lifting strategies as well

Chewing and Sucking heavy work input

Oral motor exercises and input through the mouth and face offer heavy work through the jaw, cheeks, tongue, and neck. These can be very organizing and regulating strategies.

  • Chew gum, dried mango, or other dry fruit
  • Drink think liquids through a straw e.g. yogurt, thick milkshake
  • Specially designed necklaces, bracelets and toys are available for chewing.
  • Chew on a straw
  • Blow through a straw
  • Eat crunchy snacks
  • Drink a smoothie through a sippy cup with a straw-type top
  • Use a “crazy straw” in a cup.  The smaller opening is great for oral motor input.
  • Play “Simon Says” with mouth exercises: Suck cheeks in/puff cheeks out/Make a big “O” shape/Stretch out the tongue. Use these printable Simon Says commands to target oral motor skills.
  • Chew gum
  • Use a straw to suck and pick up pieces of paper.  Transfer them carefully to a cup using only the straw.
  • Drinking through a sports water bottle

Try this resource for more information on heavy work through the mouth.

More Heavy Work Tools

Animal Walks

Activities like bear walks, crab walks, or crawling like a snake can engage the muscles and joints while being fun for kids.

Climbing Activities

Encourage climbing on playground equipment, climbing walls, or indoor climbing gyms. Other ideas include using playground equipment for sensory input, or climbing up a slide, when safe and appropriate.

Climbing provides heavy work for the upper body and core muscles.

Squeezing Activities

Using stress balls, therapy putty, or hand squeezers can help improve hand strength and provide sensory input.

Other squeezing heavy work activities include:

Weighted Blankets or Vests-

Weighted vests and compression garments can be used during quiet times or when sleeping to provide continuous deep pressure to the body.

Another idea is using a regular blanket as a sensory burrito.

Yoga and Deep Pressure Poses-

Some yoga poses, like downward dog or child’s pose, provide deep pressure to specific body parts and can be calming for children.

You can also include partner yoga poses in small groups for added heavy work.

Digging in the Garden-

Gardening activities, such as digging holes or moving soil, engage the muscles and joints. Check out our post on sensory gardening for more information on these benefits.

Bouncing on a Therapy Ball-

Sitting or bouncing on a therapy ball engages core muscles and provides sensory input.

  1. For a great resource filled with heavy work activity ideas, grab this set of heavy work activity cards that offer themed brain break cards, in 11 pages of themed heavy work activity cards, with 8 activities for each theme.
  2. Here are free (Spring themed) heavy work cards to get you started.
  3. Creating an individualized sensory diet with scheduled heavy work sensory activities (and other sensory input as needed) is part of a sensory diet. Read this resource for what a sensory diet is and this resource on how to create an effective sensory diet.
  4. This free slide deck offers a strategy to add heavy work in teletherapy sessions with children.
  5. Here are construction truck themed heavy work tasks.
  6. Kids love these dinosaur themed heavy work activities.
  7. Here are outdoor heavy work activities that can be done right in the backyard.

You will quickly discover how powerful heavy work as sensory input is and how much fun the children have when they engage in these activities. In addition to heavy work, there are various other sensory based tools that you can use to assist children who may have more complex sensory needs.

Children with sensory processing difficulties benefit from sensory diet which introduces a variety of specific sensory experience that assist with regulation.

Want to use themed heavy work activities in therapy, home, the community, games, and the classroom? Grab the Heavy Work Activity card set:

Heavy work activity cards

Use these heavy work cards to help with building body awareness, motor planning abilities, proprioceptive input, or a movement activity as a brain break to pay attention between learning activities. Included in the pack are:

  1. Trucks Heavy Work Activities
  2. Insects Heavy Work
  3. Sea Animals Heavy Work Exercises
  4. Farm Animals Heavy Work Ideas
  5. Jungle Animals Heavy Work
  6. Woodland Animals Heavy Work Tasks
  7. Superheros Heavy Work Exercises
  8. Sports Heavy Work Activities
  9. Monsters Heavy Work
  10. Summer Heavy Work Ideas
  11. Butterfly Life Cycle Heavy Work

Each activity page includes 8 movement and heavy work cards in that theme.

These heavy work strategies can be added to home programs, teletherapy activity plans, or used as brain breaks during learning and play.

Click here to get your collection of Heavy Work Activity Cards.

Free heavy work activities printable list of sensory ideas

Free Heavy Work Activities Printable

Need heavy work ideas to use on the go? Need sensory strategies to offer to a parent or caregiver? Want to print this information so you can use the printed material to educate parents, caregivers, teachers? Want a printable list of heavy work activities?

Enter your email address into the form below to grab this free printable information packet.

FREE Information Packet on Heavy Work Activities

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    Another great information graphic that I love is this way of describing self regulation strategies. Heavy work is one of the important ways to weave self regulation and emotional regulation into the day. Other ideas include play, imagination toys, and building an emotional vocabulary. This comes from our resource on self regulation strategies for preschoolers.

    We all have sensory needs and heavy work is a great tool to have in your toolbox to meet these preferences.

    I hope this resource has been a helpful way to better understand heavy work as a tool that we all need!

    Printable Heavy Work Activities to Support Sensory Needs in Kids

    Heavy work provides deep pressure input to the joints and muscles, which can have a calming and organizing effect on the nervous system. This type of proprioceptive input is often used in occupational therapy to help kids with regulation, attention, and body awareness. Our Heavy Work Activity Cards make it easy to implement these strategies. So, if you’re building a sensory lifestyle, supporting a child before transitions, or just looking for ways to help kids feel more grounded during the day.

    Heavy Work Activities for Summer

    We wanted to add some information to this article, as a way to support families and caregivers of kids who are home from school during the Summer months. This can be a time when routines are off and there is more screentime. We know that screens can be a regulating tool for some kids. Most of us get that, right? When you feel dysregulated, it’s calming to take some time and scroll. While that can work and be something we all use as a coping mechanism, for some kids it can be too much, especially when the screen time becomes ongoing throughout the day.

    So, as an addendum to this article on heavy work, I wanted to add some tips I give to parents who have kids at home for the Summer once school is out.

    Heavy work activities provide proprioceptive input that can help children:

    • Improve body awareness
    • Support self-regulation
    • Increase attention and focus
    • Develop motor planning skills
    • Build core and upper body strength
    • Prepare for transitions and daily routines

    These are heavy work strategies for Summer.

    Summer heavy work activities

    Summer Heavy Work Activities for Kids

    Summer is the perfect time to use what you have in the home or yard to practice incorporating proprioceptive input into daily routines. This is what we’re talking about when we say the phrase “sensory lifestyle” as a way to incorporate sensory diets into the day to day.

    Heavy work activities provide resistance to the muscles and joints, helping children develop body awareness, motor planning, regulation, and attention. The best part is that many heavy work activities can be incorporated into everyday summer fun and family routines.

    We broke this next section down into different types of Summer heavy work strategies. Some ideas are specific to chores. Others are more outdoor ideas. Still others are play-based. So when the kids are bored this Summer, this is a list to pull ideas from. You can find a printable list of these ideas in The OT Toolbox Membership (level 2 members). Or, you can get a different list, our 101 things to do this Summer for a printable fridge list. That list does incorporate heavy work, but it’s not as specific as this below.

    Outdoor Chores and Yard Work

    First, I have a list of chores that incorporate heavy work. This is good for year-round because the chores never end. But, during the Summer months, it’s a good time to have a list of tasks kids need to do before they hop on their screens or go out to play with friends. These chores add heavy work input, so it’s calming and organizing as a warm-up activity for the day:

    • Pull weeds from the garden. If you don’t have a garden or plants, pull weeds from a lawn.
    • Carry watering cans to water flowers and plants. Or pull the hose to water a garden, grass, or plants.
    • Push a wheelbarrow filled with mulch, soil, or garden tools. Or, take out the trash cans each week. Then pull them back into their place after the garbage truck has come.
    • Rake leaves, grass clippings, or garden debris.
    • Help move bags of mulch, potting soil, or bird seed.
    • Bring groceries into the house.

    Community-Based Heavy Work

    These ideas involve the community. Heavy work options can be built into outings into the community.

    • Carry library books
    • Help carry groceries for an older family member
    • Push the shopping cart or carry a shopping basket in stores
    • Use a reusable tote bag to carry items in stores
    • Walk to destinations carrying a backpack
    • Volunteer to help set up chairs at church or community events
    • Help stock shelves at a food pantry

    Backyard Play Activities

    We have an older article on backyard sensory diet activities you may want to check out. These ideas below are great for outdoor play:

    • Set up and carry pieces of an obstacle course
    • Push and pull a wagon loaded with toys
    • Carry buckets of water for water play
    • Build a fort using lawn chairs, cushions, pool noodles, and blankets
    • Play tug-of-war with a rope

    Pool and Water Play Heavy Work

    Summer means going to the pool, playing in the sprinkler, and Slip and Slides. The great thing is that all of these summer water activities are heavy work activities, too!

    We have some beach sensory diet activities that incorporate water play and sensory input. Be sure to check out those ideas too.

    • Carry pool noodles, kickboards, and pool toys
    • Fill and dump large buckets during water play
    • Push floating toys or inflatable rafts across the pool
    • Move water using large sponges or watering cans
    • Help set up and put away sprinklers and water toys
    • Pull the hose out to the middle of the yard. Use it to spray and play in the water. Then when done, pull the hose back or wind it back up.
    • Use a lawn sprinkler. Jump, run, and play in the sprinkler.

    Household Heavy Work Activities

    These are more chore idea, but geared toward indoor tasks. We love having a chore list for incorporating gross motor tasks with heavy work input.

    • Carry laundry baskets to and from the laundry room
    • Help unload groceries and put items away
    • Push a vacuum cleaner across carpeted areas
    • Wash outdoor furniture using a scrub brush
    • Move dining room chairs.
    • Sweep floors
    • Dust furniture
    • Make beds
    • Wipe down windows and doors using firm pressure

    Play Ideas with heavy work input

    Next are heavy work activities designed around play. These are great for Summer days.

    • Dig in a sandbox or garden
    • Climb playground equipment
    • Ride a scooter uphill
    • Carry beach gear to and from the car
    • Build sandcastles using wet sand
    • Help wash the family car
    • Push a toy lawn mower
    • Collect and carry sticks for a campfire
    • Pick up and stack firewood
    • Move rocks during landscaping projects

    Because summer often includes changes in schedules and routines, incorporating heavy work into play, chores, and outdoor activities can be an easy way to support a child’s nervous system while keeping them active and engaged.

    Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

    Eco Map in Occupational Therapy: How Relationships Impact Participation

    by

    One tool we can use in occupational therapy is an eco map. This visual graphic organizer is a way to explore relationships that can impact our clients’ functional performance of occupational therapy.

    Relationships influence nearly every aspect of daily life. The people around us can support our success, create opportunities for participation, provide emotional encouragement, help us complete daily tasks, or sometimes create challenges that make participation more difficult. In occupational therapy, understanding these relationships is an important part of understanding the whole person.

    eco map

    This free Eco Map Worksheet helps individuals identify the people in their lives, explore how those relationships influence daily activities, and recognize areas where additional support may be beneficial. Whether used with children, adolescents, adults, or older adults, an ecomap provides a visual representation of the social environment that surrounds an individual and impacts occupational performance.

    What Is an Eco Map?

    An ecomap is a visual tool, much like a mind map, that helps a person identify important relationships and connections within their environment. The individual places themselves in the center of the map and then identifies people, groups, organizations, and support systems that play a role in daily life.

    Unlike a family tree or genogram, an ecomap focuses on current relationships and how those relationships affect participation, well-being, and functioning. It helps illustrate both supportive and stressful connections while highlighting resources that may strengthen occupational engagement.

    We can use an eco map in OT sessions to help our clients recognize how the people in their lives help them, support them, or maybe impair function. This gives them a visual snapshot of the person’s support network and the environmental factors that influence daily occupations.

    Why Relationships Matter in Occupational Therapy

    The Occupational Therapy Practice Framework, Fourth Edition (OTPF-4), identifies supports and relationships as an environmental factor that can significantly influence participation and performance. Environmental factors include the physical, social, and attitudinal environment in which people live and engage in occupations.

    We can use an eco map with our clients AND we can use it on ourselves to help identify supportive relationships to target burnout as a professional.

    In functional occupations, supports and relationships include:

    • Immediate and extended family
    • Friends and peers
    • Neighbors and community members
    • Teachers and educational personnel
    • Coworkers and supervisors
    • Healthcare providers
    • Personal care assistants
    • Community groups and organizations
    • Online communities and virtual supports
    • Service providers and support professionals

    These relationships can act as facilitators that support participation or barriers that limit engagement in meaningful activities.

    Social Participation as an Occupation

    The Occupational Therapy Practice Framework identifies social participation as an occupation. Social participation includes activities involving interaction with family, friends, peers, coworkers, community members, and other social groups.

    Examples include:

    • Community participation
    • Family participation
    • Friendships
    • Intimate partner relationships
    • Peer group participation

    These occupations are often overlooked when discussing daily functioning, but they play a critical role in overall health, quality of life, and participation.

    The ability to establish, maintain, and navigate relationships affects educational participation, work performance, leisure activities, self-care routines, and emotional well-being.

    Relationships and Activities of Daily Living

    Many individuals rely on support systems to successfully complete Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs).

    Supportive relationships may help with:

    Activities of Daily Living (ADLs)

    • Bathing
    • Dressing
    • Feeding
    • Grooming
    • Functional mobility
    • Personal hygiene

    Instrumental Activities of Daily Living (IADLs)

    • Meal preparation
    • Household management
    • Transportation
    • Medication management
    • Financial management
    • Shopping
    • Community participation

    For example, an older adult may depend on adult children for transportation to medical appointments. A teenager may rely on caregivers to establish routines that support independence. A college student may depend on peer support while learning independent living skills.

    The ecomap helps identify these relationships and the ways they support participation.

    Relationships and Work Performance

    Relationships also influence occupational participation within work environments.

    When we look at the task of “work”, it’s important to understand the things that impact participation. This is important for burnout that happens in the therapy professions. These components can include:

    • Creating, producing, and distributing products and services
    • Maintaining work skills and patterns
    • Managing time use
    • Managing relationships with coworkers, managers, and customers
    • Following leadership and supervision
    • Initiating and completing work tasks
    • Complying with workplace expectations
    • Seeking and responding to feedback

    Success in work environments often depends on social interaction skills, communication abilities, problem-solving, collaboration, and support from others.

    An ecomap can help individuals identify:

    • Workplace mentors
    • Supervisors
    • Coworkers
    • Job coaches
    • Professional supports

    These relationships may significantly impact work performance and job satisfaction.

    Using an Eco Map to Screen for Strengths and Areas of Need

    One of the most valuable uses of an ecomap in occupational therapy is as a screening and discussion tool.

    While it is not a standardized assessment, it provides insight into a client’s social environment and support systems.

    As clients complete the map, therapists can observe:

    • Availability of support systems
    • Diversity of social connections
    • Community involvement
    • Social participation opportunities
    • Areas of isolation
    • Relationship strengths
    • Sources of stress
    • Potential barriers to participation

    Patterns often emerge quickly. Some individuals may have strong family support but limited community involvement. Others may have extensive social connections but lack practical supports for daily activities.

    These observations can guide intervention planning and goal development.

    How to Use the Eco Map Worksheet

    Begin by placing the name of the client in the center circle of the map.

    Next, identify important people and supports within the individual’s life. These may include:

    Family

    • Parents
    • Siblings
    • Grandparents
    • Extended family

    Friends and Peers

    • Close friends
    • Classmates
    • Teammates
    • Social groups

    School and Work Supports

    • Teachers
    • Supervisors
    • Coworkers
    • Mentors
    • Job coaches

    Healthcare and Service Providers

    • Occupational therapy providers
    • Counselors
    • Physicians
    • Support staff

    Community Supports

    • Faith communities
    • Volunteer organizations
    • Clubs
    • Recreational groups

    Online Supports

    • Virtual communities
    • Support groups
    • Online learning communities

    For each relationship, the individual can record:

    • Who the person is
    • Their relationship to the client
    • How they provide support
    • Whether the relationship feels supportive, neutral, or stressful

    Reflection Questions for Occupational Therapy

    Eco maps are common in the social work field. However, we don’t really use them much in the OT profession. Yes, we look at relationships in our assessments. But really working through how these supports impact our clients with an eco map worksheet isn’t a common practice. That’s why we wanted to make one that has reflection questions related to function. We wanted to create an eco map that’s specifically designed for occupational therapy.

    After completing the ecomap, reflection questions can help deepen insight and guide treatment planning.

    Consider discussing:

    • Who supports you the most?
    • Who helps you participate in daily activities?
    • What occupations are easiest when support is available?
    • Where do you wish you had more support?
    • Which relationships create stress?
    • What community resources might strengthen participation?
    • What supports would help you reach your goals?

    These discussions often reveal intervention opportunities that might otherwise be overlooked.

    Supporting Occupational Performance Through Relationships

    Occupational therapy recognizes that participation does not occur in isolation. People engage in occupations within environments that include relationships, expectations, supports, and social systems.

    The Eco Map Worksheet provides a practical way to explore those connections and understand how relationships influence daily life. By identifying strengths, barriers, and opportunities for support, therapists and clients can work together to build stronger pathways toward participation in meaningful occupations.

    Whether the goal is increased independence, improved social participation, greater success at work or school, or stronger community engagement, understanding the role of relationships is an important step toward achieving meaningful outcomes.

    References

    American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process (4th ed.). The framework identifies supports and relationships as environmental factors and recognizes social participation, work, education, ADLs, and IADLs as occupations influenced by social contexts and interpersonal relationships.

    Free Eco Map

    Want a free printable eco map? Print off this worksheet and use it to analyze supports in your clients’ lives.

    This worksheet is inside The OT Toolbox Membership. Log in and use the orange search bar inside the membership to search for “eco map”.

    Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

    Free Reset Menu-Resetting Your Nervous System

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    free reset menu

    In this blog post, we are talking all about a nervous system reset, using a simple printable reset menu we’ve created…much like picking a meal, you can pick regulation strategies that help to calm your body in everyday situations.

    What’s A Nervous System Reset?

    Our nervous system is constantly taking in information from the environment. Noise, schedules, social interactions, school demands, work responsibilities, and even excitement can impact how regulated we feel.

    When the nervous system becomes overloaded, we may notice:

    • Difficulty focusing
    • Irritability
    • Emotional outbursts
    • Increased anxiety
    • Restlessness
    • Fatigue
    • Difficulty completing tasks
    • Trouble transitioning between activities

    A nervous system reset helps bring the body and brain back into a more regulated state so that learning, participation, and meaningful activities can happen more successfully.

    It’s like this; Have you ever had one of those days when everything feels overwhelming? Maybe your thoughts are racing, your body feels tense, or you find yourself becoming frustrated over small things. Children experience these feelings too. In fact, many kids struggle to recognize when their nervous system is overloaded and need support finding effective ways to regulate.

    That’s what a nervous system reset is. It helps to calm down your body and thoughts so you can do what you have to do.

    nervous system reset menu

    Let’s talk about a Reset Menu

    That’s where a reset menu can help.

    A reset menu is a collection of simple activities that help support resetting your nervous system, improving self-regulation, and creating opportunities to return to a calm, organized state. Think of it like a restaurant menu. Instead of choosing food, you’re choosing activities that help your body and brain feel more balanced.

    You’ve probably heard the term, sensory diet. It’s kind of like using those sensory diet tools that work for the individual to help meet sensory needs. With a reset menu, we’re talking about a similar strategy…just different terms.

    Whether you are a parent, teacher, therapist, or someone looking for strategies to support emotional well-being, a reset menu can provide practical tools for managing stress and improving regulation throughout the day.

    What Is a Reset Menu?

    A reset menu is a visual list of sensory and regulation activities that individuals can select when they need a break, feel overwhelmed, or want to improve focus and attention.

    Unlike a checklist that requires completing every item, a reset menu offers choices. The goal is to help children and adults learn which strategies work best for their unique nervous systems.

    One day you may like one strategy, another you may like a different one.

    Some people feel better after movement. Others need quiet, deep breathing, or a few minutes outdoors. A reset menu encourages self-awareness and independence by allowing individuals to choose the activities that help them feel their best.

    You can self-reflect on what works, what you need in the moment and make choices based on what you see about yourself.

    Understanding Regulation Through the Nervous System

    From an occupational therapy perspective, regulation is not simply about behavior. It is about how the nervous system responds to experiences and whether a person feels safe, organized, and ready to engage.

    When we are regulated, we are more likely to:

    • Learn new information
    • Problem solve
    • Communicate effectively
    • Participate in daily activities
    • Connect with others

    When we are dysregulated, the brain shifts its focus toward protection and survival rather than learning and engagement.

    A reset menu helps bridge that gap by offering activities that support the nervous system and encourage regulation.

    Creating Your Own Reset Menu

    The most effective reset menus include a variety of sensory and regulation strategies. Consider organizing activities into categories so individuals can choose what feels helpful in the moment.

    Movement Menu

    Movement is one of the fastest ways to support nervous system regulation.

    Try:

    • Jumping jacks
    • Animal walks
    • Wall push-ups
    • Stretching
    • Dance breaks
    • Yoga poses
    • Obstacle courses
    • Taking a walk
    • Climbing stairs
    • Marching in place

    Heavy Work Menu

    Heavy work activities provide proprioceptive input that many people find organizing and calming.

    Try:

    • Carrying books
    • Pushing a laundry basket
    • Pulling a wagon
    • Moving chairs
    • Wheelbarrow walks
    • Resistance bands
    • Bear hugs
    • Tug-of-war
    • Kneading play dough
    • Building with large blocks

    Calm and Relaxation Menu

    These strategies help slow the body and support emotional regulation.

    Try:

    • Deep breathing
    • Listening to calming music
    • Guided imagery
    • Reading
    • Progressive muscle relaxation
    • Looking at nature
    • Coloring
    • Journaling
    • Quiet time
    • Meditation

    Sensory Reset Menu

    Sensory activities can help organize the nervous system and improve attention.

    Try:

    • Drinking cold water
    • Chewing crunchy foods
    • Using a fidget tool
    • Wrapping up in a blanket
    • Smelling calming scents
    • Playing with sensory bins
    • Using textured materials
    • Taking a warm shower
    • Looking at calming visuals
    • Using a weighted lap pad

    Social Connection Menu

    Co-regulation is one of the most powerful regulation tools available.

    Try:

    • Talking with a trusted adult
    • Playing a game with a friend
    • Reading together
    • Sharing a joke
    • Asking for help
    • Taking a walk with someone
    • Giving a hug
    • Spending time with family

    How Occupational Therapists Use Reset Menus

    Occupational therapists frequently use reset menus to support self-regulation and sensory processing. Rather than telling a child what they must do, therapists often help children identify which activities help them feel calm, alert, focused, or organized.

    Over time, children learn to recognize their own needs and independently select strategies that support participation in school, home, and community activities.

    This self-awareness is a critical component of lifelong regulation skills.

    Teaching Kids to Use a Reset Menu

    Introducing a reset menu works best when children practice using it before they become overwhelmed.

    Some helpful tips include:

    • Review the menu during calm moments.
    • Model using the strategies yourself.
    • Allow children to personalize their menu.
    • Offer choices instead of directives.
    • Reflect on which strategies helped after using them.

    The goal is not perfection. The goal is helping children build a toolbox of regulation strategies they can use throughout life.

    Free Reset Menu Printable

    Our free Reset Menu printable provides a simple way to introduce sensory and regulation strategies at home, in the classroom, or during therapy sessions.

    Use it as:

    FREE Nervous System Reset Menu

      We respect your privacy. Unsubscribe at anytime.
      Built with Kit

      Remember that every nervous system is unique. What works for one person may not work for another. The power of a reset menu is that it encourages exploration, choice, and self-awareness.

      When children learn how to support their own regulation, they develop skills that can improve participation, learning, emotional well-being, and independence for years to come.

      Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

      The Sensory Lifestyle Handbook
      The Sensory Lifestyle Handbook

      The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.

      The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.

      Making Friends Worksheet

      by

      This Making Friends Worksheet was designed to support social emotional learning and executive functioning skills, for use in therapy or at home. We have other friendship activities on our website that you’ll also want to check out.

      making friends worksheet

      Helping children develop friendship skills is an important part of supporting participation in school, community, and daily life. This free making friends worksheet is designed to help kids build social awareness, and the social skills needed for communication skills, emotional regulation, and problem-solving abilities through simple and meaningful reflection activities. Whether you are a therapist, teacher, counselor, or parent, this printable can be used in many different ways to support social emotional learning across settings.

      Making Friends Worksheet

      Friendship skills are often connected to much more than simply “being social.” Children use executive functioning skills, emotional regulation, perspective taking, flexible thinking, and self-monitoring when interacting with peers. For some students, making and keeping friends can feel overwhelming because of anxiety, impulsivity, difficulty reading social cues, or trouble initiating conversations. These are very real examples of using self regulation skills in social situations.

      This worksheet helps break those skills into manageable pieces while encouraging positive social participation.

      The making friends worksheet can be used as an individual activity, small group discussion, classroom counseling tool, or therapy warm-up. Students can reflect on what makes a good friend, practice conversation starters, identify ways to solve social problems, and create personal friendship goals. The simple format allows children to explore friendship-building skills without the pressure of direct social interaction in the moment.

      This is a great tool for social emotional development that I like to use in OT sessions because we can also sneak in handwriting and coloring!

      Using a Making Friends Worksheet in Occupational Therapy

      Occupational therapy practitioners often address social participation as part of functional performance in school, play, and community engagement. Friendship skills impact recess participation, classroom collaboration, group projects, self-confidence, and emotional well-being. Social participation is recognized within the American Occupational Therapy Association Occupational Therapy Practice Framework as an important occupation for children and adolescents.

      This making friends worksheet can support occupational therapy sessions by helping students:

      • Develop social problem-solving skills
      • Practice emotional awareness
      • Improve self-reflection
      • Build communication strategies
      • Increase participation in peer activities
      • Strengthen self-regulation skills during social interactions

      The worksheet also naturally supports handwriting, visual motor skills, and pencil control when students complete written responses, checklists, and drawing activities.

      Executive Functioning and Friendship Skills

      Many social challenges are closely connected to executive functioning. Children rely on executive functioning skills during nearly every social interaction. For example, students use working memory to remember conversation details, inhibition to avoid interrupting, cognitive flexibility to handle disagreements, and emotional control to manage frustration during peer interactions.

      A child who struggles with executive functioning may appear shy, impulsive, overly controlling, withdrawn, or emotionally reactive during social situations. Sometimes these students want friendships but lack the planning, initiation, or flexible thinking needed to maintain interactions successfully.

      This making friends worksheet can help support executive functioning by encouraging children to:

      • Think through social situations before reacting (and using coping strategies when needed)
      • Generate possible conversation starters
      • Reflect on social outcomes
      • Identify calming strategies during conflicts
      • Practice perspective taking
      • Develop self-monitoring skills

      Pairing social emotional learning activities with executive functioning supports often creates more meaningful carryover into real-life situations.

      Screening for Social Emotional Needs

      This worksheet can also help therapists and educators informally observe social emotional needs. While it is not a standardized assessment, it can provide valuable insight into how a child thinks about friendships, communication, and emotional responses.

      As students complete the worksheet, observe:

      Students who have difficulty answering open-ended social questions, identifying emotions, or generating social strategies may benefit from additional support in social emotional learning, self-regulation, or executive functioning intervention.

      Therapists can also compare verbal responses versus written responses. Some children demonstrate stronger social understanding verbally but struggle to organize thoughts on paper due to executive functioning or written expression difficulties.

      Ways to Use the Making Friends Worksheet

      This making friends worksheet works well across a wide range of ages and ability levels because it can easily be adapted and graded based on student needs.

      For younger children or students with developmental delays, adults can read the questions aloud and complete the worksheet together through discussion. Students may circle answers, draw pictures, or role-play responses instead of writing full sentences.

      For older students, the worksheet can become part of deeper conversations about friendship challenges, emotional regulation, peer pressure, conflict resolution, or self-advocacy. Therapists and teachers can expand the activity by practicing real-life social scenarios or creating role-play situations connected to classroom routines, recess, group work, or extracurricular activities.

      The worksheet also works well in:

      • Lunch bunch groups
      • Counseling sessions
      • Push-in classroom support
      • Social skills groups
      • SEL centers
      • Executive functioning intervention groups
      • Speech and occupational therapy co-treatment sessions

      Because the activity is flexible, it can be used repeatedly while targeting different social goals.

      Grading the Activity for Different Needs

      One of the easiest ways to grade this activity is by adjusting the level of support provided.

      For students who need more support:

      • Use visual examples
      • Provide sentence starters
      • Complete responses together verbally
      • Use role-playing instead of writing
      • Limit the number of questions completed

      For students who need a greater challenge:

      • Ask for multiple solutions to social problems
      • Encourage perspective taking
      • Have students explain why a strategy works
      • Practice real-life social scripts
      • Add writing prompts or journaling extensions

      Therapists can also incorporate movement, sensory supports, or regulation breaks while completing the worksheet to help students maintain attention and emotional regulation during social discussions.

      Supporting Functional Participation Through Friendship Skills

      Friendship development affects much more than social interaction. Positive peer relationships influence classroom participation, emotional well-being, confidence, self-advocacy, and school engagement. Children who feel successful socially are often more willing to participate in learning activities, collaborative tasks, and group problem-solving situations.

      This making friends worksheet provides an approachable way to begin conversations about social participation while supporting executive functioning, emotional regulation, and communication skills in a functional and meaningful context.

      Whether used in occupational therapy sessions, counseling groups, classrooms, or at home, this printable can help children build greater confidence in navigating friendships and social interactions.

      Research supports the connection between social emotional learning, executive functioning, and school participation. Emotional regulation and executive functioning skills contribute significantly to peer relationships and classroom success. Social participation and self-regulation are also recognized as foundational components of child development and occupational performance within pediatric occupational therapy practice.

      We have a great resource that was developed by therapists and early childhood educators, Exploring Books Through Play, that supports friendship.

      This digital, E-BOOK is an amazing resource for anyone helping kids learn about acceptance, empathy, compassion, and friendship. In Exploring Books through Play, you’ll find therapist-approved resources, activities, crafts, projects, and play ideas based on 10 popular children’s books. Each book covered contains activities designed to develop fine motor skills, gross motor skills, sensory exploration, handwriting, and more. Help kids understand complex topics of social/emotional skills, empathy, compassion, and friendship through books and hands-on play.

      Click here to get your copy of Exploring Books Through Play.

      social emotional activities for kids

      Stress Bucket Worksheet for Emotional Regulation

      by
      my stress bucket worksheet

      Helping children recognize stress and develop healthy coping strategies is an important part of supporting emotional regulation and participation in daily activities. This free stress bucket worksheet helps kids identify stressors, notice body signals, reflect on emotional responses, and build personalized coping tools that support regulation across home, school, and community settings.

      my stress bucket worksheet

      Free Stress Bucket Worksheet

      The idea behind a “stress bucket” is simple and meaningful for children. Everyone has stress that builds throughout the day. When too many stressors pile up without healthy ways to release them, the bucket begins to overflow. For children, this overflow may look like emotional outbursts, meltdowns, shutdown behaviors, irritability, avoidance, impulsivity, trouble focusing, or difficulty participating in daily routines.

      Using a visual model like the stress bucket can help children better understand what is happening inside their body and brain while developing awareness of the tools that help them feel more regulated and successful.

      Looking at Stress Through a Holistic Lens

      Here’s the thing; stress does not come from one single source. Many factors contribute to a child’s ability to regulate emotions, maintain attention, and cope with daily demands. A holistic approach considers the whole child, including sensory processing, emotional experiences, executive functioning, physical needs, environmental supports, and social participation.

      Some children experience stress because of academic pressure, transitions, social conflict, or difficulty managing expectations. Others may feel overwhelmed by sensory input such as noise, crowded environments, clothing textures, movement, or unpredictable routines. Executive functioning challenges can also contribute significantly to stress when children struggle with organization, task initiation, time management, flexible thinking, or emotional control.

      Physical and environmental factors matter as well. Poor sleep, hunger, illness, overstimulation, fatigue, lack of movement, or inconsistent routines can all contribute to a child’s stress bucket filling more quickly.

      This stress bucket worksheet encourages children to begin identifying the different experiences, feelings, and situations that contribute to stress while helping adults recognize patterns that may impact participation and regulation.

      Using the Stress Bucket Worksheet in Occupational Therapy and the Classroom

      This worksheet can be used in occupational therapy sessions, counseling groups, classrooms, SEL lessons, or at home. It works well as both a teaching tool and a reflective activity.

      The stress bucket worksheet supports:

      Because the worksheet combines visual supports, checklists, and reflection prompts, it can also support handwriting, visual motor integration, and written expression goals during therapy sessions.

      The activity naturally opens conversations about how stress affects learning, behavior, attention, relationships, and participation in daily tasks.

      Executive Functioning and the Stress Bucket

      Stress and executive functioning are closely connected. When stress increases, executive functioning skills often become less efficient. Children may have greater difficulty organizing thoughts, focusing attention, controlling impulses, or managing emotions when their stress bucket becomes too full.

      At the same time, executive functioning challenges themselves can create stress. A child who struggles to start assignments, keep track of materials, transition between tasks, or manage frustration may feel overwhelmed throughout the day.

      This stress bucket worksheet can help children:

      Helping children understand the connection between emotions, stress, and executive functioning can improve carryover into real-life situations and increase independence with self-regulation.

      Screening for Needs and Strengths

      Although this worksheet is not a formal assessment, it can provide valuable insight into emotional regulation patterns, coping abilities, and executive functioning challenges.

      As children complete the worksheet, therapists, educators, and parents can observe:

      • Emotional vocabulary
      • Ability to identify stressors
      • Awareness of body signals
      • Self-reflection skills
      • Coping strategy knowledge
      • Perspective taking
      • Problem-solving abilities
      • Flexibility in thinking
      • Emotional insight

      The worksheet may also reveal strengths. Some children can identify stressors clearly but need support developing coping tools. Others may already use effective calming strategies independently but struggle recognizing stress before reaching overload.

      Patterns within responses can help adults determine whether additional support may be needed in areas such as:

      • Emotional regulation
      • Sensory processing
      • Anxiety management
      • Executive functioning
      • Social emotional learning
      • Self-advocacy
      • Interoception

      This information can guide intervention planning while helping adults better understand the child’s daily experiences.

      Helping Kids Develop Coping Tools

      One of the most important parts of the stress bucket worksheet is helping children identify coping tools that actually work for their individual needs. Not every strategy is effective for every child, and coping tools should match the child’s sensory preferences, emotional needs, environment, and regulation style.

      The worksheet can help children begin exploring strategies connected to:

      • Sensory regulation
      • Movement
      • Emotional expression
      • Executive functioning
      • Social support
      • Cognitive reframing
      • Relaxation

      For example, children who report feeling physically restless or overwhelmed by sensory input may benefit from movement breaks, heavy work activities, stretching, or calming sensory supports. Children who struggle with racing thoughts or worry may benefit from journaling, visual schedules, breaking tasks into smaller steps, or talking through concerns with a trusted adult.

      Children who become overwhelmed during transitions may need environmental supports, visual reminders, or advance preparation strategies. Others may need help identifying calming activities they can realistically use within the classroom environment.

      The goal is not simply to teach coping tools but to help children understand:

      • When they need a strategy
      • Which strategies help
      • How to use them independently
      • How stress affects participation and behavior

      Grading the Stress Bucket Worksheet

      This worksheet can easily be adapted for different developmental levels and support needs.

      For younger children or children with communication challenges, adults can:

      • Read questions aloud
      • Use drawing instead of writing
      • Provide visual choices
      • Complete the activity verbally together
      • Use role-play or examples
      • Focus on simple body signals and emotions

      For students who need more support with executive functioning:

      • Break the worksheet into smaller sections
      • Complete one section at a time
      • Use sentence starters
      • Provide examples of coping tools
      • Add movement breaks during the activity

      For older students or adolescents, the worksheet can be expanded through:

      • Journaling
      • Deeper reflection questions
      • Stress pattern tracking
      • Discussion of social stressors
      • Goal setting
      • Planning personalized coping routines
      • Identifying triggers and preventative strategies

      The worksheet can also be revisited over time to help students notice patterns and build self-awareness as they develop stronger regulation skills.

      Supporting Functional Participation Through Emotional Regulation

      Emotional regulation impacts every part of a child’s daily life. Stress can affect attention, learning, social participation, transitions, sleep, self-care, and overall well-being. Helping children recognize stress and develop coping tools supports greater participation across environments.

      This stress bucket worksheet provides a visual and approachable way for children to explore emotions, understand stress responses, and begin building personalized regulation strategies that support success in meaningful daily activities.

      Research supports the important relationship between emotional regulation, executive functioning, and participation in school and daily occupations. Executive functioning and self-regulation skills are foundational for learning, emotional well-being, and social participation. Occupational therapy practitioners also recognize the importance of supporting emotional regulation and participation through holistic, occupation-based approaches that consider the whole child and their environment.

      Free My Stress Bucket Worksheet

      Enter your email address into the form below to get the Stress Bucket worksheet. This item is also found inside The OT TOolbox Membership. Go into the membership and search Stress Bucket Worksheet.

      Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

      Eye Movement and Occupational Therapy

      by
      eye movement

      This is an online version of our email Lunch and Learn newsletter all about eye movement.

      Eye movement skills play a major role in reading, writing, attention, classroom participation, and play. These are the functional tasks we target as goal areas in occupational therapy. When children struggle to keep their place while reading, skip words, lose items on a busy worksheet, or become visually overwhelmed, the challenge may be connected to visual tracking, scanning, or saccadic eye movements. These foundational visual processing skills help the eyes move efficiently across a page, shift between targets, and locate important visual information in the environment.

      eye movement skills in kids

      In this week’s Lunch & Learn, we’re taking a closer look at eye movement skills, why they matter for learning, and practical activities, tools, and resources that therapists, educators, and families can use to support visual attention and visual efficiency in kids.

      Why Worry about Eye Movement?

      We often hear concerns like:

      • “My student loses their place while reading.”
      • “They skip words or lines.”
      • “Copying from the board takes forever.”
      • “They can find items in the classroom, but worksheets are overwhelming.”
      • “Reading comprehension is impacted even though they know the material.”

      Many times, these challenges are connected to visual eye movement skills.

      Today’s Lunch & Learn focuses on three important ​visual processing abilities​ that impact reading, attention, handwriting, and classroom participation:

      • Visual Tracking
      • Visual Scanning
      • Saccades
      • Convergence

      These are foundational visual efficiency skills that allow children to gather information from their environment and use it effectively during learning tasks.

      What Are Eye Movement Skills?

      Eye movement skills help the eyes move efficiently while reading, writing, copying, scanning, and navigating environments.

      These skills allow us to:

      • Follow moving objects
      • Shift attention between targets
      • Find information visually
      • Maintain place while reading
      • Move the eyes smoothly across a page

      When these skills are difficult, children may appear inattentive, distracted, slow, or frustrated during academic tasks.​ Vision has a huge impact on learning​!

      Q1: What is visual tracking?

      Visual tracking is the ability to smoothly follow a moving object with the eyes.

      This skill is important for:

      • Following words across a page
      • Watching a ball during sports
      • Copying from the board
      • Reading fluently

      Children with tracking difficulties may:

      • Lose their place while reading
      • Use a finger excessively when reading
      • Skip lines
      • Complain of eye fatigue

      Learn more about visual tracking. ​

      Try visual tracking activities here to incorporate play into developing visual tracking skills.​

      Q2: What are saccades?

      Saccades are quick eye movements that shift focus from one target to another.

      We use saccades constantly during:

      • Reading
      • Copying work
      • Looking between objects
      • Completing worksheets

      During reading, the eyes do not move smoothly across text. Instead, they jump from word to word using saccadic eye movements.

      Children with saccadic difficulties may:

      • Skip words
      • Read slowly
      • Lose their place
      • Have trouble copying accurately

      Learn more about saccades and learning.​

      Try some of these visual saccades activities.

      Q3: What is visual scanning?

      Visual scanning is the ability to search for and locate visual information efficiently.

      This skill impacts:

      • Finding information on worksheets
      • Completing word searches
      • Locating classroom materials
      • Reading charts and graphs
      • Organizing written work

      Children with scanning difficulties may:

      • Miss information on a page
      • Appear disorganized
      • Take extra time completing tasks
      • Overlook visual details

      Try visual scanning activities.

      Try scanning activities for reading. ​

      Why These Skills Matter for Attention & Learning

      Eye movement skills directly impact:

      • Reading fluency
      • Attention to task
      • Visual attention
      • Writing accuracy
      • Visual endurance
      • Classroom participation

      When eye movement skills are inefficient, children may use more energy simply trying to visually manage the task, leaving less cognitive energy available for comprehension and learning.

      These visual efficiency skills are often connected to:

      • Visual motor integration
      • Executive functioning
      • Visual perception
      • Postural control
      • Attention and regulation

      Explore the full ​Visual Motor Resource.

      Activities That Support Eye Movement Skills

      Try incorporating:

      • Mazes
      • I Spy games
      • Hidden picture tasks
      • Tracking flashlights or bubbles
      • Word searches
      • Ball activities
      • Spot-the-difference games
      • Reading guides or trackers

      You can also use movement-based activities to support visual attention and regulation at the same time.

      Read about visual perception.

      More visual perceptual activities.

      Strategies for visual perception challenges.

      Shop Resources for Visual Processing

      Looking for ready-to-use activities and tools?

      These OT Toolbox resources support visual tracking, scanning, perception, and visual motor development:

      ⭐ Visual Processing Bundle

      The Visual processing Bundle is a bundle of materials to support therapy providers in treating visual processing skills.

      ⭐ Tangram Shapes Visual Perception Packet

      The Tangrams Shapes Visual Perception Packet are Printable Puzzles to Strengthen Visual Processing & Spatial Awareness. The Tangrams Shapes Visual Perception Kit is a fun, hands-on way to develop essential visual processing skills through engaging, screen-free play. Whether you’re an occupational therapist, teacher, or parent, this printable kit supports children in building the foundational skills they need for handwriting, reading, and math.

      Join the Visual Processing Lab

      If visual processing is an area you work on often in therapy or the classroom, come join us inside the: ​Visual Processing Lab​

      Inside the Lab, you’ll find:

      • Visual processing activity ideas
      • Printables and worksheets
      • Visual motor tools
      • Visual perception strategies
      • Therapy planning ideas
      • Hands-on intervention resources

      Free Email Series: ​https://www.theottoolbox.com/visual-processing-lab/​

      Action Step

      This week, observe a child during a reading or worksheet task.

      Ask yourself:

      • Are their eyes moving efficiently?
      • Are they skipping lines or words?
      • Is visual scanning impacting accuracy?
      • Does the task require more visual support?

      Sometimes what looks like attention difficulty is actually a visual efficiency challenge.

      Share This Lunch & Learn

      New this month, our Lunch & Learn newsletters are now available on The OT Toolbox website so you can easily share them with:

      • Families
      • Teachers
      • Therapy teams
      • Colleagues

      Feel free to share the link to this article with anyone supporting children’s learning and development.

      Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.