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. 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:

Vegetable Quesadilla Learning with Cooking

April 3, 2024April 3, 2024 by Colleen Beck OTR/L

This recipe for making a vegetable quesadilla with the kids was originally published in July 2015. We updated it in April 2024 with resources on using the quesadilla recipe for developing life skills and executive functioning. The easy quesadilla recipe is a great tool for developing brain skills in the kitchen.

Cooking with the kids in the kitchen is such a wonderful learning opportunity. The sights and smells of new and interesting foods and the textures and tasks of cooking provide children with a rich experience. Then there is the awareness of accomplishment. Kids can help to prepare the food that feeds the family. Kids can learn the steps of cooking a meal from start to finish. All of this is so supportive to developing executive functioning skills and life skills.

Life skills recipe for OT- an easy vegetable quesadilla recipe

Vegetable Quesadilla Recipe Kids Can Make

This week in our Cooking With Kids A-Z series where we made a recipe for each letter of the alphabet, we are exploring Mushrooms. We made a vegetable quesadilla while learning along the way.

I love to use cooking tasks like the simple veggie quesadilla to support skill development. We’ve previously explained how cooking tasks support fine motor skills. Just like all of the scooping, dicing, and mixing strengthens motor control and coordination, the process of preparing a recipe’s ingredients, using kitchen tools, using safety in the kitchen, washing hands and dishes, and preparing the food are all areas of development for daily life skills.

Cooking is functional and function is cooking! Love that as an OT!

So, when you allow kids to cook and prepare foods, they are gaining so much more than just a snack!

This post is part of our month-long Learning with Free Materials series where we are sharing learning ideas for homeschoolers and school-extension activities using items that are free or mostly free (i.e. CHEAP or you already have in the home), and is part of the 31 Days of Homeschooling Tips as we blog along with other bloggers with learning at home tips and tools. While the food needed to create this meal is not free, you do need to feed your family. So, while doing the chore of making dinner, why not learn along the way?

The educational opportunities that go along with cooking are a free lesson in math, process, direction following, listening skills, and safety.

This post contains affiliate links.

Vegetable Quesadilla Recipe with mushrooms, peppers, onions, and two kinds of cheese, a great dish for kids to eat and make in the kitchen. Cooking with kids is a great learning opportunity in so many areas!

How can kids learn when cooking?

When cooking with kids, there are so many learning opportunities. Create a list of steps for the recipe and have your child read as they work. Children can check off completed steps. Stress the importance of completing the recipe in order. Oral and verbal direction following are worked on while kids cook. Kids can learn about safety while cooking. Shredding cheese with a grater, using a knife, and cooking at the stove are opportunities for safety lessons.

Did you know that occupational therapy learn to use cooking tasks as a therapy modality in their education? It’s true! We have entire courses dedicated to activity analysis and often times, cooking tasks play a huge role in those lessons.

We learn to use a simple cooking task to support many areas, from safety and motor skills, to balance, to practically every underlying area that supports function and development of skills.

In fact, executive functioning skills and cooking are pretty much co-existing, so a task like our simple veggie quesadilla is the perfect modality for supporting development. It’s practical and engaging!

When we cook, executive functioning skills are in motion, including cognitive processes such as planning, organization, task initiation, problem-solving, working memory, attention to detail, and self-monitoring. These skills are crucial for daily living and can be developed and enhanced through various activities, including cooking.

We included information on this aspect in each of the steps listed below. We also included information on the life skills components for each step of this recipe. Talk about activity analysis!

Easy Vegetable Quesadilla Recipe

First, you’ll want to gather the ingredients for the vegetable quesadilla recipe. Planning and Organization: Before starting a cooking task, the individual needs to plan by gathering all the necessary ingredients and cooking tools. This step requires thinking ahead and organizing the workspace.

Life Skills Application- You can’t cook without ingredients and you can’t complete daily life tasks without your materials! Just as organizing ingredients and tools is crucial for cooking, being able to organize one’s belongings, workspace, or schedule is essential in daily life. This can translate to managing personal items, setting up a workspace for efficiency, or planning a daily agenda.

Life Skill Activity– Ask your kiddos to conduct a safety audit in the kitchen, identifying potential hazards.

Ingredients:

2 Tortillas
2 Tablespoons olive oil
Vegetables (peppers, mushrooms, onions, etc)
1/2 cup shredded Monterrey Jack cheese
1/2 cup shredded Cheddar cheese
salsa, ranch dressing, or sour cream to dip

Directions:

We began our Vegetable Quesadilla recipe by shredding a cup of cheddar and Monterrey Jack cheese. Put these aside on a plate.
Chop, dice, and slice green peppers, red peppers, yellow peppers, onion, and mushrooms. The nice thing about a vegetable quesadilla is that you can substitute and add any vegetable. Add in tomatoes, squash, beans, hot peppers, or eggplant…your produce department or garden is the limit!

Attention to Detail: Paying attention to the size and uniformity of the chopped vegetables can enhance focus and attention to detail.

Life Skill Application- Chopping, dicing, and all of the fun of cooking requires fine motor control and concentration, similar to tasks such as writing, typing, or assembling small parts. The precision needed for chopping can improve one’s ability to perform tasks that require attention to detail, like filling out forms or crafting.

Life Skills Activity- Try chopping and cutting with different kitchen tools.

3. Next, warm 2 tablespoons olive oil in a pan. Sauté all of the vegetables except the mushrooms. Task Initiation and Self-Monitoring: This means that adjusting the heat to the correct temperature requires self-monitoring for safety. And, the ability to start a task promptly is needed to stay on task.

Life Skill Application- When you cook, you have to keep an eye on the stove or there can be huge safety issues! Starting and then monitoring the sautéing process supports life skills tasks like beginning a laundry cycle and checking on it periodically. It teaches us to start tasks independently and monitor their progress, adjusting as needed.

4. After 2-3 minutes, add the mushrooms to the pan. Continue cooking until soft. Teach the kids about safety with the oven at this point!

5. Warm a Quesadilla Maker and place a tortilla on the bottom.

6. Spread out the cooked vegetables over the tortilla. Working Memory: Remembering the order of ingredients and where they are placed on the tortilla engages working memory.

Life Skill Application- Placing ingredients on the tortilla in a specific order involves understanding sequences and spatial relationships, and this is a skill we use day in and day out! Think about life skill tasks like organizing a drawer or planning how to pack a suitcase efficiently.

Life Skills Activity- Manage a small budget for a project or a shopping list, making sure to stay within the set limits.

7. Sprinkle cheese all over the vegetables and layer a second tortilla on top of the cheese. Close the lid to the quesadilla maker and allow it to cook until the light changes, indicating done-ness (about 4-5 minutes). Problem-Solving: Deciding when to check on the quesadilla in the quesadilla maker uses problem solving. If you are cooking in a pan on the stove top, you’ll need to flip the quesadilla at this point. This ensures it is cooked evenly without burning involves problem-solving and decision-making skills.

Life Skill Application- Cooking each side for the right amount of time requires time management, similar to allocating time for different tasks throughout the day. Adjusting the heat if the quesadilla is cooking too quickly or too slowly involves problem-solving, which is applicable in situations like adjusting plans when an unexpected event changes the day’s schedule.

8. Slice the quesadillas along the section lines using a pizza wheel. Goal Achievement: Completing the cooking process and serving the quesadilla provides a tangible result, reinforcing the concept of following through to achieve a goal.

Life Skill Application- Cutting and serving food is a huge life skill! This is one that you will use several times a day.

Life Skills Activity- Prepare the food and ask the kiddos to focus on the layout and organization of the content to make it appealing.

Serve with salsa, sour cream, or ranch to dip.

With a vegetable quesadilla, children get the opportunity to try new vegetables that might be new to them. The hand-held finished dish is a fun one to eat.

Dipping the quesadilla slices into ranch, salsa, or sour cream may encourage your child to try this recipe and new tastes. Have fun experimenting with vegetable combinations!

Here are more recipes that kids can make to support skill 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.

Kinesthetic Learning Activities for Outside

April 1, 2024April 1, 2024 by Colleen Beck OTR/L

This blog post about kinesthetic learning is an older blog post from March 2017 that we updated in March 2024 to add more information on what kinesthetic learning means and what it looks like for kids. Check out our suggestions and strategies below.

The thing about kinesthetic learning is that it’s happening all day long. We know the power of play and how play drives learning in children. After all, we OT practitioners preach about play being the primary “work” in children!

We’ll explain a little more about kinesthetic learning below. The thing is that there is incredible opportunities for movement and learning through movement when exploring in the outdoors, so this older blog post focused a lot on outdoor experiences as a medium for kinesthetic opportunities.

What is Kinesthetic Learning?

Kinesthetic learning refers to a style of learning where individuals learn through physical and movement activities. This sounds a lot like tactile learning, right? It’s actually a lot like a term you have probably heard in recent years: multisensory learning.

Kinesthetic learners prefer to engage in the learning process by moving, doing, and touching. This allows them to use their body to explore and the sense of touch to explore and learn about the world around them. For those that have a strong sensory touch, this is great! This approach is grounded in the belief that students learn more effectively when they are physically active or involved in the learning process.

The thing about kinesthetic learning is that there is the added benefit of proprioceptive input and heavy work through the hands as the child learns and explores.

Tactile learners and kinesthetic learners are a lot alike.

Kinesthetic learners need to move their bodies, manipulate materials, and really interact with learning materials. These children tend to fidget, wiggle, slouch, or get up out of their seats when in the classroom setting. This site has a lot of great information on kinesthetic learning.

Kinesthetic Learning Activities

Kinesthetic learning activities are powerful for some kids. It can mean the difference between paying attention and grasping a concept and missing it all together. Some of my favorite kinesthetic learning ideas include those that involve gross motor work and the senses.

Some kinesthetic learning ideas include:

Clipping clothes pins marked with letters onto the edge of paper and then writing the letters. Here are more clothes pin activities.
Counting paperclips in groups of ten
Sorting colored beads into different containers.
Creating alphabet shapes with playdough.
Using a hopscotch grid to learn numbers or math operations.
Themed sensory bins
Building geometric shapes with toothpicks and marshmallows.
Tracing letters or numbers in a sand tray. Here’s what you need to know about writing trays.
Assembling puzzles that correlate with lesson themes.
Conducting a scavenger hunt to find objects related to the lesson.
Using a ball to pass around for answering questions or storytelling.
Walking along a tape line to improve balance while discussing a topic.
Playing charades to act out vocabulary words or historical figures.
Matching socks to teach pairs, colors, or patterns.
Using body movements to represent mathematical operations (e.g., jumping for addition).
Organizing classroom objects by size, color, or type.

More ideas for kinesthetic learning include:

Physical Manipulatives: Using physical objects to teach concepts can be particularly effective in subjects like math and science. For example, using block activities are so much fun for some kids and it’s great to teach mathematical operations.

Interactive Notebooks: My daughter has an ELA notebook full of cut outs and interactive activities. They cut out worksheets and glue the pieces into a regular lined notebook. The act of cutting, pasting, drawing, and writing helps all of the vocab and spelling words to “stick”. It’s funny because she can flip through the notebook and find a random vocabulary word because she remembers the cut outs that she did and where they are pasted into the book. It’s fascinating to watch!

Movement-Based Games: We LOVE board games! There are so many board games that can be used to learn concepts and they are so much fun for learning through play. Games that require movement can be used to teach various concepts.

Building and Construction: Tasks that involve building or constructing models can enhance understanding, especially in subjects like engineering, physics, and geometry.

Outdoor Learning: See below for more info. The thing about taking the learning outside the classroom is that kids gain so many vestibular and proprioceptive input through learning . This could include nature walks, geological expeditions, or physical education activities.

Dance and Music: Incorporating dance and music to explain concepts, especially in younger classrooms, can be an effective kinesthetic learning strategy. For example, creating a dance routine to explain the water cycle.

I recently shared a post on tactile learning with a sight word sensory tray. I talked a little bit about kinesthetic learning and how some kids just seek tactile input in their learning.

Kinesthetic Learning Activities for Outside

Taking the learning outside can make a big difference. As the weather warms up, it can be hard to keep the attention in the classroom. The birds are chirping, trees are blossoming, and the muddy lawns are calling! So, when kids want to be nothing more than outside playing, how do you keep them focused and learning?

Try taking the learning outside! These kinesthetic learning activities are perfect for the outside play this time of year and all year long. Add some movement and outdoor play and facts are sure to stick when kids are out of the classroom and outdoors!
Try taking the learning outside to really get some space and movement into the learning experiences. You could try these activities when practicing math facts, spelling words, vocabulary, memorization, or many other areas.

Outdoor Learning Activities that Use Kinesthetic Movement

There are several kinesthetic activities that allow for learning while outdoors.

Balance Beam Adventure- Use a jump rope or a board to create a balance beam maze on a driveway or sidewalk. With sidewalk chalk, draw fish in a pond. Kids can walk on the balance beam without falling into the “water”. When they are on the balance beam, ask kids to hop while stating facts or other learning tasks. Try a bean bag toss game when on the balance beam. Kids can toss a bean bag into a target while spelling words. Here are more outdoor balance beam activities.
No Peeking Simon Says- Play Simon Says outside in the backyard. This version requires kids to keep their eyes closed when they perform the actions. As they play, ask them questions. You might ask them to touch their nose for “true” facts or to touch their shoulders for “false” facts. Get creative with movement and learning with this one! Simon Says commands can incorporate movement and learning for practically any subject.
Backyard maze- Create a maze in the backyard by placing obstacles around the lawn. Kids can look at the simple maze and then walk with their eyes closed as another person “guides” them with verbal directions around the obstacles. Set up stations around the obstacle course where they need to answer questions. This can be as simple as a printed out sheet of questions. They just may recall the answers later by thinking about where they were in the obstacle course when they learned about those facts!

This pre-reading obstacle course is perfect for kinesthetic learners.

Backyard Yoga- Try yoga in the outdoors with kid-friendly yoga games like found in this book (Amazon affiliate link) Try having your child close their eyes during yoga moves to incorporate position of body in space. Add deep breath spelling or math facts while breathing in and out for several counts.
Hopscotch Math- Practice math facts like addition or multiplication with a hopscotch game on the driveway.
Sidewalk Chalk Learning- Kids can use sidewalk chalk in so many ways! Write out spelling words. Do math homework on the driveway. Write out vocabulary words. Use patio pads or bricks to work on perimeter, area, or geometry. What would you add?
Take a Walk- Go on a stroll while reviewing information. What a great way to learn in nature!

Try some of these outdoor lawn games with the kids.

How can you add learning and movement to the backyard to better serve your kinesthetic learners?

outside activities for kinesthetic learning for kids

How to incorporate sensory and motor play into playing outside

Sensory diet activities can be specific to sensory system like these vestibular sensory diet activities. Sensory activities can be prescribed according to need along with environment in order to maximize sensory input within a child’s day such as within the school day. Using authentic sensory input within the child’s environment plays into the whole child that we must understand when focusing on any goal toward improved functional independence.

Many sensory diet activities can naturally be found outdoors. In fact, outdoor sensory diet activities are a fun way to encourage sensory input in a child’s environment and without fancy therapy equipment or tools.

It’s a fact that kids are spending less time playing outdoors. From after-school schedules to two working parents, to unsafe conditions, to increased digital screen time, to less outdoor recess time…kids just get less natural play in the outdoors. Some therapists have connected the dots between less outdoor play and increased sensory struggles and attention difficulties in learning.

Knowing this, it can be powerful to have a list of outdoor sensory diet activities that can be recommended as therapy home programing and family activities that meet underlying needs.

That’s where the Outdoor Sensory Diet Cards and Sensory Challenge Cards come into play.

They are a printable resource that encourages sensory diet strategies in the outdoors. In the printable packet, there are 90 outdoor sensory diet activities, 60 outdoor recess sensory diet activities, 30 blank sensory diet cards, and 6 sensory challenge cards. They can be used based on preference and interest of the child, encouraging motivation and carryover, all while providing much-needed sensory input.

Here’s a little more information about the Outdoor Sensory Diet Cards

90 outdoor sensory diet activities
60 outdoor recess sensory diet activities
30 blank sensory diet cards, and 6 sensory challenge cards
They can be used based on preference and interest of the child, encouraging motivation and carryover, all while providing much-needed sensory input.
Research tells us that outdoor play improves attention and provides an ideal environment for a calm and alert state, perfect for integration of sensory input.
Outdoor play provides input from all the senses, allows for movement in all planes, and provides a variety of strengthening components including eccentric, concentric, and isometric muscle contractions.
Great tool for parents, teachers, AND therapists!

Be sure to grab the Outdoor Sensory Diet Cards and use them with a child (or adult) with sensory processing needs!

We also love the learning opportunities in our Fine Motor Kits!

Working on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, or scissor skills? Our Fine Motor Kits cover all of these areas and more.

Check out the seasonal Fine Motor Kits that kids love:

Letters Fine Motor Kit — Summer Fine Motor Kit

Kit de motricidad fina de verano — Summer Fine Motor Kit

Or, grab one of our themed Fine Motor Kits to target skills with fun themes:

Want access to all of these kits…and more being added each month? Join The OT Toolbox Member’s Club!

Occupational Therapy in Schools

April 3, 2024April 1, 2024 by Colleen Beck OTR/L

Occupational therapy in schools looks a lot different than it has in the past. With social distancing requirements, sanitizing needs, and changes to school schedules, therapists are looking for ways to meet the needs of their students. This year, school-based OT looks different than any other year, and occupational therapy activities will reflect those changes.

Here, you will find strategies that school-based OT practitioners can use in the classroom as part of push-in services, in small groups, or in an individual, pull-out model.

What is school based Occupational Therapy?

One thing that I love about the profession of occupational therapy is that there are many environments and areas to cover. It’s all about the individual and the functional performance areas can be drastically different simply based on the environment.

In school based OT, occupational therapy providers support students in their education. We might support fine motor, visual motor visual perceptual, sensory motor, executive functioning skills, cognitive skills, physical skills or other area which impacts the student’s ability to learn.

School-based occupational therapy practitioners are either occupational therapists (OTs) or occupational therapy assistants (OTAs) who use meaningful activities
(occupations) to help children participate in the tasks they need to do in order to learn and participate in the school day. School based occupational therapy practitioners addresses the physical, cognitive, psychosocial and sensory components of performance which impacts learning.

This might look like supporting needs in academics, play at the playground or at recess, social participation, self-care skills (ADLs or Activities of Daily Living), and transition skills.

From targeting skills like executive functioning in schools to developing fine motor skills through play (ideal for the preschool occupational therapy interventions!), school based OT professionals do it all!

While OT in the medical model can cover similar areas in some ways (underlying developmental areas like fine motor skills and functional skills like self care or handwriting), there are big differences too.

What does a School Based OT do?

A school based OT can work on many different areas in the school environment. It will all depend areas the student struggles with in their education. Basically, if a student’s developmental challenges impact their ability to participate in their education, then OT may be involved to support these areas of need.

It all starts with an OT evaluation. Here is information on how to request an OT evaluation.

Depending on the needs of the student, a school based OT can address:

Fine motor skills (impacting areas like holding a pencil, cutting with scissors, using school materials, managing clothing fasteners, manipulating materials like books and glue sticks, etc.)
Gross motor skills (impacting areas like moving throughout the school, using playground equipment, walking in the hallway, etc.)
Visual-motor integration
Sensory processing- For example, here are ideas for using playground equipment to support sensory needs.
Sensory Diet creation
Coming up with sensory strategies in the classroom to meet needs
Self-regulation
Handwriting
Self-care and daily living skills- for toileting, clothing fasteners, shoe tying, managing coats or jackets for leaving the school building, washing hands, etc.
Feeding needs (in some cases)
Social skills
Play and leisure skills
Executive functioning- including organizing materials, attention and focus, problem solving, planning and prioritizing projects, etc.
Assistive technology use
Environmental modifications- for example, supporting needs like getting on and off the toilet for physically involved students
Mobility considerations- accessing areas of the school, bus, auditorium, cafeteria, hallways, etc.
Transition skills
Behavioral strategies
Motor planning and coordination
School participation and access
Other areas

Then, knowing that these are all of the areas that a school based OT provider can address in the school environment, there are different roles the OT plays as well.

Roles of a School Based OT

The school based OT has many roles in the school system. AOTA has a resource on this which describes roles like: educator and trainer, resource consultant, advocate, leader, and researcher. These roles typically happen all day long as a school based OT!

When it comes to actually intervening with students, a school based OT can support students in various models:

Direct OT Interventions
Consultation
Professional Development and Training

The typical school based OT will do all of these roles in a single day! Let’s cover each of these roles:

Direct OT Interventions

Direct treatment is done following the OT screen and evaluation, and completion of OT goals which are added to the student’s IEP. There will be a process which is followed, depending on the state requirements, which may include RTI, MTSS, etc.

Direct OT interventions can look like one on one therapy sessions, group OT sessions, or push-in therapy interventions. All of these models provide services to support at-risk students. The main thing to remember is that we always use the most appropriate intervention model to improve the academic outcomes and school conditions the individual student’s learning.

School Based OT Consultation

Consult refers to periodic “check ins” with educators that are involved with the student. The school based OT professional providing consult services will address specific needs and make recommendations that are carried out in the classroom. The consult process involves checking in with the teacher or teacher assistant on how the recommendations are being used and how it’s going.

For example, I’ve moved students from direct intervention into a consult model when the student has progressed to a certain point. I’ve used the consult model with students in middle school OT or high school OT who have had several years of direct interventions.

Another example of consultation is supporting teachers by setting up a calm down corner in the classroom. The teachers that I’ve worked with in this way have been very appreciative.

Professional development and training

This can be a tricky area of the school based OT provider’s job requirements, because if the OT provider is a contracted OT, time spent training and educating educators or other members of the staff may not be paid time. However, this time can roll into the consult model if specific and individualized training and education is provided. For example, in one situation, I ran a training to a group of educators and special educators on using the ALERT program with one student. The training session was individualized for the particular student and we went over recommendations for this one student that would be implemented into the classroom. We scheduled this time as a meeting and it was billed to the student because we were setting up the program for this one individual.

Another area of professional training is to support the entire school by setting up a sensory room. The school based OT professional is a valuable asset for the school in this regard.

Some admin will pay for this time in the way of a staff development training session. OT providers who are employed by the school district however, may have these requirements built into their contract. It’s just one more component of the school-based OT’s job description!

Group Occupational Therapy

Many OTs need to move from a push-in model to pulling each one of their students out of the classroom for therapy intervention. Other therapists will focus on pushing into the classroom for a small group activity with a couple of students who are in the same classroom.

Regardless of the model, occupational therapy activities will need to have social distancing practice in place and thoughtful use of supplies. Looking for group occupational therapy activities that can be completed with a small group?

How to address social distancing in small groups in school occupational therapy this year.

Some recommendations for group OT can include:

Arranging the occupational therapy room so that students are well-spaced out. Using painters tape to create marked stations for each student can be used for social distancing, but also to help kids work on personal space, body awareness, and spatial awareness. Students can carry this skills over to functional tasks such as standing in lines in the hallway or getting on/off the school bus, or in the community.

Sensory coping strategies in the classroom can be adjusted to address social distancing requirements while meeting the child’s needs. Think about Simon Says, wall push-ups, I Spy games, etc. These therapy Simon Says commands can target many different skills through play.

Brain breaks can be used on an individual basis, in small groups, or in the whole classroom.

Mindfulness activities can be implemented in therapy sessions or in small groups.

Pushing into the classroom to work with a small group might be something that some therapists have to do per school recommendations and wishes. When pushing in to the classroom, precautions can be taken to try a group activity without close interaction like “I Spy” or “What’s missing?” visual perception games. Add handwriting to these group activities to work on specific skills, too.

There are points for both push-in service and pull out model of school occupational therapy during a pandemic. For example, pushing into the classroom or using a consultation model can mean less equipment that needs to be sanitized between sessions.

School Occupational Therapy Tips

These suggestions can be used by school-based OT professionals in pull-out sessions or in push-in therapy in the classroom.

Plan ahead. Use this interactive school-based OT planner to plan out activities based on themes and come up with a plan for each week. This can help with accessing materials and using what student’s have in their desks to work on certain skills. (See below for how to use what the student has in their desk.)

Organize the OT space so that items can not be accessed by students. Keeping items out of reach of students will allow for less sanitation time between sessions.

Pull out items that will only be used during that session and place each used item into a designated bin or “sanitize zone”. These items can be sanitized after each session and allowed to dry after the use of sanitizer.

Washing hands before/after each session. When children come into the occupational therapy space as a small group, or when a small group is seen in push-in services, therapists can have each child wash and dry their hands or use hand sanitizer both before and after each session. Make it part of functional goals, if it is something that can be used to meet the goals of the child. Hand-washing offers opportunities to work on eye-hand coordination, fine motor skills, tactile sensory experience, attention, organization, motor planning, and more…all part of a functional activity of daily living. Add in the clean-up portion (throwing away paper towels) and you’ve got aspects of IADL work as well.

Allow time for washing hands/sanitizing. we know that as therapists, we have a FULL schedule. Some OT professionals juggle 60+ students and many different school districts. But, allowing time for sanitizing and hygiene is a must. It’s not going to be easy, but like everything else, we are going to be forced to slow down and take that necessary time. Try to add that cleaning/sanitizing time right into sessions. The student can do their last activity while the therapist sanitizes materials.

Incorporate outdoor recess as a therapy session. So many goal areas can be addressed through play and social interaction in outdoor recess. While this “down time” might look different than it has in years past, games and small group activities can be incorporated into occupational therapy sessions, in a “push-in” model that occurs outdoors. Here are sensory diet activities for outdoor recess.

Outdoor occupational therapy sessions. Sensory processing activities on the playground is an excellent way to work on sensory needs and regulation. What’s more, is that the outdoors offer the perfect environment to work on so many OT goal areas. Take students to the playground for sensory and motor work. Use a blacktop surface for fine motor and core strength activities. Use a shading lawn area to work on various coping strategies. Here are sensory diet activities for the playground.

Use teletherapy slide decks- Even though OT professionals may be in the schools (or virtual depending on the district and state), there are many free teletherapy resources like OT slide decks available that can be used in person, too. Try these teletherapy activities, specifically this alphabet slide deck that teaches letters with a handwriting, letter formation, and gross motor brain break activity.

These occupational therapy teletherapy activities can be helpful for remote learning, hybrid models, or even in the classroom.

School-Based OT Kits

Using an inexpensive kit for each student can be an easy way to target a variety of goal areas with a few materials. Here, you will find suggestions on how to create a kit for each student. This is great for the school based OT who travels from building to building throughout their day.

Small occupational therapy kits can be created at a low cost. Here are some OT kits that we’ve covered:

A small kit for each student may be necessary. I tried to come up with a list of LOW cost materials and ones that can be spread across a caseload. For example, a $1 deck of cards can be split up among man students as they each get 5-6 cards. A pack of pipe cleaners or a pack of straws can be distributed among many students, especially if the pipe cleaners are cut into smaller sizes.

These kits can be organized into a plastic zip-lock baggie for each student. Write the child’s name on the bag and make sanitizing the outside of the bag part of the child’s session. Kids can participate in this aspect, too…an essential self-care ADL of hygiene!

School Based OT Materials

OTs working in schools cover a lot of different areas. But, the skilled therapy provider knows how to use a limited supply materials to support a variety of needs.

Play dough mini-tubs- Here are fine motor activities using play dough.
Pony beads- Here are fine motor activities using beads.
Piece of bubble wrap- A big sheet of bubble wrap can be cut into small sections and added to a toolkit. Use it for fine motor work, opening the thumb web-space, or a sensory fidget. You can even use bubble wrap in a visual perception exercise.
Pipe cleaners- These are great fidget tools! Here is just one way that pipe cleaners can be used for precision and dexterity.
Mini-erasers- Stack them, sort them, and use mini erasers in visual perceptual activities.
Coins- Manipulating coins is a fine motor workout.
Stickers- These 10 reasons why kids need to play with stickers explains it all.
DIY tongs- Use craft sticks to make DIY tongs.
Craft sticks- A handful of craft sticks can be used for fine motor work or visual perceptual activities. Here are pick-up sticks activities that can be modified with craft sticks.
Sheet protector
Craft pom poms- Use craft pom poms for fine motor work.
Straws
Playing cards- Grab a deck of cards and add a handful to each OT kit. Use playing cards in fine motor work and other activities.
Clothes pins- Here are fine motor activities using clothes pins.

Use the items students have in their desks. This year, they will be using more individual items that come from home and are separated from other students, so use those materials. Some items and occupational therapy activities include:

Markers- Use regular markers in occupational therapy activities like the ones we have listed.

Scissors- Students will likely have their own set of scissors in their desk. Work through this scissor crash course to work on precision and dexterity.

Colored Pencils- If students have colored pencils, use them to work on handwriting, visual motor skills, and fine motor work. Here are colored pencil activities.

Pencil box- If students have a pencil box to hold their materials, use that pencil box in OT activities!

Crayons- Crayons are always on the back-to-school list. There is a reason why crayons are so effective in building skills…Use those power tools in school occupational therapy sessions. Here is just one way to work on distal finger control with crayons. And, kids will love this 3 crayon challenge!

Ruler- If kids have a personal ruler in their desk, use that to work on bilateral coordination, eye-hand coordination, fine motor skills, pencil control. Here is one way to use a ruler to help with cursive writing.

Small pencil sharpener- This is a school supply item that is often times on the back to school supply list. But this year, it will be even more important for students to have their own pencil sharpener. Why not use it to work on arch strength, bilateral coordination, pinch and hand grasp, and endurance? Using a small pencil is effective in tripod grasp and hand strength, but kids can sharpen those pencils and work on skills, too.

Books- Books and workbooks can be used for proprioceptive input and heavy work.

Folders and papers- Kids can work on organization and executive functioning skills with the materials they have in their desks. Folders, papers, and all of the “stuff” can get overwhelming fast, especially for the child struggling with impulse control, focus, attention, and other executive functioning skills. Work on those areas with strategies.

Use these school occupational therapy suggestions to address social distancing, small groups, and changes to school OT this year.

School Occupational Therapy Activities

In other cases, it might look like recommendations for a routine or wellness. This wellness wheel can be helpful in addressing the balance of kids at home and at school.

As therapists, maybe we can offer movement-based activities or brain breaks that can be done as a whole group. Perhaps a consult with a teacher on one student leads to a deep breathing session for the whole class.

Educating parents, teachers, administrators, and even the students themselves on the connection between movement, coping tools, behavior, and cognitive processes will become more necessary.

While many students receiving OT in schools have handwriting goals, OT’s are definitely not handwriting teachers. It is a very common functional task that needs support. Here are handwriting activities to try.

Try some of these mindfulness and coping tools that can be used in school occupational therapy sessions or consultation:

Incorporate recess activities into a sensory diet to meet self regulation needs.

Brain breaks can be used on an individual basis, in small groups, or in the whole classroom.

Mindfulness activities can be implemented in therapy sessions or in small groups.

This easy coping strategy requires no materials or items, making it sanitizing-friendly.

These anxiety and sensory coping strategies can be helpful with re-acclimation to the classroom and learning.

Working on social emotional skills can be helpful in identifying emotions as a result of reentering the classroom…and help kids come up with coping tools.

Here is a free Space Theme Therapy Slide Deck.

Here is a free Strait Line Letters Slide Deck.

Here is a free “Scribble theme” Handwriting Slide Deck.

Teach Letters with a free interactive Letter Formation Slide Deck.

Try this free interactive letter writing/brain break slide deck.

Final note on school based OT

Remember to take time for self-care as a therapist and address the stress and burnout with coping strategies and balance. Rest. Use these tips for occupational therapists to stay organized yourself. You’ve got this!

Occupational Therapy Month (Ideas for 2024)

April 10, 2024April 1, 2024 by Colleen Beck OTR/L

Happy occupational therapy month! April is OT month and every year, I love to recirculate this blog post because it offers so many OT memes and social media graphics for explaining what we do in occupational therapy. This year, we’ve got a few fun free OT PDFs for OT month, too, so if you are working in school based therapy, in clinics, or in homes and want to celebrate the OT profession WHILE building skills, those resources are for you.

I also wanted to update this blog post because, and I don’t know about you, but I am busier than ever before. There are new challenges that seem to be getting more difficult each year that impact the profession. Some things that I’m seeing that are new challenges for OT professionals include:

Demanding schedules (higher number of students on caseload than ever before, more eval requests, extremely high productivity…)
Challenging client needs. Kids seem to be struggling just as much as we are. I’m seeing more referrals for self regulation needs, emotional skills, and coping needs, in addition to the very tasks that limit functional performance. We as OT professionals are skilled in supporting the whole person. And it seems like there are more and more of our clients that are struggling in the social/emotional/regulation area than ever. Do you see this too?
Limited time in the schedule for making things fun and engaging. When the schedule is full of demanding caseload numbers, it’s hard to find the time to come up with new and fun activities that keep the attention of kids we learn. It’s a recipe for burnout on the part of us as the practitioner, and the child as the client/student.

What other areas are you seeing struggles in as an OT provider?

So, because of these things that seem to be more and more prevalent, I added a few ideas to this OT month activity post. I added ideas that don’t take up extra time, or don’t require bringing in cookies (i.e. making cookies for colleagues that might not even recognize the true value of OT). In years past we might have provided a workshop or seminar on the value of OT. But who has time or energy for that?! Just thinking about creating a workshop is exhausting. Then try to find time in the schedule to fit one in…it’s just an unfeasible thing. There’s no way!

OT Month Activities

Below, you’ll find easy ways to celebrate OT month so we can celebrate the profession of occupational therapy and share with others what an amazing thing it is to be an OT professional!

Below, you’ll find ideas for OT month:

OT Month memes (share them on social media!)
OT month printable activities. Use the free occupational therapy PDFs in treatment sessions. Grab all of them below.
If you are a member in The OT Toolbox membership, log in and head to OT Month resources. You’ll love the grab and go activities!
Collaboration ideas to celebrate OT month with your colleagues

Also be sure to check out our occupational therapy jokes post…it’s a fun way to celebrate OT month with colleagues!

I’ll update this post each day during the first week of April so you can gather your OT month materials. And, don’t forget to grab some of the memes below to share on your social media (just link back to this page) so you can celebrate occupational therapy along with all of your friends!

OT Month Activities

There are a five fun, EASY ways to celebrate OT month. Pick out these activities for the whole month of April:

But before we get started with the OT month ideas, be sure to check out this Autism acceptance month, during the month of April and all year long.

Share OT memes on social media! Scroll below for a new graphic explaining what we do in therapy sessions (and why!). There are enough for every day in April. You’ll even find inspirational occupational therapy memes, too. Here are more OT memes to share.
Get creative with fun and festive OT month activities. Make OT month even better with an April occupational therapy calendar that is a perfect addition to your therapy lesson plans this year. Let’s make occupational therapy month exciting with fresh OT ideas!
Use some of our OT month worksheets and activities that build skills. Not your typical “worksheet”, these are printable activities that get kids moving and functioning, with an emphasis on FUN. You’ll find 5 new OT month activities that celebrate the profession and use therapy materials for occupational therapy awareness.
- Occupational Therapy Wordsearch– Work on visual perception, handwriting, and more with occupational therapy words
- Occupational Therapy Month Fine Motor Game– This printable game is great for building hand strength and fine motor skills with an OT theme.
- OT Month Match It Game– Much like the visual spatial awareness powerhouse, Spot IT, this OT version builds so many skills.
- Occupational Therapy Coloring Pages– Print and build skills in coloring, eye-hand coordination, strength, and more.
- OT Equipment List Writing Pages– Work on handwriting, copying skills, AND OT awareness with these free printable pages.
Grab the OT Materials Bundle! During the month of April, it’s only $8 and includes 13 OT month resources using supplies that we use every day during OT sessions. You’ll also find 8 bonus articles on ways to grow as a professional.
Collaborate with other OT professionals! April is the perfect time to grow as a professional, celebrate others in the field and chat all things OT. In the OT Materials Bundle, you’ll find articles on how to collaborate with others, how to reflect on OT practice, how to find an OT mentor, and ways to network as a busy OT professional.

Low effort ways to celebrate OT month include wearing a t-shirt for occupational therapy month

Low-Effort Ways to Promote OT Month

Those of us working with demanding schedules, the thought of setting up a whole “OT month” event is exhausting! We added this list of ways to celebrate Occupational Therapy Month with little to no effort. These ideas can be integrated into your daily work routines without requiring significant additional effort.

Share Educational Posts on Social Media. Sharing a quick post on Facebook or Instagram is a low pressure way to celebrate the profession. Share some quick facts about OT, educational memes, or inspiring stories about occupational therapy. Check out The OT Toolbox on Facebook and The OT Toolbox Instagram page for one-and-done social media sharing.
Wear OT-Themed Shirts. This is an easy way to promote the profession. Grab an OT-themed shirt from Amazon (affiliate link) and you’re good to go. We have put together a whole page of OT shirts over on our Amazon page. This can serve as a conversation starter and a way to spread awareness about the field. Click here for our OT shirts list (affiliate link).
Change your Email Signature. One super simple way to promote the profession is to edit your email signature. Add a one-liner or a banner to your email signature that celebrates OT Month, such as “Proud to Celebrate Occupational Therapy Month!” or include a brief message about the importance of OT in improving patients’ lives. We included some fresh email banners to the bottom of this blog post that you can add to your email signature.
Tell your Clients! One way to celebrate OT month is to bring it up in therapy sessions. Briefly discuss the significance of OT Month with clients during sessions, and highlight how occupational therapy has impacted their lives. This can enhance client awareness and appreciation of the profession.
Thank another OT! A simple (and free way to celebrate OT month) is a simple thank you to your OT colleagues. I love to thank my co-workers for their dedication and hard work, and it’s a nice way to authentically appreciate the efforts that others put into their work each day. I like to think of it as starting small with a simple word of thanks and appreciation. It can expand and encourage your workplace!
Share OT Resources: Recommend blog posts (like this one!), articles, podcasts, or social media posts about occupational therapy to your friends. We try to share a lot of information in our email newsletters and in blog posts that really reflect the impact that an OT has on development. Simply sharing these blog posts with others can have an impact on the person you share it with, as well as promotes the profession.

I hope these low cost ways to support and promote OT help!

Occupational Therapy Month Memes

As Occupational therapy professionals, we can celebrate the profession that we love by sharing a bit about what we do. This includes informational memes that advocate for the profession of occupational therapy, those we serve, and the interventions that we use as tools to support functional skills. You’ll also want to check out our blog post on occupational therapy memes. This is a fun way to share a joke or two about the profession. We also have a post on sensory memes that are just about sensory processing.

Below are OT memes that can be shared on social media.

Each image is an underlying area that influences development and includes a therapist quick tip. These are occupational therapy tricks and tips!

It’s my hope that each day in April, you’ll share your creative ways to work on these skills.

DAY 1: Kinesthetic Learning- Try these kinesthetic learning activities.

DAY 2: Vestibular Activities- Try these vestibular activities.

DAY 3: Try these toys and tools to help with visual attention.

DAY 4: Try these activities to address laterality and hand dominance.

DAY 5: Try these activities to develop and address proprioception needs.

DAY 6: Try these distal finger control exercises.

DAY 7: Try these Neat Pincer Grasp activities.

DAY 8: Try these activities to develop tactile discrimination and the tactile sense.

DAY 9: Try these Bilateral Coordination activities.

DAY 10: Try these activities if you are wondering, “What is motor planning?”

DAY 11: Try these olfactory sense scented play ideas.

DAY 12: Try these eye-hand coordination activities.

DAY 13: This is a fun visual scanning activity.

DAY 14: Read more about in-hand manipulation activities.

DAY 15: Read more about finger isolation.

DAY 16: Try these precision of grasp activities.

DAY 17: Try this activity to build visual discrimination.

DAY 18: Read more about visual memory here.

DAY 19: Try this activity to develop visual closure.

Form constancy visual perception activity

DAY 20: Try this technique to develop form constancy.

DAY 21: This is a fun way to develop visual figure ground skills.

DAY 22: Try these visual tracking tips and tools.

Day 23: Try these auditory processing activities.

Day 24: Work on core strengthening with music.

DAY 25: Use these strategies to build intrinsic hand strength.

DAY 26: Try these task initiation executive functioning strategies.

Wrist extension in occupational therapy month

DAY 27: Use these toys for extended wrist stability.

DAY 28: Use these ideas to help kids learn impulse control.

DAY 29: This is a fun way to practice oral motor exercise.

DAY 30: Try these activities to help with visual spatial skills.

More OT Month Graphics

Use these OT month graphics to promote occupational therapy. The professional of occupational therapy is an incredible profession. Let’s share all that we love about OT and bring awareness of this amazing profession to others!

Occupational therapy month images to share

Happy Occupational Therapy Month!

As we step into occupational therapy month again with another April, let’s remember what it is that makes our profession special. Occupational therapists (OTs) and occupational therapy assistants (OTAs) help patients to participate in every day occupations! We help people do the things that occupy others’ time. We help others do the things that matter most to them It’s all of the most meaningful activities a person desires and needs to participate in for daily life.

For children this may include things like doing cartwheels, riding a bike, getting dressed, writing their name, brushing their hair, or playing with friends.

For us as professionals, the most important thing IS to serve and support others. OT is the most encouraging, enlightening, and inspiring profession there is, and YOU are a part of that light!

YOU make a difference in the world. That difference makes a ripple of impact. Helping one person achieve a small goal effects that person’s family and everyone they are in contact with. Now multiply that wellbeing to your entire caseload.

Occupational therapists are difference makers!
Occupational therapy assistants are difference makers!
We literally do, as occupational therapy professionals, what matters most in this world.

Happy OT month, fellow occupational therapy professionals!

Occupational Therapy Email Signature

One way that we mentioned above, which is a low effort way to celebrate OT month, is by updating your email signature. Here are some email signature banners that you can add to your email. So, every time you respond to an email, this celebration of OT month will go out, promoting the profession!

To use these OT email signature banners, copy and save the picture to your computer or device. Then go into your email settings and add the image to your email signature. That’s all you need to do! Then, you can celebrate occupational therapy all month long!

Happy occupational therapy month banner for email

April is occupational therapy month banner

April is occupational therapy month email signature

Have fun celebrating all that occupational therapy is!

Pipe Cleaner Bunny and Carrots

March 22, 2024March 22, 2024 by Colleen Beck OTR/L

These pipe cleaner bunny crafts are a fun Easter craft that supports fine motor skills. We LOVED making these and then using them over and over again!

With Easter being right around the corner, these pipe cleaner bunny crafts and pipe cleaner carrots are a great way to add fine motor skills to your Easter occupational therapy line up. These bunny cuties were easy to make and have been seen a lot in our play time recently. This isn’t the first time that we’ve made Easter Bunny fine motor activity.

Pipe Cleaner Bunny and Pipe Cleaner Carrots

So WHAT is a manipulative?? (Even spell check doesn’t know, so maybe we should explain…) These cute little bunny manipulatives can be used for so many fun activities: counting, patterning, sorting, arranging…so much learning can happen with little objects that kids can manipulate.

We use these in Easter sensory bins and to develop a few fine motor skills, too!

You’ll also want to check out our other Bunny Activities:

Pipe Cleaner Bunny

So we love making fun kids crafts that double as a therapy tool. When you bend and fold pipe cleaners into shapes, you’re actually working on several skills:

I’ve caught baby Girl playing with these bunnies and carrots as she made them talk to each other. What a great way to work on language and conversation! Throw these bunnies and carrots into a sensory bin and you’ve got a sensory activity where the kids can explore textures and senses.

There are SO many ways these manipulatives can be used in learning and play.

How to make a Bunny with Pipe Cleaners

Here’s what we did to make the pipe cleaner bunnies…

First, you’ll want to gather your materials:

White pipe cleaners
Pink pony bead

Check out the directions to make the pipe cleaner bunny craft under each picture. We wanted to add a step-by-step visual.

Fold the pipe cleaner to make Bunny ears.

To start, I created a handful of Easter Bunnies using off-white pipe cleaners. It’s not hard to do…

1. Bend the pipe cleaner to make two bunny ears.

Ben a pipe cleaner to form an Easter Bunny

2. Twist the pipe cleaner around and through the first “ear”, then through the second “ear”. The second ear is not a complete loop, so the tail end of the pipe cleaner doesn’t really go through the ear.

You’ll pinch the pipe cleaner so it stays put. See the next picture.

How to make an Easter Bunny using a pipe cleaner

3. Pinch the “ears” in place and pull the long end strait down.

4. Thread a pink bead onto the pipe cleaner for the bunny’s nose.

Use these pipe cleaner Easter bunnies and carrots for pretend play and counting activities

5. Wrap the long end of the pipe cleaner straight up and around your thumb.

6. Repeat twice, making one loop to the right of the bead and one loop to the left of the bead.

7. Pinch it so it stays in place. You can kind of squash the bunny down to make it stay put.

counting, sorting, patterns with pipe cleaner Easter bunny and carrot manipulatives.

Pipe Cleaner Carrot

The pipe cleaner carrots are just a piece of an orange pipe cleaner bent into a carrot shape and a small piece of green pipe cleaner twisted around to make a stem. Super easy to make.

Make a handful of each and you’re ready for counting, patterns, sorting, adding, and subtracting…

How many ways can you think of to learn and play with these guys?

Pipe cleaner Easter Bunny and carrots for pretend play

Our bunnies have been found all over the house this last week. The carrots made their way into the Little People house and eaten by the Lalaloopsy friends. The bunny manipulatives have even been caught hanging out with a few Ninja Turtles!

Let us know if you make these bunny and carrot manipulatives. We would love to see how you’re learning and playing!

For more Easter fine motor activities, check out the Spring Fine Motor Kit.

Spring Fine Motor Kit

Score Fine Motor Tools and resources and help kids build the skills they need to thrive!

Developing hand strength, dexterity, dexterity, precision skills, and eye-hand coordination skills that kids need for holding and writing with a pencil, coloring, and manipulating small objects in every day task doesn’t need to be difficult. The Spring Fine Motor Kit includes 100 pages of fine motor activities, worksheets, crafts, and more:

Spring fine motor kit set of printable fine motor skills worksheets for kids.

Lacing cards
Sensory bin cards
Hole punch activities
Pencil control worksheets
Play dough mats
Write the Room cards
Modified paper
Sticker activities
MUCH MORE

Click here to add this resource set to your therapy toolbox.

Grab your copy of the Spring Fine Motor Kit and build coordination, strength, and endurance in fun and creative activities. Click here to add this resource set to your therapy toolbox.

Oral Motor Exercises with a Cotton Ball Bunny

March 22, 2024March 22, 2024 by Colleen Beck OTR/L

Working on oral motor exercises as a sensory processing strategy for self-regulation, or as an oral motor tool to address physical needs? Ok, so we made a cute little cotton ball bunny to use in an Easter sensory activity as a small world play area to work on fine motor skills with an Easter theme. However, using them in imagination play, but, there are so many oral motor benefits to using these little cotton ball bunnies, too.

It was so much fun with that little cotton ball bunny family that we turned it into a big old collection of bunnies! That’s not all…we used them in an oral motor exercise, with major self-regulation benefits. Here is a how to for this Easter craft for kids as well as a run-down on oral motor skill work with everyday items.

One thing I love about this is that we were blowing cotton balls with straws as a calming and regulating activity, but it was a lot of fun, too!

You’ll also want to check out our other Bunny Activities:

Oral Motor Exercises with an Easter Theme

Oral motor skills play a big part of feeding. In fact oral motor problems and feeding can impact food preferences as well as ability to eat certain food textures. There is a lot of information on oral motor skills on The OT Toolbox.

We’ve covered development of oral motor skills to the physical traits you may see with oral motor issues such as exaggerated jaw movements and issues that arise with stability bite patterns. Here is more information if you are wondering if feeding issues are related to oral motor skills or sensory concerns…or both.

Adding sensory work through the mouth in the form of proprioception is a powerful way to help kids recenter and gain input that is calming and regulating. That input “wakes up” the muscles of the mouth.

There is a mindfulness portion to this oral motor strategy, too. Taking deep breaths is so important in relaxation it brings awareness to your body. In this Easter oral motor activity, kids can blow through a straw to move the cotton ball bunnies while focusing on a static viewpoint at the end of the straw.

Did you know that blowing cotton balls with straws can do all of this??

Talk about centering and regulating! You can even ask the child to breathe in while you count to 5 and then breath out as they move the bunny with the power of their breath.

This oral motor exercise uses straws and cotton ball bunnies for an Easter themed

Oral Motor Exercises for Heavy work

To do this self regulation activity, it’s actually pretty simple.

Line up a row of cotton ball bunnies on the table.
Give the child a straw and ask them to blow into the straw to push the bunny toward a target.
You can ask them to move a certain number of bunnies in a specific amount of time, or they can simply move all of the bunny family with their breath.

Oral Motor Exercise

I wanted to try a little Easter-themed game with Big Sister. (She didn’t know that it was actually an oral motor exercise that supports development!)

I put the cotton ball bunnies out on the table, along with the grass and some straws. She had to blow the bunnies into the grass using a straw.

Scroll below for instructions on how to make the DIY grass matt to use in sensory play activities.

To make the oral motor exercise easier or harder:

Try using different lengths of straws to change the breath power and amount of deep breathing they need to take.
You can also pinch the straw to require more effort in the oral motor therapy idea.
Try using different types of straws, too. Some ideas include using a large sports straw like we did in the pictures here, or a coffee stirrer straw.

The options are endless and can be means of grading this activity up or down to meet the specific needs of the child.

This is a fun exercise/game for kids with oral-motor problems including poor lip closure, stability of the jaw, or muscle development of the mouth, jaw, and tongue. Blowing through a straw can also help with sensorimotor integration.

Older kids who constantly put things into their mouth (pencils, clothing, fingers…) may be seeking oral input/sensorimotor input that their body needs.

This game is a fun way to work on any of these areas. Use fatter straws at first and work toward thinner straws for a graded exercise. If this activity to too difficult for your child with oral-motor or sensorimotor needs, try a smaller item such as a feather or a crafting fuzz ball.

You could also work on oral motor skills and the proprioceptive heavy work with this Egg Boat activity.

Oral motor exercises like these are beneficial to add heavy work input through the mouth and lips that is calming and regulating.

These oral motor exercises have an Easter theme anc can work on oral sensory needs for self-regulation or oral motor therapy.

Make this Easter fine motor activity using a cotton ball bunny craft. Kids will love to use this in an Easter play activity with preschoolers and toddlers

Fine Motor Skills Activity

These little Easter bunny crafts were perfect to in a fine motor skills activity, too. With a tray, a handful of river rocks, and a DIY crepe paper matt, we made an Easter-themed small world to work on fine motor skills with my littlest one.

My daughter, who was a toddler in these photos, loved to explore and play as she picked up and moved the cotton ball bunnies, the rocks, and small carrots.

Easter play ideas using a DIY sensory mat and cotton ball bunny crafts for kids to use in fine motor work.

To make the grass matt, we used a roll of green crepe paper. It was glued on one side to a sheet of construction paper. I asked my preschooler to snip into the edges of the top side of the crepe paper, so it made a fringed edge. This was a great scissor activity for her.

This Easter play activity turned out to be a fun fine motor activity for toddlers and a fine motor ideas for preschoolers, too! I think the quote from my preschooler was… “Wow, this is cool, Mom!”

This cotton ball bunny craft is so much fun for fine motor skill activities and oral motor skills work.

Easter Play IDEA

Play idea for toddlers- Baby Girl especially loved playing with the little bunnies in an Easter small world play set-up. She would move the bunnies, stones, and carrots one at a time from the bowl to the grass…and then back again.

Play idea for preschoolers- Big Sister had fun using the bunnies for imagination play, making them go into their garden, lining up the rocks, and making the bunnies steal the carrots.

Little Guy wanted nothing to do with any of this. I guess there were not any superheroes or bad guys involved. Cute little bunnies are not his thing 🙂

This Easter play idea is great for workingon fine motor skills with toddlers and preschoolers.

We are having a lot of fun with our little bunnies!

Make this cotton ball bunny craft to use in easter themed sensory play and fine motor skills activities

TO make the Cotton Ball Bunny Craft

Making this Easter bunny craft is super easy.

We used a glue gun to make sure the pieces were securely attached for sensory play with my toddler. However, regular craft glue would work as well.
You’ll need a cotton ball, white foam sheet, and a pink felt sheet.
Cut out two large white ears and two smaller pieces for the inner ear.
Use the craft glue to hold these pieces in place.
Add gentle pressure to make sure all of the pieces are securely attached.

This bunny craft came together fairly quickly, so I was able to create a whole set of the bunnies.

Then, use them to play!

This Easter craft idea is great for fine motor activities for preschoolers and toddlers with an Easter theme.

Spring Fine Motor Kit

Score Fine Motor Tools and resources and help kids build the skills they need to thrive!

Lacing cards
Sensory bin cards
Hole punch activities
Pencil control worksheets
Play dough mats
Write the Room cards
Modified paper
Sticker activities
MUCH MORE

Click here to add this resource set to your therapy toolbox.

Grab your copy of the Spring Fine Motor Kit and build coordination, strength, and endurance in fun and creative activities. Click here to add this resource set to your therapy toolbox.

The Size of The Problem Activity Ideas

March 19, 2024 by Colleen Beck OTR/L

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.

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.

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:

Self regulation
Impulse control
Working memory
Emotional regulation
Time management
Planning and prioritization
Social and emotional skills
Self reflection
Emotional Control
Task Initiation
Task Completion
Working Memory
Planning
Mental Dexterity
Prioritizing
Processing Speed
Organization
Attention
Self control
Self-Monitoring
Impulse Control
Cognitive Flexibility
Foresight
Hindsight
Self-Talk
Problem Solving
Persistence
Shift

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.

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.

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

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.

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!

Coping Strategies for Kids

March 19, 2024March 19, 2024 by Colleen Beck OTR/L

Whether it’s the classroom, home, or day to day life…coping strategies for kids are needed. Coping strategies are mechanisms or tools to adjust and respond to emotions, stressors, and unbalance so that one can function and complete daily occupations, or everyday tasks. Coping tools help to balance and regulate a person. Coping strategies can look different for every individual and that’s why this giant list of coping skills will be powerful in building a toolbox of strategies for kids (or teens and adults!)

Coping strategies like the ones listed here can be used in conjunction with an emotions check in and feelings check in to support self awareness and self regulation skills.

the strategies that we’ve shared here are great for adding to a budget sensory room in the school environment, or a calm down corner at home.

What are Coping Strategies

We all need coping strategies! It can be difficult to cope with stress or worries as a child. Most of the time, it can be hard to just figure out what is going on with the mood swings, frustration, behaviors, and lack of focus. Most of these problems can be a result of a multitude of problems!

And, helping kids to understand the size of the problem is part of this because then we can help them know how to cope.

Self regulation strategies use coping mechanisms to support various states of emotional and behavioral levels. The Zones of Regulation and the Alert Program both use coping tools to support emotional and behavioral needs.

From emotional regulation concerns, to sensory processing issues, to executive functioning struggles, to anxiety, communication issues, or cognitive levels–ALL of the resulting behaviors can benefit from coping strategies.

Here on The OT Toolbox, I’ve shared sensory coping strategies for anxiety or worries. These can be used for so many other underlying concerns as well.

It’s not just anxiety or worries that causes a need for sensory-based coping strategies. Emotional regulation, an unbalanced sense of being, stress, situational or environmental issues…the list of concerns that would benefit from sensory coping tools could go on and on.

Incorporating sensory strategies and sensory play into a coping toolbox can help kids with a multitude of difficulties. Try using some of these ideas in isolation and use others in combination with one or two others. The thing about coping strategies is that one thing might help with issues one time, but not another.

Coping Strategies for Kids

One thing to remember is that every child is vastly different. What helps one child cope may not help another child in the same class or grade. Children struggle with issues and need an answer for their troubles for many different reasons. The underlying issues like auditory processing issues or low frustration tolerance are all part of the extremely complex puzzle.

Other contributions to using coping strategies include a child’s self-regulation, executive functioning skills, self-esteem, emotional regulation, and frustration tolerance. That makes sense, right? It’s all connected!

Coping Skills for Kids meet needs

Coping skills are the tools that a person can use to deal with stressful situations. Coping strategies help a us deal with occupational unbalance, so that we can be flexible and persistent in addressing those needs.

Coping skills in children can be used based on the needs of the individual child. Also, there is a lot to consider about the influence of factors that affect the person’s ability to cope with areas of difficulty. Likewise, feedback from precious coping efforts relates to the efficacy of a coping plan. (Gage, 1992).

Coping skills in kids depends on many things: wellness, self-regulation, emotional development, sensory processing, and more.

Having a set of coping skills benefit children and adults! Every one of us has stress or worries in some manner or another. Children with sensory processing issues, anxiety, or social emotional struggles know the stress of frustration to situations. It’s no surprise that some of these issues like sensory processing disorder and anxiety are linked.

Research on wellness tells us that child well being is dependent on various factors, including parental resources, parental mental health, parental relationship quality, parenting quality, father involvement, family types, and family stability. What’s more is that taking a look at the overall balance in a family and the child can provide understanding into things like stress, frustration, anxiety, and overwhelming feelings. The wellness wheel can help with getting a big picture look at various components of overall well-being.

Coping Flexibility

In fact, studies tell us that coping flexibility may be an important way to investigate coping. Coping flexibility, or an individual’s ability to modify and change coping strategies depending on the context, can be impacted by executive functioning difficulties including flexible thinking, working memory, impulse control, emotional control, and self-monitoring.

And, having more coping strategies in one’s toolbox coping may be an important precursor to coping flexibility, especially because having flexibility in coping abilities can only be obtained if an individual is able to access and use different coping strategies. It’s the chicken or the egg concept!

Another study found that children who used problem solving or constructive communication were better able to manage stress and that those who used maladaptive strategies like suppressing, avoiding or denying their feelings, had higher levels of problems related to stress. It makes sense. The most effective coping strategies are ones that adapting to the stressors rather than trying to change the stressors.

So, how can we help with stress and frustrations? One tool is having a set of sensory coping strategies available to use in these situations.

Types of coping skills

All of this said, we can break down coping skills for kids into different types of coping strategies that can be added to a coping toolbox:

Physical- exercise, movement, brain breaks, heavy work are some examples. Physical coping strategies might include pounding a pillow in frustration, using a fidget toy, running, yoga.

Sensory- While there is a physical component to sensory coping strategies (proprioception and vestibular input are just that: physical movement…and the act of participating in sensory coping strategies involves movement and physical action of the body’s sensory systems) this type of coping tool is separated for it’s uniqueness. Examples include aromatherapy, listening to music, mindfulness (interoception), and sensory play.

Sensory strategies that are motivating can be a big help for some kids. Try these train themed sensory activity ideas to get your creative juices flowing.

Emotional- Thinking about one’s feelings and emotions is the start of emotional regulation and social development. Acting out feelings, talking to a friend or teacher…communication is huge!

These social skills activities are a great way to build awareness of self and others and can double as coping tools too.

Communication- Talking about feelings, talking to others, writing in a journal, singing. Have you ever just had to “vent” your feelings about a situation? That ability to “let it all out” is a way to process a situation and talk through solutions, or find common ground in a situation.

List of Coping skills

1. Move- Get up and run in place, jog, do jumping jacks, or hop in place.

2. Fidget tools in school– Use learning-friendly fidget tools, perfect for the classroom or at-home learning space. Here is one desk fidget tool that kids can use while learning.

3. Talk- Talk about it to a friend, talk to an adult, or talk to a teacher.

4. Snuggle- Grab a big cozy blanket and pile pillows around you to build a fort of comfort! The pressure from the blanket and pillows provides proprioceptive input.

5. Take a bath or hot shower.

6. Blow bubbles. The oral sensory input is organizing.

7. Sensory water play.

8. Scream into a pillow.

9. Pound play dough. Try a heavy work dough like this DIY marshmallow proprioception dough.

10. Use a keychain fidget tool. This is a DIY fidget tool that kids can make while building fine motor skills. Attach it to a belt loop, backpack, or even shoe laces for circle time attention.

11. Exercise. This alphabet exercise activities can be helpful in coming up with exercises for kids. Use the printable sheet to spell words, the child’s name, etc. This alphabet slide deck for teletherapy uses the same letter exercises and offers exercises for each letter of the alphabet. Use it in teletherapy or face-to-face sessions or learning.

12. Look at the clouds and find shapes.

13. Deep breathing. Deep breathing exercise are a mindfulness activity for kids with benefits… Try these themed deep breathing printable sheets: pumpkin deep breathing, clover deep breathing, Thanksgiving deep breathing, and Christmas mindfulness activity.

14. Take a walk in nature.

15. Play a game.

16. Build with LEGOS.

17. Listen to the sounds of the ocean on a soothing sounds app or sound machine.

18. Count backwards. Try walking in a circle while counting or other movements such as jumping, skipping, or hopping.

19. Drink a cold drink.

20. Drink a smoothie. There are proprioceptive and oral motor benefits to drinking a smoothie through a straw. Here are rainbow smoothie recipes for each color of the rainbow.

21. Squeeze a stuffed animal.

22. Listen to music.

23. Hum a favorite song.

24. Blow bubbles.

25. Chew gum.

27. Tear paper for fine motor benefits and heavy work for the fingers and hands.

28. Smash and jump on ice cubes outdoors. Jumping on ice is a great activity for incorporating prioprioceptive sensory input.

29. Journal. The Impulse Control Journal is an excellent tool for self-awareness and coming up with a game plan that works…and then keeping track of how it all works together in daily tasks.

30. Guided imagery.

31. Think of consequences.

32. Stretch.

33. Go for a walk.

34. Write a story or draw a picture. Sometimes it helps to crumble it up and throw it away!

35. Blow up balloons and then pop them.

36. Take a time out.

37. Animal walks.

38. Imagine the best day ever.

39. Swing on swings.

40. Name 5 positive things about yourself.

41. Draw with sidewalk chalk. Drawing can relieve stress.

42. Try a pencil topper fidget tool for focus during written work.

43. Add movement- This monster movements slide deck uses a monster theme for core strength, mobility and movement breaks. It’s perfect for teletherapy and using as a coping strategy.

44. Try this easy coping strategy that only uses your hands.

45. Take a nap.

46. Sensory-based tricks and tips that help with meltdowns.

47. Use calm down toys.

HEAVY WORK coping skills

Brain breaks are a powerful and effective way to address regulation needs, help with attention, and impact learning into the classroom or at home as part of distance learning.

The impact of emotions and changes to routines can be big stressors in kids. They are struggling through the day’s activities while sometimes striving to pay attention through sensory processing issues or executive functioning needs. Brain breaks, or movement breaks can be used as part of a sensory diet or in a whole-classroom activity between classroom tasks.

This collection of 11 pages of heavy work activity cards are combined into themed cards so you can add heavy work to everyday play.

heavy work cards for regulation, attention, and themed brain breaks

Coping strategies for kids printable

Want a printable list of coping tools for kids? This list of coping skills can be printed off and used as a checklist for building a toolbox of strategies.

Get the printable version of this list. It’s free!

Try these sensory coping strategies to help kids with anxiety, stress, worries, or other issues.

Printable list of sensory coping strategies for helping kids cope.

Coping strategies can come in handy in many situations:

When saying “calm down” just isn’t enough…

When a child is easily “triggered” and seems to melt down at any sign of loud noises or excitement…

When you need help or a starting point to teach kids self-regulation strategies…

When you are struggling to motivate or redirect a child without causing a meltdown…

When you’re struggling to help kids explore their emotions, develop self-regulation and coping skills, manage and reflect on their emotions, identify their emotions, and more as they grow…

Gage, M. (1992). The Appraisal Model of Coping: An Assessment and Intervention Model for Occupational Therapy, American Journal of Occupational Therapy, 46, 353-362. Retrieved from : oi:10.5014/ajot.46.4.353 on 5-24-27.

Managing Resistance in Therapy

March 18, 2024March 18, 2024 by Colleen Beck OTR/L

how to engage a resistant child in therapy

So often, we see a child of therapy evaluation and find a need for therapy intervention, but that’s where the resistance begins. Here we are talking how to manage resistance in therapy, and not only that; but how to engage with kids so that we get the truly motivated buy-in for engaging in occupational therapy interventions.

We’ve all had to pull some magic out our our OT hat to engage a resistant child in therapy. The thing is that working on hard things is…hard! Let’s go over some therapy activities for resistant clients. We’ll also cover examples of client resistance in therapy. You might have seen some of these a time or two in your therapy sessions!

Resistance in therapy

If you’ve worked in OT for even a short time, you have probably experienced resistance from your clients. There are many reasons for barriers to participation in occupational therapy intervention. From differing perceptions to the outcomes of OT interventions, to not understanding what occupational therapy is and what it can do for the client, understanding therapy process is just one aspect of client resistance.

There are so many different reasons why a therapy client my object therapy participation. Encouraging participation in therapy sessions and functional engagement in daily tasks can be a couple of underlying areas that we are trying to address in therapy sessions. But what’s more is that beyond client resistance, there may truly be functional occupations that are being missed or delayed as a result of resistance to therapy.

Additionally, when children are asked to participate in a therapy activity or to stop doing a preferred activity and move to another, sometimes challenging, task. In this way the transitions for children to move from preferred to non-preferred activities is sometimes hard to get their “buy in,”.

It doesn’t have to be that way, however.

Let’s cover various techniques to support children showing resistance in therapy sessions. We’ll also cover how to support follow transitions and make engaging in therapy fun through meaningful games and some simple resources to utilize to make sure therapy activities happen smoothly throughout the therapy session.

examples of client resistance in therapy

I’m sure, if you’ve worked with kids before, that you’ve seen a few (or all) of these examples of client resistance in your therapy sessions.

Complain about therapy activities
Express doubts about the therapy’s effectiveness
Challenge the therapist’s suggestions
Question the purpose of the therapy
Non-Compliance with therapy tasks
Refuse to participate
Skips therapy sessions
Silent during therapy
Refuses to engage
Changes the subject
Sarcasm or joking as a way to avoid participating
Hostile behaviors
Make excuses
Tantrum or meltdown
Leaving the room or therapy area
Ignoring instructions
Complaining about therapy tasks

Other things like body language or bad language can be examples of resistance to participate in therapy, too. In a few cases, I’ve experienced physical aggression during therapy sessions. These situations were with students who had behavior plans in place by the school. Some students had a history or physical aggression across all classrooms. If there are events like hitting, kicking, biting, spitting, throwing objects, or other physically aggressive acts, then therapy sessions would stop for the safety of the student and others, including myself as the therapist.

It can depend on the student, however, a behavior plan will have a list to follow in various situations, and there might even be a paraprofessional that is with the student at all times.

Why do clients show resistance in therapy?

Before we get into strategies to encourage functional participation, let’s break down why we may see failure to participate during therapy sessions.

Therapy makes the client look and feel “different” than everyone else- Going to a therapy session is not something that every child or teen does, so attending therapy can be a reason that makes them look different. This can lead to resistance to participate and a feeling of dread when it comes time for therapy sessions.

Especially for our middle school students receiving OT services, and for individuals who are very much aware that they are doing something that not everyone else is, this can be a big deal.

Don’t understand occupational therapy- Many times, we as therapy professionals are ready to evaluate or treat a resistant client and the individual states something like, “why are you here?” or “what is occupational therapy” or “who are you and why are you asking me these questions?”!

Do any of these questions sound familiar? Many times clients/patients/students are referred to occupational therapy evaluations without knowledge. This is the case in hospital or clinical situations when OT orders are part of the inpatient process. In the school based scenario, a student is referred to occupational therapy by the IEP team or a child’s parent. Refer to differences between an IEP and 504 for more information.

Many times, the individual has no idea they are going to be seen by OT. This can lead to refusal and a resistance to participate. Whether you are working with a child in the classroom setting in a push in model or pulling a child out of the classroom, this can be a reason that resistance to participate in therapy occurs.

Therapy is hard- Therapy tasks aren’t always easy, especially if your child is participating in an activity that they love doing. If asked to step away from an activity before they are done, they may become upset and non compliant. This can be true with the child working on handwriting tasks or working on strengthening. It is HARD to write and copy all of those sentences. It requires a lot of concentrated effort doing something difficult.

The same is true for strengthening tasks that require engagement and consistent use of muscle groups. It’s easier to regress to that comfortable and “easy” positioning. As an adult, if you are working on a project on your computer, how much advance notice would you like before you have to finish what you are working on and move to a new activity?

Therapy is a change from the normal day to day activities- Even if the typical day to day functions is something that is being worked on, including participation and functional performance, it can be a change from the “norm” to engage in therapy sessions.

Would you appreciate your coworker walking in while you are typing mid sentence, closing your laptop lid, taking you by the hand stating “it is time for the staff meeting. Let’s go!”

Or would you rather they say “just letting you know that you have five minutes before the staff meeting, see you there!”

My guess is that you would like to have some advanced notice before you have to stop working. This is the same for a child who is playing. When they are actively engaged in an activity, they have a plan and don’t appreciate being interrupted in the middle of it. This could be anything from playing with play dough, to completing a puzzle or pretend play.

Therapy challenges the unexpected- Sometimes when kids or teens participate in therapy sessions, they don’t know what to expect. They know that they are working on specific skills, but what if that skill of task is so new and novel that the fear of the unknown exists.

This can be particularly true with things such as toileting. For the child with interoceptive sensory considerations, they may have no idea how a bowel movement on the toilet feels.

This fear of the unknown can be a real area of resistance.

Clients Resist certain parts of therapy

What if children don’t want to stop what they are doing and resists participation in some therapy activities?

You have probably seen this in action when a child LOVES a specific therapy game or activity. It might be that they love anything to do with a therapy swing. But what might really be happening is that the child is overly focused on that item because it’s been a cause for positive feedback in the past.

Or maybe, if the item is a sensory activity like a sensory swing, that the child receives the sensory input that they crave.

Or, perhaps the preferred activity is a highly motivating activity because it’s a theme or character that the child really loves. In these cases it can be very difficult to move from the preferred activity to a non-preferred activity.

In many cases, the child even becomes overstimulated or dysregulated as a result of focusing on that one particular activity, or as a result of reciting too much stimulation or a certain type of sensory input from that one activity.

When a child feels like they don’t want to transition to a new activity or that they didn’t have enough time to finish the task they were completing, they may become upset and hard to calm down.

In these cases, using a positive redirection activity that will give children the ability to comfort themselves and they are feeling overwhelmed.

Giving them time and space to calm down is very important, especially in a non-threatening way. If the child is upset, part of the therapeutic process is to support the child to calm down, identifying feelings and emotions, and offering support. Therapy professionals can guide them through communicating how they are feeling and participating in solving the problem at hand.

How to engage a Resistant Child in therapy

the child that resists therapy sessions is struggling. But that doesn’t mean the therapy strategies and goals are not appropriate!

Whether you are working in a clinic, hospital setting, or school-based, resistance to therapy happens. When giving instructions and laying out transition expectations to young children, it is important to keep in mind their individual and collective developmental age range in order to give clear and concise directions.

The following are strategies to engage the child or teen showing resistance in therapy.

This can include components of getting buy-in that are important to include in every direction given to a young child.

1.Clear and concise expectations- Having a plan of expectations and then using clear directions in those expected task completion is a key way to support engagement.

Use these tips to support and give clear expectations with clients:

When giving a statement or direction to a child, make sure that it is easy to understand.
Keep in mind the age of a child and their receptive language skills.
Using one or two step directions, children will be able to remember what is being told to them.
When giving the directions, make sure you are in the same room as the child (not yelling “it’s time for dinner” from the kitchen area), preferably kneeling down at their eye level.

Additionally, certain tools can support the “flow” of therapy sessions and offer a visual cue for participants with concrete expectations. Strategies that can support these expectations in therapy include:

2. Stick to Routines. When we work on daily routines, such as bedtime, clean up time, morning routines, leaving the house, etc., we use routines to make sure that the routine of events is the same every time. This strategy can carryover to therapy interventions. Using a similar routine for therapy sessions can include premeditated steps in order to allow children to feel successful and prepared for what is coming next.

Here is a great example of a therapy session routine:

Arrive to therapy
Check in
Sit in the same spot in the waiting room
Move to the therapy clinic area
Hellos and talk about last session
Discuss areas that the client wants to work on
Warm up activities
Address identified needs
Preferred activity
Cool down activities
Discuss home program and plan for next visit

Another schedule strategy that can be used for countering resistance to participation in therapy includes staggering preferred activities with non-preferred tasks. For the child that struggles with handwriting and really is resistant to handwriting tasks, you can stagger preferred activities (while selecting options that also address underlying areas of need or other goal areas). You can come up with a treatment intervention plan that includes options for the client to select from that are both preferred and non-preferred.

This strategy can look like:

Arrive to therapy
Check-in
Select activities to address based on goal areas
Preferred activity
Non-preferred activity
Preferred activity
Non-preferred activity
Preferred activity
Cool down activities
Discuss home program and plan for next visit

One of the best ways to make transitioning from a preferred activity to a non-preferred activity is to make it FUN! When the transition process is exciting, children will join right in.

You can find more examples of daily routines that are used for functional participation here on the website.

3. Utilize Auditory Cues– To make sure that the child in therapy hears what you are saying, when you are giving them the directions, have them stop and look at you.

A fun way to do this with young children is to have a saying such as “1,2,3 FREEZE” where they put their finger over their lips and look at you. There are so many other fun “stop and listen” sayings and games that you can find in this video.

4. Creativity- If you’ve ever worked with kids before, then you know that engaging a resistant child in therapy sessions requires creativity, flexibility, and patience. The kids we serve are struggling in some way (developmentally, cognitively, with sensory processing, or many other ways) and that impacts the way they do things they need to be doing or want to do (This is the functional aspect of OT).

When we work with kids on these challenges, it can be hard for them to actually do the things that we ask them to do. For example, your student with handwriting goals might think “Writing is hard, so why do I want to do hard things?”

It’s our job as the OT professional to help our clients and patients to feel comfortable while building skills. That might mean using less of a structured session and more of a safe space where the child can express themselves.

We do this with our OT thinking caps on, and sometimes that requires some real creativity.

Some of the ways I like to have fun in occupational therapy sessions to make kids feel more comfortable (while being creative about working on those goals) includes:

Play: Play is the work of the child at all ages. You can use play activities, games, toys, and creative activities that align with therapeutic goals.
Use their Interests: Tailor your OT activities to the child’s interests. That might mean using specific therapy themes or writing interests-based handwriting lists. When you incorporate interests into OT sessions, it can increase engagement and motivation.
Sensory Strategies: The benefit with using sensory activities like slime, sensory bins, etc. is that it is engaging and motivating. Some kids love (and crave) this sensory input.
Movement: Some of our kids LOVE to move. They crave movement. You can incorporate activities that involve movement, such as obstacle courses, yoga, or simple exercises. These can help the child focus, reduce anxiety, and improve their mood.
Storytelling and Role-Play: You can help your therapy client to participate by including storytelling or role-play. This can help them express emotions, practice social skills, and work through challenging scenarios in a safe and controlled environment. Floor play does this to meet OT goals.
Crafts: Use OT crafts to help kids to express their feelings and experiences. Some kids love drawing, painting, or sculpting. This can be particularly effective for children who may have difficulty expressing themselves verbally.
Technology and Digital Tools: The draw of the screen is real! But with recent advances in technology, we as OTs can use that to our advantage to support very functional skills. Use OT apps to promote the skills that need development.
Choice and Control: A simple choice board can do wonders! Give children some control over their therapy sessions by allowing them to choose between activities. This can help increase their sense of autonomy and engagement.
Build a Therapeutic Relationship: You learned about “therapeutic use of self” in your OT classes. That tool is a real strength! Spend time building rapport and trust with the child. Show genuine interest in their thoughts, feelings, and interests. A strong therapeutic relationship can reduce resistance and increase engagement. We have some rapport activities in a blog post about back-to-school because that time of year can be a time to strengthen those OT/student relationships.

Games for Resistance in Therapy

Here are four games that make participating in therapy interventions fun. Use these ideas to counter resistance to therapy activities.

Timer Games – Using timer games are great for making clean up time fun. These games include: “How fast can you clean up all the toys?” or “Can Charlee put all the blue blocks away faster than Henry can put all the green ones away?” When children are engaged in a game during clean up, it’s not so boring!

Movement Songs – Pairing movement and music together to get children to a specific place will make the transition very exciting. I love using songs like “We are the dinosaur marching marching” or “Flap your arms like a butterfly to the line” or “Jump like a bunny all the way, over to the _____.” When pairing a movement activity with a direction and melody, children learn that transitioning to the new activity location is just as fun as what they have been doing!

Jobs – Making children an active part of the next activity, but giving them a very specific job, makes them feel important and gives them purpose for moving to the next activity. For example, if you want your child to transition to nap time, they can help pick out the books that are going to be read to the children, or they can put a new pillow case on their pillow. If children are transitioning to mealtime, they can set the table, or hand the other children their name cards. There are so many different jobs that allow children to become part of the new activity.

Visual Supports- When creating a routine for the classroom or at home, there are several ways to include visual supports to make transitions easier for the children and for you. Using a visual schedule will make your days so much calmer! You can create a visual schedule for different parts of your day (such as morning and bedtime routines) or for your full day. The visual schedule will help children understand what is coming next.

Every day children are asked to transition at least 50, maybe 100 times. That is A LOT! Children don’t always have a lot of control over what is going to happen during their day, but allowing them time in between new activities, making the transition fun, and giving them a job to feel important, will make transitions feel less like a chore. As adults, if we stay consistent, giving children directions while being mindful of their developmental level, our days will become less stressful and more fun!

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