Colleen Beck, OTR/L is a pediatric occupational therapist and the owner and author of The OT Toolbox website. She manages all of The OT Toolbox social media accounts and runs the popular newsletter.
Read about Colleen's experience and career as an occupational therapist, including how The OT Toolbox began on our About The OT Toolbox page: https://www.theottoolbox.com/about-us/
Colleen created The OT Toolbox in 2011 and since then has written thousands of blog posts designed to support therapy providers, educators, parents, counselors, admin, and caregivers in promoting the healthy development of kids.
Check out Colleen's blog posts below:
After a long day at school, many children come home and seem to fall apart. You might see them come home and begin crying, yelling, shutting down, or refusing to do anything. This after-school meltdown (or sensory breakdown) isn’t just about being tired or hungry.
For many kids, especially those with sensory processing challenges or executive functioning difficulties, school requires an enormous amount of self-regulation. It all becomes a fight or flight response at a certain point.
sensory overload after school
What’s happening here? Kids spend hours sitting still, following directions, managing transitions, and trying to fit in. By the time they get home, their emotional and sensory “cup” is empty. The meltdowns you see are often the result of holding it all together all day long. Understanding why this happens is the first step in helping kids decompress, reset, and build the tools they need to self-regulate at home.
After a long day at school, some kids come home dysregulated (in a state where regulation isn’t happening) and it can be easy to miss the signs. It might look like the child that crashes and takes a nap as soon as they walk in the door (hello, teenagers!) or the child that is clingy/whiny/jumping off the walls during the after school hours. These actions aren’t them having a “bad day” or “acting out.” It’s actually clues that the child’s nervous system is overwhelmed during daily tasks and the tasks of the day. (What we call occupations…like learning, playing, socializing, riding the bus, and managing new routines).
In today’s YouTube video and visual guide, we break down signs of dysregulation during occupation, including:
Trouble with organization, attention, or executive function
Sensory overload from sound, light, touch, or smell
Irrational, impulsive, or aggressive behaviors
Working memory difficulties
Panic attacks, sleep troubles, or toileting challenges
Poor fine motor skills or handwriting
A tendency to shut down, give up, or resist tasks
They might not hear you
Here’s the full list in our short video:
Next, let’s talk about some questions that come up from parents regarding sensory overload after school.
FAQ: After-School Meltdowns and Emotional Regulation in Kids
Why does my child melt down after school?
Many kids “hold it together” during the school day. They are working hard to suppress big emotions, masking sensory sensitivities, and meeting expectations. When they get home to their safe space, that built-up stress is released in the form of a meltdown. It’s a release of emotional pressure, not a sign of defiance or misbehavior.
How can I help my child decompress after school?
Create a predictable after-school routine with calming options: quiet time, a snack, deep pressure activities like a weighted blanket, or movement like swinging or jumping. Let your child have a choice in how they unwind. This gives them some control and supports regulation. Try these after-school calming strategies.
What are the signs of emotional dysregulation in kids after school?
Some common signs include irritability, withdrawal, meltdowns, trouble transitioning, refusal to talk, or physical symptoms like headaches. These behaviors are often a sign that your child is overstimulated or emotionally drained. Explore signs of dysregulation
Why does my child seem fine at school but fall apart at home?
This is known as “masking.” Many children, especially those who are neurodivergent, work hard to appear regulated in public. At home, where they feel safe, they release the emotions they’ve been suppressing. This isn’t manipulation. They are actually showing signs of emotional exhaustion. Read more about masking and meltdowns
What calming strategies help with after-school meltdowns?
Try a sensory bin, a body sock, drawing/coloring, swinging, or deep breathing. Some children benefit from heavy work (proprioceptive) activities like wall pushes or carrying a backpack. Check out these heavy work activities
What are after-school sensory needs and how can I support them?
Sensory needs after school may involve a need for quiet, movement, oral input (like chewing), or touch. Pay attention to your child’s behavior and give sensory-rich but calming input after school. Use our calm down corner ideas
How can I prevent after-school meltdowns in my child?
Build in time for transition after school. Avoid rushing into homework or structured activities. Let your child decompress and refuel. Create a consistent routine, and reduce extra demands during that time. Use a sensory-friendly visual schedule.
Why do ADHD kids hold it together at school and then crash at home?
ADHD brains are working extra hard to stay organized, focused, and quiet at school. That effort can be exhausting, and home becomes the place they release the stress. Support them with empathy and structure, not punishment.
What are some after-school routines that help neurodivergent kids?
Routines that include sensory breaks, low-demand time, a calming activity, and predictable structure help reduce meltdowns. Use visual schedules or simple picture cards to help kids know what’s next.
How do I support emotional regulation at home after school?
Normalize big feelings and teach self-regulation strategies. Use visual supports, sensory tools, and lots of co-regulation. Focus on connection before correction. Browse self-regulation activities
How to help after school meltdowns
After-school meltdowns are common in kids who hold it together all day at school, only to release their emotions the moment they get home. If you’re wondering how to help a child who melts down after school, it starts with understanding that this behavior is a result of exhaustion from managing expectations, transitions, and sensory input throughout the day.
These after-school meltdowns in kids often happen because children are finally in a safe space where they can decompress.
One effective after-school meltdown strategy is to create a calming after-school routine with quiet time, a healthy snack, and sensory activities.
Parents searching for ways to help kids decompress after school can try setting up a predictable transition period with activities like deep breathing, stretching, or time in a sensory corner.
Knowing how to calm a child after school begins with giving them space, avoiding questions right away, and using consistent strategies that meet their unique sensory or emotional needs.
These calming techniques are not only effective in managing meltdowns after school, but also support emotional regulation in the long term.
Having a set strategy list is key. For developing kids, emotional regulation and executive functioning skills impact not just learning but function. When it comes to emotions, regulating behaviors, and the mental skills of executive functioning, you can see how all of these areas play a role in everything we do on a day to day basis.
Some other ideas for educators include being proactive in the classroom. This actually helps the student during the day because short movement breaks support learning. Educators: Set up simple brain breaks or sensory corners.
The therapist on the team can help to share supportive strategies and tools with families to help them carry over regulation strategies at home.
And finally, the parent can bring it all together by creating a transition routine to help kids shift from school to home without becoming overwhelmed. A huge component is the impact of screens too. This screentime checklist can help.
Self Regulation Support Packed with visuals, charts, and strategies kids can use throughout the day, perfect for home or school. Get it in the shop. Members: get it here.
Sensory Diet Cards + Sensory Activity Lists Build a sensory strategy system that helps meet individual needs, even in busy classrooms. Get it in the shop. Members: get it here.
Classroom + Home Connection Many students hold it together all day… until they don’t. When kids walk through the door after school and instantly melt down, it’s often because of underlying sensory or regulation challenges that built up throughout the day.
P.S. All of these resources (plus more) are included in your OT Toolbox Membership. It’s your one-stop spot for back-to-school therapy tools!
The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.
The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.
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.
Today, we have a couple of separation anxiety activities that can support kids who struggle with school drop off. Many times, kindergarten or preschool drop off is full of tears, especially those first few weeks of school. Here, you’ll find a great connection activity to help preschoolers and parents find a way to make preschool drop off easier by connecting through the book, Owl Babies. Use this Owl Babies activity to help with that preschool separation stage. This post shares movement based separation anxiety activities that can help kids who are experiencing separation anxiety in preschool drop off, with ideas based on the children’s book.
Separation anxiety can occur at various ages and stages, including toddler, preschool, kindergarten, and school-aged.
For example, in the toddler years, separation anxiety is quite common. However, if there is extreme separation anxiety, this might be a toddler behavior red flag or something to look into.
Separation Anxiety in Preschool or Kindergarten
Step into a preschool classroom on the first day of school and you will likely see a few tears here an there (possibly some of those tears coming from the parents dropping off their child for the first time!).
Separation anxiety in preschool age is normal! But here’s what you need to know about that visible preschool behavior that may be fueled by something besides getting used to leaving mom/dad/caregiver for the first time…and how to help with a simple preschool self-regulation strategy.
The movement-based, sensory activity we share below can actually be used with preschool through kindergarten:
the 3 year old preschooler who is just being dropped off for the first time
the 4 year old preschool student
pre-k kids
kindergarten students
older, grade school students who are sad or upset on the first day of school
preschool anxiety
So, what is happening with preschool anxiety that causes tears, meltdowns, and clinging to mom or dad at the day care or preschool drop off?
You have probably seen it before:
Every Monday, Wednesday, and Friday, it’s time for preschool. The routine at home is the same: excitement, packing the bag, and gearing up for a day of learning colors, songs, preschool activities, and nursery rhymes. Getting into the car and driving to preschool is no problem.
But then you pull into the parking lot and the worries begin.
Tears, crying, clinging to Mom, negotiations, promises of seeing the little one in just 2 short hours.
Two minutes later, she is happy, playing with play dough, and dry of all nose drips.
It might even seem as if the preschool separation meltdown is just part of the morning routine.
As a momma of four, I’ve seen plenty of tear-filled drop-offs.
And it just never stops breaking your heart.
Separation anxiety is actually considered a normal process that occurs in early childhood, as a result of a maturing physical, cognitive, and emotional development. Specifically, the areas of development that lead to a period of separation anxiety in young children include:
Visual processing system (visual memory, visual closure)
Social-emotional maturation (emotional connections, attachment, and feeling safe with certain individuals)
Despite the normal development that results in fears, worries, or flat out meltdowns following or leading up to a period of separation, severe separation anxieties do have the potential to negatively impact a child’s social and emotional functioning and this is especially true when the young child then avoids certain places, activities, and experiences that are necessary for healthy development.
Separation Anxiety Disorder
Sometimes, the family, parents, or caregivers also avoid these places, experiences, and activities. This can lead to even more negative experiences. When the family supports avoiding certain places or situations because of the young child’s separation, we can have situations where separation anxiety “hangs around” longer than is part of typical development.
Officially, Separation Anxiety Disorder (SAD) is defined as “developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached” (American Psychiatric Association, 2000). However, for the young child, separation angst does not mean a disorder is present. It is only when the anxiety levels are so severe that they are not appropriate for developmental age that the official diagnosis of Separation Anxiety Disorder should be investigated.
For those with severe symptoms, Separation Anxiety Disorder may result in school refusal and a disruption in educational attainment, refusal to attend doctor’s appointments, dentist visits, or other situations where a child is separated, no matter the physical distance, from the parent or caregiver.
What causes Separation Anxiety Disorder?
There are many developmental areas that enable to progression of separation anxiety in toddlers and preschoolers from levels of worry and age-appropriate anxiety at separation to an inefficient and “disorder” level of worry.
Studies show us that some of these considerations may include:
Parenting behavior
Low parental warmth
Poor attachment
Trauma to the parent during the baby’s young years (death in the family, environmental, or other big situation)
Trauma to the child (Adverse childhood experiences, both large and small)
Insecure or anxious attachment styles
Diminished sense of control over one’s environment
Overprotective and over involved parenting behaviors
Parental intrusiveness- including extreme decision making on the part of the parent
Parental intrusiveness- including providing excessive assistance in the child’s daily activities (beyond age-appropriate ability)
Common signs of separation anxiety in kids
The natural and developmental stage of separation anxiety occurs from around age 6 months when the baby is able to notice that something is missing from their field of vision. This skill requires development of several areas:
Visual perception
Attention
Working memory (executive function)
Sensory motor
Separation anxiety typically continues from around 6 months of age to about 5 years of age, however signs of separation anxiety can persist after age 5 and through age 6.
However, the cognitive and emotional development that occurs during this age allows for kindergarten and younger elementary aged individuals to separate from their loved ones and know that they will be there even when the are not in view.
Once the underlying areas noted above develop (around 6 months of age), you may see some common signs of separation anxiety:
Crying when the parent leaves the room or home
Upset and crying when a babysitter or caregiver comes into view
Tantrums
Avoidance behaviors (refusing to participate in activities that require separation)
Clinging to parents
Refuse to attend certain situations
Apprehension about harm coming to parents
Fears the parent will leave and not return
Running from the classroom/school bus/appointment setting
Today, I’m sharing a simple trick for helping kids with separation anxiety at kindergarten, preschool, or other drop-off situations like day care, a caregiver’s home, nursery school, or a church Sunday school room. These separation anxiety strategies can be addressed in occupational therapy sessions, used in cognitive therapy, or simply trialed at home or at school. Each of the separation anxiety activities listed below may be helpful in any situation where there is anxiety and stress as a result of separation from a parent or caregiver.
separation anxiety activities
One tool that can support separation anxiety in the classroom is starting each day with a feelings check in. This can help to get a handle on how emotions are impacting behaviors.
This post contains affiliate links.
Social Stories- Use social stories to create a visual narrative about how drop offs go and that parents will be back to get the child. Social stories can offer a verbal narrative for the child to use during these situations. Some of our social stories include:
Self-Regulation Strategies- Practice the regulation tools that support the individual’s emotional status with self-regulation strategies. Select a set of calming or heavy work strategies that can be used in preparation for the separation situation, whether that be using at the school bus stop (like this deep breathing school bus exercise) or while driving into school. Having those set of strategies readily available and discussing how the child feels will go a long way.
Movement-based separation activity – One fun way to work on separation anxiety in preschoolers that becomes part of the routine…here we are talking about the preschooler or kindergarten aged child that cries, clings to Mom or Dad, but then warms up to the classroom activities.
Practice routines- Do the same thing every day during the week in preparation for school, including bed times, morning routines, and transportation routines. These visual schedules can help with some individuals.
Wearable Charm- Another similar strategy is to create a DIY separation anxiety charm. Kids can make this along with the family adding heavy work through the hands. then, wear the charm to know that parents and caregivers still love and miss them even when not in view.
Get enough sleep– Practicing good sleep hygiene is important for the child as well as the parent or caregiver. This has an impact on behavioral response and self-regulation. Read a related blog post on supporting newborns not sleeping as sleep in young ones in the home can impact sibling and parent sleep.
Books about Separation- The activity listed below uses the book Owl Babies. But we added a heavy work goodbye sign that parents and children can use at school drop offs to ease separation anxiety. Or, this activity could work for kids that struggle with the transition to the classroom, because they are missing Mom and Dad or other caregiver.
Use the book, Owl Babies by Martin Waddell!
Use a magic number- In some cases, it can be hard for children to separate for even a very short period of time, and even in an environment such as the home. One strategy is the magic number technique. In this activity, the child and parent/caregiver can practice away time for short periods of time. Select a “magic number”. Then, move away from each other by going into a different room of the house. Use a timer or a watch to count up to that magic number. Try increasing the magic number up by a few minutes at a time until it’s less difficult to spend time apart.
Create a plan- Having a plan or set of coping strategies prepared for time apart can help. For the kindergarten separation anxiety issues, maybe looking at a picture of the family that is stashed inside a pencil box would help. For another student in kindergarten, maybe touching a special keychain attached to the shoe or belt loop would work. Having this plan prepared before heading into the kindergarten room or daycare setting is key.
Owl Babies Activity
We read the book, Owl Babies (affiliate link- As an Amazon Influencer, I earn from qualifying purchases) and fell in love.
The sweet little Owl Babies in the book wake up from a nap to find their mother gone from the nest. The owl siblings go through a series of concerns and thoughts about where their mom might be with a little almost-tears.
My older kids thought the book was pretty awesome and decided that each of the owl babies in the book were one of the girls in our family. There were a few similar personality traits that aligned with the owls in the book and the sisters in our house.
The idea of knowing that mom comes back when she leaves is a lesson we’re going through at Sunday School each week and one that happens so often with kids. Just like the Owl Babies (affiliate link), it can be hard to stay calm and not worry when mom goes away.
We decided to come up with an owl themed movement activity that kids could do when they are feeling anxious after leaving mom or dad.
School Drop Off Anxiety
This activity would be perfect for preschool kids or kindergarten students who are experiencing separation anxiety at the start of school or in a new classroom situation. For kids that cry at school drop off, or really struggle with missing Mom or Dad, this school drop off anxiety activity can help.
To do the activity, first read Owl Babies (affiliate link) together. Then, talk about how the owls in the book must feel when they see their mother has gone out of the nest. Finally, talk about how when the mom or dad in your family has to go away for a little while, they always come back and that they are thinking of the little one in your home while they are gone.
One easy way to help with separation anxiety is to come up with a hand signal. We decided that making a bird wing sign would be a lot like an owl in flight. Hook your thumbs together and spread your fingers out to create the wings of an owl.
Then, wrap both hands around your thumbs to create a little owl baby of your own. Now, squeeze your hands tight to give them a hug. Your child can do this motion when the are feeling sad or nervous at school. Tell them to think about the owl babies in the book (affiliate link) and how they felt when their mom came back.
Squeezing the hands tightly can provide a bit of proprioceptive input that is calming in a stressful situation like the preschool drop-off. A simple hand hug might be just the thing that can help! It’s a self regulation activity that supports the whole body as a mechanism to address emotional regulation needs that show up as crying, clinging, and bolting “behaviors”.
Then, when you pick up your little baby, be sure to swoop them up in a big hug!
This activity would work with preschoolers who are a little older than my two year old. She really enjoyed the book, Owl Babies (affiliate link), though and we have read it again and again!
Let me know how this tip to help with separation anxiety works with your preschooler!
This Owl Babies activity is a fun and interactive book for kids of all ages!
Let’s go a bit further with kindergarten separation anxiety and how to support this need.
Kindergarten Separation Anxiety
One thing about kindergarten separation anxiety is that it may not rear it’s head until after school has started. Typically (in many cases, not all cases), young children and parents are very excited for their little ones to head off to kindergarten. There are a lot of new things to experience as a new kindergartener!
However, one new consideration may end up being a case of worries and anxieties after the school year has begun!
What’s going on here?
At the start of a school year, after school has been in session for a few days or weeks, things start to get old, quick. The young child has to wake up early every day. They have to spend 8 or more hours in school, paying attention, and on high alert, every day, Monday through Friday. There are new routines, new peers, new rules, new learning, new transportation, and they can be on high alert all day.
Sometimes we see kindergarten students who experience a separation anxiety from their parents or guardians as a result. This involves stress and worries that might be brought up during the night, before bed, before school, at school, or even during slow times at home.
The kindergarten child who is attached to their special parent, guardian, sibling, etc. are now spending many hours away from their person, people, and routines.
Kindergarten separation anxiety may include fears as well:
they are going to miss out on something at home
their special person will become sick or have an accident while they are not together
they, the kindergartener, may worry that they will become sick, lost, or hurt while away at school
they may worry that they will become lost in the school or on the way to school
Some things that we see with kindergarten separation anxiety may include:
Outbursts at home before school
Refusing to get ready for school
Outbursts or meltdowns before bed or on Sunday night
Refusing to go to school
Refusing to go on the bus
Refusing to sleep alone
Being afraid or fearful when they weren’t before
Refusing to do things they used to like to do like playing with friends
Refusing to leave the home or be away from their parent/guardian
Feelings of intense fear or helplessness
Agitated behavior
Anxiety that presents as crying, tantrums, shrinking away, or running away from unfamiliar people or situations
Excessive fear about other situations
Trouble falling asleep or staying asleep
Reverting to younger habits such as sucking their thumb or talking in a “baby voice”
Restlessness
Trouble concentrating or paying attention
Worry during other times of day or night
There may be other things going on too. With the kindergarten age, it might be hard for the child to express all that they are experiencing. We can however, support separation anxiety in kindergarten students.
How to support Kindergarten Separation Anxiety
One of the most important ways to help a kindergarten student who is experiencing separation anxiety is by giving them words for what they are experiencing.
Talk about separation anxiety- It’s important for the child to realize and understand that we all have worries and anxiety. We all experience stress at some point or another. We can come up with tools to support and work on these worries, however, so they don’t become all that we think about. What we don’t want is for the worries to prevent participation in all of the fun activities that comes along with kindergarten!
Give words to the feelings that the child is feeling. This involves interoception (the sensory system that allows us to recognize internal sensations). One of these aspects is headaches that come because of worries or anxiety. Other feelings might be rapid heartbeat, stomach ache, dry mouth, sweating, cold hands, tingly fingers, etc.
Read books about separation anxiety in kindergarten. There are a lot of great books out there about kindergarten separation anxiety in particular. That tells us that this is a very common issue!
Some of our favorites include: (Amazon affiliate links below)
Focus on Kindergarten Friendships- One of the fun things about kindergarten is meeting new friends. But being worried and over-thinking might mean that there is less time to talk to friends and do all of the fun kindergarten things! Try helping your kindgergartener to focus on friends when they are feeling very anxious about going to school.
Enlist a friend to help walk them to the classroom
Have a buddy to get started during the day
Check in with a friend when they feel the worries
Create a social support system with a small group of friends by having playgroups on the weekends or after school.
Make a Clock- Using paper, make or draw a clock with the time that the child will reunite with their adult. This visual cue can help them to see that they will return to their loved ones. Include “grace” time for a window of time to allow for the school bus, traffic, etc. Plus this is a good clock activity too!
Separation Anxiety Occupational Therapy
Just like in kindergarten, sometimes we see clients that are worried or anxious about coming into the occupational therapy space. This might especially be the case for the new child experiencing OT for the first time. For parents to better know what to expect in OT sessions, read our getting started with occupational therapy blog post.
Using some of the same strategies listed above and under kindergarten separation anxiety can support these kiddos so they can participate in therapy. Separation anxiety may need work with a child psychologist, however occupational therapy can support families and the team using meaningful and motivating strategies as well as tools that enable the individual to participate in daily functional tasks.
Work to establish a secure relationship to the teacher/therapy provider/classroom support staff/peers with the aim of reducing dependence on parents or guardians in the school environment over time
Create a social story on being away from loved ones for short periods of time
Educate parents and educators on the limbic system and the possibility of the child being in a fight or flight state as well as tools to support the child in this manner
Educate and provide interventions on interoception and support the child with tools to slow a fast heart rate, etc.
Support the child and the family as a unit with education on co-regulation
Create a consistent goodbye routine. Try a wave at the window, a special hug pattern, or a simple phrase you repeat each day. This predictability helps ease transitions.
Use a comfort item like a small object from home, such as a blanket, scarf, or paper heart with kisses
Keep goodbyes short and positive
Talk about emotions. Name what your child might be feeling and normalize it: “It’s okay to feel sad or nervous when saying goodbye.”
Practice separation in small ways. Try short separations before school starts, such as staying with a trusted babysitter or family member for brief periods.
Prepare your child for what to expect. Talk about who they’ll see, what they’ll do, and when you’ll be back. Use visuals or picture schedules if needed.
Build self-regulation skills. Use calming strategies like deep breaths, squeezing a stuffed animal, or stretching to help regulate emotions during drop-off.
Encourage independence with routines. Allow your child to take part in getting ready, putting on their backpack, or walking to the classroom to build confidence.
Involve familiar family members. If multiple caregivers are part of the routine, make sure they follow the same goodbye pattern to provide a sense of security.
Watch for physical symptoms. Complaints of stomachaches or headaches can be signs of anxiety. Take these seriously and seek support if they persist.
Use books and pretend play. Reading books about school or playing “going to school” with dolls can help your child process and understand their feelings.
Limit big changes at the same time. If possible, avoid starting preschool during other major transitions such as a move, new sibling, or recent illness.
Stay calm and supportive. Your emotional state influences your child’s. Show confidence in their ability to manage the separation.
Communicate with the teacher. Let the classroom teacher know your child’s needs. Teachers can offer extra support during arrival time.
Seek help when needed. If anxiety is impacting your child’s daily function or not improving over time, talk with a pediatrician or occupational therapist.
Separation Anxiety and Occupational Therapy
Occupational therapy empowers individuals with meaningful and motivating tasks. When separation worries interfere with the things that matter most to the child, we see the intersection with occupational therapy.
As an occupational therapist supporting families in both early intervention and school-based settings, I often help parents navigate preschool separation anxiety with developmentally appropriate strategies rooted in emotional regulation. One of the first steps is understanding that separation anxiety is a type of anxiety that emerges when a child feels unsafe or unsure when leaving primary caregivers, especially in a new place with new people like a preschool classroom or a new babysitter.
It can look like temper tantrums, crying, clingy behavior, or even physical symptoms such as stomachaches or headaches. Some children experience nightmares or regressions in sleep routines. These are not behavioral “problems,” but symptoms of separation anxiety that reflect developmental needs. Pediatricians and child development professionals, including an MD, often agree that this is a normal stage that can benefit from structured support and consistency, not punishment or abrupt transitions.
One powerful tool I recommend is establishing a simple and predictable goodbye routine or goodbye ritual. This could be a wave at the window, a special hug sequence, or even a secret handshake. This can be something consistent that becomes part of your family’s life and supports the child’s ability to manage emotions.
Younger children may also benefit from a transitional object like a blanket or a paper heart with kisses on it tucked into their pocket or backpack. These comfort items act as sensory tools to reduce tension and help children self-soothe throughout the day. When families create and practice these routines together, it eases the stress of the exit and builds resilience over time.
It’s also important to involve family members in the routine if multiple primary caregivers are involved in drop-off. In some cases, when separation anxiety in preschoolers becomes disruptive or persists beyond the expected developmental window, it may be helpful to consult with a pediatrician to rule out other concerns such as illness or to discuss options if anxiety feels like a disaster at every drop-off. These small, meaningful strategies can transform what feels overwhelming into a smoother, more confident transition. It’s helpful for both the child and the parent!
Occupational therapy empowers individuals with meaningful and motivating tasks. When separation worries interfere with the things that matter most to the child, we see the intersection with occupational therapy.
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.
Hand strengthening and finger strengthening are a part of occupational therapy interventions, in every day tasks. There is more to developing strong and efficient hands than just using a hand grip exerciser or therapy putty to strengthen fingers.
Here, you will find a collection of fine motor resources and hand strengthening activities that can be used to improve tone in the hands, increase stability in the thumb and fingers, develop and define arches of the hands, improve precision with in-hand manipulation, improve endurance in hand strengthening activities.
Below, you will find hand strengthening activities for kids, hand strength activities for adults, and therapy tools to develop hand strength. The activities to strengthen fine motor skills included in this post are perfect to improving grip strength, pinch strength, or as part of a finger exercises program for handwriting.
One thing to keep in mind when it comes to hand strengthening and when creating a hand strength exercise program is that it is very possible (and a theme of a pediatric OT!) to develop fine motor skills and hand strength through play!
Hand Strengthening
Let’s take a closer look at hand strengthening…in fun and creative ways!
Occupational therapists use functional tasks, or daily occupations, to improve hand strength so that the clients they work with can lead functional lives: so they can have strong and efficient hands to do those tasks that take up their day.
Think about it this way: with weak hands, it is very difficult for a child to color a coloring page. But, through coloring and using crayons, they are improving their hand strength so they can color larger pictures or tackle more difficult fine motor tasks.
Adequate finger and hand strength is a crucial foundation skill necessary to successfully perform most activities of daily living such as opening snack wrappers, flushing the toilet, opening the tap, buttoning your shirt and so the list goes on.
Not only do we need adequate hand strength for our ADLs, it directly impacts on our ability to perform school related tasks such us cutting, writing and manipulating materials such as glue.
How do you know if a child has weak hands?
Hand strength is an important area of development.
Kids who struggle with hand strength may have difficulty with grasping a pencil, coloring, holding and using scissors, managing clothing fasteners, attaching a seatbelt, squeezing a glue bottle, opening and managing food containers, tying shoes. There are many fine motor activities needed in school that will be a red flag for determining if a child has weak hands.
Luckily, there are many fun ways to improve a child’s hand strength.
The best way to improve overall strength is through meaningful and motivating activities…especially everyday play!
Here, you will find a collection of pinching, pulling, and pushing activities, weight bearing activities, squeezing activities, and overall grip and pinch activities.
These ideas improve tone in the hands, increase stability in the thumb and fingers, develop and define arches of the hands, improve precision with in-hand manipulation, improve endurance in hand strength, and address hand separation into a fine motor side and a power side.
Fine Motor Strength is essential for so many reasons! From maintaining a grasp on a pencil to opening and closing scissors, to buttoning buttons, snapping snaps, tying shoes, coloring a picture without stopping, to most everything we do…hand strength matters!
I wanted to cover fine motor strength and the skills kids need for pencil grasp, managing scissors, working clothing fasteners, and using those hands. So often, we see weak arches, instability, and low tone in the hands that transfers to awkward use of the hands, impractical grasps, and poor endurance in writing or coloring. Sneaking in a few strengthening activities each day can make a world of difference!
Hand Strengthening Activities
Today includes a collection of hand strengthening activities that can be used as hand strength activities for adults, and to develop hand strength. Scroll through the activities below to find creative hand strengthening ideas to improve grip strength, pinch strength, or as part of a finger exercises program for handwriting.
One way I can tell if hand strength is an issue is if a child (or adult) is able to push the button on a seatbelt or car seat buckle to release the seatbelt. That button requires A LOT of strength in the hands, doesn’t it? You need various components of stability too: wrist stability, thumb stability, arch development, finger strength, separation of the sides of the hand, as well as range of motion of the upper body (shoulder, elbow, forearm, wrist, fingers) and crossing midline. This is a challenging functional task for those with hand weakness.
For younger kids, it’s a safety issue to be able to push that button on the seatbelt. But at a certain age (different for each child depending on various issues), if they should be able to release their seatbelt, but they can not, this tells me that hand weakness is something to work on.
There are, of course many other examples at various ages and stages with age-appropriate tasks that also show me that hand strength is lacking. This is just one example.
Let’s go into these factors effecting hand strength…
What Impacts Hand Strength?
Hand strength is impacted by various components. When it comes to hand strength, there is a lot to uncover. Many aspects of motor skills impact strength and endurance in the hands. Some of those areas include these concepts:
Intrinsic hand strength
Thumb strength and stability
Motor control
Separation of the sides of the hand
In-hand manipulation
Wrist stability
Wrist extension
Finger strength
Range of motion of the arm: upper arm, forearm, wrist, fingers, and thumb
Hand muscle tone
A hand therapist will have various hand strength norms by using a dynamometer to measure grip strength, pinch strength of various pinches. Having an understanding of hand musculature and anatomy of the hand and upper extremity is important too.
First, check out our huge online library of fine motor activities. This is a collection of all of the fine motor activities on The OT Toolbox. There’s something for everyone.
One thing that makes a big difference in fine motor dexterity is addressing separation of the sides of the hand. This post explains more about motoric separation of the hand and here is another fun activity that really strengthens those muscles.
Intrinsic Hand Strength
One of my favorite ways to work on hand strength is by using tongs. These OT activities using tongs are great for developing and strengthening the arches of the hands for improved intrinsic strength.
In fact, the intrinsic muscles are the muscles in the hand that define the arches of the hands, bend the knuckles, and oppose with the thumbs. Activities like this intrinsic muscle strengthening activity can easily be replicated at home or in the therapy room.
Among these muscles are a group called the lumbricals. The lumbrical muscles have a job to bend (flex) the MCP joints and extend (straighten) the PIP and DIP joints. When the lumbricals are in action, the hand might look like it is holding a plate with the big knuckles bent and the fingers extended. Read more about strengthening the intrinsic muscles here.
When kids write or color with a thumb web space area squashed shut, it’s a sign of problems. Then might be compensating for thumb instability, underdeveloped hand arches, and/or poor strength. Each of these problem areas will lead to difficulties with handwriting, dexterity, manipulation of small items like beads, and pencil grasp.
Another activity that is easy to set up is using play dough or more resistive thera-putty and pushing pegs (we used Lite Bright pegs) into the dough. Writing with a closed web space is inefficient and will cause poor and slow handwriting, especially as kids grow and are expected to write at faster speeds. A closed web space while attempting to manage fasteners such as buttons and zippers will lead to fumbling and difficulty. So, what do you do if you’ve got a kiddo who is squashing that web space shut during functional tasks? I’ve got a few ideas on how to work on open thumb web spaces.
Thumb Strength and Stability
Next let’s talk about thumb stability and strength. This is needed to support dexterity of the thumb in pincer grasp movements and in opposition of the thumb to the fingertips.
In-hand manipulation is a skill requiring strength in the hands. Activities like this in-hand manipulation activity can boost these skills. There are several aspects to in-hand manipulation: ▪ Finger-to-Palm Translation: Movement of an object from the fingers to the palm i.e. picking up a coin and moving it to the palm.
▪ Palm-to-Finger Translation: Movement of an object from the palm to the fingertips. (i.e. moving a coin from the palm to the fingertips to insert into a vending machine.)
▪ Shift: Slight adjustment of an object on or by the finger pads. (i.e. adjusting a pencil up and down in your hand.)
▪ Simple Rotation: Turning or rolling an object 90 degrees or less with the fingers moving as a unit. (i.e. unscrewing a toothpaste lid)
▪ Complex Rotation: Turning an object more than 90 degrees using isolated finger and thumb movements. (i.e. Turning a paperclip)
Each of the above skills can occur with items “squirreled away in the palm using the pinky finger and ring finger. This is called “with stabilization”. If other items are not pocketed away in the palm while in-hand manipulation occurs, it is called “without stabilization”.
One way I like to work on in hand manipulation is to use a foam puzzle and fill the spaces with beads. You can have the child hold the beads in the palm of their hand. Then, they can drop the beads into the puzzle spaces one at a time. Sort by colors or just drop a certain number of beads into the spaces. This works on coordination skills.
Wrist stability is one of the essential areas that impact hand strength.
Due to the anatomical nature of the tendons in the forearm and hand, a stabile wrist impacts hand strength, specifically grip and pinch.
When the wrist is flexed (bent forward towards curved fingers in a grasp), there is little chance of fine motor dexterity. A flexed wrist in functional tasks limits use of the fingers due to the tendons of the fingers being shortened as they work to stabilize the wrist. The fingers just can’t move like they are supposed to.
There are many exercises and activities that can be done to build the stability of the wrist so that it maintains a slightly extended position during fine motor activities.
One fine motor activity I like to use in OT sessions is to have the child use a small pencil sharpener to sharpen a pencil. A shorter pencil is better because you encourage the hands to move closer to the pencil sharpener. It makes the hands work hard to twist the pencil to sharpen it. This really works on wrist stability and hand strength.
Upper Body Strength Impacts Hand Strength
Upper body strength is made up of the muscles in the upper chest, muscles in the upper back and muscles attached to the shoulder joint. All of these muscles work together to create stability at the shoulder joint. This shoulder girdle stability is essential for establishing a solid anchor for the rest of the arm. Without this anchor it is difficult to develop good control in the lower arm, hands and fingers. In therapy-speak we talk about developing proximal stability before we can achieve distal control.
The stronger body enables functional performance in purposeful activities, specifically strong and efficient hands.
hand strengthening activities:
Hand strengthening activities can use the items you have in your home or therapy bag. Activities that involve play are best for developing hand and finger strength in kids. Some of these ideas can integrate play and stronger hands:
How will you use the hand strengthening activities and ideas listed above? Maybe in a home exercise program or in a therapy program that runs throughout the school year? Maybe you will use the ideas at home or in a clinic. The ideas are endless!
Think about it, how much do you use your hands throughout the day? Would you say it is from the moment you turn off your alarm clock in the morning to the minute you cover up in bed at night? How about the times you use them during the night, such as when you go to the bathroom or readjust the covers or the pillow?
One trick I like to use is using colored pencils to make little circles and then color them in with small pencil strokes. It really works on intrinsic hand strength and arch development.
If you’re like many of us, the list of necessary tasks you need to do using your hands each day could go on and on and on. No matter how often you use your hands, they need to be in good shape and strong enough to manage all the tasks you need and want to do daily.
However, with children, they don’t necessarily think about the times they need to use their hands and the strength the hands need throughout the day, but we bet they often think of the times that their hands have failed them and they were too weak and they couldn’t accomplish the tasks and activities that were important to them. We do believe they think about those times.
On a personal note, I work with many kids in the clinic that struggle with cutting, coloring, handwriting, drawing, pencil grasp, gameplay, dressing, and other self-care skills and the one factor that often comes into play with my kiddos is their decreased hand and finger strength.
Hand Exercises for strength
We put together a list of hand exercises for strength. You can find this below and it includes using tools like hand grippers, therapy putty, a squeeze ball, rubber bands, and other items. We wanted to include both items that you can find in the home and items that might be in a therapy bag or in therapy supplies.
For this blog post, we will be addressing hand strength exercises and activities that can be used in the clinic, classroom, and home setting with many of them simply using some inexpensive supplies that you may already have on hand.
Some are direct exercises for older kids while some will be fun game-like exercises or activities for younger kids because we all know children need to be motivated at their level of age and level of interest, that’s why we’ve given you a variety of ideas. Board games have a lot of small pieces that are great for manipulating and using in play. These are great fine motor items for older kids!
Also, one last note, please don’t forget that even gross motor activities can also help build hand strength too! Things like wall push ups, animal walks, crawling, heavy work exercises, pulling themselves while prone on a scooter board, weight-bearing over therapy balls, climbing, and playing on the playground equipment are all fun ways to add gross motor input but also support wrist strength and stability and strengthening of the arches of the hands.
hand strengthening exercises for kids
Below are hand strengthening exercises for kids that use a variety of different materials. You’ll find different activities and ideas under each section.
power grip is simply taking a ball of therapy putty and squeezing with a gross grasp until as flat as possible, repeat
flat pinch is taking the therapy putty and creating a fat therapy log for the fingers to pinch flat as they attempt to stay, repeat
full grip is taking the therapy putty and creating a fat therapy log placing it vertically within the hand and then squeezing to make the log grow out of the top within the webspace, repeat
thumb press is taking a log or ball of putty and squeezing or pressing the thumb into the ball or log, repeat
finger curl is taking the therapy putty and placing at the base of the fingers within the palm and then squeezing the fingers into the putty making and fist, repeat
Squeeze ball exercises:
gross grasp is squeezing the ball repeatedly with the whole hand and holding for 3-5 seconds and repeating multiple times
gross grasp with a squeeze ball that has a face – simply squeeze with the whole hand to distort the face on the squeeze ball
Squeeze and feed the tennis ball (the size of the slit opening can make the ball easier or more difficult to squeeze open)
squeeze the ball open to feed the ball individual objects
squeeze the ball and scoop dry beans with a spoon to feed the ball
Rubber band exercises
wrap rubber bands around the fingers including the thumb and then stretch out the hands and fingers to spread the fingers outward as far as possible, repeat
Hand pushes and pulls
simply place palms of hands together and push together, repeat
place a small squeeze ball between the palms of the hands and push together to flatten the ball, repeat
simply intertwine fingers together and attempt to gently pull them apart, repeat
Palm rotation with bounce balls or marbles
place 2-4 marbles or small bounce balls into the palm of the hand and attempt to rotate them in a circle while only using one hand
Fist to fan to fist fingers
open the hand by fanning (spreading) out the fingers and hold
close the hand by fisting the fingers together and hold
Make an O to fan to O position
curl the fingers into an O shape and hold
open the fingers into a fan and hold
Piano push
slightly curl the fingers like playing the piano and then push against a stable surface such as a tabletop or wall, repeat
Crumbling paper balls
Use any type of paper and work on this task as bilateral or unilateral exercises.
bilateral – use two hands with both working individually to crumple flat sheets of paper into paper balls (you can re-use each sheet by flattening the sheet again after crumpling or you can use a new sheet)
unilateral – use one hand at a time to crumple flat sheets of paper into paper balls (same as above you can re-use each sheet or you can use a new sheet)
Wringing water out of washcloths or sponges
bilateral – use both hands together to twist and wring out a wet washcloth or a small hand towel
unilateral – use one hand at a time to squeeze a wet washcloth to wring out the water
bilateral/unilateral – use two hands at the same time, but both working individually to squeeze water out of sponges
Create tongs out of a Pringle’s lid or other large flexible lids
use these recycled lids as tongs and squeeze with the whole hand to pick up objects and sort them
You can also use cardboard to cut shapes or even small squares. Then use tongs to pick them up and sort them. Here is how we used cardboard hearts with tongs
Condiment bottles and a turkey baster
use condiment bottles or a turkey baster to blow cotton balls or pom-pom balls in a fun race against a partner (you can use one or two hands to squeeze)
Milk the latex glove
this hand strengthening exercise is where you fill a latex glove with water and then knot the opening. Use a pin to poke a small hole into the tip of each finger then a child will work on squeezing the water out of each finger like milking a cow.
Spray bottle – Either use water or add food coloring or watercolors to the water. Then spray the water onto paper. We even painted snow with the spray bottles.
use a spray bottle to form letters on the sidewalk or side of the building
use the spray bottle to clean a chalkboard
Robot or Gripper claw apparatus
full hand reacher and/or gripper apparatuses are easy for kids to use to pick up objects at a distance to transport to a nearby laundry basket or box or simply from left side to right side or vice versa
Office supply tool use to promote hand strength when in use:
Stapler to staple along a strip of paper or even around shapes
Hole punch to punch holes along a strip of paper or even around shapes
Bottle glitter glue to trace letters or shapes
Rubber band wrap to wrap around a canned good or a fun pool noodle friend
Marker cap removal or matching to simply remove and put back on the marker or before use mix up the color caps on the markers and have the child fix your mix-up of marker caps
Scissor cutting with play dough or putty to cut play dough or putty logs or snakes into pieces
House tool use to promote hand strength when in use:
New plunger removal from the floor (ugh, don’t use a used one) – simply use it on a hard floor surface to push down and pull up
Pushing and pulling a weighted laundry basket – simply have a child push a weighted laundry basket across the floor or tie a rope onto the basket and have a child pull it hand-over-hand to themselves
Pulling a rope with any weighted object on the end such as a weighted scooter board, box, or even a chair – make sure they use hand-over-hand
Pull pieces of Velcro apart – you can use large strips
Place whole hand chip clips onto the edge of a box, rope, etc., and remove
Grasp and lift a canned good for hand strength in all planes – up, down, left, right, cross midline, bicep curl, etc.
Roll a water bottle or canned good in the open hand while supine on the tabletop – probably for an older kiddo
Palm down wrist flexion exercise – drape over the edge of a table and grasp a water bottle or dumbbell and flex up while lifting – probably for an older kiddo
Bean bag spatula flip (grasp activity) – use bean bags and a kitchen spatula to flip bean bags from one side to the other
Use commercially available tools and games to promote hand strength (Amazon affiliate links included below):
Amazon affiliate links are included in this blog post. As an Amazon Influencer, I earn from qualifying purchases.
Pop Toobs – pull apart for the fun sound and push together to do again or use more than one and link them together. Read about how to use pop tubes for fine motor skills.
Squigz – push onto a dry erase board, hard surface floor, or therapy ball and pull off in a color sequence
Squeeze animals – distort their bodies and faces or use bath toys that blow air, have children blow small pieces of cotton balls or pom-pom balls in a race against a partner. Here is how we used squeeze bath toys in a sensory bin.
Lego brick building and destruction – use the bricks to build simple towers or even buildings or objects with the use of picture cards. You can also use them to build words.
Build and destruct Mr. Potato Head – use the fun game to work on hand strengthening. They can build the correct way or a distorted way for fun.
Build and destruct Cootie Bugs using the fun game to work on hand strengthening. This one is a little tricky for younger kiddos as the legs must go in at a slight angle which may make them more appropriate for older kiddos.
These resources include 10-12 no-prep game boards that you can print and play to practice finger isolation, left and right-hand discrimination, overall fine motor coordination, finger dexterity and build hand and finger strength. If you want to jazz up any warm-up routine, these are what you need as they are engaging for kids and are a great tool to use before coloring, cutting, handwriting, or typing work.
Want to read more about hand strengthening and further build your therapist toolkit?
It’s my hope that these resources are a huge help for you! Here are a few more topics related to strength in the hands that you may need in your therapy toolbox:
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:
When working on hand strengthening, it’s helpful to understand the difference between intrinsic and extrinsic hand muscles. This is important for us occupational therapy providers who are explaining WHY we are doing the activities we are doing in therapy sessions, and how they relate to everyday tasks and the daily activities that require fine motor strength.
Intrinsic hand muscles are the small muscles located within the hand itself, responsible for fine motor control, finger coordination, and refined movements like isolating the index finger, forming a tripod grasp, or manipulating small objects.
Intrinsic hand exercises: Activities such as putty pinches, finger walks, or buttoning tasks are great examples of intrinsic hand exercises that target these small muscles.
Extrinsic hand muscles originate in the forearm and are responsible for larger hand movements like gripping, squeezing, and lifting. These muscles work in tandem with the hand to support strength and endurance.
(Basically, you want to target the small muscles within the hand)
Therapy putty pinches – Pinch putty or clay using the thumb and each finger individually (especially the index finger).
Buttoning practice – Use shirts or button boards to build fine motor coordination.
Paper crumpling – Crumple a sheet of paper into a ball using one hand.
Coin flipping – Practice flipping and stacking coins using the thumb and fingers.
Finger opposition drills – Touch each fingertip to the thumb in sequence.
Bead stringing – Use small beads, LEGO, or Duplo blocks to promote precision and control.
Pegboard tasks – Place and remove small pegs using a pincer grasp.
Clothespin clipping – Pinch and place clothespins on the edge of a container.
Squeeze-and-release sponge – Encourage refined grip with a wet sponge. Bonus: Use chalk pieces on the wet surfaces.
Lacing cards – Thread yarn or string through holes to improve finger dexterity.
Extrinsic hand exercises: Examples of extrinsic hand muscle strengthening activities include wrist curls using a small can, squeezing a stress ball, or using a hand gripper. Supporting both muscle groups builds the foundation for coordinated, strong, and functional hand use in daily tasks.
These activities want to target the larger muscles in the forearm that control hand movement)
Wrist curls – Use a small can or light hand weight to curl the wrist up and down.
Squeeze ball or therapy ball – Strengthen the flexor muscles through repeated gripping. Another good idea is to use squeeze bottles to spray water at a target. You can also use a squeeze glue bottle to get that squeeze action.
Theraband wrist extensions – Anchor the band and pull the wrist up and back.
Hammer rotations – Hold a small hammer or similar object and rotate the wrist side-to-side.
Playdough squeezing and rolling – Roll thick dough into logs using palm pressure.
Weighted object carry – Carry grocery bags or weighted items to build endurance.
Towel wringing – Twist a wet towel to activate both grip and wrist muscles. Bonus: Use the towel for a tug-of-war game.
Opening jars – Simulated or real jars help build functional forearm strength.
Elastic band finger extensions – Place a band around fingers and stretch outward.
Wall push-ups or tabletop push-offs – Engage upper forearm and wrist stabilizers. Kids also love animal walks or wheelbarrow races.
Does My Child Have Hand Weakness?
Wondering if your child might have hand weakness? There are a few common signs to watch for that can point to weak grip strength and reduced use of important muscle groups in the hands.
Kids with hand weakness may tire quickly when writing or coloring, avoid fine motor tasks like cutting or drawing, and struggle with daily activities such as opening jars or zipping jackets.
You might notice them using their whole arm to move rather than isolated finger or wrist motions, or frequently switching hands during a task. A loose or awkward pencil grasp, low endurance during schoolwork, or difficulty with utensils can also signal reduced hand grip strength or limited mobility in the small muscles of the hand.
As an occupational therapist, our job is to analyze function. That’s the everyday activities we do. You can check functional activities like towel wringing, using scissors, or managing clothing fasteners. This can offer insight into different types of grip strength, such as pinch grip and power grip.
If you notice these signs, it can help to introduce functional exercises that build strength through play, such as squeezing sponges, using therapy putty, or practicing with clothespins. A pediatric occupational therapist may use tools like a hand dynamometer to assess hand strength and create a plan that targets specific muscle groups for improved hand function.
Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.
The school based-Occupational Therapist is getting ready to head back into the school year this Fall. Getting organized can be one of the hardest parts of school-based OT. These tips and tricks are some that I’ve used during my years as an Occupational Therapist working in the schools.
Getting Organized for Back-to-School as a School-Based OT
A new school year brings new schedules, caseloads, and responsibilities. The workload can feel overwhelming before the first week ends. Building strong organization systems now is actually a form of self care that supports a smoother year and protects against burnout. A well-planned routine can help you stay focused on your students and the meaningful work you do.
Organization begins with the tools you use daily. Here are some ideas I like that are free or inexpensive and are easy to implement:
Paper Planner
A physical calendar or paper planner keeps schedules, meetings, and deadlines in one place. Writing things down creates a visual record that’s easy to reference during a busy day.
Weekly Brain Dumps
Weekly brain dumps clear mental clutter by moving every task, reminder, and idea onto paper. This keeps priorities visible and reduces the risk of forgetting important details. It’s important to put it on actual paper as opposed to a digital list on your phone. Then cross off those tasks or to-do’s when they are done@
Clean your space
A tidy workspace supports focus. Clearing surfaces at the end of the day means you start fresh each morning. Decluttering removes unnecessary items and creates space for the materials and tools you use most. Having a designated home base for keys, wallet, and phone prevents wasted time searching for essentials.
Morning routines
Morning routines set the tone for the day. Planning clothes, meals, and therapy materials the night before prevents rushing. This extra preparation gives you more time to connect with students and begin the day with energy. Recognizing your own wins, no matter how small, helps maintain motivation and reinforces the value of the work you do.
Strong organization habits allow you to manage the demands of school-based OT more effectively. Clear systems, purposeful routines, and intentional self-care can help you maintain balance through the school year.
One of the tell-tale signs of a school based OT is the suitcase on wheels that is pulled around from school to school. Some school-based OTs pull a bin or carry a large bag, but whatever the means of dragging around that bag of OT tricks, it needs to be organized and it needs to be all in one place.
The OT who works in schools might see kids from Kindergarten on up through high school age in the same day. They could be travelling from school to school within a single school day and have a work day that includes visits to classrooms, scheduled IEP meetings, make parent phone calls, and complete annual reports.
In order to avoid feelings of overwhelming disorganization, the school-based OT needs to be organized!
These are some of the ways that I maintained order while working as an Occupational Therapist in the schools:
A great travel bag: A bag on wheels is perfect for pulling fine motor tools, visual motor integration exercises, various types of scissors, and creative treatment activities. You’ll want a bag on wheels because sometimes an OT working in schools has to set up shop in storage areas, stairwell hallways, or backstage extra rooms. Being a therapist who only visits a particular school one day a week, most Occupational Therapists don’t get a special work area. They might need to find a desk area where they can and that can mean a lot of walking inside the school. You’ll also want to use a durable bag with a lot of pockets for holding treatment materials.
Paper organization: An accordion-style file folder is great for organizing different types of writing paper, several thicknesses of paper for teaching scissor skills, and therapist-parent communication forms or home recommendation sheets.
Binder: Keep all of your documentation sheets, schedules, calendars, note pages, and treatment planning templates in one place. A portable three hole punch is perfect for filing away and organizing sheets of paper while on-the-go.
More School-based Occupational Therapy organization ideas:
Take time to observe students in their natural environment. Plan on “pushing in” to the classroom with treatment occurring right at the student’s work space. Making adaptations and accommodations can happen with the tasks the student is working on at that moment.
Make time to get to know the “helpers” and staff in your school. The school principal, secretary, custodian, and teacher’s assistants can be a great help.
Keep extra pens, post-it notes, and highlighters in your bag.
I am hopeful that these tips will help with organizing a successful start to the school year. An organization system can be so helpful in improving productivity, maximizing time management, and reducing feelings of overwhelming stress due to paperwork and disorganization.
One tip that I always use as a school-based OT is using a paper planner. I NEED to write things down on calendars, lists, and have it all in one place. Digital just doesn’t work for me!
That’s why I created my own therapy planner where I can pull out the types of pages that I need for my specific caseload. I print off pages and use them over and over again to make lists, brain dumps, and more.
The Build Your Own Therapy Planner is the ultimate back-to-school organization tool for school-based OTs. Designed with flexibility in mind, it lets you choose exactly the pages that work for your caseload so you can stay organized all year long.
The planner includes a one-page master planning sheet to map out your schedule with teacher lunch, recess, specials, and caseload information all in one place. This is perfect for taking the chaos out of scheduling. You’ll also find monthly calendars, to-do lists, IEP-at-a-glance pages, evaluation and re-evaluation trackers, and monthly consultation logs to keep your workload on track. For a personalized touch, choose from a variety of cover designs and patterned pages that you can print, laminate, and reuse to make your planner fun and functional.
It’s great for tracking meetings, planning therapy sessions, keeping tabs on your students’ progress. The Build Your Own Therapy Planner is designed to help you start the school year organized and confident.
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.
A child with food texture issues can have a lot going on beneath the surface. What looks like extremely picky eating can be texture aversions that impact nutritional intake and participation in meals. Let’s explore specifically food texture sensitivity and what to do about this aspect of “picky eating”.
This may be a complicated topic, because what one person deems “picky” may be another person’s dream diet. It’s all subjective, to say the least. But when does food preference become an issue and who can help? Sometimes young children can have sensory food aversions to specific textures. It’s here that we’re covering specific and common food texture sensitivity that we see in children.
An occupational therapist can help, of course!
Related: Not sure if you have a picky eater? Seeking out an occupational therapist to complete a feeding evaluation is key. Also be sure to check out the Food Inventory Questionnaire for more clarity.
TYPES OF FOOD TEXTURE ISSUES
When food texture issues are the main culprit of a nutrition deficit, an occupational therapist can help you and your family identify the underlying factors and provide solutions to develop a broader food acceptance. Now, let’s dive into the various types of different textures of food and try to get into the mindset of a “picky eater”.
Some things to consider are the various textures that a single type of food can have. When you break down each type of food, you can see how a child might have a fear of food textures. The foods they are eating might be different each time they try them!
Fruit Textures
In the fruit category, we have lots of different textures going on. You may come across a child who eats certain kinds of fruits, like grapes, but will not touch foods of a different texture, like strawberries. But why is sensory touch an issue? Let’s break down the various textures, both inside and outside of some common fruits:
Various meats are very common for children to avoid because of the meat textures. Oftentimes, the exception here is with processed meats like we would find in chicken nuggets.
The texture of tough meat can be really difficult to chew as an adult, much less a child. Because the texture is so different from what many babies start out eating (purees), the introduction to meat may be a bit of a shock for toddlers.
Meat texture can range from crumbly (ex: ground beef) to stiff (ex: chicken breast) and from wet (ex: rarer steak) to dry (ex: plain baked turkey).
If a child is averse to meat, try offering it in many different forms before ruling it out! I find that cold cuts are often the most accepted of meats (besides chicken nuggets), usually offered on their own or alongside other sandwich foods.
Cheese Textures
While there are harder cheeses, most toddlers are exposed to softer cheeses like mozzarella string cheese or sliced American or cheddar cheese. However, the temperature of these cheeses changes their textures.
We need to think about what reactions we get for something gooey like a grilled cheese sandwich versus something more firm, like a string cheese straight from the fridge.
Most cheese is smooth and soft, meaning that the sensory input is fairly “low”. I have the word “low” in quotation marks because although it may seem like it is not very much input compared to something harder, crunchier, or bumpier, it may still be a texture that is non-preferred for some, leading it to feel like a much greater sensory experience for them.
Pureed Foods
Pureed foods, and foods with a pureed consistency are often the most accepted foods on this list, as they are introduced very young and do not need to be touched by the hands to eat.
Using a spoon instead of the fingers reduces the amount of sensory nerve stimulation that is associated with the food texture, and is, therefore, lighter on the system.
Pureed foods have a soft, silky, slimy, slippery texture. They do not require much activity from the mouth to eat – no chewing or moving the food about – all they have to do is swallow. This limits the amount of time to experience the food texture as well.
If your toddler is stuck on purees, try first to introduce purees with chunks. Oatmeal is a good option in this category as well.
Texture of Bread
Most toddlers love bread. The texture of bread is soft, smooth, not very complex in flavor, and easy to chew. It’s a calming food texture to eat!
Just like cheese though, the texture of bread can change, or be different depending on warmth of bread and especially the type of bread. In the case of bread, the texture changes when you toast it or add anything as a topping.
Texture changes between the middle of bread and the crusts may be why so many children prefer their sandwiches crustless! If your child does love bread but has limited nutritious foods in their repertoire, consider enriched breads with whole grains to try and fill that gap.
Cracker Texture
Crackers share some of those characteristics: they are generally smooth and lightly flavored, but they are moderately crunchy. The addition of a “crunch”, or being a firmer item in general, may be the difference between your child being able to eat bread, but not crackers.
Crackers can vary from brand to brand. Goldfish crackers from the commonly known brand can have a different taste and texture than a generic or store-bought brand. Similarly, a saltine can differ from brand to brand.
This list of foods and associated textures is certainly not exhaustive, but we hope you can use it as a resource to think about food textures moving forward.
HOW TO BROADEN FOOD ACCEPTANCE
There are many ways to address food texture issues so that nutritional input is broadened to a healthy diet. Some of these considerations are occupational therapy interventions that may be addressed in therapy sessions. Below, we’re covering:
Oral sensory strategies for food texture sensitivity
Play-based strategies for addressing texture sensitivities
Explore food texture issues by playing with food
Texture exploration without food
Oral Sensory Techniques for food texture issues
They are various ways to improve texture acceptance, but not very many that we can discuss without knowing more specifics about which food textures are causing an issue. Broadly speaking, alerting techniques are recommended for kiddos that have limited food texture tolerance.
Alerting sensory techniques for feeding involve increasing stimulation to the nerves in the mouth in a way that the child enjoys. By increasing input in a positive way, the nerves become desensitized and primed for experiencing more textures.
If this were completed in a fashion that the child did not enjoy, the technique is no longer valid. In other words, forcing someone to do something they dislike is never a good way to increase that behavior in the future.
Examples of alerting sensory input for feeding include:
Cold items like popsicles or frozen teethers/chewies
Vibrating items like an electric toothbrush or a (Amazon affiliate link) z-vibe
Fun candies like pop-rocks (for that sizzle and bang!) or rock candy (for that super interesting mix of sharp, smooth, and crunchy texture). Candy is not the best mechanism for broadening a diet, but it can be a very well-accepted item that provides a new texture to the mouth.
Alerting sensory inputs are not only beneficial for increasing food tolerance, but they are also great for attention, self-regulation, and more! Check out our posts about Sensory Popsicles and Sensory Water Bottles for more information on that.
Play-Based Sensory Techniques for Issues with Food Texture
In conjunction with oral sensory techniques, I always offer families ideas to explore various textures in and out of the kitchen.
Explore Food Texture Issues by Playing with Food
Important Disclaimer: Families that are not comfortable using food for non-nutritive purposes, like some of the activities below, should refrain from doing so. You know your family’s needs best!
Exploring Texture sensitivity through Play without Food
You can use pretend foods during playtime (they could be invisible or plastic/wood), or create a themed sensory bin using a variety of sensory bin bases for various textures. But really, ANY way to increase your child’s sensory input, especially to textures, will benefit their feeding experience. Remember that these items do not need to be mouthed to help. Just touching the skin increases texture tolerance. Here are some ideas:
I will be the first to admit that sometimes, picky eaters are just picky eaters regardless of the sensory experience. If this is the case for your little one, I would check out Kids Eat in Color, a nutritionist who has tons of great resources for families with questions about picky eaters.
Also, your OT may suggest other ways to increase functional independence during meal times with some adaptive equipment for eating. Although it may be stressful, try to keep mealtimes low-pressure and fun!
The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.
The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.
Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her background is in Human Development and Family Studies, and she is passionate about providing individualized and meaningful treatment for each child and their family. Sydney is also a children’s author and illustrator and is always working on new and exciting projects.
Texture Progression
Introducing a texture progression or hierarchy can help children gradually tolerate a wider range of food textures.
Starting with smooth, predictable textures like purees and moving toward mixed, chewy, or crunchy textures gives the nervous system time to adapt without overwhelm.
Occupational therapists often use this approach to guide safe and structured food exploration, helping children build confidence and reduce anxiety at mealtimes.
Case Example:
OT Strategies for Food Aversion
Occupational therapy offers hands-on tools that support oral sensory needs and food exploration. Items like textured spoons, chew tubes, and vibrating tools (such as a Z‑Vibe) can help children tolerate new textures while building oral-motor strength.
These tools can be especially useful for children with sensory processing challenges, making feeding therapy more effective and personalized.
Multisensory Mealtime Approaches
Sensory challenges with food rarely begin and end at the table. Preparing the body through deep pressure activities, vestibular input (like swinging), or calming breathing exercises before meals can help reduce sensory defensiveness.
Integrating sensory diet strategies into mealtime routines creates a more supportive environment for children who are sensitive to food textures, smells, or presentation.
When to Seek Professional Help
Some feeding issues go beyond picky eating and require support from an occupational therapist or feeding specialist.
Signs such as frequent gagging, weight loss, refusal of entire food groups, or high distress around eating are red flags.
An OT trained in feeding therapy can assess oral-motor function, sensory sensitivities, and behavior patterns to create a targeted plan that supports safe and successful mealtimes.
Sensory Feeding Therapy Strategies for Texture Challenges
Sensory feeding therapy helps children who experience discomfort, vomiting, or refusal when trying new foods. These responses are often related to how their body processes sensory information, especially in children with sensory processing disorder or those on the autism.
Feeding therapists use evidence-based strategies like gradual exposure, play-based food exploration, and calming routines to reduce anxiety during meals. This type of therapy is especially helpful for kids who have developed strong food texture aversions and need structured, supportive guidance.
Food Texture Progression for Feeding Therapy
When working with kids who have food texture aversion, it’s important to move slowly and intentionally through food textures. Begin with very smooth, uniform foods and work toward more complex textures as tolerance improves. This sample texture progression supports swallowing, chewing, and comfort with small bites:
Mixed textures: oatmeal with fruit, cereal soaked in milk
Crunchy or firm textures: dry cereal, crackers, raw veggies
Multi-textured: layered meals like lasagna or sandwiches
Unpredictable or resistant foods: salads, meats, mixed dishes
Progression can vary from child to child. Take cues from their preferred texture, use a fork to offer small bites, and always allow the child to lead. Click to see examples of food chaining activities that follow a texture progression.
Feeding OT Strategies for Food Texture Aversion
Children with food texture aversion may show symptoms like gagging, refusal, or strong reactions when offered unfamiliar or mixed textures. These reactions are a sign of sensory overload or a lack of integration between texture, taste, and smell.
Occupational therapists support these challenges using strategies like tactile food play, gradual exposure, and oral motor warm-ups.
Introducing new foods alongside preferred snacks in small amounts and without pressure can reduce fear and build tolerance.
Picky Eating Sensory Approach: What Parents Should Know
Picky eating isn’t always a behavior issue. It often stems from sensory discomfort. Children on the autism spectrum, or those with sensory processing disorder, may react to certain textures with avoidance, gagging, or even vomiting.
Foods like eggs, pasta, or cereal can feel too slippery, sticky, or crunchy depending on the child’s sensory profile.
A picky eating sensory approach focuses on building trust, offering food without pressure, and supporting regulation during meals. Simple steps like involving the child in food prep or offering foods on divided plates can make meals feel safer.
When to Seek Feeding Therapy Professionals
Sometimes, food refusal goes beyond picky eating and requires help from feeding therapists or OT professionals. Red flags include sudden refusal of smoothie, soups, or other familiar foods, extreme discomfort with food smells or textures, or refusal to swallow certain consistencies.
If your child regularly refuses vegetables, gags at new textures, or eats fewer than 10 different foods, it’s time to consult with a professional. Feeding therapy offers structured, individualized support and helps families develop realistic strategies for long-term success.
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.
Let’s talk body awareness activities using proprioception, or heavy work to bring awareness to where the body is, how the body moves, and awareness of self. Proprioception is one of the senses that is involved with everything we do. This sensory system plays a major role in body awareness. Below you’ll find body awareness occupational therapy activities to support this motor concept.
Be sure to check out a related resource, our self awareness games blog post for activities to support overall awareness of self.
Take a quick moment to stop and consider the position you are in right now. Are you lounging back on a couch? Sitting at a desk? Bouncing on a city bus as you glance at your mobile device? Are you perched in an office chair with your legs folded under you? Are you hanging out at the playground and glancing at your phone while your kids run in circles?
Here’s one of my favorite OT tips for supporting proprioception and body awareness skills: If you need activities that provide proprioceptive input, and for quick grab-and-go options, our Heavy Work Activity Cards make movement breaks easy and visual.
What is Body Awareness?
The definition of body awareness is this… Body awareness refers to being aware of the body’s position in space at rest and during movement. This concept can be broken down into having an awareness of body parts by name, movement, discrimination of sides of the body, and movement throughout space.
Being aware of our body position is something that happens automatically and naturally. That body awareness occurs naturally. The proprioceptive sense allows us to position our bodies just so in order to enable our hands, eyes, ears, and other parts to perform actions or jobs at any given moment. Proprioception activities help with body awareness.
The proprioceptive sense sends information about our body’s position to the brain so that we inherently know that our foot is tapping the ground as we wait on the bus or that our leg is curled under the other on the couch even while we do other actions or tasks.
This awareness allows us to walk around objects in our path, to move a spoon to our mouth without looking at it, and to stand far enough away from others while waiting in a line at the grocery store. It enables a student to write without pressing too hard or too lightly on their pencil when writing, and it helps us to brush our hair with just the right amount of pressure.
Proprioception is essential for everything we do!
Sometimes, the proprioceptive system does not do it’s job.
When the proprioceptive system isn’t functioning properly, body awareness and motor planning can be a problem.
When a child needs to pay attention to where their body is in space at all times, they can not attend to other important information like what is happening in their world around them. He or she can not automatically adjust to environmental changes. The child then needs to visually compensate in order to adjust his or her body. This can result in a child being clumsy, fearful, are even scared in certain situations.
Examples of Body awareness
Below are two situations that describe a child with proprioception challenges. In both, imagine a child who struggles to know where their body is in space.
Body awareness navigating bleachers- Imagine you are sitting on a set of bleachers in a crowd of wiggly, moving, and LOUD students. There is a lot going on around you, whether you are at a sporting event or in a gymnasium.
But, you also notice the bleachers don’t have a bottom to the steps; that is, you can see directly down to the ground below you. Kids are standing up, sitting down, jumping, roughhousing, and you are SCARED.
Your body doesn’t know how to position itself in a safe manner. You don’t know what action will come next and you don’t know where to look. You don’t know where your feet are or if your hands are supporting you.
Climbing up and down the bleachers is downright terrifying! For the child with proprioceptive struggles, just sitting on a set of bleachers can be challenging and overwhelming.
Body awareness sitting at a classroom desk- Now think about the child who is sitting at their desk and is required to write a journal entry. For the child with proprioceptive challenges, this can be a task with many “self-checks”.
They need to look at their feet to make sure they are under their desk so they don’t get in trouble for almost tripping someone between the desk aisles. They need to make sure they are sitting upright in their chair and that their back is touching the chair’s backrest.
They need to hold the paper and the pencil like they were taught. They need to align the paper and the words and then think about how hard to press on the paper, how to make the lines for individual letters, and how to string together letters to make words.
What a workout it is just to get settled in and started on a writing task! By now they might have lost several minutes of the writing time and they still don’t know what they are even writing about!
Both of these situations happen on an every day basis.
For the child with proprioception difficulties, the ability to be aware of their body in space and plan out motor actions is very much a struggle. These kids might appear fidgety, unsure, overwhelmed, clumsy, awkward, uncoordinated, or lazy.
When children or adults struggle with awareness of body positioning or movement patterns during activities, functional tasks can be a struggle. Every day tasks are difficult or impaired.
Occupational therapists work with individuals of all ages on functional tasks that occur in all aspects of daily living. Movement is part of the daily task completion, so it is likely that if body awareness is an issue, there are functional impairments at play.
Occupational therapy professionals will focus body awareness goals on the functional task that is impaired.
OT goals for body awareness can be specifically focused on improving body awareness during those functional tasks. Activities that address those goals can include heavy work, attention to task, motor planning, fine or gross motor skills, sensory input in the way of organizing proprioceptive input or vestibular input, visual cues and prompts. There are many ways this skill area can be addressed and these goals will be individualized for the child or adult.
Additionally, OT goals for body awareness may focus on motor planning. Proprioception is very closely aligned with body awareness and motor planning.
Need more information on proprioception and the other sensory systems and how they impact independence? Grab this free sensory processing disorder information booklet and free email series on sensory processing.
In this blog post, we are specifically discussing how to use proprioception activities to help with body awareness.
The proprioceptive system is alerted through heavy work activities that involve heavy pressure, firm sensations, large, forceful motor movements, and pushing or pulling activities. These actions can be calming and organizing.
Try these proprioception activities to help with body awareness at home, in the classroom, or in play.
Proprioception activities at home
Carry full laundry baskets to the laundry area
Empty wet clothes into the dryer
Change sheets
Pull weeds
Pull garbage cans to and from the curve
Carry in grocery bags
Carry donations to the car
Wash windows
Scrub carpets
Shovel snow
Rake leaves
Mop floors
Vacuum
Rearrange furniture
Proprioception activities in the classroom
Carry piles of books
Rearrange furniture
Help gym teacher move mats
Carry bin of lunchboxes to/from the lunch room
Wall push-ups
Chair push-ups
Clap erasers
Stack books in the library
Place chairs on desks at the end of the day, pull them down again in the morning
Looking for more ways to add proprioception activities into play and therapy? Try the ideas below. Just click on the images to read more.
In the Sensory Lifestyle Handbook, we cover motor planning and body awareness concepts as they are deeply related to sensory processing. Much like the body awareness activities listed in this blog post, the book discusses how to integrate functional tasks within the day that offer organizing and regulating input through functional activities.
Not only are these activities regulation tools, they are also activities that support development of body position in space and awareness of the body’s movements.
The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.
The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.
Body Scheme and Body Awareness
Another way that you may have heard body awareness phrased is “body scheme”. This is just another way to explain the awareness one has of their body and the various parts of the body. Body scheme allows us to be aware of the spatial relationships of where the body is in space in a given activity.
Body scheme involves proprioceptive awareness so that we can move and interact in the world around us.
We can define body scheme as the awareness of body parts and the position of the body and it’s parts in relation to themselves and to the objects in the environment.
When there are deficits in body scheme, we may see certain difficulties:
challenges with apraxia, or difficulty with purposeful movement in relation to sensory input, movement, and coordination.
The individual might not recognize body parts or the relationship between them. This is especially observed in neuromuscular disturbances such as a CVA (stroke)
Movements may be considered unsafe. We might see difficulties with intentional movement and problems navigating busy hallways, stadium steps, bleachers, etc.
There are typically related deficits related to body scheme or body awareness difficulties. These may include:
Body awareness challenges like moving and utilizing the body without looking at or thinking about how the body needs to move. This awareness of the body in space results in functional and efficient movements with coordination.
Challenges with body scheme may be a cause of brain damage or brain injury such as a neuromuscular impairment. However, difficulties with body scheme may be a result of other deficits as well, including visual-spatial deficits, sensory processing challenges, verbal, or conceptual considerations.
Using Heavy Work Cards for Proprioceptive Input and Sensory Regulation
Proprioception is the body’s ability to sense its position in space, and when kids engage in heavy work activities, like pushing, pulling, lifting, or jumping. These types of activities activate the sensory processing system. This input supports better motor planning, coordination, and self-regulation. Our Heavy Work Activity Cards are a simple way to offer proprioceptive input through movement-rich activities that can be done in short bursts throughout the day.
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.
Did you know the important role that heavy work activities play in our ability to learn, focus, attend, and participate in everyday tasks? It’s true. We all need calming and organizing sensory input in the form of heavy work tasks that provide proprioceptive input through the muscles and joints. Here, we’ll cover what heavy work is, when heavy work is needed, and specific heavy work strategies that kids of all ages can do at home, in the classroom, or in their therapy session.
Heavy work can be so many things! Below you’ll find ideas for pushing, pulling, lifting, jumping, chewing, and other ideas for adding organizing proprioceptive input.
Want printable versions of these activities to use at home, in the classroom, or therapy? Try our Heavy Work Activity Cards for easy access to movement-based sensory input.
Heavy Work Activities
In a different world children would be ready to learn at all times. In an alternate universe children would not have temper tantrums or meltdowns in shopping centers. In another time and place all of us would be well-regulated all day and all night!
But that’s not how things work and anyone spending time with children will know that there are moments when they are out-of-sync and not quite with the program.
We all experience dysregulation at one point or another! We cover more on this in our recent blog on on the Alert program, which also has ideas for heavy work input.
And that’s all part of their journey of growing, developing and learning. You will be happy to know that when you are faced with these rather challenging times there is a powerful tool you can use to help children become more regulated…heavy work!
You can rely on heavy work to help you out to organize a dysregulated nervous system.
WHAT is HEAVY WORK?
Heavy work is activity that requires effort from our muscles and these tasks usually involve activation of the muscles and joints of the body through the proprioceptive system by movements such as pushing, pulling or lifting. The movement activities create resistance input to the muscles and this feedback is ultimately what calms and regulates the sensory system.
The sensory system that is activated during heavy work activities is called the proprioceptive system. The proprioceptive system receives messages when the muscles move to do work. These messages flow back and forth to the brain. The brain decides how much force a muscle should use based on the task at hand.
This allows children to use the correct amount of force when they need to hold something gently or when they need to lift something heavy.
It’s a complex system that is constantly adjusting to make sure the brain is getting the right information from all the joints and muscles in the body and as well as making sure the muscle output is appropriate to the task. This concept is also known as body awareness and allows us to know where our body is in space and how to move our body.
The take away message about the proprioceptive system is that it is a universal and powerful regulator.
By working with the proprioceptive system you can even out disturbances in other sensory systems. You can increase energy levels if you need to and you can reduce high energy levels to help children reach a calm, comfortable space to interact with the world.
So when is heavy work appropriate to support learning and participation in daily tasks?
WHEN TO DO HEAVY WORK
The beauty of heavy work is that they are really easy to incorporate at home, in the classroom and in therapy settings. Adding heavy work to a child’s daily routine will contribute to the development of their sensory processing.
Children will also gain valuable tools that they can use when the feel that they need to regulate themselves. How often you use heavy work input will depend on the individual child. Be guided by the child’s enjoyment and response to the activity that you introduce.
Consider including a heavy work activity in the morning before going to school and again in the afternoon when children arrive home from school. Heavy work can also be incorporated into bedtime routines to help the sensory system feel calm and restful.
At school, heavy sensory input for the whole class can be incorporated at regular intervals during the day. Incorporating heavy work (and other sensory system input) into daily functional tasks, or setting up a sensory lifestyle, are all concepts covered in the book The Sensory Lifestyle Handbook.
Strategies like pushing a ball or heavy basket, or wall push ups and chair push ups are some examples of heavy work. Heavy work offers effort from the muscles and joints and requires the proprioceptive sensory system. The resistance provides feedback through the receptors in the muscles, joints, and ligaments. This is what is calming and regulating because the movements are organizing.
Why Heavy Work?
If you look at the iceberg image above, you’ll notice that the image depicts an iceberg with activity words above the water level. These tasks depict the heavy work actions that we see in action.
Heavy work may include:
Pushing
Pulling
Lifting
Carrying
Chewing
Jumping
Carrying
Squeezing
Climbing
Pinching
Brushing
Any other actions that use the muscles and joints with weight of the body or object
Under the water level, you’ll notice words and phrases that depict underlying skills. These are the components of heavy work that you might not “see” in action, but they are occurring with and through heavy work.
These are skills that we need for everyday tasks. Heavy work involves these components, and are what makes body awareness and movement happen. These are the skills that contribute to the organizing and regulating capacity of heavy work. The potential of these underlying components to contribute to the effectiveness of heavy work activities.
Proximal joint strength and stability (elbow, wrist, etc.)
We like to say that it’s like the chicken and the egg saying. The underlying and contributing factors of heavy work contribute to the heavy work actions and the heavy work actions contribute to the underlying contributing factors.
How to use heavy work activities
Now you are ready to use heavy work sensory input to create happy, well regulated children!
Specific children may be given opportunities to engage in additional heavy work activities during the day if they are struggling with sensory processing and attention the classroom.
Some deep pressure work activities require no equipment and very little space. Others may require some props and a bit of space. Select your heavy work activity according to the space and items available to you.
And have a few options available. Each child has a different sensory make up and preference and will respond differently to the heavy work input that you introduce. You will soon discover the activities that they enjoy and the activities that help them to feel calmer and more regulated.
Pushing Heavy Work Activities
Pushing or pulling heavy objects, like a wagon, a weighted sled, or a suitcase, engages the muscles and joints of the proximal leg joints and the large muscle groups of the legs. These activities also engage the proximal joints and shoulder girdle of the upper extremity, as well as core strength and stability.
Wall push ups- stand an arm’s length away from a wall and place both hands on the wall at shoulder height. Bend your elbows and lean into the wall until your nose is touching the wall. Return to the original position. Repeat ten times.
Chair push ups- sit in a chair with you palms on the seat of the chair at either side of you. Push on your arms and lift your bottom and legs off the seat of the chair for a few seconds.
Pushing a box across the room- fill a box with books or toys and kneel in front of it. Push the box across the room.
Fill a laundry basket with laundry and ask your child to push it through the house.
Push a large therapy ball or medicine ball along the floor and up the wall as high as you can go
Pushing off a wall or object while on a sensory swing
Pulling heavy work activities include activities like some yoga moves, playing tug of war, doing pull ups, and more.
Pulling Heavy Work activities
Closely related to pushing, pulling heavy work uses the upper and lower extremities and the core.
Pulling on a rope- tie a rope to a tree, pole or secure door handle. Hold the rope and see how far you can lean back while pulling on the rope. You only need one person for this tug-of-war game!
Tug of war- if two or more children are available have a game of tug of war
Pull up bar- it may be tricky for children to perform pull ups but just hanging from a bar is great work for muscles.
Pulling and stretching a piece of theraband or stretchy material.
Wall push-Ups- Have children perform wall push-ups by pushing against a wall with their hands. This provides resistance and helps build upper body strength.
Jumping is a great organizing heavy work activity and ideas include using a trampoline, doing jumping jacks, rocket jumps, or star jumps, and other jumping games.
Jumping heavy work Activities
Jumping activities add heavy work through the hips, knees, and feet.
Trampoline- this provides endless hours of heavy work activity. Wonderful proprioceptive input while children enjoy the pleasure of jumping.
Jumping on a mattress on the floor or couch cushions placed on the floor.
Rocket jumps- crouch down and place your hands on the floor next to you. Count down from ten and leap into the air raising both hands up to the sky. Repeat the rocket launch a few times.
Star jumps / jumping jacks are great for co-ordination and heavy work.
Sitting on a small therapy ball and bouncing up and down.
Hopper balls with handles are also a fun way to bounce around.
Lifting heavy work activities include carrying a weighted backpack or stack of books, doing laundry, and yoga.
Lifting heavy work strategies
Lifting weighted items or carrying heavy objects such as books, backpacks, or baskets of laundry offer heavy work. In addition to holding weighted items, lifting can involve the body weight as well.
Carrying bags- allow children opportunities to carry bags of groceries or laundry at home
Weighted backpack- place a few magazines in a backpack and encourage your child to walk around with the backpack for a few minutes.
A message could be placed in the backpack and your child could deliver this message to a family member at home or to another teacher at school.
Carry a stack of books
Carry a full laundry basket
Carry a full tote bag
Weighted stuffed animal
Leg lifts, raising arms over head, holding a bridge position
Oral motor exercises and input through the mouth and face offer heavy work through the jaw, cheeks, tongue, and neck. These can be very organizing and regulating strategies.
Chew gum, dried mango, or other dry fruit
Drink think liquids through a straw e.g. yogurt, thick milkshake
Specially designed necklaces, bracelets and toys are available for chewing.
Chew on a straw
Blow through a straw
Eat crunchy snacks
Drink a smoothie through a sippy cup with a straw-type top
Use a “crazy straw” in a cup. The smaller opening is great for oral motor input.
Play “Simon Says” with mouth exercises: Suck cheeks in/puff cheeks out/Make a big “O” shape/Stretch out the tongue. Use these printable Simon Says commands to target oral motor skills.
Chew gum
Use a straw to suck and pick up pieces of paper. Transfer them carefully to a cup using only the straw.
Activities like bear walks, crab walks, or crawling like a snake can engage the muscles and joints while being fun for kids.
Climbing Activities
Encourage climbing on playground equipment, climbing walls, or indoor climbing gyms. Other ideas include using playground equipment for sensory input, or climbing up a slide, when safe and appropriate.
Climbing provides heavy work for the upper body and core muscles.
Squeezing Activities
Using stress balls, therapy putty, or hand squeezers can help improve hand strength and provide sensory input.
Another idea is using a regular blanket as a sensory burrito.
Yoga and Deep Pressure Poses-
Some yoga poses, like downward dog or child’s pose, provide deep pressure to specific body parts and can be calming for children.
You can also include partner yoga poses in small groups for added heavy work.
Digging in the Garden-
Gardening activities, such as digging holes or moving soil, engage the muscles and joints. Check out our post on sensory gardening for more information on these benefits.
Bouncing on a Therapy Ball-
Sitting or bouncing on a therapy ball engages core muscles and provides sensory input.
For a great resource filled with heavy work activity ideas, grab this set of heavy work activity cards that offer themed brain break cards, in 11 pages of themed heavy work activity cards, with 8 activities for each theme.
Creating an individualized sensory diet with scheduled heavy work sensory activities (and other sensory input as needed) is part of a sensory diet. Read this resource for what a sensory diet is and this resource on how to create an effective sensory diet.
You will quickly discover how powerful heavy work as sensory input is and how much fun the children have when they engage in these activities. In addition to heavy work, there are various other sensory based tools that you can use to assist children who may have more complex sensory needs.
Children with sensory processing difficulties benefit from sensory diet which introduces a variety of specific sensory experience that assist with regulation.
Want to use themed heavy work activities in therapy, home, the community, games, and the classroom? Grab the Heavy Work Activity card set:
Use these heavy work cards to help with building body awareness, motor planning abilities, proprioceptive input, or a movement activity as a brain break to pay attention between learning activities. Included in the pack are:
Trucks Heavy Work Activities
Insects Heavy Work
Sea Animals Heavy Work Exercises
Farm Animals Heavy Work Ideas
Jungle Animals Heavy Work
Woodland Animals Heavy Work Tasks
Superheros Heavy Work Exercises
Sports Heavy Work Activities
Monsters Heavy Work
Summer Heavy Work Ideas
Butterfly Life Cycle Heavy Work
Each activity page includes 8 movement and heavy work cards in that theme.
These heavy work strategies can be added to home programs, teletherapy activity plans, or used as brain breaks during learning and play.
Need heavy work ideas to use on the go? Need sensory strategies to offer to a parent or caregiver? Want to print this information so you can use the printed material to educate parents, caregivers, teachers? Want a printable list of heavy work activities?
Enter your email address into the form below to grab this free printable information packet.
Another great information graphic that I love is this way of describing self regulation strategies. Heavy work is one of the important ways to weave self regulation and emotional regulation into the day. Other ideas include play, imagination toys, and building an emotional vocabulary. This comes from our resource on self regulation strategies for preschoolers.
We all have sensory needs and heavy work is a great tool to have in your toolbox to meet these preferences.
I hope this resource has been a helpful way to better understand heavy work as a tool that we all need!
Printable Heavy Work Activities to Support Sensory Needs in Kids
Heavy work provides deep pressure input to the joints and muscles, which can have a calming and organizing effect on the nervous system. This type of proprioceptive input is often used in occupational therapy to help kids with regulation, attention, and body awareness. Our Heavy Work Activity Cards make it easy to implement these strategies. So, if you’re building a sensory lifestyle, supporting a child before transitions, or just looking for ways to help kids feel more grounded during the day.
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.
For young (and old) children, a great calming classroom tool that supports learning, social participation, and school tasks is the calm down corner. A calming corner in the classroom can be a great sensory strategy to support emotional regulation needs in students. It’s a place to calm or re-organize in a personal bubble, meeting regulation needs so learning can happen. Let’s go over fun calm down corner ideas to support various regulation needs in the classroom.
As a pediatric OT, I love easy activities that I can use over and over again. One of my favorites are my heavy work activity cards that I can print off and use different themes based on the time of the year. Stock your calm-down corner with visual supports like our Heavy Work Activity Cards, which offer quick movement options for sensory regulation.
They are a great addition to calm down corner ideas like the ones below!
Calm Down Corner
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A classroom calming area can include a variety of movement and sensory based activities or tools.
A place to sit: A visual space for a child to sit in their calming area, that is large enough for one child only. This could be a bean bag chair, a cushion or a pillow. These soft spots will help make the cozy corner comfortable so children feel they can stay as long as they would like. There are so many options when it comes to Flexible Seating tools – bean bag chair, movement seat, deflated beach ball seat, couch, soft chair, floor mats, large pillows
Soft surfaces – yoga mat, gymnastics mat, or soft rug
Timer – visual timers with countdown options are great
Preferred sensory items such as tactile toys, chewing items, plushies, fidgets, etc.
Books: Looking through picture books of all kinds, helps to give children something to do, while keeping their minds calm. Most of the time that children are interested in using a cozy corner, is when they are feeling overwhelmed.These Zones of Regulation booksthat talk about different feelings and support regulation and processing through feelings such as sad, scared, angry and more. These empathy and friendship books are another tool to consider. Place the books in a basket or a shelf for easy access.
Emotional Supports: Visual and tactile supports help people of all ages, but it is essential to have a visual space in the classroom for preschoolers to retreat to when they need time to calm down. Soothing Sammymakes creating this area simple and makes it a positive experience for children. This adorable golden retriever has his calm down house which can be placed in the cozy corner, with items that help children calm down using their sensory system. As they calm down, they can use the visuals included in the kit to explain to other children and adults how they are feeling and what they need support with.
Stuffed Animals or Baby Dolls: When feeling lonely, sad, scared or overwhelmed, having access to baby dolls or adorable stuffed animals makes the space less lonely. Additions such as baby doll blankets, bottles and other caretaking tools, allow children to comfort others as they work on comforting themselves.
Personal space: Adding a privacy cover or even simply a boundary to the cozy corner space helps children not to be distracted by other aspects of the environment. Placing fabric, cloth or other child-safe covers over the cozy space allows children to feel like they are in charge of their own space. Some child care centers place the cozy areas in small tents, (Amazon affiliate links) canopies (affiliate link) or wooden privacy cube like this one. (affiliate link)
A feelings check in could be a great addition to this space. The child could enter the calm down area and identify how they are feeling and then use strategies to support those needs.
This list is just the beginning! A calm down corner can include any item from the list above or classroom sensory diet strategies, based on the needs of the individual student.
Calm down corners can be quiet soothing areas to decompress for certain learners, while others need a more active calm down area in classrooms.
How to Add movement to a calm down corner
There are many different ways that children can calm down. Movement is one of the most beneficial and complicated ways to manage feelings and emotions.
There are two different types of movement patterns that support the sensory system.
Both of these types of movement activities increase awareness of where a body is in space, calms the central nervous system and regulates emotions in an amazing way. Movement is complicated as it can be alerting and calming. Picking the right activity for the desired outcome is tricky, but effective.
Help your learner understand what they need for self regulation, rather than bouncing all over the calm down corner.
How is movement calming?
Have you noticed that children seem to pay attention longer after moving around for a while? This isn’t just because they are tired after completing an active task. Children and adults are able to attend for longer periods of time when movement breaks are embedded into their daily schedules due to the sensory benefits it provides.
For adults that have desk jobs, it is widely known that every 20 minutes, they should stand up. This not only helps blood flow, but also awakens the body. When children are engaged in circle time, implementing movement based activities within circle (like freeze dancing, jumping and marching) is beneficial to improving attention.
Movement has many benefits, including helping calm down when feeling overwhelmed with emotions.
When the sensory system becomes overstimulated due to internal feelings and frustrations, some people are quick to seek out movement activities to calm down. Adults may go for a walk or run, chew gum, lift weights or kick a ball. This strategy directly affects proprioceptive input.
There are many ways the body processes movement. This impacts the central nervous system in different ways.
Proprioceptive inputs is one of the ways the body processes movement. It tells the brain where the body is in space. Proprioception is guided by skin, muscle, and joint receptors in the body, to connect to the brain through the nervous system. In this way, a person knows where their body is in space, and what the body is doing, without needing to watch the body parts move. A great example of proprioception, is being able to walk down the stairs without looking at ones legs or feet
Heavy work, or tasks that involve heavy resistance, offers input to the muscles, joints, and connective tissue, and is essential to regulating the sensory system
In this article on neuroplasticity, evidence suggests the sensorimotor cortex that governs proprioception is not fixed, and can be changed through external manipulation.
Vestibular movement, like proprioception, also helps alert us where our body is in space. This system operates through the inner ear, passing information to the brainstem, affecting many areas of the body. If a person starts jumping, rocking to music, or dancing to calm the body, it activates the vestibular system. This article on vestibular activities does a great job explaining this system.
more about the vestibular system
Receptors in the inner ear, found in two structures (the otolith organs and the semicircular canals), respond to linear/angular/rotational movement, gravity, head tilt, and quick movement changes.
The receptors in the ear, provide information to the central nervous system about the body’s position in space. Information is used to:
control posture, eye, and head movements
correct the eyes with head and body movements
muscle tone and postural adjustments
perceive motion and spatial orientation, and integrates somatosensory information
Through the vestibular and proprioceptive systems, the body processes information about where it is space, interprets movement patterns, and recognizes touch and joint pressure. These senses greatly impact the ability to calm down by triggering pressure points through movement (such as rocking or swinging).
When a child (or adult) becomes upset or overwhelmed, it is helpful to utilize the vestibular and proprioceptive systems as intervention tools. This helps a person calm and self regulate, in order to process their feelings and problem solve.
Because children often need sensory strategies to self regulate, having a designated calm down area set up in the home/classroom makes redirecting children to the appropriate calming activities much easier.
The Soothing Sammy program is a great way to encourage children to take part in creating their own calm down corner through a story about a dog, Sammy, a golden retriever. As children help build Sammy’s calm down area to use when overwhelmed, they are gently taught that it is okay to have a variety of feelings. As children look through the book, they learn how to use objects in their calm down corner when needed, including drinking water, wiping their face with a cloth, jumping on a small mat (proprioceptive and vestibular input) and much more.
There are so many items that we can add to a calm down corner and every calm down corner will be different based on individual children’s needs. In the Soothing Sammy curriculum, there are recipes for lavender bubbles, slime, tactile fidgets, paint, and others.
Proprioception Calm Down Corner Ideas
Here are some great proprioceptive strategies to include in a calm down corner:
Calming Corner Printables- Print off the sensory stations listed below. These support heavy work needs (and vestibular input)
Jumping mat or small trampoline. When children jump, they put pressure on their joints
Weighted blanket. Weighted blankets provide deep pressure over the entire body, making this activity one of the an effective whole-body proprioceptive strategies to help children calm down
Watering plants. Lifting a watering can, can impact joints all over the body. As children stoop down to pick up the watering can, moving it over plants of different heights, they are getting great input
Weighted ball. Lifting and rolling over a weighted ball increases proprioceptive input in the hands, arms, shoulders, and core.
Play Dough. Squishing, squeezing and pulling apart playdough or clay, increases proprioceptive input in hands and small joints.
Some of these activities can be alerting or calming, therefore some trial and error may be needed.
Vestibular Calm Down Corner Ideas
Movement with changes in positioning can be calming as well. Think slow, rocking movements. Here are some Vestibular strategies to include in a calm down area:
Farm Brain Breaks – These simple, yet fun activities, provide visual ways to complete vestibular activities
Calming Corner Printables- Movement like yoga poses or those offering brain breaks can be just the calming input needed.
Swinging – Help your child move and sway in different directions with an indoor or outdoor swing. A Sensory Swing for modulationis an amazing way to provide an option to swing in a home or preschool setting
Trampoline – Provide a small trampoline for your child to jump on. (Amazon affiliate link:) This toddler trampoline with handle is perfect for indoors spaces
Dancing – Any type of movement to music, including freeze dancing or shaking instruments (such as a tambourine, bells, maracas) or using scarves, are wonderful additions to a calm down corner
Yoga Poses – There are several themed yoga poses perfect for children. Add a yoga book or cards like these Unicorn Yoga Posesto any calm down area
calming corner printables
One tool to add to a calming corner or calming space is a printable that offers a visual designed to promote calming and organizing self-regulation. These calming corner printables are easy to print off and start using right away.
Over the years, we’ve created seasonal sensory paths, or sensory stations that support regulation needs. We’ve received wonderful words of thanks and feedback letting us know how loved these sensory stations have been.
Check out each of these seasonal calming corner printable packets. Pick and choose the ones that support your needs in the classroom, therapy clinic, or home:
Additionally, other calming corner printables might include deep breathing posters. We have many free deep breathing exercises on the website, including:
Finally, a brain beak printable like our popular alphabet exercises makes a great wall poster for a calming corner of the classroom.
Keep in mInd about setting up a calming corner in classroom
Calm down areas should incorporate all the senses, as every mood, trigger, situation and response is different. Equally important is the co-regulation aspect, which relates to responding to the mood and behavior of those around us, or the peers that may be present in a classroom or home setting.
By utilizing a variety of calming tools in a calming corner, or calm down space within the classroom, children will be able to identify what they need, the moment they need it, while still engaging in active learning.
It can be daunting and complicated providing for the needs of all of your different learners, however, by incorporating vestibular and proprioceptive materials in a calm down corner, children are able to use these powerful movement strategies when they need them the most, all while taking a multisensory approach to academics.
Sensory Corner
We’ve covered ways to set up a calming area, but what if you really want to feature the cozy aspect of a sensory space in a classroom or home? A sensory corner is very much the same concept, with different terminology. The key to a calm down space is incorporating sensory components within these areas.
Research shows that having a designated space for children to have alone time in, during their school day, is a way to support emotional development and independence, while also teaching children that it is okay for their friends to take a break.
When combining visual, tactile and other sensory components into the design of a cozy area, children will independently seek it out when they need a break from their peers.
in the classroom is a cozy or quiet space for one child to spend time independently when they feel like they need a break from the regular commotion of a preschool day. This area can be used to take a sensory break, to calm down when they are feeling upset or overwhelmed, or to just take a break.
This area should be accessible for all children at any time of the school day. This area is best used when it is at the child’s level, is situated in an area of the classroom that is far away from the busier/louder areas of the classroom, and includes sensory supports to encourage calming and peaceful experiences.
Whatever you call your safe space, and however you set it up, what matters most is your intention.
Why Use a Sensory Corner?
A calming corner or a sensory corner may be used for many various reasons.
There are hundreds of reasons why children might need to take a break from other children in the classroom. They may feel sad, overstimulated or just need time to recharge.
This may include:
Feeling overstimulated in the classroom
Overwhelming feelings
Needing to recharge or refocus
Having a bad day
Changes in routines
Feeling “out of sorts”
Worried about a home situation
Worried about a friend situation or social situation
Worried about a test or project in the classroom
Sadness about home situations
Missing family or pets
Not sure what to expect or what is expected of them
Remember that the goal of the sensory corner is to offer a safe space, or to give children a place to calm down, feel safe, and regroup when they are overcome with big emotions at school.
One thing to consider is that a calm down area of the classroom can be effective at the start of the school year due to transitions in the classroom when a new classroom may mean a lot of unexpected sensory input. This is a great addition to back-to-school sensory activities that support students of all abilities.
Where to put a cozy area:
When looking at an indoor preschool classroom set up, there are many centers that are utilized by children throughout the day. The key is to avoid adding visual noise, or visual clutter when adding a cozy area to the classroom.
Some of the busiest areas include the circle time/gross motor area, the block area and the art areas. These areas tend to attract groups of children at once and aren’t the best spaces to put next to a calming area.
The library, dramatic play and animal/science areas, tend to be more quiet spaces in the classroom. Each of these spaces will support a calmer environment to build a calm down area. When deciding what wall or area to place the calm down spot, keep in mind the following environmental components:
Is there a window nearby that will give off too much light?
Are there large gross motor/sensory spots that are noisy?
How many pictures are on the wall, and are they soothing?
What are the colors of the walls by the calming area, and are they overstimulating?
Is the space adequate for one child, or will more children try to encroach on their alone time?
Can this space be easily visible by a teacher doing active supervision?
Is this space near high traffic areas, like the entry door or bathroom?
Many spaces may feel like the perfect spot for a calm down space inside the classroom. You know your kids the best and where they spend most of their time. As the school year progresses, there may be times where you want to move your calm down area to a better spot, and that’s okay!
Outdoor Sensory corner Ideas
Don’t forget about the outside as an option for a calm down space! We know the many benefits of outdoors as a calming area, so simply going outside is a great option for calming the mind and body while organizing (or regulating) the sensory motor systems. The outdoors is one way to add free sensory motor options to the classroom.
Kids need quiet spaces while they are playing outdoors also. When setting up an outdoor learning environment, make sure to incorporate some independent areas in a shady area of the playground. These spaces could be near the garden, near a book reading area, under a nice shade tree or near a swing. You can even add an outdoor sensory swing as a calming option.
When setting up an outdoor area as a sensory corner for classroom breaks, consider what science says: Research on outdoor sensory play tells us that playing outdoors supports development, but there are emotional benefits as well as benefits to learning.
Some components to think about when setting up your outdoor calm down area include:
Is it sunny or shady?
Is it near an area where children will be running quickly?
Is it near a highly trafficked area, like a parking lot, walkway or door?
Quiet cozy areas should be available for children at all times. It isn’t a punishment corner, rather a space that children can “take a break” when they need it.
Here are 5 simple ways to incorporate cozy spaces outdoors so children have the opportunity to play on their own when needed.
1.Place to Sit: The first step to creating a safe space is for children to have a space to be on their own. You can create this in a similar way with an area rug or cushion like the indoors, or you can create something with more of a visual “splash” like these calming spaces in children’s swimming pools.
2. Gardens: Nature is a great accessory to a cozy nook area outside. Consider creating a cozy nook with a variety of plants. Adding trellis’s and arches where different vegetables and flowers and grow over a child’s safe space, incorporates natural colors and healthy foods into the safe space that children will spend their time. Sensory gardening is also a great option for a sensory break from the classroom that fosters learning!
3. Swings: Attaching a child safe swing to a tree provides a sensory rich safe space where children have the opportunity to have quiet time and self soothe. There are so many sensory swing options including a hammock swing and a platform swing.
4. Individual Art Space: Child initiated process art in nature can be a calming and essential experience that supports children when they are overwhelmed or overstimulated. A simple way to create this individualized space is by attaching an easel to a fence and offering different mediums to use with the easel (markers, paint, chalk.) Some of these creative painting ideas are fun to try in a sensory calm down space.
5. Sensory Table: A small sensory table or a sensory bucket is a wonderful way to encourage individual calming time while outside. You can add a variety of different materials to the sensory tub, or offer options of 5 or six sensory buckets. This could include bubbles and wands, sand, goop or some more of these sensory bin ideas. Another idea is to set up a nature table. You could even use a picnic table with a sand writing tray on top where users draw in the sand on the table surface.
Best Practice for Calm Down Corners
No matter what you call them: calm down corners, cozy corners, or sensory corners…and no matter where they are located: indoors or outdoors, in the home, or in the classroom, these sensory spaces are a valuable tool for promoting self-regulation and emotional well-being.
They provide a dedicated space for students to practice calming techniques and engage in activities that help them manage their emotions. Calming corners may include tools such as breathing exercises, visual aids with coping strategies, mindfulness activities, and calming sensory items like stress balls or visual timers…or any item that offers a sense of peace.
The key is to create an environment that is quiet, comfortable, and free from distractions, allowing students to recharge and regain focus when needed!
If you are setting up a calm down corner for your classroom as you gear up for a new school year, be sure to check out our resource on back-to-school sensory activities as an addition to your classroom calming area.
Heavy Work Activities for Calm Down Corners and Self-Regulation
Including heavy work in a calm-down corner can help children reset their bodies and minds during times of dysregulation. The resistance and pressure involved in heavy work helps to activate the proprioceptive system, which is known to reduce anxiety and improve self-regulation. Use our Heavy Work Activity Cards in your calm-down space to give kids structured, calming options they can choose independently.
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.
In this blog post we are covering all things vision impairment and occupational therapy. Visual Impairments such as convergence insufficiency, impaired visual saccades, or other visual problems like blurred vision can present as a problem in the classroom. Students with visual impairments will flourish with effective classroom accommodations for visual problems. Below, you will find strategies that school-based occupational therapists can use as accommodations for addressing visual needs while meeting educational goals.
Be sure to check out our resource on vision as a starting point.
Visual impairment can mean a lot of things. Basically, this is any vision disability where eyesight is impacted. Vision impairment is a term used to describe any reduction in a person’s ability to see that cannot be fully corrected with glasses, contact lenses, medication, or surgery. It can affect one or both eyes and may involve difficulty with visual acuity (clarity), visual fields (peripheral vision), or how the brain processes visual information.
Vision impairment includes a wide range of conditions, from mild vision loss to complete blindness. It can impact daily activities such as reading, writing, navigating environments, recognizing faces, or participating in school and work tasks. The World Health Organization defines vision impairment as a presenting visual acuity worse than 20/60 in the better eye, and blindness as worse than 20/400.
In occupational therapy, vision impairment is considered in the context of how it affects function, independence, and participation in meaningful activities.
Types of Visual Impairment
Occupational therapy works with an enormous variety of diagnoses and conditions. There can be many reasons for a visual difficulty. These can occur in childhood or at any age.
Here’s a list of diagnoses and eye conditions associated with visual impairment:
There are so many ways an occupational therapy professionals can help with vision needs. We have a full list with more examples below.
Adapt tasks and environments (contrast, lighting, positioning).
Use tactile, auditory, and kinesthetic compensatory strategies.
Incorporate vision-related goals into play, self-care, school, and leisure tasks.
Collaborate with vision specialists (e.g., Teachers of the Visually Impaired, Orientation & Mobility instructors).
Promote safe mobility through environmental modifications and task adaptations.
Build strength, balance, and core stability through play or movement-based interventions.
Support motor development with hands-on guidance and tactile cues.
Collaborate with physical therapists and orientation & mobility specialists as needed.
Encourage self-advocacy and confidence in movement through supportive, success-based activities.
Offer large print options
Work alongside a behavioral optometrist or vision rehabilitation professional like vision therapy
Training in various devices and supports in various environments
Work with a mobility specialist
Visual Impairment Accommodations for the Classroom
The fact is, vision impacts learning. When visual problems exist, it can be be helpful to next address what to do about those problems to maximize learning. Often times when vision is discussed as a concern, a parent or caregiver may push back saying that the child has had their vision checked, and that they can see fine. Despite education, and handouts, the parent still resists getting a more in-depth vision evaluation for their child. Now what? Good news is that there are some accommodations that can be made in the classroom to assist the child. These strategies are also great for kiddo’s who already have glasses but are still struggling.
What are accommodations for visual problems?
Accommodations are strategies set forth that allow a student to change the method of how learning happens. Accommodations for visual problems can address visual needs through changes in seating, presentation of visual information, test information, or classroom activities without modifying what is tested, completed, or taught.
The visual accommodations listed below are means for addressing visual problems without changing classroom expectations for learning.
Preferential Seating
Preferential seating means a lot of different things to every professional. Typically, it mean that the kiddo is placed at the front of the room, closest to the teacher where they can receive an increased level of support from the teacher. However, this is not necessarily the best for a child with vision deficits. There are a few keys points to preferential seating for kiddos with vision deficits that should be considered.
● Proximity to the board ● Direction in which the child is facing in relation to the board or main work area ● Level of visual distractions around the room including posters, boards and other children ● Is the goal of seat work and need for use of board to achieve completion of work?
Proximity to the Board
Being closest to the board is not necessarily the best position for a child facing vision challenges particularly if they are not acuity based in nature.
For instance, a child that is struggling with saccades and tracking may not succeed in a front and center position. This would challenge their eyes constantly to look in all directions for information. A better position for them would be to the left or to the right in the first 2-3 rows. This would limit the amount of tracking to either side that would need to be completed.
This position would also benefit a child with who struggles with filtering visual information and needs information to be limited on one side.
When recommending a seat based on proximity to the board, it is important to think about what challenges the kiddo is facing visually and to recommend a seat that promotes success.
Face the Front
Is the Child Facing the Board?
There are a lot of classroom set-ups these days that have children not facing the board or at an awkward angle. This is okay if the child is not expected to copy work from the board or utilize information from the main learning space.
When it doesn’t work, is when the child needs to utilize this information. It is best to have the child facing the board straight on or with a slight angle if they are not seated in the center. Limit turning of the head over 45 degrees to prevent eye strain and an increased chance of the child losing their place when copying.
There are times that it is appropriate to have the child’s back to the board and main learning space. I will get to that in just a moment.
Reduced Visual Distractions
Limiting visual distractions and over stimulation is a large part in helping kids with visual deficits. If there is too much information in front of them or around them, they are more likely to get lost visually, leading to more time needed to complete tasks and increases in errors when copying or missing written steps.
This is one of the few times that it is okay to have a child’s back to the board or main work area. Especially, if the child does not need to see the main area. Typically, this is the case for lower levels of education such as kindergarten through second grade, or when the curriculum begins to focus on board directed teaching.
Other ways to limit visual distractions are to keep the main learning space clear of extraneous posters, charts or decorations, along with conscious choices for seating the child. Having the child’s back to busy walls and a large portion of their peers can be helpful.
Most people think that windows are distractions for kiddos, but for a child with vision deficits, sitting near or facing a window can give a much needed visual “break” from stimulation. So don’t rule out a window seat yet!
Increased White Space
Worksheets can be very overwhelming for a child with a visual deficit. They may have a hard time reading a busy worksheet, completing a math worksheet or miss parts of multi-step directions.
One way to help avoid this is to provide increased white space. White space refers to the amount of blank or void areas on a piece of paper. The higher the amount of white space, they less likely a child with vision deficits is to struggle.
This means limiting the number of math problems on a page from 6 to 3 for example. Or utilizing the Handwriting Without Tears lined paper versus traditional triple lined paper.
Sometimes changing the handout or worksheet is not an option and other strategies need to be utilized. The use of an extra sheet of paper to block out extra information can be helpful in creating the white space that is needed.
Decreased Visual Distractions
I touched on this in preferential seating section in regards to the overall placement of the child in the room. However, visual distractions can also come from items in the child’s work space. Distractions may include name tags, behavior systems, letter lines, a peer across from them and even work to be completed. These visual distractions may cause the kiddo to feel visually unorganized leading to the appearance of sloppy work and poor time management, and even signs of anxiety.
One way to help eliminate visual distraction within the workspace is to limit what is on the child’s desk. Keep the kiddo’s work space limited to a name tag and one other item. If other items are needed on the desk or workspace, have them arranged so that they are not in the child’s direct line of sight while working.
For instance, crayon boxes and utensils may be shared at a table or grouping of students. Have the items place to the left or right of the child so that their direct line of sight is clear.
Also limit that amount of ‘work’ that is place in front of the kiddo. I say ‘work’ lightly as most ‘work’ for kids are worksheets and craft projects. By presenting one item at a time, it can help the child’s visual space remain clear and help them stay visually organized and on task.
Visual Structure for Reading and Writing
Sometimes limiting visual distractions is not enough support for visual organization. Sometimes, the child needs even more structure to support successful learning patterns and work completion.
One strategy is to provide the child with graph paper to write on. This is very structured and provides concrete boundaries for letter orientation, sizing, and spacing. It also provides visuals for completing math problems in straight lines.
Other forms of visual structure include colored lines to indicate top and bottom of the lines for writing, along with highlighted “spacer” lines for completion of longer work.
Color coding can also be a helpful tool in providing visual structure for older children. It be as general as a different colored folders/notebooks for each subject to allow the child to quickly scan and find what they need, to as complex as writing parts of a math equation in different colors. Or even going as far as to writing the parts of a paragraph in different colors.
Visual structure can be as simple, or as complex as it’s needed to be to meet the kiddo’s needs.
Each child is different and finding the right visual supports is a trial and error process that takes time and patience to work through. Evaluating the child’s weaknesses will help to determine the best supports and path for success in the classroom despite their visual challenges.
More resources that can help with understanding and advocating for visual impairments:
Now what? When vision problems are suspected after a screening by the OT, it is best practice to refer the family to a developmental optometrist.
A developmental optometrist will complete a full evaluation and determine the need for corrective lenses, vision therapy or a home program to address vision concerns.
As occupational therapists, it is imperative that we rule out vision problems before treating handwriting or delays in visual motor integration, to ensure the best possible trajectory of development and success for the child.
Occupational Therapy Vision Screening Tool
Occupational Therapists screen for visual problems in order to determine how they may impact functional tasks. Our newest Visual Screening Tool is a useful resource or identifying visual impairments. Visual screening can occur in the classroom setting, in inpatient settings, in outpatient therapy, and in early intervention or home care.
This visual screening tool was created by an occupational therapist and provides information on visual terms, frequently asked questions regarding visual problems, a variety of visual screening techniques, and other tools that therapists will find valuable in visual screenings.
This is a digital file. Upon purchase, you will be able to access the 10 page file and print off to use over and over again in vision screenings and in educating therapists, teachers, parents, and other child advocates or caregivers.
One thing about a visual impairment that we don’t often think of at first is the body awareness and orientation aspect. These areas can really impact functional skills, which our primary goal in occupational therapy.
There are other things we want to consider as well when we work with the child with a visual challenge. These items are listed below and they can be part of our evaluation as well as treatment interventions. We’ll want to add these factors to our documentation of therapy treatment sessions when we are offering our accommodations or rehabilitation services because each area listed might impact quality of life and life skills.
Because the school based OT helps with the child’s educational performance and participation, these are areas we should be aware of when creating treatment plans.
Peripheral vision
Vision loss or level of challenge
Visual acuity
Low vision and resulting needs
Visual fields
Visual tracking
Visual attention
Visual memory
Occupational therapy Evaluation for Visual Impairment
Occupational therapy plays a key role in supporting individuals with visual impairments by addressing how vision affects daily function and participation. When working with children or adults with visual impairments, OTs consider several key areas as part of an OT evaluation:
Visual Acuity
Clarity or sharpness of vision.
Affects reading, writing, recognizing faces, and seeing details in the environment.
Visual Fields
The entire area a person can see without moving their eyes or head.
Peripheral field loss can affect safety, mobility, and spatial awareness.
Visual Tracking (Oculomotor Skills)
The ability to follow a moving object or maintain focus on an object while the head moves.
Impacts reading fluency, copying from the board, and ball skills.
Visual Scanning
The ability to scan a space or environment efficiently.
Important for locating objects, navigating spaces, and reading.
Visual Attention
Focusing on relevant visual information while ignoring distractions.
Affects classroom performance, self-care routines, and task completion.
Visual Discrimination
Telling the difference between similar-looking objects, letters, or shapes.
Impacts handwriting, reading, and puzzles.
Visual Memory
Recalling visual information after seeing it.
Essential for spelling, following directions, and remembering routines.
Visual Figure-Ground
Distinguishing an object from a background.
Important for finding items in a cluttered space or reading text on a busy page.
Depth Perception
Understanding spatial relationships between objects.
Crucial for mobility, stairs, catching a ball, and pouring liquids.
Eye-Hand Coordination
Using visual input to guide fine motor tasks.
Affects handwriting, dressing, cutting, and feeding.
Visual Motor Integration
Coordinating visual perceptual skills with motor output.
Impacts drawing, writing, and tool use.
Occupational therapy plays a key role in supporting individuals with visual impairments by addressing how vision affects daily function and participation. When working with children or adults with visual impairments, OTs consider several key areas:
1. Visual Acuity
Clarity or sharpness of vision.
Affects reading, writing, recognizing faces, and seeing details in the environment.
2. Visual Fields
The entire area a person can see without moving their eyes or head.
Peripheral field loss can affect safety, mobility, and spatial awareness.
3. Visual Tracking (Oculomotor Skills)
The ability to follow a moving object or maintain focus on an object while the head moves.
Impacts reading fluency, copying from the board, and ball skills.
4. Visual Scanning
The ability to scan a space or environment efficiently.
Important for locating objects, navigating spaces, and reading.
5. Visual Attention
Focusing on relevant visual information while ignoring distractions.
Affects classroom performance, self-care routines, and task completion.
6. Visual Discrimination
Telling the difference between similar-looking objects, letters, or shapes.
Impacts handwriting, reading, and puzzles.
7. Visual Memory
Recalling visual information after seeing it.
Essential for spelling, following directions, and remembering routines.
8. Visual Figure-Ground
Distinguishing an object from a background.
Important for finding items in a cluttered space or reading text on a busy page.
9. Depth Perception
Understanding spatial relationships between objects.
Crucial for mobility, stairs, catching a ball, and pouring liquids.
10. Eye-Hand Coordination
Using visual input to guide fine motor tasks.
Affects handwriting, dressing, cutting, and feeding.
11. Visual Motor Integration
Coordinating visual perceptual skills with motor output.
Impacts drawing, writing, and tool use.
OT Considerations
Adapt tasks and environments (contrast, lighting, positioning).
Use tactile, auditory, and kinesthetic compensatory strategies.
Incorporate vision-related goals into play, self-care, school, and leisure tasks.
Collaborate with vision specialists (e.g., Teachers of the Visually Impaired, Orientation & Mobility instructors).
In addition to sensory processing and perceptual aspects, visual impairments often come with physical challenges that occupational therapists must consider. These physical issues can impact mobility, posture, coordination, and overall independence. Here are key physical areas related to visual impairment that OTs address:
Postural Control and Stability
Children or adults with visual impairment may adopt compensatory postures (e.g., tilting the head, leaning forward) to optimize remaining vision.
Poor postural control can affect sitting balance, endurance, and core strength, limiting participation in seated tasks like handwriting or meals.
Gait and Mobility
Visual impairment may lead to cautious, unsteady walking, wider stance, or shuffling.
Individuals may avoid movement altogether due to fear of falling, leading to decreased physical activity and muscle weakness.
Balance and Vestibular Integration
The visual system plays a large role in maintaining balance.
Without reliable visual input, individuals rely more heavily on vestibular and proprioceptive systems, which can be underdeveloped or dysregulated.
Motor Planning (Praxis)
Difficulty visualizing actions before performing them can lead to trouble with sequencing, initiating, or completing motor tasks.
This affects dressing, navigating environments, and tool use (like scissors or utensils).
Spatial Orientation and Body Awareness
Visual cues help us understand where we are in space and how to move around obstacles.
Visual impairment can lead to reduced spatial judgment, making tasks like reaching, climbing, or navigating stairs more difficult.
Delays in Gross and Fine Motor Skills
Infants and young children with visual impairments may miss out on visually-motivated movement (e.g., reaching, crawling, walking), leading to motor delays.
Fine motor skill development can also be impacted due to limited visual feedback.
Fatigue and Overuse
Individuals with visual impairments may experience increased fatigue due to constant physical and cognitive effort to compensate.
Overuse injuries (especially in the neck, shoulders, and hands) can result from repetitive adaptive strategies (e.g., leaning, squinting, using mobility aids).
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.
