Colleen Beck OTR/L

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

Independence with Dressing Skills

September 21, 2023April 20, 2016 by Colleen Beck OTR/L

dressing skills for occupational therapy

Here we are covering dressing skills as an ADL that are used in occupational therapy dressing interventions, as well as dressing skills for preschoolers and all ages, specifically the underlying fine motor skills needed for dressing skills.

These self-dressing skills are typically initiated in the toddler years, however if a toddler has little to no awareness or regression in these skills, a look at toddler behavior red flags may be in order. Self-dressing is part of child development at this stage. Let’s cover this in greater detail…

Dressing skills

“I can do it myself!”

It’s a phrase that most parents hear at one time or another as their child begins to develop the skills needed for independence in self-care. Sometimes, however, there are factors that interfere with appropriate development of function.

Parents may wonder when their child will begin to pull on their shirt or don shoes and socks with independence. The ability to dress one’s self with independence requires the development of many fine motor skills.

This month in the Functional Skills for Kids series, we are exploring Dressing as an activity of daily living. Stop by to see all of the posts in the series here.

Fine motor skills needed for independence with dressing. Kids and parents will like these ideas to build independence. Part of the Functional Skills for kids series by Occupational Therapy and Physical Therapy bloggers.

Dressing Skills that Require Fine Motor Skills

Pulling on socks, managing buckles, and tugging on a hat. There are many portions of self-dressing that require fine motor skill development;

Pulling socks off requires a pinch grip, strength in the hands, and bilateral coordination.
Putting socks on requires arch development, opposition of the thumb, intrinsic hand strength, bilateral coordination, wrist extension and ulnar deviation.
Pulling pants up requires eye-hand coordination, bilateral coordination, and wrist and hand stability.
Fastening snaps and pulling up zippers on pants (Clothing fasteners will be addressed in another month’s topic)
Donning and doffing undergarments requires pinch grasp
Threading a belt through belt loops requires bilateral coordination, prehension grasp, pincer/tripod/functional grasp and wrist positioning
Fastening a belt buckle requires tripod grasp and bilateral coordination, hand dominance or preference, extended wrist and ulnar deviation.
Donning and doffing a shirt requires bilateral coordination, crossing midline, extrinsic and intrinsic muscle strength of the hands, and forearm supination and pronation.
Donning an doffing a coat requires bilateral coordination, crossing midline, extrinsic and intrinsic muscle strength of the hands, and forearm supination and pronation.
Clothing fasteners such as buttons, zippers, snaps, buckles, and ties require intrinsic and extrinsic muscle strength, prehension grasp, in-hand manipulation, hand preference and bilateral control and eye-hand coordination.
Pulling on boots requires a hook grasp of the hand, strength, and proximal stability.
Donning a winter cap requires precision grasp, bilateral coordination, and motor planning.
Shoe tying and one handed shoe tying require motor planning, visual perception, fine motor skills, balance, and more.

If it seems as though every step of dressing requires fine motor skill development, that is because it’s true! Each step of each dressing task requires many fine motor skills.

Fine Motor Manipulation Skills that are Necessary Independent Dressing

Let’s break down these fine motor skills a bit to see how they are helping a child complete tasks independently.

Fine Motor Skills Needed in Dressing:

Extrinsic Muscle Strength: The extrinsic muscles move the fingers and thumb in full flexion and extension. They enable a power grasp on functional items. The extrinsic muscles are essential for cohesive work alongside the intrinsic muscles of the hands during dynamic grasp patterns.
Intrinsic Muscle Strength: The intrinsics allow us to use graded movements, shape the arches of the hands, and enable dexterity and precision. They control the flexion and extension of the Metacarpophalandeal joints and power movements such as finger adduction, finger abduction, thumb abduction, thumb adduction, thumb flexion and thumb opposition.
Prehension: There are three types of prehension grasps-static grips, gravity dependent grips, and dynamic grips.
In-Hand Manipulation: This fine motor skill typically develops around two years of age. Between 2-3 the child progresses in palm-finger translation and shift. However, at this age, they may prefer to manipulate objects between two hands instead of within one. Read more about in-hand manipulation skills here.
Hand Preference and Bilateral Control: From the age of 2-3, a child will switch hands to avoid crossing the midline, They may show use of a preferred hand, but it may switch between activities.
Eye-Hand Coordination: Eye-Hand Coordination is accuracy of reach and control of the arm in space, guided by vision. During dressing tasks or any functional skill, the reach should be accurate and controlled, and directed by the shoulder’s stability and mobility. In reaching for items, the hands and eyes should work together with smooth visual tracking of the hand and with the eyes guiding the hand.
Precision of Release: There should not be immature releasing patterns noted during dressing tasks. These might include flinging or dropping objects. Rather, the child should be able to release items while their arm is positioned in space and with controlled motions. Read more about precision of release.
Motor Planning: During functional tasks, there should be coordinated movements with appropriate positioning and posturing. Read more about motor planning here.
Separation of the Two Sides of the Hand: Separation of the two sides of the hand allows for stability and power with precision of the thumb, pointer finger, and middle finger.

Biomechanical Postural Control in self-dressing

Before the fine motor skills can be used in functional tasks, such as dressing, there are biomechanical skills that are prerequisite.

These are proximal stability skills that enable distal precision and control.

Postural Control– Proximal to the arm is the upper body. Postural instability will effect the use of the forearm, wrist, hand, and fingers and complicate the motor planning and use of the hands in functional reach. When we reach with two hands, we shift our weight and move our body’s center of gravity. Without dynamic control of one’s posture, shifts in weight will result in over or under reach of distal motions.
Shoulder stability with motion– Fine motor use of the hands requires stability of the shoulder joint. The joint needs to maintain stability even during motion and in all planes for controlled arm positioning.
Control of the forearm– The arm between the elbow and wrist moves in supinated and pronated motions. Supination is essential for many precision tasks and allows us to see what our fingers are doing in tool or fastener use. Pronation is typically used for power grasps and hook grasps in functional tasks.
Wrist Position– A functional wrist position is essential for precision grasp and manipulation. Extension of the wrist controls the length of the finger flexor muscles to an optimal position for grasp and precision. Positioning the wrist in 40 degrees of wrist extension allows for efficient muscle function. The wrist also moves with radial and ulnar deviation. A position of 15 degrees of ulnar deviation promotes stability and force in the ulnar side of the hand.
Palmer Arches- While palmer arch development is a component of fine motor skill development in itself, it is also a proximal stability source for precision of the distal fingers. Appropriate arch development provides positioning and stability to allow for fine motor dexterity of the fingers.

Tips to Promote Independence in Dressing Skills

When fine motor skills are the problem area behind decreased independence in self-dressing, it is helpful to build individual skills.

Children should be provided with many repetitions of self-care skills in environments where dressing tasks are happening naturally.

Dressing practice happens at the beginning and end of the day but there are many opportunities for working on the fine motor skills needed in dressing tasks.
Donning shoes and socks can happen before going outdoors and when coming into the home.
Toileting is a way to practice lower body clothing management throughout the day.
Children can further build independence with dressing through pretend play by using dress-up clothes.
Repetition can be a strategy for increasing opportunities for practice.
Provide various dress-up clothes in different social roles for many ways to practice dressing skills.
Encourage role play as a technique to build fine motor skills in dressing: Children can dress a baby doll.
Provide alternate opportunities to practice fine motor skills needed for dressing such as toys to help kids practice dressing skills.

Fine motor skills needed for independence with dressing. Kids and parents will like these ideas to build independence.

Develop fine motor skills needed for functional tasks with these activities:

Gross Grasp Activities

In-Hand Manipulation Activities

Motor Planning Activities

Open Thumb Web Space Activities

Hand Dominance Activities

Grip Pattern Activities

Precision of Grasp and Release Activities

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.

Tangrams and Visual Perception in Handwriting

October 20, 2024April 19, 2016 by Colleen Beck OTR/L

I kind of love to share tricks for improving handwriting. There are so many “parts” to written work. There’s fine motor dexterity, pencil grasp, strength, endurance, visual perceptual skills, cognitive skills among other parts to handwriting. You can see more about these topics on our Handwriting page. One big way to develop the skills needed in written work is to address visual perception.

Kids love to play. It’s in their soul. Play is the primary occupation of a child and so it only makes sense to work on functional skills like handwriting though play. Practicing writing over and over again sounds pretty boring to me and I can bet that any kiddo will agree. Today’s activities are designed to work on the visual perceptual skills needed for handwriting using tangrams.

Get ready to play and build your way to neater handwriting!

Work on handwriting skills using tangrams to address the visual perception skills needed for written work.

This post contains affiliate links.

Visual Perception and Tangram Activities

If you’re looking for fun ways to work on handwriting, these activities are the way to go. I’ve come up with creative puzzles, drawing activities, and building challenges that will work on all of the skills needed for improving line awareness, letter formation, and neatness in written work.

Our Melissa and Dough tangram set is used a lot in our house. It’s a great open-ended toy that doubles as a therapy tool for building skills such as eye-hand coordination.

RELATED IDEA: Try DIY Sponge Tangrams for these hands-on learning activities.

We created these file folder activities using the tangrams and came up with activities that will work on all of the areas of written work. Building skills like Position in Space and Visual Discrimination are important when it comes to improving neatness in written work.

We printed off some worksheets and attached them to a file folder with paper clips. I set out the tangram shapes and showed my kindergartner and preschooler how to copy the forms. While they built shapes, they were developing and refining skills like Eye-Hand Coordination and Sequential Memory.

We set up a few different activities using the file folder station. It’s a nice activities because all of the pages can be attached to the same file folder using the paper clips. The pages can be rotated out and more complex sheets added in. When you’re done, simply close the file folder and slip it away with the tangram box to play another day.

Visual Perceptual Skills and Handwriting

This activity workbook has information on all of the visual perceptual areas necessary for written work:

Visual Spatial Relations
Visual Discrimination
Visual Figure Ground
Form Constancy
Visual Memory
Eye-Hand Coordination
Sequential Memory
Visual Closure

It’s available in our Shop for $6.

All printable sheets in the workbook were created with design creation tools (The handdrawn examples in the images in this post are just a mock-up for a visual example of the activity.)

Looking for more ways to learn and play with Tangrams? Try these:

Pattern Matching Race from Learning 2 Walk
Pattern Block Pattern Trains from The Kindergarten Connection
Reading Games with Pattern Blocks from Books and Giggles
Tangrams and Visual Perception in Handwriting from Sugar Aunt
Pattern Block BINGO with Printable Mats from School Time Snippets
DIY Sponge Tangrams

Read about the Visual Perception, Tangrams, & Handwriting Workbook

Improve Handwriting with Art

July 11, 2019April 15, 2016 by Colleen Beck OTR/L

There are some kids out there who absolutely HATE handwriting. Let me re-phase that. There are a ton of kids who completely despise to their core the act of working neat handwriting, pencil grasp, slowing down so people can read their words, and writing on the lines. A ton. I’ve worked with many (many!) kids like this. I’ve recommended fun activities to about a zillion parents and teachers of these kiddos. It just isn’t fun and it is work for them. Poor handwriting can result from so many factors: fine motor development, motor planning, visual perceptual skills, and attention, are just a few of the areas that interfere with neatness in written work.

So how do you possibly get through to build those areas up when the child is resistant to pick up a pencil and copy written work?

You make it completely NOT handwriting practice.

I’ve got a super creative way to sneak in skills like pencil control, line awareness, spatial awareness, and letter formation. And kids won’t realize they are building their ability to write on lines, space between words, and form letters the correct size. And it all uses art!

Work on handwriting skills like line awareness, letter formation, pencil control, spatial awareness, and bilateral coordination with tangle art!

Work on Handwriting with Tangle Art

Affiliate links are present in this blog post.

I was lucky enough to snag a copy of my friend Jeanette’s new art book, Tangle Art Drawing Games for Kids: A Silly Book for Creative and Visual Thinking. This book is completely creative with easy and fun ways to get arty. I flipped through the book and loved every single project. They are no-prep art ideas that require only a pen and paper for most of the ideas. You could do every project in the book and then go back to the beginning and re-do them all and still be inspired to create new and fun art.

Seriously, the new favorrite book in our house is Tangle Art Drawing Games for Kids: A Silly Book for Creative and Visual Thinking!

One project in the book drew me in when i saw it. Ice pop stick tangle art is the perfect workout to build the skills needed for neatness in handwriting while creating fun art.

We followed the directions in the book to make shapes using craft sticks. Just tracing the craft sticks is a great way to work on bilateral coordination. When a child writes, it is essential that they hold the paper with their non-dominant hand. Then need to stabilize the paper in order for the pencil to glide across the page.

Just try writing without holding the pencil and you will notice a difference in neatness. This small task is often one that slides when kids loose attention in a handwriting task. You might see them slouch over at their desk and write without holding the paper.

Tracing those craft sticks is a nice way to physically attend to the bilateral coordination needed in handwriting tasks.

We used both the jumbo-sized craft sticks and the regular size to build more pencil control. Use a sharpie marker to get a thicker line for building line awareness.

After you’ve got your shapes on the paper, hand over a bunch of brightly colored fine point markers. You can do some tangle art that is described in Tangle Art Drawing Games for Kids: A Silly Book for Creative and Visual Thinking or you can make letters and numbers in the craft stick shapes. Try adding color to a section and then make shapes and letters in the color.

It is fun for kids to make hidden messages in the shapes by spelling out a name or word with all of the letters.

If your kiddo is VERY anti-letters, try working on spatial awareness and pencil control by practicing the writing strokes needed for letter formation. Instruct them to make counter clockwise circles close to one another, diagonal lines, horizontal and vertical lines, and mountain shapes.

Encourage them to use those fine point markers to write very closely spaced lines. We also tried a few cursive line formations.

For the younger crowd, this activity is great for pre-writing skills, too. Coloring in the shapes encourages the motor skills needed to move the pencil in handwriting.

Now go off and make art while working on handwriting! Don’t forget to grab your copy of Tangle Art Drawing Games for Kids: A Silly Book for Creative and Visual Thinking! You will love it!!

Visual Closure Activity Bugs Theme

February 17, 2023April 14, 2016 by Colleen Beck OTR/L

There is a lot that goes into reading and writing. One of the skills that makes up the ability to read words and form letters in handwriting tasks with fluency is visual closure. Visual Closure is the ability of the eyes to visualize a complete image or object when only a portion is seen. A child can see just part of a letter or number when reading and recognize how to write that figure. They can read a word or sentence without focusing on each letter and how it is made. Visual Closure is an essential skill for reading with fluency. It’s necessary for written work to happen without concentrating on each letter’s lines and curves. Visual Closure allows us to comprehend words and letters without actively assessing each line.

Children with difficulties in visual closure may have trouble completing mazes, puzzles, or worksheets. They might have difficulty identifying items that are partially obscured by other items, such as finding a serving spoon hidden in a draw full of items. They might have difficulty with spelling or math tasks or concepts.

Visual Closure Worksheets

This post contains affiliate links.

These visual closure worksheets can help work on the skills needed to develop visual closure. You can get these worksheets as a FREE resource if you join our newsletter subscriber list. These worksheets and tons others are included in our subscriber-only library.

To use these visual closure worksheets: Match up the bug on the left with the bug on the right. We used yarn to complete the match so that we could re-use this sheet. You could also laminate these to re-use.

For the second worksheet, match up the broken bug image with the rotated bugs. Have your child circle the bug that matches the broken bug exactly.

Looking for more bug activities? Try these:

Looking for more visual perception activities for kids? Try these:

Create your own race track

Benefits of Stickers in Occupational Therapy

Visual Tracking with Cardboard Tubes

Second Grade Math Outdoor Learning Idea

August 11, 2022April 13, 2016 by Colleen Beck OTR/L

There is nothing like learning in the great outdoors. The breeze in your hair, the birds tweeting, and bugs getting involved in the outdoor classroom. Learning outside with the kids is a fun twist on the everyday math homework! We love to spend time outdoors. And, I love to sneak learning activities into our play. This Math Scavenger Hunt idea was a fun way to practice second grade math concepts like adding and subtracting two digit numbers. Our math rocks made this move and learn activity extra fun.

We’ve shared quite a few outdoor learning activities on the blog before. The favorite in our back yard was this pre-reading literacy activity. We even used a few of the same hiding places for today’s math activity.