Following directions can mean a lot of things. Following commands, making something, or getting somewhere. Today we are going to focus on directional concepts. Directionality is the ability to understand and use information related to direction and space. This includes understanding concepts like left/right, up/down, in front of/behind, above/below, inside/outside, etc. Thankfully, we are not going to cover things like, “turn west out of the parking lot,” because no one understands that anyway. There is a relationship to body awareness and proprioception at stake here, too.
The reason we need to worry about this in therapy sessions is that the a spatial relations concepts are very important to functional tasks.
We will take a look at following directions, direction signs and words, body in space to find your way and activities to help enhance directional concepts.
What are DIRECTIONAL CONCEPTS
You may have recently seen our post on left right discrimination. Directional concepts take it one step further.
Not only do you need to know left from right, but behind, in front, before, after, beside, inside, and dozens more. Coincidentally, many of the directional words are prepositions (or many prepositions are directional words). These are spatial relations words like:
over/under
left/right
above/below
east/west
in front/behind
near/far
These words are important to direction following.
Popular singer Jack Hartman has a catchy preposition song. There are lots of songs about directional concepts on youtube if that is your preferred method of teaching.
In occupational therapy, we use play to support development of skills. It’s an easy tool to help kids understand spatial relations concepts.
How to Work on Directional Concepts Through Play
Occupational therapy and play go hand in hand. It is the primary role of the child, after all. Luckily, we can use play as a tool to support development of skills like directional concepts at any age.
The best way to learn is by doing. Getting kids up and moving is a great way to teach directional concepts. Kids can memorize prepositions and direction words all day long, but they will learn faster by engaging in movement activities.
Use a stuffed animal or toys for following directions – ask students to put their bear on the table, behind the plant, below a chair, etc.
Body movement – kids can work on directionality by following commands. Say things like jump on the bed, jump off the bed, go around the trash can, crawl under the table. As they move their body, your learners will make a connection with the word and action
Obstacle course – create a course in your clinic/class/home for learners to follow. Give verbal, picture, or demonstration instructions. They can be: go around the table, then under the chair, then over the yellow mat, through the tunnel, up the slide, etc.
Simon Says – this classic game is all about giving and following directions. Simon says touch your left hand to your right ear. Travel west across the room (just kidding). Put your left leg in front of you. Directions can be as simple or complex as your learners can handle
Relay races – these can combine obstacle courses and Simon Says commands all in one
Hula hoop games – use a hula hoop as a prop for following directions. Put one foot in the hoop. Put the hoop over your head. Stand behind the hoop
Hokey Pokey – this classic song is a great practice for in/out, left/right, and body parts
Line dance songs – the Cha Cha Slide, Cupid Shuffle, and several other line dance songs combine several different directions in the song. These fast paced songs not only get kids moving, but they learn to follow directions while having fun
Teaching directional concepts is important for kids.
MORE WAYS TO TEACH DIRECTIONAL CONCEPTS
Beyond getting up and moving, here are some tricks to teaching directional concepts:
Teach in opposites – we already reviewed left and right, but how about up/down, on/off, in front/behind, before/after
Use visual cues – pictures help learners associate an action with words. Look at books, picture cards, signs, or videos.
Positional songs – singing helps language development, increase memory, and understand concepts. Help your young learners master positional/directional words with these circle time songs that your students will love! This resource is packed with simple, memorable songs (set to childhood tunes you probably already know) that will capture the attention of your students and keep them engaged and learning. You’ll find headers, posters, and printables, too, to help you teach the important early childhood topic of spatial relations!
Task boxes – simple task boxes are a great visual hands-on method of teaching concepts. Make laminated cards and use clothespins or clips to match the concept with the word.
Interactive books are another great way to teach directional concepts.
Chunking – teach in small chunks instead of lots of concepts all at once. For example, maybe one week you work on up and down, incorporating many activities for these two words in isolation.
Barrier games – this is a great concept for learning directional concepts. Students can work in pairs, or you can have an adult work with each learner. Students sit across from each other with a barrier between them. Each player has the same items. The students take turns giving the other player very specific directions (per ability level) on how to arrange the materials in front of them. The goal of the game is to have all the players’ materials look the same at the end of the activity.
Mental Blox (Amazon affiliate link)- this is a great game. One of the sub games in it is giving and following directions. Instead of students copying the card, give them directions to make their design without seeing the card. Then they can try and teach the concepts to you or another student.
Writing on a vertical surface or slant board – I recently wrote a post on the benefits of writing on a vertical surface. One of them was understanding concepts of up and down better. If you think about it, “up” makes more sense on a wall than a flat piece of paper
Another tool to have in your therapy toolbox is a variety of movement and spatial relations worksheets like we have inside The OT Toolbox membership club.
WORKSHEETS AND PAPER PENCIL GAME FOR DIRECTIONAL CONCEPTS
A great way to round off your lessons on directional concepts and following directions, is to put pencil to paper. Writing things down can help with muscle memory and understanding.
After all this research, I am inspired into adding new activities to my toolbox. I have a better understanding of what directional concepts mean, and how to facilitate learning. I still need someone to explain what “turn west out of the parking lot means.”
It’s important to recognize that when we tell our students a direction, there might be directional challenges at play that impact functioning skills.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
One way to develop executive functioning skills that is very practical is by combining chores and executive functioning skills. Engaging in chores can be an effective learning tool for young people. In a recent post we highlighted Age-Appropriate Chores, demonstrating which chores are appropriate for certain aged children. Today we are going to focus on chores and executive functioning skills. Engaging in chores can be a great way for teens to work on their executive functioning skills. We wanted to highlight how chores foster executive functioning skills in teens. Insert your email address in the field below to receive your free handout.
Check out our resource on IADLs because this is a good place to start when it comes to doing those “chore” tasks that we all need to do to live functioning lives.
What are executive functioning skills?
Executive function refers to a cognitive process that helps with planning, initiation of tasks, organizing, managing time, problem solving, and self-regulation. Many adults and teens with ADHD have difficulty with executive dysfunction. This translates into weak prioritization skills, time blindness, and an inability to orchestrate concurrent tasks.
This is all critical for managing daily life, and even the simplest of tasks. Check out this post on Executive Function Disorder.
CHORES AND EXECUTIVE FUNCTIONING SKILLS
To make it easier to understand the role of chores and executive functioning skills, we can break EF down into the components, and analyze how chores can foster these skills.
When working on chores and executive functioning skills, think about how difficult task initiation can be.
Many people, not just teens have difficulty with task initiation and follow-through. Here is one of my previous posts on Task Initiation Strategies. This information can easily carry over to teens. In this article on how to teach task initiation, you can explore how to teach task initiation to children and teens who need their strategies a little more play based.
Procrastinators in particular struggle with task initiation. Sometimes getting started is the hardest part. Having a list of chores and responsibilities helps foster task-initiation when there are deadlines and expectations involved. You can help your teen by setting realistic goals, helping them break the task down into chunks if needed, create visuals or lists, and do specific task teaching. Our resource on breaking down goals is a great place to start with this strategy.
For an example, you can look at the task of sweeping a floor. To help with task initiation, you might:
First remove things from the floor like furniture or other items.
Next, get the broom and dustpan.
Then, you can divide the room into smaller sections to do one section at a time.
Just getting started is the biggest hurdle for many people. So, having some planning and organization processes in place can help to get this chore done.
PLANNING in Chores
Planning for chores is another executive functioning skill necessary for success. Sometimes planning for a chore can be the hardest part. People do not know where to begin. Help them by providing, or encouraging them to make checklists of supplies, steps involved, and the standards they need to meet. For example, when it comes to sweeping a floor, you can break down the task and make sure that there are certain steps that are met before you move onto the next step…
Going back to our sweeping the floor example, you can plan to sweep every Monday, Wednesday, Friday, and Saturday.
Part of planning and executive functioning may be preparing for “what ifs” and obstacles. A sudden obstacle can derail any task, making it difficult for you to complete the task. When planning, try and talk through any obstacles that might come about when completing a certain chore.
Example: Vacuuming – what if you go into a room and there is stuff all over the floor? What if you get so far and the cord will not reach? Do you know how to empty the vacuum if it gets full? How are you going to manage your time if you want to vacuum and someone does not want to be disturbed?
With our sweeping the floor example, another part of problem solving is remembering which areas of the floor have already been swept and which areas still need attention.
TIME MANAGEMENT and Chores
My article on procrastination highlighted the reasons people procrastinate and the downfall of putting off tasks. Some people suffer from time blindness. They have no sense of how much time has elapsed. People who tend to procrastinate or be time blind, can benefit from timers, setting enough time aside for the task, and limiting multi-tasking.
Chores are a great way to practice time management. Help your teen determine how much time the task should take, and when they should get started/finished. Practicing chores has more leeway than your boss might, in terms of timelines and workload.
With our sweeping a floor example, we might want to set a timer. We can also determine what is an appropriate amount of time to thoroughly sweep the floor without taking too long or rushing. You might want to use an app like a Pomodoro app that counts down time.
ATTENTION TO DETAIL in chores
Above, I mentioned quality control standards. If you live with a teenager, you know this is a big one. People tend to rush through tasks just to get done. They miss a lot of the key details when completing tasks. Doing chores requires attention skills!
Attention to detail is an executive functioning task not to be missed. This may take some demonstration as your teen’s “good enough” might not meet your standards. These can be part of your planning checklist as they go through the steps to complete the task.
Example: Cleaning the bathroom: highlight all the areas that need to be cleaned. Demonstrate what “clean” means, and how they will know something is clean. Point out things like spittle around the sink, dirt around the toilet bowl, and dust bunnies in the corners.
You can play quality inspector when rewarding for a completed chore. At first, expect some mistakes, and some things you will have to go over after they have finished. What grade did they get, and how does the pay out work? $1.00 for a grade A job, $.80 for B work, $.60 for a C, etc. Be sure to give the reasons for your grade so your learner can make adjustments the next time.
With our floor sweeping example, this might look like staying focused on the task, avoiding distractions like phones or interruptions. We might want to set a short term goal to continue to sweep even if the task is repetitive or tedious, and aim for a clean floor.
SELF REGULATION and chores
Being responsible for chores can help build the executive functioning skill of self-regulation. Learners need to manage their emotions, deal with distractions, and ignore the impulse to cut corners. Help your teen identify their emotions such as fear of failure, perfectionism, or overwhelm, and talk though them. Imagine what advice you would give a friend instead of your child. Recognize their emotional barriers.
Some other self-regulation skills that chores can build are:
work tolerance
frustration tolerance
taking turns
sharing (responsibilities and jobs)
working together
working independently
emotional regulation
Another way to build executive function through self-regulation is to help your child practice autonomy. Teach them to advocate for themselves when they reach a road block they can not solve. Better yet, encourage them to work hard to problem solve by themselves. Try giving limited instructions after the initial trials to build independent thinking and follow through.
For our sweeping the floor example, self-regulation might look like; Managing frustration if floor debris or dirt is difficult to gather or if the debris scatters when sweeping it into the dust pan. The goal is to stay calm to complete the task efficiently.
FLEXIBILITY AND ADAPTABILITY in chores
Some people are more mentally flexible than others. Routine has its place, however, mixing things up helps build adaptability. Once your teen has mastered one chore, start them on something new. Throw in some obstacles that will need to be problem solved (like encountering a messy room, or running out of cleaning supplies).
Doing chores allows great opportunities for flexibility. What might happen if you run out of toilet cleaner? Is there something else you can use, or does the task have to be put on hold? Chores offer chances to adapt without significant consequences – the dishwasher will not explode if the dishes are delayed by 15 minutes.
SELF REFLECTION AND self ASSESSMENT in chores
After the chore is finished (and maybe before you give your grade on how completely the chore was done), ask your teenager to assess their work. There is going to be a tricky balance between praising them for a job well done and pointing out flaws.
Direct them back to the checklist to review if all the steps were completed. Ask about their time management, attention to detail, planning, level of independence, problem solving and self-regulation to help them reflect.
For our sweeping the floor example, this means the individual has to continuously checking the cleanliness of the floor and ensuring no spots are missed. It helps to teach them to evaluate the thoroughness of the task…and this skill carries over to every chore, too!
How to Work on Executive Functioning Skills with Chores
Chores are a life skill that needs to be done. It’s a tool and a means for supporting executive functioning skills.
Here are some tips to help with doing chores even when executive functioning skills are a challenge…because doing the chores is a great way to actually work on those cognitive skills that then carry over to so many other areas of life.
Make a to-do list of chores that need to be done each day.
Use an app to help with chore lists
Make a routine that has you doing certain chores on certain days of the week. For example, clean your room on Saturday. Take out the trash on Tuesday night. Sweep Monday, Wednesday, Friday. Do laundry on Sunday. Then, you have one chore to do on certain days. This can really help to get those tasks done.
Have a plan. Include chores in your weekly routine and weekly lists, included with other tasks like schoolwork, jobs, activities, etc. You can even set a timer in your phone for the day of the week and the time that you will do certain chores.
Stack chores- This basically means you do two related things at one time and then try to make that part of your routine. Maybe you run the water in the kitchen sink to do the dishes and you wipe off the counters while the sink is filling up.
Try a visual reward chart. There are many different types and you can adjust this to meet the needs and the level (age) of the individual. Even adults can see progress on a reward chart that is as simple as crossing tasks off a list.
Set a timer. Pick the amount of time you want to spend on a task and then set a timer. See if you can get it done by the time the timer goes off. This helps with task completion and sustained attention.
Put the phone away. This one is huge! When you have a certain task to do like folding laundry, it can be easy to have your phone on with a video playing as you fold. However, before you know it, you’re sucked into a video and the folding isn’t happening. Put the phone away until the task is done and then maybe use the video watching as a reward once the task is completed.
Focus on accomplishments. I love this strategy for doing chores even when executive functioning skills are a struggle. This just means that you try to identify the benefits of actually having the chore done and accomplished. Maybe you really dread cleaning out the dishwasher. It’s a terrible task, right? So boring and monotonous. But if the dishwasher is cleared out, what does that mean? You will have a clean counter because you can put dirty dishes into the dishwasher. You can have clean utensils and plates to eat from. Basically, you want to list out as many positive benefits of actually doing the task that you can think of. It will feel so good to actually get this job done! This strategy can help you to push past the resistance. Especially when you do this automatically. The more you focus on the benefits, the more natural this process becomes.
Another tactic for doing chores even when executive functioning skills are a struggle is to take a look at how you spend your time. Use a calendar or an app and track how you spending time. How much time to you actually spend doing daily chores and how much time is spent on social media or on your phone? Seeing those actual numbers or actual blocks of time marked off can help you to see the chunks of time that ar available or are wasted.
These are chores you can use to improve executive functioning skills.
Chores that Develop Executive Functioning Skills
Here’s a list of chores that can help develop executive functioning skills, with an emphasis on different cognitive skills that make up executive functioning:
Sorting Laundry
Executive Functioning Skills: Planning, organization, working memory
Kids must sort clothes by color, size, or type and plan out washing cycles (e.g., whites, colors).
There are several steps to the task of laundry, so this can be a challenge for some to do the whole process. Start with just one piece, like sorting laundry. Then add washing. Then drying. Then folding. Then putting away clean laundry.
Completing multiple steps in a sequence (pulling sheets, arranging pillows) helps build initiation and persistence. I don’t know about you but making a bed is a good chore for self-regulation skills, too. It’s frustrating to get those sheets just right!
Setting the Table
Executive Functioning Skills: Planning, organization, working memory
Remembering which utensils and items go where, organizing the table, and making sure all of the settings are complete.
Deciding where to start, organizing items, and maintaining focus until the room is tidy.
Washing Dishes
Executive Functioning Skills: Task initiation, time management, sustained attention
Beginning the task promptly, maintaining focus until all dishes are washed, and managing time effectively. Then there is the drying of dishes and then putting away clean dishes.
Taking Out the Trash
Executive Functioning Skills: Task initiation, working memory, time management
Remembering to do this regularly and making sure the trash is disposed of in the correct location. This one is important because if trash isn’t taken out in time for the trash pick up, you’ll have trash building up around the home.
Managing time to ensure thoroughness and checking to ensure all smudges are gone.
Organizing a Backpack or School Supplies
Executive Functioning Skills: Planning, organization, working memory
Making sure all of the needed materials are included, packed in an organized way, and nothing is forgotten.
Emptying the Dishwasher
Executive Functioning Skills: Task initiation, sustained attention, working memory
Remembering where each item goes and staying focused until all dishes are put away properly.
In The OT Toolbox membership, we have a bunch of executive functioning resources for doing chores.
Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.
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Teachers Pay Teachers has some great resources on teaching chores, creating a lesson plan, and documenting progress.
Life skills cards – This set of 10 pages of Life Skills Cards help break down functional skills and measure them. Some goals such as “improve self help skills” are broad, and often overwhelming. These life skills cards help break a large goal into functional tasks, giving learners a visual reminder of the tasks being practiced, and a way to track them. Learners use a punch, or other tool, to mark each time they have practiced the task.
A final note about chores and executive functioning skills…
The reason we highlight teens and executive functioning skills is; this is the age range where it really begins. While younger children can demonstrate attention to detail, some time management, and planning skills, it is not without much supervision and instruction. The prefrontal cortex that helps with decision making, is not fully functioning until our kids are in their late 20s!
The Impulse Control Journal…a printable resource for helping kids strategize executive functioning skill development. When saying “calm down” just isn’t enough…
When a child is easily “triggered” and seems to melt down at any sign of loud noises or excitement…
When you need help or a starting point to teach kids self-regulation strategies…
When you are struggling to motivate or redirect a child without causing a meltdown…
When you’re struggling to help kids explore their emotions, develop self-regulation and coping skills, manage and reflect on their emotions, identify their emotions, and more as they grow…
Grab the Impulse Control Journal to build organizational strategies, planning, prioritization, habits, and mindset in kids.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
They say it takes a village to raise a child. Likewise, it takes a dozen different methods to teach one. Unfortunately, kids are not the same, nor do they learn like one another. Just when you have one figured out, along comes another child with a different set of ideas and learning methods. We have been featuring different methods and resources to teach chores and other tasks. We started by learning about appropriate ages for chores, moved on to task initiation strategies, continued to find ways to prevent the summer slide, and finally we are onto the task trackers.
As a pediatric OT, I use a form of a task tracker in most therapy sessions, in the way of a checklist or visual schedule of some type. This is another version that is great for specific needs.
Free Task Tracker Worksheet
Once you have established a set of chores/tasks that you would like your learner to complete, it is time to implement a few different task trackers and charts. In this post you can get access to our free Task Tracker worksheet.
Simply add your email below, and the OT Toolbox will send you the free PDF for downloading. Better yet, you can become a member of the OT Toolbox. This will save you from having to add your email address each time we post a fabulous new resource. Plus, the membership area has a lot of resources that are exclusive to members. I love that the posts and other information on in the membership area is grouped by different categories. One quick search will bring you dozens (or hundreds) of cool resources.
WHY DO WE NEED A TASK TRACKER?
In some ways, increased paperwork might seem like more work. In reality, paper charts cut down on your overall effort, by streamlining tasks and ideas. How many of you benefit from to do lists, calendars, and visual aids? I know I do. I have several checklists, charts, and worksheets to help me remember everything I need to do in a timely manner.
Without a visual aid, it is difficult not only to complete all the task but makes self-reflection more difficult. As a therapist, I am often data driven. We log what we see and do, not only to document it, but to reflect.
HOW DOES THE TASK TRACKER WORK?
Like many resources from the OT Toolbox, there are different ways to use this task tracker. By the time you have a task tracker, you have most likely modeled, taught, and reviewed the tasks several times. The task tracker comes in when your learner is working on doing their chores (or daily tasks) mostly independently.
Your task tracker can be as unique as your learner. You can use one tracker for each day or week. The list can include several trials of the same task, or a complete list to finish.
THIS OR THAT?
At the top is a column called “this or that”. You can use this column in several ways.
Prefill in this section with two choices in each box. Your learner can circle the one they choose for the day/week/hour, or whatever time frame they are allowed for each task.
Your learner can repeat the same two tasks (picking whichever one that day) for the allotted number of trials.
Example of This or That: I might put do the dishes and/or fold laundry in the “this or that” column. Scenario one allows for multiple trials of the two selected task. Scenario two would add two different variables in each row.
Another way to fill in this area is to have a separate list of chores, or tasks. Your learner can fill in each box with their choice from the list. Giving your learner some autonomy and choice will help them get motivated to complete the task (or get started if they are struggling in this area).
One way to complete this activity section is to make sure that all the tasks get done at some point. Therefore, your learner has a choice in the order they do things, but everything eventually gets done.
Maybe you think differently and truly want to give your learner autonomy in what help they provide. There are benefits and drawbacks to this approach.
HOW YOU ARE WORKING ON IT TODAY
This section of the task tracker has another great visual. Your learner can check to the right if they are doing it, or have it finished. The middle-dotted line can be left blank, or your learner can describe how it is getting done.
I see the “how are you working on it” section for tasks that have multiple parts, require practice or trials, or need to be problem solved.
Your learner can keep their to do list organized by visually documenting if they are in progress, must get started, or have already completed the tasks.
DATE ACTIVITY CHECK MARK
This section below in the task tracker is yet another visual reminder for logging tasks. This works great for accountability, but also if you are working on a reward system. Your learner can log the number of trials they have done, practices, or the list they have completed.
THE TOP WIN on a Task Tracker
As an exercise in executive functioning and task completion, this section lets your learner reflect on their progress. What was their top win for the week? Perhaps they have logged the same task eight times, and on the eighth time they did it without help. Maybe you got all your tasks done for the week. That is certainly a top win.
You might need to help your learner reflect at first. They may not have the sight to reflect on their accomplishments yet. Try not to give the answers, but maybe ask questions. Was there something you did by yourself? Did you get more than you thought you would done?
I FED MY ENERGY BY
This section on the task tracker is another exercise in self-reflection. How did your learner get through the tough times? What did they use for motivation to get started?
They might think literally like “I ate seven snacks a day” or “I drank lots of water”. These are indeed ways to feed ones’ energy. Other ways to feed energy might be working toward a reward, realizing some tasks build muscle and strength, or pleasing someone else. Hopefully they did not feed their energy by fearing what would happen if they did not finish the task, or refused to get started.
Fear of retribution is a good motivator, but not the best idea. Far better to work toward a positive reward, than fearing a negative one.
WAYS TO MODIFY AND PERSONALIZE YOUR TASK TRACKER
There are many ways to modify, personalize, and adapt your task tracker:
Laminate the task tracker to make it reusable.
Make it bigger. Blow up the task tracker to a larger sheet of paper to post somewhere prominent
Make it smaller. By shrinking the task tracker, you can make it pocket sized
Add picture symbols for non-readers
Prefill some of the areas and have your learner circle their choice. This can be done in all sections, especially if your learner has difficulty reflecting and writing answers
Print it onto colored paper – colored paper can be motivating
GLITTER! I love some glitter. The shinier the better. When I walk by a glittery list , it may help me get started.
Change the types of tasks. Tasks do not need to be chores. They can be school work, self care, activities of daily living, or daily tasks. Your list might have reading/writing/math for 20 minutes. My list might have brush your teeth/take a shower/get dressed as items to be completed.
This task tracker does not need to be exclusively for children. Young adults, or anyone who struggles with executive functioning can benefit from visual resources and reminders to get them through tasks. At first these types of activities take time, but with practice they tend to go quicker. Once your learner is adept at doing tasks and chores, they may not need this list, or be able to visualize it in their mind. Many learners get stalled at the idea of doing tasks, or their first roadblock. Use visual guides to help them succeed.
Free Task Tracker Sheet
We have a printable task tracker sheet that you can use starting today. We love to use this worksheet to support executive functioning skills by breaking down the steps of tasks. We love this as school based OTs for completing school assignments, homework, projects with multiple steps, chores, and daily functional tasks. Use it in a way that works for your needs!
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
Clinical therapists, in their efforts to understand the “why” of certain behaviors, have been asking about Polyvagal Theory. You probably know more than you think about this, but have not put all the pieces together. This is something we as pediatric occupational therapy providers need to be able to answer questions when our occupational therapy clients ask!
According to the Polyvagal Institute, “Polyvagal Theory is a way of understanding how our nervous system responds to different situations, like stress, danger, or safety. It was developed by Dr. Stephen Porges, a neuroscientist and psychologist, in 1994. In simple terms, Polyvagal Theory helps us understand how our body and brain work together to respond to stressors that are a part of everyday life as well as experiences that are more significant, such as trauma.”
A lot of the information presented on this topic is hard to decipher from a clinical perspective. While I find medicine fascinating, it is difficult to understand all the scientific terminology related to Polyvagal theory.
At first glance, this article popped up: “The Polyvagal theory describes an autonomic nervous system that is influenced by the central nervous system, sensitive to afferent influences, characterized by an adaptive reactivity dependent on the phylogeny of the neural circuits, and interactive with source nuclei in the brainstem regulating the striated muscles of the face and head”.
In this post we will learn the nuts and bolts of this theory, but more importantly, how it correlates to the learners we work with. When I read descriptions like the ones above, I try and imagine talking to a teacher or new parent using this definition. While I, as an experienced pediatric occupational therapist, might sound smart, I am not likely to have others “buy in” to therapy if they can not understand what we are doing.
POLYVAGAL THEORY IN LAYPERSON’S TERMS
Now that you have clinical definitions in your toolbox, what does Polyvagal theory actually mean? Polyvagal theory breaks down the function of the vagus nerve and its’ connection with the rest of the body.
The vagus nerve is a large nerve that goes from the base of the brain to the gut, connecting the brain to the body. The vagus nerve plays a key role in regulating our heart rate, breathing, and digestion, as well as our emotional state.
The theory suggests that the central nervous system (made up of the brain and spinal cord) has three branches:
Fight or flight is the first branch. This is activated when we are in a threatening or dangerous situation. In polyvagal theory this is termed “mobilization,” and is the body’s way of preparing to fight a threat, or run away from it.
The second branch is the “collapse” response. Our body feels powerless to respond and will often shut down, or become unresponsive to stimuli in the surroundings. In Polyvagal theory this is called “immobilization.” You might have referred to it as shut down or freeze state.
The third response state is the “social engagement” response (termed ‘ventral vagal’ in the Theory), which is activated when we feel safe and connected to others. This is when we are relaxed and open to social interaction, and is communicated in our eyes, facial expressions, and tone of voice. This branch is referred to as the “relaxed” state.
All three of these branches are controlled by different parts of our nervous system, but are managed by the vagus nerve. Polyvagal theory suggests that by being able to understand these different branches or response states, we can better manage our own health and wellness, and understand the behavior of others (including empathy).
NEUROCEPTION AND POLYVAGAL THEORY
Here is where things get tricky. If our systems worked correctly 100% of the time, we would not be over or under-responding to stimuli.
The autonomic nervous system has a build in monitoring system that interprets information about risk through sensors in the body (neuroception). These sensors determine danger, without involving the thinking parts of our brain. Autonomic can be thought of as “automatic”. Neuroception scans people, our body, and the environment for cues of safety or danger. The nervous system reflexively shifts to manage the situation for a survival response.
A neurotypical system with a great sense of resilience will have greater cues detecting safety, whereas a less resilient person’s system will lean toward detecting threat.
When in a calm state, the nervous system is less likely to activate the fight or flight response.
If our neuroception or feedback monitoring system is faulty, it sends a signal of danger when we are actually safe, or signals safety when we are in danger.
Some people find themselves in a constant state of hypervigilance, just waiting for a threat.
Hypervigilant people may seek out risky behaviors to keep their body in this state of arousal.
Polyvagal theory and sensory processing
Polyvagal theory sounds a lot like regulation, arousal level, and sensory processing. When we understand the polyvagal theory, it is easier to see that sensory processing is a function (or dysfunction) of the vagus nerve.
What kind of people come to mind when you think about polyvagal theory and sensory processing?
People with anxiety disorders – often in a constant state of high alert, easily triggered, sensitive, and “jumpy.” I think I gasp 50 times a day.
Autism spectrum – classically linked to arousal level difficulties, behavioral responses, and over/under reactions to stimuli.
Depression – sometimes people with depression miss signals around them, or may exaggerate their responses.
Sensory seekers – the risk takers often do not have the same feedback mechanism to alert them to possible danger.
Sensory avoiders – these people are often overly fearful of stimuli or events around them.
HOW CAN I APPLY POLYVAGAL THEORY TO EVERYDAY LIFE?
Recognize your response to stress and anxiety. Even if we do not realize that our brain has detected danger, there is an automatic reaction. A lot of it is self reflection skills. Pay attention to your nervous system activation and what that looks/feels like, or interoception skills (increased heart rate, breathing, blood pressure, sweating, flushing). Learn to recognize these responses in the people you work with. I have many children whose pupils dilate, or ears turn bright red when overstimulated.
Practice or teach self-regulation. This is the ability to manage your response to stressors. We often teach this through deep breathing, deep pressure, gentle touch, quiet words, yoga, meditation, or other calming activities.
Build social connections – according to Polyvagal theory, building social connections can help us feel safe and secure. This can help reduce stress responses.
Identify triggers – learn what makes you (or your clients) feel unsafe or in danger. Learn to work through or avoid certain triggers. We do a lot of work on this with sensory therapy. My book, Seeing your Home and Community with Sensory Eyes is full of chapters that describe typical daily triggers and responses.
Seek professional support. If you feel you are struggling with your mental or emotional health, or your responses to stimuli are not typical, an occupational therapist or mental health professional that understands the vagus nerve and self-regulation can help.
Basically, having an understanding of the tools available can be used along with a stop and think strategy to help us interact in the environment and stressors around us.
HOW CAN I USE POLYVAGAL THEORY IN HEALTHCARE OR SCHOOLS?
The most efficient treatment aims at uncovering the cause or “why” our learners do certain things. We do not just put band aids over a gaping wound. This is a temporary fix, that does not lead to long term results.
Understanding that the responses we see are an autonomic or uncontrolled response to stimuli, can help you accept your learner’s responses differently. This can lead to better informed quality of care. Example: understanding that you were hit or bitten because your kiddo was responding to something we were asking them to do, rather than being naughty, goes a long way.
Trauma informed care – learning about Polyvagal theory helps with trauma informed care building trust, safety, and empowerment. A child (or adult) who feels safe around you is more likely to step out of their comfort zone and keep trying.
Mind body interventions – teach relaxation techniques as part of your treatment plan. Words are often not enough to calm an overactive state. Empower your learners to take control of their body and nervous system
Pain management- understanding the role of the vagus nerve can help understand the response (or over/under response) to pain to treat your patients more effectively.
Caregiver/client relationship – when you show that you understand what a person is going through, it builds trust and a willingness to go through the healing treatment process.
Polyvagal therapy
Polyvagal therapy can be talk-based therapy, or sensory based therapy to help reprogram the central and autonomic nervous systems. It can involve yoga, meditation, and mindfulness.
Immersion therapy aims to slowly surround the person with the stimuli that is triggering, helping their body have a more appropriate response to it. Slowly working with sounds, smells, or textures, can help desensitize the ANS response. The key is to do this slowly, while watching for bodily responses.
Desensitization is similar to immersion – the body is slowly desensitized or accustomed to certain stimuli. This may be through slowly working from something easy to tolerate, to more difficult input. Example: when working with textures you may start at dry beans, then dry noodles, rice, sand, playdough, putty, all the way to shaving cream.
Dialectical Behavioral Therapy (DBT) is a type of talk therapy. “Dialectical” means combining opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors.
Journaling can help understand and manage emotions. The OT Toolbox has many resources to get you started journaling and self-monitoring.
Deep breathing- Breathe in through your nose with short breaths for four counts. Then Hold your breath for 7 seconds. Then slowly breathe out for 8 seconds. Repeat this a few times.
Arm hugs- Wrap your arms around your upper arms and place them just below the deltoids. Gently give yourself a hug and breathe in and out.
Tap your collar bones with both hands. Place your right hand on your left collarbone and your left hand on your right collar bone. Tap your fingers one at a time.
Place one hand on your chest and the other on the back of your neck. Breathe in and out deeply.
Arm taps– Place the palm of your hand on the opposite shoulder with both hands. Gently pat up and down both arms at the same time.
Neck turn and look– Sit with your shoulders back. Gently look over your right shoulder and look as far to the right as you can with both eyes. Hold that position and gently breathe in and out. You will feel a release of pressure in your chest and a sigh. Then repeat on the opposite side.
Eye gaze up– Bend your neck to one side by placing your left ear toward your left shoulder. Look up toward the ceiling with your eyes. Hold that position as you breathe in gently. You will feel a slight release of pressure in your chest and a sigh of breath. Then repeat on the other side. Hold that position until you feel the sigh.
Hum! This is a simple way to focus on breath work. I also saw a meme recently that said you can’t think about ruminating thoughts at the same time as you are humming. This is a good way to stop stressing or anxiety thoughts.
Gargle– This is another simple way to stimulate the vagus nerve. Bonus is that it’s a life skill that some of our kids need too.
Meditation and mindfulness– This is another life skill that kids and adults need throughout life, so now is a good time to work on this with kids and teens.
POLYVAGAL THEORY BEST TREATMENT IDEAS
During my career, I have found the best treatment has been understanding my learners. Once I take a step back and show them that I understand their fears, pain, and objections, I can create a bond of trust that begins the healing process. While I do not like getting hit/bitten/slapped, or chasing a kid down the hallway, I do not get angry about it. I understand their response is often out of their control, and they usually do not have the language to be able to express themselves.
This has taught me much patience in working with people who struggle. As a highly sensitive person myself, polyvagal theory gives me grace to understand that I am a work in progress. Sometimes my body has a mind of its’ own, and I have to practice what I preach.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
Communication is a vital part of livelihood, so these types of expressive language are a huge part of everything we do. It starts at birth and continues until almost our final breath. Infants cry from the moment they are born, signaling some sort of need or distress. Their needs are met based on the type, volume, and intensity of their cry. This is why we as occupational therapy providers, and other readers of this site (parents, educators, other therapy providers, etc.) can use this information in supporting the kids we live with and work with. It’s the social skills aspect that helps to shape the foundation for other areas of development.
We wanted to include examples of how you can document when these different types of communication are used in therapy sessions, so be sure to look at the documentation examples below each communication type.
Having an understanding of communication types is important for occupational therapy and other therapy professionals for documentation purposes. We can use these types of communication with our clients, and it’s important to document that.
When we think about communication, we think about talking. Speech therapy is highly sought after due to the number of people who can not communicate. Talking is just one form of communication. Let’s take a look at all the different types of communication and what we can do to foster them.
TYPES OF COMMUNICATION
How many different types of communication can you think of beyond the spoken word? Since spoken language is one of the highest levels of communication, it is what we consider when thinking about types of communication. This is so important because when there are sensory needs, behaviors, or any type of challenge with daily functional tasks, we can see a lack of meeting specific needs. That’s where the self awareness piece comes in. You’ve seen the behavior iceberg imagery before, right? When we see behaviors, below the iceberg are underlying needs. Those needs are often not communicated and so what we do see is the behaviors or emotional outbursts. Self-awareness plays a major role in self-regulation skills and knowing when and how to implement self regulation strategies that support the individual’s needs.
However, there are many other ways to get our wants and needs met than just using our voice.
There is verbal and non-verbal communication as two broad categories.
Verbal communication is the way we talk to communicate needs.
Non-verbal communication is a huge category that needs to be broken down into different subcategories to do it justice. There are eight different types of non-verbal communication.
Nonverbal communication can be difficult for our therapy kids (and all of us) to understand and recognize. There are several types of nonverbal communication:
Body language
Gestures
Paralinguistics (loudness of voice)
Proxemics (personal space)
Eye gaze
Hepatics
Appearance
Artifacts
All of these types of nonverbal communication types require insight and awareness. Autistic individuals in particular and other neurodivergent can really struggle with this awareness. You can support this need with self awareness activities and self awareness games.
This information can help our kids that we work with by using the different types, depending on needs, when it comes to visual schedules and other tools.
Body language is a powerful type of communication. It can help us understand others. It helps us understand how people are feeling. You can use body language to express intention. Research suggests we make certain judgements about a persons’ intelligence based on facial expressions. Having body awareness is part of this. If you’re not sure where your body is in space, then it’s difficult to use it in communicating wants and needs.
Eye contact (or lack of it), crossing your arms, stepping closer or further away, facial expressions (smiling, frowning, surprise), stiffening your body, melting into the floor, and yawning are just some types of body language.
Some lesser-known types of body language signals are; pupil size, blinking, and biting the lips. The absence of body language or facial expressions can signal communication also.
Documentation Example for Body Language:
“During the session, (the student) was engaged in a group activity to encourage social interaction. She used body language and gestures to communicate with peers, such as nodding to show agreement and waving to greet others. She also used her hands to demonstrate actions like “come here” and “stop.”
Gestures
Gestures are like sign language but less precise or formal. Think about the kind of gestures you use daily. This may be intentional, or subconscious. Some gestures are universal, while others might be more cultural or geographic in nature (be careful about using certain gestures when travelling)
Waving hello or goodbye
Giving a high five
Pointing to something
Nodding or shaking your head
Stomping your feet
Clenching your fist to indicate anger
Thumbs up or down to indicate approval or disapproval
The “ok” sign to signal everything is alright. In some parts of Europe this signal means you are nothing, and in some South American countries it is a vulgar gesture
The “V” sign means peace or victory in some countries, but in the United Kingdom and Australia it is takes on an offensive meaning when turned backward (like showing the middle finger in America)
Showing the middle finger – in the US this is a powerful gesture. It shows clear meaning of unhappiness and is meant to be quite offensive
Documentation Example for Gestures as Communication
“The client was guided through an obstacle course designed to improve his balance and coordination. The therapist used gestures and visual cues to direct the client through the course. The client responded to these non-verbal cues effectively, following the therapist’s hand signals to climb, jump, and crawl. He also used gestures to communicate his needs, such as pointing to a water bottle when he was thirsty.”
Paralinguistics
This is the tone of voice or loudness. Not necessarily spoken word. Screaming, grunting, yelling, crying are forms of communication. With language, tone of voice can convey a message.
How to document paralinguistics in therapy sessions
“(The client) participated in a storytelling activity where he was encouraged to adjust the loudness of his voice based on the context. The therapist provided feedback on using a louder voice when calling for attention and a softer voice during one-on-one interactions.”
Proxemics
Proxemics means personal space. Personal space is another type of non-verbal communication. There are different factors that influence how much space we believe belongs to us. Social norms, cultural expectations, situational factors, personality characteristics, sensory perception, and level of familiarity are just some of the factors. COVID had a big effect on personal space. Some people loved the six-foot barrier between people, while others found this difficult to adjust to.
Documentation Example for Proxemics:
“(The student) engaged in role-playing scenarios to learn about personal space. The therapist used visual aids and physical demonstrations to show appropriate distances for different social interactions, such as standing closer for friends and farther for strangers.”
Eye Gaze
People’s eyes can indicate a range of emotions. Steady eye contact can mean someone is being honest. Shifty eyes and avoiding eye contact are of seen as a sign someone is lying or being deceptive.
This can be especially misleading when people who have a social disorder such as autism avoid eye contact. Gaze and eye contact doesn’t need to be a goal, but documenting this can have it’s role.
Documentation example for Eye Gaze:
“(The student) participated in interactive games designed to encourage eye contact, such as peek-a-boo and follow-the-leader. The therapist provided positive reinforcement whenever he made eye contact during interactions.”
Haptics
Haptics are touches. Julia Wood in her book Interpersonal Communication writes that touch is used to communicate status and power. Higher status individuals tend to invade personal space more than that of lower status. Women tend to use touch to convey care, concern, and nurturance. Men tend to use touch for power or control over others. A caregiver’s touch has a strong influence on behavior and social interaction in babies.
“(The student) was involved in activities that incorporated touch, such as high-fives, handshakes, and patting on the back. The therapist modeled appropriate touch and explained its use in different social situations.”
Appearance
Choice of clothing, hair style and other appearance factors are also a type of communication. Appearance can alter judgements, interpretations, and physiological reactions. We make first impressions about how someone looks.
Documenting for appearance as a communication form:
“During the session, (the student) was guided through activities related to personal hygiene and appearance, such as brushing hair and selecting weather-appropriate clothing. The therapist used visual schedules and modeling to teach these skills.”
Artifacts
With the rise of online presence objects and images are types of communication that can communicate without language. You might use an avatar, a meme, or emoji to convey a thought or impression. Wearing a particular uniform or badge says something about you.
Documentation example for artifacts:
“(The student) used various artifacts, such as picture cards and a communication board, to express his needs and preferences. The therapist guided the student in selecting and using these tools during activities.”
Forms of NON-VERBAL COMMUNICATION
There are various forms of communicating through nonverbal communication as well. This is how we relay our needs and wants without speaking. This includes sign language and use of electronic devices, written work, and other means like facial expressions.
SIGN LANGUAGE
Sign language is considered a form of non-verbal communication. It is based on visual cues through the hands, eyes, face, mouth, and body. Sign language combines body language and gestures. Some sign language gestures are universal, however just as there are different types of spoken languages, there are many types of signs.
NON-VERBAL COMMUNICATION THROUGH ELECTRONIC DEVICES
Non-verbal communication in a digital world is becoming more important than ever. Electronic devices combine written communication, pictures, and symbols. There are several types of assistive technology devices that are used for non-verbal communication. These range from low tech output such as a read aloud book or choice board, to a dynamic machine with layers of words and phrases. These can be accessed by tapping on the screen/board, or through eye gaze technology.
If your child could benefit from a speech generating device, there is a process to follow with a specialized therapist and assistive technologist. This includes trials on different types of devices and training. Occupational Therapy and Speech Generating Devices is a helpful article to understand the role of AAC in therapy.
Documentation Example when Using ACC
(“The client) was provided with an AAC device to assist in expressing her needs and choices during therapy. The therapist programmed the device with simple phrases and images relevant to the session activities. The client used the AAC device to indicate her preferences, such as selecting the “play with blocks” icon and saying “more” through the device when she wanted to continue an activity.”
Types of VERBAL COMMUNICATION
There are two types of verbal communication, written and oral. Both convey messages.
WRITTEN WORDS
The written word can be a powerful tool to convey a message. It can be used to write stories, emails, texts, messages, articles, and more. It can be helpful when communicating between people who cannot communicate with spoken language. Pointing to a written item on a choice board or menu is an effective method to get your wants and needs met.
Written words can also include pictures, symbols, picture exchange cards, and photos to convey a message.
With the invention of Google Translate and other language apps, it is now possible to communicate in different languages with each other. This has proved especially helpful in cities where there are many cultures in one area.
Written communication, like any other types of communication can cause misunderstanding. There may be a delay in getting an answer, or difficulty getting the message across. Over written communication there are often difficulties interpreting feelings and meanings behind the text. Without facial expression, gestures, and body language, it can be hard to figure out the meaning of a message.
Documentation example for written communication
“(The client) participated in activities aimed at improving his handwriting skills, such as tracing shapes and writing simple words. The therapist observed and documented client’s progress in forming letters and maintaining proper grip on the pencil. The student also used written communication to express his feelings about the activities, writing words like “fun” and “hard” to describe his experiences.”
ORAL COMMUNICATION
When we think of communication, verbal language is what we often think of. This is a high level of communication and takes years to master. It starts with cries, babbling, and putting words together. Once this is mastered; storytelling, vocabulary, semantics, grammar, and pragmatics are developed. Oral communication can be between two people, to a large group, in a speech or television program, discussion, on the telephone, video conferencing, or a meeting.
While the output is similar in different types of oral communication, non-verbal communication plays a big part in the setting. For example, a phone conversation might not convey much non-verbal language, where a video conference or meeting would. A teacher uses a different volume and tone of voice than a store clerk.
Documentation Example for Verbal Communication
Verbal communication will be used a lot during therapy sessions! Here is an example of how you can document this means of communicating that occurs in therapy sessions:
“During the session, the client was encouraged to verbalize her feelings and choices. She was asked to describe her favorite toys and the activities she wanted to do. The client responded verbally with single words and short phrases, indicating her preferences and emotions. For instance, she said, “I like the red car” and “I feel happy.”
LISTENING IS A FORM OF COMMUNICATION
Is listening a type of communication? Yes. It is often overlooked because we are so busy trying to get our message across. Listening is important for two-way conversation. Being able to listen can be a difficult skill. You may find yourself thinking about what you want to say rather than really listening to the sender. This is not active listening. You may hear what is being said, but are not processing it fully. A good conversationalist is not only a great speaker, but also able to listen. At the same time, the speaker needs to read cues and take breaks to let another person take a turn.
Take some time to look around you and process all the types of communication happening at once. Just because your child is not verbal, does not mean they are not trying to communicate in some way. Sometimes they are not using the most effective way to communicate like spitting, or hitting, but they are getting some message across. Take time to acknowledge what they are trying to convey and give them tools to make better choices in terms of communication. There are so many options out there, with a lot of trial and error you are bound to find some combination that allows your child to get their wants and needs met.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
This month we have been featuring summer worksheets to help you get your kids motivated to do “work” during the summer…or to use in a Summer occupational therapy session. Today we are adding another one to the toolbox! Cut and Paste Ocean Patterns is yours to download for free.
We also recently added our Ice Cream I Spy activity to our free downloads. We have other ocean and fish themed free OT worksheets as well:
It is no secret that I love summer. I love it even more, now that I am working in the schools and have nine weeks off! I spent 25 years working year-round in a clinic. During those years I witnessed the struggles parents had keeping their learners engaged during the summer. Parents (and their teachers/therapists) also had to contend with summer learning loss.
As a parent of grown children, I spent many summers keeping my girls active and cognitively engaged. I have mentioned it several times, but I want everyone to understand the impact summer learning loss has on your child.
Hint- our ocean animals pattern activity is a cut and paste worksheet that is perfect for Summer!
Summer Learning Loss Facts
Students lose the equivalent of one month of learning during the summer vacation source
Students lose up to 2.6 months of math skills over the summer
Reading skills decline by about the equivalent of two months
Summer learning loss can be recognized as early as Grade One
Teachers spent up to six weeks reviewing past material in the fall to make up for summer learning loss
Those numbers are staggering, aren’t they? This was my panic every summer when my girls were young. One way to minimize the summer slide is by adding daily routines and seated work. This does not mean eight ours at the kitchen table. It means 20 minutes daily of targeted work.
CUT AND PASTE OCEAN PATTERNS TO THE RESCUE!
One way to get started is by gathering resources to meet the needs of your learners. This Cut and Paste worksheet is a good start! It’s an ocean animals pattern activity so it’s a great therapy theme for the Summer months.
Pair the cut and paste worksheet with the I Spy and Handwriting worksheets offered this month, and you are well on your way to developing a summer home program or treatment plan. To get your FREE Cut and Paste Ocean Patterns PDF, simply enter your email in the box below. By the magic of the internet, your PDF will travel from our creator at the OT Toolbox, to YOUR inbox.
Want to avoid having to enter your email address below? Become a member today. Not only will you get these free cut and paste worksheets at your fingertips, but there is a ton of member only content available to you. As a bonus, the materials in the member section are gathered into topics and categories for easy browsing.
HOW TO use CUT AND PASTE OCEAN worksheets
The directions are simple and straight forward on this one.
Color the animals on the worksheet.
Then ask learners to cut the images.
Glue them into the correct spaces to create patterns on the worksheet.
STEAM learning, or science, technology, engineering, arts, and math is at the forefront of learning. Adding the “A” is new, to expand the reach of the program. Pattern learning is an important math concept. We are adding a dynamic component to it with scissors, crayons, and glue.
Take your project to the next level by asking learners to color the objects they see in matching colors. Not only does this help build visual motor skills, but sorting items by color will aid your learners to understand the pattern concept.
If you are like me, you may have 100 kids on your caseload, all in different levels. Even if you only have ten, they are likely to have different abilities. As a busy caregiver or practitioner, it is important to streamline your offerings to meet the needs of as many learners as possible.
HOW TO MODIFY THE CUT AND PASTE OCEANS PDF
There are some great ways to grade or modify this cut and paste ocean patterns worksheet to meet your learners where they are:
Precut the shapes for your learners who are not able to cut the squares
Shorten the activity by skipping the coloring section
Use Bingo markers or stickers to match the pattern instead of coloring. Using different colors will help them solve the pattern easier
Take out the motor component by adding to a smart board and moving the pieces with your pointer or finger
Higher level learners can write the matching words to the pictures, then create a story or memory. This turns into a multilevel activity to use during many sessions. They can also draw about their ideas, or copy the designs.
Laminate the page for reusability. This saves on resources, and many learners love to write with markers! Note: while some learners love to use wipe off sheets, others become upset they cannot take their work with them. For those who want to save their work, consider taking a screenshot of it.
When you laminate the worksheet, you can vary how you do it. Precolor the shapes to make matching easier, have learners use dry erase markers to color the items, or use grease pencils/crayons to color inside the shapes.
Enlarging the font may be necessary to beginning level students who need bigger space to cut and color.
Vary the level or types of prompting offered, to grade the activity, to make it easier or harder
Drippy wet glue is messy, and not as convenient as glue stick, however it is superior for different reasons. The added benefit is the sensory input from touching the wet glue, as well as fine motor strengthening from squeezing the bottle is worth the sticky mess.
How to Adapt a Cut and Paste Worksheet
You can use some of our tips (from an experienced OT) to take your ocean worksheet to the next level and meet different levels with the same sheet.
Think ouside the box by turning making this into a new activity all together, or using it as part of a larger plan.
Velcro the back of the squares, after laminating and cutting them, to create a matching game. Velcro adds fine motor resistance for improving pincer skills and hand strength.
Make this cut and paste ocean worksheet part of a larger lesson plan, including gross motor, sensory, social, executive function, or other fine motor skills
Talk about the pictures, describe their characteristics, and give context clues to help your learner understand why certain pictures match
Learners can explore other games they could make using this activity
Gross motor – run across the room collecting pieces to add to the cut and paste ocean activity. This is a great activity for an OT obstacle course.
Sensory – put the pieces into a sensory bin with an ocean theme. Use aquarium gravel as the base to your ocean themed sensory box.
Executive function – hand the papers out with very limited instruction. Record how well your learners can follow instructions and make the picture look exactly like the example.
The possibilities for grading and modifying activities like this free cut and paste ocean patterns worksheet are endless.
CHANGING YOUR MATERIALS IN ORDER TO GRADE/MODIFY YOUR TASKS
Do you think about the materials you offer to your learners as you hand them out? Something as simple as changing the writing tool, type of scissors, or paper weight can make a big difference. I mentioned glue above. Changing from a glue stick to wet glue can have a big impact on how the project goes.
Scissors:
small toddler scissors are just right for tiny hands.
Self-opening or loop scissors are another way to make cutting easier for those learning to cut, or lacking the intrinsic hand muscles to open and close scissors.
Did you know left-handed people cut in a clockwise direction while their right handed friends cut counter-clockwise? This allows the helper hand to support the paper adequately while cutting.
lightweight paper is much more difficult to stabilize than heavy weight construction or cardstock paper.
Colored paper may be easier or more difficult for children to work with because of color contrasts.
The page can be laminated first, using wipe off markers to color in the design. This is a great way to make this page reusable. Cutting the pieces before coloring it may be necessary. Although this takes away the cutting task, it may be a great adaptation for children who are not able to cut yet.
Types of writing utensils:
There are endless possibilities for coloring and writing. Markers, highlighters, crayons, colored pencils, paints, watercolor, chalk, or dry erase pens all provide different input, and require different levels of fine motor skill to manipulate.
Chalk, with its grainy texture, provides sensory feedback and can be a positive (or negative) experience
Markers glide easily, requiring less precision and grip strength. Pipsqueak are smaller versions of traditional markers and are easier for smaller hands to grip. They now come in fat and skinny versions.
Dot markers (Bingo pens) are great for making big marks
There are several different types of pencils and grips to try. Try the different types of pencil grips and see what works for each learner.
Change writing utensils to appeal to different students, and improve their level of motivation.
When you first begin to break your treatment plan down into its parts, it can seem like a lot of work. As with anything new, there is a learning curve. Many of the adaptations and modifications come easily to me at this point in my career. By doing this work, I am more efficient and effective.
OTHER PARTS TO YOUR OCEAN LESSON PLAN
Teachers know what they are doing when they create fun lesson plans. It engages their students, and adds meaning to their work. You can do the same with this cut and paste ocean page, along with some other fun activities:
Beach Therapy Kit -This Beach-themed Therapy Kit has everything you need to work on handwriting, scissor skills, self-regulation, motor planning, gross motor skills, and visual motor development…all with a Beach theme!
Mermaid & Sandcastle Activity– Another free Google slide deck, this one is a fun interactive activity where kiddos can move the mermaid’s accessories. Have them write the words, recall the items they added, all while working on sequencing, motor planning, fine motor work & more. Then, use the interactive sandcastle slides to decorate a sandcastle. There’s also a writing prompt slide to address more handwriting or typing skills.
Sensory diet activities at the beach– a sensory lifestyle incorporates the environment into sensory needs. When vacations or travel take sensory families on the road, self-regulation can occur anywhere.
This Narwhal craft is great for scissor skills and challenges graded scissor skills in cutting simple and complex shapes.
Beach ball seating idea– Need a sensory solution that doesn’t break the bank? Use a beach ball as an inexpensive sensory seat!
Beach play dough– Create a sensory play experience with a beach theme and challenge fine motor skills.
Hopefully this post inspired you to create an amazing ocean themed or summer lesson plan based on our latest freebie: The Cut and Paste Ocean Patterns worksheet.
Free Ocean Pattern Printable
Get the printable here, by entering your email address into the form. This one is also found inside our Membership club.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
Whether it is summer break and you are looking to keep your kids involved, or curious about age-appropriate chores, here is a great post and printable for you. It feels like over the past couple of generations, there has been a shift from creating independent, to dependent children. I can not count how many times I advise parents that their child can be dressing themselves, helping around the house, and taking care of their belongings at a young age. Included in this post is a FREE downloadable chore chart for listing and tracking jobs around the house.
The fact is that chores are a “lead in” to life skills. They aren’t exactly a job for kids to do, but a way to participate in the family. Giving kids chores that they can accomplish teaches them much more than just learning to do laundry or how to load the dishwasher. Our resource, Life Skills Chore Cards is a support tool to help teach these skills.
AGE-APPROPRIATE CHORES
“When I was a kid……” How many times have you heard or said that to someone? Maybe it is because we are too soft on our children in this generation, or maybe people feel parents were too hard on their kids years ago. Whatever your belief, do not lose sight of what your child is capable of.
This Facebook post certainly got commenters worked up on the ages listed for many common household chores.
Many of the comments on a recent social media post were very negative on the ability of young children to accomplish the chores listed on the image. Other comments were positive and encouraged others to consider working alongside little ones in these household tasks. It is a good read to gain perspectives from both sides.
This post came about after a recent Facebook post on chores that had a lot of conversation. The post had an image that showed chores that kids could do at certain ages. However, some readers thought some of the chores were too difficult for the ages listed. Some readers said things like:
“This chore list isn’t appropriate at all.”
“This may be the dumbest chore list I’ve ever seen.”
“If this is a list created for neurotypical children, I’d take it down a notch for neurodivergent children.”
“This is just irresponsible.”
“I find these lists are extremely unsupportive as it’s back making comparisons of children and possibly causing shame for families.”
“Yeh. Fair. In between age expected tantrums”
“This is ridiculous!”
“This seems really off. My son helps a lot at 4 and I wouldn’t trust him to do many of these things safely and some of them he couldn’t even reach to do like clean a mirror?”
“Yeah, no. Some of these are age appropriate and others are certainly not.”
“This chore list is inaccurate and misinformed.”
The commentors, in most cases, took the graphic very literally and viewed the chores and ages as the child independently attending to the chore items with an end result that would be as perfect as of an adult’s. It seems like most of the comments assumed the child would self sufficiently be able to do tasks like managing toilet cleaning, using knives, and other tasks.
The thing is that these tasks might not work for every child. And they might not be able to independently and completely do the tasks, especially every time or on their own.
But, if you ask a pediatric OT or a Montessori teacher, yes, these tasks could be done as a participant. As a learner. As an observer. As a helper. As an area of growth.
That is, mayyyyybe these tasks can be done with the assistance and teaching of a parent or adult. And, with guidance, gentle lessons, and patience. A child could do most of these tasks, in many cases, alongside an adult or older child/teen. You would not assume they do them 100% perfectly on their own, and the image doesn’t suggest that. It also doesn’t say the child is responsible for these tasks in the home. It’s not meant to be unsupportive or guilt trip parents and families based on what kids can’t or are not doing in the home. It’s not a one-size-fits-all list of rules.
It’s a guideline.
When we see age appropriate lists like this, it’s not meant as a “to do list” as one commentor said. It’s designed to support parents and guardians with tasks that they CAN involve their kids in. Maybe you are cleaning toilets and your 4 year old participates alongside you or moves the brush in the toilet bowl. Are they 100% doing the task and is it perfect? No! But, they are learning about caring for the home, participating in IADLs, self-esteem, self-confidence, pride, and a sense of belonging in the family.
Will a child between the ages of 1-2 years old do the tasks listed under that age on this list as a “chore”? NO, of course not. But can they watch an adult, participate in assisting, mimic, “help”, or even just watch as their adult talks through or just does the task. And that’s appropriate!
One commentor mentioned the chore list “oozes with middle class Eurocentric normatively of household tasks”. Well, it’s one list out of millions that are out there. Is this list all inclusive? No. Is it going to mimic every family everywhere with typical tasks? No, of course not. Is it an idea? Is it options? Is it a guide for a place to start? Sure.
This Facebook post was a reminder that not everything you see on social media applies to everyone, everywhere.
Why not encouraging independence and age-appropriate chores?
So, what are some reasons why a parent or guardian would not encourage independence with household chores? There are actually a lot that come up…and these reasons could be part of why so many negative comments came up in the Facebook post listed above.
I want them to be a child for longer – doing chores does not rob them of their childhood, it empowers them
I like things done my way – we all have a set way of doing things. It is fair to our children to let go of some of that control and teach them. You can always sneak back and fix things if it bothers you that much.
It takes too long for them to do the chores – everyone is in a hurry. In the beginning it takes children a long time to do new things. After a while it will get faster. At first, choose times when you are not in a hurry to include your child.
They can not do it alone – help them with the parts they can not do. They might not be able to empty the whole dishwasher, but unloading the silverware is a great start. I remember learning to iron, and being tasked with ironing just the handkerchiefs for a long time ($.10 each)!
My child has special needs – people can learn at different rates, with cuing, or at a different age level. Not all three-year-old children will be able to dress themselves, but they can help with part of the task. A person who has significant needs may be able to direct their care if they can not do it themselves. Something as simple as an eye gaze or gesture to make selections is a way of showing autonomy and empowerment.
Can they really do this? You will never know until you try. Teach with different methods such as chunking and backward chaining.
Chores versus Maintenance
I just read an article that described the difference between chores and daily maintenance. Chores are defined as larger jobs such as dusting, mopping, vacuuming, etc. Daily maintenance are the jobs that we do to take care of our belongings. Daily maintenance might include hanging up your wet towels, putting dirty laundry in the basket, bringing dishes to the sink, or putting items away that have been used.
Think of daily maintenance as the things your house cleaner does not do daily (unless you have a housekeeper who follows you around cleaning up after you). Add some of these daily maintenance items to your list of obligations. Add items such as bring your dishes to the sink, throw items in the trash, and hang up your wet towels to the activities of daily living list along with brush your hair and teeth.
Another term for chores is instrumental activities of daily living or IADLs. Check out this article on IADLs for more information.
What are some of the other daily maintenance activities that adults do automatically and can be shifted to the responsibility of the mess maker? Follow a teenager around for a day and make your list from all the things they “forget” to do. A word of advice? Start early, making this as much of a habit as brushing teeth or eating breakfast.
HOW TO TEACH AGE-APPROPRIATE CHORES
The first and most important step is to have the expectation that your young person can do it. It takes significant teaching, practice, and lots of reminders, but they can learn.
Expectation- start with the mindset that you are going to make the time and effort to teach the tasks and expect they be attempted. The free Age-Appropriate Chore list you can download today has a list of expectations.
Follow through – once you have the mindset that your learner is going to do a certain chore, make it part of the daily/weekly expectations. The second and third sections of the free PDF downloadable age-appropriate chore list has a daily checklist to list the items to do each day/week, and a box to check when the chore is complete. Feel free to tweak this in a way that makes sense for you.
Reward- daily maintenance items such as hanging your towel and throwing your trash away do not need to have big rewards attached. Maybe a “thankyou” or “way to go” can be given in appreciation. Larger chores however, can come with some incentive. Your reward system can be personalized to your beliefs and values. I believe that I would not go to my job and work hard all day without some sort of compensation. This is why we get paid to do hard things. The reward can be anything that is meaningful.
REWARDS FOR CHORES
Rewards are as personalized as the chores themselves. What are some of the rewards you offer to your learners?
One tool we love to use is our screentime checklist. It can involve doing chores that support the household as a system in order to get the screentime. Of course, you could include other tasks on the checklist like reading a book, working out, going for a walk, etc. but for many, including tasks like folding your laundry, feeding pets, and taking out the trash is a great list of jobs to do before playing video games.
Money – cold hard cash. There is value in teaching about money management. A job well done can earn a cash reward to be spent on something of value to the learner. Money management is another subject entirely in how you teach this, and place expectations on saving versus spending.
Fake or pretend money – you can use pretend money as a value reward system to be traded for certain items at home or in the community. Items in your house such as snacks or new toys can have a monetary value on them to be earned.
Token Economy – this system is a cashless system. It is not only used to buy tangible objects, but to trade them for other rewards. These rewards can be whatever is motivating. TV time, electronics, Legos, a snack, free time, or whatever works.
QUALITY TIME VERSUS MONETARY REWARDS
Quality time – this is one of the five love languages. Some people value quality time over a tangible reward. Once your learner can help with or complete some chores, this should naturally free up some daily time for quality interaction. What does this mean for you? Snuggles on the couch, movie night, a date outing, playing catch in the yard? Quality time does not have to have a monetary value attached. The time is the value.
Tangible or monetary quality time – perhaps there is something that your learner would love to do that is often out of reach due to time or money constraints. Maybe this can be the reward for a week or month of hard work. A trip to the ice cream parlor, an outing to the water or amusement park, going to the nail salon or a shopping adventure, or a day trip to a ball game can be a huge motivator for many.
Some rewards can be bigger than others. There are times when your learner can delay gratification to earn something big. Younger learners tend to need immediate rewards to tie into their hard work, like a Skittle for completing a step of the chore.
Reward systems are as personalized as your child/learner themselves. Find out what works for them to help them get through the hard work.
What chores for different ages?
So, knowing what we do about child development, including the physical, cognitive, and social and emotional development of kids, asking a pediatric occupational therapy provider is a great way to decide on which chores to do with kids at different ages.
The toddler years are a time of learning, and following along with mom, dad, guardians, and siblings can mean that they are involved in chores…even though you are not handing your toddler a dustpan and expecting them to clean the floor. At this age, it’s about watching to participate, rather than “doing”.
picking up toys with assistance
putting dirty clothes in the hamper, with assistance
helping set the table (putting cups on a table, with direction and assistance)
dusting low surfaces (wiping surfaces, with direction and assistance)
watering plants (pouring water, with assistance and direction)
putting away groceries (taking items out of grocery bags)
putting stuffed animals on their bed
throwing away trash- Putting garbage into a trash bin, with direction
Chores for Preschoolers
Preschool aged kids will also require direction and assistance. Again, you’re not going to expect your preschooler to assume the responsibility of doing any of these tasks. It’s about doing the chore alongside the child, with guidance and assistance. All of the chores listed below are teaching moments.
making the bed
putting away toys
helping set the table
watering plants
sorting laundry
folding towels
feeding pets
wiping tables and countertops
helping to put groceries away
putting dirty clothes in the laundry basket
dusting low shelves and furniture
helping to clean up spills
carrying light items to the trash or recycling bin
assisting with meal preparation (washing vegetables, stirring ingredients)
brushing their teeth with supervision
putting books and magazines back on shelves
Chores for Elementary Aged Kids
Older kids can do more challenging chore tasks but will absolutely need reminding, cues, and assistance. While elementary aged kids are gaining confidence, executive functioning, and motor skills, they are still developing in all of these areas. You still won’t be able to expect these chore tasks to be done efficiently or independently, but this is improving.
vacuuming floors
sweeping and mopping floors
taking out the trash loading and unloading the dishwasher
cleaning bathroom sinks and counters
folding and putting away laundry
helping with meal preparation (measuring ingredients, mixing)
setting and clearing the table
feeding and caring for pets
dusting furniture
cleaning windows with supervision
helping to wash the car
putting away groceries
watering outdoor plants and garden
making their own lunches
organizing their own room and personal spaces
Chore List for Teens
Teenagers can do more extensive chores and multistep chores. The teenage years still will need reminding and support at times, because we know that executive functioning skills are still developing.
cooking complete meals
washing and folding laundry
cleaning bathrooms (toilets, showers, sinks)
mowing the lawn and outdoor yard work
grocery shopping with a list
managing their own schedule and appointments
babysitting younger siblings
organizing and deep cleaning their room
washing windows
vacuuming and mopping floors
taking care of pets (feeding, walking, grooming)
helping with household budgeting and finances
running errands (picking up items, delivering packages)
assisting with car maintenance (checking oil, tire pressure)
cleaning out the refrigerator and pantry
RESOURCES ON TEACHING SPECIFIC AGE-APPROPRIATE CHORES
For some people, teaching tasks is a task in and of itself. Check out some of these great articles to help teaching certain chores. The chore in the article (such as laundry) can be changed to whatever task you are teaching, as the methods are the same.
Life skills cards – This set of 10 pages of Life Skills Cards help break down functional skills and measure them. Some goals such as “improve self help skills” are broad, and often overwhelming. These life skills cards help break a large goal into functional tasks, giving learners a visual reminder of the tasks being practiced, and a way to track them. Learners use a punch, or other tool, to mark each time they have practiced the task.
Laundry Skills – Washing and drying clothes is an independent living task that anyone who manages their activities of daily living and instrumental activities of daily living must learn. Check out this post to understand the “why and how” of teaching laundry skills.
Cooking Skills – this post highlights how to teach cooking skills to children and why it is important.
Bright Horizons has a good resource on how to involve children in chores that can be useful, too.
What does a Pediatric OT think of chores for kids?
As a pediatric occupational therapist whose worked with many kids, here’s what I think; Raising children is hard work. Taking time out of our busy day to teach them, is also hard work. This is something we signed up for. Make the time and effort to create wonderful, capable little people. Your child’s future spouse, partner, roommate, landlord, or teacher will thank you.
Free Printable Chore List for Kids
One tool inside our Membership Club is a resource for supporting routines and skill-development through chores. We put together a list of age appropriate chores, with simple tasks that kids can do at different ages. You’ll also find a page for the whole family to work together on tasks each day. Then there are weekly chore task sheet for larger chores like laundry that might take several days. You can print off this resource and use it over and over again.
To get this printable set, enter your email address into the form below, or if you are a member, log into your account to grab the copy.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
Summer is here! My two favorite things are summer and ice cream. What better way to honor these two things than a FREE I Spy Ice Cream printout! Just because the kids are out of school, there is no reason to stop working on essential skills. If you’re looking for a summer occupational therapy activity, then you are in the right place! Pair this I spy activity with our other ice cream activities for themed fun:
Get the free Ice Cream I spy page by entering your email address into the form at the bottom of this page.
In fact, this is the best time, since they are not getting daily reinforcement at school. I have written before about the staggering percentage of information lost during summer holiday. Here is the latest research on the “summer slide.” Using some tools in a Summer OT program like the I spy activity below is perfect because it’s seasonal, yet fun for kids. Summer work and review is especially important for students with special needs, or those who are more prone to setbacks.
I SPY ICE CREAM
The mere mention of the phrase “school work” during the summer, can elicit groans and refusals that can be heard down the street. Head your reluctant learners off at the pass by providing fun engaging summer activities. Create a binder or notebook with lots of the free downloadable worksheets we offer on the OT Toolbox. Start by adding your email below get your hands on this I Spy Ice Cream PDF.
This great I Spy Ice Cream worksheet primarily targets visual perceptual skills, while also throwing some visual motor input in there. As always, it can be adapted and modified to meet the needs and levels of many types of learners.
Visual Perception Overview
As a review, visual perception refers to the brain’s ability to make sense of what the eyes see. This is not the same as visual acuity which refers to how clearly a person sees (for example “20/20 vision”). A person can have 20/20 vision and still have problems with visual perceptual processing.
Good visual perceptual skills are important for many every day skills such as reading, writing, completing puzzles, cutting, drawing, completing math problems, dressing, finding your sock on the bedroom floor as well as many other skills. Without the ability to complete these every day tasks, a child’s self esteem can suffer and their academic and play performance is compromised.
Visual perception can be broken down into seven different sub-categories:
Sensory Processing: Accurate registration, interpretation, and response to sensory stimulation in the environment and the child’s own body.
Visual Attention: The ability to focus on important visual information and filter out unimportant background information.
Visual Discrimination: The ability to determine differences or similarities in objects based on size, color, shape, etc.
Visual Memory: The ability to recall visual traits of a form or object.
Visual Form Constancy: The ability to know that a form or shape is the same, even if it has been made smaller/larger or has been turned around.
Visual Closure: The ability to recognize a form or object when part of the picture is missing
VISUAL PERCEPTION AND THE I SPY ICE CREAM WORKSHEET
After reviewing the visual perception overview, what skills do you think the I Spy Ice Cream addresses? If you said sensory processing, visual attention, discrimination, visual memory, spatial relationships, and figure ground; you would be right!
If the ice creams were different sizes, shapes, and directions, form constancy would also be addressed. There are a lot of worksheets out there that do just that (see below for links!).
The directions for the I Spy Ice Cream worksheet instruct students to color each of the ice cream treats a different color, then find and color the matching items. Lastly, they need to count how many of each item they found, and write it in the boxes.
OTHER SKILLS ADDRESSED USING THIS FREE DOWNLOAD
As mentioned above, visual perception is the key skill addressed with this free PDF of I Spy Ice Cream. There are many other skills being worked on simultaneously:
Hand strength and dexterity – staying in the lines while coloring builds hand muscles and develops muscle control.
Visual motor skills are combining what is seen visually and what is written motorically. It requires coordination to be able to translate information from visual input to motor output. Coloring, drawing, counting, cutting, and tracing are some visual motor skills.
Sequencing – will your learner do the ice cream items in order? Will they look for the easy and/or obvious answers first?
Scanning – does your learner look in methodical order, or search in a haphazard pattern all over the page?
Proprioception – pressure on paper, grip on writing tool
Counting/Learning Numbers – Count the items to understand number concepts in addition to writing them correctly.
Fine motor strengthening, hand development, and grasping pattern
Bilateral coordination – remembering to use their “helper hand” to hold the paper while writing is important for development. Using one hand as a dominant hand instead of switching back and forth is encouraged once a child is in grade school, or demonstrates a significant strength in one or the other.
Strength – core strength, shoulder and wrist stability, head control, balance, and hand strength are all needed for upright sitting posture and writing tasks.
Executive function, following directions, attention, attention to detail, focus, sequencing, planning, task completion, neatness, impulse control, compliance, behavior, and work tolerance are all important skills to learn
Social function – whether working alone, or together in a group, you can address problem solving, sharing materials and space, turn taking, and talking about the activity
Remember, you can assess all these skills at once, or focus on one or two. Some skills above will be addressed without your conscious knowledge, while other skills you can be directly focusing on.
HOW TO ADAPT AND MODIFY THIS ACTIVITY
The beauty of children is they are not all created equal. This can pose a challenge as you try and provide activities for learners of all levels. Fortunately, most of our downloadable worksheets can be graded or modified in some way to meet the needs of different levels of learners.
Lowest level learners can point to the matching pictures without having to use motor skills
Middle level learners can use dot markers or stickers to match the ice cream, instead of coloring. They can also circle the matching pictures if coloring is too difficult
Higher level learners can elevate this task by writing an idea about ice cream treats, then create a story or memory out of this idea. This turns into a multilevel activity to use during many sessions. They can also draw about their ideas, or copy the designs.
Use other items to mark the matches like Bingo chips, pom poms, pennies, pieces of play dough, cereal, Legos, or whatever you have handy.
Laminate the page for reusability. This saves on resources, and many learners love to write with markers! Note: while some learners love to use wipe off sheets, others become upset they cannot take their work with them. For those who want to save their work, consider taking a screenshot of it.
Make this part of a larger lesson plan including gross motor, sensory, social, executive function, or other fine motor skills
Talk about the animals, describe their characteristics, and give context clues to help your learner understand why certain pictures match
Enlarging the page may be necessary to beginning writing students who need bigger space to write, or larger items to color.
Project this page onto a smart board for students to come to the board and write in big numbers.
Different levels or types of prompting may be needed to grade the activity to make it easier or harder
Learners can explore other games they could make using this activity
Work in pairs or in a small group to address problem solving, turn taking, and negotiation skills.
can you believe there are still more ways to adapt and modify the i spy worksheet?
Sensory – add real ice cream treats to explore. Describe it in detail. Talk about how it feels, smells, and tastes, or what emotions it might evoke.
Executive function – hand the papers out with very limited instruction. Record how well your learners can follow instructions without prompting.
Social skills – sharing resources promotes social function. Talking about a themed lesson plan builds social skills.
Have students write on a slant board, lying prone on the floor with the page in front to build shoulder stability, or supine with the page taped under the table
OTHER RESOURCES TO ADD TO THE I SPY ICE CREAM WORKSHEET
Creating a folder or binder is a great way to pre-plan your summer activities or save them for next year. The OT Toolbox is full of great resources for you to explore:
Beach Therapy Kit -This Beach-themed Therapy Kit has everything you need to work on handwriting, scissor skills, self-regulation, motor planning, gross motor skills, and visual motor development…all with a Beach theme!
Summer Memory game – Use the memory cards in writing prompts, sensory play, and fine motor work, too: Kids can color and cut the memory cards, copying the colors from one sheet to the other to really build visual memory and visual scanning skills.
Fairytale Fine motor kit This Fairy Tale Fine Motor Kit, with almost 100 pages of fun fairy tale themed activities is sure to please princes and princesses everywhere!
Become a member of the OT Toolbox and get unlimited access to new and exciting content!
Free Ice Cream I Spy Worksheet
To get this printable, just enter your email address into the form below. We’ll send it to your inbox so you can print it off from any device and from any location (school or home). This printable is also found inside The OT Toolbox membership club.
All this talk about ice cream makes me think about summer treats. I think I hear the ice cream truck coming!
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
Work on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, scissor skills, and much more so that kids can accomplish self-care tasks, learn, and grow through play all summer long.
This bundle is perfect for the pediatric occupational therapist who needs resources and tools to use in summer therapy sessions.
Summer Memory Game- perfect for playing Memory or using in sensory bins
Summer OT Packet ($20 value)
180 Outdoor Sensory Diet Cards- for when your kiddo is “sooooo bored” or using in sensory diets
BONUS: Summer Sensory Activity Guide
This is a digital product that will last all Summer long!
Summer Fine Motor Kit
The Summer OT Bundle is your ticket to sending the kids back to school in the Fall without worrying about the “Summer Slide”. Each Fall, kids need to catch up on areas that they’ve lost over the summer months. With the Summer OT Bundle, there is no worry about falling backwards. Use the materials to maintain and even grow motor skill development this summer so kids can thrive and jump into learning next Fall.
If you are new to school based occupational therapy treatment, you may be confused about how this differs from the private medical model. Once you have a few IEP/504s under your belt, you will become a master in defending what therapist in the school do (and do not do). Knowing the points of a school occupational therapy scope of practice is essential. This is a harsh reality, and takes a while to get used to this treatment model compared to outpatient OT. In this article, we will explore how school-based therapy differs from private therapy, and determine What School Based OT’s Should Address.
Ideally in the helping profession, occupational therapists should “fix what is broken.” This is the model I followed for 25 years before moving to the school district. School based therapy is a different ball game all together. We are “related services,” meaning we provide a service to help students meet their educational goals.
This is where is gets tricky. While it may be true that Johnny can not tie his shoes, will not eat cafeteria food, or wear button-down shirts, he is getting his education without the need to do these things. Here is why: Johnny can wear Crocs or Velcro shoes, he can pack a lunch or survive on water during the school day, and can wear other clothes instead of a button-down shirt.
I had a high school student I inherited who had a buttoning goal. He only wore button-down shirts to church on Sundays, never to school. Number one, this was not affecting his education, and number two, if he had not learned buttoning by age 19 with years of training, my few minutes a month was not going to make much of a difference. For the record, I tried. I added the caveat that he had to wear button shirts to school to make it educationally relevant (this was a stretch), and made sure he was working on this every day. After months of what I knew was going to be wasted time, we settled on Velcro shirts that have buttons attached to looked like a real button-down dress shirt.
DOCUMENTATION ON SCHOOL OT VERSUS MEDICAL BASED THERAPY
There are differences in documentation in the medical model of occupational therapy and the school occupational therapy model. This is because of differences in intervention based on medical needs vs. educational needs. Here is what the American Association of Occupational Therapists has to say on school-based therapy versus a medical model. This is a great brochure to have on hand for parents and staff at your schools.
Does School Occupational therapy address self help skills?
What self help skills should a school occupational therapy practitioner address?
This depends on the educational setting. As a general rule, school-based therapist should not be expected to teach cooking, grooming, and laundry unless it is educationally relevant. One of our schools has a program that makes and sells cookies as part of their life skills class. One student was having fine motor difficulty measuring, rolling, and cutting the cookies. For him, this specific cooking and life skills goal was relevant to his education.
The student who just wanted to make pancakes, but this task served no educational purpose, was not in need of skilled therapy for this task. If making pancakes were part of his educational program, then yes it might be relevant to address from a fine motor, or executive function skills angle.
self-help skill that may be addressed in School OT
Sometimes a school occupational therapy referral will target self help skills. And sometimes this is appropriate when it impacts education. Here are some things to consider:
Using utensils – maybe. While it is true that your student can get by using their hands to eat, is it safe? Beyond safety there is social appropriateness, and improving fine motor skills to consider. Check out our resource on using a spoon and fork to assist with this area.
Grooming – maybe. If there is a reason your student must brush their hair or teeth at school as part of their educational program, then you may have a case to address this. Deodorant? Maybe not. This might come into play with the middle school student or high school student who is using the pool in the school physical education class.
Toileting – the physical aspects of toileting such as clothing management, hand washing, motor coordination, and adaptations, yes. Maybe even as far as advising on a time schedule or visual supports. Sitting with a kid for 20 minutes waiting for them to go; maybe not. The Toilet Training Book is a good resource for supporting a variety of levels and needs.
Laundry – if this is part of their educational program. Some programs have life skills built in like laundry tasks. If this is the case, this might be an educationally relevant goal. If so, goals like these are often addressed at a problem-solving indirect level.
Chores – again educationally relevant ones. These are all great life skills but what educational impact do they have to get specific therapeutic services? Emptying trash cans, recycling, cleaning dishes, washing tables, etc. may be part of a classroom management routine, or may be just a life skill being taught at school. Consider the relevance before committing to long term direct intervention on waste management.
WHAT HandwRiting Needs Should SCHOOL BASED OT ADDRESS?
Handwriting is a big one…it seems like every school based occupational therapy student has a handwriting goal. Check out my post on “How Long Should OT Address Handwriting Skills?” (Coming soon) in order to gain an understanding of when and how much intervention to provide in handwriting. Handwriting services at some point need to be dismissed if the student is not motivated, progressing, over a certain age, or producing functional work.
Instead look for underlying causes of handwriting difficulties such as weakness, coordination disorder, sensory processing difficulties, or visual perception deficits. Address the underlying causes to improve overall fine motor skills and handwriting.
Some things to ask yourself are:
Does cursive handwriting need to be addressed or could this be done at home through a home program (likely much more effective with daily practice)
Should near point copying skills be addressed to support the ability to copy homework from a chalkboard?
What about pencil pressure? When the pencil markings tear paper and result in illegible written work, should this be addressed?
When should we target writing speed? When the written work is illegible because it’s too fast or when it’s so slow that the student can’t keep up with written material. What is the fine line between these areas.
The list could go on and on!
WHAT Sensory Processing Needs SHould SCHOOL BASED OT ADDRESS?
We all have sensory issues. Everyone has idiosyncrasies that make us unique. I am sensitive to smells, textures, and auditory input. However, I function just fine in my work setting. I wear clothes that I like, use gloves if I need them, and have ear plugs if something is too loud. My sensitivities are bothersome at times, but not impacting my work to the point that I can not do it.
Sensory processing difficulties can have some educational impact. There are many students who are so sensitive to smells, sounds, or textures, that it impacts their learning, or the learning of those around them. Attention and behavioral challenges interfere with learning and acquiring new information.
Sensory based strategies can help set the foundation for improved learning. These techniques and adaptations are put in place with the sole purpose of helping students reach their academic milestones and participate in their education.
Social skills and social function in the school system
What school-based OTs should address in terms of social skill functioning depends on the expectations in the classroom. There is a place for therapists to address social skills in class either in a direct or consultative model. These might include:
Self-advocating (asking for help or raising one’s hand)
How to Decide if a need is in the scope of practice for school occupational therapy
Because we are a helper profession, it is going to take some practice and reinforcement to truly understand the role of therapists in the school system. This advice is not just for occupational therapists. Physical therapists and speech language pathologists go by the same standards.
When deciding what to address in therapy, ask yourself some questions:
Is this skill relevant to their education?
Can a teacher provide the same information/practice? If so, you can provide recommendations and advice rather than direct treatment
Can this student perform all functions of their school day without this skill? This is especially relevant when being asked to address shoe tying, eating, hair brushing, or buttoning. *You can work on buttons and tying shoes as an activity to improve your fine motor coordination goal
Is this something that matters to the teacher and/or parent? If not, you will not get the carryover you need for success
Does the child have the necessary skills to function in their environment? Their handwriting might not be perfect, but at some point, it is functional, and works for their educational setting
Will adding OT have a positive or negative impact? Some students do not need to miss any instructional time being pulled out for therapy or having a therapist push into a classroom. A consultative model or recommendations may suffice
Is it time for dismissal? At some point the teachers know what to do to follow your OT plan of care, or your therapy interventions are not having any impact on the student’s education. Therapy can become a crutch for parents/teachers/students. It is nice to feel wanted and needed, but opening your schedule to help new students is even nicer.
Thoughts from An experienced OT on the scope of school based occupational therapy
This is the end of my third year as a school-based OT. I am finally getting my head wrapped around my role in the school system. After 25 years in outpatient private practice, it has taken me this long to reprogram myself. There are still times when I want to address something because the child needs it as a life skill. I must go back to my list of questions above and ask myself if this is truly an educational need.
As my caseload grows, unfortunately some of these decisions are becoming easier based on time constraints. I find myself prioritizing the students who truly need skilled therapy to survive the day at school, or have some sort of educational impact. Students who in theory should have more therapy due to their function level, get less because their needs are stable, they are not progressing, and their teachers are doing a great job helping them access their education.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
