Hula Hoop Activities

hula hoop activities

A hula hoop is a great old-school toy and specific hula hoop activities can be used to not only build strength, coordination, balance, and motor planning, but can be used in other areas such as learning, sensory, and visual motor, as well as gross motor coordination. Hula hoops are versatile and inexpensive, while being colorful and attractive, to spark the interest and motivation of children. There are a wide array of hula hoop activities that can be done, in addition to the traditional method.

hula hoop activities for therapy and gross motor development

Hula hoop Activities are great!

Hula hoops can be used indoors or outdoors and with children and adults of all ages. That’s right all ages. In addition to the conventional manner, there are several imaginative and thoughtful hula hoop activities that are fun and safe for all!  

Hula hoops are cheap and easy to find. If you don’t have, or can’t find a hula hoop that’s okay, you can make your own hula hoop! The directions are included in this post. People can decorate it however they wish, making it a special craft activity too. 

Take a look at some fun, creative hula hoop activity ideas to get kids up and active, and a little ‘hoopy’ this season! 

The hula hoop games and activities below are great for outdoor lawn games this summer, but they can be included in indoor therapy obstacle courses or games to get kids moving!

Gross Motor hula hoop games:

  • The Floor is Lava Games These are fun games for home on a rainy day. Use a hula hoop as a “safe island” when playing is game. They work on jumping, leaping, hopping, rolling, and crashing.
  • Hula Hoop Jumps – provide heavy work input through the core and gross motor muscle groups, to improve regulation, and body awareness. 
  • Rabbit Hole – is a cooperative gross motor group activity that helps to teach the concept of personal space, using a hula hoop, and safety cones.  This is a great way to teach about personal bubbles.
  • Hula Hoop Run activities – use several hula hoops positioned out on the ground, or floor to create a “tire run” pathway for kids to hop, jump, or leap through. There are several pattern ideas included, which will address gross motor coordination, balance, and agility while having fun too!
  • Hula Hoop Pass – Grab some friends and a hula hoop! Children hold hands while standing in a line or a circle, while working to move the hula hoop around the group, stepping in and out of it, ducking through it, while holding hands. This works to shift the hoop to the next person, until it makes it from the first, to the last person within the group. This is an incredible coordination and motor planning activity that helps to build group cooperation and teamwork.
  • Don’t Jiggle the Spiders! Much like our spider obstacle maze, you can wrap yarn around a hula hoop and thread spider rings through the string. Then, children can move the hoop as a hand-held obstacle course has a fun way to have children work on balance and body control as they work to move through the spider web, designed on a hula hoop, and try not to ‘jiggle the spiders’ while doing so. 
  • Basket of Toys- Here is a fun twist on the traditional toy scavenger hunt. In this game, you scatter small toys or water balloons and hula hoops on the ground. Children work to move the toys and balloons using their feet to their specific hula hoop. What happens if they pop a balloon while kicking? They must visit the Toy Master (and adult or a specific player) and complete a motor task to earn another balloon. A fun way to work on gross motor skills, motor control, and eye-foot coordination. 
  • Hula Blockers is a fun hula hoop game in which each player stands in their own hoop tossing a bean bag into another player’s hoop, while simultaneously attempting to defend their own hula hoop space, blocking another player’s bean bags from landing in their space.

Add these Gross Motor Coordination Activities for more fun. Or check out these Gross Motor Toys for some fun games.

Sensory hula hoop actitivies:

  • Hula Hoop Mobile here is a fun visually stimulating idea for children with visual impairments, or other challenges, that might benefit from a colorful hanging mobile that has texture, sound, weight, and visual appeal. It can be used for individual play, or as a group activity.
  • Sensory Hula Hoop Video – need a fun sensory tool for babies? Then this Sensory Hula Hoop video might be a fun DIY for you! It includes a variety of visually stimulating materials as well, as texture and sound. It can be placed flat on the floor to encourage tummy time, or hung above a baby lying supine, to encourage reach and exploration. Note: Always choose baby-safe materials to prevent injury. 
  • Baby and Toddler Tummy Time Activity- Another spin on the sensory hula hoop activity, is to attach baby rattles and baby toys around the circle, then have babies start with tummy time in the center of the hoop. This is a great tool for adding novel activities to tummy time. The circular positioning of the toys around the hoop encourages babies to reach, visually scan, roll, and pivot on the upper body, as they move and stretch to reach, and engage with different toys. 
  • Hula Hoop Canopy – If you’re feeling really ambitious you can create a Hula Hoop Canopy with lights and sheer curtains. It makes a great addition to a calming corner.
  • Hula Hoop Tunnel Activity – Make a tunnel with several hula hoops and you can even add scarves or longer strips of streamers for children to move through making it a gross motor AND sensory experience in one!

Eye-Hand Coordination hula hoop games:

  • Hula Hoop Web – use masking tape to create a Hula Hoop Web in the hoop. Have children toss cotton balls or pom-pom balls to stick to the web.

  • Hula Hoop Target – Hang a hula hoop from the ceiling or a tree, and you have an instant target for ball tossing.
  • Hula Hoop Bullseyes- Lay different-sized hula hoops on the ground, creating a bulls-eye target. Place numbers inside the hoop to create targets, to score points when tossing a bean bag.
  • Place safety cones on the ground for children to toss a hoola hoop around the cones, to score points. 
  • Hula Hoop Basketball – Hang a few hula hoops from a basketball goal for young children to have their Hula Hoop Goal for ball play. A great way to have younger kiddos enjoy their own skill level of basketball. 
  • Flight School Create this fun game by having children fold paper airplanes, then try to fly them through hula hoops that are hung from the ceiling. Include children of all ages with this fun activity, as you can hang the hula hoops at different heights to accommodate any skill level.  Another way to play when hanging the hoops at different heights, would be to use a point system, and score points based on the different heights of the hoops.  

Learning games with a hula hoop: 

  • Around the Clock hula hoop activity is a fun way to work on time with kiddos in the classroom, during therapy, and at home! 
  • Hula Hoop Zones Activity- Use red, yellow, green, and blue hoops to work on the Zones of Regulation™ curriculum in the classroom and during therapy. Read more on this activity.
  • Find and Rhyme game is a great way to work on rhyming with young children! All you need are some hula hoops, and plastic plates. It’s similar to a scavenger hunt for words. Here is an explanation.
  • Personal space – Need to help children understand personal space? The use of a hula hoop is the perfect tool! They can sit or stand inside of it, to help them visualize their own personal space, and the space of others. I’ve seen them used while sitting at a table during snack time to help children understand their personal space.

make your own hoop

Here are the instructions for Making a Hula Hoop. They include a brief explanation of the three most common types of tubing people use to create one. If you think you need more detailed instructions for creating a hula hoop, take a look at How to Make Your Own Hula Hoop, and see how they designed their hoop using irrigation tubing. 

Want another fun idea for creating a hula hoop? I found this Snap Together Hula Hoop (affiliate link) that children can work on building before using!  This type of hoop makes it easy to transport and adds another element of motor skills while building and deconstructing.

more outdoor fun

There’s only one last thing to say about hula hoops, remember to join in the fun yourself and enjoy some screen-free playtime with kiddos! 

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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Regina Allen

Regina Parsons-Allen is a school-based certified occupational therapy assistant. She has a pediatrics practice area of emphasis from the NBCOT. She graduated from the OTA program at Caldwell Community College and Technical Institute in Hudson, North Carolina with an A.A.S degree in occupational therapy assistant. She has been practicing occupational therapy in the same school district for 20 years. She loves her children, husband, OT, working with children and teaching Sunday school. She is passionate about engaging, empowering, and enabling children to reach their maximum potential in ALL of their occupations as well assuring them that God loves them!

Gross Motor Coordination Activities

Gross motor coordination activities

Hop, skip, jump, push and pull are all skills needed, to build foundational gross motor coordination.  Gross motor coordination activities are an engaging way to build these skills. Delays in gross motor coordination can impact the academic learning process of a child. These are skills that are needed to sit and engage in the classroom, participate in P.E./on the playground, navigate the school setting/bus, transition between classrooms/within the classroom, doff/don coats and backpacks, and transport of a lunch tray within the cafeteria. We’ve previously covered gross motor toy recommendations, so you’ll want to check out that resource, too.

Related, you’ll want to check out our blog post on indoor gross motor activities for preschoolers.

Gross motor coordination activities for occupational therapy or physical therapy using play to develop balance and coordination.

gross motor coordination

What exactly is gross motor coordination?  Simply stated, it is the use of large muscle groups in controlled movement patterns that includes all extremities. Gross motor coordination is needed for a child to engage in coordinated and free play, navigation in their environments, and overall self-care. 

 If a child struggles with any of the following:

  • core strength
  • balance
  • body awareness
  • coordination
  • crossing midline
  • posture

they could struggle with attention, focus, and overall engagement in school.

They need to be able to manage themselves in their academic environment so as to be able to learn and grow in their development. Some gross motor movement is all about mindfulness or developing self control.

Gross Motor Coordination involves both conscious use of motor actions and automatic use of motor actions.

Conscious Use of Motor Coordination

Conscious use of motor coordination involves learning a new skill, while focusing on performing the task or exercise, with that being their sole intent.

An example of conscious use of motor coordination is solely focusing on skipping, without adding music, following directions or any variables.

Automatic Use of Motor Coordination

Automatic use of motor coordination involves being able to move through the actions without thinking of the actual movements, resulting in higher levels of skill.

Running while listening to an iPod, moving around obstacles, and drinking from a water bottle is a good example of automatic motor coordination.

Moving from conscious to automatic motor coordination is the end goal. Children must be able to balance and coordinate their bodies automatically, not think about the movements or actions.

This frees up their attention to focus and process necessary academic information, such as listening to the teacher and learning higher level concepts and skills within the classroom. 

gross motor coordination activities

One of the very first gross motor tasks that a young child completes is rolling, lifting up off the floor in the superman pose, and the different types of crawling.

These skills transfer to more and more coordinated motor tasks with development and play experience.

Check out this Gross Motor Activities Book about Core Strengthening with Music and Movement.

Development occurs proximal to distal, which is essentially from the core to the extremities. First, a child must have adequate core strength and stability in order to fully engage in gross and fine motor skill development.

You can find core strength activities on the OT Toolbox website.

basic core strengthening activities: 

  • sit-ups
  • planks
  • push-ups
  • wall-kicks
  • pulling self on a scooter board
  • donkey kicks
  • crab walks
  • yoga poses
  • wheelbarrow walking
  • therapy band exercises
Use these gross motor coordination activities to develop coordinated movement patterns in kids.

gross motor coordination Home Exercise program

At-home exercise programs are important to engage the family in their child’s therapy program. At-home gross motor coordination activities provide the family with some easy and fun ways to work as a family while developing important skills.

A daily routine is most effective, however, the family can work on a weekly routine if that is all the time they have (every little bit counts).

Hopefully, when the family sees the difficulties their child has in doing some of these gross motor coordination activities, and understand the impact it has on their academic learning and overall school success, they will invest more time into their program.

  1. Follow the Leader: Think about sprinkling in some old movements with new ones to help the child feel successful, but also encourage them to participate in the harder or more difficult movements. Ideas include: clapping, marching, arm circles, twirling, side to side jumping, crawling, sidekicks, hopping, stair climbing with hands and feet, and body swaying.
  2. Obstacle course – Think about keeping it simple at first with just 2-3 obstacles and then add additional obstacles as they improve their skills. Ideas include: jumping over pillows, walking around multiple chairs or bar stools, crepe paper laser maze in the hallway or between chairs, tunnels created with tables and chairs, or even pool noodles in the hallway
  3. Dance moves – Find YouTube dance move videos for the child to engage in ,or just try silly dances such as animal dancing, freeze dancing, and animal sound dancing.
  4. Jump rope or hoola hoop moves – Try jump roping by either continuously moving the rope overhead and jumping, or if this is not possible, try flipping rope overhead, pause behind feet, and step over in a continuous manner. If the child is not ready for jumping rope, try wiggling the rope on the ground like a snake while the child jumps over it. If jump roping is not an option, try the same idea with use of a hoola hoop!
  5. Ball dribbling – Use a playground or basketball to do some ball dribbling using one hand at a time and then advance to bilateral hand dribbling from left to right and right to left. You can even have them dribble with the ball by bouncing off the wall to the floor or ground. The OT Toolbox has a few more ideas to work on bilateral coordination.
  6. Target toss – You can use a variety of objects for this activity such a stuffed animals, bean bags, pillows, or balls. Toss them into a basket, try cornhole, toss into tape shapes on the floor, or even at a target on the wall. 
  7. Rolling – Have the child roll themselves down a hill or an incline created with a wedge or other surface. Don’t have an incline? That’s okay, roll up in a blanket or a flat sheet!
  8. Twister or Twister Moves (Amazon affiliate links)– These two games are two of the best games for older kiddos to play in order to work on gross motor coordination! Kids really love them and so do the families! 
  9. Climbing – Have the child climb up a rope ladder, stairs, or the ladder on a bunk bed. Create a coordination exercise with obstacles on the floor to crawl over such as pillows or cushions off of the sofa. Go to the neighborhood playground and use the climbing wall!
  10. Simon Says – This simple game can be a fun way to work on coordination skills. You can incorporate the use of left and right directionality to make it more of challenge. Print off these Simon Says commands for therapy-friendly activity cards.
  11. Tightrope balance beam – Place a jump rope or a strip of masking/painter’s tape on the floor to have the child walk on the line in order to remain on the tightrope – be careful and don’t fall off!  Incorporate heel to toe, side stepping, squatting to pick up items, and walking backwards. A slack line across a canyon will be the ultimate goal! These indoor balance beam ideas will keep you covered for indoor activities and these outdoor balance beam ideas are great for outdoor play.
  12. Hopscotch – Draw a hopscotch board on the driveway or the sidewalk and play this classic game. You can even do it even on a rainy day by using tape on the floor in the home.
  13. Hippity Hop Balls and Pogo Jumpers (Amazon affiliate links)– Many families have one of these at home, and they are great to work on overall gross motor coordination. Hop around the house or create a path to have the child hop on.
  14. Pillow jumping – Create a path around the room with pillows or stuffed animals on the floor and have the child jump over them with two feet or if they are ready for an advanced move, on one foot! If you are in someone else’s home, make sure the parents are ok with their child jumping on pillows or furniture first.
  15. Big shoe walking – Allow the child to walk around the house in shoes that are too large for them. Have them try slippers, boots, sneakers, and sandals. It’s super fun and highly motivating! While not the safest option, children love walking around in high heels!
  16. Crawling – Simply crawl on all fours to maneuver around the room by crawling around, over, or under furniture. It can be the fun way to work on coordination exercise.
  17. Ball rolling on a tape maze – Create a maze on the floor and have the child work on rolling a ball on top of maze lines, either by using their hands and crawling or standing and using their feet
  18. Ball rolling on a wall – Have the child work on rolling a ball up and down the wall with their feet, while lying supine, or roll the ball on a tape maze using their hands. Create the maze in either a horizontal or vertical fashion.
  19. Skateboard – No, this isn’t standing and riding, as this is most likely a dangerous coordination exercise for the child who is challenged with gross motor coordination. However, have you thought about having them sit or lie on the board to use it like a scooter board? It can potentially be a good tool for coordination. 

Need a free printable handout for fun gross motor activity ideas?  Grab it here! This printable set contains an equipment list and activity ideas specifically for the home. 

Gros Motor Intervention Ideas

Intervention ideas for a therapy session can include many of the gross motor coordination activities above that are easy to do without much equipment.

Other ideas can include the use of therapy balls, scooter boards, swings, a trampoline, bucket stilts, and other various equipment. If you don’t have the room for these items, or access to them where you are providing services, there are other ways to work on gross motor coordination too.

Take a look at some of these fun ideas to build motor coordination:

  • Hand games – Any type of hand game is the perfect tool to work on motor coordination for kids. Classic ‘Give me 5’, hand stacking, and slap hands are great for bilateral coordination of the upper extremities. Here are some easy hand games, or finger play songs that you might want to try. 
  • Clapping activities – Use of symmetrical and asymmetrical hand movements can easily be upgraded and downgraded based on the child’s skill level. Try some of the ideas found in Why You Should Teach Your Kids Clapping Games
  • Balloon volley – Have child do balloon volley with a partner in sitting, standing, or even kneeling. This is a super fun way to engage in coordination and you can do partner games easily during therapy. Don’t have a partner? That’s okay, have them try to do it with use of frisbee or their own hands. Add in a baton held horizontally and you’ve got another game! 
  • Partner yoga poses– This is a great gross motor coordination task for a small group or for partners!
  • Rapper Snappers or Pop Tubes (Amazon affiliate link)– Have the child pull these apart and push them back together. This is not as easy at it looks. It makes a great motivator as the sound can be quite rewarding. Don’t do it in a library or a quiet hallway, as it can be quite loud. Don’t ask how I know this.
  • Crab walk soccer – Have the child learn crab walking first. When they are ready for a little extra challenge, have them work on kicking a ball while in the crab walk position. They can play with a partner or simply kick the ball to a target. 
  • Suspended ball hit – Suspend a ball or balloon from the ceiling or a swing suspension system and have them either stand while holding a baton horizontally to strike a ball/balloon back and forth to themselves. If your student can not stand for this activity, they can sit and do the same. Need an extra challenge? Tall kneeling is a good position!
  • Mirror image – Play mirror imaging by having the child copy the moves that you do like looking in a mirror. 
  • Zoom Ball – Have the child work on building coordinated arm movements to pull the handles of the ball on a string and send the ball to their partner. Do it while standing, sitting, and kneeling. You can even try it with your arms behind your back! Use these zoom ball games to get started.
  • Laundry basket pulley – Have child sit or stand to pull a rope attached to a weighted laundry basket or box and have them pull the rope hand-over-hand towards themselves to bring the basket/box to themselves. 
  • Resistive Band or Handee Band exercises – The use of resistive bands is a simple way to work on coordination. Using fun exercise cards can keep them focused and engaged by design.  The Handee Band program is designed for younger kiddos, as the cards are designed with fun active characters. 
  • Heavy Work Movements– Actions that incorporate the proprioceptive sense and vestibular sense offer movement with sensory benefits. These Heavy Work Activity cards are perfect for all learners.
  • Hokey Pokey – An easy, classic game that children enjoy and can be played as a small group or individually during therapy.  You can easily incorporate directionality with this game too!
  • Playground equipment – Head out to the playground at a school and voila! Tt’s gross motor coordination opportunities galore! Explore swinging, sliding, rocking, and climbing.
  • Animal walks and other types of movement patterns – Have the child work on some of these fun animal walks as they are one of the best ways to have children work on coordination skills during therapy sessions.
  • Themed Exercises- Other thematic exercises are a super fun way to have children work on the coordination of upper and lower body movements. If you want a print and go resource that utilizes the alphabet, then grab this free printable resource from The OT Toolbox, Alphabet Exercises for Kids.  
  • Rhythm games – Use songs and poems to help a child perform hand or body rhythmic patterns that work on coordination while utilizing an auditory assist. YouTube videos can be a good tool for this activity.
  • Gross motor coordination exercises – These are basic exercises that address overall body coordination while using upper and lower extremities in a coordinated manner:  windmills, jumping jacks, standing cross crawls, supine cross crunches, and toe touches. The OT Toolbox has you covered with Jungle Animal Heavy Work Coordination Exercises.

gross motor coordination Therapy Equipment Ideas

If you need activity ideas to use equipment during therapy sessions, here is a list of ideas that utilize the some of the most common tools used during clinic practice or school settings.  If you want an overall big picture of gross motor toys in therapy, read this Gross Motor Toys article.

  1. Trampoline – Use of the trampoline for jumping is a great form of coordination.  Want to engage the upper body more? Try tossing and catching a ball while jumping to further work on coordination skills with use of a trampoline.

2. Scooter board – The scooter board can be used in a variety of ways to address coordination skills. 

  • Lying supine and pushing off of the wall with the feet
  • Lying prone and pulling self across the floor
  • Pulling self while seated using a hand-over-hand pattern with use of a rope anchored by therapist or a secure hook
  • Driving the scooter board by kneeling and pushing the board to targets on the floor
  • Try this fun deck set (Amazon affiliate link) for scooter boards which provides many activity ideas that focus on coordination.

3. Therapy ball – A therapy ball is another equipment tool that can be utilized in a variety of ways to address coordination skills.

  • Lying supine and having child pull themselves to sitting with support from an adult
  • Lying prone while walking back and forth on their arms and hands – maybe even doing an activity too 
  • Performing therapy ball slaloms with use of cones and a baton 
  • Try this fun deck set (Amazon affiliate link) for therapy balls which provides multiple ideas that focus on strength and coordination.

4. Therapy platform swing – A therapy swing provides ample use of coordination while engaging in fun activities to build coordination.

  • While seated crisscross in the middle, have the child work on batting a balloon or catching a ball.
  • While seated crisscross in the middle, have the child use a baton to reach and ‘catch’ loops or bead necklaces. 
  • While lying prone, have child work on creating ice cream sundaes.
  • While lying prone, have the child pick up and toss bean bags at a target.

5. Bucket Stilts (Amazon affiliate link)– These are fun way to work on coordination skills and kids are always interested in how they work and often ask if they can try them.  Yes, you can!  Just the design and purpose of this toy is what builds coordination. So, really no explanation is needed.

6. Safety cones – These are really inexpensive and can be found at the dollar store. All you need are a few of them to either place on the floor or elevate them on inner tubes like safety cone toe taps to address coordination. 

7. Wobble Balance Board – An effective equipment tool to address coordination skills simply by the use of it. Use it inverted or not! 

8. Shark Run – An easy way to work on coordination skills either in the therapy session or at home. Have the child start by putting two mats or pillows in front of each other and then while standing on the farthest one, bend and reach back to pick up the other pillow or mat, move it to the front and step on it next, then repeat. This creates a path to walk across the room and try to stay out of the water and avoid the sharks!

A Final Note on Gross Motor Coordination

While all of these gross motor coordination activity ideas are great, don’t forget there are other ways to have the child build their skills. They can engage in community activities such as karate, gymnastics, swimming, dance, yoga, ballet or organized sports. While your child says they would rather sit in front of their electronics, these gross motor coordination activities can be just as fun.

Regina Allen

Regina Parsons-Allen is a school-based certified occupational therapy assistant. She has a pediatrics practice area of emphasis from the NBCOT. She graduated from the OTA program at Caldwell Community College and Technical Institute in Hudson, North Carolina with an A.A.S degree in occupational therapy assistant. She has been practicing occupational therapy in the same school district for 20 years. She loves her children, husband, OT, working with children and teaching Sunday school. She is passionate about engaging, empowering, and enabling children to reach their maximum potential in ALL of their occupations as well assuring them that God loves them!

Occupational Therapy for Down Syndrome

Occupational therapy interventions for down syndrome

Occupational therapists (OT practitioners) provide skilled services to help many different people, with or without a diagnosis. In this article, we will talk about Down syndrome, more specifically common interventions and strategies when providing occupational therapy for Down syndrome.

Occupational therapy interventions for children with Down syndrome.

Occupational Therapy For Down Syndrome

Occupational therapy practitioners work with many diagnoses. In pediatrics, the diagnosis of Down Syndrome may be seen in early intervention services, in school-based therapy, or in the outpatient setting.

An occupational therapist will perform an evaluation and develop an individualized plan of action designed to meet specific needs. Occupational therapy interventions may be related to areas such as:

  • Oral motor concerns impacting feeding
  • Positioning and feeding techniques
  • Physical motor skills including gross and fine motor skills
  • Achievement of motor milestones including rolling, sitting, position changes, and use of the arms and legs, etc.
  • Facilitation of self-care skills
  • Refinement of fine motor skills
  • Sensory needs
  • Social or emotional needs
  • Self-regulation needs

This list may not include every area addressed in occupational therapy. Let’s go into more detail about OT and the individual with Down syndrome.

First, let’s cover the diagnosis of Down syndrome.

WHAT IS DOWN SYNDROME?

Down syndrome is a genetic disorder caused by additional copy of chromosome 21. In regard to functional performance, the typical characteristics of Down syndrome include:

  • Low muscle tone
  • Relatively short limbs, including hands, fingers, and thumbs
  • Mild to moderate intellectual disability
  • Developmental delays

People with Down syndrome are often active members in their communities, able to participate well in school and social events, and can raise a family. Each case is unique, and health professionals such as occupational therapists are available to help improve functional independence along the way. 

what is Occupational therapy for Down syndrome?

In order to fully understand the involvement between the occupational therapist and person with Down syndrome, it is critical to learn the role of the OT.

During the initial evaluation of a person with Down syndrome, the occupational therapist will assess many different skills to determine the specific needs. They will try to answer broad questions like, “How independent is the person with activities like eating, dressing, and playing?”, and specific questions, such as, “What types of grasps do they use?”.

Developmentally appropriate assessments will be used to measure fine and gross motor skills, cognition, and sensory regulation. 

down syndrome: Fine Motor Skills

The whole body is responsible for strong fine motor skills; starting with core then shoulder strength, moving down toward strength and mobility in the hands and fingers.

The general decrease in muscle tone and joint stability that is common in those diagnosed with Down syndrome, makes the development of fine motor skills more challenging. 

Physical features impacting fine motor skills

The hands of a child with Down syndrome have a typical pattern of development, including shorter hands, fingers, and thumb than the average child, that can further decrease dexterity.

The palms may also lack the curvature that is required for skills like thumb opposition. We call these the arches of the hand, and they are useful during any skill that requires the hand to move around an object, big such as a water glass, or small like buttons. 

Because of these physical features, coupled with general muscle weakness and loose joints, occupational therapy for Down syndrome will likely offer activities to increase fine motor skills.

Gympanzees has a great article on developing fine motor skills for children with Down Syndrome.

Dexterity and Down Syndrome

  • Use small items, like beads/pompoms/Cheerios/buttons, to pinch, place, string, glue down, or count.
  • You can increase the challenge by encouraging holding onto multiple items in one hand, but only placing one at a time – much like we hold a set of coins and use a singular hand to find and place the correct coin. This is referred to as in-hand manipulation

Joint Protection and down syndrome

  • Braces or splints may be used to help support the joints in a functional position, while the child continues to build strength. 

Arm Strength and down syndrome

  • Weight bearing through the arms is a great way to build shoulder strength for fine motor development – try animal walks, wheelbarrow walking, or crawling through tunnels!

Hand Strength and down syndrome

  • Get those fingers moving by shaping playdough or putty; roll, squeeze, poke, smash, and pinch it! Increase the challenge as the skills develop by selecting firmer putty or by adding additional steps to the activity. 
  • The OT Toolbox has great resources for overall fine motor hand development

Gross Motor Skills for down syndrome diagnosis

Just like fine motor skills, the base of gross motor skills is the core. A person needs that proximal stability first, before they can build movement skills.

Increasing the core strength leads to improved balance, coordination and dynamic movement control. These areas are addressed as they impact functional participation in feeding, self-care, learning in the school setting, and participation in functional tasks.

Individuals with Down syndrome tend to have a more challenging time with strength and motor planning to move from one posture to the next due to low tone.

For example, moving from a seated position on the floor to standing. The sequence should be: seated on the bottom, to a 4-point crawl position, to kneeling, to a single leg kneels, then standing. This sequence and combination of movements may pose an extra challenge due to limited mobility, strength, and muscle tone.

Below are some ways to improve occupational therapy for Down syndrome can improve gross motor skills. 

Core Strength and down syndrome

  • There are so many play-based activities that strengthen the core. Almost any activity can be done in prone (on the tummy), which can improve core strength and offer some weight-bearing in the arms at the same time
  • When you think core strength, think balance. Use balance beams, one-foot stand, wobbly surfaces, etc. Just make sure to prioritize safety and comfort. 

Positional Changes and down syndrome

  • The more change, the better. Set up a game or obstacle course that encourages movement up/down, side-to-side, rolling, or scooting.
  • The most important goal is to get that body moving!

down syndrome and Sensory Regulation 

Are children with Down syndrome more or less likely to experience sensory differences? Yes. This is the reason occupational therapy for Down syndrome and sensory regulation will be an important part of the treatment process.

There is one clear reason why people with a diagnosis of Down syndrome may experience more sensory processing difficulties – low muscle tone again. Individuals with low muscle tone may have a harder time processing proprioceptive input. This is the sense that our muscles and joints pick up to tell the body where they are in space. 

Because of this decreased proprioceptive input, people with Down syndrome frequently need more input in order to grade the force of their movements.

For example, they may experience difficulties in choosing how hard or how soft their movements should be. They may knock something down by pushing too hard, or drop something by mistake by not holding tight enough. 

This can also skew how an individual with Down syndrome eats food. They may not feel the food in their mouth very well until it is full, and start over-eating or pocketing food in their cheeks. People diagnosed with Down syndrome often grind their teeth as a way to get more input and stability through the jaw.

  • Increased proprioceptive input
    • Weighted items: vests, lap pads, blankets 
    • Exercise, weight bearing, jumping 

In addition to low tone, another common comorbidity to Down syndrome is hearing loss. This is important to address as a sensory need because an individual may react strongly or under react to auditory stimuli. Sensory tools should be trialed for a few weeks to see what will work best to regulate the child’s sensory system. These tools should be used intermittently throughout the day, and never forced on a child. In order to be effective, they should be voluntary and not be used as a reward or punishment. 

  • Auditory Processing Strategies 
    • Noise reducing headphones
    • Auditory feedback tube (like this)
    • Assistive technology for hearing loss

A Sensory Diet is a great treatment option for sensory processing and Down syndrome. The OT Toolbox also has a great resource called the Sensory Lifestyle Handbook to address and understand sensory processing needs.

For more play-based ideas for early intervention for working with learners with Down syndrome, here is a fun article on outdoor sensory activities.

If you are a fan of the OT Toolbox, you can access all of these resources much easier by becoming a member. As a member, you will:

  • Be able to download each of them with a single click (No more re-entering your email address and searching through folders!)
  • Receive early access to new printables and activities before they’re added to the website (You’ll find these in the What’s New section.)
  • Receive a 20% discount on all purchases made in the The OT Toolbox shop!

For all of these skills, the most important part of occupationl therapy for Down Syndrome is to meet the child where they are. An Occupational therapist will make an assessment of their learner’s current level of functioning, providing a “just right” challenge, that is motivating for that particular learner. Because of potential delays in cognitive ability, and the physical difficulties associated with Down syndrome, these new skills may not develop quickly, and may not progress at all. Occupational therapy can help with adaptations to approach these tasks in a different way, or modifications to the environment to increase independence. 

Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her
background is in Human Development and Family Studies, and she is passionate about
providing individualized and meaningful treatment for each child and their family. Sydney is also
a children’s author and illustrator and is always working on new and exciting projects.

Valentine’s day activity sheet

valentine's day activity sheets

In today’s free printable the Valentine’s Day Activity Sheet, all the Valentine stuff is certainly mixed up!  This set of Valentines pencil control scanning worksheets combines visual motor and visual perceptual skills in several different PDF forms to delight and entertain even the most picky learner! Add this resource to your Valentine’s Day occupational therapy activities.

Valentine's Day activity sheets to work on visual perceptual skills

Valentine’s Day Activity Sheet

Add this hearts and roses worksheet to your therapy line-up. This is such a fun time of year to add creative resources like the Valentine activity sheet described below. It may even become a new Valentine tradition!

Do you have any Valentine’s traditions? Maybe making handmade valentines, baking cookies, or going out to a favorite restaurant.  Sometimes traditions are purposeful, while other times they just happen. If something “works” one year, it tends to become a tradition whether you want it to or not.  There are expectations in motion, or maybe just lack of creativity.  Hey, she liked it last year, let me do it again for 25 years.

For at least fifteen years I received a box of Russell St****rs chocolates for Valentine’s day.  I am not a fan of this kind of chocolate.  I probably faked enthusiasm the first year, thus starting a tradition.  In short, traditions are ok, but it is also awesome to mix things up a little!

Before looking at the Valentine’s Day Activity Worksheets, we need to understand:

What is visual perception and why is it important? 

Visual perception is being able to look at something and make sense of it.  Items have to be “perceived” in the correct way for motor output, reading, following directions, self care, and just about everything we do. That jacket that is inside out?  It takes more than just fine motor skills to right it.  The eyes and brain need to “see” that the jacket is inside out, where the problem stems from, then use motor skills to correct it. 

Check out this article from the Vision Learning Center about breaking down visual perceptual skills.

While righting jackets and reading are not the most enticing tasks for developing visual perceptual skills, Valentine Printable Scanning Sheets are!

Better yet, to avoid having to submit your email address each time, consider becoming a member of the OT Toolbox! Membership has it’s perks. As a member you will not only be able to find every single one of the free printables offered on The OT Toolbox, but you’ll:

  • Be able to download each of them with a single click (No more re-entering your email address and searching through folders!)
  • Receive early access to new printables and activities before they’re added to the website (You’ll find these in the What’s New section.)
  • Receive a 20% discount on all purchases made in the The OT Toolbox shop!

Valentine’s Day Activity Sheet for Visual Perception

This great bundle of free visual scanning/pencil control printables works on several different visual perceptual skills:

  • Visual memory – remembering what was seen long enough to find it somewhere else
  • Visual scanning – being able to look at all of the choices (either in random or sequential order)
  • Visual form constancy – looking at items that might be slightly different or in a different position and recognizing they are the same figure

four more visual perceptual skills

We use these to make sense of what is seen.  Can you think of examples of activities or everyday tasks that require these skills?

  • Visual figure ground – picking out items from competing backgrounds
  • Visual spatial relations – identify items in relation to other items. What is in front, next to, behind
  • Visual closure – making sense of an item when only given part of it, such as doing a puzzle
  • Visual discrimination – the ability to idenfity differences between objects which may be obvious or subtle

When thinking about figure ground, picture looking for an item in the refrigerator.  This skill requires being able to perceive or “see” the item among a forest of other items.  Visual spatial relations may be looking at pictures to determine what is in the foreground and what is in the background, or how far something is.  There are a lot of pictures and games that trick the mind’s eye into thinking it is seeing something else.  The brain has to work extra hard to decipher these.

In case you missed it, Colleen Beck posted a great article on visual perception:

Some people have amazing visual perceptual skills, while others really struggle. I have mentioned before, there is a gender divide when it comes to visual perceptual skills.  Males were designed to hunt/gather/protect, therefore their eyes do not perceive subtle differences.  Do not despair!  These can be taught, or at least compensated for.  

Knowing that visual perceptual skills can be a weakness for many, it is important to address these difficulties early, and train the brain to recognize the difference between objects, be able to find things, and solve puzzles.  Learners who struggle with anything, are going to be less likely to want to do something that is challenging.  Make it fun!  Get puzzles that have the theme your learner gravitates toward. The OT Toolbox has a great Valentines Day Fine Motor bundle to add to your theme. Use food or other motivating items to teach these skills.

While I tend to discourage more electronic use than is already imposed on young minds, here are a couple of fun examples of online games that are motivating AND build visual perception from the Sensory Toolbox.

As always, there are a dozen ways to adapt and modify these Valentines Day Activity Sheets to meet the needs of most of your learners.  

This Valentine scanning pencil control worksheet is no exception:

  • Laminate the page for reusability. This saves on resources, and many learners love to write with markers!
  • Print in black and white or color for different levels of difficulty
  • Cut the shapes and make a matching game instead of using a writing tool to draw lines
  • Talk about the items, describe their characteristics, and give context clues to help your learner understand why certain pictures match
  • Copy some of these designs to add to the visual motor element
  • Try different writing utensils. This is not only motivating, but some learners work better with markers as they glide easier on paper. Did you know that golf sized pencils promote more of a tripod grasp than traditional long pencils? Try having your learner color with one inch crayons to enhance their grasp
  • Enlarge the task for beginning writers who need more writing space
  • Shrink the task for older learners who need to learn to write smaller
  • Velcro the back of the Valentine items, after laminating and cutting them,  to create a matching game
  • Have students write on a slant board, lie prone on the floor with the page in front to build shoulder stability, or supine with the page taped under the table
  • Project this page onto a smart board for students to come to the board and write in big lines
  • Graded prompting may be needed to grade activity to make it easier or harder
  • Make this part of a larger lesson plan including gross motor, sensory, social, executive function, or other fine motor skills
  • Don’t miss this great post on Valentine’s Day Activities, including Valentine’s Day Playdough, and a Valentine’s Day Shredded Paper Sensory Bin

Besides visual perception and/or writing, what else is being addressed using this Valentine’s scanning, pencil control printable?

  • Fine motor – grasping pattern, wrist stability, intrinsic hand muscle development, pencil control
  • Bilateral coordination – hand dominance, using “helper hand”, crossing midline
  • Proprioception – pressure on paper, grip on writing tool
  • Strength – shoulder, elbow, wrist, hand, core, head control
  • Visual perception – scanning, figure ground, line placement, crossing midline, visual closure, seeing parts to whole
  • Executive function/behavior – following directions, attention, focus, sequencing, planning, task completion, frustration tolerance
  • Social function – working together in a group, problem solving, sharing materials and space, turn taking, talking about the activity

It can be very frustrating if you have excellent visual perceptual skills and other people do not “see” the world as you do. Take comfort in the fact that these skills can be learned with a little bit of effort.  Until then, make sure the Ketchup is always on the same shelf, and the clothing is never inside out!

Free Valentine’s Day Activity Sheet

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    Superior visual perceptual skills here! – Victoria Wood, OTR/L

    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.

    **The term, “learner” is used throughout this post for readability, however this information is relevant for students, patients, clients, children of all ages and stages or whomever could benefit from these resources. The term “they” is used instead of he/she to be inclusive.

    Looking for more pencil control activities?  Look no further: