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Perineal Hygiene

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perineal hygiene and pericare tips

Here, we are covering an aspect of potty training that comes up for every parent: pericare, or perineal hygiene, and teaching kids how to wipe when toilet training. So often, a young child learns to use the toilet and other aspects of potty training, but then struggle for a long period of time with the wiping aspect. Teaching children to wipe thoroughly is a hygiene task that can be limited by many underlying areas. Here, you’ll find strategies to help wiping bottoms and interventions for perineal hygiene. Also check out ADLs for more information on daily tasks.

How to teach pericare, or perineal hygiene needed to wipe completely during toileting.

What is pericare?

For the uninitiated, pericare (or peri-care) is short for perineal care. Perineal care refers to the hygiene and self-care of the perineal area following toileting, cleaning, and wiping of the perineal area of the body is the “private parts” area. Pericare is a term for the hygienic tasks involved in this part of the body, such as wiping one’s bottom.

Anyone of any age may need help wiping their bottom with their perineal care, but it is especially important to teach our little ones the proper way to manage their bottoms as they become more independent. 

This component of toileting is one that impacts overall independence and self-care with the toileting process. So often, we cheer and celebrate making it to the toilet on time, but the perineal hygiene aspect is equally as important.

Related: Potty Training Seats for Special Needs

You may be thinking, “Why do I need to teach my child how to wipe!?!”. For something that is such a natural task for many, it can feel odd to teach somehow how to do it.

However, learning how to maintain a clean bottom is important for one’s health and confidence. Wiping properly, washing gently, and wearing appropriate clothing decreases the risk of yeast infections, urinary tract infections, and odors. Plus, discussing peri-care can open the door to many other conversations about the body, health, and safety – if that’s something you are interested in exploring with your child.   

A great time to educate your child about peri-cares is while potty training. It is easier to teach the correct way first than to re-learn how to do it later. If you are stuck on potty training, we feel you there! Check out this Toliet Training Book that can help you help your children of varying needs.

Don’t be discouraged if your child is already potty trained and they have yet to learn how to take care of their bottoms independently – it can take time and practice! 

Development of Pericare

An important area to cover first is the development of pericare skills. It is so important to remember that we are talking about young children who are learning a whole new skill with toileting. There are many considerations: autonomy, body awareness, interoception, self-awareness, the sensory processing and interoception aspect, family perspectives…potty training can be very overwhelming for kids.

Then, to break it down even further, the hygiene aspect of toileting is another ball game!

In our book, The Toilet Training Book, we cover the development of potty training and really cover what underlying skills play into potty training and independence with toileting.

But, one important thing to remember is that a three year old child may be able to make it to the toilet in time to go, flush, and wash their hands, but the wiping aspect can developmentally, come with time.

Developmentally, perineal hygiene, or wiping completely after toileting, may be a skill achieved during a range of 4-6 years. This range is so wide due to the underlying skills, sensory considerations, motor skills, and cognitive growth needed for perineal hygiene including knowing when and where to wipe after a bowel movement or urination, using enough pressure on the toilet paper to clean completely, wiping enough times to clean completely, and maturity to complete the task.

The emergence of these skills takes time, but there are ways to support development of perineal hygiene.

GET COMFORTABLE with perineal hygiene

Everyone wants a clean bottom, let’s start there. It can be smelly and embarrassing to talk about, but it is an important step to understanding personal healthcare.

We want to give you the confidence to discuss this in any way that you and your family feel comfortable with because it is a “touchy” subject for some. The more comfortable you are with peri cares, the more comfortable the child will be. 

Let’s start off the potty training wiping techniques by talking about good hygiene.

Here are some ideas to talk about perineal hygiene with kids:

  • Make it silly: Some people respond best to humor but watch out for demeaning jokes. 
  • Make the conversation about pericare hygiene scientifically accurate: It becomes less embarrassing when you hardly know what is being said! 
  • Make pericare sound similar to washing hands: We have to clean away the germs; they can make us sick! 
  • Make discussions about perineal hygiene your own: You know your family best. Think about terminology that works for the individual. In what ways can you increase trust and comfort for all? 

GENERAL GUIDELINES for teaching perineal hygiene

Here are some general tips for a healthy bottom that should be shared for children and adults alike. Please speak to your family physician if you have any questions or concerns related to your child’s unique needs. 

  • Wear breathable (preferably cotton) underwear that is not too tight. Change daily or when soiled. 
  • Don’t hold it in. While it is good to wait to “go” until you reach the toilet, holding in pee or poop for too long can result in a variety of issues. 
  • If it is comfortable, sit on the toilet with elevated feet. You may have heard of the (Amazon affiliate link) Squatty Potty – placing the legs in more of a squatting position helps bowel movements pass. More importantly, children should have access to a either a smaller potty or a footstool (or a box,etc.) near the toilet so that their feet do not dangle. 
  • Wipe from front to back to reduce bacteria entering the urethra. Talk about anatomy and why wiping front to back is effective and safe.
  • Wipe gently with 3-4 squares of folded toilet paper (each household can determine the amount – some kiddos use way too much!) until clean. I always recommend to look at what you are wiping away so that you learn about how much you need to wipe. 
  • Consider use of warm or cool wipes over toilet paper.
  • When bathing, wash the genital area gently with mild soap and rinse with clean water. No soap should be entering the body through the anus or the vagina. 
  • For bathing a uncircumsized child, refer to this article for great information and consult your family doctor for personalized advice.   

Pericare INTERVENTION IDEAS

Children will not know unless we lead them, so here are some fun ways to teach pericare! 

Areas that can be broken down to increase overall self-care include:

  • Address balance
  • Pulling up and down undergarments
  • Wiping front to back
  • Wiping thoroughly
  • Wiping with enough pressure
  • Gripping the toilet paper
  • Washing hands after wiping
  • Reaching around to the back

Each of these areas can include aspects of balance, gross motor skills, fine motor skills, strength, coordination, sensory processing, executive functioning skills, and visual motor skills. It’s important to look at each individual’s area of difficulty and then break it down into the underlying areas that are impacting success with pericare.

First look at the area of difficulty. Then, consider how underlying areas are impacting that particular area. Come up with intervention strategies that support that need and create a “just right” challenge to build independence and pericare functioning.

Let’s look at each of these areas of perineal hygiene…

Pulling up and down undergarments:

  • Fine motor strength and coordination fine motor activities to the rescue! There are so many fantastically fun ways to increase this skill, but here are some that are more directly associated with potty training.
    • Lei Obstacle Course: Grab some Hawaiian-inspired leis, hula skirts, or long necklaces and create a long pathway. As a child walks through the pathway (hopefully to another fun activity in the course), they must step inside the lei and pull it up as high as it will go. If it fits over their arms/head, they can wear it as a necklace. Pulling up the lei and wiggling their body through will strengthen the same skill as in pulling up pants. Reverse the challenge to mimic pulling pants down.
    • Silly Socks: Grab a variety of socks in fun colors and different sizes and see how many you can put on in one minute! Layering socks up the arms and legs (and removing them, too!) mimics the skill of pulling up and down undergarments. 
    • Stickers: Challenge them to peel off stickers all along the waistband of their pants. Don’t forget the backside! 

Pericare: Wiping Activities

Balance and reach are huge parts of perineal hygiene. Staying balanced on the potty while wiping is a big challenge for our core strength, flexibility, and range of motion. To practice this skill through play-based activities, see the ideas below! 

Play-pretend: Place peanut butter on the back of a disposable or washable diaper and have your child wipe it off. Any familiar paste will do – sun butter, nutella, cookie butter…anything to wipe! When they think they are done wiping, show them the diaper to see if they actually cleaned it. 

Art-based: Wipe a plastic plate with toilet paper to create an art project – the toilet paper acts as the paintbrush. They must wipe clean the whole plate! For an extra challenge, place the plate behind their backs, and the work of art in front of them. 

Play activity: Using static electricity, tape, or velcro, have your child squat to “pick up” pom-poms or other sticky and lightweight items on their bottoms (think: window stickers, damp tissues, etc.). They carry them carefully to a container and remove them one by one. You can really make this game your own!

Wiping Front to Back

There are so many ways to work on perineal hygiene to cover other aspects besides the balance consideration. Consider these strategies to teach kids to wipe front to back:

  • Use toys, books, clothing, and other items to work on teaching front and back directional concepts.
  • Teach children to count to help with wiping a certain number of times.

Reaching Back to Wipe During Perineal Hygiene

  • Clip and unclip clothes pins on the back of clothing to work on reaching back and around..
  • Use a pool noodle to reach around and through the legs to work on reach, visual attention, scanning, and eye-hand coordination. You can tap the pool noodle on a target and create a game.
  • Practice wiping the backside in the bathtub.
  • Put a handkerchief or scarf in their back pocket for the child to reach for and pull out.
  • Put stickers on the child’s back or pants for them to reach for and grab.

Wiping with enough pressure

  • Work on tearing paper for hand strength and eye-hand coordination to pull off appropriate sizes of toilet paper.
  • Use play dough, LEGO, tong activities to develop hand strength.
  • Wipe dry erase marker off a dry erase board. Then, position the dry erase board on the ground between the feet to bend and wipe. Then, position it behind the back to reach and wipe.
  • Wipe peanut butter or washable paint from a plastic baby doll.
  • Help kids to wipe thoroughly by painting with toilet paper with having them try to wipe a blob of paint off a plastic plate and remind them to keep going until the plate was empty.

More perineal care and potty training tips

Looking for more information on underlying considerations that impact toileting? Need strategies, supports, and tools to facilitate independence with toileting skills? Need support strategies for potty training an older child, but not know where to begin?

Looking for ways to help individuals with toileting skills when cognitive, behavioral, motor skills impact participation in independent toileting? Trying to initiate or progress with potty training when a diagnosis of Down Syndrome, Autism, or a motor skills challenge is at hand? Check out the Toilet Training Book: A Developmental Take on Potty Training for Kids of All Abilities.

Resources for toilet training kids of all abilities
The Toilet Training Book: A Developmental Look at Potty Training for Kids of all Abilities

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.

The Development of Balance

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Development of balance

Balance development is a pivotal part of child development. Gross motor coordination, balance and motor planning are all part of the processes of acquiring these skills. Here, we cover balance development, strategies to support this skill, and specific balance activities.

Development of balance from infancy through preschoolers.

Balance Development

Acquiring or practicing balance can be seen in a toddler swaying step by step, a child pretending the sidewalk curb is an Olympic balance beam, or a teenager managing their new crutches.

Strong standing and walking balance equal safe mobility, which opens the door to so many wonderful new things; running, jumping, cartwheels, backflips…you get the picture.

Achieving physical balance plays an important role in the development of many different skills, some of which may surprise you!

WHAT IS BALANCE?

Before officially diving into the development of balance, we first need to define and understand it. 

  • Balance – According to the Harvard Medical School, balance is the ability to distribute your weight in a way that lets you stand or move without falling, or recover if you trip. Good balance requires the coordination of several parts of the body: the central nervous system, inner ear, eyes, muscles, bones (Check out this list of bone names), and joints
  • Static Balance – maintaining body position during an unmoving task, such as sitting or standing
  • Dynamic Balance – the ability to remain standing and stable while performing movements or actions that require displacing or moving oneself

The various muscles of the body contract or relax in order to maintain the proper balance for our daily activities, as controlled by our balance center in the brain; the cerebellum. 

In addition to the cerebellum, the inner ear also sends signals to the brain, to give a status report on the environmental changes that affect balance. The inner ear is where the vestibular system is located.

Its’ fluid picks up on the motion and position of the head, constantly sending information back to the brain via the eighth cranial nerve. When there is a medical issue within the ear, such as an ear infection or torticollis, it may affect balance. This is generally in the form of dizziness or unsteadiness. 

The primary source of information for the following list of balance developmental milestones was primarily sourced here.

Information from different sources may vary slightly, largely due to the fact that developmental patterns fall into different ranges. For a general list of developmental milestones, refer to the CDC resource here.

For balance to occur, we need lower extremity strength integrated with other areas of development, including vision and processing of vestibular input.

Balance Development in the first year

Prenatally

  • The vestibular system is developed at five months pregnancy

0-3 MONTHS

  • Primitive reflexes (uncontrolled movement) lay the groundwork for future motor development
  • Tummy time develops vision and postural control required for optimal balance later on 

4-6 MONTHS

  • Rolling prone to supine (front to back), then supine to prone (back to front)
  • Supported sitting, then unsupported sitting

7-9 MONTHS

  • Picks up a dropped toy, may fall while reaching
  • Begins to army crawl, cruise crawl, or scoot
  • Holds majority of their own weight while standing supported
  • May squat up and down while standing 

10-12 MONTHS 

  • Pulls self up to stand, then stands unsupported
  • Manipulation of toys/ movement of arms while sitting unsupported 
  • Moves in and out of laying and seated positions with control
  • Cruises along furniture or walks supported

Development of Balance in Toddlers 

13-16 MONTHS

  • Walking unsupported, but may tumble easily
  • Crawls up and down furniture and stairs with support for safety
  • Begins to learn how to walk faster/run 

17-19 MONTHS

  • Is able to get onto small chairs without help
  • Walks up stairs while holding on with one hand
  • Runs stiffly and falls often
  • Can pick up objects while standing, without losing balance

2 YEARS

  • Pulls off socks without losing balance
  • Runs with improved coordination
  • Can kick a ball without losing balance

Development of Balance in PReschoolers

3 YEARS

  • Can briefly balance and hop on one foot
  • May walk upstairs with alternating feet (without holding the rail)
  • Able to pedal a tricycle

4 YEARS 

  • Hops on one foot without losing balance
  • Throws a ball overhand with coordination

5 YEARS:

  • Skips, jumps, gallops, and hops with good balance 
  • Stays balanced while standing on one foot with eyes closed 

The majority of our balance skills have developed by age 5, but will continue to fine-tune up until around age 12. Remember to keep in mind, these are averages for the typically developing child. 

Balance is required to do just about anything in daily life. 

Balance is needed to stand at the mirror while brushing teeth, get out of the car, and put on socks, to name just a few. Without the development of this balance skill, support aids (walkers, crutches, braces) may be necessary for safety and function.

Static Balance

Did you know that balance is also related to non-physical, or static tasks?

Research suggests that when balance is improved, so are attention and learning skills. Good balance helps children develop better reading, writing, and language skills, as well as improved concentration. 

One way balance is theorized to improve academic skills, is through increased body control, and knowing where the body is in space (proprioception). Having better body control and knowing how to coordinate movement in various environments is important.

Correct body awareness makes it easier to have a comfortable seated posture. Good balance also makes activities such as sitting still while moving the head to look up at the chalkboard, and then back down to write easier. 

Check out these Body Awareness Activities from the OT Toolbox.

Without proper body control, it is just that much more difficult to perform the tasks of a student: copying from the board, holding and reading long textbooks, carrying materials from space to space, and supporting an upright seated posture for many hours a day.  

How to Support Balance Development

Knowing the huge impact that balance has on the body, what can you do to improve it?

Check out this blog post on balance activities.

The OT Toolbox has great articles on gross motor skills, that will suit the needs of your children. Check these out and let us know your favorites!

If you love all of the great resources found above, consider becoming a member.

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.

This resource is just one of the many tools available in The OT Toolbox Member’s Club. Each month, members get instant access to downloadable activities, handouts, worksheets, and printable tools to support development. Members can log into their dashboard and access all of our free downloads in one place. Plus, you’ll find exclusive materials and premium level materials.

Level 1 members gain instant access to all of the downloads available on the site, without enter your email each time PLUS exclusive new resources each month.

Level 2 members get access to all of our downloads, exclusive new resources each month, PLUS additional, premium content each month: therapy kits, screening tools, games, therapy packets, and much more. AND, level 2 members get ad-free content across the entire OT Toolbox website.

Join the Member’s Club today!

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.

Audio Books for Occupational Therapists

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audio books for occupational therapists

Today, I’ve got a list of free audiobooks for occupational therapists. These occupational therapy audiobook ideas can be used to develop, learn, and grow as a therapist. These occupational therapy books are audiobooks, making them great tools for learning new skills while on the go.

Therapists are short on time, so occupational therapist audio courses and audiobooks are the way to go when it comes to learning. One of the best things about growing as a professional is the ability to continue to learn. As therapists, we strive to develop in our profession to meet the needs of our ever-changing client list. Reading or listening to books for occupational therapists is just one way to learn and grow professionally.

Here, we’re covering parenting books on Audible, or audio books that OTs can recommend to parents to better understand parenting and child development.

These audiobooks for occupational therapists are great for the travelling OT, or listening to while on a commute to work, covering a variety of areas that can improve your occupational therapy practice, in educating OT clients, advocating for occupational therapy patients, and improving OT practice areas.

Audible Books for Occupational Therapists

Amazon affiliate links are included below.

Amazon has some great mindfulness audiobook resources for parents and professionals available on Audible and other formats. Audiobooks are a great alternative to paper books, as they can be listened to almost anywhere.

There are tons of resources on mindfulness in audiobooks. I tried to find ones that had good reviews, were accurate and easy to read/listen to, and provided useful strategies.

If you are an Amazon Prime member, You’re eligible to claim 2 free titles from our entire selection (one title per month thereafter) with a free Audible 30 day trial. A standard trial includes 1 credit for an audiobook download. After the Audible trial period, all members receive 1 credit per month.

Click here start your free Audible Trial Period.

Recently, I came across a few books on Amazon that are perfect for therapists looking for books to grow and learn in different aspects of occupational therapy.

These are audiobooks that can help OTs grow as a practitioner by staying on tap of hot topics. As therapists, we strive to advocate for our clients, educate parents, teachers, or others on the child’s tribe or team. These are audiobooks for occupational therapists that can help us grow as therapists!


Best of all, they are available as audiobooks for those of us looking for books to listen to while commuting, cooking, or working out!

Free Audio Books for Occupational Therapists

This post contains affiliate links.


Audible is a subset of Amazon and offers free books to members. While the membership does have a fee, there is a free 30 day trial, where books can be listened to anytime and anywhere. 


There’s more: When you sign up for the free trial of Audible, you’ll get two free books. In addition to the 2 Free audiobooks, you’ll also get 2 Free Audible Originals to get you started. 


After your free trial ends, if you do choose to continue with the membership, you’ll get 1 audiobook and 2 Originals per month after trial. You can cancel anytime and keep all your audiobooks. You’ll also get 30% off the price of additional audiobook purchases. 


So, after reading this, I had to check to see what books are available on Amazon’s Audible that would be interesting as an OT. How cool to grab a free audio book on a topic I wanted to learn more about!
 

Parenting Books on Audible

Balanced and Barefoot: How Unrestricted Outdoor Play Makes for Strong, Confident, and Capable Children– Written by occupational therapist, Angela J. Hanscom, describes children of today who have more sedentary lifestyles and desperately need outdoor play in order to develop their sensory, motor, and executive functions.

The book describes nature as the ultimate sensory experience, and helps you discover little things you can do anytime, anywhere to help your kids achieve the movement they need to be happy and healthy in mind, body, and spirit.

Sensory Processing Disorder: Not Just a Strong-Willed Child, Book 1– This audiobook is a resource for parents that therapists can recommend for those looking for more information on Sensory Processing Disorder or those striving to empower their child.

By listening to this audiobook, you’ll learn more about what is sensory processing disorder, common behaviors of different types of SPD, differences between SPD and some other look-alike conditions like ADHD, OCD, ODD and anxiety disorder, tips on how to manage SPD at home, school, and community.

Overcoming Dyslexia– This book on dyslexia helps us to understand, identify, and overcome the reading problems that so many kids struggle with in schools. In this audio book, you’ll learn exactly what dyslexia is and how to identify dyslexia in preschoolers, schoolchildren, young adults, and adults.

You’ll discover how to work productively with the teacher of a child with dyslexia or reading challenges. Included are exercises to help children use the parts of the brain that control reading, including a twenty-minute nightly home program to enhance reading. There are also ways to improve a child’s self-esteem and more.

Also be sure to check out our blog post on dyslexia and occupational therapy.

The Smart but Scattered Guide to Success: How to Use Your Brain’s Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home– This audiobook helps the listener identify their executive skills profile and shares effective steps to boost organizational skills, time management, emotional control, and nine other essential skills.

This is a resource for parents and therapists who may be struggling with executive functioning skills or those working with teens or older clients. 

Smart but Scattered Teens: The “Executive Skills” Program for Helping Teens Reach Their Potential– This audiobook describes research-based strategies for promoting teens’ independence by building their executive functioning skills in order to get organized, stay focused, and control impulses and emotions.

Bright Kids Who Can’t Keep Up: Help Your Child Overcome Slow Processing Speed and Succeed in a Fast-Paced World– This audiobook is geared toward those kids who struggle with processing speed in tasks like classwork, homework, caring for themselves, motor tasks, or following directions.

Ten Things Every Child with Autism Wishes You Knew– This audiobook describes 10 characteristics that help illuminate, not define,  children with autism. The book describes and helps listeners  understand the needs and the potential of every child with autism. It’s been said that “Every parent, teacher, social worker, therapist, and physician should have this succinct and informative audiobook in their back pocket”.

1001 Great Ideas for Teaching and Raising Children with Autism or Asperger’s– This book shares tons of tips, strategies, tools, and resources that can be helpful to parents, teachers, and therapists working with kids with autism or Asperger’s syndrome. There are modifications for older kids to help children achieve success at home, in school, and in the community. 

The Autistic Brain: Thinking Across the Spectrum– This book by Dr.  Temple Grandin teaches listeners the science of the autistic brain, and with it the history and sociology of autism.

The Loving Push: How Parents and Professionals Can Help Spectrum Kids Become Successful Adults– This book is described as an essential roadmap for parents, teachers, therapists, and anyone working with the child with autism. Another resource by Dr. Temple Grandin, psychologist and autism specialist Dr. Debra Moore share insight in helping kids  build on their strengths to improve motivation in real life strategies.

What’s Going on in There?: How the Brain and Mind Develop in the First Five Years of Life– This book by a research neuroscientist describes how the baby’s brain is formed, and when each sense, skill, and cognitive ability is developed from conception through the first five years.

The book shares development of motor skills, social and emotional behaviors, and mental functions such as attention, language, memory, reasoning, and intelligence. 

The Emotional Life of the Toddler– This audiobook covers the emotional development of kids through the toddler years, with the latest research on this crucial stage of development. This is a great resource for the pediatric OT.

Raising an Emotionally Intelligent Child: The Heart of Parenting– Dr. John Gottman shares strategies to teach their children self-awareness and self-control and to foster good emotional development. This audiobook is a resource for parents and those working with families with young children.

Raising Your Spirited Child, Third Edition: A Guide for Parents Whose Child Is More Intense, Sensitive, Perceptive, Persistent, and Energetic– This audiobook is the very same as the book that has been voted one of the top 20 parenting books out there. It’s a tool therapists can use to provide parents with the tips and tools they need based on research and practical strategies for raising spirited children. It’s a book for anyone who knows meltdowns, behavior, and spirited kids!

  What are your favorite audiobooks for occupational therapy? You know, those audiobooks you LOVE that advance your practice knowledge, improve your advocacy for OT clients, and help to educate parents or teachers of  occupational therapy clients?

These audiobooks for occupational therapists are great for advancing as an occupational therapist by reading the hot topics in the field, so that you can advocate for OT clients, educate the parents and teachers of kids on an occupational therapy caseload.

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

Emotional Intelligence

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Emotional Intelligence activities for kids

Emotional intelligence in children is a skill that takes practice, example, and more practice to develop. For all of us, emotional intelligence can be an ongoing skill that impacts social emotional skills, relationships, and functioning in day to day tasks. Here we are

For those of us raising children and working with children it is clear that they need more than ‘book smarts’ to navigate the rather complex world that they are growing up in. For a long time the intelligence quotient or Emotional IQ was the only benchmark for measuring children’s potential and predicting how well they would achieve.

In more recent times people studying development and psychology realized that there were other skills necessary for achieving success in the world. One of these sets of skills has become known as Emotional Intelligence.

Emotional intelligence is the ability to manage and understand your emotions and those around you with empathy and perspective. These emotional intelligence activities for kids develop Emotional IQ through play.

What is Emotional Intelligence?

Emotional intelligence is described as the ability to understand and manage your own emotions and to understand the emotions of those around you. The concept of emotional intelligence also known as emotional quotient or EQ developed in the 1990’s and has gained widespread acceptance in recent years.

Instrumental in the development of the theory and models of emotional intelligence is Daniel Goleman a psychologist and author. Goleman and emotional intelligence may be terms that you’ve heard connected, where he describes four main domains that make up Emotional Intelligence.

These domains are self-awareness, self-management, social awareness, and relationship management. What do each of these emotional intelligence domains mean?

  • Self-awareness – Self-awareness is having conscious knowledge of your own character and feelings. This results in being able to recognize your strengths and weaknesses. Self-awareness in kids plays a role in emotional control, mindset, habits, and executive functioning skills.
  • Self-management – Self-management is being able to control and manage your emotions in a healthy way. Self-management for kids involves self-regulation, mindset, habits, and self-control. Co-regulation plays a role in this aspect as well.
  • Social awareness – Social awareness is the ability to pick up the emotions of other people and to understand what they are feeling. This can be a challenge for children of all needs.
  • Relationship management – Relationship management is the ability to build relationships with others through positive interpersonal communication skills (Segal, 2020). Children develop relationship management skills through example by watching others in their lives, by interacting with peers and adults, and through play.

The domains are further broken down into twelve competencies and learnable skills that are relevant to the specific domain. (Matlock, 2017)

At the bottom of this post, you can find hands-on activities for children that develop each area of these emotional intelligence skills.

Emotional intelligence and emotional leadership

Emotional leadership is a term developed by Goleman and others, and refers to leadership in groups, impacted by one’s emotional intelligence. When you take a look at the domains of EI, you can see how they play into the functioning of a group.

Occupational therapists know a thing or two about group management and group leadership. At it’s infancy, occupational therapy played a major role in group therapy and mental health. While this domain of occupational therapy intervention is no longer primary area of intervention, there are still many OTs working in the mental health arena and especially in the group treatment intervention.

Emotional leadership is an important part of group occupational therapy sessions, as the participants are interacting with others in the group and developing specific individualized goal areas but also group goal areas. Groups in therapy have a leader, often the therapist, but sometimes the therapist presents as a facilitator but one that keeps the group on track as the group interacts with other participants.

In this way, participants can develop emotional leadership skills and skills that can be used outside of the group setting as a development of emotional intelligence and emotional learning.

It is clear that a lot of work has been done on developing an understanding of emotional intelligence and the components that make up this construct. But how important is emotional intelligence in the lives and development of our children?

Is Emotional Intelligence Important?

Cognitive behavioral therapy recognizes that feelings or emotions can influence thoughts. When emotions run high they can alter the way our brains work and this can have a negative effect on our cognitive abilities. Our feelings can influence the decisions we make and how we interact with other people. It makes sense that having a greater understanding of our emotions will help guide how we interact with others.

Improving our emotional intelligence makes it easier to resolve conflicts, manage our stress and interact appropriately with those around us (Segal, 2020). And children will definitely benefit from developing these skills. Children’s learning is influence by their emotional state so managing emotions in a positive way allows children to be receptive learners at school.

Emotional intelligence includes the ability to name emotions. The act of naming emotions tends to diffuse their intensity and lessens the negative impact they may have on our cognitive abilities. The psychologist Dan Siegel refers to this as ‘name it to tame it’ (Schwartz, 2015). The value of recognizing feelings and emotions is evident but how does emotional intelligence develop.

Development of Emotional Intelligence

When asked how emotional intelligence develops in a recent interview Daniel Goleman stated that “emotional intelligence begins to develop in the earliest years. All the small exchanges children have with their parents, teachers, and with each other carry emotional messages. These messages repeat over and over to form the core of a child’s emotional outlook and capabilities.” (Scholastic, viewed 2021)

As adults interacting with children it becomes important to ensure that we are able to recognise and manage our own emotions. Once we are able to do this we can become valuable role models for children and we can provide opportunities for them to see emotional intelligence in action. Recognizing and discussing emotions with children lays a foundation for their self-regulation.

The development of emotional intelligence begins in infancy, through interactions with caregivers, and continues as children are socialized across their school years alongside parents, peers, and teachers. Emotional intelligence is gained through both informal experiences (observations and conversations) and through and formal instruction (being taught emotion vocabulary, learning self-regulation strategies).

How emotional intelligence is taught depends on age, but unlike learning other skills such as math and science or English language arts, there is no age at which it is too early or too late to develop your emotional quotient. The parts of the brain needed to develop emotional intelligence are active from birth and will continue to develop throughout life.

As with many developmental tasks it seems that the first few years of life the brain is at its most receptive to learning key skills. And emotional intelligence is one of these important skills. (Brackett, Cipriano, 2015) 

This resource on executive functioning skills and emotional regulation shares more information on the role executive functioning skills play on emotional IQ.

 How to Teach Emotional intelligence?

An essential part of developing emotional intelligence is being able to talk about feelings. This skill set is often termed emotional literacy and it is something that we are able to teach young children.

We can teach children to read and understand emotions and to respond appropriately to their own emotions and the emotions of others. Goleman explains that you can teach young children about the most basic emotions, such as happiness and anger and when they get older touch on more complicated feelings, such as jealousy, pride, and guilt (Scholastic, viewed 2021). 

It is important to remember to include a range of emotions both positive and negative when talking about feelings.

Although it is not always comfortable talking about negative emotions it is important that children recognize and accept the wide range of emotions that they are likely to experience during their lives.  We can incorporate opportunities to promote emotional intelligence in our everyday lives. 

Emotional intelligence activities for therapy, the classroom, ad home to help children develop emotional intelligence skills for functioning.

Emotional Intelligence Activities

What does promoting Emotional Intelligence look like in a therapy session?

As an occupational therapist (and a parent!) it can be overwhelming to think about the number of developmental needs that fall within your domain of influence. My therapy approach has always been aligned with building confidence and self-awareness in the children that I treat so in that way emotional intelligence has been fostered through incidental learning and interactions.

In more recent times I have used tools and resources that focus specifically on building skills that will enhance emotional intelligence – empathy, self- regulation, communication skills – depending on what the individual child needs. 

In my therapy session the first few minutes are spent getting a gauge of where the child is at and what their mood is like. By spending a few minutes engaging one on one with the child I am able to assess their level of attention, level of arousal and motivation at the time. I also have a mood meter on my wall and the kids love moving the arrow to the colour that corresponds to how they are feeling that day – low energy, just right energy, slightly high energy or off the chart energy levels.

With a reluctant child I might get the ball rolling by sharing how I am feeling that day and using the mood meter to plot my energy levels. I also have a feeling chart called ‘How does your jellybean feel today?” adapted from a book by Susan Jelleberg (Jellybean Jamboree).

This introduces the idea of naming emotions and of expanding our vocabulary related to emotions. In this way I feel I am working on the self-awareness component of emotional intelligence. 

The next step is ensuring that the child is in a good space to learn and this means aiming for a calm-alert level of arousal. The Zones of Regulation offer a number of tools to help children reach that just right space. Some children need activities to lift their energy and some children need activities to lower their energy levels. I find deep pressure or proprioceptive activities work like a charm and I also use breathing activities frequently in my therapy sessions.

In this way we tackle some of the self-management aspects of emotional intelligence. 

Social management is a tricky one for young children to pick you. Learning that the people around them do not always think and feel the same is them is an on-going process. There are some lovely activities to encourage empathy in children and to help them become aware of other people’s feelings.

Finally relationship management is encouraged through appropriate interactions between myself and the child during the therapy session. For some children this means learning how to deal with losing a game or competition, learning the skills of turn taking in conversation, or how to give and receive complements.  

So within the confines of a short therapy session, while working on other specific OT goals, it is very possible to facilitate and encourage a child’s emotional intelligence. An understanding of emotional intelligence and is various elements means that it is also possible to encourage its growth in the classroom and in our homes.

And it is with this well-developed emotional intelligence that I believe our children will be able to successfully navigate the world they are growing up in and find meaning in their lives. 

For further information on some of the component skills and activities related to emotional intelligence have a look at the following links. There are numerous resources on the OT Toolbox that deal with developing different components of emotional intelligence.  

Self-Awareness Activities for Kids

To develop self-awareness it is important to be able to understand what you are feeling. Children can participate in some of the following activities in increase their awareness of emotions.

These self-awareness activities promote social emotional development through the awareness and process of practicing identification of emotions:

These emotions playdough mats can be used to teach kids emotion names and emotions they may have felt in the past. Kids can create the facial expression that matches the emotion name, building self-awareness of emotions.

Penguin emotions game– Use this penguin theme emotions activity to support emotional intelligence in kids.

Social emotional learning– This social emotional skills worksheet supports the development of emotional intelligence by allowing children to draw in facial expressions that match various emotional states.

Social emotional learning 2– This comprehensive resource on social emotional learning supports development of emotional intelligence by offering resources and information on how children develop emotional skills and ways to support that development.

Spring matching emotions slide deck game– This Spring themed emotions activity supports the development of emotional skills by offering practice and matching of facial expressions.

Emotions Check in– You can foster a sense of self awareness by allowing kids to identify their emotions. This can be a part of the routine in the classroom, home, or with each therapy session. A sightly different strategy would be identifying feelings with a feelings check in.

Self-Management Activities for Kids

To develop self-management skills you need to move beyond identifying emotions and figure out strategies that will help to regulate these emotions and subsequent behaviours. 

This Zones of regulation toolbox offers a collection of activities and resources designed to promote self-regulation and self-management skills for kids.

Breath control is an important skill for kids to achieve in developing and refining self-management skills.

Deep breathing exercise cards are a powerful tool to use in building and developing self-management skills for kids. Print off these cards and use them over and over again to meet the interests and needs of a whole classroom or clinic of children.

Proprioception activities are heavy work movement activities that provide children with a sense of awareness when it comes to how their body moves through space or in a given situation.

Social Awareness Activities

To develop social awareness you will need to understand other people’s emotions effectively. These hands-on social awareness activities are strategies that children can use to develop emotional intelligence in social situations.

Empathy for others- Developing empathy requires practice and awareness. This Quick as cricket activity for Empathy helps children to understand the perspectives of others through a classic children’s book. The hands-on accompaniment activity gives kids a chance to practice their empathy skills and put them to work in social situations or through the social interaction with others.

Try these friendship activities to work on specific skills in developing social awareness, relationships skills, and interpersonal skills in children.

Through books, families can look at the pictures and come back to specific concepts again and again. And, adding hands-on, multi-sensory play experiences brings those concepts home. Be sure to check out our resource on calm down toys for more ideas.

In the resource, Exploring Books Through Play, you’ll do just that.

This digital, E-BOOK is an amazing resource for anyone helping kids learn about acceptance, empathy, compassion, and friendship. In Exploring Books through Play, you’ll find therapist-approved resources, activities, crafts, projects, and play ideas based on 10 popular children’s books. Each book covered contains activities designed to develop fine motor skills, gross motor skills, sensory exploration, handwriting, and more. Help kids understand complex topics of social/emotional skills, empathy, compassion, and friendship through books and hands-on play.

Click here to get your copy of Exploring Books Through Play.

Relationship Management Activities

To develop relationship management skills you will need to know how to develop and maintain good relationships with other people. These relationship management activities are strategies to work on emotional intelligence during interactions and relationships with others. 

These Social skills interventions are therapy activities designed to promote relationships with others through hands-on activities that give kids practice to support relationship skills with others.

This resource on Executive functioning in school is helpful in addressing relationships with peers, mentors, and teachers.

To work on emotional development requires many executive functioning skills, including impulse control, working memory, mindset, attention, planning, self-talk, inhibition, and more. To address these skills in kids, using a fun, hands-on approach to talking about these skills through lists, drawing, and goal-setting is key. You’ll find the exact tools to address these needs in the printable, Impulse Control Journal.

Impulse Control Journal the OT Toolbox

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.

Contributor to The OT Toolbox: Janet Potterton is an occupational therapist working predominantly in school-based settings and I love, love, love my job. I have two children (if you don’t count my husband!), two dogs, one cat, two guinea pigs and one fish. When I am not with my family or at work I try to spend time in nature. The beach is my happy place.

Kindergarten Learning and Play Activities

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kindergarten activities

Below are kindergarten activities that promote development of skills needed during the kindergarten year. These are great activities to use for kindergarten readiness and to help preschool and Pre-K children build the motor skills in order to succeed in their kindergarten year. You’ll find kindergarten letter activities, Kinder math, fine motor skills to build stronger pencil grasps when kindergarteners start to write with a pencil and cut with scissors. You’ll also find kindergarten sight word activities for when that time of the Kinder year comes around. Let’s have some fun with 5-6 year old activities!

Be sure to check out our tools to support name practice for kindergarten to work on name writing skills!

Kindergarten activities and kindergarten readiness activities

Kindergarten Activities

 What you’ll notice is missing from this massive list of Kindergarten activities, is handwriting, writing letters, and even writing names. (And writing letters in a sensory bin falls into this category too! Before kindergarten, children should not be copying letters into a sensory bin. You’ll see letters formed incorrectly, letters formed from bottom to top, and letters formed in “chunks”. The same rule applies to tracing letters and words and even “multisensory strategies” for writing. It’s just too early. Unfortunately, we see a lot of preschools and standards doing the exact opposite. You’ll even find online sites sharing preschool and Pre-K writing that is just in poor advice.
 
Here’s why: prior to kindergarten age, kids are not developmentally ready for holding a pencil, writing with a pencil, and writing words. Their muscles are not developed, and asking them to write letters, copy words, and trace with a pencil is setting them up for improper letter formation, poor pencil grasp, and weak hands. 
 
What children aged 5 and under DO need is play! They need exposure to sensory experiences, sensory play, coloring, cutting with scissors (even if it’s just snipping), puzzles, games, beads, blocks, stamps…there are SO many ways to help pre-K kids and preschool children develop the skills they need for kindergarten and beyond.
 
Kindergarten is such a fun age.  Kids in kindergarten strive when they are given the chance to learn through play and hands-on activities.  These are our favorite Kindergarten activities that we’ve shared on the site, with Kindergarten math, reading and letter awareness, Kindergarten Crafts, and Kindergarten Play.   
 
 

Kindergarten Functional Tasks

Kindergarten is the stage when children go off to school for perhaps the first time. That’s why prior to kindergarten, it’s great to “practice” a lot of the functional tasks that children will need to do once they go to kindergarten. Some of these may include:

Now…not all of these functional skills will be established for every kindergarten child…and that’s OK! Kindergarten can be the year to practice these tasks in the school environment. 

Kindergarten Letter Activities

Kindergarten is all about letters, upper case and lower case letters, and sounds.  They learn how letters go with sounds and work on decodable reading.  These letter learning activities will help your kindergarten student with identification, sounds, and beginning reading skills.

Kindergarten Letter activities for letter learning
 
 
 
 
Name Soup Writing Your Name | Building Letters Cotton Swabs | Fizzy Dough Letters | Handwriting Cookie Cutters
 
 
Learning Letters Push Pins | Letter & Writing Travel Kit | Letter Formation with Styrofoam | Upper & Lower Case Letter Seek
 
 
LEGO Letter Stamps | Color & Letter Sticker Match | Name Building Sensory Soup | Sensory Letter Play
 
 
Letter Identification Bin | Upper & Lower Case Letter Match | Decodable Reading With Nature | Pressing Too Hard When Writing
 
 
Visual Motor Letter Learning with Bubble Wrap | Rainbow Writing Handwriting Practice | Winter Letters Outside


Kindergarten Math Activities

Kindergarten students work with manipulating items to discover and explore numbers and patterns.  They solve simple addition and subtraction problems, more or less, comparing amounts, and shapes.
 
These Kindergarten math ideas will be a fun way to discover math ideas with playful learning.
Kindergarten Math ideas

 
 
Caterpillar Math Craft | Math with Checkers | Cardboard Tangrams | Play Dough Math
 
 
Lego Shapes | Styrofoam Cup Math | Cardboard Building Shapes | Art Worksheets
 
     
 




   
 
 
   
 
Easy Shapes Big Rig Craft | Rainbow Color Sort | Apple Math
 
  
 
Sugar Aunts Counting Nature | Snowball Math | Penguin Themed Math Counting
 
    
 

Kindergarten Sight Words and Reading:

Kindergarten students learn sight words throughout the school year. These sight word activities are fun ways to learn with play while reinforcing sight word skills.
  
Sight Word Scavenger Hunt | Sight Word Scooping
 
   
 
 
   
Sight Words with String | Sight Words Ping Pong Bounce | Sight Words Sensory Bin | Bottle Cap Sight Words Stamps
 
 

Sight Words Manipulatives | Outdoor Pre-Reading Letter Hunt

Kindergarten Books and Activities

Extending book ideas with crafts and activities are a fun way for Kindergarten students to become engaged with reading.  Listening to an adult read is a powerful tool for pre-readers.  They learn language, speech, articulation, volume, and tone of voice.  These book related activities will extend popular stories and engage your Kindergartner.

Book ideas activities for Kindergarten
 
 
 
  
 
 
 

 
Ten Apples Up on Top Baked Cotton Balls | Pete the Cat and His Four Groovy Buttons Snack | Activities Based on Books | Bears on Wheels Letter Match
 
 

Snowball Fight math activity
Press Here Sensory Bin
Harold and the Purple Crayon Play Dough
Little Blue and Little Yellow Puffy Paint
 

Kindergarten Fine Motor Play

Fine motor skills in Kindergarten students are essential for effective pencil control and handwriting, scissor use, and clothing and tool manipulation.  Kindergartners may have little experience with tools like scissors, pencils, hole punches, staplers, and pencil sharpeners. In fact, there are MANY fine motor skills needed at school. All of these items require dexterity and strength.  
 
In-Hand manipulation play for fine motor skills: We had so much fun with water beads.  This post shares two ideas for improving in-hand manipulation skills which are so important for dexterity in self-care, handwriting, coin manipulation…and so much more!
 
Finger isolation, tripod grasp, eye-hand coordination, bilateral hand coordination…Fine Motor Play with Crafting Pom Poms has got it all!  We even worked on color identification and sorting with this easy fine motor play activity.
 

What play ideas can you come up with using common tools? These items are GREAT ways to build hand strength and dexterity that will be needed in kindergarten for pencil grasp development and endurance in handwriting. 

  • tweezers
  • tongs
  • beads
  • toothpicks
  • hole puncher
  • peg boards
  • lacing cards
These fine motor activities will engage your student in fine motor skills for effective hand use in functional school tasks.
 
Kindergarten Fine Motor activities
 
 
 
   
 
DIY Light Box | Rainbow Beads | Beads & Feathers | Fine motor Color Match
 
   
 
Fine Motor Color Sorting | Fine Motor Pom Pom Play | Play Dough and Rocks | In-Hand Manipulation Water Beads
 
   
 
Icicle Scissor Skills | Lacing Cards Carry Out Container | Flower Pretend Play Fine Motor | Color Sorting Scissor Skills
 
 
 
Pipe Cleaner Box Fine Motor Play | Christmas Pencil Control Sheets
 
  
 
Tripod Grasp Fine Motor Color Sort | Fine Motor Pom Pom Play | Fine Motor Lock and Keys
 

Kindergarten Play:

Play in Kindergarten is essential for so many areas.  Kindergartners are young students who need brain breaks from desk work.  Not only for that reason, but for turn-taking, language, social interaction, self-confidence, problem-solving, and interaction, play is an important part of your Kindergarten student’s daily lives.  

Play builds skills! Check out this post on the incredible power of play. Play helps kids learn and develop cognitive experiences and the neural connections that impact their educational career, beginning right now! Occupational therapists know that play is the primary occupation of children, but what’s more is that play builds the very skills that kids need to learn and develop.

Kindergarteners can gain valuable input through play:

  • Cognition
  • Problem Solving
  • Executive Functioning Skills
  • Attention
  • Strength
  • Balance
  • Visual Motor Integration
  • Visual Processing
  • Sensory Integration
  • Self Regulation
  • Language Development
  • Self-Confidence
  • Fine Motor Skills
  • Gross Motor Skills
  • Social Emotional Development
  • Stress Relief
  • Behavior
  • Imagination
  • Creativity

Try these play ideas in the classroom or at home for fun learning (through play)!

   
Teaching Spatial Concepts | Bugs and Beans Sensory Play | Back to School Story Stones | Butterfly Life Cycle Activities
 
 
 
Outdoor Small World Play | Painting Toys in the Water Table | Sticks and Stones Simple Sensory Play
 
   
Farm Sensory Bin | Water Bead Tea Party Pretend Play | Monochromatic Water Bin Sensory Play | Corn and Cookie Cutters Sensory Bin
 

Kindergarten Crafts

Crafts in Kindergarten are a great tool for so many areas.  Students can work on direction following, order, patterns, task completion, scissor skills, fine motor dexterity, tool use, and more by completing crafts in Kindergarten.  

Kindergarten crafts can have one or more of the areas listed here to help and build skills:

  • Scissor practice (placing on hand and opening/closing the scissors)
  • Exposure to different textures and art supplies
  • Practice with using a glue stick and bottle of squeeze glue
  • Practice cutting strait lines and stopping at point
  • Practice cutting simple shapes
  • Practice cutting complex shapes
  • Coloring
  • Painting with finger paints and paint brushes
  • Experience washing hands after crafting
  • Opportunities for creative expression
  • Opportunities for rule-following and direction following
  • Multi-step directions
  • Experience copying a model for visual motor benefits

Try a few (or all!) of these Kindergarten crafts for fun arts and play with your student. 

Kindergarten Craft ideas
 
 
 
 

Grand Old Duke of York Craft | Process Art Monster Cupcake Liner craft | Shoe Charm craft | Caterpillar Math Craft

 
 
 
Easy Shapes Backhoe Craft
We’ll be adding more to this resource soon, so stop back to find more Kindergarten learning ideas.  

Retained Primitive Reflexes & Child Development

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Retained primitive reflexes

This post is all about retained primitive reflexes, what retained reflexes look like, and how they impact child development. You’ll find specific strategies to integrate retained primitive reflexes as well. In a recent blog post, we discussed what are primitive infant reflexes, and why they are so important to infant development. Now, it is time to discuss what can happen if these reflexes hang around for too long.

Remember that every case is unique, and if your child matches these characteristics, that does not necessarily mean that they have retained that reflex. If you are concerned about your child’s abilities and how they may relate to retained reflexes, we recommend talking to your pediatrician.

For more information on primitive reflexes and their impact on child development, be sure to check out some of these books on primitive reflexes.

Retained primitive reflexes

retained Primitive Reflexes

The term “retained primitive reflexes” might be a phrase you’ve heard before. But what does that mean and what do retained reflexes look like in children? Well, there is a lot to cover.

Basically, as infants develop into toddlers, their primitive reflexes should do what health care professionals call “integration”. The response that comes with the primitive reflex should integrate into a more mature or voluntary movement. When primitive reflexes are retained, those instinctive actions, movements will remain past the typical age range…they continue to exist. They are retained.

If primitive reflexes are still present long after they should have integrated, the child will display certain characteristics specific to the retained reflex, many of which limit their development and academic skills.

Just to add some background information, when we say that primitive reflexes are integrated, that means that the movements (or reflexes) are absorbed and contributing to characteristics, actions and neurological responses. To put it in other words, a reflex moves along a neurologic arc and when integration of those reflexes occurs, a process where specific stimulus results in a predictable response (or lack of that predictable response) so that movements are more efficient. This occurs so the neurologic system is connected and communicating efficiently. It’s all part of the nervous system.

PALMAR REFLEX

The palmar reflex is important for the development of purposeful grasping, something that an infant is learning throughout their first year of life. The palmar reflex can be seen when you place your finger in the palm of an infant’s hand and their reflexive response is to hold on to your finger. What an adorable reflex, right?

This is not something we want to see in an older infant or child, though. While the response is necessary for a newborn to learn how to use their hands, it limits an older infant or child to only using their hands and fingers for a strong grip.

retained palmar reflex

Children with a retained palmer reflex may:

  • Get fatigued very easily with handwriting or fine motor tasks, like stringing beads.
  • Have a sensitive or “ticklish” palm
  • Open and close their mouths while using their hands for tasks like writing or cutting with scissors.
  • Have difficulty in speech articulation

The mouth and the hands are connected via neural pathways in infancy, and that connection is still strong in those who have the palmar reflex. This is why the movements of the mouth and speech may be involved in the retained palmar reflex.

How to integrate the Palmar Reflex:

  • Tasks that encourage separate use the fingers
    • Squeeze a ball with one finger and thumb, alternating fingers to squeeze
    • Stringing Beads
    • Playing with small Legos or similar toys

MORO REFLEX

The Moro reflex is also called the startle reflex – it can be seen in a frightened infant up to about 4 to 6 months old. The reflex causes a baby to stretch out their arms and legs, and quickly bring them back in, in jerky movements. This is in response to the feeling of falling, a loud sound, or a drastic change in temperature.

Retained Moro Reflex

Children with retained Moro reflexes are often very sensitive to stimuli – sounds, tags on clothing, lights, etc. They tend to lack emotional and self-regulation skills and have a difficult time paying attention in class. Without an integrated Moro reflex, their fight or flight response can be activated very easily causing them to have deficits in many areas of life.

How to integrate the Moro Reflex:

  • Starfish Exercise
    • While seated, open up into a big “X” shape with straight arms and legs.
    • Cross right ankle over left & Cross right arm over left
    • Open up to big “X”
    • Cross left ankle over right & Cross left arm over right
    • Repeat
  • This is also how you can test for its presence! If a child has a very difficult time completing these actions, without another known cause, they may have a retained Moro reflex.

TONIC LABYRINTHINE REFLEX

The tonic labyrinthine reflex (TLR) is used for head and postural control. We know that baby has poor control of their head and neck when they are born, and this reflex is part of what helps them gain control over this part of their body.

Retained Tonic LABYRINTHINE reflex

This reflex typically integrates around 4 months old, but if it persists, the following may occur:

  • Difficulties judging space, speed, depth, and distance.
  • Toe walking
  • Discoordination in simultaneous movements, such as walking or swimming.
  • Avoiding lying on their stomach.

Children with retained TLRs tend to be perceived as clumsy and often have a difficult time sitting upright and still in their chairs. This can decrease their ability to pay attention in the classroom setting. When posture exercises in kids don’t work, sometimes it’s easy for teachers or parents to wonder what is going on, when a look at retained reflexes may be in order. In some cases, integrating the TLR reflex can support posture.

How to integrate TONIC LABYRINTHINE REFLEX

  • Incorporate activities on their stomachs as much as possible, or for as long as they can manage each day.
  • Try reading, watching TV, or playing with a toy while on their tummies
  • Daily practice will strengthen their muscles and correct this response.

ASYMMETRICAL TONIC NECK REFLEX

This reflex is important to the initiation of crawling, as the arms and legs move as a baby turns their head while on their belly. While infants are on their bellies, and while crawling, they are exposed to a ton of visual stimulation by looking at their arms moving, looking and grabbing toys, etc. Tummy time is so important for this reason and more!

The ATNR should disappear around the time an infant is gearing up for crawling, around 6 months old.

Retained ASYMMETRICAL TONIC NECK REFLEX

If asymmetrical tonic neck reflex doesn’t integrate, the following may occur:

  • Poor Coordination during movements like skipping or riding a bike
  • Trouble crossing midline
    • Example: Moving right arm to left side of the body to buckle a seat belt.
  • Poor visual tracking = academic issues
    • Difficulty reading and writing

A quick test for a retained ANTR starts with having the child stand with both arms directly out in front of them. Ask the child to slowly turn their head all the way to the left. Their left arm will remain straight and their right arm will bend if the reflex is still present.

How to integrate the ATNR

  • Lizard Crawling Exercise
    • Start on the stomach
    • Look to your left, and bend your left elbow and left knee
    • Look to your right, and bend your right elbow and right knee

There are many more primitive reflexes, as well as postural reflexes, that are important to child development and student success. We have not covered everything here, but we hope to have given you a nice place to start building your understanding of what may happen when primitive reflexes are maintained over time.

Want to learn more about primitive reflexes, what to do when reflexes are retained, and how to know there might be an issue? Check out this primitive reflexes course. (affiliate link)

Assessment And Integration Of Primitive Reflexes For Improved Independence In Daily Activities is a course on primitive reflexes where you’ll learn how to, screen, test and integrate retained primitive reflexes and find tools to help your client or child improve motor, social and daily functioning skills by implementing fun, therapeutic, and functional activities!

In this primitive reflexes course, created by two occupational therapists, you’ll find modules and functional intervention activities for:

  1. Moro reflex
  2. The Tonic Labyrinthine (TLR) & Landau Reflex 
  3. The Rooting Reflex
  4. The Asymmetrical Tonic Neck Reflex (ATNR)
  5. The Spinal Galant Reflex
  6. The Palmar Grasp Reflex
  7. The Symmetric Tonic Neck Reflex (STNR)
  8. Support for kids who push back
  9. Printable handouts, screening tools, and checklists
  10. Information on postural reflexes, yoga, sensory diets, and more
  11. Case studies
  12. Research
  13. AOTA continuing education: 1.05 AOTA CEUs

If your child has retained primitive reflexes, learning to integrate them could lead to improved development in many areas:

  • Social Skills
  • Learning
  • Motor Skills
  • Executive
  • Functioning
  • Coordination
  • Reading & Writing

Find out more and gain insight and tools on retained primitive reflexes and start supporting kids needs with “Assessment And Integration Of Primitive Reflexes For Improved Independence In Daily Activities” today

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.

What are Primitive reflexes?

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what are primitive reflexes

Have you even heard the term reflexes and wondered what are primitive reflexes? One of the many things that your newborn’s pediatrician will check periodically is their primitive reflexes. The existence of reflexes can be a great marker for neurological health in people of all ages, as they are controlled by the nervous system – the brain, spinal cord, and nerves. Primitive reflexes develop in the womb and are integral to an infant’s survival and future development. Below we will break down each of these reflexes and their purpose. Be sure to read our blog on retained primitive reflexes as well, to discover how to support reflex integration.

what are primitive reflexes

Related: Books About Primitive Reflexes 

What are Primitive Reflexes?

As infants develop into toddlers, these reflexes should do what health care professionals call “integration”. The response that comes with the primitive reflex should integrate into a more mature or voluntary movement.

If they are still present long after they should have integrated, the child will display certain characteristics specific to the retained reflex, many of which hold back their development and academic skills. 

Let’s begin with the most easily noticeable reflex that babies have: the palmar reflex. This is also known as the grasping reflex. You will see this when you place your finger into the palm of an infant’s hand, and they hold on tight. This is an adorable response that can make you feel pretty special, but it is involuntary up until about 6 months of age when the reflex should disappear. 

PALMAR REFLEX

The palmar reflex is important for the development of purposeful grasping, something that an infant is learning throughout their first year of life. 

Fun Fact: if your baby is holding your hair in a death grip because of this reflex, stroke the back of their hand with your finger – it should initiate a release of the grasp. 

ROOTING REFLEX

The rooting reflex is one of the main “survival” reflexes. The rooting reflex can be elicited by stroking an infant’s cheek with your finger, or more likely, a bottle or breast nipple. This is because when the cheek is stimulated, the infant will turn his or her head towards that stimulation. 

If you ever need your baby to pay attention to their feeding, try giving their cheek a little stroke or tap so they turn towards the feeding source. This response should be seen in infants up until about 4 months of age. 

SUCKING REFLEX

Similar to the rooting reflex, the sucking reflex is necessary for an infant’s feeding abilities. To stimulate the sucking response, touch the roof of the infant’s mouth and they will automatically begin sucking. 

Most infants learn this skill very quickly (they do get tons of practice, after all!) and the reflex will disappear by about 2 months old. 

MORO REFLEX

This reflex is the first of three on this list that is a response to a change in body position. Also known as the startle reflex, the Moro reflex can be seen by gently dipping a baby’s head and neck backward, as if they are falling. It can also be elicited by other stimuli like a startling noise or a drastic change in temperature. 

The response that you will see in the baby is that of fear – their arms, legs, and head will reach out and then tuck back in – jerking their body back and forth. They may also open and close their hands and may even cry. The movement that is created by a startling stimulus is to protect your baby and allow them to move away from the stimuli even before they can control their own movements. Pretty cool, huh?

You may notice the startle reflex really kicking in around 1 month old. If your baby is inconsolable and moving around their body in this way, securing supporting their bottom and their head should help them realize that they are safe. By six months old, or as early as two months, this reflex will disappear. 

TONIC LABYRINTHINE REFLEX

The tonic labyrinthine reflex (TLR) is used for head and postural control. We know that baby has poor control of their head and neck when they are born, and this reflex is part of what helps them gain control over this part of their body. 

It’s important to know that posture in kids that impact functional performance (sitting at a desk for example) can be a result of a retained reflex and this is an area that is sometimes overlooked.

The TLR can be seen when moving the head and neck forward and backward. When the head moves forward toward the chest, the arms and legs bend and the baby assumes the fetal position. When the head moves back away from the chest, the arms and legs straighten. You can see this really well during tummy time! 

The TLR will disappear by about 4 months old so that more advanced reflexes and movements can begin development. 

ASYMMETRICAL TONIC NECK REFLEX

Last on the list of movement-based reflexes is the asymmetrical tonic neck reflex (ATNR). As the name suggests, this reflex has to do with the neck. You can see the reflex if you turn a baby’s head to one side while they are laying on their backs. They will reflexively straighten their arm and leg on the side that they are looking, and bend the arm and leg of the other side. That is where the asymmetrical part comes in: their left side and right side of their body are opposite. They look a bit like an archer, about to shoot an arrow. 

This reflex is important in the birthing process, as the motions of the head can control the movement of the rest of the body help the baby through the birth canal. It is also important to the initiation of crawling, as the arms and legs move as a baby turns their heads while on their belly. For this same reason, the ATNR is crucial to the development of hand-eye coordination. 

The ATNR disappears around the time an infant is gearing up for crawling, around 6 months old. 

MORE ON PRIMITIVE REFLEXES

There are a few more infant reflexes that we did not mention, and you can check them out if you are looking to learn more!

The Spinal Galant Reflex, the Babinski Reflex, the Landau Reflex, and the Symmetrical Tonic Neck Reflex (STNR) are some that we missed in this article. The Landau and the STNR are actually not primitive reflexes, as they develop after the baby is born, but they are developmentally important nonetheless! 

Luckily, we have a resource to share that covers these reflexes and much more…

Check out this primitive reflexes course. (affiliate link)

Assessment And Integration Of Primitive Reflexes For Improved Independence In Daily Activities is a course on primitive reflexes where you’ll learn how to, screen, test and integrate retained primitive reflexes and find tools to help your client or child improve motor, social and daily functioning skills by implementing fun, therapeutic, and functional activities!

In this primitive reflexes course, created by two occupational therapists, you’ll find modules and functional intervention activities for:

  1. Moro reflex
  2. The Tonic Labyrinthine (TLR) & Landau Reflex 
  3. The Rooting Reflex
  4. The Asymmetrical Tonic Neck Reflex (ATNR)
  5. The Spinal Galant Reflex
  6. The Palmar Grasp Reflex
  7. The Symmetric Tonic Neck Reflex (STNR)
  8. Support for kids who push back
  9. Printable handouts, screening tools, and checklists
  10. Information on postural reflexes, yoga, sensory diets, and more
  11. Case studies
  12. Research
  13. AOTA continuing education: 1.05 AOTA CEUs

If your child has retained primitive reflexes, learning to integrate them could lead to improved development in many areas:

  • Social Skills
  • Learning
  • Motor Skills
  • Executive
  • Functioning
  • Coordination
  • Reading & Writing

Find out more and gain insight and tools on retained primitive reflexes and start supporting kids needs with “Assessment And Integration Of Primitive Reflexes For Improved Independence In Daily Activities” today.

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.

Messy Eating

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Benefits of Messy eating for babies and toddlers

Have you ever noticed that small children eat meals with recklessness? Bits of food covers the face, cheeks, hands, lap, floor, belly, and even hair. Part of it is learning to use utensils and manage food on the fork or spoon. But there’s more to messy eating too! Messy eating for a baby or toddler is actually a good thing, and completely normal part of child development. And, letting a small child get messy when they eat, and even playing with their food as they eat is OK!

Messy eating in babies and toddlers has benefits to developing tactile sensory challenges and fine motor skills in young children.

Messy eating

I’m sure that your mother never told you it was okay to play with your food at the dinner table, but I’m here to tell you otherwise. Playing with food is not only okay, it is vital to development of self feeding skills and positive engagement with food. When young children play with their food they are engaging in a rich, exploratory sensory experience that helps them develop knowledge of texture, taste, smell, changing visual presentation of foods and oral motor development.

When play with food is discouraged it can lead to food texture issues, picky eating, oral motor delays and increased hesitancy with trying new foods later on.

Eating with hands- Messy benefits

When solid foods are introduced to baby, it is often a VERY messy ordeal. There is food on the chair, the bib, the floor, you…everywhere but the baby’s mouth. Often times, parents may feel discouraged or don’t like the mess that is the result, but it is OK. In fact, the messier the better.

Exploring food textures with the hands provides tactile experience to the hands, palm, and individual fingers. Are foods sticky, chunky, goopy, or gooey? All of that exposure to the hands is filed away as exposure to textures.

Picking up and manipulating foods offers fine motor benefits, too. Picking up and manipulating bits of food offers repetition in pincer grasp, graded precision, grasp and release, eye-hand coordination, bilateral coordination, crossing midline, and proprioceptive feedback. All of this is likely presented in a baby seat or high chair that offers support and stability through the trunk and core. When that support is offered to babies and toddlers, they can then work on the distal coordination and dexterity. At first, manipulation of food is very messy as those refined skills are developed, but it’s all “on-the-job training” with tasty benefits!

Research shows that a child moves through a series of exploratory steps before successfully eating new foods. This process involves messy play from the hands, up the arms, onto the head and then into the mouth. The steps of this process cannot happen unless the child is encouraged to touch, examine and play with their food. In today’s culture of sterilization and cleanliness, this often counterintuitive to parents and a hard pattern to break.

Promoting Play with Food

Mealtimes can be rushed affairs, making it hard to play with food, but they are not the only times we engage with food throughout the day.

Cooking and meal prep are two of the most common opportunities for play and engagement with food. These activities present perfect opportunities for parents to talk about color, size, shape, texture, smell and taste of the foods that are being prepared. Use of descriptive words,
over exaggeration when talking about and tasting foods, along exploration opportunities develop a positive interest in foods.

Babies can be involved in kitchen prep as they play with appropriate utensils and kitchen items like baby-safe bowls or pots. Toddlers enjoy being involved in the food preparations and can wash, prep, and even chop soft foods with toddler-safe kitchen tools.

Explore these cooking with kids recipes to get small children involved in all the benefits of the kitchen.

Here are more baby play ideas that promote development.

Food Art

Free play with foods like yogurt, jello and applesauce are also great opportunities to promote messy play and creativity. Utilize these foods for finger painting, or painting with other foods as the brushes. This activity challenges tactile and smell regulation, along with constant changes in
the visual presentation of the food.

Creativity with Food

When presented with food for free play, or at the dinner table encourage their creativity–carrot sticks become cars or paint brushes, and raisins become ants on a log.

The sillier the presentation, and more engaged the child becomes, the more likely they are to eat the foods you have presented to them. Especially, if these foods are new, or are non-preferred foods. High levels of over exaggeration also leads to increased positive experiences with foods, which in turn leads to happier eaters, and less stressful mealtimes
down the road.

Ideas like these flower snacks promote healthy eating and can prompt a child to explore new textures or tastes in a fun, themed creative food set-up.

Messy Eating and Oral Motor Development

Not only does play promote increased sensory regulation and positive engagement with foods, it also promotes oral motor skill development.
Oral motor skill development is promoted when a variety of foods are presented and the mastered skills are challenged.

Here is more information on oral motor problems and feeding issues that are often concerns for parents. The question of feeding concerns and picky eating being a sensory issue or oral motor motor concern comes up frequently.

Foods that are long and stick like such as carrots, celery and bell peppers, promote integration of the gag reflex, along with development of the transverse tongue reflex that later supports tongue lateralization for bolus management.

Foods such as peas, or grapes promote oral awareness and regulation for foods that “pop” when bitten, and abilities to manage multiple textures at one time.

Messy Eating and Positive Mealtimes

Whether you have a picky eater, or are just trying to make mealtimes fun, play is the way to go!

Play with food is critical to development of oral motor skills and sensory regulation needed to support positive meal times. Through the use of creative play, exposure, and over exaggeration these milestones can be achieved.

Although the goal is for your child to eat new foods there are many steps we need to conquer before getting there. Don’t worry, these can be fun and stress free! 

Let me ask you a question. If you were presented with a new food, something so new and anxiety provoking that you don’t want it near you and you definitely don’t want to touch it; do you think you would want it anywhere near your mouth? About in your mouth? Even more, how about swallowing it? The answer for most would be NO WAY! 

Well, we can’t expect the same from our kids. If they don’t want to look at or touch a food, they most definitely will not want to eat it! So before getting kids to put new foods near or in their mouth, we need to take several steps back and learn how to interact with it. This is where the fun can come in! 

This week we are going to experiment with various ways of play or interacting with foods. Remember, the goal in not to eat it. The goal is simply to interact with it and hopefully to start getting messy with it! Let’s kid you child comfortable with touching food and have fun doing it. This will not only get them a few steps closer to eating it, but it will also build positive associations with the food and also make them more comfortable with various aspects of it. This can include the color, texture, shape, smell, etc. The more foods we play with, the more of these they are feeling comfortable with. So in short, let’s start our food journey with our hands and our eyes by getting messy! 

10 Ways to Support a Child’s Milestone Development at Home!

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Support milestone development in natural environments at home

Every home is different, but here are some options for you to be able to swiftly encourage milestone development during your normal, everyday life. While they do have their benefits, child growth and development doesn’t require fancy play centers, playgroups, and activity centers. Here you will find easy ways to integrate child milestone development right into the daily family life at home. Here is information on child development to get you started.

Use these easy ways to support milestone development at home when getting out of the house is difficult.

If you just read the word “milestones” and still aren’t so sure what that means, you are not alone! You can also pop on over to The Child Mind Institute to learn more about what milestones are.


You don’t need a bunch of fancy equipment to help your child reach their milestones, even if they show signs of delay. I hope that this list of ideas will spark ideas of your own so that your family’s needs can be met in ways that work for you.

That is really what the natural environment is all about. Contrary to its name, it isn’t about green trees and blue skies or organic fruits and vegetables. The natural environment is wherever your child spends their time. Often, it is considered their home, but it could be the library, or the park, or grandma’s cabin. The point is that the natural environment is somewhere that is a recognizable, comfortable, and safe place for your child.

It just so happens that this magical place is where most of their development takes place, and that is why it is so important to use these spaces effectively for the naturally-occurring learning opportunities they provide!

These strategies to support milestone development can happen in the home.

How to Support Milestone development at home

For starters, I would like to kick off this list with a few overarching ideas to support development right in the day-to-day tasks of everyday life at home. There is so much development to be had by involving your child in things that are done in and around the home.


ONE: PUT THEM TO WORK
Playing and chores alike help your child reach their developmental milestones. In order to reach fine motor milestones and gross motor milestones, those little muscles need to be challenged!


TWO: INTEGRATE INTO YOUR LIFE
If you are doing laundry, your kiddo can help push laundry baskets to develop their gross motor muscles. If you are making pancakes, they can pop little chocolate chips in one by one to work on fine motor skills. Setting aside extra time for your baby’s milestones is not always necessary.


THREE: SHARE WITH YOUR BABY
In some ways, treating your infant or toddler to a friendly conversation is all that it takes to give them a little extra boost in communicative and cognitive development. Talk to your baby, share your interests, show them your work. This will strengthen their understanding of your spoken
language, and encourage them to use their mouths and faces for communication, too!

5 WAYS TO SUPPORT YOUR CHILD’S MILESTONES IN THE
NATURAL ENVIRONMENT

1. Support your child’s Development with family workouts

Family workouts are a great way to support milestone development and health and wellness of the whole family! Use at-home workouts to ensure that your baby gets in their tummy time (and more!) is to encourage your baby to work out with you. If you lift weights, your mischievous 18-month-old can lift his stuffed animals, books, wooden blocks, or whatever else may be around.

Or, maybe you are more of a yoga mom, and you and your toddler can work on balancing poses or squats like chair pose or goddess pose. You’ll feel great not only because you got in some exercise time – but also because you are helping your child become stronger!

2: Support developmental milestones in the kitchen

Use meal preparation times to your advantage! Cooking with kids in the kitchen offers powerful experiences for child growth and development. If you like to bake, offer your little one some dough to smash and squeeze between their fingers. Their blossoming fine motor skills, like handwriting, will thank you.

Baking is often rich in sensory experiences as well; the smells, the
textures, the tastes! Sensory-rich experiences like these are integral to the healthy development of the sensory system.

There’s more; cooking offers opportunities to develop direction-following and other cognitive development as well.

The next time your game-day guacamole needs smashing, you’ll know who to call.

3: Support motor skill development with chores

We know how much of your days are filled with laundry. It feels like it’s a never-ending cycle (no pun intended). Why not recruit some help? Your little one can help you out at their level. If they are able to distinguish between colors and reach, grab, and place objects, then they can
separate your whites from your colors. Maybe that is a bit too advanced: instead, they can take your sorted piles and throw them in the washing machine. When you’re done, have them push, pull, drag, carry – whatever they can manage – that laundry basket to its destination.


This strengthens so many skills. We’re talking fine motor, gross motor, cognitive, and sequencing skills. Plus, you can make something as dull as laundry day a bit more interesting.

4: Promote child development with day-to-day tasks

Supporting cognitive milestones can be done right in the home. Anytime you need to get some grown-up desk work done, your child can do their work, too! Offer them a pencil and paper – I am sure they would love it if they got to use something from your work bag – and let them get to it! Now they are kept busy so that you can have a few
moments to complete your schedule, email your colleagues, or document your tasks that week.

Allowing them the opportunity to use various writing utensils, instead of just one kind of chunky crayon, gives their little hands and fingers a challenge.

Strengthening their grasp will improve handwriting outcomes as well as things like dressing ability (hello, buttons and zippers!) and independent skills in achieving feeding developmental milestones. Not to mention the visual motor development that coloring can offer.

5. Support child development with downtime

Some days, all you can do is keep everyone alive. Maybe it’s putting on some Bee Gees and dancing to their classic hits because if you didn’t, mental breakdowns would ensue.

Dancing is great for growing bodies! Or maybe you just need time away inside of a good book, and your baby can cuddle your chest while you read. They can also peruse a book of their own while you take your escape. No matter their age or abilities, don’t overwhelm yourself, do what you need to do to keep your family safe and happy.

Looking for more? Click here to learn more about occupational therapy for babies!

For more ideas on milestone development and child development, head over here to get ideas for play based on your child’s age.

References

  1. Woods, J. (2008). Providing early intervention services in natural environments. The ASHA
    Leader, 13(4). https://doi.org/10.1044/leader.FTR2.13042008.14
  2. Butcher, K. & Pletcher, J. (2016, December). Cognitive development and sensory play. Michigan State University Extension. https://www.canr.msu.edu/news/cognitive_development_and_sensory_play
  3. The Center for Vision Development. (2020). Visual motor integration.
    https://www.thecenterforvision.com/visual-motor-integration/

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.

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