Supporting Student Strengths in the Classroom

student strengths in the classroom

When working with kids, we as professionals support students in many ways, but one of the most important ways to support kiddos is by highlighting individual student strengths in the classroom. We’ve all been there: feeling down about our own insecurities. That negativity impacts our mood, behavior, and the way we respond to others. For kids that struggle with various areas, they may constantly be aware of how they are challenged to learn, make friends, participate in classroom activities. We as occupational therapy professionals can bring positivity and support through the simple act of highlighting the good. Our students on every ability level will thrive when using their strengths as meaningful motivation!

Student strengths in the classroom to support learning and classroom tasks using student's personal strengths

Here, we are talking about how to support students by identifying student strengths, understanding how to use those strengths to support the child, and how professionals can identify individual strengths for each student.

Student Strengths in the Classroom

School professionals and paraprofessionals do so much for our students, and it is not always easy. One way to bring some positivity to the classroom is to highlight all of the wonderful strengths you see.

Student strengths in the classroom environment are obviously an important aspect of school performance. We all thrive when we feel we do something well. It makes us want to learn more about the topic. Doing a job or task well makes us want to achieve because we know we are good at that particular thing.

We know that using a strengths-based approach works for Autistic learners, trauma-informed therapy interventions, specific diagnoses such as cerebral palsy, and essentially everyone!

What Are Student Strengths

Let’s start with defining exactly what are student strengths and how to facilitate functional skills and learning through the use of strength-based participation.

Student strengths are exactly that; the strengths of the individual student! So often, we talk about the challenges a student has. We see the behaviors, the deficits, and weaknesses, and the diagnosis. These negative aspects are what the student is reprimanded on. It’s what makes them stand out (in the eyes of the student) and makes them different than their peers. But when we highlight strengths, we are shifting the focus to the positive.

All students have strengths. Every one has interests, positive aspects, special skills, and abilities that make them unique. Student strengths are any personal trait that makes them who they are!

When an individual’s personal strengths are highlighted, there is a ping of dopamine that offers feedback through the nervous system. There is a feeling of “good” that travels through the brain and body. This positive feedback can support regulation, mood, emotions, behavior, communication, and participation.

When student strengths are highlighted in the classroom, students thrive.

When student strengths in classrooms are highlighted, not only do individual students thrive in academic learning but in these other areas, but the whole classroom can be impacted too. The classroom can grow and develop together as a unit when they see that each student’s special skills and abilities play a role in their teamwork. Each student brings something special to the table and when these special skills are identified, students can empathize with more understanding.

A student that struggles with attention and has physical behaviors or anger might be very talented at drawing. That special interest can be used to create a classroom poster that shows how we are all different, but all of us have some unique qualities that make us who we are as individuals.

Simple wording that highlights the positive aspects of a student go much farther than the constant barrage of negative messaging. Our students pick up on this wording. So, when we put a positive spin on the terminology or ways we describe a child’s positive qualities, we are doing a benefit for not only the student, but the whole classroom’s view of the world around them.

Highlighting student strengths can support teamwork and empathy. It develops individuals into leaders, teammates, and supports conflict resolution.

Let’s take a closer look at student strengths…

List of Student Strengths

A child may be constantly in motion, but they can also be described as active or energetic. A student might be impulsive or take risks but they can also be described as adventurous or confident. Simply putting a different, positive spin on skills and abilities can make a difference.

Some student strengths include:

  • Artistic
  • Accepting
  • Confident
  • Self-assured
  • High self-esteem
  • Friendly
  • Sociable
  • Outgoing
  • Creative
  • Imaginative
  • Capable
  • Insightful
  • Perceptive
  • Talented
  • Intellectual
  • Deep thinkers
  • Daring
  • Energetic
  • Honest
  • Friendly/Makes friends easily
  • Talkative
  • Articulate
  • Kind
  • Loving
  • Empathetic/Sensitive to the needs of others
  • Affectionate
  • Fun-loving
  • Active
  • Loyal
  • Determined
  • Organized
  • Resilient
  • Humble
  • Caring
  • Helpful
  • Introspective
  • Reserved
  • Thoughtful
  • Altruistic
  • Trusting
  • Modest
  • Affectionate
  • Warm
  • Sympathetic to others, including to strangers
  • Benevolent
  • Predictable
  • Thorough
  • Ambitious
  • Consistent
  • Grateful
  • Forgiving
  • Patient
  • Original
  • Innovative
  • Clever
  • Curious
  • Strong
  • Tactful
  • Brave
  • Calm
  • Optimistic
  • Funny/humorous
  • Polite
  • Loyal
  • Persistent
  • Conscientious
  • Self-disciplined
  • Leader
  • Reliable
  • Resourceful
  • Hard-working
  • Persevering
  • Controlled
  • Goal-oriented
  • Unselfish
  • Mindful
  • Amiable
  • Considerate
  • Happy/cheerful
  • Great interpersonal skills
  • Communicator
  • Critical Thinker
  • Problem Solver
  • Great at Public Speaking
  • Teamwork
  • Collaborator
  • Accountable
  • Active Listener
  • Adaptable
  • Decision-maker

You can see how this list could go on and on…and on! Highlighting the positive aspects of students in the classroom is powerful!

How to identify Student Strengths

As student supporters – whatever role that may be – we should harness those individual strengths into greater achievement for all of our students.

One easy way to identify strengths of an individual student is to think about each subject, unit, or specials class. How does the student behave in each?

What is their engagement like in music versus physical education; math compared to reading? Maybe they are the first to raise their hand during social-emotional learning or cringe when they know writing time is next. No strength is too small; maybe they are not academically achieving in any traditional subject but are a leader on the playground or in the hallway. 

Let’s say our student, Charlie, loves science class for the action. They show great strength in exploring and understanding scientific concepts. However, they hate writing because they never know what to say and are not confident in their penmanship yet. 

As a supporter of this student, our role is to find ways to bring their favorite aspects of one subject into their least favorite. For example, Charlie really does cringe at the idea of writing, so I try to break that down. If they present with reduced fine motor or visual motor skills and therefore handwriting is a challenge, how can we use their strength in science to increase their writing skills? 

The first thing that comes to mind is to intentionally and meaningfully include writing in the science lesson. It’s technically “science” time, but guess what: we are going to be strengthening fine motor skills with eyedroppers and writing the results of our experiment! 

The best part about integrating one subject into another is that it is a universal approach – all children will benefit from combined learning! 

How to Use Student Strengths as Motivation  

We all know how difficult it can be to motivate students. My favorite word that correlates with motivation is ‘meaningful’. If you can make something meaningful to someone else, it becomes motivating. Using a student’s strengths is a great way to create meaningful learning. 

One method to ease into meaningful learning is to make a list of preferred topics.

We can use Charlie again here – you see that all of their folders are superhero-themed. They are always donning Super Mario or Minecraft and talking about their beloved cat during their free time.

Taking the time to make a list of preferred topics for each of your students may take some time, but it will be so worthwhile! Make the list of ideas accessible to all those who work with this student, and most importantly, to the student themselves. 

With a list of their favorite things in hand, Charlie always has preferred options of what to write about. Even when not writing, there is always the comfort of having meaningful subjects nearby. Better yet, they are from a teacher (or another supporter) who wants to connect with them – how cool is that? 

This doesn’t always have to be simply based on what a student likes; if a student is a good leader, give them more autonomy or leadership roles to produce quality work. Or if a student is a strong speller, de-scrambling words as a part of the writing process could be motivating. 

The just-right challenge is often most motivating: it is just easy or familiar enough to initiate a task (using our strengths)…but just hard enough to still learn, grow,  and feel accomplishment! 

ENVIRONMENT: Student STRENGTHS in the Classroom Environment

A person’s environment is a big deal to occupational therapists. We participate in functional tasks in so many different environments and those places impact function in a major way.

One model of occupational therapy is called the Person-Environment-Occupation model and it is used in many different settings, including schools.

This model is exactly what it sounds like; the combination of a unique person and all their traits, PLUS the environment they are in, PLUS the occupation that they are doing. All of this results in performance. The big picture here is that the environment plays a huge role in how well we perform. 

Simply put, the Person/Environment/Occupation model breaks down who we are, where we are, and what we are doing.

Unique person and all their traits + environment + occupation = performance 

Simple equation using the Person-Environment-Occupation model used in occupational therapy to focus on occupational performance.

When you take a look at this performance model, and consider the use of personal strengths to support successful performance, we can help individuals thrive. Adding personal strengths to the equation supports completion of the task, buy-in, motivation, and meaning.

Strengths-based Classroom Environment-

Thinking back to our example student from above, let’s go a bit further by using this model to look at how to add student strengths into occupation:

What can we do to make Charlie’s environment optional based on their strengths and weaknesses? They are a great direction-follower and do not get distracted easily, so their seat may be best near peers that could use a positive role model. In addition to this, they have good eyesight so do not need to be placed at the front of the room. 

Charlie’s room job is to turn on and off the lights, so the pathway should be clear and perhaps a seat close to the light switches may be nice. Charlie is very organized and that is apparent when you look at their desk area! 

Because Charlie has reduced writing skills, placing their seat in view of the helpful visuals (wall dictionary or alphabet, grammar posters, etc.) will be important.

To increase their engagement in writing, offer various pencils or erasers in a communal spot, and bring their love of drawing (a stone’s throw away from writing) into the classroom by offering time to decorate the classroom walls or their locker. 

A final note on student strengths in the classroom

Again, these recommendations are universal and can be applied to all students. There is a careful balance to be had, however, to make the environment optimal for students of varying needs and abilities. 

Whenever possible, start with a student’s strengths. It can be so easy to fall into what is challenging about a student’s behaviors or grades, but dwelling on the negatives never produces many positive results. We hope to have given you a new outlook on student strengths and how to best integrate their use into day-to day school life! 

List of student strengths in the classroom handout

Free List of Student Strengths in the Classroom

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    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.

    Potty Training Seats for Special Needs

    Potty training seats for potty training special needs kids

    Occupational therapy professionals work with clients of all ages and abilities on toileting and hygiene. That’s why this resource on special needs toilet training seats is so important. In therapy sessions, a skilled assessment of the whole individual can indicate a need for postural modifications to support motor skill needs. When it comes to potty training and toileting in general, there is a LOT of information out there. And, if you ask around for suggestions for the best potty training seats, you will probably get a variety of answers.

    Some of these seats will help with independent perineal care, too because of the positioning and stability added for balance. Potty training supports like handrails, grab bars, and guards can help with the hygiene aspect of toileting.

    Special Needs Toilet Training Seats

    It can be overwhelming to weed through all of the potty seats out there on the market and in the local box store toddler aisle. The difficulty compounds when you consider potty training with special needs children.

    Today, I wanted to pull together a list of kids toilet seats out there on the market that are perfect for special needs kids, as well as typically developing kids. Why? Because so often, a few simple changes with positioning, balance, and stability can be the tool to help kids feel more comfortable, confident during the toileting process.

    Adding a stable support at the feet, back, or bottom can help a child to relax so they can toilet.

    These potty training chairs help address the underlying needs that kids might struggle with when it comes to potty training. These potty training seats and supports can be the tools needed to address a variety of underlying needs when it comes to getting started with potty training.

    Here’s the thing: it can be difficult to make suggestions or come up with a comprehensive list that covers ALL of the special needs out there. (That’s where your occupational therapy evaluation or equipment analysis will come into play!)

    BUT, I can definitely address some of the more common potty training seats out on the market and address the underlying areas that they can address and hopefully target a best fit.

    These recommendations for potty training seats are guided by development and great for kids of all needs. Use these potty training seats as suggestions when starting potty training for toddlers or preschoolers.

    Potty Training Seats are Not One-Size Fits All!

    Let’s face it. There is no one-size-fits-all approach when it comes to potty training. Because of the vast differences in in kids development, interests, motivation, physical or special needs, potty training can be a challenge to know where to start.

    This list is hopefully a start for addressing some of the areas kids need for successful potty training.

    Amazon affiliate links are included below.

    Portable Seat– This type of seat is great for kids who need a smaller opening on the toilet. Kids of all needs benefit from a larger seat area when first potty training. This one is nice because it can be carried from place to place when on the go outside of the home. Just fold it up and place in it’s carrying bag. Using a portable seat can make it easy to add interests when beginning potty training. Add interests such as special toys and items to make sitting motivating.

    Squatty Potty– The squatty potty is a helpful way to provide a more stable base of support while sitting on the toilet seat. Kids can place their feet on the support that curves around the toilet base and improve balance while sitting. This base of support can help kids who need extra support or have balance needs.

    The Step and Go stool is another, more inexpensive option. Adding a supportive base can help calm nerves of unsupported sitting. Children can use a wider base of support with this type of stool.

    Potty Training Chart– While this isn’t a potty training seat, a training chart can be used to promote extended sitting on a potty chair, and to allow kids the ability to build up patience to sit and wait on a potty chair.

    Starting out by using a potty training chart to encourage kids just to go to and sit on the potty seat is a great start for younger kids or those who need to accommodate for sensory needs.

    A visual tool such as a potty training chart can be a practical way to reinforce individual skills that make up the process of toilet training. The nice thing about toilet training charts is that they can be individualized, based on the child’s needs.

    Some kids with special needs or sensory needs may be afraid of walking into the bathroom. A sticker chart can be one strategy to address that aspect given various modifications or activities that can help address needs.

    Step Stool with Handles– Having a handle can help little ones who struggle with balance or feeling unstable when sitting on a regular sized toilet seat. This one has a step stool that provides a base of support through the feet.

    Toilet Seat with Pee Guard– This seat insert has handles and slight curvature to the sides of the toilet seat ring, providing support and a sense of stability when seated on a regular size toilet. The urine guard is helpful for both boys and girls.

    Three-in-one Potty Training Seat– As a mom of four, this 3-in-one potty training seat is a favorite. It goes with kids from the toddler stage when a smaller, floor potty chair is helpful in training. The ring insert can then be used when transitioning to a regular sized toilet. Finally, the seat forms a step stool for using either on the toilet or when washing hands. This is a convenient toilet training seat for families!

    A lower toilet position is closer to the ground and fits a smaller bottom. This helps with transition to a regular size toilet and allows for comfort and confidence in young children. This potty training system is great for the child who appreciates consistency.

     Ring Reducer– There are many styles of toilet seat ring reducers out there and they serve a great purpose; to reduce the size of the opening on the toilet seat, allowing for small kids to feel more safe and secure when sitting on the toilet. This is a good transition seat to a regular sized toilet. For kids who struggle with coordination and balance, this ring reducer can be just the ticket to potty training success.

    Disposable Seat Covers– These seat covers are convenient for kids who tend to grab the toilet seat when sitting on a regular-sized toilet. When out and about in the community, it can be helpful for some kids to use a seat cover that is more effective than just using toilet paper. Some of our kiddos can’t tolerate sitting without holding onto the seat or just can’t follow the directions to “not hold onto the seat”.

    These special needs potty training seats can be a guide to getting started with potty training for special needs kids.

    Physical Limitations and Special Needs Toilet Training

    While these potty training seat options just cover the surface of potty training, it’s important to remember to consider the underlying and developmental aspects of potty training.

    The therapist’s perspective can play an important part in identifying any developmental or transitioning needs when it comes to potty training. While there are many more specific tools that can be used with special needs toilet training as well as typically developing kids, these are just some of the basics.

    Remember that there truly is not a one-size-fits-all aspect for toileting. Some of our kids with more physical special needs or developmental considerations may benefit from a more extensive and supportive seating system.

    That’s where the occupational therapist comes into play with identifying needs and tools that will promote independence and function.

    There are many considerations that should be addressed when it comes to seating and toilet seats. First and foremost is the safe positioning of the individual on the toilet. Other considerations, depending on the special diagnosis may include:

    • reflex development and maturation
    • muscle tone
    • range of motion
    • balance
    • motor skills
    • attention span
    • motor planning
    • visual perceptual skills
    • postural reactions
    • joint tightness
    • eye mobility
    • cognitive considerations
    • weakness
    • sensory processing challenges
    • self-concept
    • body awareness

    In the book, The Toilet Training Book: A Developmental Take on Potty Training for Kids of all Abilities, we cover more on special diagnoses and potty training, including strategies and tips for individuals with cerebral palsy, Spina Bifida, trauma, Traumatic Brain Injury, ADHD, Autism, and other general considerations.

    Use these potty training seats for special needs kids when beginning the potty training process with kids of all needs.

    Potty Training Seats for Physical Needs

    Toileting Seat System- There are many toileting systems on the market that address physical needs. Seating systems are intended to  promote positioning, safety, mobility, transfers, function, and quality of life of the individual. Look for a system that meets the budget and can efficiently accommodate various needs such as toileting, showering/bathing, hygiene, etc.   

    Systems can come with a variety of adjustments and supports. Consider the need or use of the following supports:  

    • Headrest
    • Backrest
    • Armrests
    • Lateral back supports
    • Harness
    • Seat belt
    • Tray
    • Anterior support
    • Hip guides
    • Abductor
    • Urine deflector or guard
    • Calf supports
    • Lower extremity lateral supports
    • Ankle straps
    • Footrest
    • Tilt in space (backward/forward)
    • Recline
    • Height adjustments
    • Push handles (for caregiver support)
    • Wheeled base
    • Molded and Foam cushions
    • Pan/adaptability for use over a toilet or as a stand-alone toilet chair  

    Support Station for Toileting- A standing support station can be used in assisted hygiene or assisted toileting. The standing station can be a support to transfers and can be beneficial to clothing management, self-care, skin care, and undergarment changing.   

    The support station is a helpful tool for improving function and dignity of clients as can perform aspects of toileting, as well as participate in self-care. This is a means for reducing diaper use as well, further improving dignity.

    Additionally, support stations are a tool for improved safety of caregivers. When clients stand at a standing support frame, they are truly building strength, endurance and self-care skills in a natural manner within the occupation of toileting. 

    Wiping after toileting and special Potty seating

    When it comes to pericare, there are things to consider with the various special needs toileting systems.

    • Can the child maintain their balance while reaching for toilet paper?
    • Can the child weight bear or shift their weight from side to side or forward in order to wipe?
    • Can the child reach around their body to wipe?

    For More information on Potty Training 

    Watch for information coming soon to this space on the new Toilet Training Book! It’s about to be released and is your go-to resource on potty training based on development and individualized needs.

    This book was created by occupational therapists and physical therapists who are experts in the field of child development, sensory processing, motor skills, and function.    Need more information and real strategies to improve potty training success? Want insider tips and tools from the occupational therapist’s and physical therapist’s perspectives? The Toilet Training Book is here!

    Potty Training Help

    Tackling potty training is a challenge for all kids! What if you had the inside scoop on development in your back pocket? 

    What if you had the know-how of occupational therapists and physical therapists with DECADES of experience to guide you?  

    The Toilet Training Book offers a developmental look at potty training for kids of ALL needs.

    • This digital e-book is a deal of a resource at $19.99

    The Toileting Book is a comprehensive resource covering every aspect of toilet training.  

    Details about The Toileting Book:  

    • Written by a team of experienced pediatric occupational therapists and physical therapists with decades of experience  
    • Packed with information on toilet training readiness and achievement of toileting success
    • Includes Toilet Training Guides for special populations (children with fine or gross motor needs, behavioral or cognitive challenges, physical disabilities, etc.) including Sensory Processing Disorder, Trauma-Informed Needs, Autism Spectrum Disorder, Cerebral Palsy, Spina Bifida, Spinal Cord Injuries
    • Provides information on interoception and the role this sensory system plays in potty training
    • Discusses common toileting equipment and special needs toileting tools
    • Includes tips and suggestions for individualized toilet training 

    This book is available in digital, e-book format AND in a physical, soft-cover book format.

    The Toilet Training Book- the potty training resource you need!

    Perineal Hygiene

    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.

    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.

    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.

    Behavoral Issues with Potty Training

    Potty Training problems and tips

    Here we are covering behavioral issues with potty training and potty training problems that impact toilet training in kids. Teaching a child to potty train is a complex task. You’ve probably tried some of the common tips for potty training. But what happens when there are real problems? There are many components that can affect a child’s progression and retention of toileting independence. Let’s go deeper.

    Behavioral issues with potty training

    Parents often times seek out potty training help when they are working on building independence in this functional skill of childhood.  

    While there are many considerations that go into the developmental progression of independence, attention and behavior are key skills in function.

    Behavioral issues with potty training can look like many different things:

    • Intentionally urinating on the floor
    • Impulsive actions in the bathroom
    • Hyperactivity during toilet training
    • Playing in the toilet
    • Using too much toilet paper in anger or frustration
    • Hitting
    • Aggression during toileting





    Full disclosure: This post contains affiliate links.

    Potty Training Tips and Help for kids with attention or behavior problems

    Behavior and Potty Training

    It is important to note that many times, behaviors that are seen with potty training are a result of potty training starting too soon.  

    When a child demonstrates behaviors, there is often times, a communication point that the child is trying to get across: Behaviors are many times just information.

    Other times, behaviors are normal development of a child’s cognitive and imagination.  Children who are potty training might refuse to take time to toilet, make urine or fecal messes on the floor intentionally, throw objects into the toilet, or refuse to use certain bathrooms, among many other behaviors.


    It is important to take the behavior objectively and think about the behaviors as information. Information should be viewed objectively and without bias.  

    A behavior can be viewed as good or bad but in order to address the behavior, it is necessary to figure out the reason behind the behavior.  

    A child who has tantrums and hits an adult is considered to have bad behavior while a child who attends to a task is considered to have good behavior.  This bias is a perception of behavior.


    There are many reasons behind behaviors related to potty training and the act of toileting.

    Problems with potty training and behaviors during toileting may be a result of:

    • Sensory concerns with steps of toileting
    • Fear of going into the bathroom
    • Anxiety as a result loud hand dryers or other sources of over-stimulation
    • Fear of self-flushing toilets
    • Consider a need for a special toilet training seat, especially for kids with special needs.
    • Uncertainty of the steps of toileting
    • Difficulty with fine motor or gross motor/positioning needs related to toileting
    • Constipation due to holding output or other physical discomfort
    • Cognitive delays limiting understanding of portions of the toileting process
    • Unfamiliarity with surroundings when using different bathrooms
    • Difficulty with the breakdown of a multiple step task such as clothing management, toileting, and hygiene
    • Inability to communicate effectively
    • Typical development of boundary pushing and expression of language and cognition

    For a more comprehensive look at all areas that can impact successful toilet training, be sure to dive into The Toilet Training Book: A Comprehensive Take on Potty Training for Kids of all Needs and abilities.

    These types of difficulties can result in reactions that lead to frustration and tension between the child and adult.    

    It is important to remember the causes of behaviors throughout the potty training process.  

    Once there is a potential reason identified for the cause of behaviors related to toileting, examine the behaviors and consider the following questions:

    • What is the child getting or not getting from the behavior?
    • What makes the behavior stop?
    • What makes the behavior continue?
    • What are precursors to changes in the behavior?
    • Does the child withhold toileting breaks to avoid going into the bathroom?
    • Does the child demonstrate cognitive, communication, sensory, fine motor, or gross motor difficulties that might interfere with steps of the potty training process?

     

    How to support Children with potty training problems    

    Let’s talk tips to help with behaviors related to potty training.

    Aggressive behaviors might include shouting or physically hitting and might occur suddenly as a result of frustrations perceived by the child.  Other children might become upset in certain bathroom environments like public restrooms.  Still others might overly focus on certain details.  It is important to try and understand what is causing the child to become angry, upset, anxious, or agitated.  

    Some of these strategies can work to support children that struggle with potty training problems.

    Modify the Task– One tip to adjust the precursors to behaviors in toileting is to modify the task or simplify the steps that you are asking the child to complete.    

    Begin where the child is consistently successful. A child who’s anxiety of entering a bathroom prevents further progression of independence may begin with the child walking into the bathroom, and staying in the bathroom for a count of five.    

    Continue practicing this portion of potty training until there is success.  Then the child will be capable of moving on to other steps of toileting.  

    Gradual progression of potty training coincides with waiting to begin potty training until the child has shown readiness cues.  

    Take time to respond– Before responding or reacting, take a moment before you respond as the parent. Before reacting to potty training behaviors, consider:

    • Think about the cause of the aggression or anxiety.
    • Focus on the child’s emotions.
    • Be positive and reassuring.
    • Provide reassurance through calm a voice and phrases.
    • Reduce noise and distractions to help the child relax.
    • Follow the child’s lead.
    • Realize that some behaviors can indicate that the child isn’t ready and they are communicating a lack of readiness through their behaviors.
    • Keep it simple: reduce verbal cues.
    • Boys can sit to pee at first until they get the hang of the physical act of awareness of the urge to urinate and clothing management.
    • Use the same gender roles to make learning easier.
    • Begin potty training when it works for your family time-wise: don’t start potty training during a vacation or when other changes are happening in the household.
    • Also accept that there will never be perfect timing to start potty training.

    Support perineal hygiene with specific strategies.

    Attention Considerations in Potty Training

    Like the reasonings behind behaviors seen in potty training, children often times have a reason for inattention leading to poor carryover of skills or steps of toileting.  

    There are certain attention areas that should be achieved by children before attempting to begin potty training. 

    A child should have an attention span that allows them to respond appropriately to verbal instructions when they are given one step verbal cues:

    • Sit down in a chair.
    • Stand up.
    • Walk to another room.
    • Imitate a parent in a simple motor task.
    • Point to body parts when asked.

    If a child is not able to attend to these tasks, they may not be ready to begin attention.

    Strategies for Helping with Challenging Behaviors and Attention Difficulties during Potty Training 

    Tips and help for potty training with behaviors and attention problems like this key chain schedule.

    Potty Training Schedule

    Visual Supports– These might include visual schedules, or visual supports are schedules, dry erase boards, and timers.  

    Start with this information on how to use visual reward charts for the most success.

    A schedule can be as basic as a “first-then” cue or complex and including each step of the potty training process. I have created a customized schedule card that can be attached to a key chain and taken to various bathrooms during outings as well as used in the home.

    Use the steps printable to customize the schedule card to meet the needs of your child.  

    Another quick tip can include using an Alexa skill to create a timer or schedule for time to try the bathroom routine.

    How to make a customized potty training schedule for kids:

    • Print the schedule images. Cut out the pictures that work best for your child’s needs.  You can adjust the length or steps of the schedule based on your child.  Changes to potty training schedules should be practiced for at least two weeks before giving up on a specific technique or schedule.
    • Using card stock, cut a 2 1/2″ by 9″ length.  
    • Create  2 1/4″ x 2″ card stock squares for covers.  
    • Fold and tape the covers to the back of a 2″ square card stock.  This will hold the different steps of potty training.  
    • Create a small slit and attach a badge clip. Use this clip-on schedule by attaching to clothing or hang it in a bathroom.



    Choices– Incorporate choices into the potty training process.  Choices might include:

    • Do you want to use this restroom or that one?  
    • Do you want to use the paper towel or the hand drier?
    • Do you want to walk or hop into the bathroom?  

    Choices like these allow the child to feel in control of a situation that has to happen.  Toileting is a task that must occur and the choice that a child makes can sometimes be withholding toileting or purposefully urinating on the floor instead of in the toilet.  

    Positive Reinforcement– Positive behaviors can be rewarded to provide feedback to the child with behaviors.  Feedback is the information about the outcome of a response.

    1. Internal feedback is the response of the sensory systems in respond to a task.  A child feels better after toileting.  

    2. External feedback comes from a source.  In potty training, external feedback might be visual cues or praise from a parent in response to completed tasks.  A reward system is another type of external feedback.  

    Feedback can be provided after every completed step of potty training, or it can be varied to transition to the end of tasks.  Feedback (like a small food reward) that is given after every step of potty training becomes a crutch.  

    Positive reinforcement should be transitioned to the end result of toileting, including hygiene, washing hands, and leaving the bathroom in order to help with skill retention.


    Initially, a positive reinforcement such as a food or sticker reward should be given immediately after the child does the expected behavior. They can be given the reward every time they complete that part of potty training. Gradually you will increase the steps the child needs to accomplish before earning a reward. Parents should be specific with the behavior that is being reinforced. Say,“I like the way you are sitting on the toilet,” as they are given a tangible reinforcement. 

    This potty training incentive resource covers more on positive reinforcements for toileting.

    Reinforcer Chart– A child who is working on multiple steps of potty training or who has moved on from single step positive reinforcement can use a reinforcer chart to earn a small prize after multiple successful attempts at toileting.  

    The child might earn a toy from a prize bin or a small treat at a store. Even a picking a sticker out of a basket and allowing the child to place the sticker onto a potty training chart is a great tool that offers positive reinforcement.

    This type of reinforcement builds delayed gratification.


    Positive Communication– When behaviors arise during potty training, it is important to use effective communication and not respond with criticism to behaviors or inattention.  

    Also important is avoiding the term “good job” as a reward to accomplishing desired behaviors.  A child might not be successful but tried hard.  Other more appropriate terms include words or gestures for encouragement or suggestions for “next time”.

    Tips and help for potty training with behaviors and attention problems like this key chain schedule.

    Potty Training Tips to Help with Behavior and Attention Concerns:

    • Simplify when teaching new skills.  Break down tasks into smaller, obtainable steps to allow success.  Provide positive reinforcement to each step.  
    • Use stronger reinforcers for more difficult tasks.  This might include holding urine overnight for several nights or continuing potty training skills at different settings outside the home.  
    • Verbal cues are more difficult to fade than physical cues.  Limit the amount of verbal cues once a child has shown success with steps of potty training.  

    Potty Training Resources:
    Warwick, T. (2013, February). Effective Strategies for Decreasing Challenging Behavior in Individuals with Autism Spectrum Disorders. OccupationalTherapy.com, Article 2174. 

    Tips and help for potty training with behaviors and attention problems like this key chain schedule.

    Potty Training Book

    The Toilet Training Book is a comprehensive resource for all aspects of toilet training.

    The Toilet Training Book is a developmental resource on potty training children of all abilities and skills. Created by occupational therapists and physical therapists, and guided by child development, this toilet training resource is like no other.

    Tackling potty training is a challenge for all kids! What if you had the inside scoop on development in your back pocket?

    In the book, you’ll find guidance, tips, and actionable strategies to support all aspects of toilet training, including tools and supports for kids with physicals needs, neurotypical individuals, and children of all needs and levels.

    • Written by a team of experienced pediatric occupational therapists and physical therapists with decades of experience
    • Packed with information on toilet training readiness and achievement of toileting success
    • Includes Toilet Training Guides for special populations (children with fine or gross motor needs, behavioral or cognitive challenges, physical disabilities, etc.) including Sensory Processing Disorder, Trauma-Informed Needs, Autism Spectrum Disorder, Cerebral Palsy, Spina Bifida, Spinal Cord Injuries
    • Provides information on interoception and the role this sensory system plays in potty training
    • Discusses common toileting equipment and special needs toileting tools
    • Includes tips and suggestions for individualized toilet training

    Click here to read more about The Toilet Training Book: A Developmental Take at Potty Training for Kids of all Needs.

    Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

    How to set a table

    Here, we’re covering the life skill of setting a table. When we teach a child how to set the table, the chore itself is one that kids can do on a daily basis. So, if you are looking for an executive functioning skill task that breaks down into steps, AND is helpful, setting the table is a great one!

    Table setting as a life skill

    Before discussing the “how” to set a table, we need to learn the “why.”  Why do we need to teach kids to set a table?  Life skills are important.  If a child does not have intellectual intelligence but has life skills, they can succeed. Of course there are manners, etiquette, and grace involved in setting a correct table placement, however, learning the basics of what needs to be on the table is most important.

    In order to be ready to serve the Queen, one needs to know in which order the spoons and forks are placed (there might be seven or eight pieces), where all of the plates go, which side each type of glass goes on, and where the condiments are placed.  When visiting a five star restaurant, cruising, or eating an elegant dinner, you will encounter this type of place setting.  Serving and eating this way is a great lesson in etiquette to be familiar with.  You never know when you might be invited to dine with the Queen or eat at the Ritz!

    In a typical family’s home, setting the table likely involves a child’s chore to set the utensils, plates, bowls, and drinking glasses. Setting a table as a chore is a great way to get kids involved in the family unit to help with dinner preparations.

    How to set a table

    As an adult you probably do this daily without thinking about it.  You know the basic pieces you need in order to have a meal; glasses, plates, silverware, condiments, and napkins.  Often extra pieces are added such as placemats, bread plates, dessert silverware, and serving dishes.

    For a child, the command “set the table” may be daunting and confusing, before a regular schedule is established.  Adults often forget how challenging a new task can be, and become easily frustrated at having to give eighteen reminders during this one task. 

    As a result, children become overwhelmed and shut down.  Shut down looks like standing and staring, not doing anything, or refusing to perform the task.  Of course it is easier for the adult to just do the task for the child, however, eventually you will want this child to leave the home or be able to survive outside of its’ walls.

    Setting a Table: An Executive Function Task

    Setting a table involves organization, working memory, visualization, sequencing, and task chunking.

    • Organization: knowing which pieces need to come first, second, third.
    • Working memory: remembering what parts are needed as the task is happening
    • Visualization: being able to make a mental picture of the meal being prepared in order to get all of the correct pieces
    • Sequencing: being able to bring out pieces in the correct order (placemat before plates)
    • Task chunking: breaking the task down into chunks such as collecting all the silverware at once

    The above skills are part of executive function, built in the prefrontal cortex, necessary for success.  Without using executive function; disorganization, inability to complete a task, procrastination, inattention to details, and increased time to finish the task can happen.  

    Check out this article and FREE executive functioning skills course: Strategies to Help Combat Executive Function Disorder 

    Because the prefrontal cortex does not fully develop until the 20’s or 30’s, most children are going to need some assistance and modifications to complete basic tasks.

    How to teach kids to set a table

    There are different learning styles: visual, auditory, kinesthetic (learning by doing), and repetition.  Everyone learns differently. Visual picture cards are an excellent way to teach children any skill. 

    Table Setting Worksheet

    In the resource below, you can download a step-by-step executive function worksheet designed to teach kids to set a table as a chore and life skill task.

    The printbale resource also includes table setting visual cards. These Check out the picture cards on OT Tool Box for helping kids set a table.

    These picture cards serve as a visual reminder and framework for a task such as setting a table. They can be laminated, colored, and/or Velcro can be added to the cards so they can be moved and placed as needed.

    The table setting worksheet resource includes three parts:

    1. A task breakdown worksheet to break down the steps of setting a table
    2. Visual cue cards to help kids with the schedule and parts of setting a table.
    3. A visual schedule where the table setting task cards can be attached, to support with transition and routine building

    Have your child look at the picture cards provided and decide what items are needed for their table setting.  Once this is decided, have them put the cards in order of what needs to be done first. 

    There is some variability in setting a table correctly, however some items will need to come before others.  Here is an example of an order of operations for picture cards:

    1. Placemat
    2. Large plate, small plate
    3. Silverware – spoon, fork, knife,
    4. Glassware
    5. Napkin
    6. Condiments
    7. Food
    8. Eat

    Think about what variables work for your family or each particular student. Not everyone uses a placemat, has a bread plate, serves the food family style in dishes on the table, uses dessert silverware, or puts condiments on the table. 

    Some children just need a visual reminder of what to include on the table.  Other children will need a visual picture of what the table should look like when completed.  They need to be able to copy a diagram.

    This also can be colored, laminated, or customized to make an exact replica of the type of silverware and place settings a family uses.

    The third type of lesson involves breaking down the task into chunks on a goal ladder.

    A “setting the table” chore/goal ladder may look like this:

    • Top of Ladder: Dinner time
    • Rungs: set the table, fill water glasses, put food on table, eat

    Table setting chore for kids

    Once this task has been mastered in all of the broken down pieces, it can be added to the overall chore list.  

    Chores are an excellent way to teach:

    • responsibility
    • task sequencing
    • organization
    • life skills
    • time management
    • independence
    • overall executive function

    In addition to teaching the above skills, chores are excellent for heavy work in order to organize the sensory system and arousal level.  Heavy work activates the proprioceptive system, which provides calming and organizing for the body. There is a reason the military has their staff do chores, exercise, and heavy work as a daily regimen.  It not only builds necessary life skills, but provides organization and focus of the sensory system.

    To learn more about heavy work, check this out:

    Daily visual schedule for setting a table and other chores

    Check out this article by Colleen Beck of the OT Toolbox for more information on visual schedules:

    Life skills: setting a table

    Life skills build independence, responsibility, manners, and self-reliance. Teaching or learning a skill, such as setting a table, is not as easy as it might seem.  It involves breaking the task down into chunks or rungs on a ladder, adding visual picture cards as reminders for all the working pieces, sequencing the activity into the correct order, and finally adding it to the daily chore schedule. Activities will need to be graded (made easier or more difficult) depending on the needs of your learner, their skill level, and task mastery.

    Use this system to teach any and all life skills tasks!  Dressing, bathing, laundry, cleaning, putting toys away, organizing, or any other task can be taught using picture cards, goal ladder, and visual schedules. 

    *The terms, kids/children are used throughout this post for readability, however this information is relevant for students, patients, teens, etc.  The term “they” is used instead of he/she to be inclusive.

    Free Table Setting Visual Cards and Worksheet

    Set a Table Worksheet and Visual Cards

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      Victoria Wood

      Victoria Wood, OTR/L has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.

      Adaptive Equipment For Eating

      Adaptive equipment for eating

      This article covers adaptive equipment for eating, including adaptive feeding equipment, assistive feeding devices, adaptive utensils, plates, bowls, and other tools to support functional feeding skills.

      One of the main paths that occupational therapists help people achieve success in their daily occupations is through adaptive equipment and technology. There are so many great feeding products and eating tools available to increase independence, and today we will start off the conversation by introducing adaptive equipment specifically for feeding. 

      Adaptive equipment for eating

      A great place to start with learning more about adaptive equipment for eating and the possible need for reaching out to occupational therapy for adaptive eating tools or support is this resource on Pediatric Feeding: Is it Sensory, Oral Motor, or Both?

      Adaptive Equipment for Eating

      When it comes to helping individuals become more independent with daily occupations, feeding and eating skills have a big role. Occupational therapy, being the holistic profession that it is, recognizes the overall piece of eating has on wellness and wellbeing, nutrition, and day to day functioning. OTs focus on both the feeding aspect for nutritional intake as well as functional eating skills in use of utensils, cups, and bowls for independence.

      Let’s take a look at various adaptive equipment tools for feeding and eating:

      Adaptive utensils for feeding needs

      Adaptive Utensils

      Adaptive dinnerware includes adjusting handles on eating utensils, adding width to the utensil handle, adding weight or length, and addressing the ability to hold a spoon, fork, or knife. Other adaptive feeding needs cover difficulty bringing food to the mouth or the ability to remove food from the utensil as a result of oral motor issues.

      Let’s take a look at various adaptive utensils.

      Amazon affiliate links are included below.

      EazyHold Silicone Silicone Aide-Basically a silicone universal cuff, this adaptive utensil tool is perfect for feeding! The silicone texture makes it easy to clean, and it comes in sizes for newborns through adults. This piece of equipment can be placed around the hand and hold common objects like forks, spoons, markers, and paintbrushes making it a one-stop device for turning household spoons, knives, and forks into adaptive eating utensils. It can remarkably increase independence for individuals that demonstrate deficits in grip strength. 

      Maroon Spoon– This adaptive feeding utensil is a classic! The maroon spoon has a shallow spoon depth that can assist in feeding for users with poor lip closure, oral hypersensitivity, or tongue thrust. 

      Weighted, Thick Handled Utensils– These weighted utensils have thick handles that are great for those who can grasp a wide handle but have a harder time holding on to something smaller that requires more grip strength. If this is the case, built-up handles are a lifesaver!

      You can also use Viva Foam Tubing to make any household spoon, fork, or knife handles thicker and easier to grasp. The added weight of these utensils is also great for individuals who have tremors – the extra weight helps to combat the motion of the tremor, leading to a more successful meal time. 

      Textured Spoons– The texture on the spoon provides oral-motor stimulation to the mouth, increasing wanted oral movement patterns and decreasing hypersensitivity. The texture can also cue the user to engage with the tastes and textures while feeding. This spoon comes with extra-long handles to make hand over hand assist a bit easier, too! 

      These bendable textured spoons are great for self-feeding and oral motor stimulation as they have a smaller, hand-held size and can offer different textures for gum and tongue sensory input.

      Off- Set Spoon– This tool, and many other utensils like it, allow for easier self-feeding for individuals who have limited mobility. The angle of the spoon is turned toward the person, instead of being straight, so that they can bring their spoonful of food directly to their mouth without having to change the orientation of the spoon or their bodies. 

      Adaptive plates and adapted bowls for feeding issues

      Adaptive Eating Plates and Bowls

      When it comes to a container to hold food, plates and bowls can look like many things. Here, you’ll find recommendations for lipped plates, suction cup

      Scooper Plate– A lipped plate is just one way to help individuals scoop food from the plate surface, and not onto the table. This scooper plate is a dinner plate with a lip, or a higher edge. Here is another must-have item for individuals that have trouble scooping or stabilizing their plate or bowl.

      This “scooper plate” is a plate with high walls like a bowl that have been specifically designed to make it easier to scoop and pick up food items with a utensil. Even better, there is a suction cup feature at the bottom to secure it to the tabletop for more stability while scooping. You can also get the scooper bowl here.

      Plate Guard– Similar to the scooper plate, these plate guards can be added to any of your existing plates to add a wall to scoop against. This reduces spills, food waste, and time spent chasing food around with a utensil. That being said, there is much to learn from messy food play.

      4-Square Meal Plate– Some feeding therapy involves increasing food repertoire for picky eaters. This plate can be a great tool to help make mealtime fun and engaging for kids. For more tips on how to improve meal times for picky eaters, check out Kids Eat in Color and ABC Pediatric Therapy Network for more resources. 

      Adaptive cups and adaptive spoons for feeding needs

      Adaptive Cups

      Adaptive cups can help with drinking without lifting the head or chin or can help address other motor control and strength challenges. For individuals that struggle to hold a cup or sip from the edge of a cup, there are straw options as well. Below, you’ll find adapted cups that are designed for those with dysphasia or aspiration precautions. Those requiring thickness needs or safety concerns with swallowing liquids should consult a professional. Read this resource on oral motor issues and feeding needs to get started.

      Flexi Nosey Cup– This is a flexible drinking cup that also has a space cut out of it to fit a person’s nose. This is a simple and effective way to improve the independence of those who are limited in their ability to tilt their head back while drinking. With the space cut out for the nose, there is no need to tilt their head back while using this cup. The flexibility of the cup can control the flow of the fluid as well, to promote safe swallowing. 

      Bear Straw Cup– This kit can help teach a child how to drink out of a straw. The design keeps the liquid near the top of the straw so that less effort is required to take a sip. This can be great for those with oral motor deficits or those just learning how to suck. The kit comes with a lip block to prevent biting on the straw or having the straw enter the throat, and encourages oral motor exercise as well! 

      Recessed Lid Cup– This drinking cup is designed with two handles and a recessed lid that can improve lip closure while avoiding sippy cup use. Why do we want to avoid sippy cups? Short answer: if they are used to exclusively, for too long, they can cause dental issues and speech problems. The recessed lid cup mimics drinking from an open cup without all the spillage. Plus, it improves lip closure and tongue retraction for improved oral motor function. This kind even comes with two lid options, one that is suitable for straw use, and the other for typical drinking. 

      Flow Control Cup– This cup helps with oral motor control, lip closure, and tongue mobility that impacts sucking from a straw and managing the flow of liquids when drinking from a cup.

      Extra-Long Drinking Straw– This flexible drinking straw is extra long, addressing mobility needs that limits an individual’s ability to move closer to a cup and straw that are positioned on the table surface.

      If you are a therapist or another professional looking for brands to support during feeding therapy, take a look at Ark’s products. They make tons of oral motor tools for desensitizing and strengthening a child’s mouth to encourage the development of food repertoire and safer, more independent feeding and swallowing. 

      Finally, if adaptive feeding equipment is something that needs to be further adapted to meet the specific needs of an individual, don’t forget the many uses that Dycem will have in addressing specific needs.

      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.

      Shoe Tying Activity

      Shoe tying activity

      Shoe tying can be trying for little ones, and that’s where this shoe tying activity comes in. This shoe tying egg carton activity is one we developed in 2015, and it’s been shared thousands of times. Here’s why: This hands-on shoe tying task helps kids establish the skills they need to learn to tie their shoes in a fun and stress-free manner. 

      Kids will love this out-of-box shoe tying activity to teach kids to tie their shoes and practice shoe tying with an egg carton. Be sure to check out this massive shoe tying resource that has been recently updated so you can address all of the underlying skills needed to shoe tying with kids. 
       

      Shoe Tying ACtivity

       
      This shoe tying activity is actually part of a 31 Day series of Occupational Therapy posts using free or almost free materials. In each blog post in the series, I cover creative ways to work on functional skills using everyday materials found around the home. Today we’re using a recycled egg carton as a shoe tying tool.
       
      Shoe tying can be very difficult for kids to master.  Typically, children in Kindergarten show developmentally appropriate fine motor skills for shoe tying.  
       
      Kindergarten is a great time to start teaching kids to tie their shoes. They are gaining more dexterity in their fine motor skills, and are getting used to the routines of getting ready for school on a daily basis.  
       
      Shoe tying is part of that daily self-care schedule.  However, quite often, kids will start tying shoes at older ages. Shoe tying is tough:  There are many steps, two laces that look the exact same, and many times left./right confusion.
       
      Switching hands in tasks and not knowing the difference between left and right hand can be a challenge in a task like shoe tying where the verbal directions involve using the left hand to pinch and the right hand to pull a lace. That’s where using two different colored shoe laces is a benefit in our shoe tying activity.
       
      For left and right knowledge skills, try this related activity to work on left right confusion.
        

      Shoe Tying Egg Carton Activity

       
       
       
      Shoe tying tips using a shoe tying activity with a recycled egg carton and two different colored shoe laces to teach kids to tie their shoes..
       

       

       

       
      This post contains affiliate links.
       
       
      This shoe tying activity is a fun way to teach kids to lace and tie shoes with a fine motor twist.
       
       
      Shoe tying activity using an egg carton and two different colored laces.
       
      1. Start with a cardboard egg carton.  If you like, give it a quick spray with disinfectant spray when the kids are not around and let the disinfectant dry. I don’t typically do this step, though. We just try to make sure to wash our hands after playing with egg cartons.  
      2. Make the holes for the laces.  We used golf tees and a hammer for this part.  See how here.  It’s a fun proprioceptive activity for kids that is always a hit in our house.
      3. Grab a set of shoe laces.  Using two different colors is best for new shoe tying friends.  
      4. Tie the laces together at one end and thread them through the holes of the egg carton.  
      5. Start lacing the holes the whole way up the egg carton.  Threading the holes is an excellent fine motor task for kids.  My three year old loved this and wanted to take the laces out and do it again.  Threading the laces encourages bilateral hand coordination which is vital for shoe tying.
      6. Now we’re ready to practice tying shoes!
      How to teach kids to tie shoes using an egg carton as a shoe tying practice activity.
       
        
       

      Shoe Tying Tips

      First, be sure to visit this page on shoe tying for more tips and strategies to teach kids to tie shoes. 

       

      Many times, children are excited to learn to tie their shoes.  Embrace it, go with it, and practice!  But other times, they just don’t want to learn. That’s ok! Don’t force them and come back to practicing in a week or two. 

      If kids get frustrated with the shoe tying activity, the struggle to get them to sit down can be a difficult thing to overcome from the very beginning and only make the practice time more difficult.  If that is the case, give them time, and revisit shoe tying in a week or two.  

      The key to teaching kids to tie their own shoes is calm, quiet, practice. It’s easy for kids to get upset, frustrated, or anxious when there are so many steps and may feel rushed or upset about their fumbling fingers.    They might have Velcro shoes that they are perfectly happy to pull on quite quickly.  

      With my older child and from helping lots of kids learn to tie their shoes, I’ve seen the incentive of a new pair of sneakers with laces bring on the ambition to give it a shot.  

      Other times, it’s a creative way to practice, simplified directions, or learning steps in chunks that gives kids an oomph of “hey! I CAN do this!”  

      Shoe Tying Activities

      Here are some more shoe tying activities and tips:

      • Consistent verbal cues for each step. Use the same words each time.
      • Practice with the shoe in your child’s lap, not on their foot.  Once they master shoe tying (or at least start to get the hang of it), then practice with their shoe on their foot.  It will then take more practice with the shoe on their foot because when they are wearing the shoe, the laces shorten a bit.
      • Tying shoes has a lot to do with visual perceptual skills. You’ll find easy and fun ways to work on visual perceptual skills through play here. 
      • Place the shoe in their lap or on the floor positioned with the heel close to them and the toe pointing away.
      • Practice with two different colored shoe laces.
      • Tie your own shoe as you prompt your child to tie theirs.  Do the steps at the same time.  Sit beside and position your shoe slightly in front of your child.  You want them to see your shoe as a model in the same position as yours and in a place where they can see your shoe without having to turn their head to much.
      • Avoid saying “right” and “left” when talking about the different strings.  Keeping track of the right/left sides can complicate things for a young child.  Use the names of the laces if you are using two different colored laces or just say, “the lace on this side of the shoe”, or the “Pick up the lace with the hand you write with.”
      • Work in chunks.  Practice only the first step until your child masters that part.  Then, teach the next step and work on those tow steps together before moving onto the next step.
      • Practice with items other than laces.  Shoe laces can be very difficult for young kids to manage.  If they have any trouble with fine motor skills or bilateral hand coordination, it is especially difficult.  Try practicing with stiff shoe laces, wire-edged ribbons, pipe cleaners (twist the ends of two together for length!), or Wikki Stix.
      • When you get to the step where your child pinches the loop, make sure they are holding it close to the shoe.  If they are pinching the loop too far from the shoe, the knot will be too loose.
      • If you’ve been practicing shoe tying for some time and your child is just having too much difficulty, it might be other underlying reasons.  To tie shoes, kids need fine motor skills, bilateral hand coordination, visual perceptual skills, hand-eye coordination, and hand strength just to get the task of shoe tying done. If you feel your child has a difficulty in one of these areas, contact your pediatrician for a referral to an Occupational Therapist for individual evaluation and treatment.
      • I like the simplified steps below for shoe tying.  They are simple and easy for kids to remember.  Write them down and read them as you go through shoe tying with your child.  Our newsletter subscribers can get the image below as a free printable.  J
       
      Teach kids how to tie their shoes free printable
       

      Shoe Tying Task Analysis

      Breaking down the steps to shoe tying and deciphering where the struggle is happening can be a huge part of addressing shoe tying struggles. Use this list of steps to tie shoes to assess where the break down is occurring. 

      Next, look at the underlying areas that play into that aspect of tying shoes. Is it fine motor coordination? Pinch strength? Crossing midline? Bilateral coordination? Attention and focus? All of these areas play into the overall task analysis of shoe tying. 

      Then, focus on addressing those skills during the functional task itself.

      Let’s take a look at each step of shoe tying:

       
      Easy Steps to Teach Kids to Tie Their Shoes:
      1. Put both laces on one side of the shoe.
      2. Pick up one lace and go over and under the other lace.
      3. Hold the ends of both laces and pull tightly.
      4. Pick up the middle of the left lace and pinch it at the bottom.  Hold it close to the shoe.
      5. Pick up the other lace and wrap it around the loop.
      6. Push the lace through with your finger.
      7. Grab the loop with your hand…Grab the other loop with the other hand…And pull.
       
      (Remember to avoid using the words “right” and “left” unless your child has a good grasp of these words.  You can instead use the names of the colored laces, if using two different colored laces, OR use “the lace on this side” or the “hand you write with”. 

       

      Shoe tying activity and shoe tying tips
       

      More Shoe Tying Activities

      Looking for more ways to practice shoe tying with kids?  These toys and tools are fun ways to practice with kids.

      They are additional ideas for your soon-to-be-shoe-tyer.  Perhaps you have friends or relatives who are asking for gift ideas for your child, or you are looking for ideas for upcoming holidays.  These are a few ideas that I love for working on shoe tying and can help kids in their fine motor dexterity to help them become successful at tying shoes.
       
       
      Shoe tying toys and activities
       
       

      Shoe Tying Toys

      • This Melissa & Doug Deluxe Wood Lacing Sneaker is a great practice tool, with it’s bright colors and stiffer laces than the ones typically on shoes that we wear.  Practice on the model before moving to your child’s real shoe.

      • If you have a little one who loves to read, this I Can Tie My Own Shoes Book is a real incentive to practice shoe tying.
      •  Sometimes, kids just can’t get the hang of shoe tying no matter how hard they try.  These Tie Buddies Shoe Accessory are great for kids that have trouble at the “loop part” of shoe tying.  They eliminate the loops and give kids something to hold onto while tying.  Kids with hand weakness will benefit from this tool.
      • Another modification to shoe tying are these No Tie Shoe Lock Laces .  They can be laced in shoes and help the child’s shoe stay snug.
      • Magic Shoelaces are another way to modify shoe tying.  Use these until your child is ready and able to practice effectively.  They are great laces for kids with difficulties in any of the underlying skills needed for shoe tying.
      • I love a creative practice technique when it comes to any skill for kids.  This Plastic Lacing Cord is an excellent way to practice shoe tying with a more resistive lace.  Use them in place of shoelaces in the egg carton activity that we shared today.
      • For more functional and appropriate play to work on shoe tying, I love this Colorful Caterpillars Game .  It works on bilateral hand coordination and strength needed to tie shoes with dexterity and ease.


        She tying activity with an egg carton and shoe tying tips

      I hope you were able to find some helpful tips and tools in this post.   


      Love this post?  Pin it!  And don’t forget to use that shoe tying joke!  Jokes help with shoe tying 🙂

      Try these shoe tying tips and tricks for teaching kids how to tie their shoes, from an Occupational Therapist
       

      Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

      Oral Motor Exercises

      Oral motor exercises and activities for kids

      There are many reasons to incorporate oral motor exercises into your therapy plan. Here, we are covering the reasoning behind several oral motor exercises and strategies to work on mobility and functioning in the mouth, tongue, lips, and jaw.

      These oral motor exercises are kid-friendly and improve coordination, strength, and mobility of the mouth to facilitate feeding, oral discrimination, or sensory needs.

      Why Oral motor Exercises?

      When we talk about oral motor exercises, it’s important to know why we are considering specific exercises. When it comes to oral motor exercises, we are striving to improve the functioning of the mouth, jaw, lips, cheeks, and tongue so that the child can demonstrate coordination needed for sound production and articulation. Other issues can arise in manipulation (chewing, movement of foods and liquids, tolerance of various textures, and swallowing food and liquids).

      When it comes to feeding issues, there can be a question of whether the feeding problems are a result of sensory processing challenges and/or oral motor considerations. Check out this resource for more information on pediatric feeding and oral motor issues or sensory issues that impact feeding abilities.

      Kids who struggle with feeding may be impacted by oral awareness and oral discrimination. These skills enable us to both be aware of the motions of the muscles and joints of the mouth to enable positioning for oral sound creation as well as movements to control and mobilize the chewing and manipulation of foods and drinks of various textures.

      Oral discrimination is essential for safety, efficiency, and function when eating.  When oral discrimination is a challenge, children can have resulting food aversions, be unaware of food in their mouth, or not be able to tolerate certain types of food textures, tastes, or temperatures.  They may have difficulty with managing various textures and end up with messy eating during meals. Oral discrimination also effects skills like speech and tooth brushing.

      Start here by reading more about the development of oral motor skills. Typical development of oral motor skills is an important consideration when it comes to self-feeding and movements of the mouth, tongue, and lips in tolerating new foods or textures in feeding.

      Specific reasons for incorporating oral motor exercises into a therapy program may include issues with the following movements:

      The oral motor exercises listed below can offer additional opportunities for strength and coordination of oral motor skills, as well as heavy work proprioception through the mouth as calming input to organize the body.

      Oral Motor Exercises

      These activities are not the only ones that can be done to address oral discrimination issues.  Additionally, it’s important to know that therapists understand that oral discrimination is just one piece of the feeding puzzle.  Considerations such as tone, sensory processing, and oral-sensory exploration as well as many other components make up feeding.

      Tips for Oral Motor Exercises

      1. These specific oral motor exercises can be selected based on the specific needs of the child. Each exercise many not work for all individuals. And, the exercises should be modified as needed to grade up or down (make them easier or harder) based on the needs of the individual.
      2. For each exercise listed below, add a repetition to complete the task. Add in a specific number of repetitions.
      3. Add the number of days these exercises should be completed each week.
      4. Incorporate function whenever possible. Working on feeding? Add real foods of interest. Use utensils or cups when possible. Incorporate the occupation of play to make the exercises motivating and fun.
      5. Consult with a pediatric occupational therapist!

      Oral Motor Exercise Ideas

      Remember that not all of these exercises are needed for every child’s specific needs. Pick and choose the exercises that meet the needs of the child you are working with.

      • Bring their hands and fingers to his or her mouth and lips.
      • Play tongue Simon Says with a mirror.
      • Play the “hokey pokey” with your tongue and cheeks.
      • Try messy play with food.
      • Encourage tolerance of a spoon or other feeding utensil in different parts of the mouth.
      • Open and close your mouth.
      • Move your tongue from side to side.
      • Press your lips together and then smack your lips apart.
      • Explore different types of utensil textures (plastic, metal, plastic covered, etc.)
      • Hold and play with a toothbrush, bringing the brush to their mouth and face.
      • Encourage mirror play, identifying parts of the mouth.
      • Add rhythmical, whole- body play with therapy balls, uneven surfaces such as trampolines or crash pads to improve proprioceptive input. (Great for core strengthening and stability needed for feeding, teeth brushing, etc.)
      • Explore mouth play with teething toys and tools.
      • Explore use of teething toys and tools in different positioning (prone, supine, side lying, etc.)
      • Use rhythmical music along with tapping the cheeks or lips.
      • Offer frozen fruit on a tongue depressor. Try this recipe for frozen fruit skewers.
      • Chew a straw.
      • Pucker your lips in a pretend kiss.
      • Blow a party noise maker.
      • Blow a kazoo.
      • Use a straw to pick up squares of paper and drop them into a bowl.
      • Make fish lips.
      • Apply Chapstick (scented or unscented) and press your lips together as you move your lips from side to side.
      • Puff up your cheeks.
      • Smack your lips.
      • Whisper the sounds the letters of the alphabet make from A-Z. Notice how your mouth moves. Or, spell out your name or other words by whispering the sounds the letters make.
      • Blow bubbles
      • Blow through a straw to move a cotton ball or small craft pom pom along a line. Can you move it through a maze?
      • Freeze water to a popsicle stick and lick or suck until the ice melts.
      • Try making these Shirley Temple popsicles. They are a tasty oral motor exercise tool.
      • Pour water into an ice cube tray. Add popsicle sticks to create a cube pop. Lick and suck until the ice melts.
      • Scoop peanut butter onto a spoon. Lick it off with the tip of your tongue.
      • Point your tongue to the end of your nose. Hold it there as long as you can.
      • Point your tongue to your chin. Hold it there as long as you can.
      • Push your tongue into your right cheek. Hold it there and then press the end of your tongue into your left cheek.
      • Count your teeth using your tongue. Touch each tooth with the tip of your tongue.
      • Chew gum. Can you blow a bubble?
      • Deep breathing mouth exercises. Use these printable deep breathing cards.

      Themed Oral Motor Exercises

      You may want to check out these themed oral motor exercises for development of motor skills in various points throughout the year. These themed exercise can be added to weekly therapy themes to increase motivation and carry through. Here are several themed oral motor exercises for kids:

      Deep breathing exercise cards for oral motor skills and proprioceptive input through the mouth and lips

      Want printable oral motor exercises? Grab the Deep Breathing Exercise Cards. The pack of deep breathing cards includes oral motor exercises for heavy proprioceptive input through the mouth, tongue, and lips, and oral motor activities using different themes, totaling 113 different exercises.

      The Oral Motor Exercises can be done anytime, using just the mouth. These strategies offer exceptional proprioceptive input through the lips, tongue, and cheeks, making a calming heavy work activity that can be used in sensory diets to help children achieve a calm and ready state of regulation.

      Click here to get your copy of the Deep Breathing Exercise Cards.

      Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.