Occupational Therapy Obstacle Course

Occupational therapy obstacle courses

Occupational therapy practitioners often times use obstacle courses in therapy sessions to target specific skills through the child’s primary occupation: play. It is through an occupational therapy obstacle course that one can work on sensory input, balance, coordination skills, heavy work input, visual motor skills, bilateral coordination, visual motor skills, direction following, and so much more. Let’s break down OT obstacle courses for functional performance.

Obstacle courses, and the components of gross motor obstacles are a great tool to have in your “therapy bag” of tricks!

Occupational therapy obstacle course ideas

Occupational therapy obstacle courses

Life is full of obstacles. Navigating life’s obstacles builds strength, character, resilience, and focus. Occupational therapy obstacle courses can do the same!

There are so many ways to target occupational therapy goals using an obstacle course. For example, you can use the various types of crawling to incorporate different heavy work input, targeting strength, stability, and motor planning skills.

Obstacle courses are naturally a sensory obstacle course, through the actions and activities involved, however specific themes and underlying targets can be incorporated as well.

Occupational therapists and occupational therapy assistants use obstacle courses, to address a variety of needs. 

In this blog post you will discover the benefits of obstacle courses, how they help development using obstacle course, and ideas to build amazing obstacle course activities.

Benefits of obstacle courses

What are the benefits of occupational therapy obstacle courses?

At first glance, obstacle courses build muscle strength, coordination, and motor planning.  This is just the tip of the iceberg. While occupational therapy obstacle courses are great for building strength and coordination, they do so much more. 

  • Executive function – following directions, attention, focus, sequencing, planning, initiation, and  task completion
  • Social function (if working with peers) – working together in a group, problem solving, turn taking, waiting, sharing, and negotiation
  • Behavioral skills – compliance, behavior, and work tolerance
  • Sequencing – remembering all of the tasks in the correct order
  • Motor planning – Target motor planning by working through new obstacles and movement patterns builds new skills and motor pathways
  • Kinesthetic learning – learning by doing, rather than talking about an action
  • Strength – core strength, shoulder and wrist stability, head control, balance, and hand strength are built through obstacle courses. These skills lead to improved sitting balance and fine motor skills
  • Bilateral coordinationBilateral coordination refers to coordinating both sides of the body to do the same action such as holding onto a rope, or alternating actions such as climbing a ladder
  • Proprioception – information comes into the body through the muscles and joints. This information helps with arousal level, coordination, and attention
  • Sensory information – tactile, visual, olfactory, vestibular, and auditory receptors are activated during obstacle courses

How do occupational therapy obstacle courses help development?

All of the skills above are core skills needed for further development. Fine motor skills are built from core strength. Attention and focus are built and regulated from sensory input. Following directions builds working memory. Executive function and social skills are necessary for academic and professional development. 

How to develop an obstacle course in occupational therapy

One thing that comes up often is that one will see an OT clinic full of fun toys and think, “OK, in occupational therapy, we play.” This is true! However there is purpose behind each skilled selection of the toys and therapy equipment, and this is particularly true in an OT obstacle course.

ere are the important steps in setting up an OT obstacle course:

  1. Determine the goals to be addressed.  What is the priority for your learner?  
  2. Build your course around the goals, with emphasis on the highest priority goal
  3. Add motivators – learners work harder given motivation
  4. Create a beginning and ending point – everyone needs to know how far they need to go
  5. Check out Pinterest for obstacle course ideas
  6. Select your obstacle course ideas
  7. As always, Amazon (affiliate link) is full of resources for items to incorporate in your obstacle course

Obstacle Course Ideas

Depending on the goals in which are being targeted, you can select from many different obstacle course equipment and activities:

By using any combination of the occupational therapy goal areas above, you can create a “course of action” to move through a therapy session while accomplishing goals. Combine these target areas with a client’s interest such as super heroes, animals, sports, events, or therapy themes, and you’ve got a client-centered therapy activity that is not only meaningful but also motivating

Examples of occupational therapy obstacle courses

Build your course around your prioritized goal(s) to target specific areas:

  • Following directions – set up several obstacles in succession with different variables to follow and remember.  Over, under, times 10, backward, clap your hands, touch your toes.
  • Executive function – have your learner develop and organize the obstacle course for themself or another partner. They can write it down, draw pictures, or use verbal skills to describe the course
  • Self regulation – incorporate heavy work into the course. This could include wearing ankle weights, pushing a ten pound ball, wearing a heavy backpack, and several repetitions of the course
  • Frustration tolerance – make the course very challenging. Add several elements that will challenge your learner, then change the sequence to continue to add more of a challenge
  • Social function – have one learner teach another, pair two learners of different levels to work on waiting, taking turns, and tolerance.  Two similar peers can build competition, or dealing with emotions
  • Coordination – vary the difficulty of the course to build different levels of coordination. Time your learner to measure improvement in coordination without falling
  • Visual motor skills – each time your learner finishes a round of the obstacle course, they have to write a letter, draw a picture, cut out a design, or put pieces into a puzzle

sensory obstacle courses

Obstacle courses naturally offer sensory input. By moving through and around obstacles, a child can participate in organizing and regulating sensory processing tasks in a very real and functional manner. It’s through play that this happens.

Sensory obstacle courses are in fact, every obstacle course! In a typical obstacle activity, sensory input includes:

  • Proprioceptive inputHeavy work input occurs through movement activities but also by using obstacle course equipment such as ladders, ball pits, tumble pits, foam equipment, crawling, animal walks, etc. Each activity offers different motor planning opportunities and different types of body awareness input.
  • Vestibular input crawling, scooting, sliding, jumping, rolling, tumbling, climbing, etc.
  • Visual input Visual processing skills are part of navigating in, through, around, under, over obstacles on a course.
  • Tactile input Moving through a course offers tactile input through movement and manipulation of objects and equipment.
  • Auditory While not always a necessary aspect of sensory obstacle courses, auditory processing can be targeted in obstacle course objectives.

You’ll notice that the first three areas listed are the “big three” sensory systems that calm and regulate the body and play a major role in sensory processing. Because of this, an obstacle course is a great therapy tool and often used in sensory interventions. Sensory obstacle courses can be used as part of a sensory diet.

The Tactile Sensory System is one of the earliest developed senses of the body.  The skin is the largest and the most prevalent organ. The skin performs unique duties for the body.  Most importantly, the skin protects and alerts us to danger and discriminates sensation with regard to location and identification.

These two levels of sensation work together yet are distinctively important.  Discrimination of touch allows us to sense where a sensation is felt on the body.  With discrimination, we are able to discern a fly that lands on our arm. 

The second level of the tactile system alerts us to danger.  It allows us to jump in response to the “fight or flight” response when we perceive a spider crawling on our arm. The information received from the tactile system also includes light touch, pain, temperature, and pressure.

When either of these levels of sensation are disrupted, tactile dysfunction can result.  This presents in many ways, including hypersensitivity to tags in clothing, a dislike of messy play, difficulty with fine motor tasks, a fear of being touched by someone without seeing that touch, a high tolerance of pain, or a need to touch everything and everyone.

When the tactile system is immature or impaired, the brain can become overly stimulated with resulting poor organization and regulation of input.  Children can then experience difficulty with behavior and concentration as a result.

Treatment for the child with an impaired tactile sensory system focuses on providing a variety of deep- and light-touch experiences (Koomar & Bundy, 1991).  Additionally, resistance activities, much like those indicated for decreased discrimination of vestibular and proprioceptive information, may be used in the therapeutic sensory diet.

The Proprioception Sensory System is the recognition and response to the body’s position in space with an internal feedback system using the position in space of the joints, tendons, and muscles.  This sensory system allows the body to automatically react to changes in force and pressure given body movements and object manipulation.  The body receives more feedback from active muscles rather than passive muscle use.  Related to the proprioception system is praxis or motor planning.  Individuals are able to plan and execute motor tasks given feedback from the proprioceptive system. Praxis allows us to utilize sensory input from the senses and to coordinate hat information to move appropriately.

Treatment for the child with an impaired proprioceptive sensory system focuses on providing intense proprioceptive information and improving postural responses.

The Vestibular Sensory System is the sense of movement and balance, and uses the receptors in the inner ear and allows the body to orient to position in space.  The vestibular system is closely related to eye movements and coordination. 

Vestibular sensory input is a powerful tool in helping children with sensory needs.  Adding a few vestibular activities to the day allows for long-lasting effects.  Every individual requires vestibular sensory input in natural development.  In fact, as infants we are exposed to vestibular input that promotes a natural and healthy development and integration of all systems. 

The sensory vestibular activities listed in this book are playful ways to promote performance and tolerance to movement activities.  They are also challenges against gravity to help kids with difficulties in equilibrium, balance, self-regulation, and adjusting to typical sensory input. 

The vestibular system operates through receptors in the inner ear and in conjunction with position in space, input from the eyes, and feedback from muscle and joint receptors, is able to contribute to posture and appropriate response of the visual system to maintain a field of vision. 

This allows an individual to detect movement and changes in the position of the head and body.  Dysfunction in the vestibular system may result in hypersensitivity to movements or hyposensitivity to movements. 

Attention and focus are built and regulated from sensory input.

Printable sensory stations in obstacle courses

Sensory paths and sensory stations can support the areas listed above by simply printing off materials to use in a simple or complex sensory obstacle course.

An obstacle course can be anything.  It can start as simple as furniture, couch cushions, and a puzzle, or become as elaborate as American Ninja Warrior. First, determine your “why”, then come up with the “what and how”. 

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

DIR Floortime and Floor Play

DIR Floortime

Have you heard of DIR Floortime as a tool for helping children thrive and achieve their greatest potential?  Occupational therapy professionals often use Floortime, or the DIRFloortime (or Floortime for short) as one of the tools in their therapy toolbelt. The fact is that floor play for infants, babies, and toddlers is so effective in many aspects of play, but we wanted to cover a bit more about the Floortime approach to development and learning.

In this post we will explore the various types of floor play, including DIR Floortime, for children of all ages, as well as explain why playing on the floor with your child is important. Play age and stage of development guides DIR floortime as well as floor play in a general sense.

What is Floor Play?

First, let’s cover what we mean by floor play. In this blog post, what we mean by floor play is just that: play on the floor!

Children will play just about anywhere – most are skilled at making any landscape their personal playground. The most commonly accessible playground, however, is the floor! So much play and movement can happen on the floor, which makes it a perfect location for developmental milestones to occur in little ones. Older children continue to be drawn to the floor as they sit down to play with trucks, dolls, and build forts.

When babies and infants are on the floor, they can develop and learn during tummy time, but also while on a play mat in a variety of positions.

Older babies strengthen their bodies and learn how their movements are in their own control while playing on the floor. They learn about the world around them this way. They gain motor skills and begin to engage with toys through play on the floor.

Toddlers develop social emotional skills, refined motor skills, strength, coordination, and eye-hand coordination skills through floor play.

Older children build more strength, endurance, postural control, social emotional skills, confidence, self-regulation, and executive functioning skills through floor play.

There are so many benefits to getting down on the ground with your child an engaging in floor play, no matter the age!

Related, this article on parallel play describes additional information on play at different ages and stages.

Floor Play For Babies

Why should I put my baby on the floor? Isn’t it dirty? How do I keep them safe down there? 

Check out this post on Floor Play for Babies for a specific floor play idea for young children.

For young children, movement may be reduced as a result of placing babies in “containers” or seats. This limited movement opportunity can impact typical development and reflex integration.

Floor Play Activities

Isn’t it dirty? Some floors are dirty. Some houses have dirt floors. Never take for granted that your patient has a great/clean environment to play on the floor. Provide a washable tablecloth, sheet, blanket, or large mattresses on the floor to encourage movement.

In fact, playing on the floor with our children is so important that a model was born from it, called DIR Floortime. 

What is DIR Floortime? 

DIR Floortime stands for Developmental, Individual-Differences, and Relationships. It is a model used primarily to guide caregivers of children with Autism Spectrum Disorder (ASD). As you can imagine, this model guides parents to use the most important place for child-led play,…the floor! 

The DIR Floortime model emphasizes the importance of following a child’s lead, joining them on the floor, at their height, playing with them based on their choices.

dir floortime is different than other programs

Many programs for Autistic children are designed to help them change, in order to act more like children without Autism. However, this can be an area of concern. Floortime therapy encourages acceptance and appreciation of who the child is, and highlights that caregivers can best support the child by following their lead.

Through this type of interaction, caregivers can build strong relationships, and improve the social-emotional skills of the child. 

DIR Floortime training is a certification process that teaches and promotes an approach to intervention. The training is appropriate and targeted for therapy professionals working in preschool through school-aged students. Through the DIR/Floortime principles, therapy professionals learn and intervene through practice, self-reflection, and mentorship, while meeting the needs of their clients in different environments and settings.

Although DIR Floortime interventions are primarily used as a model to better understand and build relationships between an ASD child and their caregiver, I find it a great model for any child-adult relationship.

Learn more about DIR Floortime principles on their website

Playing on the floor with your child not only leads to gains in motor development, but as DIR Floortime and various researchers report, playing on the floor is also integral to the development of social and emotional skills! It’s a win-win-win. 

floor time Activities by Age:

As your baby ages into a toddler and into a child, they will continue to benefit from playing on the floor with you.

Infants and Babies

Floorplay activities for babies is a good resource to check out when it comes to development and the infant/baby. It’s during the early years that the young baby support development of motor, sensory, and cognitive skills. It’s important to engage with your baby during floor play time, both when laying in tummy time or on their backs or sides.

Babies should be interacted with during floor time play, and not just placed on the floor with some toys or a play mat.

Some activities for this age include playing on the floor and engaging with baby by:

  • Singing songs
  • Getting close to baby’s face and making eye contact
  • Baby massage
  • Rubbing baby’s back while humming or singing

During the vast stages of baby development, floor play is about engaging with your little one. Tummy time can still be a challenge for this age, but keep going! This is a great age to engage with eye contact, physical contact while supporting emotional development and continued motor and cognitive skills.

Spend a lot of time talking to baby during floor play. Use different tones of voice, and make sounds with your mouth and tongue when talking and playing to baby. This is a great way to develop auditory processing skills, too.

Floor play during the first year can include (among many other play ideas) a means for motor skill development too:

  • Play mats
  • Toys scattered on the floor to encourage reaching, rolling, and sitting
  • Sing and speak nursery rhymes and gently move baby’s arms and legs during floor play
  • Supporting baby on lap and reading books, talking, and interacting/engaging with baby
  • Mirror play

For older children: toddlers, preschoolers, and older kids, floortime is a fantastic way to support development through engaging with the little one in a respectful and playful way. Floorplay is fun! It’s a joyful way to support a young child’s development.

When it comes to specific activities and play ideas, the most important thing to remember is to make the play time meaningful. This looks like themes or activities that align with the individual’s interests.

Consider the following when coming up with floor time activities:

  • Favorite topics
  • Favorite characters (from TV, movies, books, games, videos, etc.)
  • Favorite colors
  • Preferred activities
  • Sports
  • Seasonal activities

While floortime can cover any topic or theme, the most important piece is getting down on the floor with the child and playing! Let the play be guided by the child and

the best part of floor play

The best part of floor play, is how easy and inexpensive it is to support your child by playing on the floor with them. You don’t need the “best” toys or even any traditional toys at all. Your body, voice, household objects (blankets, paper, remote control, books), creativity, and a positive attitude will go for miles.

For even more ideas of how to play with your infant or child on the floor, check out this great post for toddler play ideas.

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.