If you are looking for fun ways to help toddlers develop skills through play, then this hand eye coordination activities for toddlers is for you. During the toddler years, there is much development happening. Whether you need fun ways to help little ones build gross or fine motor skills, this hand eye coordination activity will support the cognitive and physical development the young child can use for learning and play.
Hand Eye Coordination Activities for Toddlers
Hand eye coordination refers to the coordination between visual input through the eyes and physical motor movements through an integration of the visual and motor systems in order to use the hands and arms.
Hand Eye coordination for toddlers is necessary for play, self-feeding, and increasing independence in young children.
This is a developmental skill that begins at a young age and progresses in skill and precision.
Examples of Hand Eye Coordination in Toddlers
Toddlers gain precision and accuracy in motor skills at a rapid rate. You’ll notice this as they become more and more refined in motor skills. Some examples of activities that require hand-eye coordination during the toddler years includes:
Taking off clothing (shirts/pants) and putting on clothing
Putting toys into containers, bags, purses
Participating in pretend play
Self-feeding using feeding utensils (Read here for tips on how to hold a spoon to encourage self-feeding skills
Drinking from an open cup
All of these functional areas of day to day activities for toddlers build skills through actually participating in the task. However, you can definitley foster the underlying skills needed to support independence through play! For example, we love using play based learning or a craft for 2 year olds and all ranges of toddlerhood!
Why build hand eye coordination in toddlers?
There are many benefits to encouraging hand eye coordination activities in toddlers. Through play, you can create opportunities for young children to gain the type of play that the young child needs. This includes fine motor play, gross motor play, and not screen use!
Some benefits for toddlers to participate in hand eye coordination tasks includes:
Try the hand eye coordination activity we did using an inner tube. This is a great color activity for young children.
This was a fun little play activity for the Toddlers. Niece and nephew (19 months) was with us one day and LOVED doing this.
I put the blue inner tube and a little basketful of balls out on the dining room floor. I put one ball into the center of the inner tube and he was INTO it! Little nephew went crazy putting the balls in the center, taking them out, putting them back into the basket. This was FUN!
What are we learning with this activity?
Eye-Hand Coordination
Toddler Visual-motor skills
Cause and effect (if I throw this ball into the center, it might bounce out…)
Learning colors
Gross Motor Skills (throwing, rolling, bouncing)
We’ve been on a BLUE kick around here these days.
This was a fun little play activity for the Toddlers. Nephew (19 months) was with us one day and LOVED doing this.
This little (and EASY…seriously, it does not get much easier than this…) game will be coming out again. This Aunt can clean up the breakfast mess when something like this is going on!
Tips for Toddler Hand eye coordination skills
When setting up activities for toddlers, some tips include following the child’s lead. Offer support when needed, but allow the young child to participate in the process. Sometimes working and playing along side the toddler offers a model that the young child can copy if they like, but they won’t feel pressured and they still have the autonomy that gives them a sense of success.
Most of all, have fun!
Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.
If you’ve ever run a therapy session with a fun game of Simon Says, than you know the challenge of coming up with effective Simon Says commands on the spot. The beauty of a good game of Simon Says is that you can target any gross motor, fine motor, sensory motor, and visual motor skill area that you need to, making it the perfect gross motor coordination game that supports a variety of skills.
Simon Says Commands
Woohoo, it’s Simon Says for OT! Who doesn’t love a good game of Simon Says? It’s a classic game that builds a variety of skills without kiddos knowing it.
Below, you’ll find a great list of therapist-approved Simon Says game commands and, you can grab a Simon Says commands pdf so you can print off these game ideas and use them in any therapy session, or as a brain break in the classroom or home, too.
Let’s cover all of the Simon Says ideas!
How to Play Simon Says
If you’ve never heard of Simon Says or don’t have a clue what it is, it’s a fun game that is easy to implement in any location.
First, you identify one player for the role of Simon and that player will give the other players commands for actions to perform. (There are many targeted goal areas identified with commands listed later in the post.)
Second, the game has a trick with it, Simon MUST preface the command by saying, “Simon Says”, or the command is NOT to be followed.
If a player follows that direction and completes the movement when “Simon” doesn’t say “Simon Says”, they are out of the game or can lose one of their tally strokes or chips that is given to each player before play.
If they DO NOT follow one of the stated Simon Says commands, they are out or lose a stroke or chip too.
Third, the last player standing or the player with the last chip or tally stroke is the winner.
Simon Says Examples:
Simon: “Simon Says hop on one foot.”
Other players:Correctly follow the direction and hop on one foot.
The players that completed the correct action stay in the game or can stay in the game and do not lose a token or tally chip/tally mark.
Simon: “Simon Says hop on one foot.”
Other players:Incorrectly do not follow the direction.
The players that did not complete the correct action are out of the game or can stay in the game and lose a token or tally chip/tally mark.
Simon: “Hop on one foot.”
Other players:Incorrectly follow the direction and hop on one foot.
The players that completed the incorrect action (Simon didn’t say “Simon Says”!) are out of the game or lose a token or tally chip/tally mark.
Simon: “Hop on one foot.”
Other players:Correctly do not follow the direction and do not hop on one foot.
The players that did not complete the incorrect action (Simon didn’t say “Simon Says”!) stay in the game or do not lose a token or tally chip/tally mark.
Easy, right? Not too fast friends! A child’s (and adults’) attention, impulsivity, and patience can play a role in their ability to listen, act, and wait while playing this game.
Think about each child and what kind of commands you may need to give them to help them play successfully.
Younger students or those working to improve the cognitive skill of following sequences can improve these areas with certain adaptations. Give them simple commands that have few words and one step. Think about saying something like, “Simon Says clap your hands” vs. saying, “Simon Says spin around and then clap your hands”, see the difference? This will help a child focus on one skill at a time and then build from there as they age or become better at following multiple directions.
If a child struggles with verbal or processing skills, consider the use of a visual choice board, like this one by Panda Speech Therapy, that displays someone speaking coupled with a visual that demonstrates the action that Simon Says to do. This is a great modification to help children that need this type of support to be successful during play or even those who are new to learning how to play the game.
Think about the OT skills that can be facilitated with this game:
With therapy equipment, range of motion, muscle strengthening, and spatial relationships
Target whatever area you need to with children based on their goals and you’ve got a fun time with focus!
Think about the social skills that can be targeted while following and giving multiple skill-driven directions – don’t forget to either simply say the direction or add, “Simon Says” to give kiddos the true direction to DO vs. the fake direction to REMAIN STILL.
Simon Says Ideas
The list of Simon Says ideas below are separated by area of development. You’ll find specific movement ideas for:
Visual motor skills
Fine motor skills
Gross motor skills
Sensory motor skills
Social skills
Emotional skills
Oral motor skills
Simon Says Commands to Target Visual Motor Skills
Draw a row of circles
Draw a face
Draw a person
Trade drawing tools with your neighbor
Use different colors and write the letters of your first name
Write the ABCs
Build a block tower
Build block stairs
Build a block pyramid
Write the numbers 1-10
Toss a ball up to self and catch
Walk a ball on the wall
If you need more visual motor command ideas to help, look at these fun resources:
If you are looking for a combination of Simon Says Commands that address multiple areas, you can find a list of these below from A-Z. Enjoy!
A – Air write your name
B – Blow pretend bubbles
C – Cross crawls or crunches
D – Deep breaths
E – Excited body movements
F – Fingertip taps to thumb
G – Give a compliment
H – High 5 someone
I – ‘I love you’ hand sign
J – Join hands or arms with someone
K – kangaroo hops
L – Lick your lips all around
M – Make a sad face
N- Number 8’s in the air
O – One leg stands each leg
P – Print the alphabet
Q – quick run in place
R – Roll out a playdough square
S – Stick out your tongue
T – Twirl around
U – Up on toes stretch
V – Valentine’s heart hands
W – Wave to someone
X – XO to give self-hug
Y – Yawn for feeling tired
Z – Zig-zag line in air
Lastly, you can also be creative and think about how you can use Simon Says Commands with commercial board games, like Operation, Perfection, Twister, Whac-A-Mole, Spot It, Avalanche, or Kerplunk. Think about just changing it up by using Simon Says commands or NOT, to direct the child in what they should or should not do. It’s a new approach to some common board games used in pediatric OT and the kids will love it!
Free printable Simon Says Commands for craft stick labels.
Free Alphabet Simon Says Popsicle Stick Labels
I am so excited to share this newest resource. All you need is a printable page with the popsicle stick Simon Says commands and craft sticks. We used the larger-size popsicle sticks to make the popsicle stick commands.
Kids can pull a craft stick out of a cup and use the command to create actions based on movements for each letter of the Alphabet. This set goes with our Alphabet Exercises blog post where each letter of the alphabet has a corresponding exercise or motor action.
Want a copy of these popsicle stick exercise labels? Enter your email address into the form below. OT Toolbox members can also find this printable inside the Member’s Club (along with the full list of Simon Says cards listed above in printable card form AND in popsicle stick label format).
Regina Parsons-Allen is a school-based certified occupational therapy assistant. She has a pediatrics practice area of emphasis from the NBCOT. She graduated from the OTA program at Caldwell Community College and Technical Institute in Hudson, North Carolina with an A.A.S degree in occupational therapy assistant. She has been practicing occupational therapy in the same school district for 20 years. She loves her children, husband, OT, working with children and teaching Sunday school. She is passionate about engaging, empowering, and enabling children to reach their maximum potential in ALL of their occupations as well assuring them that God loves them!
You may have heard the term motor planning but wondered what this means and what does it look like to utilize motor planning skills in everyday activities. Here, we are breaking down this important motor skills topic. Occupational therapists are skilled at analyzing movements and underlying skills needed to perform the things we do each day, or the tasks that occupy our time, and establishing an efficient and coordinated motor plan is one of the main aspects of this assessment.
Motor Planning
When we perform an action, there are movements of our bones, joints, and muscles that enable our bodies to move. It’s through this movement that the body and brain receives feedback, or a motor concept that tells the brain and body that we have moved in a certain way in order to accomplish a specific action. This is the motor plan for that particular task at work!
Let’s look at a child’s motor skills in a specific action to really explore this concept.
Ok, so you’re walking along a hallway with an armful of bags and see a ball in your path. You walk around it and continue walking. But, hold on. That was a pretty cool ball. It was all red and shiny. It looked like a really fun ball to bounce. You stop, turn around, walk back to the ball, stoop down, put down your bags, and pick it up. Woah. It’s not only red and shiny, but it’s a little heavy too.
It takes a bit more muscle oomph than you were expecting. You hold your arm up high, with the ball up over your head. Totally not a baseball player’s pose, but all awkward and kid-like. You know. Pure fun throwing.
You toss that red, shiny, heavy ball as hard as you can towards a big old blank wall on one of the hallway walls. Now watch out! That red, shiny, heavy ball is bouncing around like crazy!
It’s bouncing off of the wall and right back at you! You jump to the side and then to the left and right as it bounces back and forth between the walls of that hallway. You have to skip to the side to avoid your bags.
The ball stops bouncing and rolls to the side of the hall.
Well, that was fun. You pick up the ball and hold it while you gather your bags. Now, you see a boy coming down the hall who sees that red, shiny, heavy ball in your hand and says, “Hey! There’s my ball!” You smile and toss the ball as he reaches out his hand and catches. “Thanks!!” he says as you wave and start walking down the hall again.
What is Motor Planning?
Motor Planning happens with everything we do! From walking around objects in our path, to picking up items, to aiming and throwing, drawing, writing, getting dressed, and even dodging red bouncy balls…
Motor Planning is defined as the problem solving and moving over, under, and around requires fine motor and gross motor skills and planning to plan out, organize, and carry out an action. We must organize incoming information, including sensory input, and integrate that information into our plan. We need to determine if a ball is heavy or light to pick up and hold it without dropping it.
You might hear of motor planning referred to as praxis.
Praxis (generally also known as Motor Planning, but also it’s more than simply motor planning…) requires observing and understanding the task (ideation), planning out an action in response to the task (organization), and the act of carrying out the task (execution). A difficulty with any of these areas will lead to dyspraxia in many skill areas.
Praxis includes motor planning, but also involved is ideation, execution, and feedback, with adjustment to that feedback. You can see the similarities in motor planning, which refers to the conscious and subconscious (ingrained) motor actions or plans.
Motor Planning is needed for everyday tasks. Think about the everyday activities that you complete day in and day out. Each of these actions requires a movement, or a series of movements to complete. There are both gross motor movements, fine motor movements, and posture all working together in a coordinated manner.
putting on a coat or jacket (on top of other clothing such as a shirt so that in this case, there isn’t the tactile feedback available of the fabric directly on the skin’s surface)
performing sports actions such as swinging a baseball bat or tennis racket, running, or gymnastics like doing a cartwheel
The interesting thing is that a movement plan, or the physical action that is completed whether the action has been performed in the past or if it is a new movement. A motor plan for a new task can be completed without thinking through how to move the body because it is just inherently completed.
When we complete unfamiliar tasks and need to stop and think through how the body needs to move, is when we see inefficient movement, or motor planning issues.
Motor Planning Difficulties
Above, we talked about praxis as another term or way to name the motor plan concept. When there are difficulties with motor planning, we are referring to the opposite of praxis, or dyspraxia.
Dyspraxia can be a result of poor sensory integration, visual difficulties, fine motor and gross motor coordination and ability, neural processing, and many other areas.
Motor planning difficulties can look like several things:
Difficult ability to complete physical tasks
Small steps
Slow speed
Pausing to think through actions
Clumsiness
Poor coordination
Weakness
These challenges with motor function can exist with either new motor tasks or familiar actions. Deficits are apparent when speed is reduced so that the functional task isn’t efficient, when the motor task is unsafe, or poor completion of the task at hand.
There are diagnoses that have poor motor planning as a component of the diagnosis. Some of these disorders can include:
When motor planning difficulties exist, this can be a cause for other considerations related to movements, and demonstration of difficulties when participating in movement-based activities:
challenges in social interactions
anxiety
behaviors
social skills issues
Today, I’ve got a quick and easy fine motor activity to work on motor planning with kids. This activity is part of our 31 Days of Occupational Therapy series where we’re sharing fun and frugal ideas for treatment of many OT skill areas with items you might already have in your house.
Motor Planning Activity
Affiliate links are included in this post.
To make this motor planning activity, you’ll need just a few items:
one red pom pom. These are items we had in our crafting supplies, but you could modify this activity to use items you have. Other ideas might be beads, pin pong balls, ice cubes, or any small item.
Fill the baggie with the pom poms and squeeze out the air.
Seal the baggie.
Use a permanent marker to draw on a maze from one side of the baggie to the other. You can make this as complex as you like.
Add additional mazes, or two different pom pom colors for the maze. Work the red pom pom from one end of the maze to the other.
Squeezing the pom pom is a fine motor work out for the hands. You’ll need to open up the thumb web space (the part of your hand between the thumb and fingers, and use those intrinsic small muscles of the hand. Both of these areas are important for fine motor tasks like coloring and writing.
Use this motor planning exercise as a warm-up activity before writing, coloring, and scissor activities. This is a great activity to have on hand in your therapy treatment bag or to pull out while waiting at the doctor’s office.
Motor Planning Activities
Looking for more ways to work on dyspraxia with your kids? These are some fun fine and gross motor activities that are fun and creative.
The best thing about all of them is that they are open-ended. Use them in obstacle courses or in movement tasks to incorporate many skill areas. These are some fun ideas to save for gift ideas. Now which to get first…
Work on fine motor dexterity and bilateral coordination while encouraging motor planning as the child matches colors of the nuts and bolts in this Jumbo Nuts and Bolts Set with Backpack set. The large size is perfect for preschoolers or children with a weak hand grasp.
Practice motor planning and eye-hand coordination. This Button Mosaic Transperent Pegboard is a powerhouse of motor planning play. Kids can copy and match big and bright cards to the pegs in this large pegboard. I love that the toy is propped up on an incline plane, allowing for an extended wrist and a tripod grasp. Matching the colors and placing the pegs into the appropriate holes of the pegboard allow for motor planning practice.
Develop refined precision of fine motor skills with eye-hand coordination. A big and bright puzzle like this Puzzle-shaped Block Set allows kids to work on hand-eye coordination and motor planning as they scan for pieces, match the appropriate parts of the puzzle pieces, and attempt to work the pieces into place. Building a puzzle such as this one can be a workout for kids with hand and upper extremity weakness.
Strengthen small motor skills. Kids of all ages can work on motor planning and fine motor skills with this Grimm’s Rainbow Bowls Shape & Color Sorting Activity. Use the colored fish to place into the matching cups, as children work on eye-hand coordination. Using the tongs requires a greater level of motor planning.
You can modify this activity by placing the cups around a room for a gross motor visual scanning and motor planning activity. Children can then follow multi-level instructions as they climb over, around, under, and through obstacles to return the fish to their matching bowls.
Encourage more gross motor planning with hopping, jumping, and skipping, or other gross motor tasks. This Crocodile Hop A Floor Mat Game does just that. It is a great way to encourage whole body motor planning and multiple-step direction following.
Address balance and coordination. These Gonge Riverstones Gross Motor Course challenge balance skills as children step from stone to stone. These would make a great part of many imagination play activities as children plan out motor sequences to step, cross, hop, and jump…without even realizing they are working on motor planning tasks.
Introduce multiple-step direction following and motor planning. These colored footprints like these Gonge Feet Markers support direction following skills. Plan out a combination of fine and gross motor obstacle courses for kids to work on motor planning skills.
Make hand-eye coordination fun with challenges. For more fine motor coordination and motor planning, kids will love this Chickyboom Balance Game as they practice fine motor skills, hand-eye coordination, and about balance and mathematics.
Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.
Lower extremity strength and coordination are areas of development needed for so many functional tasks that children complete throughout the day. Here we have a fun and creative way to develop gross motor coordination by building strength in the legs and core of the body so that lower extremity coordination and mobility are used in daily tasks such as self-care, mobility, and play. Motor planning in the lower extremities drives play, and play drives lower extremity strength!
These are great activities and ideas to add to an obstacle course.
Add this to our other balance activities to develop stronger legs and lower body in kids here on the site. We’ve talked before how the development of balance occurs through play.
Lower Extremity Strength
When it comes to building strong core, legs, hips, and ankles, there are many lower body strengthening exercises that can be done:
Lunges
Squats
Planks
Yoga
Animal walks
Wall sits
Side-lying Leg Lifts
Prone Leg Lifts
Bridges
While these exercises develop strength and stability in the core and lower body, they are just that…exercises. There is no function to completing them. However, as occupational therapists, our practice is driven by function.
If a client wishes to develop the strength and stamina to complete exercises such as the ones listed above, that is the functional task, and working on these exercises in a graded manner is a no brainer. It’s the functional task which is being addressed.
There is another side to the coin as well. Using lower extremity strengthening exercises to support development, stamina, add resistive feedback, and develop motor planning skills can drive functional performance by building on underlying areas.
When therapists use lower extremity strengthening exercises in therapy sessions, several underlying areas are addressed all at once:
Balance
Coordination
Muscle strengthening
Eye hand coordination
Vestibular input
Stretching
Proprioceptive input
Stability
Body awareness
Personal space
Lower extremity strength is needed for functional tasks such as:
hopping
skipping
jumping
kicking a ball
riding a bike
playing on playground equipment
running
tying shoes
getting dressed
bathing
toileting
so much more!
Lower Extremity Exercise Activity
One way to make this skill into a game is to use the skill-building as a game, an obstacle course, or a challenge.
This lower extremity exercise challenges motor planning, balance, and vestibular input, while encouraging the child to pull weight back over their heels in dynamic stance.
Materials needed:
Ball
Something to use as a target (cone, bucket, bowl)
To do the lower extremity and motor planning exercise:
Set up a basket, cone, or bucket, or other target behind the child.
Ask the child to stand with feet shoulder width apart, in front of the basket/bucket.
The child can reach through the legs to place a ball or small toy through their legs and into the target.
Challenge them to return to standing and pull the toy or ball up to shoulder height and repeat.
As occupational therapy students, we had to learn bone names and all about anatomy and physiology. Naming bones comes in very handy as an occupational therapist! But, if you are working in pediatrics, kids need to learn names of bones, too! For one thing, kids learn bone names in school. But did you consider the interoception aspect to teaching bone names? When it comes to internal feelings or anatomical states that impact sensory processing and internal body actions, learning names of bones supports this awareness of self. Add this fun way to learn names of bones to your anatomy and physiology games!
Bone Names Activity
Learning human anatomy has a special place in my heart. I mean, those semesters in Human Anatomy, Anatomy lab, and clinical kinesiology bring back fond memories.
So, when my kids ask questions like how their arm can pick up a sandwich, I have a little fun telling them about bones, joints, and muscles. This bone naming activity is just one fun way to teach bone names and teach kids about anatomy.
(Moving a sandwich is a big deal in our house!)
We’ve done a body part identification activity before, using band-aides, but these labels were a big hit with my kids. We used them to practice for a test for my big kids.
My Kindergartner and Second grader had a bones theme in their gym class, we had fun talking about the bones in our body, and made this Bone Identification and movement activity. (It would be great as a skeleton activities for preschoolers, too.
Bones Activity
This bone activity for kids is one they won’t forget…and when teaching human anatomy to kids, it’s one that will stick! The fun stickers help! 🙂
This post contains affiliate links.
I threw this activity together really quickly. We had a few sheets of blank address labels, and I grabbed a red permanent marker (affiliate link). I made a quick strip across the top and bottom of the address labels and then wrote in black marker (affiliate link), “Hello my name is” with the bone names below.
While we used this bone identification activity with kids, it would be a great way to learn bones as part of an anatomy and physiology lesson for OT or PT students, too!
list of bones in human body
After I wrote out the names of the bones, I tested my kids on what they knew. They recalled most of the bones from gym class lessons, but we had a few that needed practicing.
For the second grade and kindergarten physical education curriculum, they had to know this list of bones in the human body:
skull
humerus
radius
ulna
carpals
phalanges
clavicle
sternum
ribs
pelvis
femur
tibia
fibula
tarsals
Complete List of Bone Names
Above is just a simplified list of bone names, which can be used for teaching kids about the skeletal system. A more complete list is as follows. The bone identification activity shown below can definitely be used for this complete list of bone names and bone types. Classifying and naming the entire skeletal system requires much practice, and as occupational therapists we know the power of multi-sensory learning!
Bones in the skull (includes bones in the head and face):
Cranial bones:
frontal bones
Parietal bone
temporal bones
occipital bone
sphenoid bone
ethmoid bone
Facial bones:
mandible
maxilla
palatine bone
zygomatic bone
nasal bone
lacrimal bone
vomer bone
inferior nasal conchae
Bones in the thorax:
sternum
ribs
Bones in the throat:
hyoid bone
Bones in the vertebral column, or spine:
cervical vertebrae
thoracic vertebrae
lumbar vertebrae
Bones in the pelvis:
coccyx
sacrum
ossa coxae (hip bones)
Bones in the legs :
femur
patella
tibia
fibula
Bones in the feet:
Ankle (tarsal) bones:
calcaneus (heel bone)
talus
navicular bone
medial cuneiform bone
intermediate cuneiform bone
lateral cuneiform bone
cuboid bone
Instep bones:
metatarsal bone
Toe bones:
proximal phalanges
intermediate phalanges
distal phalanges
Bones in the middle ears:
malleus
incus
stapes
Bones in the shoulder girdle:
scapula or shoulder blade
clavicle or collarbone
Bones in the arms:
humerus
radius
ulna
Bones in the hands:
Wrist (carpal) bones:
scaphoid bone
lunate bone
triquetral bone
pisiform bone
trapezium
trapezoid bone
capitate bone
hamate bone
Palm or metacarpal bones:
metacarpal bones
Finger bones or phalanges:
proximal phalanges
intermediate phalanges
distal phalanges
We had a blast sticking the labels all over ourselves while saying “Hello my name is humerus!” in funny voices.
While we had the labels on our body parts, we practiced the motions of that bone. We talked about how that bone could move and what it could do.
Yes, your humerus has a job in picking up a sandwich! (This is a very important fact when teaching bone names to preschoolers!)
Bone identification activity with a doll.
Even the baby doll got in on the bone labeling action.
How cute are those tarsals??
Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.
In this post, you will find calming bedtime relaxation stretches for kids and families, based on the popular children’s book, Time for Bed. These activities are perfect for helping kids calm down before bed. We know the power of sleep hygiene in child development, but let’s consider the powerful impact of stretches before bed have on children.
Relaxation Stretches for Kids Sleep
An important thing to cover when it comes to helping children fall asleep and stay asleep at night is the concept of pre-bedtime yoga. When kids participate in bedtime stretches as part of their bedtime routine, it’s a sensory diet that supports sleep.
Use animal theme yoga poses to support relaxation at bedtime.
Related is our resource on the role occupational therapy professionals can play in sleep for the whole family, when it comes to supporting a baby or newborn not sleeping.
Relaxation Stretches for Kids Sleep
An important thing to cover when it comes to helping children fall asleep and stay asleep at night is the concept of pre-bedtime yoga. When kids participate in bedtime stretches as part of their bedtime routine, it’s a sensory diet that supports sleep.
I love to bring this concept together for kids by first talking about how everyone needs sleep. Kids, adults, and even pets and animals. Sleep supports growth, learning, and allows our brains to rest. You can even use a few of our hibernation activities to take this concept further with kids, depending on the interest level.
Children can get a little wound up before bed. All it takes is one rouge energy burst and you’ve got giggling kids bouncing from every surface imaginable.
Couch cushions? check. They are jumping up and down.
Running from room to room? Check. There’s two of them chasing one another back and forth will the occasional knee slide across the hardwoods.
Practicing the living room tumbling skills? Yep and check. There’s one more doing somersaults across the room.
Why must they gang up on me with their endless energy during those exhausting pre-bedtime hours?
Having a set of bedtime relaxation stretches in the nightly routine can support sensory needs and promote a sense of calm before bedtime, just when children are wound up and excitable.
benefits of stretching before bed
We know that sleep is a necessary occupation for all of us, but for children sleep patterns and healthy sleep cycles support so many aspects of development.
Cognition
Learning
Behavior
Nutrition
Emotional development
Social development
When children don’t get enough hours of sleep, or if they don’t get quality sleep on a consistent basis, there are several things that can occur:
Poor focus
Trouble concentrating
Attention and behavior problems
Poor academic performance in school
Excess weight or increased food intake
Problems paying attention
Health problems: obesity, type 2 diabetes, poor mental health, and injuries
Decreased physical activity
Poor mental health
Unhealthy risky behaviors related to decision-making
Risk-taking behaviors, bullying,school violence-related behaviors, and physical fighting
Higher risk of unintentional injury
There are several studies describing the benefits of stretching before bed. Kids can benefit from a pre-bedtime stretching sessions to integrate sensory processing systems and the calming benefits of slow movement, heavy work as a regulation tool. This calms the body and helps with relaxation before bed.
Stretching before bed supports sleep quality. One review of multiple studies found that mindfulness meditation practices that incorporate gentle stretching, such as yoga and tai chi, generally improve sleep quality.
Another study found that older adults reported improved sleep quality after performing low level physical and cognitive activity. The researchers found that gentle stretching resulted in better sleep than when the participants performed more strenuous exercises, such as aerobics.
Bedtime stretches help kids stay asleep. A study into resistance exercise training and stretching found that exercises could improve symptoms of insomnia. In the study, the participants performed stretching in 60-minute sessions three times per week for a period of 4 months. The results showed improved sleep quality when stretching in the evening.
Better sleep supports learning and executive functioning skills. Other studies tell us that better sleep hygiene in children support development of executive functioning skills.
yoga poses for stress relief
Today, I’m sharing a great way to calm kids down before bed so that quality sleep is possible. These yoga poses for stress relief and bedtime relaxation promote organizing heavy work through the proprioceptive sensory system and gentle movement through the vestibular sensory system.
Another contributing factor is the interoceptive system which connects our internal systems such as digestion, heart rate, circadian rhythms, and muscle tension. All of these factors play a vital role in impacting sleep, with both the ability to fall asleep, and the ability to stay asleep throughout the night. This study shares more on the interoceptive system’s role in sleep.
These organizing and calming yoga poses stretch the muscles and joints to offer feedback to regulate an overactive system.
If you’ve ever participated in a yoga session, you know the benefits of certain yoga poses in reducing stress and anxiety.
It’s important to make the connection between stress responses, anxiety, over-active thoughts, and a hyper-response to stimulation and emotional responses. The difficulty in identifying and describing emotions in self (a huge part of social emotional learning and development) is referred to as Alexithymia.
Specifically, alexithymia is defined as difficulty identifying and describing emotions in self. We know that noticing and understanding internal body signals (aka interoception) is crucial to a bodily systems, so it makes sense that if interoception is affected, using or showing emotions, and identifying emotions in self will be affected.
Interoception influences emotions by it’s control and underlying influence on internal processes of the body: toileting, hunger, thirst, and sleep!
When interoception impacts sleep, it then further impacts emotions:
stress
getting angry or frustrated easily
anxiety
fear
worry
overly emotional responses
sadness
over-excitability
hyperactive responses
All of these emotional responses are normal and good feelings to experience. However, when sleep is reduced, they can move into an area of impacting other functional tasks or everyday occupations.
You’ll also find information and resources in this article on the limbic system including the stress response. You can see how all of these concepts fit together to impact daily functioning.
How to use yoga poses for stress relief with children
Using yoga to support relaxation at bedtime is not a new concept. Yoga naturally supports relaxation through the heavy work input of the proprioceptive sense.
However, yoga also adds the benefit of deep breathing exercises to calm and center the body as an organization tool.
When it comes to bedtime, adding anything to the nightly routine can mean a delayed bedtime, so making the relaxation stretches part of the routine that is already in place is important. If you read a book together each night, incorporate stretches into that. If brushing teeth and going to the bathroom are the only tasks that happen each night, use the time just after those jobs to do a few stretches.
Adding bedtime stretches for the purpose of relaxation doesn’t need to be difficult. The most important thing here is to make it work for your situation and home. down the somersaults and hardwood floor stunts into relaxing bedtime.
Here are some tips to support relaxation at bedtime:
Use bedtime relaxation stretches in a nightly routine. A visual schedule can be helpful with some kids.
Dim the lights and turn on soothing music
Read a book before bed
Drink a warm drink as a calming food/sensory tool.
Set the mood for sleep with a calming bedroom or sleep space: snuggly blankets, cozy pillows, or cool temperature, depending on the individual’s preferences.
Use the relaxation stretches listed below.
One way that helps to get kids relaxed before bed is reading a great book. When kids can listen to an engaging story that is read aloud, their bodies can’t help but slow down.
Bedtime Relaxation Stretches for Kids
These bedtime relaxation stretches are a combination of relaxing yoga moves and heavy work that helps to ground the body through proprioceptive input to the body’s sensory receptors in the muscles.
Performing these relaxing stretches can help transition kids to a calmed state that allows for a better sleep.
Below are forms of yoga poses for children.
We decided to use one of our favorite going to bed books, (Amazon affiliate link) Mem Fox’s Time for Bed.
In the book, we hear a rhyming verse about each animal’s transition to sleep. It’s such a beautiful book to snuggle up with kids during night time routines. In fact, Time for Bed can easily become one of those books that you read over and over again.
We loved looking at the watercolor pictures in Time for Bed and picturing each animal as it got ready for sleep.
To go along with the book, we tried some of these bedtime relaxation stretches.
Grab your copy of the free printable below by entering your email address into the form, or going to The OT Toolbox Member’s Club and heading to the Mindfulness Toolbox.
To do these exercises, simply cut out the printable on the lines, and create a small stack of stretches. Kids can do one or more of these relaxation stretches to calm down before settling in with the Time for Bed book. (affiliate link)
Simply pull out a couple of the stretches and join your child on the floor to perform each stretch. The stretches are designed based on the animals in the book.
When doing the stretches, hold the stretch for 2-3 minutes while maintaining deep breathing.
Print off these relaxation stretches for a bedtime calm down session for kids.
As we all know, kids will be kids. If your child is getting too wound up from the stretches (because sometimes the sleepy sillies take over and make concentrating on stretches and relaxing deep breaths nearly impossible!) simply put the stretches away and try them another day.
Relaxation stretch for kids, incorporating yoga poses for stress, anxiety, or to calm down before bed.
Your child will love doing these bedtime relaxation stretches with you and the whole family!
Little Goose Stretch– Lie on the floor on your back, with your feet raised up on the wall. Keep your knees straight. Spread your arms out on the floor like a goose. Bend and point your toes slowly.
Little Cat Stretch– Snuggle in tight! Sit criss cross applesauce on the floor. Bend forward at the hips and place your head on the ground. Stretch your arms out on the floor over your head.
Little Calf Stretch– Grasp both hands together behind your back. Bend forward at the hips and raise your arms up behind you.
Little Foal Stretch– Lie on your back and pull your knees in with your arms. Hold the position and whisper about your day.
Little Fish Stretch– Take a deep breath. Hold your breath in your cheeks and puff out those cheeks. Slowly let out your breath with pursed lips.
Little Sheep Stretch– Stand facing a wall and place your feet shoulder width apart. Place your hands flat on the wall, shoulder width apart. Push against the wall by bending and straightening your elbows.
Little Bird Stretch– Close your eyes. Think about your day and take deep breaths. Breathe in through your nose and out through your mouth. Add a “wing” component by raising your arms up high as you breathe in and lowering them as you slowly breathe out.
Little Snake Stretch– Lie on your back on the floor. Keep your legs straight and cross them at the ankles. Place your arms over your head on the floor. Cross them at the wrists.
Little Pup Stretch– Get into a downward dog yoga position.
Little Deer Stretch– Sit on the floor with your legs straight. Spread them far apart and bend at the hips to touch one foot. Hold it and then stretch to touch the other foot.
Try this tonight! Do a few stretches and then snuggle up while reading Time for Bed! (affiliate link)
MORE relaxing bedtime books for kids
These relaxing bedtime books for kids are other ideas to use to support calming sensory input in a relaxation bedtime routine:
Free Printable set of relaxation stretches for bedtime
Use the Time For Bed book and relaxation stretches we used above in a bedtime routine of your own. Get a printable PDF of these stretches by entering your email address into the form below. Or, members in The OT Toolbox membership club can grab this PDF by logging in and heading to Brain Break Tools.
One more thing! If you are into creative ways to extend and learn based on books, you will LOVE this resource! 50 activities based on books that address friendship, acceptance, emotions…This ebook is amazing for covering all things emotional development through play!
Bilateral Integration is an area that kids need for so many tasks…but it’s not a developmental milestone that stands out unless a problem is necessarily noticed unless there is a problem. What we do notice in as our kids grow and develop are the motor skills that impact functioning. We notice use of both hands, fluid and efficient movements in tasks like playing, getting dressed, and interacting with peers. Let’s take a look at bilateral integration and dissect how to support this essential sensory motor skill.
Another resource that supports this information is our blog post on bilateral coordination. You’ll find many bilateral integration activities in that blog post.
Bilateral Integration
From writing and holding the paper, to holding a art project and cutting with scissors, to zippering a jacket, coordinating both sides of the body in an efficient manner is a skill that is necessary for almost everything we do.
Bilateral coordination develops from a very young age. When babies begin to bring both hands together at their mouth, you are seeing coordinated efforts begin. When the infant pushes up on both arms while lying in a tummy time position, the integrated movements of both hands and legs occurs along with strength and control.
Research tells us that motor tasks like jumping, jumping jacks, riding a bike, hopping, etc. become easier and more fluid with age as children develop. It’s through play, sensory input, motor skill experience, and activities that these skills are developed.
Below, you will find bilateral integration activities that can be incorporated at various ages. Use these bilateral coordination activities to promote coordinated and efficient movements in meaningful activities.
What is Bilateral integration?
Bilateral integration refers to the ability of both sides of the brain to work together in a coordinated manner. We see this ability when the skills associated with the left side of the brain are done in conjunction with skills associated with the right side of the brain.
Skills associated with the left side of the brain:
Speech and language- Understanding using language (listening, reading, speaking and writing)
Comprehension
Math problems and facts
Handwriting
Linear thinking
Memory for spoken and written messages
Logic
Verbal language
Sequencing
Skills associated with the right side of the brain:
Creativity and imagination
Creative thinking
Spatial skills
Intuition
Art, drawing, and creative artistic skills
Musical skills
Then, when other aspects of functional performance are added to the mix and the individual is still able to complete the task, this is bilateral integration in action.
Those other considerations include:
Attention and focus
Proprioceptive input
Vestibular input
Visual information
Motor targets achieved, or motor control shown by fluid movements
Praxis- movements thought about and completed in coordinated manner
When both sides of the body work together in a coordinated manner so that the individual can manipulate objects such as cutlery with various amounts of force modulation, taking in sensory stimuli such as sights, sounds, tastes, and proprioceptive and vestibular input, and managing posture, coordination, and body awareness, bilateral integration is visible.
When bilateral coordination or bilateral integration is intact and progressing appropriately through development, it is an indicator that both sides of the brain are communicating effectively and sharing information during functional tasks.
Tasks that require bilateral integration
Knowing what we covered above, it is easy to see how some daily tasks are impacted by coordinated and integrated motor skills requiring both sides of the body. Each of these skills requires and has input from other sensory systems and cognitive systems as well, such as proprioceptive input, executive functioning, attention, and even creative thinking and problem solving.
Writing and holding the paper in a stable position
Cutting and holding the paper steady and at an appropriate height
Putting on a coat while holding a backpack (or other item)
Tying shoes
Pulling up pants and not losing balance
Putting socks on
Jumping jacks with coordinated movements
Turning a page and writing or copying work
Typing
Squeezing toothpaste and brushing teeth
Flossing teeth
Playing an instrument
Using a knife and fork
Pouring water from a pitcher into a cup
Cooking skills: chopping, cutting, slicing, peeling, taking food out of packages, putting food into the microwave or stove, taking food out of the fridge
Reaching for objects
Stabilizing an object with one hand while manipulating another object with the other
Jumping rope
Catching a ball
Riding a bike
Swimming
Many more tasks!
Bilateral Integration Activities
Amazon affiliate links are included in this post.
First, let’s talk about some ways that coordinated use of the arms and legs are needed for coordinated movements. These are skills and tasks that can easily be performed by some children. Others, who struggle with motor planning, core strength, posture needs, left-right discrimination, visual motor skills, or many other areas can struggle. It’s easy to see that simply addressing some areas won’t fix the issue when an underlying concern is present.
To promote the skills needed for these tasks, try some of the activities listed below to promote bilateral integration:
Bilateral movements are part of everyday life for baby! From turning, creeping on the floor, rolling, sitting, crawling, cruising on furniture, and taking first steps, babies are developing bilateral integration skills from birth.
Read here about the types of crawling, all of which integrate bilateral coordination and motor planning.
Encourage these bilateral integration activities with babies:
There are ways to support child development at this stage through age-appropriate play that will support the child’s progression at later stages, too.
Provide various toys and objects appropriate for young babies. Include bold colored objects including black, white, and red items or contrasting colors, toys, or pictures on a blanket or play mat during tummy time. This black and white board book (affiliate link) can be propped up or used while on an adult’s lap.
Provide gentle infant massage during and after bath time, and on all extremities. Here is a resource book on infant massage. (affiliate link)
Provide toys and age-appropriate objects for reach and grasp. This banana toothbrush teether (affiliate link) has molded handles that make it a great teething item for little ones.
Provide teething toys as baby brings hands together at their mouth.
Provide toys that are appropriate for mouthing that can be held in both hands.
Provide hand-held toys while the child is seated in a high chair. This one (affiliate link) has a suction cup base to keep it stable, but has a black and white ring at the base that babies can grasp with one hand while manipulating with the other hand.
Provide toys of various weights when seated upright to provide resistance against gravity and to promote strengthening of the upper extremities. Blocks, rings, sorting toys, or something like this quality teething toy (affiliate link) made of heavier materials can be useful to provide variances in weight, while still allowing the baby to manipulate the item.
Provide toys available on a high chair or table surface at various distances to provide opportunities for depth of perception when reaching for toys and bringing them to the mouth.
Continue tummy time while playing in prone to promote strength and stability in upper extremities.
Use the ideas in our baby play library for more ideas.
Bilateral Integration Activities for Toddlers
Provide toys requiring one hand to stabilize a base while the other hands manipulates an object. Shape sorters are great for this.
Use these crayons for toddlers to support bilateral coordination skills during coloring.
Bilateral Integration Activities for Preschool
Preschool is a time for building hand strength, coordination, eye-hand coordination, and improving motor skills needed for the upcoming years. You can find many preschool activities here on our website, but some specific ways to support bilateral integration include:
Encourage kids to participate in cooking activities.
Use play dough to cut with scissors and roll out play dough snakes or balls of play dough.
Age-appropriate crafts and craft sets are great for this age.
Play with stickers of various sizes.
Make “snow angels” on a carpet or fluffy blanket
Simon Says is a great game for encouraging novel and varied motor combinations. Use these Simon Says Commands to get started.
Play various song and movement games such as the Hokey Pokey, Farmer in the Dell, etc. Here are movement and song activities that can be used in circle time, warm-ups, centers, or in group activities. All of these move and dance songs promote core strength and stability.
Climb on outdoor play areas at playgrounds and in low trees.
Draw with both hands! This four leaf clover activity is a powerful one as it covers a variety of skills.
Bilateral Coordination Activities for School-Aged Kids
In schools, development of bilateral integration is important for tasks like putting on a coat or jacket and backpack, holding a paper with the supporting hand and writing, and using scissors. There are many other bilateral integration tasks that happen throughout the day.
Some ways you can support development of these skills include:
Folding origami or other paper crafts are great at this age.
Last thoughts on encouraging bilateral integration
The best way to encourage and promote integration of both sides of the body? Movement and play! Get the kids active, moving, and experiencing various planes against resistance and with exposure to all types of sensory experiences.
The combination of proprioceptive input into a play experience that promotes strengthening in a fun way provides all of the benefits kids need to improve bilateral coordination skills. Add personal interests as the child grows. And finally, have fun!
This interactive and hands on game to teach matching uppercase and lowercase letters is a fun gross motor game for preschool and kindergarten. Use this interactive letter activity along as an alphabet matching with objects and a sensory-motor learning activity!
Matching uppercase letters to lowercase letters is a literacy task that supports reading skills, but also challenges visual discrimination skills, form constancy, and visual scanning, all of which are visual processing skills needed for handwriting and reading comprehension. What’s fun about this activity is that it builds these skills in a fun way!
Be sure to grab our color by letter worksheet to work on letter matching, visual discrimination skills.
Matching Uppercase and Lowercase Letters
Learning letters and matching upper and lower case letters is a Kindergarten skill that can be tricky for some kids. We made this easy prep letter identification activity using items you probably already have in the house. If you’ve seen our blog posts over the last few days, you’ve noticed we’re on a learning theme using free (or mostly free) items you probably already have.
Use a permanent marker to write one lower case letter of the alphabet on each coffee filter.
With your child, match the magnetic letters to the lowercase letters on the coffee filters.
Ask the child to help you crumble each letter inside the coffee filter that has its matching lowercase letter.
Continue the play!
More ways to match uppercase and lowercase letters
By matching the magnetic uppercase letter to the lowercase letter on the coffee filter, kids get a chance to incorporate whole body movements and gross motor activity while looking for matching letters.
With your child, first match up each lower case coffee filter letter to the upper case magnetic letter.
You can spread the filters out to encourage visual scanning and involve movement in the activity, OR you can stack the coffee filters in a pile and one by one match up the letters. This technique requires the child to visually scan for the upper case magnet letters.
Try both ways for more upper/lower case letter practice!
We then wrapped the coffee filters around the magnets in a little bundle. There are so many games you can play with these upper and lower case letters:
Match the same letter– match uppercase letters to uppercase letters and lowercase letters to lowercase letters.
Alphabet matching with objects– Match an object that starts with the letter of the alphabet. Use small objects inside the coffee filter and match it to lowercase letters written in the coffee filter with uppercase magnet letters.
Match the picture with the letter– Print off pictures of words that start with each letter of the alphabet. Then match the picture with letters of the alphabet using lowercase letters written on the filter and uppercase letters in magnetic letter form.
Play a letter memory game– Hide letters around the room and challenge kids to find the letters in order to match the uppercase letter to the lowercase letters.
Letter sound matching– Make a letter sound and challenge kids to find the letter that makes that sound.
Letter Hide and Seek- Hide the bundled up letters around the room while your child hides his eyes. Send him off to find the letters and ask him to open the bundle and identify the letter.
Letter Toss Activity- Toss the coffee filter bundles into a bucket or bin. Any letters that make it into the bin are winners!
Name the letters- Unwrap the bundles and name the letters. Spread the coffee filters out around the room. Toss magnetic letters onto the matching lower case letter.
Letter toss game- Toss a bean bag onto the coffee filters. The child can identify the lower case letter, then go to the pile of magnetic letters and find the matching upper case letter.
Can you think of any more ways to work on upper and lower case letter matching with coffee filters and magnetic letters?
Matching Big and Small Letters
The nice thing about this activity is that you can teach the concepts of big and small letters. When we say “big letters” and “small letters”, we are showing the concept of letters that touch the top and bottom lines, or the upper case letters.
And teaching children the difference between those big letters and the small letters which touch just the middle point are part of the visual discrimination process that is needed for handwriting on the lines, or line awareness skills.
You will enjoy more alphabet posts from our archives:
If you are a new parent, then you have probably heard that tummy time is important for your baby, but it’s so important to process the concept of container baby syndrome. In this blog post, we are covering container syndrome, what this means, and what you can do to support your most precious little one.
What is Container syndrome?
Container Syndrome is a term used to describe the lack of skill in infants who are not allowed ample movement opportunities. Container Baby Syndrome is the result of an infant being placed in a container for an excessive amount of time during the day.
Importantly, this is not to shame use of baby containers…or to say that use of these items is to be omitted at all costs. It’s important for the wellbeing of the caretaker to put the baby down sometimes! Things need done around the home. Parents need a shower, or some time to themselves. Other children need cared for.
The important thing to know here is that we are talking about constant use of baby holders all the time, during the day and night. Moving the baby from one container to another is the issue.
Constant use of positioners, or devices is what leads to the syndrome known as baby container syndrome, not using some of these items sporadically.
This extended time leads to structural, movement, and behavioral challenges as a result.
Baby containers include baby equipment and items such as:
Restrictive playpen that does not allow for movement
Crib
Car seats
Strollers
Bumbo seats
Bouncy seats and swings
Rockers
Nursing cushions
Vibrating chairs
Jumpers
Exersaucers
positioning pillows
Slings
Floor seats
Infant swings
Walkers
Jumpers
The other issue is when the devices are used for nighttime and daytime sleep.
It’s easy to fall into that trap of the newborn sleeping in the rocker chair or bouncy seat because the reclined position puts the upper body into a reclined position, which can help with reflux that a baby might have. The warmth and close sides allow the baby to fall asleep easily. But when the newborn is sleeping in this positioner all night and then wakes for a short period and then goes back to sleep in the same device, is when we see the issues with constant pressure on one side of the head and neck positioning that can lead to issues.
For support and help with newborns not sleeping through the night, be sure to check out our blog post on this topic. Occupational therapy professionals can help with sleep during the newborn stage which impacts so many aspects of functional development and family dynamics.
All of the time spent in these baby containers adds up! When in a positioning device such as the ones listed above, little ones are limited in the motor development that results from stretching, wiggling, turning, reaching, and otherwise moving.
Why Worry About Container Syndrome?
As a new parent, you might be wondering “why can’t I just use the wonderful bouncers, baby rockers, and other entertainment devices for infants and toddlers? After all, I got all of these amazing baby chairs, rockers, and positioners for my baby shower…can’t wait to use them!“
Why should I put my baby on the floor? The biggest reason has to do with the benefits to development. Putting a baby in a container such as a jumper, positioning seat, bouncy seat lead to something called container baby syndrome.
It’s understandable why the baby seat or jumper seems like a better option than the floor for a baby. Parents and caregivers have shown a great deal of support for baby “containers” like bouncy seats, Bumbo seats, and activity centers. In fact, these baby holders have become so popular over the years, that a term has been coined; “container baby syndrome”.
When babies are constantly keep in a space where they cannot freely move, how can they be expected to roll, crawl, or walk, when it is the developmentally appropriate timeframe?
Furthermore, babies need experiences where they can learn from their world in a physical way.
They need to discover “what happens when I move my arm and head like this”?’ Babies may fall over, and have some stumbles along the way, but this is how young children learn about gravity and develop postural stability.
Without those learning opportunities, children will only learn that their seat will catch them from falling, no matter how much they wiggle.
With fewer movement opportunities, a delay may be seen in typical development and reflex integration. More serious issues may occur when we keep babies still, like a flattened head from lying down (positional plagiocephaly) or a tight neck that reduces head movement (torticollis).
There is the visual component too. When babies are in a positioner such as a bouncy seat, they are positioned on their back with little to no neck movement. The neck, back, spine don’t receive the time (even minutes) to stretch, turn, and move. But the eyes are limited as well.
When placed on the back in a reclined position, the eyes are not strengthened to look and gaze based on head and neck movements. The eyes may stay in one place and are not challenged to focus on different depths and peripheral stimuli.
Neck movements are limited to turning from side to side, and they eyes tend to follow the neck. This limited eye movement can later impact other areas of development.
Where did container syndrome come from?
In 1992 the “back to sleep” campaign was introduced to lessen the likelihood of sudden infant death syndrome (SIDS). While the rate of SIDS went down 50%, (yay!) container syndrome rose 600%, to one in seven babies!
This is astounding.
Parents are so nervous about SIDS, they place their babies in various containers most of the day. While this seems a safe, convenient, and supportive option, the use of too many “containers” can lead to container baby syndrome.
Babies who have not had enough tummy time may resist this at first, giving the false impression that the container is the best place for them.
Facial asymmetry. The sides of the baby’s face may appear unequal as a result of skull deformity and flatness
Torticollis. The baby has difficulty turning the head to one side, or keeping the neck and head straight due to muscle tightness on one side of the neck
Decreased movement, strength, and coordination -the baby may not be able to roll, sit up, crawl, lift the head or reach with their arms while on their tummy.
Delayed milestone achievement
Speech, sight, hearing, and cognitive problems – Visual skills can be affected such as following moving objects with the eyes and seeing toys from different distances. Hearing can be disordered, as baby does not hear from all angles. Delayed cognitive skills may arise because the infant is not able to problem solve, explore their environment, or develop language skills
Attention deficit hyperactivity disorder (ADHD)
Increased weight/obesity
How to prevent container syndrome in babies
Container baby syndrome is 100% preventable. If you suspect your baby or a client of yours has symptoms of this syndrome, speak with their pediatrician, get a referral to a physical therapist, and begin working on exercises.
Allow baby plenty of supervised free time on a blanket on the floor, or in a large play yard. Encourage tummy time, reaching for toys, exploration. Some caregivers feel unsure about putting their baby on the floor. A blanket, sheet, or other floor covering can be placed and washed after usage. Or, use toys such as a baby gym to encourage belly play.
Limit baby’s exposure to containers. Use only when transporting the baby, or there is truly no other safe option
Increase supervised tummy time during the day. Your baby may cry and resist at first, as this may be difficult or uncomfortable. Start slowly and persevere. Colleen from the OT Toolbox has a great article on Tummy Time Myths.
Hold your infant in your arms, or in a sling for short periods during the day. This will encourage movement, increased head control, and socialization
Rotate baby through various stations and positions during the day. Holding a baby all of the time is not healthy for a growing child either.
Use gates and other borders to secure a safe place for baby to play, away from wandering pets, or siblings who may step on them
EDUCATE caregivers and other people about the danger of container baby syndrome. Encourage caregivers to provide opportunities for the baby to explore their environment freely. Demonstrate tummy time and other appropriate movement experiences
Activities to Prevent Container Syndrome
Now that it is understood that playing on the floor is important, let’s get into the many different ways you can do it! One of the easiest ways to encourage floortime with your baby is to lay a blanket on the floor, preferably with a carpet underneath for comfort, and place a toy or two near the baby.
Depending on their age and abilities, the baby may be totally independent, rolling and playing happily. If the children are younger, or less comfortable playing by themselves, this is a great opportunity for a caregiver to step in. A fair amount of babies do not like being on their tummy for various reasons, including medical or sensory.
Babies who have gastrointestinal issues may be hesitant to engage in tummy time, as it is uncomfortable. Work through these difficulties while encouraging floor play.
How do I keep them safe down there? Prepare a safe and clean environment for movement. This may involve baby gates, barriers, or a large corral to allow freedom of movement, without risking baby falling down the stairs. Lie on the floor yourself and see what is down there at child level. You may be surprised to notice extension cords, small objects, or other unsafe objects while you are down there.
2 months or younger: Talk with your baby, showing them toys, describing them, and giving them to their hand to feel and explore. Sing songs – whatever songs you know! Encourage them to wiggle their arms and kick their legs along with songs, tickles, or kisses.
3-4 months: Your baby will be able to hold tummy time for a bit longer by now. If they have trouble staying there, lay down with them! Be a part of the team, showing them how fun being on their tummy can be. Babies around this age can reach and bring toys to their mouths, so give them safe opportunities to do so.
5-6 months: Rolling should be part of the baby’s physical development around this time. Encourage this movement by enticing them with something they love. Maybe it’s you, a special toy, the TV remote, or their next bottle. Try singing Five in the Bed. When the song says “Roll over!” show your baby how to roll. During this time of development, your baby may be moving more than ever. They may even be crawling! Encourage even more floor play with these new skills. As long as the area surrounding them is safe, and you are close by, tons of fun (and important development) can be had! Read here about the types of crawling you might start to see at this age.
7-8 months: Just like rolling, encourage crawling by giving the baby lots of space on the floor (that may mean moving aside some furniture) and placing toys or books in various places. There are so many fun games to be played! Playing “Peek-a-boo” where the baby pulls a blanket or towel off to show what’s underneath, is a classic game and critical to development. This teaches baby object permanence. Scatter toys near and far to encourage looking, stretching, and moving.
9-10 months: Around this age, your baby will really be on the go. Maybe a baby obstacle course is up their alley…crawl over mom’s legs, under the coffee table, around the dog, and up the step into the kitchen! Creative barriers and safety gates will likely come into play around this stage to keep young children safe.
11-12 months: Almost one-year-olds may be walking, which means they will likely not tolerate being in a “container” very well anymore. Now that they are cruising on furniture, squatting to pick up toys, and participating more in play, they may likely lead the way! See what your child’s interests are during floor playtime and follow their lead.
Need more tummy time information? The OT Toolbox has several articles on baby play that support the development of balance and coordination through play.
Baby Brain Building with Balls– Encourage eye-hand coordination, visual tracking, visual scanning, bilateral coordination, crossing midline, motor planning, and more.
Another great resource to read more on how to promote development through play is DIR Floortime as it covers strategies to support development through interest-based play.
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.
A final note on container syndrome
While the “back to sleep” campaign has certainly been successful, it is not without pitfalls. The rule of thumb for parenting is; everything in moderation. Not too much screen time, sweets, or containers. Parents do not need to be laden with guilt over container baby syndrome. Most caregivers are doing the best they can with what knowledge they have. As they learn more, they will do more.
NOTE* The term “they” is used instead of he/she to be inclusive.
