Managing Resistance in Therapy

client resistance in therapy

So often, we see a child of therapy evaluation and find a need for therapy intervention, but that’s where the resistance begins. Here we are talking how to manage resistance in therapy, and not only that; but how to engage with kids so that we get the truly motivated buy-in for engaging in occupational therapy interventions

Address client resistance in therapy

Resistance in therapy

If you’ve worked in OT for even a short time, you have probably experienced resistance from your clients. There are many reasons for barriers to participation in occupational therapy intervention. From differing perceptions to the outcomes of OT interventions, to not understanding what occupational therapy is and what it can do for the client, understanding therapy process is just one aspect of client resistance. 

There are so many different reasons why a therapy client my object therapy participation. Encouraging participation in therapy sessions and functional engagement in daily tasks can be a couple of underlying areas that we are trying to address in therapy sessions. But what’s more is that beyond client resistance, there may truly be functional occupations that are being missed or delayed as a result of resistance to therapy.

Additionally, when children are asked to participate in a therapy activity or to stop doing a preferred activity and transition to another, sometimes it is hard to get their “buy in,” but it doesn’t have to be that way.

Let’s cover various techniques to support children showing resistance in therapy sessions. We’ll also cover how to support follow transitions and make engaging in therapy fun through meaningful games and some simple resources to utilize to make sure therapy activities happen smoothly throughout the therapy session. 

Why do clients show resistance in therapy?

Before we get into strategies to encourage functional participation, let’s break down why we may see failure to participate during therapy sessions.

Therapy makes the client look and feel “different” than everyone else- Going to a therapy session is not something that every child or teen does, so attending therapy can be a reason that makes them look different. This can lead to resistance to participate and a feeling of dread when it comes time for therapy sessions. 

Especially for our middle school students receiving OT services, and for individuals who are very much aware that they are doing something that not everyone else is, this can be a big deal.

Don’t understand occupational therapy- Many times, we as therapy professionals are ready to evaluate or treat a resistant client and the individual states something like, “why are you here?” or “what is occupational therapy” or “who are you and why are you asking me these questions?”!

Do any of these questions sound familiar? Many times clients/patients/students are referred to occupational therapy evaluations without knowledge. This is the case in hospital or clinical situations when OT orders are part of the inpatient process. In the school based scenario, a student is referred to occupational therapy by the IEP team or a child’s parent.

Many times, the individual has no idea they are going to be seen by OT. This can lead to refusal and a resistance to participate. Whether you are working with a child in the classroom setting in a push in model or pulling a child out of the classroom, this can be a reason that resistance to participate in therapy occurs. 

Therapy is hard- Therapy tasks aren’t always easy, especially if your child is participating in an activity that they love doing. If asked to step away from an activity before they are done, they may become upset and non compliant. This can be true with the child working on handwriting tasks or working on strengthening. It is HARD to write and copy all of those sentences. It requires a lot of concentrated effort doing something difficult.

The same is true for strengthening tasks that require engagement and consistent use of muscle groups. It’s easier to regress to that comfortable and “easy” positioning. As an adult, if you are working on a project on your computer, how much advance notice would you like before you have to finish what you are working on and move to a new activity?

Therapy is a change from the normal day to day activities- Even if the typical day to day functions is something that is being worked on, including participation and functional performance, it can be a change from the “norm” to engage in therapy sessions.

Would you appreciate your coworker walking in while you are typing mid sentence, closing your laptop lid, taking you by the hand stating “it is time for the staff meeting. Let’s go!”

Or would you rather they say “just letting you know that you have five minutes before the staff meeting, see you there!”

My guess is that you would like to have some advanced notice before you have to stop working. This is the same for a child who is playing. When they are actively engaged in an activity, they have a plan and don’t appreciate being interrupted in the middle of it. This could be anything from playing with play dough, to completing a puzzle or pretend play. 

Therapy challenges the unexpected- Sometimes when kids or teens participate in therapy sessions, they don’t know what to expect. They know that they are working on specific skills, but what if that skill of task is so new and novel that the fear of the unknown exists.

This can be particularly true with things such as toileting. For the child with interoceptive sensory considerations, they may have no idea how a bowel movement on the toilet feels.

This fear of the unknown can be a real area of resistance. 

Clients Resist certain parts of therapy

What if children don’t want to stop what they are doing and resists participation in some therapy activities?

You have probably seen this in action when a child LOVES a specific therapy game or activity. It might be that they love anything to do with a therapy swing. But what might really be happening is that the child is overly focused on that item because it’s been a cause for positive feedback in the past.

Or maybe, if the item is a sensory activity like a sensory swing, that the child receives the sensory input that they crave.

Or, perhaps the preferred activity is a highly motivating activity because it’s a theme or character that the child really loves. In these cases it can be very difficult to move from the preferred activity to a non-preferred activity. 

In many cases, the child even becomes overstimulated or dysregulated as a result of focusing on that one particular activity, or as a result of reciting too much stimulation or a certain type of sensory input from that one activity. 

When a child feels like they don’t want to transition to a new activity or that they didn’t have enough time to finish the task they were completing, they may become upset and hard to calm down. 

In these cases, using a positive redirection activity that will give children the ability to comfort themselves and they are feeling overwhelmed.

 Giving them time and space to calm down is very important, especially in a non-threatening way. If the child is upset, part of the therapeutic process is to support the child to calm down, identifying feelings and emotions, and offering support. Therapy professionals can guide them through communicating how they are feeling and participating in solving the problem at hand. 

How to engage the child that resists therapy sessions

Whether you are working in a clinic, hospital setting, or school-based, resistance to therapy happens. When giving instructions and laying out transition expectations to young children, it is important to keep in mind their individual and collective developmental age range in order to give clear and concise directions.

The following are strategies to engage the child or teen showing resistance in therapy. 

This can include components of getting buy-in that are important to include in every direction given to a young child. 

1.Clear and concise expectations- Having a plan of expectations and then using clear directions in those expected task completion is a key way to support engagement.

Use these tips to support and give clear expectations with clients:

  • When giving a statement or direction to a child, make sure that it is easy to understand.
  • Keep in mind the age of a child and their receptive language skills.
  • Using one or two step directions, children will be able to remember what is being told to them.
  • When giving the directions, make sure you are in the same room as the child (not yelling “it’s time for dinner” from the kitchen area), preferably kneeling down at their eye level.

Additionally, certain tools can support the “flow” of therapy sessions and offer a visual cue for participants with concrete expectations. Strategies that can support these expectations in therapy include:

2. Stick to Routines. When we work on daily routines, such as bedtime, clean up time, morning routines, leaving the house, etc., we use routines to make sure that the routine of events is the same every time. This strategy can carryover to therapy interventions. Using a similar routine for therapy sessions can include premeditated steps in order to allow children to feel successful and prepared for what is coming next.

Here is a great example of a therapy session routine:

  1. Arrive to therapy
  2. Check in
  3. Sit in the same spot in the waiting room
  4. Move to the therapy clinic area
  5. Hellos and talk about last session
  6. Discuss areas that the client wants to work on
  7. Warm up activities
  8. Address identified needs
  9. Preferred activity
  10. Cool down activities
  11. Discuss home program and plan for next visit

Another schedule strategy that can be used for countering resistance to participation in therapy includes staggering preferred activities with non-preferred tasks. For the child that struggles with handwriting and really is resistant to handwriting tasks, you can stagger preferred activities (while selecting options that also address underlying areas of need or other goal areas). You can come up with a treatment intervention plan that includes options for the client to select from that are both preferred and non-preferred.

This strategy can look like:

  • Arrive to therapy
  • Check-in
  • Select activities to address based on goal areas
  • Preferred activity
  • Non-preferred activity
  • Preferred activity
  • Non-preferred activity
  • Preferred activity
  • Cool down activities
  • Discuss home program and plan for next visit

One of the best ways to make transitioning from a preferred activity to a non-preferred activity is to make it FUN! When the transition process is exciting, children will join right in. 

You can find more examples of daily routines that are used for functional participation here on the website. 

3. Utilize Auditory Cues– To make sure that the child in therapy hears what you are saying, when you are giving them the directions, have them stop and look at you.

A fun way to do this with young children is to have a saying such as “1,2,3 FREEZE” where they put their finger over their lips and look at you. There are so many other fun “stop and listen” sayings and games that you can find in this video.

Games for Resistance in Therapy

Here are four games that make participating in therapy interventions fun. Use these ideas to counter resistance to therapy activities.

  1. Timer Games – Using timer games are great for making clean up time fun. These games include: “How fast can you clean up all the toys?” or “Can Charlee put all the blue blocks away faster than Henry can put all the green ones away?” When children are engaged in a game during clean up, it’s not so boring!  
  1. Movement Songs – Pairing movement and music together to get children to a specific place will make the transition very exciting. I love using songs like “We are the dinosaur marching marching” or  “Flap your arms like a butterfly to the line” or “Jump like a bunny  all the way, over to the _____.” When pairing a movement activity with a direction and melody, children learn that transitioning to the new activity location is just as fun as what they have been doing! 
  1. Jobs – Making children an active part of the next activity, but giving them a very specific job, makes them feel important and gives them purpose for moving to the next activity. For example, if you want your child to transition to nap time, they can help pick out the books that are going to be read to the children, or they can put a new pillow case on their pillow. If children are transitioning to mealtime, they can set the table, or hand the other children their name cards. There are so many different jobs that allow children to become part of the new activity.
  1. Visual Supports- When creating a routine for the classroom or at home, there are several ways to include visual supports to make transitions easier for the children and for you. Using a visual schedule will make your days so much calmer! You can create a visual schedule for different parts of your day (such as morning and bedtime routines) or for your full day. The visual schedule will help children understand what is coming next. 

Every day children are asked to transition at least 50, maybe 100 times. That is A LOT! Children don’t always have a lot of control over what is going to happen during their day, but allowing them time in between new activities, making the transition fun, and giving them a job to feel important, will make transitions feel less like a chore. As adults, if we stay consistent, giving children directions while being mindful of their developmental level, our days will become less stressful and more fun!

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

Occupational Therapy for Teenagers

occupational therapy for teenagers

Occupational therapy for teenagers can look a lot different than OT interventions for preschoolers. Middle school occupational therapy and high school occupational therapy sessions focus more on transitional stages as children age into teenagers and beyond.

occupational therapy for teenagers

Occupational Therapy for Teenagers

In the younger grades, school occupational therapy practitioners go into the school setting armed with playdough, scissors, pencils, crayons, glue, fidgets, and a few games/puzzles. 

What about the middle school occupational therapy population…and those years following in the high school OT interventions?  These teenagers are not motivated by crayons, Candyland, letter formation exercises, or cut and paste activities.  Nor should they be.  Unless your middle school caseload is in a self contained classroom functioning at a preschool level, these games and activities are not appropriate or practical. This post will explore the tricky transition from elementary to middle school occupational therapy.

Starting in late elementary school, many therapists transition their caseload from a direct to indirect, or consultative therapy model at this time, especially if they have been working with a particular student for several years.

Reasons OT for teenagers moves to consultation

When a student remains on the OT caseload into the middle school setting, therapy typically does transition to consultation. Why? There are several valid reasons for doing so.  There are many reasons why transitioning from direct services to a consultation model is appropriate for teenagers (in middle school and high school). The primary reasons for transitioning to a consultative model are:

  • Teenagers are self conscious and do not care for a therapist coming into their general education classroom to sit by them, observe, or ask questions. A consultative model allows the student to take ownership over their therapy recommendations.
  • Middle school schedules are busy. It can be difficult to ensure carryover of occupational therapy goals when there are many different teachers on the student’s schedule. Therapists make suggestions but then the recommendations may not be carried over to each class. Additionally, pulling a student for individual therapy weekly means they are missing valuable learning time.
  • Handwriting habits are set and unlikely to change at this age. Pencil grasp development and letter formation skills are often formed by the age of eight, making adjustments in middle school difficult. The same is true for Visual perceptual skills.
  • Students do not want adaptations that make them stand out from their peers. They will resist noise cancellation headphones, a scribe for written notes, alternative seating, weighted items, or noticeable fidgets.
  • Executive function – many middle schools already incorporate these skills into their program through schedules, planners, online classrooms, and reminders.
  • Students in the middle school and high school settings are most likely using technology, virtual classrooms, and email to do much of their school work by this point.
  • Students have often been receiving services since early elementary school.  Changes are less likely to happen at this stage, if they have not already.

Direct interventions Occupational Therapy for teenagers

Middle school occupational therapy is not a one size fits all model.

There are several reasons to keep a student on a direct therapy service model during middle school and the high school years. It’s important to realize that moving from direct services to consultation should not occur simply because the student ages out of the elementary buildings.

Teenagers receiving occupational therapy services may continue on with the direct therapy model for several reasons:

  • Self contained students work at a different pace than their mainstreamed counterparts. They may continue to need more intervention.
  • Lower level learners will need to be transitioning to a life skills or self help model, if they have not already. This means new objectives and goals to address. Some of these areas to address include: life skills cooking tasks, starting at the beginning with cursive name writing, changing clothing for gym or swimming at school, perineal care to address menstruation needs, or other skills.
  • Middle schoolers are a different breed of people. There are new social expectations, hormonal changes, levels of independence, and increased demands for self help skills or self-regulation skills.
  • It may take time to educate families and caregivers about this change in service model, and expectations. Automatically moving everyone to an indirect model, or discharging them, may be too abrupt for anxious parents or overwhelmed teachers

The Role of the occupational therapist with teenagers

The teenage years bring many changes that impact functioning abilities that impact the education in middle school or high school.

Seruya and Ellen write about the Role of the Middle School Occupational Therapist.  They highlight several important factors or strategies to intervention

  • Involve your learner in decision making about goals and objectives. These will be more meaningful and motivating to your students.
  • Transition away from typical handwriting goals to more functional goals
  • Teach typing and word processing.
  • Address motor skills use of calculators, rulers, graph paper, etc.
  • Address organization of locker and homework planner.
  • Provide adaptations if your learner is not able to complete work in an effective manner. A scribe to write notes for them, word processing versus written documentation, lessen the workload if writing is too labor intensive, preferential seating to improve attention.
  • Address any lingering or new sensory concerns.  Provide adaptation for these with preferential seating, alternative seating, gum or fidgets for self regulation, ear plugs to reduce incoming sounds, and organizational tools.
  • Address important life skills – learners need to know their emergency contact information, effectively groom themselves, take care of feminine hygiene issues, advocate for themselves, and follow a schedule.
  • Some interventions may require private therapy to be more appropriate such as meal preparation, laundry, ordering from a menu, shopping, budgeting, or filling out an application. These would be appropriate goals for students in a self contained classroom.

how to improve handwriting for teenagers

There are times when therapists are called to continue to address handwriting in their middle school population.  Intervention needs to be functional, beyond basic letter formation. Functional handwriting can mean learning to write the letters in a name in print or cursive, filling in forms, and essential handwriting life skills.

Handwriting help for middle schoolers

Miss Jamie, a school based OT, has written a post about Addressing Handwriting in Middle Schoolers.  She has gone so far as to write a second post here.  

One handwriting goal for middle schoolers, or even handwriting in high school may address the letter formation or number formation to write identifying information such as name, address, phone number.

For example, a handwriting goal for teenagers may be:

“This student will be able to independently write identifying information (name, address, phone number) without a model with 80% legibility.”

Another handwriting goal might be:

“The student will be able to write or access information to fill out a form independently.” 

The OT Toolbox has a great post about filling out forms. (Coming soon)

Transition to middle school and high school occupational therapy

What can you do to help this transition to middle school occupational therapy and high school occupational therapy?

  • Educate – teachers, parents, and other caregivers may not understand the role of the occupational therapist in middle school.  It may be time for a little education on the services provided and the therapeutic model. 
  • Empathy – reducing therapy minutes may feel like the student is not going to improve, or they are being given up on.  It is tough for parents to imagine their learner may never write a sentence, read independently, or live alone.  This is the time to gently begin this conversation.
  • Collaborate – work with educators and families to determine what are appropriate functional goals and needs in the classroom, and how they can be addressed. This blog on collaboration between OT and educators can assist.
  • Continue Direct Intervention– There may be a need for direct therapy intervention. Keep your students motivated with relevant and important treatment activities. 
  • Address life skills.  The OT Toolbox has a series of life skills posts including cooking, laundry, filling out forms, and social stories.

Working with teenagers in occupational therapy can be challenging. A few final tips for the OT working in middle schools or high schools:

  1. Remember teenagers are suddenly big and somewhat awkward.
  2. Keep goals and objectives focused on relevant and functional skills.
  3. Educate staff and caregivers about the role of the OT in schools.
  4. Provide resources, and make adaptations to the educational environment to help students better access their curriculum. 
  5. Try not to be in the hallways when they are transitioning between classes!  

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

Victoria Wood

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

Sensory Activities For 1 Year Olds

sensory activities for 1 year olds

This blog post is one of the oldest posts on the site, but the sensory activities for 1 year olds that we shared way back when are just as fun now! When this post was written, the babies that played with the balls and muffin tins were just 11 months and going on 1 year. Those little ones are now 11 years old! This is such a great brain building activity for babies that I wanted to reshare the idea for the latest crop of babies out there!

If you are looking for more Baby activities, try the fun over on our Baby Play page. You’ll also find some great ideas for different ages on this post on baby sensory play.  We’ve been busy!

sensory activities for 1 year olds

sensory activities for 1 year olds

This sensory activity for 1 year olds is an easy activity to set up. You’ll need just a few items:

  • colorful balls
  • muffin tins

You can add create another sensory activity for the babies with the same colorful balls and a cardboard box or basket. We also used an empty cereal box with hole cut into the sides.

Each sensory activity here supports development of eye-hand coordination, grasp and release, core strength and stability in dynamic sitting, positioning and seated play on the floor (floor play).

Baby and Toddler Brain Building activity using balls and a muffin tin. Perfect for developing fine motor skills, visual perceptual skills in an active activity for sitting and mobile babies.

An important consideration is the use of baby positioners as they can impact powerful movement-based play in babies.

The best for sensory play for 1 year olds is just playing on the floor! There are so many benefits to playing on the floor with a basket of balls and a few muffin tins.

Baby and Toddler Brain Building activity using balls and a muffin tin. Perfect for developing fine motor skills, visual perceptual skills in an active activity for sitting and mobile babies.

What do babies love to do? Take things out and put them back into containers.

We have a bunch of different colored and sized balls that are so fun to play with in so many ways. I had my nephew here one day and we needed something different to do. My nephew and my Baby Girl are both 11 months old and they absolutely loved this play activity! 

I pulled out my muffin tins and they had a blast putting the balls into the tins, taking them out, putting them back into the box, and pulling them out again!

Little Guy (my 3 year old ) loved joining in too. Really, who could resist playing with all of these colorful balls???

Peek a Boo Sensory Activity for 1 year olds

What else do babies love? The peek-a-boo game!

It’s at this age (around one year) that babies often struggle with separation anxiety when being dropped off at a caregiver’s when separated from their parents or caregivers. You will even see signs of separation angst when a parent goes into another room, which can especially happen when the baby is tired.

The next sensory activity for baby was a fun one!

We had an empty cereal box that I cut circles into. They had a ton of fun putting the balls into a hole, and pulling a different one out as the box moved around…there were a lot of little hands in there moving that box around 🙂

The it’s-there-then-it’s not of a great game of peek-a-boo (or peek-a-ball in this case!) is awesome in building neural pathways of the brain. 

 

 

More sensory activities for babies

Other sensory activities for 1 year olds and babies include using small baskets or boxes to transfer the balls from one container to the other.

Transferring from box to box…working those hands to pick up different sized/weighted/textured balls.  Dropping the ball to see what happens is so predictable, but it is important in learning for babies. Just like when baby drops the cup from her highchair a million times…

We had a ball!

(couldn’t resist that one…heehee)

Baby and Toddler Brain Building activity using balls and a muffin tin. Perfect for developing fine motor skills, visual perceptual skills in an active activity for sitting and mobile babies.

Need more sensory ideas for 1 year olds? Try these:

  • Sensory tables- put interesting toys, textures, scoops, and containers on a low table like a coffee table. The new cruiser or early walker can stand at the table and explore the textures
  • Messy play on a highchair- Strap baby in and encourage messy food play. Thing about apple sauce, pudding, or mashed potatoes.
  • Textured fabrics- Put a bunch of fabric scraps into a box and invite the one year old to pull them out and put them back in.
  • Play with cups and spoons– with supervision- This is a great activity for eye hand coordination skills.

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. 

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!

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.

Supporting Student Strengths in the Classroom

student strengths in the classroom

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

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

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

Student Strengths in the Classroom

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

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

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

What Are Student Strengths

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

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

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

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

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

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

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

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

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

Let’s take a closer look at student strengths…

List of Student Strengths

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

Some student strengths include:

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

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

How to identify Student Strengths

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

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

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

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

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

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

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

How to Use Student Strengths as Motivation  

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

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

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

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

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

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

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

ENVIRONMENT: Student STRENGTHS in the Classroom Environment

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

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

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

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

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

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

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

Strengths-based Classroom Environment-

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

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

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

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

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

A final note on student strengths in the classroom

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

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

List of student strengths in the classroom handout

Free List of Student Strengths in the Classroom

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

    Perineal Hygiene

    perineal hygiene and pericare tips

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

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

    What is pericare?

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

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

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

    Related: Potty Training Seats for Special Needs

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

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

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

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

    Development of Pericare

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

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

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

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

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

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

    GET COMFORTABLE with perineal hygiene

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

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

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

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

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

    GENERAL GUIDELINES for teaching perineal hygiene

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

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

    Pericare INTERVENTION IDEAS

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

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

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

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

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

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

    Pulling up and down undergarments:

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

    Pericare: Wiping Activities

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

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

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

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

    Wiping Front to Back

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

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

    Reaching Back to Wipe During Perineal Hygiene

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

    Wiping with enough pressure

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

    More perineal care and potty training tips

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

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

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

    What you need to know about Sensory Swings

    Sensory swings

    If you’ve ever walked into an occupational therapy gym, you may have seen a variety of sensory swings and wondered, “why does occupational therapy swing kids in their OT sessions?” There are many reasons why, and in this blog post, we’ll cover sensory swings, the best swings to use for sensory needs, and why!

    Sensory swings for sensory input and occupational therapy swings used in OT sessions

    Sensory Swing Movements

    Swings are simply a great tool for sensory input as well as sensory integration. The predictability of linear swinging can be calming and settling for the children who need that support. 

    Having the swing perform unpredictable moves such as rocking, spinning, side to side movement, and even start and stop movements while suspended in air, can be very alerting and stimulating for the children who need that support.

    In our blog post, Sensory Swings for Modulation you will read how powerful the swing can be when used as a sensory strategy for individual sensory processing needs and modulation. 

    There are many considerations when it comes to sensory swings, however. A swing can be a tool for modulation but it can also cause sensory dysregulation in users.

    Dysregulation refers to internal needs of the sensory systems that result in meltdown because the sensory processing system is out of balance.

    You might find that only 5 minutes of intense swinging leads to dysregulated sensory system with overstimulation. This state can require a long period of time and intervention to get the individual to reset or calm down.

    When it comes to sensory swings, different types of movements can impact modulation or dysregulation. It’s important to be aware of these considerations before using a sensory swing as a tool in therapy.

    Each individual will be different and it can be a delicate balance of movements that are stimulating verses calming. A swing for one child might spiral into dysregulation with a lengthy period of time and calming input required to regulate the sensory systems. Other individuals may crave intense movements and can benefit from that swing input for a longer period of time, allowing for functional participation.

    Alerting sensory swing movements

    In general, fast rotary vestibular input is often stimulating. Likewise, quick and sporadic movements on the swing are stimulating.

    The vestibular sense which is utilized during swing use helps to activate more body awareness, muscle tone, balance, and coordination as well as providing a level of increased alertness. If you want to learn more about vestibular activities in general, you can read the blog post Vestibular Activities.

    Calming sensory swing movements

    Calming or regulating sensory swing movements may include gentle, linear movement to calm the vestibular system. These swing pushes should be rhythmical and linear movement as these are more calming swing movements.

    The proprioceptive sense can be activated during swing use by reclining in a swing and rocking rhythmically in a swing providing deep pressure input to the body can help soothe strong emotions and decrease engine levels of high alertness. This helps with self-regulation and body control. 

    You can see that there are many different variables and each individual will require independent assessment from a qualified professional. This is why simply adding a sensory swing to a sensory room in a school can be a detriment to all of the students. School administrators and educators should always consult the occupational therapy professional before using a sensory swing in the school environment.

    Types of sensory swings in occupational therapy and activities to do with sensory swings

    Occupational therapy Swings

    Sensory processing is not the only area that can be addressed with the use of swings.

    How you utilize a swing and even the type of swing you use, can help a child to work on core and upper extremity strengthening, balance, visual processing, bilateral coordination, motor planning, righting reactions, body awareness, position in space, gross motor coordination, neck extension, eye-hand or eye-foot coordination, and visual tracking.

    When working with occupational therapy swings, each child is different in their needs and their preferences and it is up to you as the OT professional to determine what is needed and what needs to be worked on for skill development.

    It is also your role as the OT practitioner to guide and educate other professionals and parents of children to ensure the child’s needs are being met properly and that safety measures are being utilized.

    Now, two questions for you regarding those OT swings:

    1. Do you know what swing to use for the kiddos you see in therapy? 
    1. Do you often ask what activity can I do while they are on this swing so they will continue to remain motivated?

    Well, let’s take a look at six of the most common occupational therapy swings utilized in therapy clinics and therapy rooms in schools.

    Also, there are swings that parents can use indoors or outdoors to address a child’s sensory needs.  If you read our post Outdoor Sensory Swing you will learn how taking sensory play activities into the outdoors will provide children with many outdoor sensory experiences just by using the world around us.

    If purchasing a sensory swing is just simply too expensive to think about, read all about how you can use the playground equipment to address Sensory Integration at the Playground with the guidance of the therapist to meet each child’s needs.  

    Bolster Sensory Swing

    A Bolster swing challenges balance, vestibular processing, motor planning, cervical extension endurance, proximal control/stability, and core strengthening, The child can lie prone, inverted, kneel, sit or straddle the swing. 

    Bolster Swing Activities:

    1. Have a child work on hanging inverted like a koala bear and then time them to see if they can meet or beat their last best time.
    2. Have a child kneel on the bolster while hanging on and then attempt to toss bean bags into a basket.  
    3. Have a child straddle the bolster swing like a horse and use a reacher to pick up bean bags from the floor and then try to toss them into a basket using the reacher to toss.
    4. Spread balls around on the floor under the swing and have the children lie prone on the swing and attempt to reach out to pick up the balls and place them in a basket. You will move the swing around as needed.

    Ladder Sensory Swing

    A Climbing ladder swing provides the challenge of motor planning while simultaneously working on balance, strength, and body awareness. The child simply works to climb the ladder from the bottom to the top and then back down again. It adds the fun of swinging while providing a challenging workout.

    Ladder Swing Activities:

    1. Place a bucket or basket filled with puzzle pieces, letters, shapes, or other items at the top of the ladder for a child to retrieve one at a time by climbing up and down the ladder swing. Then, have them either put the pieces into the puzzle base or practice writing the letter or drawing the shape before going back up the ladder to grab the next item. 
    2. An adult can stabilize the bottom of the swing by holding it steady while the child climbs or an adult can slightly twist and turn the ladder swing while the child attempts to climb up and down. It’s called the ship on the rocky seas! 
    3. Place two or three articles of clothing at the top of the ladder and have the child retrieve one at a time and when they get to the bottom they can work on zipping, buttoning, or snapping!

    Hammock Swing

    A Cuddle hammock swing (also called a cocoon swing), provides proprioceptive input, assists with soothing strong emotions, and gives a nice deep pressure input which is calming and grounding for some children. This swing can be an easy first swing for children who need more gross motor support and are fearful of the movement other swings provide.  The Lycra-type material allows children to sit, stand, or lie in the swing making it a highly versatile swing. 

    Hammock Swing/ Cocoon Swing Activities:

    1. Have a child lie prone with their head and arms positioned outside the swing. This position creates a form of weight bearing through their arms and works on full upper body strengthening. They will work to pull and push themselves using the floor while inside the swing. 
    2. Place items around on the floor under the hammock just out of the reach of the child and then have them pull themselves along the floor to reach the items, such as bean bags, to toss into a basket. 
    3. Have the child lie prone and then grasp and hold your hands while you are seated on the floor in front of them. They will pull themselves toward you to shift the swing back and forth. 
    4. Have the child lie supine and reach up to remove clothespins that are clipped on the edge of the swing. The swing provides body support but works on building upper extremity strength and endurance as the child works against gravity to reach up. You can alternate activities and have the child place the clothespins instead.
    5. Have the child recline or lie within the swing and simply do deep breathing or mediation exercises while slowly swinging back and forth. 

    Pod Swing

    A Hanging pod swing provides vestibular input, assists with balance, and makes a nice cozy pod that gives children a sense of calm regulation and relaxation to just simply cool inside. This swing can serve as a good first swing as it allows for seated support while simply swinging slowly and provides more comfort to children who may be more fearful of the freedom of other types of swings. 

    Pod Swing Activities:

    1. Try turning off the lights, playing soft music, and have a child hold a small fidget or light-up toy while swinging slowly back and forth as they stay cuddled inside. 
    2. Place a pillow inside of the pod swing and have the child climb inside to provide a cushy, deep pressure input while swinging slowly and rhythmically in a linear fashion.
    3. Blowing bubbles for the child to watch while seated in the swing provides a calming feel as the motion of the bubbles will be slow as they descend. 
    4. Have the child sit in the swing and complete deep breathing or mediation exercises while slowly swinging back and forth. 

    Platform Swing

    A Platform swing (or this version of a platform swing with net base or material platform base) is the most common swing found in therapy settings and provides the opportunity for calming and alerting to get the child’s engine right where it needs to be for a treatment or classroom session. It is highly versatile as it can help a child build upper body strengthening, core strengthening, balance, and motor planning. 

    Platform Swing Activities: 

    1. Use this unstable surface swing to challenge a child’s body positioning to include side-lying, tummy time, tall kneeling, standing, criss-cross sitting, long sitting, and partial kneeling. 
    2. Have the child lie prone with their head and arms positioned over the edge. Then have them walk with the upper extremities around the floor picking up puzzle pieces to place in the puzzle base located in a central location. Pieces are picked up one at a time. 
    3. Place different colored bean bags in a circle on the floor around the swing. Call out different colors and have the child rotate themselves while lying prone on the swing and using their hands to walk around on the floor to stop at each color called out.  Letters and shapes can be used for this activity too.
    4. Place cones on an elevated surface and while the child is either lying prone or in a quadruped position, have them reach out to drop rings onto the cones. 
    5. Have the child sit criss-cross in the center and toss a beach ball to themselves.

    Trapeze swing provides a good opportunity to work on upper extremity strength and endurance, gross grasp skills, trunk strength, and motor planning. If you add lower extremity work also, then you address upper and lower body coordination. 

    Activities:

    1. While swinging or not, encourage a child to hold and lift their legs to kick a ball.
    2. While swinging, the child can simply jump over a therapy ball that is placed inside of a tire tube. 
    3. Simply work with a child on grasping and swinging while pumping the swing with their own feet. 
    4. While swinging or not, have a child hold on and lift their legs to kick a set of bowling pins or have them attempt to pick up each bowling pin with their feet and place them in a basket. 
    5. While swinging the child, can work on timing and release to let go and crash into a crash pad.

    Sensory Swing Tips

    What do you do with all of this information and activity ideas? Go get onto a swing and try out some of these fun activities! That’s right, we as adults need to have some fun too!

    But, after you’ve tried them, demonstrate them to the kiddos as they will most likely be more motivated to do the same activity after they see YOU do it. After all, you and I both know that the best way to teach a child is by setting a good example and you’ll get to have some fun in the process! It’s a win-win folks! 

    One tip for using a sensory swing in a therapy session can include a visual schedule with a plan that helps the individual with regulation needs. It can include swinging, then heavy work, music, blowing bubbles, dim lights, heavy rhythmic play, and deep breathing. All of these sensory tools regulate the system and can calm the system after the movement from the sensory swing. This is just one example and each individual will benefit from different strategies.

    Be sure to take a look at the maximum pounds allowed for some swings as you’ll want to be sure that it will work for all of your kiddos before purchasing.

    Always supervise children while on swings especially when rotary swinging as this can instigate seizure activity in some children.

    The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.

    The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.

    Regina Allen

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

    Summer Occupational Therapy Activities

    Summer occupational therapy activities

    Looking for summer occupational therapy activities to support skill building or developmental areas with a summer OT theme? Today, we have a spin on our traditional occupational therapy activities to bring you Summer occupational therapy strategies that can be used in summer sessions or in home programs for the summer.

    Summer Occupational Therapy Activities

    Summer OT activities may look a little different than previous years. In years past, therapists may have been gearing up for an end of another school year and a break from in-person OT sessions. In recent years, you may be seeing more pencil grasp needs, self-regulation needs, handwriting issues, and fine motor skill needs.

    What hasn’t changed about the end of a school year is the carefree days of summer that are ahead. As an OT, I love the feeling of the start of summer. There is just something about back-to-the-basics play of summer. Running around the backyard, hopping on bikes, sidewalk chalk, sprinklers and water play…summer play is a goldmine of motor and sensory activities that can boost those underlying skills kids NEED.

    Because of this, I wanted to put together a resource on summer occupational therapy activities that can be implemented today. These are strategies to use for your own child to boost development and challenge skills. These are ideas to use in teletherapy or in home programs. These are play ideas that help kids with the balance of screens and active play. Use the summer resources for parents, teachers, and therapists to develop underlying skills in very fun ways! These are AWESOME summer occupational therapy activities!

    Let’s help kids struggling from a year of mega-screen overload meet the goals they need to thrive. Plus…take more time for you this summer by using done-for-you resources!

    Occupational therapists can use these summer occupational therapy activities when planning OT home programs for for summer programs.

    Summer Occupational Therapy Activities 

    In many areas, schools are winding down for the year. You may have a few weeks or a few days left. The daily countdown of number of remaining school days is dwindling.

    You might be wondering how to balance work-from home and making summer days count.

    You might be wondering how to keep the kids busy this summer without breaking the bank.

    You might be a clinician thinking about summer programming and need a few fresh ideas.

    You might be thinking about summer plans and ways to encourage development in fun ways the whole family can enjoy.

    You might be a therapist putting together summer home programs.

    You might be a teacher who is READY for the final bell to ring this school year 🙂

    I wanted to put together a list of resources for summer activities that can boost the skills kids need. The “summer slide” can happen in handwriting and other school-based therapy goal areas, too!

    Summer Occupational Therapy Activity Ideas

    Occupational therapy practitioners often use movement and sensory experiences in therapy sessions to challenge motor planning, motor skill development, and incorporate sensory motor activity through the primary occupation of childhood: PLAY.

    Because of this, sensory motor rich activity is recommended as supplemental and everyday activity for kids of all ages to support development of skill growth. Many of the OT activity ideas listed below also support executive functioning skills, problem solving, and other cognitive aspects of functional tasks.

    First, grab this summer sensory path printable packet. It’s a free sensory path printable with a summer theme. Use it in therapy clinics, home OT sessions, or in summer sensory camps!

    Try adding these OT activities to your summer bucket list:

    • Make our 3 ingredient kinetic sand– Making kinetic sand offers heavy work through the hands as a self-regulation tool and offers a tactile sensory experience.
    • Make a kite craft to develop fine motor skills, visual motor skills, eye-hand coordination, and scissor skills.
    • Play TV tag (or one of these tag games)- Tag is a great gross motor activity to develop endurance, motor planning, coordination, balance, and visual motor skills while adding proprioceptive and vestibular input to regulate the system.
    • Make an ice cream craft to support hand strength and fine motor skills. This craft is great for developing scissor skills too.
    • Play sidewalk hopscotch– Use sidewalk chalk to draw a hopscotch board. Then play using rocks or bean bags. Hopscotch is a great tool to add heavy work, vestibular and proprioceptive input, and to challenge motor planning, balance, and other gross motor skills. Hopscotch is a way to teach skipping skills, too.
    • Paint rocks- This sensory experience challenges tactile input and offers a fine motor activity. Use finger paints or a paint brush to incorporate tool use and more fine motor work.
    • Wheelbarrow walk– This exercise is a heavy work exercise that helps kids with motor planning, movement, and endurance through play while adding heavy work. Use wheelbarrow walks in relay races or in obstacle courses.
    • Make a flower craft– Go on a nature walk as a motor and sensory experience. Then use the nature hunt findings to make a fine motor flower craft. There will be no two crafts alike with this fine motor activity.
    • Plant seeds- There are so many sensory benefits to gardening. Read more about sensory gardening with kids.
    • Wrap sticks in string- This simple activity is big on bilateral coordination, fine motor skills, precision, eye-hand coordination, and executive functioning skills. Go out in the yard and gather some small twigs. Then, tie a knot with the string and wrap around the stick. Switch out colors to make colorful designs and patterns. Can you cross different colored strings or yarn together to make a pretty wrapped stick? You can see how we wrapped craft sticks in string here.
    • Make lemonade- Making food with kids is a huge fine motor, sensory motor, and executive functioning tool to develop many skills with kids of all ages. Check out our cooking with kids page for tons more cooking ideas and recipes for kids as well as why each recipe supports development of skills.
    • Make a bug catcher– This fine motor activity is a huge hit with kids, and you can use the materials you have on hand. Just raid the recycle bin or grab some boxes and containers before they go into the trash can. Then, head outside to catch some bugs. This is a challenging activity that supports fine motor, visual motor, and sensory development.
    • Visit a playground- Playing at the playground has many sensory integration benefits and there are so many ways to use regular playground equipment to develop motor and sensory skill sin kids. If self-regulation is a challenge, then the playground is a wonderful summer haven for supporting specific needs.
    • Play tug of war- This heavy work game offers strengthening, balance, motor planning, and proprioceptive input that can be calming to support self-regulation needs.
    • Play in the sprinkler- A hallmark of hot summer days is playing in the hose or sprinkler. Children can practice putting on their swimming suit, applying sunscreen, and work on hopping, jumping, skipping, and moving through the sprinkler. And, don’t forget about involving the child in setting up and removing the sprinkler and hose, too. Pulling a hose is an opportunity for proprioceptive input that can be very calming.
    • Pick flowers- Go on a sensory nature walk with the family along a trail or in a park. Picking flowers supports development of visual perceptual skills, working memory, visual processing, fine motor, and self-regulation skills. Getting outside in nature can be a great overall activity that supports development and is a reset for the whole family.
    • Make lunch for your family- Develop fine motor skills, sensory experiences, executive functioning skills, and functional participation development by making lunch or dinner. Here are all of our cooking with kids recipes where you’ll find specific recipe ideas that support development, all from the perspective of an occupational therapist.
    • Chalk line obstacle course- Work on balance, motor planning, gross motor skill coordination through play using sidewalk chalk to create a driveway obstacle course. Can you hop on lily pads, tiptoe along a bridge, and animal walk on a wavy line?
    • Make DIY musical instruments- Making musical instruments are a fun way to build fine motor skills and address auditory processing skills too. Ideas include:
    • Climb a tree- Climbing on trees and limbs are a wonderful way to offer proprioceptive input, vestibular input, visual processing skills with depth perception, visual scanning, and eye-hand coordination. Holding on to a branch, pulling oneself up and over limbs, crossing midline, and bilateral coordination are developed through play. When finished, this is a powerful confidence booster!
    • Write a letter to a friend- (or a post card or email!)- Work on letter formation and other handwriting skills by writing a short letter or card to a friend this summer. It’s a very functional handwriting task that kids will be proud of!
    • Make a fairy garden- Use materials found around the home to support development of fine motor skills. The pretend play is a fun way to develop social emotional skills, too.
    • Wash the car (or a bike)- Support gross motor development by using a sponge, soapy water, and the hose to add proprioceptive input.
    • Watch and draw birds- Look for birds outdoors, in the yard, or from the windows. Address visual scanning, working memory, and pencil skills.
    • Go on a rainbow nature hunt- Use a piece of contact paper and find items of different colors of the rainbow to make a rainbow nature hunt craft. This is a great activity for fine motor, visual processing, and heavy work input.
    • Trace a friend with chalk on a driveway or sidewalk- Use sidewalk chalk to trace a friend on the driveway or sidewalk. This is a great activity to develop fine motor skills, and can support development of interoception by drawing internal organs and talking about how the body works inside and out!
    • Make bubble wands with pipe cleaners- use pipe cleaners and beads to develop fine motor skills to make a bubble wand. Then support oral motor skill development by blowing bubbles.
    • Play Red Rover- Lawn games like red Rover develop gross motor skills, visual motor skills, and executive functioning as well as adding proprioceptive and vestibular input.
    • Write the alphabet with chalk- Writing letters with sidewalk chalk supports the motor plan to create each letter and offers great proprioceptive feedback through kinesthetic learning. Writing letters with chalk or names and words can be a fun summer activity. Then spray the letters and words off with the hose or a spray bottle for more motor skill development!
    • Find shapes and images in the clouds- Look up to work on visual canning, memory, attention, and visual motor skill by finding shapes and outlines in the clouds.
    • Bake cookies
    • FInger paints
    • Fly a kite
    • Splash pad or water park
    • Write in a journal
    • Call a friend
    • Start a kickball game
    • Make leaf rubbings
    • Play hide and seek
    • Catch fireflies
    • Tie dye
    • Play cards
    • Build a fort
    • Have a sleepover
    • Play with glow bracelets at night in the yard
    • Read a book outside
    • Have a family game night
    • Draw self-portraits
    • Walk a pet

    Need even more summer ideas?

    ~Add these hula hoop activities to therapy sessions.

    ~Use sidewalk chalk to support fine motor skills.

    ~ Print off and send home this list of 100 things to do this Summer. It’s a therapist-approved list of Summer activities!

    ~Print off these Summer Writing Lists to work on handwriting skills.

    ~Grab some of the materials in The OT Toolbox Member’s Club. There is something for everyone and Summer themed activities to support all skill levels.

    ~ Do some or all of the activities listed here in this Sensory Summer Camp at Home plan. All of the activities and ideas are free and use items you probably already have.

    ~ Sneak in handwriting practice while traveling with these motivating and authentic ideas. HERE are a few MORE natural writing experiences for summer that keep those pencils moving.

    ~ Try some of the activities in this Summer Activity Guide designed to encourage play and creativity in activities for the whole family.

    ~ Practice the motor planning and fine motor skills needed for handwriting and with a sensory twist using the ideas outlined in this Sensory Handwriting Backyard Summer Camp.

    ~ Try these Backyard Vestibular Activities for Summer to encourage movement and sensory experiences right in the backyard.

    ~ Print off this June Occupational Therapy Calendar for ideas to last the whole month. (It’s from a couple of years back so the dates are off, but the activities still work!)

    ~ These no-prep, basically free summer activities won’t break the bank and boost the underlying skills kids NEED, in fun ways.

    ~ Use sidewalk chalk to boost fine motor skills.  

    ~Make a summer time capsule with the whole family and create memories that can be looked back on years from now.   

    ~Create a summer kick-off bucket filled with toys and items for months of sensory play.     

    ~The kids will love these frozen fruit kabob snacks. It’s a great alerting sensory snack that doubles as a healthy summer treat.

    One tool to support Summer OT home programs, OT tutoring sessions, or occupational therapy summer camps is our Summer Occupational Therapy Activities Packet.

    It’s a collection of 14 items that guide summer programming at home, at school, and in therapy sessions. The summer activities bundle covers handwriting, visual perceptual skills and visual motor skills, fine motor skills, gross motor skills, regulation, and more.

    You’ll find ideas to use in virtual therapy sessions and to send home as home activities that build skills and power development with a fun, summer theme. Kids will love the Summer Spot It! game, the puzzles, handouts, and movement activities. Therapists will love the teletherapy slide deck and the easy, ready-to-go activities to slot into OT sessions. The packet is only $10.00 and can be used over and over again for every student/client!

    Grab the Spring Occupational Therapy Activities Packet HERE.

    NEW RESOURCE: The Summer Fine Motor Kit– This 90 page packet it specifically designed to build the motor skills kids have been limited in over the past year or so: handwriting, cutting with scissors, small motor manipulation, arch development and hand endurance, strength, pinch, and coloring. The Summer Fine Motor Kit includes different tools and materials than our other fine motor kits, but has some of the most-requested favorites in fun summer themes:

    • Summer Play Dough/Handwriting Mats (3 writing paper styles: single rule, double rule, and highlighted lines)
    • Lacing cards
    • Color and cut sensory bin cards
    • Sea Creature, Summer Play, & Summer Treats Silly Paths (great for pencil control and eye-hand coordination)
    • Tracing mazes/ Fine motor mazes
    • Symmetry drawing page
    • Fine Motor Flip Pages (flip a coin or small object and place them along a path)
    • Glue skills pages
    • Prewriting shapes sheets
    • Toothpick art activities
    • Pencil control worksheets/Fine motor placement paths
    • Scissor skills activities (simple and complex shapes)
    • Sensory bin cards

    NEW RESOURCE: The Summer OT Bundle– Want to cover all your bases this summer? This bundle has everything you need for therapy planning, home programs, summer camps, Grandma’s house, or extended school year programs so you can just print and go. The bundle is $20 and includes:

    The ideas listed above should help you create therapy home programs, and keep the kids loaded up on creative, open-ended, and movement-based PLAY that their little bodies NEED!

    Use these summer occupational therapy activities when planning sensory activities, fine motor, and gross motor developmental ideas for kids.

    Want to take summer play to the next level? Be sure to grab your copy of the Summer OT Activities Bundle!

    Summer activities for kids

    Use these Fine Motor Kits for hands-on activity kits to develop fine motor skills, strength, dexterity, and manipulation. Kids LOVE these fine motor kits for the motivating activities. Therapists love them because it’s fresh, fun ways to work on pinch, grip, manipulation skills, and much more. Try some of these themed therapy kits: