NESCA has unexpected availability for Neuropsychological Evaluations and ASD Diagnostic Clinic assessments in the Plainville, MA office in the next several weeks! Our expert pediatric neuropsychologists in Plainville specialize in children ages 18 months to 26 years, with attentional, communication, learning, or developmental differences, including those with a history or signs of ADHD, ASD, Intellectual Disability, and complex medical histories. To book an evaluation or inquire about our services in Plainville (approx.45 minutes from NESCA Newton), complete our Intake Form.

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bilateral coordination

Learning to Ride a Bike: A Rite of Passage

By | NESCA Notes 2021

By: Jessica Hanna MS, OTR/L
Occupational Therapist, NESCA

If there is one positive takeaway from the COVID-19 pandemic, it’s the ever-growing love for being outdoors. It’s spring, the flowers are blooming, the sun is out, and the air is light. Everything in our body is telling us to go outside and play.

For many kids with and without disabilities, bike riding is meaningful, liberating, and a rite of passage. Close your eyes and try to remember the first time you rode a two-wheel bike. Can you remember the color of your bike? The smell in the air? The complete joy it brought you? That was the day we all felt a bit more confident and like we grew a bit taller.

So how do we help our children achieve this meaningful occupation? The days of running behind our children while holding onto their bike seat, telling them to pedal, not to stop, and hoping for the best and that they will forgive us when we let go (when we clearly promised we would not let go!) should be far behind us. But are they?

A lot goes into learning how to ride a bike, so do not let your child give up so soon when it takes more than a couple of days, weeks, or months to get it right. Consider the following skills that are addressed in learning to ride a bike:

  • Attention and concentration
  • Bilateral coordination
  • Balance
  • Body awareness
  • Core strength
  • Hand-eye coordination
  • Motor planning
  • Postural stability
  • Sensory processing
  • Upper and lower extremity strength
  • Visual scanning

Children as young as five years of age will begin to acquire and develop the skills needed to ride a two-wheel bike, and still others may not feel ready until they are pre-teens or even into adulthood.

Before getting started, here are a couple things to consider regarding the equipment involved in learning how to ride a bike:

  • Bike – The height of the bike is a crucial element to success when learning how to ride. When seated on the bike, your child’s feet should be firmly planted on the ground. The bike seat may appear too low and the bike too small; however, this technique enables movement security, engages proper core and postural stability, and increases confidence.
  • Braking System – Be sure to learn the difference between hand brakes vs. coaster brakes (using feet to backpedal). Both braking systems have pros and cons. Hand brakes are a personal favorite. They are more flexible to position, offer better control, but require adequate hand strength and coordination to manipulate. Coaster brakes (using your feet to pedal backward to brake) use an intuitive motor planning motion for children. When you pedal forward, you go; when pedaling backward, you stop. They are helpful for children who lack the hand strength skills to wrap and squeeze their hands around a hand brake; however, they provide awkward foot positioning and the constant tendency to backpedal.
  • Helmet – Safety, Safety, Safety! When handling a bike for any occasion (i.e., walking a bike, doing balance drills on a bike, or riding a bike), it should become an automatic habit to wear a helmet. Your child should be in charge of putting on and taking off their helmet independently. There is nothing more important than wearing a helmet that fits correctly with fasteners that can be easily manipulated. When choosing a helmet, be cognizant of the type of fastener/clasp it comes with and if your child has the fine motor skills to adjust it (this skill could take time to learn).If you are unsure if your child’s helmet is a good fit, any cycling store will be more than pleased to assist in finding your child the most appropriate size. 
  • Pedals – When learning to ride for the first time, the removal of pedals should be highly considered. It provides the opportunity to address balance, core, and postural stability for both younger and older children while also increasing movement security.
  • Training Bike – Which is best…balance bikes vs. training wheels? Balance bikes are light in weight and can be introduced to children at a much younger age than a pedal bike. They promote core strength and increase motor planning, sequencing, and balance training skills, making the transition from a balance bike to a two-wheel pedal bike more fluid and easier to manage. Training wheels promote ease in learning motor planning techniques to push on pedals while providing assisted balance. It’s important to note that removing the balance component can be disadvantageous when transitioning from training wheels to a two-wheel pedal bike.

Overall, the literature supports the observation that, for children with and without disabilities, learning to ride a bike is a popular activity that increases confidence, provides opportunities for shared recreation with families and peers, and promotes social inclusion (Dunford, Bannigan, Rathmell (2016).

Several of the many clinical diagnoses of children who can ride a bike follow here; however, this list is certainly not inclusive of the many other diagnoses that do not preclude children from bike riding:

  • ADHD
  • Anxiety
  • Autism Spectrum Disorder
  • Cerebral Palsy
  • Developmental Coordination Disorder
  • General learning disability
  • Hearing impairment
  • No diagnosis

The art of bike riding can be broken down into various steps, from learning how to use the kickstand to the act of pedaling. Each step deserves attention, because through repetition and practice, confidence is achieved.

If using these tips feels difficult or is not helping your child with the level of focus and skill they need to successfully achieve their goal to use a bike, we recommend reaching out to your occupational therapist or getting an occupational therapy evaluation. If in-person direct services continue to be a concern, biking riding skills can be offered via telehealth from the comfort of  your home. Jessica offers successful biking riding drills and adaptive home exercise plans through telehealth that address the skills required to learn to ride a bike. Contact NESCA’s Director of Clinical Services Julie Robinson, OT, to learn more at: jrobinson@nesca-newton.com.

 

References
Dunford, Bannigan, Rathmell (2016) Learning to ride a bike: Developing a therapeutic intervention. Children Young People & Families Occupational Therapy Journal 20(1) 10-18

 

About the Author

Jessica Hanna has over 10 years of pediatric OT experience in conducting assessments and providing treatment of children and adolescents with a broad range of challenges and disabilities, including autism spectrum disorders, sensory processing disorders, visual impairments, cerebral palsy, executive function deficits and developmental disorders of motor function. Prior to joining NESCA, Jessica trained and worked in a variety of settings, including inpatient and outpatient hospital settings, private practice, schools and homes. She has served on interdisciplinary treatment teams and worked closely with schools, medical staff and other service providers in coordinating care. In addition, Jessica provided occupational therapy services at Perkins School for the Blind and Spaulding Rehabilitation Hospital pediatric inpatient unit, where she conducted comprehensive evaluations and interventions for children with a broad range of presentations.

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

The Therapeutic Great Outdoors—Part 2

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

In last week’s blog, we provided the first five ideas on how to teach and build OT skills by getting outdoors. This week, we bring the next installment of ideas to help build skills while also providing a break from being cooped up together. Take it a step further and build in some kindness lessons by offering neighbors or passers-by some of the outputs from the suggested ideas and projects!

  1. Make Fossils. This activity consists of finding unique and special treasures outdoors and making imprints of them back inside. First, find some small solid objects, such as rocks, small sticks, acorns, leaves or shells. This is a perfect activity to do after a nature scavenger hunt! Then have your children press these objects into playdough or plaster of Paris to make their own fossils. Children work on their fine motor skills as they roll out the plaster, pinch their objects and push them down to make an imprint. Try making this great playdough recipe together before you get started. For some extra creative options, to try include: incorporating small toys, such as dinosaur figurines or LEGOs or using cookie dough as a base, then eat your fossils for a snack!
  2. Make a Bird Feeder. There are many different creative ways to make bird feeders with your children. Choose a bird feeder that requires multiple fine motor skills and is appropriate for your child’s level! Two options are:
    1. Bagel Feeder – Start with a bagel. Help your child tie a string or piece of ribbon through the center hole of the bagel in a large loop. Next, have your child choose a topping to put onto the bagel. I generally suggest peanut butter! Have the child practice spreading this topping all over the bagel. Using a knife to spread such a thick, sticky substance is a pretty difficult fine motor task! Next have your child use their “pinchy fingers” (thumb and pointer finger) to pick up bird seed and sprinkle it on the peanut butter. The end product will be a bagel covered in peanut butter and bird seed that is ready to hang on a tree outside. Place it near a window and let your children watch the birds enjoy their creation!
    2. Cheerio Feeder – You may have heard that stringing beads is an excellent occupational therapy activity that promotes bilateral coordination, fine motor precision, motor planning and a pincer grasp. Consider making a bird feeder by stringing Cheerios (or any cereal with a hole in the center) onto a piece of string and hanging them in the trees. Birds will love to peck off the individual pieces as a snack.
  3. Paint Rocks or Shells. Painting rocks and other outdoor treasures is a great activity that allows children to be creative while using tools and practicing a functional grasp. Allow children to pick up the rocks and get messy to help promote some bilateral coordination!
  4. Draw with Sidewalk Chalk. While writing with chalk may seem very similar to writing with a pencil to us adults, for children who are just learning to manipulate a pencil, it can be a hugely different experience. Writing on the uneven ground provides tactile feedback. Holding a piece of chalk that moves with the contours of the ground requires increased hand strength. Children get to practice modulating how hard they need to push down on the chalk to make a solid line. If your child is hesitant to practice handwriting, try sneaking outside 5 or 10 minutes before them to create a few “sidewalk worksheets” for them to complete before they start to draw their creative masterpieces. For some children, there is a huge sensory piece to sidewalk chalk, as they work to tolerate the new texture and the feeling of chalk on their hands.
  5. Bring out the Bubbles. In occupational therapy, we often use bubbles to help children work on their oral motor skills. Children work to make their mouth into a round “O” shape and blow with enough force to create the bubbles themselves. Prompt your kids to pop bubbles by clapping their hands together. This helps to practice eye-hand and bilateral coordination. Next, have your child try to keep their eyes on one bubble as long as possible to practice visual tracking!

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.