NESCA is currently accepting therapy and executive function coaching clients from middle school-age through adulthood with Therapist, Executive Function Coach, and Parent Coach Carly Loureiro, MSW, LICSW. Carly specializes in therapy for individuals with Autism Spectrum Disorders and individuals who are highly anxious, depressed, suffer with low self-esteem, etc. She also offers parent coaching and family sessions when needed. For more information or to schedule appointments, please complete our Intake Form.

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body awareness

Playgrounds & Their Role in Child Development

By | NESCA Notes 2021

By: Madelyn (Maddie) Girardi, OTD, OTR/L
Occupational Therapist, NESCA

Growing up, I remember spending hours and hours at playgrounds with friends and family. Running around, scraping our knees, and swinging from one structure to the next. While we all know that playgrounds can be loads of fun, the therapeutic benefit children can gain from these unique environments is often overlooked. Playgrounds allow children to explore the environment around them, develop important social/emotional skills, and build the necessary motor abilities to be successful in life.

Think of your average playground and consider the range of equipment that is present. Each type of equipment offers its own benefits in helping a child to build skills in different areas. Some common examples of playground equipment include:

  • Slides
  • Swings
  • Spinning equipment (e.g., tire swing, Sit N’ Spin, merry go round)
  • See-saw
  • Zipline, Static trapeze
  • Climbing structures
    • Ladders, monkey bars, stepping stones, vertical/fireman’s pole, coil climber, rock wall, rope structures
  • Imaginative play/Sensory-based equipment
    • Sandboxes, ball pits, splash pads, water tables, playhouse/kitchen set-ups

Gross Motor Skills

Playgrounds are great places for children to gain exposure and practice using gross motor skills. Some of the gross motor skills that can be targeted include upper and lower extremity strength, core strength and postural control, balance, shoulder/elbow/wrist stability, and bilateral coordination. Gross motor skills are important because they allow us to perform everyday functions, navigate and interact with our environment, and engage in leisure activities like sports! They also lay the foundation for our body to develop more refined motor skills in the hands. In other words, the child must have proximal stability before achieving distal mobility (Miss Jamie O.T, 2021). As our bodies develop these gross motor skills, this sets the groundwork for fine motor control. The more opportunities we give children to practice and explore, the better!

Image Credit: (Miss Jamie O.T, 2021)

Fine Motor Skills

Traditionally, we think of seated activities, such as coloring, writing, puzzles, or beads, as targeting our fine motor –  or hand –  skills. While this may be true, engagement in playground activities is also a great way to build hand strength, dexterity, grasp patterns, upper extremity coordination, and more. Think of a child climbing on a ladder, up a slide, or across a monkey bar structure. Our hands play a vital role in these activities. While engaging with playground environment, a child has ample opportunity to develop and use what is known as the “power grasp.” This is the grip needed to stabilize an object with the pinky side of the hand, while the thumb side of the hand wraps around the object (Miss Jamie O.T, 2021). This grasp is used in everyday life, such as when holding a cup, turning a doorknob, or opening a jar. Many skills established in this environment can then be transferred to the functional tasks performed in our daily routines. The playground is the perfect place to learn them!

Sensory Processing and Integration

In addition to motor skill practice, a playground environment can provide children with a plethora of sensory experiences that benefit overall regulation. When we think of playgrounds, many times swinging, spinning, and sliding activities come to mind. These activities provide a child with important vestibular information that allow for understanding of head/body position in space. This input can be crucial for regulation, social interaction, and successful navigation of the environment. Additionally, playground activities give our bodies ample proprioceptive, tactile, and visual input. Consider a child swinging on the monkey bars. While suspended, a child receives pulling/pushing input to the joints, which allows for increased body awareness and accurate grading of movements through space. Furthermore, a child is interacting with his or her environment, constantly taking in tactile, auditory, and visual information. For many children, exposure to these sensory-rich experiences can positively impact regulation, arousal, and social and emotional development.

Social/Emotional, Play Skills

Playground environments also provide abundant social interaction for children as they are often shared, public spaces utilized by mixed ages, genders, and abilities. We know that many children are highly motivated by peers and benefit from the opportunity to observe and learn from the actions of others. Consider the different components of a playground; each promotes different patterns of play, and therefore, reinforces different developmental skills. For example, overhead structures, such as monkey bars, tend to attract older children and facilitate independent, gross motor play. This kind of activity promotes problem-solving and persistence. See-saws and swings tend to promote collaboration between children, as they require turn-taking skills, communication, and teamwork. An area such as a sandbox or water table may facilitate imagination skills, as children use their creativity and explore tool use. While we know a playground allows for progression of development in various areas, the actual type of equipment being used may influence which specific skills are being targeted (Landscape Structures Incorporated, 2021).

References

  1. Landscape Structures Incorporated. (2021). Developmental Benefits of Playground Equipment. Benefits of Playground Equipment. https://www.playlsi.com/en/playground-planning-tools/education/playground-equipment-benefits/#:~:text=Stimulate%20Development%20through%20Playground%20Equipment&text=The%20movements%20children%20perform%20on,and%20develops%20better%20body%20awareness.
  2. Miss Jaime O.T. (2021). Promoting Fine Motor Skills on the Playground. Developing Fine Motor Skills at the Playground. https://www.missjaimeot.com/promoting-fine-motor-skills-playground/

 

About the Author
Madelyn (Maddie) Girardi is a Licensed Occupational Therapist in Massachusetts with experience in both school-based and outpatient pediatric settings. Maddie received her undergraduate degree in Exercise Science/Kinesiology at The College of Charleston in South Carolina and  earned her Doctorate degree in Occupational Therapy from The MGH Institute of Health Professions in Boston.

Maddie is a passionate therapist with professional interest in working with young children with neurodevelopmental disorders, fine and gross motor delays and Autism Spectrum Disorder (ASD).

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.

 

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 Benefits of Sensory-based Play

By | NESCA Notes 2021

By: Madelyn (Maddie) Girardi, OTD, OTR/L
Occupational Therapist, NESCA

The importance of play for child development

Play is considered an essential aspect of child development as it contributes to cognitive, physical, social and emotional well-being. As a pediatric occupational therapist, play is an integral part of my job. When children have opportunities to play, this allows them to build their creativity and imagination, resolve conflicts and learn self-advocacy skills. Through play, children develop new abilities that lead to enhanced confidence and resiliency, skills crucial for navigating day to day challenges. Play allows kids to practice decision-making skills, discover areas of interest and engage in passions. (Ginsburg, 2007).

 What is sensory-based play?

Sensory play can be described as any play activity that stimulates an individual’s sensory system. The sensory system includes touch (tactile), smell (olfactory), taste (gustatory), sight (visual), hearing (auditory), balance (vestibular) and movement (proprioception). Common examples include sensory bin or sandbox play, play with shaving cream, finger paint and/or food, use of a balance beam, ball pit, and/or swings, sound tubes, and so much more!

Why is sensory play beneficial?

While we know that play is a critical part of child development, incorporating a multi-sensory approach into play activities can be particularly beneficial. When activities are fun and meaningful – our senses are engaged – we learn best!

  • Promotes learning – children who engage multiple senses to accomplish a task are better able to remember and recall learned information.
  • Facilitates exploration, creativity and curiosity in children who may be seeking, or avoiding, certain types of stimuli.
  • Allows for strengthening of the brain pathways and connections that allow for efficient sensory integration.
  • Promotes self-regulation by allowing for interaction with different mediums that may be calming for the child (Educational Playcare, 2016).

What kinds of OT skills can be targeted through sensory play?

  • Sensory processing skills
  • Fine motor skills
  • Gross motor skills
  • Feeding skills
  • Body awareness
  • Motor planning
  • Visual perceptual skills
  • Communication and play skills
  • Self-regulation and coping skills

References:

Educational Playcare. (2016, October 27). Why Sensory Play is Important for Development.
https://www.educationalplaycare.com/blog/sensory-play-important-development/#:~:text=Sensory%20play%20includes%20any%20activity,%2C%20create%2C%20investigate%20and%20explore

Ginsburg, K. R. (2007). The importance of play in promoting healthy child development and
maintaining strong parent-child bonds. Pediatrics119(1), 182-191.

To learn more about Maddie Girardi, watch this video interview between NESCA Occupational Therapists Sophie Bellenis, OTD, OTR/L, and Maddie Girardi, OTD, OTR/L.

About the Author
Madelyn (Maddie) Girardi is a Licensed Occupational Therapist in Massachusetts with experience in both school-based and outpatient pediatric settings. Maddie received her undergraduate degree in Exercise Science/Kinesiology at The College of Charleston in South Carolina and  earned her Doctorate degree in Occupational Therapy from The MGH Institute of Health Professions in Boston.

Maddie is a passionate therapist with professional interest in working with young children with neurodevelopmental disorders, fine and gross motor delays and Autism Spectrum Disorder (ASD).

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.

 

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