NESCA’s Londonderry, NH location has immediate availability for neuropsychological evaluations. Our NH clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing. Our NH clinicians also conduct evaluations for students who are at boarding schools, and two of our NH clinicians have PsyPACT authorization, allowing them to conduct evaluations out-of-state.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

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Therapeutic Toy Guide to Promote Skill-building

By | NESCA Notes 2021

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

It’s that time of year when parents and loved ones are looking for the perfect gift. As pediatric occupational therapists, we are often asked about our recommendations for the best toys and activities that encourage learning and the development of specific skills. During an occupational therapy session, toys and games are used with people across the life span for many reasons. The biggest reason is to bring joy and develop confidence while simultaneously working on skill-building in areas that require getting and maintaining attention in an effort to improve and develop independence in functional tasks.

Play and exploration of games and toys are for those of all ages. The right toy and game can be used to develop new skills and strengthen and refine learned skills.

Skills addressed through play and active exploration:

  • Attention and concentration
  • Balance
  • Coordination skills
  • Core strength
  • Executive functioning
  • Emotional regulation
  • Fine motor skills
  • Gross motor skills
  • Handwriting
  • Imaginative play
  • Motor planning
  • Sensory motor needs
  • Visual perceptual skills

How many times have you endlessly scrolled online looking for the best-fit gift, wondering if it will be one more item that ends up collecting dust on a shelf? How often do you wish a toy store existed like when we were kids, instead of walking down the same small toy aisle at the local department store and leaving with nothing? Or having to weed through page after page of online stores and catalogs?

Below is a helpful guide to therapeutic games and toys that focus on a couple of specific skill areas. Most of the games included can fall into more than one skill area, depending on how it’s used.

Coordination Skills – Skills that help develop body control and awareness. Bilateral coordination is the ability to use both sides of your body together in a coordinated way, and hand-eye coordination is when the eyes guide the hands in movement.

3 + years

  • EleFun (Hasbro)
  • Feed the Woozle
  • Kids Magnetic Fishing Games (iPlay, iLearn)
  • Instrument toys
  • Marble Run
  • Target activities
  • The Yoga Garden Game
  • Wooden Balance Board
  • Zoom Ball

6 + years

  • Bob it
  • BucketBall
  • Kan Jam
  • Klask
  • Rev balance board
  • Ring Toss
  • Simon
  • Spike Ball
  • Throw the Burrito
  • Twister

Executive Functioning Skills The ability to sustain attention, organize and plan, initiate and complete, problem solve and regulate emotions.

3 + years

  • Bee Genius (MUKIKIM)
  • Bunny Hop (Educational Insights)
  • Cootie
  • Create-A-Burger (Lakeshore)
  • Dino Escape
  • Don’t Break the Ice
  • Frankie’s Food Truck Fiasco Game
  • iPlay, iLearn Kids Magnetic Fishing Games
  • Hoot Owl Hoot
  • Movement Memory

 6+ years

  • Battleship
  • Checkers
  • Chess
  • DogPile
  • Distraction
  • Gravity Maze
  • Life Junior
  • Monopoly
  • Outfoxed
  • Rush Hour (Think Fun)

Fine Motor Skills – The ability to control the small muscles of the hands and fingers. Fine motor development contains many components. Some of those areas include pincer and pre-writing grasp development, hand strength, wrist stability, motor control, and separation of the sides of the hand.

3 + years

  • Alphabet Learning Locks
  • Bee Genius
  • Duplo Sets
  • Forest Friends Playset (Lakeshore)
  • Light table pegs and pegboard (Lakeshore)
  • Magnet Alphabet Maze
  • Noodle Knockout!
  • Pegcasso Build and Drill
  • Poke-a-Dot: Old MacDonald’s Farm
  • Pop the Pig
  • Woodpecker feeding game (iPlay, iLearn)
  • Snap Dinos (Lakeshore)

6+ years

  • Frankie’s Food Truck Fiasco Game
  • LEGOs
  • Light Brite
  • LiquiPen (Yoya Toys)
  • Mancala
  • Kanoodle
  • Operation
  • Perfection
  • Pictionary
  • Scratch Art
  • Shelby’s Snack Shack Game
  • Trouble

Sensory Play – The opportunity to receive sensory input through play. It can foster listening skills and body awareness, encourage tactile exploration and risk-taking, and promote a calming and alert state of being.

3+ years

  • Bean bags
  • Kinetic Sand
  • Monkey Noodle
  • What’s in Ned’s Head?
  • Playdoh
  • Pop Fidgets
  • Squishmellos
  • Scooter boards
  • Sit and Spin
  • Trampoline

6 + years

  • Aromatherapy
  • Bubble tubes
  • Color mix sensory tubes
  • Doorway Sensory Swing Kit (DreamGym Store)
  • Thinking Putty (scented/glow in the dark)
  • Tent
  • Tunnel
  • Water Beads
  • Weighted blanket
  • LiquiPen (Yoya Toys)

Visual Perception Skills – The ability to make sense of what is being seen. Skills are used to copy information from a board, manipulate items, identify, read, recall info, visually locate things, and write.

3 + years

  • Alphabet Bingo
  • CandyLand
  • Chutes and Ladders
  • Fox in the Box
  • Honeybee Tree
  • Magnatiles
  • Spot-it
  • Pete the Cat- I Love My Buttons Game
  • Puzzles
  • Zingo (Think Fun)

6+ years

  • Connect Four
  • DogPile
  • Guess Who
  • Jenga
  • Kanoodle
  • Klask
  • Let’s Go Code
  • Mancala
  • Perfection
  • Pixy Cubes

This list is just the tip of the iceberg of the many toys and games you will come across. Many toys and games can be therapeutically and easily graded to any individual, no matter the age. The trick is to find the just-right challenge to work on the skill area desired through fun and motivating means. We recommend reaching out to your occupational therapist if you require assistance with either new or older games and toys and how to create the just-right challenge for your child.

 

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 Working on a Vertical Surface

By | NESCA Notes 2021

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

What do you mean by a vertical surface?

If you think about it, most of the activities children do day to day are completed on a horizontal surface, where toys and tools remain static, in one position. Picture a vertical surface, whether it be a wall, window, or an easel. Working in this anti-gravity position activates new muscles and makes activities more challenging for kids. Think “tummy time,” but for our elementary-aged kids.

What are the benefits of working on a vertical surface?

  • Shoulder, wrist, and elbow stability – These activities require a child to practice bigger arm movements that may not be utilized on a traditional, flat surface. These movements promote both strength and flexibility in the joints and muscles of the upper extremities.
  • Core strength & postural control – If a child is completing vertical work in standing, he or she must reach outside of their base of support, activating those core muscles. Further increase the demands of the task by having the child complete the task in kneeling or while sitting on a therapy ball. This promotes balance and use of the stomach and leg muscles. Building this solid ‘core’ foundation is extremely important so that a child can develop more controlled movements in the upper extremities.
  • Hand strength – Working against gravity requires a child to exert increased effort while building hand strength and endurance with a utensil.
  • Visual spatial awareness & crossing midline – Working on a large vertical surface means more space to cover. This requires a child to visually scan a greater distance left to right, reaching across the imaginary “midline” of our body. Crossing midline is essential for developing bilateral coordination skills.
  • Wrist extension for pencil grasp – This is a big one! Writing on a vertical surface naturally puts the wrist in extension, the ideal position for handwriting. In contrast, a flexed wrist limits finger mobility and control.
  • Proprioception & force modulation – When performing a task on a vertical surface – think stickers or drawing – the child is required to practice grading movements so that he or she can apply the right amount of pressure for success (Boitano, 2020; Drobnjak, 2015).

What pediatric population benefits from this?

All kids would benefit from participating in these kinds of activities! Working on a vertical surface work can particularly help children to further develop the essential fine, visual, and gross motor skills. Sensory integration can also be targeted, as these kinds of activities allow a child to explore and develop proprioceptive, tactile, and visual processing skills.

Activities that can be done on a vertical or slanted surface (Boitano, 2020; Drobnjak, 2015)

  • Writing
  • Drawing/coloring
  • Tracing (stencil) activities
  • Stickers
  • Painting (finger painting or with brush)
  • Magnets
  • Spray bottle activities
  • Squigz or suction cup games
  • Felt or Velcro boards
  • Chalkboard, easel, or whiteboard activities
  • Shaving cream
  • LEGO wall
  • Window or wall washing using sponge

 

Resources

Boitano, C. (2020, April 20). The benefits of writing and working on a vertical surface! OT Outside. Retrieved October 6, 2021 from https://www.otoutside.com/news/2020/4/19/the-benefits-of-writing-and-working-on-a-vertical-surface.

Drobnjak, L. (2015, June 27). Why Kids Should Work on a Vertical Surface. The Inspired Treehouse. Retrieved October 6, 2021 from https://theinspiredtreehouse.com/motor-skills-and-more-working-on-a-vertical-surface/

 

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.

 

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