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OT skills

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.

 

Sensory-friendly Sunscreen for Tactile-sensitive Kids

By | NESCA Notes 2021

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

Our Sense of Touch

Tactile processing is our ability to sense and interpret information from our environment through our sense of touch. Information from our tactile system allows us to gauge everyday sensations such as light touch, temperature, vibration, pressure, or pain.

Tactile Defensiveness

Tactile defensiveness is a term used to describe an individual who is hypersensitive to touch. As occupational therapists (OTs), this is something we come across often on our caseloads. Sensitivity to tactile stimuli can interfere greatly with a child’s functional, day-to-day activities. It can impact one’s ability to tolerate certain types of clothing, perform self-care tasks (bathing, toothbrushing, hair brushing), or eat a range of foods. Another activity that may cause difficulty in the summer months is tolerating the feeling of sunscreen on the body. While we want our families to enjoy the beach, the pool, or spend time outdoors, this task can be daunting for tactile-sensitive kids. The anticipation of this event alone may elicit an aversive response, or, in many cases, the child may begin avoiding the task altogether.

(Movement Matters, 2020).

The Role of OT

Occupational therapists help children and families participate in meaningful daily activities. When a child is sensitive to certain stimuli, the therapist will provide an environment where controlled and guided exposure can take place. This process allows for ongoing positive interaction with the medium, often through play-based activities. The therapist can help the family find alternative solutions and to identify positive coping mechanisms that allow the individual to be successful in the given task.

Tactile Defensiveness and the Beach

As a pediatric occupational therapist, a question that often comes up in the summer months is: “What do I do if my child is having trouble tolerating the feeling of sunscreen on his skin?” The first thing you can do is consider the sensory properties of the sunscreen. Is it lotion? Is it thick? Sticky? Clumpy? Smooth? Does it absorb quickly, or does it stay on the skin? Is it greasy? Does it have a certain smell to it? Stick, spray, and powder options are great alternatives for children who may be sensitive to some of the less desirable lotions. Here are some of the most recommended, sensory-friendly sunscreen options:

      Stick options

  • Neutrogena Wet Skin Kids Stick *
  • Neutrogena Dry Touch Ultra Sheer Stick *
  • Aveeno Baby Face stick sunscreen

      Spray options

  • Babo Botanicals Sheer Zinc Spray
  • Banana Boat Light as Air

      Powder-based options – primarily for the face

  • Brush on Block Translucent Mineral Powder Sunscreen
  • Sunforgettable Total Protection Brush-On Shield

      Lotions

  • Neutrogena Dry Touch Ultra Sheer *
  • Supergoop Unseen Sunscreen
  • Biore UV Aqua Rich Watery Essence

(Evolution, 2021; No Author, 2018).

Additional Recommendations

As an occupational therapist, I am always thinking of other ways to adapt activities to make them easier for my clients. Beyond changing the actual sunscreen, here are some more ways to help make protection from the sun easier for our kids.

  • Coolibar Clothing – Limit the amount of skin that is exposed directly to the sun using protective clothing. This brand offers sun protective clothing options in shirts, hats, bottoms, and swimwear.
  • Make it a routine! – Like any other daily activity, such as getting dressed or brushing teeth, make it a part of the day! This way, it is familiar and expected.
  • Make it fun! – Play a game or sing a song while applying sunscreen. Use a timer so that the child can know when the activity is going to end.
  • Involve the child in the process as much as possible – As appropriate, have the child help with putting on the sunscreen. Use a mirror so that the child can see what is going on.
  • Proprioceptive input – Providing proprioceptive input prior to sunscreen application can help to reduce touch sensitivity. This is the sensory input one receives from the movement and force of muscles and joints. Some examples include massage/deep pressure to applicable areas, any pushing/pulling movement, use of weighted items, digging in sand, animal crawls, or wheelbarrow walks. Have the child rub down arms, legs, and back with a towel before applying sunscreen.

References:

Evolution, M. (2021, May 26). Sunscreen Ideas for Tactile Defensive Kids. Mommy Evolution. https://mommyevolution.com/sunscreen-ideas-tactile-kids/

No Author. (2018, March 31). Autism Inclusivity [Facebook page]. Facebook. Retrieved August 6, 2021, from https://www.facebook.com/groups/autisminclusivity

Movement Matters. (2020, May 3). Occupational Therapy ABC. https://www.movementmatters.com/

 

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.

 

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.

 

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.