Tag

sensory processing

Bringing OT Activities Home for the Holidays

By | NESCA Notes 2021

By: Sarah Attanasio OT/s and Lauren Zeitler, MSOT, OTR/L
NESCA Occupational Therapist; Feeding Specialist

With the holiday season in full swing, families will soon be faced with the significant routine change that comes with school vacation. During this time, it is important to continue working on skills gained and techniques learned during school and therapy. Occupational therapy (OT) sessions often include activities to promote different skills, including visual perception, sequencing problem solving, and more! OTs also utilize movement activities to target sensory modulation, bilateral coordination, and force modulation to name a few. Here are some functional activities to do with your children at home to continue promoting skills learned in school and therapy while still getting into the holiday spirit.

Setting the table

OT skills addressed: visual perceptual skills, bilateral coordination, task sequencing, problem solving, force modulation, attention

Setting the table is an easy and functional way to promote the above  essential life skills in the home environment. First, this task requires children to problem solve and decide what items they need to set the table. Children then  scan their environment to locate and gather all necessary items. Next, children must safely carry all items to the table, which typically requires them to use both hands together. While doing this, they also scan their environment to make sure there are no obstacles in the way. Finally, children have to use an appropriate amount of force when placing items onto the table to ensure that these items do not break. They have to pay attention to the task at hand and problem solve where the correct spot on the table is for these items. To make this easier for children, try focusing on fewer skills, such as providing them with a picture of the proper place setting or laying items out on the counter already. To make this harder for children, have them carry heavy items to the table, such as a full pitcher of water or create obstacles for them to avoid on their way to the table.

Baking cookies

OT skills addressed: meal prep skills, task sequencing, direction following, tool usage, bilateral coordination, force modulation, sensory integration

Baking cookies is not only an entertaining activity for children, but it also promotes many important life skills! Making cookies requires children to follow the directions of a recipe. It also requires children to pay attention and appropriately measure the correct amounts of ingredients. They also have to explore how to appropriately and safely utilize various tools, such as a measuring cup, whisk, spatula, cookie cutters, a hot baking tray, etc. Cookie dough may be an unpleasant texture for some children since it is gooey or sticky. This activity gives children the opportunity to explore an unpleasant texture and trial strategies, such as wearing gloves, taking deep breaths, taking turns manipulating dough, etc., to better tolerate interacting with various unpleasant textures. Rolling the dough using both hands together and utilizing cookie cutters are two great ways to encourage bilateral coordination and increase hand strength. To incorporate more skills into this activity, such as visual perceptual skills, have your child decorate the cookies with icing and/or sprinkles making sure they stay within the boundaries of the cookie.

Decorating with paper snowflakes

OT skills addressed: task sequencing, visual perceptual/motor skills, bilateral coordination, scissor skills, coloring skills, hand eye coordination, hand strengthening

Paper snowflakes are a holiday decoration staple, and the process of making them promotes various  life skills. First, this task requires children to problem solve what kind of design they want their snowflake to be and fold the paper accordingly. They then are required  to use their hands together to cut out their desired design while holding the paper in one hand and the scissors properly in the other hand. Try having your child draw a pattern on the snowflake for them to follow while cutting or coloring in their snowflake within the boundaries. This can be done once it is cut out to further promote visual perceptual/motor skills and hand eye coordination.

Writing cards 

OT skills addressed: handwriting skills (grasp, letter formation/line placement/sizing/spacing/legibility, writing utensil usage, handwriting posture)

A handwritten note is a simple gesture that is always appreciated by all. Writing cards allows children to practice their handwriting skills in a functional way at home. First, it is important to maintain proper posture when doing any handwriting activity. Proper handwriting posture follows the 90-90-90 rule: feet are flat on the floor with ankles forming a 90-degree angle with the floor. Knees are bent at a 90-degree angle, and the hips and torso form a 90-degree angle. Using an elevated/slanted surface is also helpful in placing children in the optimal 15 degrees of wrist extension for handwriting activities. To promote proper grasp, have your child use broken crayons or a grip on their writing utensil. Provide your child with lined paper so they have a visual of where to place letters. The addition of a “worm line” underneath the bottom line is sometimes helpful for placing letters, such as g, j, p, q, and y. If handwriting is too high of a skill for your child, have them draw a picture including shapes, such as squares, triangles, and circles as these are necessary pre-writing skills to master.

Playing family games

OT skills addressed: rule following, turn taking, cooperative play

What better way to bond as a family than a family game night?! Games are great for children as they require rule following, tolerating an occasional change of rules, tolerating winning/losing, and turn taking. Many games also incorporate essential fine motor skills in terms of functional grasp, such as hi ho cherry-o, candy land, mancala, etc. and gross motor skills, including   balance and coordination with games like twister, yoga games, ring tosses, etc.

Play in the snow

OT skills addressed: sensory modulation, force modulation, gross motor skills, proprioceptive input for body awareness

If we are lucky enough to get snow this holiday season, playing in the snow is a great, versatile activity for children. Have children engage in a friendly snowball fight or throw snowballs at targets. This will promote hand eye coordination and force modulation ensuring that they aren’t throwing snowballs too hard to the point where they hurt someone or break something. Have children make snow angels to promote bilateral coordination and body awareness. Ask them questions like: Does the snow feel cold or hot on your body? Where do you feel the snow on your body? Is the snow wet or dry? Does the snow smell/taste/sound like anything? This line of questioning promotes body awareness and sensory modulation. Shoveling snow is also a great functional (and helpful!) heavy work activity that provides children with proprioceptive input (pressure on their joints) to help them better understand where their body is in space and promote overall body/spatial awareness. Another great heavy work activity is making a snowman, as it requires children to use both of their arms together to push large, heavy balls of snow along the snow-covered ground. The possibilities of functional activities involving snow are endless!

This list offers just  a few ideas of the many activities you can do with your children over school vacation. Many activities and games can be therapeutic and easily graded to any child. 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 for more activity ideas to motivate your child over break!

 

About the Author

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

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.

 

Buyer’s Guide 101: How to Shop for a Pediatric Occupational Therapist

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

As a parent of a child who has just been referred for Occupational Therapy (OT) services, the prospect of what to do next and where to go can be quite confusing. With so many providers in the area, it can be difficult to know who would be the right fit for your family. Typically, when you reach out to express interest in OT services at NESCA, Julie Robinson, OT, our department director, will have a personal phone call with you to help you through the process. As you conduct your search for the right fit for your child and family, here are some good questions you might ask to help you determine what works best. We’ve offered answers regarding NESCA’s services to let you know more about how we provide OT services.

What type of insurance do you take for occupational therapy?

Here at NESCA, we are in-network for BCBS and Allways, and we bill them directly on behalf of our patients.

How long are your OT sessions?

We spend 45 minutes directly with a child and another 5 – 10 minutes at the end of the session to consult with the caregiver. Other practices provide 30 or 38 minute sessions to compensate for decreases in insurance payments since the outset of Covid-19.

How long do we have to wait for an OT session? 

We can initiate an evaluation within 2 – 3 weeks of initial contact. If you have availability to bring your child in for treatment during the school day, there is no waitlist at this time. If you require sessions in the afterschool hours, there is a very small waitlist.

How many patients does a clinician typically see per week?

Some practices require their clinicians to perform as many as 30 or 32 patient hours per week to maximize their income. Here at NESCA, we cap patient hours at 26 per week. It is very important for us to focus on providing excellent clinical care to our clients with staff who are not burnt out or struggling to manage paperwork, treatment planning, and administrative activities, such as phone calls and emails to support our families. We are proud to offer research-backed services and want to provide our clinicians with ample time for continued opportunities for learning, allowing them to reach their highest level of potential and skill as a therapist – which they then pass on that knowledge and skill to our families.

What does your OT practice focus on?

At NESCA, our focus of therapy is based on a holistic view of a child to encourage life-long functional skill acquisition. We use a combination of sensory motor, sensory integration, developmental, and trauma-informed techniques, as well as practice and repetition of those techniques. We offer coaching on daily living skills to address weaknesses across a variety of areas: self-regulation, executive functions, self-care skills, such as dressing and bathing, handwriting and fine motor development, feeding, academic readiness, organization and attention. Other practices may utilize sensory integration or applied behavioral analysis as the basis for their program, for example.

Does the practice provide OT services in a clinical setting, remotely, at home, in school, or in the community?

Our primary service provision at NESCA is in the office or over teletherapy. In some instances, where schedules can be accommodated, we will provide services in the home, schools, or in the community. There may be additional travel fees involved for services outside of the office.

Does your OT practice offer comprehensive or second opinion evaluations for academic programming if needed?

NESCA does provide this service.

Will your practice consult with teachers or other caregivers if needed?

Yes. Sometimes additional fees are required, as insurance does not cover this service. We believe that consultation with outside providers is a critical part of our success!

Does your practice provide any specific programs outside of traditional sensory-motor based Occupational Therapy services?

At NESCA, we provide several specialty services in addition to traditional OT:

  • Feeding therapy
  • Safe and Sound Protocol for auditory sensitivity and self-regulation
  • Handwriting Without Tears
  • Trauma-informed Sensory Integration

What makes our clinicians so special?

One of the things that makes our occupational therapists an ideal match for your family is our love for children, the work we do, and our commitment to lifelong learning and the development of our clinical skills. Our entire OT department has known each other for at least four years, and we all came together as a team from another practice, with clinicians that are hand-picked by our director. We meet together on a weekly basis to share ideas and information, as well as to support each other in our clinical development.

For more information about NESCA’s Pediatric Occupational Therapy services, please visit: http://nesca-newton.com/occupational_therapy/ or submit an online Intake Form: https://nesca-newton.com/intake-form/.

 

About the Author

Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services or other clinical therapies, 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.

 

A Halloween for Those with Sensory Challenges

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

Halloween – a holiday full of tricks and treats. For some children, getting in the Halloween spirit by getting dressed up, carving pumpkins, and going trick-or-treating with friends is what they look forward to all year. For others, dressing up in an itchy costume, not being able to see someone’s face because they are wearing a spooky mask, being out in the dark with crowds of noisy trick-or-treaters, carving pumpkins and having to touch the oooey goooey insides of a pumpkin, and seeing decorations that make sudden noises or movements may make this holiday overwhelming for these children. Halloween can be tricky for families with children living with sensory processing difficulties, but with some creativity and planning ahead, families can build their toolboxes with their own tricks to combat the challenges that come with Halloween so their child can enjoy the treats that Halloween has to offer.

Here are some tricks for some common challenges that Halloween brings up:

Prepare for the day

Have an open discussion with your child about the traditions and activities associated with Halloween. You can read Halloween-themed books or watch Halloween movies (perhaps not the really scary ones!) to prepare your child for what to expect, because the anticipation of a new routine or anticipation of participating in unfamiliar activities can cause stress on a child. Discuss the plan for Halloween regarding decorations, attending parties, going trick-or-treating, etc., ahead of time so the child knows what to expect when celebrating the holiday. Consider the use of a visual picture schedule with activities that may be added into your typical routine. Provide ample warnings for transitions, when possible, to give your child time to move from one activity to another.

Be creative and imaginative with your child’s costume

The most important aspect of a costume for a child with sensory processing difficulties is ensuring that the costume is comfortable. Certain costume material may be itchy or scratchy, costumes with masks may occlude a child’s vision or be too tight on their head, or make-up may smell off-putting to a child. Children should have the opportunity to try on their costume when walking, sitting, and reaching for things before wearing it for real to make sure they are comfortable moving around in it. It is important to remember the idea of “less is more” and to use your imagination when coming up with costume ideas. For example, if a child wants to be a superhero, consider attaching a superhero logo to the front of a shirt they wear regularly rather than having your child wear a full superhero one-piece costume that may be itchy, tight, and hot.

Choose activities that best fit your child’s sensory needs

Meaningful participation in Halloween festivities doesn’t just include carving pumpkins and going trick-or-treating. Halloween activities can include roasting pumpkin seeds, setting out the candy bowl for trick-or-treaters, doing Halloween-themed crafts, etc. It is important for you to pick activities that best fit your child’s sensory needs. For example, if your child dislikes carving pumpkins because they have to touch the messy pumpkin insides, consider having your child paint their pumpkin or decorate it with stickers instead or make a pumpkin out of paper to decorate. If you and your child really want to go trick-or-treating but your child becomes overwhelmed with noisy crowds, consider trick-or-treating on only quiet side streets, or limit your time, allowing for breaks in between. If your child becomes overwhelmed with flashing lights, loud noises, or scary decorations, consider doing a drive-by of the neighborhood before taking your child out for trick-or-treating so you know which houses to avoid. For some children who crave a great deal of movement, it may be useful to engage in some heavy work activity before participating in a Halloween activity: wall push-ups, yoga poses, carrying weighty objects, for example. It may also be useful to engage in calming sensory activity to ease the transition from a busy setting back into the house: tactile materials like playdough or putty, water play, or a sensory table may be worth trying, or consider making a play tent or fort with quiet books or puzzles, or drawing to smooth the transition.

Monitor for overstimulation

Knowing when your child has had enough of Halloween festivities is just as important as knowing how to get your child engaged in them. A child may not be overstimulated at first, but may become overwhelmed minutes later. It is important to give your child choices of activities and next steps they can take as well as alerting your child about the sequence of events and the timeframe of events so that they know what to expect. If possible, help your child learn to advocate for themselves by saying things like, “please don’t touch me,” or “no thank you, I don’t want wear that,” in order to give them some autonomy over the activities that they participate in. However, in situations where this isn’t possible, it is important as the parent to know when to stop or disengage from festivities when sensory overload occurs and return home or to a quieter, more familiar space to give the child time to decompress.

Resources:

Enjoying Halloween With Sensory Challenges. (2021). Aota.org. https://www.aota.org/About-Occupational-Therapy/Patients-Clients/ChildrenAndYouth/halloween-sensory.aspx?fbclid=IwAR23ux4OKqJmXEZdnCIzb2_Uh0of55YKuCf8ek97UEAc1jZflndR_ZEBRwM

Morin, A. (2019, August 5). Halloween Challenges for Kids With Sensory Processing Issues and How to Help. Understood.org; Understood. https://www.understood.org/articles/en/halloween-challenges-for-kids-with-sensory-processing-issues-and-how-to-help

5 Ways to Help Children with Sensory Challenges Participate in Halloween Festivities. (2021). Aota.org. https://www.aota.org/Publications-News/ForTheMedia/PressReleases/2019/102419-Halloween-Tips-Sensory-Challenges.aspx

 

About the Author

Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services or other clinical therapies, 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.

 

Back to School: Tips for the Sensory-savvy Parent

By | NESCA Notes 2021

By Lauren Zeitler, MSOT, OTR/L
NESCA Occupational Therapist; Feeding Specialist

Just like that, summer is over and it is finally time for children to head back to school! This year might look a little different as we move from remote learning and ease back into the school building full time. For children with sensory processing issues, the school building poses a great deal of anxiety as they try to deal with various sensory stimuli. The noisy bus, smells of the cafeteria, and visually overwhelming classroom are just a few examples of the daily overstimulating experiences a student with sensory processing issues encounters. Don’t fret! We will break down the school day and the core sensory systems that are impacted along with strategies to help your student succeed.

Starting the Day: Auditory Processing

As the day starts, many children hop on the bus and ride to school. This means they are encountering a noisy, chaotic vehicle filled with many other children. You might see kids respond negatively by running away, crying, or holding hands over their ears to block out the noise. Startling easily, the bus ride can be a stressful start that will set the tone for the rest of the day for students with sensory issues. It is important to utilize different strategies to prepare your child for the bus. Try these ideas to help with auditory processing:

  • Provide over the ear noise canceling headphones to wear on the bus ride
  • Provide calming music on an iPod, etc. to listen to during bus ride
  • Wear a weighted vest or lap pad during bus ride
  • Provide heavy work input to the student’s body in the morning before entering the bus

Learning in the Classroom: Visual Processing

Walking into the classroom, there are bookcases lined up, posters on the walls, desks in rows, and lots of bright lights. When it comes to visual processing, children respond in different ways. Some children avoid these stimuli, while others seek out visual input. Squinting, blinking, and covering their eyes are just some of the quick fix responses to the bothersome lights. Some kids have trouble paying attention if there are too many things to look at. To some children, the flickering lightbulb in the corner of the ceiling is much more interesting than whatever the teacher has to say. It is very easy to become distracted and overwhelmed in the visually overstimulating classroom environment. Teachers: try these strategies to help with visual processing:

  • Remove distracting posters, pictures, etc. from the walls
  • Place busy bookcases, lockers, etc. in the back of the room
  • Have easily visually distracted children sit in the front of the room closest to the board
  • Provide a calming corner with a sensory bin filled with items, such as noise cancelling headphones, stuffed animals, lavender lotion, books, etc.

Time for Art Class: Tactile Processing

It is time for art class, and your child freezes at the doorway refusing to enter the room. Glitter and glue are everywhere, and the fear of being dirty strikes again. The feeling of touching messy media can send some children into panic fight or flight mode. This goes well beyond art class’s requirement to interact with different media, often branching out and impacting their ability to participate in social experiences, such as playing on the playground. To avoid overstimulation, prepare your child’s body with these strategies:

  • Prepare the student before art class by reviewing the schedule
  • Provide heavy work breaks, such as wall push-ups before entering the art room
  • Provide a weighted vest or lap pad to use during art class
  • Find adaptations to the art project to decrease interaction with sticky substances (i.e., using glue sticks, spoons to spread glitter, etc.)

Lunch in the Cafeteria: Olfactory and Gustatory Processing

It is now time for lunch. As your child walks into the cafeteria, they look around to find their friends and are greeted with a really strong smell. What is that?! Your child is no longer looking for their friends; instead, they are trying to find a way out because the smell is too overwhelming. Try these strategies to help kids with sensitive noses:

  • Find a place in the cafeteria that your child can eat away from the food serving area (where the smells are the strongest)
  • Provide an essential oil patch or roller ball that the student can smell to calm their body and move their focus away from the cafeteria smell
  • Use essential oils, such as lavender or eucalyptus, which help calm
  • Provide heavy work opportunities before entering the cafeteria to help organize the body

Once your child has gathered their food and found the best place to eat, they sit down and look at their meal. Oh gosh – why does it look so squishy? This sandwich is slimy – that is a big no! The gustatory – or taste system – kicks in, and it does not appear happy. What can we do to help kids with sensitive taste systems? Try these strategies to help make mealtime easier:

  • Provide lunch from home to help control what options the child has to eat during the day
  • Provide crunchy food items, such as pretzels, raw veggies (carrots, peppers, cucumbers, etc.), or popcorn to promote “heavy, organizing input” to the mouth and jaw
  • Provide thick drinks, such as smoothies, to drink through a straw
  • Promote drinking water through a water bottle with a mouth piece, such as those from Camelbak
  • Provide a special treat, such as licorice, Twizzlers, or sucker candy to provide alerting and organizing input

Gym Class Makes Me Nervous: Vestibular and Proprioceptive Processing

Afternoon gym class has arrived, and your student is too afraid to participate. Bumping into the wall, being hit by a ball, or playing in a coordinated group activity is hard for some children. Echoing voices and shoes squeaking on the floor, bright colors and moving objects are enough to overstimulate anyone. With the right environment, gym class can be fun for everyone! Here are some strategies to help with vestibular and proprioceptive processing in gym class:

  • Provide the opportunity for the student to leave the gym. Let them know that if the class becomes too overwhelming they can ask the teacher for a break. Going for a walk to the bathroom or grabbing water is a great, brief break.
  • Adapt games or activities as necessary. Students will be at different skill levels, and physical activity can present unique challenges. Provide simpler options when possible.
  • Create space boundaries. Using visual cues for personal space, and working in small groups can relieve anxiety. Visual cues may also be helpful in showing children where they should position themselves for games and exercises.
  • Provide activities that promote consistent, linear movements instead of sporadic, rotational movements, to help keep these sensory systems organized.

Remember to keep school fun! The school day is where kids spend most of their week, and we want to ensure they have the best experiences possible. Recognize that not all students with sensory processing issues will have the same strengths and difficulties. Meeting a student where they’re at and discovering their specific strengths is the greatest way to set them up for a successful school year! If you have any questions or to learn more about occupational therapy services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

About the Author

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

 

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.