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sophie bellenis

Visual Motor Integration Deep Dive – Part 1

By | NESCA Notes 2020

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

If your child is currently receiving occupational therapy services in either a sensory clinic or a school-based setting, it is likely that you have heard the phrase “visual motor integration (VMI).” It has possibly been described as the ability to “see something and then recreate it with a pencil,” or “coordination between the eyes and the hands to create an intended outcome.” While these phrases or simple definitions do give some insight into the skill, there are layers to understanding the intricacies of VMI and how it may affect someone in a classroom setting. Why is visual motor integration important? Why does this skill affect a child’s ability to successfully access their curriculum? And really, why do occupational therapists seem to be so focused on this foundational skill?

Let’s start by dissecting the phrase visual motor integration, as each word truly highlights an important aspect.

Visual.

In this sense, “visual” refers to the functional visual skills and visual perception. Functional visual skills include being able to follow along a horizontal, vertical or diagonal line with one’s eyes, as well as being able to account for depth by focusing on objects that are both close to the face (a book) and far away (the whiteboard). Clinically, these skills are referred to as visual tracking and convergence respectively. Visual perception is the brain’s ability to interpret the data that the eyes are seeing and turn it into meaningful information. This is not simply the ability to clearly see something, a skill that is often assessed by school nurses or optometrist. It is the ability to understand it. Visual perception is complex in its own right, but the specific details are for another time, or potentially another blog.

Motor.

Similar to visual skills, “motor” refers to one’s overall motor skills. This includes:

  • Fine motor control – the ability to use the small muscles in the hands to make coordinated movements;
  • Gross motor – the ability to use the large muscles in the body; and
  • Postural stability – the ability to create a supported foundation when sitting or standing; a child’s postural stability is hugely affected by their core muscles and their position when sitting.

Integration.

Some students have visual motor dysfunction because of a deficit in either their visual skills or their motor skills. They find using these two skills together difficult simply because one foundational piece is already affected. Conversely, some students have trouble with VMI simply because of this integration piece. Being able to use these two skills in conjunction with intention and coordination is a skill within itself. Through standardized assessment and clinical observation, occupational therapists should be able to determine the root cause of a child’s VMI dysfunction. This helps to guide appropriate intervention and accommodation. In some ways, visual motor integration is similar to hand-eye coordination.  Being able to recreate something that a child sees, such as a square, the letter “A” or a horizontal line is truly using VMI skills.

Next week, we’ll dive further into VMI and how it serves as a foundational skill for academics, its impact on learning and the output students produce.

 

About the Author

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

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

 

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

 

The Therapeutic Great Outdoors—Part 2

By | NESCA Notes 2020

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

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

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

 

About the Author

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

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

 

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

 

The Therapeutic Great Outdoors—Part 1

By | NESCA Notes 2020

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

Aside from a spring snowfall this week, it looks like springtime may have truly arrived here in New England. Flowers are popping up on trees, the peepers and morning birds are singing and the warm sun is finally convincing most of us to leave the coats and hats inside. Now more than ever, the opportunity for children to get outside seems like a welcome reprieve from the weeks either cooped up or bundled up.  Mother Nature is a fabulous teacher and has created the perfect environment for children to work on building some of their fine motor, visual motor and sensory skills. This week, we’ll explore five of 10 creative ways to use the outdoors as the classroom, OT gym or playground that it can be! Check back next Tuesday for the next five!

  1. Get Dirty! Thankfully, some of the simplest activities work on the most skills. Letting kids get as dirty as they can works on building sensory tolerance. Digging in the dirt builds hand strength and endurance. Squatting down to play in the mud builds gross motor coordination and whole-body control. Consider bringing out utensils, cups and bowls and so your children can practice scooping, pouring and mixing!
  2. Plant a Garden. Take playing in the dirt one step further by incorporating the steps to planting a garden. This “garden” could be flower or veggie patch, a planter or just a little pot to keep on the window sill. Children work on isolating one finger by poking a hole in the soil, a pincer grasp by picking up small seeds between their thumb and pointer finger and hand strength by digging holes and burying seeds. This is also a great opportunity for children to practice the responsibility of watering plants every day. Add in some math review by having them measure the height of their plants and recording the information in a table.
  3. Climb Trees. The age-old activity of climbing trees works on building gross motor coordination, muscle strength and motor planning. To incorporate some visual skills practice, have children bring “binoculars,” or two toilet paper rolls taped together, to seek out different things that they can see from a new vantage point.
  4. Nature Scavenger Hunt. Scavenger hunts are an excellent way to target building visual skills as they prompt kids to scan their environment, search for specific things in a busy visual field and ignore the overwhelming amount of visual stimulation around them. Bring in a sensory element by asking children to observe, feel and smell each of their treasures. Check out this fabulous Egg Carton Nature Scavenger Hunt created by The Silvan Reverie.
  5. Build a Fort. Encourage kids to use their imagination and build outside. Provide them with twine or string, an old sheet, and a hammer and nails (if they can use them safely). If they are not ready to use these tools, they can practice propping sticks up against a tree to build a lean-to or gathering sticks and branches to make a platform to sit on. All of these options require motor planning, trial and error, and get kids to move their bodies.

 

About the Author

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

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

 

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

 

Helping Children Transition from One Activity to the Next

By | NESCA Notes 2020

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

Here at NESCA we often talk about Transition as the process by which an adolescent or young adult develops the necessary skills to function independently in the adult world (Big “T”), but many younger students are working to master much smaller transitions throughout the day (little “t’s”). Classroom teachers are all acutely aware of the difficulty that some student have when transitioning back from activities, such as lunch, recess, physical education or art class. These students also frequently struggle switching from math to English or social studies to science. It is a balancing act when determining what is a reasonable expectation and what supports we may need to build in for our kids to be successful during these times. Here are some tips to try at home, as parents continue to take on the role of teacher and attempt to keep children on task and sticking to a schedule.

  • Give warnings. Some children just need a quick heads-up, such as, “In 5 minutes we will be heading inside to practice your math problems!” Other children may need repetition, with 5-minute, 3-minute and 1-minute warnings. Consider using a timer if your children seem hesitant to believe that it has truly been a whole 5 minutes!
  • Remember that children love to finish! Allow adequate time for kids to complete the project or activity that they are so diligently working on. If this is not possible, identify a specific time that they can come back to the project. For example, “It’s time for you to move onto your math homework, but at 1 o’clock you can take out your art supplies and finish your picture. 1 o’clock will probably be right after we eat lunch.”
  • Use movement. Movement breaks or “brain breaks” are often great transition activities between two sedentary tasks. If a student is transitioning from Delta Math online to a reading comprehension activity, movement can help them re-regulate their bodies and wake up their nervous system a little bit. Getting outside for a quick run around the backyard, kicking a soccer ball back and forth or doing 10 jumping jacks are great outdoor options. On rainy days or when there is limited outdoor space, consider videos from GoNoodle, Cosmic Kids Yoga or The Learning Station YouTube Channel. Try to keep these movement breaks to under 5 minutes so that children do not lose their focus.
  • Use calming activities. While movement breaks may be a great option between two low energy tasks, kids may need a different strategy to help them transition back to schoolwork from a high energy activity. This is the case for many of our students after lunch in a traditional school setting. Creating a calming environment (i.e. soft music, low light and minimal distractions) and allowing children to choose one peaceful activity, such as coloring, building with Legos or reading a favorite book, to focus on for 10 minutes can help them calm their bodies and prepare for work. Make sure that it is something they truly enjoy.
  • Try a transition “cue.” A transition cue is really any prompt that is used to notify a child that it is about to be time to switch activities. It acts as a concrete representation of the upcoming shift. These prompts can be auditory, visual or tactile. Examples of each include:
    • Auditory – Many teachers use songs as auditory cues throughout the day. From the Welcome Song to The Clean Up Song, teachers prompt their students to change their behavior and get ready for the next activity of the day through song. If you do not feel comfortable singing at home or this feels too immature for your child, consider picking a song to play when it is time to start transitioning. Challenge your student to be ready for the next activity by the end of the song. Provide a direct explanation of expectations, such as, “By the end of this song I want to see the table clear of your art materials, your science notebook in front of you, and you seated at the table with a pencil.”
    • Visual – Visual cues could include a transition card that is carefully placed next a child 5-minutes before they need to move to a new activity, a visual timer or even a pre-agreed upon hand signal.
    • Tactile – Tactile cues are less frequently used in the school setting, but may be helpful at home. Some children benefit from a transition object, such as a fidget, a ball or favorite stuffed animal to hold and play with while a new activity is being set up.
  • Give feedback and teach children to self-monitor. Make sure to give feedback on both the positives and the negatives. Many children thrive on positive reinforcement and love having their successes highlighted. Consider including children in this process and allowing them to reflect on how they did during a transition. Use questions such as, “How did playing that song work for you? Was it helpful?” or “I noticed that you had a hard time calming down after we played outside today, do you think that coloring or a listening to a book on tape would help? What do you think might work for you?” Giving our children the language they need to describe how they are feeling and experiencing this learning process will help them to develop the ability to self-monitor and reflect on their own performance.

As we all do our best to get through these unique times, remember that sometimes the littlest things are the most difficult. Accept that our children are almost all still building the ability to transition successfully, and they will need time to practice, especially in the new remote learning environment.

 

About the Author

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

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

 

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

 

Skill Highlight: Touch Typing!

By | NESCA Notes 2020

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

As you are sitting at home with your child and working to find a reasonable balance of academics, physical movement, chores, social time and relaxation, one specific skill to consider targeting is touch typing or keyboarding. As we move further and further into the digital age and, more recently, an unprecedented era of remote learning, the ability to successfully type and get ideas onto the screen is paramount. We often joke that our children are more technologically adept that we are, as they easily navigate between iPad apps and turn on anything with a screen. While this is, in many ways, true, two things I constantly observe in students are the propensity to type with just their pointer fingers (hunt and peck method) and that they initially learn about a keyboard for games rather than academics.

As their fingers fly around the keyboard, I am often asked, “Why does it matter if they can use all ten fingers? Who cares if they are typing with two fingers if they are getting the information out of their head?” These are all great questions, and I hope to answer and provide clarity around the ones I hear most frequently.

Why does ten-finger, touch-typing matter?

Massachusetts State Guidelines recommend that a student should be typing at a speed of 5 times their grade level with 80-95% accuracy. For example, a third grader should be typing at 15 words per minute (3 x 5), and a seventh grader should be typing at about 35 words per minute (7 x 5). Following this formula, by graduation, a senior in high school should type with a speed of at least 60 words per minute, a functional speed for an adult in most professions.

While it is likely that some third grade students can use two fingers and type at a rate of 15 words per minute, as these students get older and the demand increases, it is unlikely they will be able to keep up with these guidelines if they have not been taught a functional typing approach.

That may be true for some students, but I promise my child is able to type quickly! Can I just let her teach herself?

While children may be able to type quickly using their own typing method, ten-finger typing uses almost of all of the intrinsic hand muscles to complete the task. This means that children are much less likely to feel fine motor fatigue than if they were using two or three fingers. While this may not matter for a young student typing a paragraph, it will absolutely affect a high school student who is working on a 10- or 15-page paper. Teaching the correct approach will set young students up for future success.

Is it okay to start later in elementary school? My student is still working on handwriting.

There are some mixed opinions on the best time to start teaching keyboarding. I personally recommend first or second grade as an appropriate starting point. At this level, most students can identify their letters and are used to using computers to some extent. As with most motor tasks, practice makes perfect, and the more time our children spend using all ten fingers to type, the better at it they will be. It is perfectly fine to learn handwriting and keyboarding simultaneously.

How much time do you recommend my child spends practicing?

I recommend students practice for about 20-30 minutes at a time. This allows time for direct practice, as well as time for playing games that promote correct finger placement. If a student can do this practice two to three times a week, they will absolutely start to develop the motor patterns necessary and commit them to muscle memory.

What are your thoughts on speech-to-text software?

Speech-to-text software programs are excellent tools when they are used with the right student. They increase accessibility, help students get information on the page and can increase the speed at which a student completes their work. I am hesitant to introduce these tools too early or with the wrong student.  The need to type will not go away and not all programs can support a speech-to-text option. Additionally, in an academic setting, using a speech-to-text option requires a student to have extra testing accommodations, such as a separate room for testing and 1:1 test administration. For some of our students, this is exactly what they need for success, but for others these accommodations are not reasonable or necessary.

Can I leave my child to practice on their own?

Children quickly slip back into old habits. I recommend keeping a watchful eye to ensure that a ten-finger approach is truly being practiced.

Is there anything else I should consider?

Yes! Make sure to consider your child’s posture as they sit at the computer. Ideally, ankles, knees, hips and elbows should all be at 90 degrees, while wrists should be “neutral” or flat.

Where can I go to find lessons or tutorials for my child?

Great Question! Fortunately, there are many excellent online options to help teach children how to type. Some free online sites that directly teach and help to practice ten-finger typing include www.typingclub.com and www.typing.com. Other reasonably priced options include Typing Instructor for Kids Platinum, Mavis Beacon Keyboarding Kidz and Mickey’s Typing Adventure. For more entertaining, game-based practice, take a look at www.abcya.com and www.typinggames.zone.

 

About the Author

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

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

 

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

 

An OT’s Guide to Home Learning: Board Games and Puzzles

By | NESCA Notes 2020

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

As social distancing recommendations, stay-at-home orders and shelter-in-place mandates continue to keep families confined to the home, parents are quickly being asked to take on the roles of teacher, therapist, warden, work-from-home professional, best friend and more. For parents of children with special needs and learning differences, this can feel extra daunting. There are countless online resources providing specific in-home activities, recommendations, and suggestions for working on targeted skills (e.g., literacy, fine motor, sensory integration, gross motor, etc.) in the home. It’s easy to get quickly overwhelmed by the onslaught of information.

While I believe there are many useful and creative free resources available online (I’ve written some of them!), our “new normal” includes many barriers to easy implementation including time, expertise, resources and confidence. Today, I want to share how some fun activities involving board games that you may already have in your home could make the task of keeping children engaged, interested and learning a little bit easier. Our game makers are getting increasingly creative and aware of their role in helping children build their skills, and the games listed below are just a few of the many options available.

5 Board Games for Development of Visual Perception

  • Connect 4 – Playing Connect 4 with the traditional rules requires kids to track horizontally, vertically and diagonally with their eyes. They need to visualize where their checker will land and place it in the correct spot at the top. Additionally, children need to monitor two colors at a time to ensure that they do not need to block their opponent on their next turn. For younger children, consider using the board to practice patterns or make shapes out of one color.
  • Quirkle – Quirkle combines colors, shapes and a grid pattern to create an interactive game for children to play with their parents. It promotes form perception, visual discrimination, tracking and matching.
  • Dominoes – There are many different games that can be played with Dominoes, making it easy to scaffold the activity for all different ages. Dominoes works on many of the same skills as Quirkle, but really allows children to practice visual figure ground. Figure ground is the ability to distinguish relevant information from a busy or overwhelming background. Dominoes have lots of different colored little dots in different patterns and alignments allowing children to practice this skill. Notably, Dominoes often have a tactile aspect allowing children to both see and feel the dots.
  • Spot it! / Spot it Jr! – Spot it! has quickly become a favorite game of occupational therapists, speech language pathologists and school psychologists alike. It practices a multitude of important skills. In terms of visual perception, Spot it! focuses on visual discrimination, hand-eye coordination, attention to detail, figure ground and more. Due to its popularity, Spot it! has provided us with an excellent variety of specific versions, such as Alphabet, NFL, Gone Camping, Animals, as well as substantial Spot it Jr.! options.
  • Memory – Unsurprisingly, the game Memory works on increasing visual memory! Children have to remember which cards they have picked, where they are on a grid and where the matches are. There are lots of options to order online, but this can absolutely be played used playing cards or DIY pictures drawn on pieces of paper. Children are also able to practice pronation/supination by flipping over the cards and placing them back down on the table.

 5 Board Games for Development of Fine Motor Skills

  • Trouble – Trouble allows children to work on building hand strength as they push down the pop-o-matic die roller. Try to ensure that children are using the muscles in their hands and fingers to push down, and limit the amount of body weight they use to help them push down. Additionally, children practice a pincer grasp as they pinch their pegs to move them around the board.
  • Hi-Ho! Cherry-O! – This game includes little plastic fruit that need to be placed in a basket to promote a pincer grasp and a spinner board that helps teach kids to flick or push a spinner.
  • BedBugs – Tongs and tweezers are part of an OT’s go-to toolbox as they promote fine motor precision, keeping an open webspace, and hand strength and coordination. This game is for children age 4 and up and provides each player with their own tongs to try and catch little bouncy bugs on a bed. Add a layer of complexity by having kids each try to catch one color!
  • Avalanche Fruit Stand – Another game that incorporates tweezers, Avalanche Fruit Stand promotes grip strength, pincer grasp and problem-solving as children need to balance different fruits on a stand. There is also a spinner to add in another element.
  • Hungry Hungry Hippos – Use this game to practice finger isolation and increase finger/hand strength. Encourage your children to use one finger at a time to depress the lever and make their hippo eat the marbles. Try switching fingers for each round.

*Bonus!* While many of these games work on more than one skill at a time, one age-old recreational activity that targets visual perception, visual motor integration and fine motor skill is simply completing a puzzle. Focus on teaching strategy and problem-solving by having your children start with the edge pieces, organize by color or choose one figure or character in the puzzle to build independently.

About the Author

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

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

 

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

 

Five Tips for Promoting Fine Motor Development in the Home!

By | NESCA Notes 2020

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

  • Writing on a vertical surface is a great way to promote proper hand/wrist positioning and fine motor growth – try taping paper to an easel or to the wall and allowing them to try writing on this plane.
  • Skip the fat pencils for our little learners. While specific adapted writing utensils for children with fine motor needs can be best assessed by an occupational therapist, for the majority of our young learners, the rule “the object promotes the grasp!” is applicable. If we want our learners to be building strength and learning proper hand positioning, I suggest trying either a standard number 2 pencil or a mini golf pencil.
  • Let your children peel off and stick on their own stickers! In reality this could end up with some ripped stickers or extra time spent on a project, but peeling off stickers promotes a pincer grasp, bilateral coordination and visual motor integration. If your child is too young to find the edge and begin to peel, consider starting the sticker and then letting them finish peeling it off independently.
  • Use scissors to cut anything and everything! While supplies of construction paper and worksheets sent home from school may be dwindling, consider letting your children cut up junk mail (make sure it’s sanitized), old magazines, newspapers and scraps of old cloth. Some of our kids will want to use these scraps to create a collage or other art projects, while others will simply enjoy the act of shredding. You can make this activity accessible for really young kids by simply having them tear the paper with both hands.
  • Bring out the tool box! Twisting a bolt onto a screw, using a wrench to tighten a hex-nut and using a hammer to pull nails out of a block of wood all help with fine motor and increasing strength. For more of a visual perception task, considering mixing all of the screws, nails and bolts together and having your child sort them into different bowls or containers.

 

About the Author

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

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

 

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

 

Remote Real-life Skills Coaching: How Does it Work?

By | NESCA Notes 2020

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

What is life skills coaching?

Coaching services in general aim to target functional life skills and help our children and adolescents to slowly build the ability to independent. While some of these skills, such as taking Uber, riding the T, or ordering in a restaurant, cannot be targeted using an online platform, the majority of these skills can absolutely be built with the help of a dedicated remote coach. Currently, many of our coaches are helping students through the great task of processing a huge life change in response to the COVID19 virus.

What skills can be worked on with a remote coach?

Hard skills are often thought of as specific, functional abilities that one can develop and perform. (In employment, these are often thought of as technical skills.) Options that can be worked on with a remote coach include cooking based on a specific recipe, ordering groceries on-line, calling to refill prescription, setting up a medication management system, typing, using Google classroom or Microsoft suite, electronic calendar management, etc.

Soft Skills include more abstract and broad abilities that are necessary for employment, academic success, and community independence. NESCA coaches work on executive function, social communication, and self-determination skills necessary for long-term independence at home, in school, and at work. Example skills taught include creating daily schedules, goal setting, preparing for interviews, organizing the home environment in order to be productive, reading and understanding IEPs and assessments, using technology to support memory, customer service skills, research skills, and more.

With the current pace and routine of life changing dramatically, NESCA coaches are working to help our clients establish healthy routines and habits. Coaches are available to help develop functional morning and evening routines, set up weekly to-do lists, develop a system to meet deadlines, use online resources for virtual learning, etc.

Who can benefit from this service?

Almost all adolescents and young adults could benefit from building life (and career or college readiness) skills, increasing independence, and practicing executive function; however, our neurodiverse population often has particular difficulty with changes in routine and greatly benefits from having a relational support to build structure and navigate change. All of our coaches have extensive experience working with adolescents and young adults with a wide range of learning, developmental, physical and social-emotional needs. NESCA is committed to helping young people who are struggling with this transition as well as families who are eager to use this unique situational opportunity to focus on skill building at home that is often difficult to fit in simultaneous to normal school demands.

What is a recommended coaching schedule?

Due to the individualized natural of coaching, the schedule and frequency can be incredibly personalized for each individual client. All of our coaching sessions begin with an intake process that includes input from both the adolescent and their family. Schedules are often developed in collaboration with the teen or young adult, the family, and the coach to best meet the client’s needs. Some example schedules that are used by current NESCA clients include:

  • Weekly Skill Building. Clients who are looking to target specific skills often choose to do a weekly session focus on learning and repetition.
  • Monday, Wednesday, Friday 30 Minute Check-ins. This model allows for a student to receive some guidance creating their own scheduling, while simultaneously holding them accountable.
  • Monday Motivation/Friday Follow-up! These sessions range from 1-2 hours and include weekly goal setting, check-ins regarding a weekly to-do list, and personal scheduling. For many clients a Friday follow-up session is an important opportunity to practice self-monitoring and review the previous week.

As somebody who coaches students in person and remotely, what differences do you notice?

I find that the main difference when coaching students remotely is when and how skills are targeted. In person, much of my coaching focuses on community integration, using our transit systems, and navigating the complex social interactions that are necessary when out in the community. Remote coaching can still target pieces of each of these skill areas but the process is in many ways more intrinsic. We may focus on learning to use the internet to find community opportunities, learning to create schedules for travel or complete applications for para-transit, using video learning to “try out” travel, employment, and community activities, and bolstering social media skills. We focused on building global skills in new ways that will help in the future, across environments. For instance, social communication by phone and video conferencing is a skill that will support social and employment success in the future.

In terms of the personal connection and opportunity to build rapport, I find that some teenagers are incredibly adept at communicating over a digital medium. Those who are not, tend to learn quickly. I am continually impressed by their ability to focus, discuss real-life topics, and build skills remotely.

 

About the Author

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

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, Transition Services, or Virtual Coaching 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.

 

School-based Occupational Therapy at Home

By | NESCA Notes 2020

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

While school districts and government officials work to plan for the current “new normal,” no concrete decisions have been made about the delivery of special education and provider services. As parents take on the huge task of educating within the home, it is important to consider how we can bolster some of the skills that are continuously targeted in the school setting. As an occupational therapist, I have provided direct services and worked with teachers who are adeptly teaching a class of 20, while simultaneously making sure that their two students with OT needs are being provided appropriate accommodations and motor practice. Here are some activities that can be done in the home to keep the development and learning going!

If your child’s occupational therapy (OT) evaluation mentions difficulty with fine motor coordination, consider incorporating these activities into your day.

  • Sort marbles, pompom or coins. Using fingers to pinch and pick up small objects helps to build strength and solidify grasp and grip patterns. Increase the difficulty of this activity by having kids push pompom and marbles through small holes or manipulate coins through slits in a tub or box.
  • Play with playdough or putty. Make shapes using cookie cutters, push beads into putty and pull them all out, roll playdough into a snake and use different pinches to create patterns from head to tail. Pinches to consider include: thumb and index finger, thumb and index+middle finger and thumb against the side of the index finger (lateral pinch).
  • String beads, cheerios or pasta with holes. This activity promotes bilateral coordination, fine motor control and grasp patterns. Scaffold this activity by starting with threading on pipe cleaners, moving to dry spaghetti and finally working to thread onto string.
  • Practice using tweezers to pick up small objects.

If your child’s OT evaluation mentions difficulty with visual perception or visual motor integration, try these!

  • Puzzles! Doing a puzzle requires multiple visual perceptual skills, as well as the fine motor precision to fit pieces together.
  • Word searches. Word searches require horizontal and vertical tracking, letter discrimination and visual figure ground ability. Consider scaffolding this activity by finding word searches that only have horizontal words, have both horizontal and vertical, or have horizontal, vertical and diagonal words.
  • Sorting activities. Objects can be sorted by color, shape, size, texture and a plethora of other characteristics. Consider using objects found in the home, such as pens, buttons, silverware or simply items in a junk drawer for sorting activities.
  • Mazes, Hidden Pictures and Spot the Difference activities can all be found online.
  • Copying activities. Draw pictures using horizontal, vertical and diagonal lines, circles, squares, triangles and crosses and have your child try to copy them exactly. This activity works on visual motor integration specifically.

If your child’s OT evaluation mentions difficulty with endurance, postural stability or core strength, try these!

  • Draw or play while lying on the ground. Tummy time is often thought of as an activity to help our newborns, but lying on your tummy and using the muscles needed to keep the upper body and head stable can be beneficial for building strength in most of our kids.
  • Yoga! Incorporate an online video or movement break into your daily routine.
  • Pretend to be different animals! Walk like a bear, slither like a snake, hop like a frog or trot like a horse. Mimicking these animals is a great activity to do while listening to music and uses all different muscles.

While it can be difficult to target our children’s specific needs without direct access to therapists and our usual resources, building in small activities throughout the day can help to maintain strength, skill development and the foundational abilities needed for academic growth.

 

About the Author

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

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

 

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

 

Making the Most of COVID-19 School Closures

By | NESCA Notes 2020

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

COVID-19 was recently declared a pandemic by the World Health Organization (WHO), and it is quickly becoming a pervasive force that we are all attuned to. As our healthcare providers, scientists and officials focus their energy on social distancing recommendations and public health measures, it seems as if time spent at home with our families – whether self-imposed or mandated – is inevitable. With our hardworking community members and officials focused on large-scale responses and issues, let’s take some time to discuss how we can create positive and productive environments in our own homes with our children while so many schools are closed.

  • Create Routines – Our children thrive on routine. Consider keeping their regular bedtime and morning routines, sitting down for lunch at the same time as they do at school, and writing out a daily schedule so that they know the plan for the day. Keeping these small things consistent can help our kids to feel regulated, calm and make a potentially scary situation feel much more predictable.
  • Request Work from Classroom Teachers – Most teachers will be sending home classwork to keep children engaged while they are out of the classroom. Make sure to request passwords to online learning sites used at school (raz-kids.com, IXL.com, etc.), have access to books at an appropriate reading level, ask about sites that provide printable worksheets, and, if still in school, bring home worksheets that could be completed during time off.
  • Schedule Recess/Playtime – While home is often seen as a place to relax and have fun, scheduling recess or play/downtime may help kids to feel like there is more of a routine. An average day at elementary schools fluctuates between time spent on learning, time to process and reflect, and time to have some fun. With an extended stay at home, it may help to touch on all of these activities. Scheduled recess allows for a child to predict when they will have a break to move their bodies and decompress.
  • Use Screens Wisely – Many parents will no doubt be working from home and have significant to-do lists of their own. While watching movies and favorite TV shows is likely an inevitable – and in many ways beneficial – tool to pass the time, consider exploring some more educational screen-based options as part of your child’s day. Resources such as National Geographic Kids, PBS KIDS.org, ScienceDaily.com, educationworld.com, TIME For Kids, Smithsonian Tween Tribune, among others can help to provide more academic content, including Social Studies, Science, Current Events and more. Commonsensemedia.org is also a great resource for finding age appropriate options.
  • Move Your Body – While getting outside for some fresh air is the ideal way for our children to move their bodies, this may not be an option. Thankfully, there are some creative ways to make sure our kids get in time for gross motor movement. Consider options such as GoNoodle.com, Cosmickids.com and Gaia.com for whole body movement and yoga videos. If you are looking for options other than video-based activities, consider building a pillow fort, keeping balloons off of the ground, having a dance party or setting up a home-made obstacle course.
  • Bolster Life Skills Education – As Kelley Challen, NESCA’s Director of Transition, so aptly explained in her blog post, the process of teaching our kids to become functional adults starts at birth. Consider spending this time teaching some skills in the home: have kids help with the process of doing a whole load of laundry from start to finish, work through a recipe for dinner together or clean surfaces around the house while explaining how to safely use different cleaning products. All of these experiences help a child to understand their future role as independent adults.
  • Work on the Broader Executive Functioning (EF) Skills – EF includes skills such as problem solving, time management, goal setting and organization. Provide sorting activities, have a child create their own schedule, set a daily goal, practice telling time or play some problem-solving games such as Heads-up, Charades or Guess Who.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. In addition to her work at NESCA, Dr. Bellenis works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual skills must be taken into account to create comprehensive educational programming.
To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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