Play Therapy Games for Children with Developmental Delays

When I work on specific skills for students with developmental delays, I always incorporate play therapy. Whether we are working on fine motor, gross motor, or perceptual skills, I make sure that the activities are fun for the child.

Working as a pediatric occupational therapist is a fun and challenging experience. I see children with a variety of diagnoses and I incorporate play therapy into my treatment on a daily basis. Because children learn as they play I carefully assess their areas of challenge as they play and work on those skill areas during play activities. The skills that I address include fine motor, gross motor, social, cognitive, and sometimes speech and language skills (usually working closely with a speech pathologist).

It can be fun, yet challenging to come up with play activities to address each of the skill areas listed above. A child may not have weaknesses in every area, but I typically incorporate all areas into a play therapy session just for skill practice.

 Here are some suggestions of play activities to work on each skill area:

Fine Motor Skills:

-        Legos

-        Play Dough

-        Magnadoodle

-        Bead Stringing

-        Block Stacking

Gross Motor Skills

-        Hokey Pokey

-        Simon Says

-        Hop Scotch

-        Rover-Rover

-        Obstacle Courses

-        Jump Rope

Social Skills

-        Social Stories

-        Board Games

-        Bingo

-        Card Games

Cognitive Skills

-        Puzzles

-        Mazes

-        Hidden Pictures

-        Concept Games

-        Concentration Card Game

Speech/Language 

-        Which one Doesn’t Belong?

-        I Spy Game

-        What color is the…?

-        Matching Games

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Keyboarding Practice

Keyboarding practice can be a major headache or it can be tons of fun! If I have the choice, I prefer to make it fun for my students, and the best way to do that is to use the many free online resources for typing practice that are available. So I thought I'd share some of my favorite websites that have keyboarding practice games and information. Have fun and practice typing every day!

Type a Balloon

Keyboard Revolution

Meteor Typing Revolution

Dance Mat Typing

Race Car Typing

Spacebar Invaders

Typing Bubbles

Elearning

TypingWeb

Type Master

Typing Games

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Ataxia

An individual with ataxia has rapid muscle tone fluctuation which can vary from low to normal tone. Because ataxia is a movement disorder, it can have a disorganizing effect on day-to-day functioning. The fluctuation of muscle tone is most observable in the arms and hands, but it also occurs in the trunk and oculomotor (visual-motor) system. With ataxia, stretch reflexes and balance reactions are frequently exaggerated leading to problems with balance and coordination.

Here are some suggestions for working with students who have ataxia:

-Work close to the body or trunk with consistent placement of the hands.

-Provide firm pressure- pull the rib cage down with heavy, consistent control.

-Work to develop control of a few midrange positions and postures.

-Include exercises to strengthen the triceps.

-Always work rhythmically and predictably.

-Provide a source of support for stability, such a something to hold onto while working.

-If the child is mobile, provide support and guidance while walking and have the child visually search for objects so he will not stabilize using the visual (occulomotor) system for compensation, which can be a safety hazard.

-Always tell the child when you are changing activities or placement of materials.

-Place objects in the same spot repeatedly for consistency.

-Work on dycem or other non-skid material for stability.

-Provide heavy toys to play with or use weighted wrist cuffs (consult a therapist to see which weight is most appropriate for each individual child)

-Use firm theraputty for hand exercise.

-Weighted utensils, and weighted pens and weighted pencils are good.

-Be aware of potential fatigue issues and provide frequent breaks if necessary.

-Always consult a physical or occupational therapist if you have specific questions when working with a student with ataxia.

For more information on ataxia, consult the following website: http://www.ataxia.org/learn/ataxia-diagnosis.aspx 

Photo Credit: Ambro @ freedigitalphotos.net

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Tummy Time Tips

     I guess it's because I'm a therapist, but moms frequently ask me, “Is tummy time really that important?”  This is an important and valid question, and every parent needs to know the answer. Tummy time plays a critical role in infant development, as it provides a base for motor skills such as head control, rolling over, and pulling up.

     Tummy time is especially important now that that the American Academy of Pediatrics (AAP) recommends that all babies sleep on their backs. Prior to 1992, most babies in the United States slept on their stomachs, but years of scientific research revealed that infants were approximately 12 times more likely to be found on their stomachs than on their backs when they had died of Sudden Infant Death Syndrome (SIDS). So in 1992 the AAP formally recommended that all infants be placed to sleep on their backs or sides to reduce the risk of SIDS. Later, the side position was eliminated from the recommendation because infants could roll from their sides to their stomachs during sleep. Since this extremely successful marketing campaign, 50% fewer infants have died from SIDS. Putting babies to sleep on their backs turned out to be a simple and effective way to save the lives of infants.

     Eventually, pediatricians and therapists noticed a sudden rise in infants diagnosed with flat spots on the head, and they also noticed an increase in the number of infants with mild delays in gross motor skills, such as rolling over and pulling up. Evidently, many parents were not positioning their infants on the tummy for play out of a fear of SIDS, and this limited tummy time was having some negative consequences. In 1996, the AAP formally recommended that parents provide babies with supervised playtime on the stomach to promote growth and development and prevent flat spots from forming on the head.

     My research has revealed that many infants resist being placed on the belly. This is probably because they aren’t familiar with tummy time and haven’t gained the head control and upper body strength that is necessary to maintain the position comfortably. But rest assured, with time and a few basic and very beneficial techniques, any infant can learn to tolerate tummy time. There is a solution to the problem, and there are ways to introduce tummy time and increase tolerance without making a parents’ and baby’s life miserable. In fact, it can be the total opposite of miserable. Tummy time provides an opportunity to spend one on one time with baby and create a special bond that can last a lifetime!

     In the beginning you should set up a regular schedule for tummy time. You can plan to carry it out after naps or after diaper changes, just be sure to have a plan in place. A general guideline should be that half of the time that baby spends for play should be on the tummy, and remember, it is important to vary your baby’s position every 15 to 20 minutes during playtime. It is important to be aware that tummy time is any combination of positions in which your infant is NOT on the back and encourages baby to use the back, shoulder and neck muscles. This includes time spent in your arms and on your lap. Most importantly, don’t look upon tummy time as a chore, keep in mind that this special time is an important part of baby’s daily routine, which provides an opportunity to bond and develop the close relationship with your infant that you’ve always dreamed of.

Also, for more information about tummy time as well as some wonderful brochures and handouts, visit http://www.pathwaysawareness.org/. 

Tummy Time Therapy Blogger Blog Hop

Below you will find all the posts in the Tummy Time therapy blogger blog hop. So many great ideas and thoughts on tummy time from Occupational Therapist and Physical Therapists.

The Importance of Tummy Time for Babies - Golden Reflections Blog

Tummy Time & Baby's First Year - The Recycling OT

How to Use a Therapy Ball to Make Tummy Time Easier and More Fun for Baby - Mama OT

5 Awesome Toys for Tummy Time! - The Inspired Treehouse

Terrific Tummy Time Positions - Your Kids OT

Tips For Tummy Time From A Physical Therapist - Pink Oatmeal

Tummy Time : The Basics - Therapy Fun Zone

Tummy Time: Developmental Consequences & Future Implications - Tools to Grow, Inc.

Tummy Time Tips - Pedatric OT Tips

Tummy Time Just Isn't For Babies - Your Therapy Source

Tummy Time - More Than Just A Buzz Word - Starfish Therapies

Tummy Time Never Gets Old - Playapy Platform

Daily Living Skills Worksheets

A fellow blogger and occupational therapist, Linda Harrison,  recently sent me a copy of her wonderful Daily Living Skills Worksheets. This book of reproducible worksheets is great for teaching independent living skills and is ideal for use with individuals with a variety of diagnoses. I work in the school setting, and I am excited to have so many different worksheets addressing skills such as goal-setting, memory/safety, and time/money management (and much more!) to use with my middle and high school students with special needs. I am highly impressed with the "functional" and "practical" nature of the worksheets...from making out a grocery list to using the bus! Go to Linda's website @ www.lindasdailylivingskills.com to check out this amazing resource for yourself!

Special Education Law

Earlier this month, I had the opportunity to attend a Related-Services Academy offered by my employer (Shelby County Schools) that was led by Dr. Wendy Ashcroft, at Christian Brothers University here in Memphis. Our group of therapists was given a thorough review of the Individuals with Disabilities Act, as well as some great information on Applied Behavior Analysis and evidence-based practice for serving children with Autism. It was such a great experience, I've decided to share some of the information with you!

Review of Sped Law:
-In 1975, Congress passed the Education for All Handicapped Children Act 
-In 1990, this act was amended to become the Individuals with Disabilities Act (I.D.E.A.)
-The most recent amendments to I.D.E.A. were signed into law by President Clinton in 1997 and President Bush in 2004. 
-Individuals with Disabilities Education Improvements Act provisions took effect on July 1, 2005.

There are Six Major Principles to the Special Education Law in the United States:
1) Zero Reject - the right of every child to be included in a free appropriate publicly-supported education system.
2) Non-Discriminatory Evaluation- the child's right to be fairly evaluated so correct educational programs and placement can be achieved.
3) Individualized Educational Program- the child's right to have a meaningful education
4) Least Restrictive Environment- the child's right to associate with nondisabled students to the maximum extent appropriate to his or her needs.
5) Due Process- the child's right to challenge any aspect of the educational program.
6) Parent Participation- the child's right to have the family involved in decisions about his or her educational program.

Photo credit: Stuart Miles @ freedigitalphotos.net


Notes from Related Service Academy, Christian Brothers University, Facilitator: Dr. Wendy Ashcroft, June 2011.

Great Resource on Visual Deficits

Dr. Mitchell Sheiman has written a wonderful book titled Understanding and Managing Vision Deficits: A Guide for Occupational Therapists. In this book, he explains how problems with vision play a role in the practice of occupational therapy and how OT’s and optometrists can collaborate to understand and manage visual disorders. This is a wonderful resource for occupational therapists that includes intervention recommendations for specific vision problems such as visual field deficits and visual neglect. There is also a section that explains vision therapy, which Sheiman defines as “an organized therapeutic regimen utilized to treat a number of neuromuscular, neurophysiological, and neurosensory conditions that interfere with visual function.” (p. 171). For more information on vision therapy, contact the American Optometric Association @ http://www.aoa.org/x5411.xml.

 Scheiman, M. (2011). Understanding and Managing Vision Deficits: A Guide for Occupational Therapists. Slack, NJ.