Monthly Archives: December 2015

Teaching Handwriting In Three Simple Stages

Parents and teachers are consistently surprised that there is a natural developmental progression in between scribbling and being a completely independent writer.  Knowing the three stages of handwriting makes any writing lesson less frustrating for teachers as well as kids.  Building skills rather than doing drills just works better!

Stage One:  An adult demonstrates how to write a letter.  Using simple terminology helps as well, but the key is that a child can watch an adult move their pencil or crayon in a specific sequence.  Why is this important?  Strong visual and verbal cues support developing a motor plan and a memory of that letter.  A child sees the correct grip and sees exactly where to start and stop, how to curve or how long a line should be.  Do not skip this step! Adults do not have to write on a child’s paper.  They can write on their own paper, placed directly above the child’s paper.  I like the paper strips from Handwriting Without Tears since they are pre-cut, sturdy thick papers, available with a bold baseline and with/without lines.

Stage Two:  The child copies a sample letter.  Why is this important?  Recognition of letters is an easier skill than rote recall (the ability to answer”show me the A”  versus “What letter is this?”).  Having a model to copy while writing is very helpful.  The Handwriting Without Tears (HWT) people place the letter or the word intermittently on their practice pages so that beginning writers see the sample right next to the space where they are writing.  No searching for the sample at the top of the page or the beginning of the line.  Bonus:  Lefties will not have to move their writing hand to see a sample.  HWT is very left-friendly!

Stage Three:  Independent writing without demonstration or a model.  This is often the stage that teachers jump to, very quickly in my opinion.  A child who can’t recall the letter, then given a baseline and told to write their name on the line, is probably not ready to be an independent writer.  That child will come up with honest errors that can become bad habits if this goes on day after day in preschool.  This stage requires that a child has full recall, not just recognition of letters, and requires that she knows the start and sequence to form a letter.

So many children that I see for private consultations have come up with their own methods of forming letters.  I wonder if these kids ever got the chance to watch an adult make a letter more than once, let alone practice that first stage of demonstration.  If a child is given a worksheet and only told what to do, they did not get instruction in the first stage of handwriting.   They have been cheated of the foundations of handwriting.

Remember:  Handwriting is used continually throughout the school years. Keyboarding never has replaced handwriting at any level of education.  Children will gradually use more technology, but they will always need to be able to write in every grade.  Always.  Right through high school.  There have been studies on the benefits of handwriting over keyboarding for long-term comprehension (really understanding a concept, not rote recall) that suggest that handwriting notes “old-school” is the way to go.

Successful young writers are able to focus on developing their grammar, content and personal expression, not erasing illegible writing.  They can finish their homework faster.  Slow or sloppy writers avoid homework even when they know all the answers, and learn to shorten their written expression.

Start out with great habits and solid skills, and writing is a joy, not a chore!


Good Posture: Is it Vestibular or Proprioceptive?

These two senses that baffle parents when kids with sensory processing issues struggle with posture and efficient, safe movement can often be confused. They are not the same, but they can both affect postural control.  Here is my attempt to make things a bit clearer on this foggy morning in NY.

Proprioception (and it’s close companion kinesthesia) are the senses that provide the brain with information about where our body parts are at rest and while moving, respectively.  That means that you can close your eyes (try it after reading this sentence) and perceive what position your fingers are in without looking.  You can tell how much pressure you are placing on an object and even how far apart your hands are from each other.  This amazing skill is accomplished by the brain’s interpretation of information it receives from muscle and joint receptors.  These little organs tell the brain about how stretched the muscles are or how firmly a joint is closed.  That is proprioception at work.

When your body moves, even a little, even slowly, muscle  and joint receptors transmit messages about which and how many muscle fibers are firing and how quickly and in what direction the joint is changing position.  Reach out to the side while looking at this screen.  You know how high your hand is at all times while moving, without looking over there.  That is kinesthesia.

A little side note:  motor planning combines the ability to create a mostly automatic mental plan of the action you want to execute (praxis), and then actually doing it with a well-funcitoning proprioceptive and vestibular system.  Thinking “I am going to reach out to the side”, then accomplishing this smoothly is motor planning.  Wow!

Simply amazing!  I never tire of anatomy and neurology.  How this system works effortlessly is nothing less than a miracle.  Knowing what to do when it does not is…. therapy.

In my early career in hospitals, I had the opportunity to work with a woman who had a stroke that damaged her proprioceptive pathways in her spinal cord but left her mentally able and without any paralysis.  No vestibular damage.  This is unusual, and for her, it was just as crippling as having a limp leg and arm.  Without looking, she could not perceive when her legs were bent or straight, whether she was crushing an orange or dropping it.  She would need constant supervision and support for the rest of her days, even with good therapy.

Does this sound a tiny bit like a child who breaks his crayon without any intention of doing so?  Crushes his cookie in his hand and then cries?  Slides off the chair and has no answer when you ask why that happened?

Not being able to sense where your body is and how it is moving while you are sitting at the dinner table is a sign that your proprioceptive processing is off.

Your vestibular system is your brain’s ability to use information from your inner ear, your eyes and your hearing to tell when and how your head is out of a centered and vertical position and where you are in space.  It is a joy to see babies tip upside down in standing, watch children twirl and fall down in laughter, and see ice skaters spin.  Being able to find that center, enjoy the feeling of being off-center, then return to vertical is what they are enjoying.

One of my colleagues is dealing with vestibular dysfunction after a head injury.  She is able to sit and eat her dinner without sliding off the chair, but don’t ask her to pick things up from the floor while tilting her head down to see the object.  She will get very dizzy.  Her vestibular system is off, but her proprioceptive system is just fine.

Kids that constantly seek spinning, get upset or disorganized after even the smallest move out of a centered position, or throw up after movement are having serious problems with vestibular processing.  Interestingly, the unsung heroes of the vestibular systems are the auditory and the visual systems.  They are big components of good processing.  Kids that are constantly distracted by background sounds, fall apart in large spaces or need to see the whole room before they can settle down calmly are probably experiencing vestibular processing problems.

Sound therapies for vestibular processing can make a huge difference, as can addressing ocular control (the movement of the eyes).  The Astronaut Training protocol is the best program that I have seen for intense vestibular treatment using all three components of vestibular functioning, but it is tough to administer correctly for very young children.  Not impossible, but much harder than for a cooperative school-age child.

This post was way longer than I expected it to be, but I kept writing because understanding how sensory processing works for practical issues like sitting for school or at the dinner table is really interesting to me.  I hope it is interesting to you as well!


Don’t live in the NYC metro area but want more information?

If you would like more feedback and ideas to help your child, visit my website: and purchase a phone/video consultation!   

Another Baby Lost to Crying

There was a news story here in NY about another newborn allegedly choked to death by a father that couldn’t take all the crying.  This is a recurring story that has to end.  If that family knew how easily The Happiest Baby on the Block techniques could have calmed down their baby, he would still be here, ready to have his first Christmas Day.

Jose Feliciano has been arrested for murder after the baby’s mother took an overdose and told someone in the facility caring for her what had happened.  I have sympathy for their entire situation.  If you do not have children, or if your newborns were almost silent, you do not know the frustration and pain of constant screaming.  THB techniques are capable of more than just giving babies better sleep.  They can prevent the slide into exhaustion and depression that parents often do not admit to.   Calm babies nurse/bottle feed better and parents feel more competent.  Everyone wins.  This time in the Bronx, everyone lost.

Most fathers do not commit murder, no matter how frustrated they are.  Perhaps we will hear about additional issues that made this dad take the ultimate action.  If only the mom had learned THB when she gave birth, or at a prenatal class, or at a well-baby visit.

I made some brief inquiries into teaching The Happiest Baby class to men about to be released from the prison system this fall.  Perhaps one of my resolutions for 2016 should be to teach that class for free somewhere in the Bronx, to some group of parents at risk.  This is a blog post I don’t ever want to write again.

For more information about The Happiest Baby on the Block, please visit my website:

Good Posture for Kids With Feeding Issues Matters

Feeding challenges are a huge source of concern for parents of children with low tone, autism, and a host of other issues.  Improving how a child sits when eating isn’t magically going to solve every problem for every child, but ignoring the benefits of good positioning will make most feeding problems worse.  Even problems not immediately associated with posture can become bigger problems when a child has poor postural stability at the dinner table.

What impact does posture have on a child’s mealtime experience?

  • posture affects how safely and efficiently a child can coordinate breathing and swallowing.  Lean back and turn your head way over to the side, then try to swallow your saliva.  Imagine if you could not bring your head to the center and tilt your chin a little so that every part is aligned and fully operational.  Then imagine that you have a mouthful of food.  Scary.  Imagine if you persistently moved your head because you are a sensory seeker and you find sitting still and balanced unsettlingly dull.  You only feel awake and happy when moving.  With a mouthful of food…..If the choice is breathing or eating, most of us would refuse the food and choose to breathe.  Good positioning can prevent a child from having to make a choice.
  • posture impacts how easily a child can pay attention, stay calm, and behave in an organized manner through the whole meal.  If a child is uncomfortable, unbalanced, or trying to find a stable and comfortable position, he is not paying attention to the taste/texture of the food.  He doesn’t know exactly where it is located in the path from his lips to the back of his mouth for swallowing.  His own involuntary movements or the movements he makes to stay alert and engaged can distract him from eating well or eating at all.  He just might want to get up and leave.
  • posture affects learning and independence.  It is harder to hold a spoon, harder to hold a cup, and harder to avoid spilling or drooling when a child is not sitting in a balanced position.  Every child, no matter their issues, looks less capable and needs more time, support, or attention when they aren’t sitting well.  Children with multiple issues might decide that they really don’t care about becoming more independent.
  • posture affects the use of social and language skills.  Sitting well makes it easier to coordinate speaking, listening, and eating.  A child struggling to stay in a stable and comfortable position isn’t able to accomplish the multi-tasking demands of dinner conversation.  If social skills are an issue, sitting for meals can become a power struggle instead of an opportunity to observe and model positive interactions, then practice them with family and friends.

My parents told me to sit up straight at the dinner table. They were concerned about manners and politeness.   For a lot of kids, how they sit at the dinner table is not a deportment issue, but it makes a big difference in their mealtime experience and the overall experience of their families or classmates.


Is HWT Gray Block Paper All You Need?

HWT Gray Block paper does so many amazing things all at once to help a young child learn to write.  I had to take the Handwriting Without Tears assessment class twice to really understand why it works.  All you have to do is read this blog post.
IMG_1107.jpgThis paper is intended for children that write at the kindergarten level.  That means that a 4 year old that is leaving his classmates in the dust can use it, and a second-grader that struggles with getting his letters small enough to fit on homework assignment sheets can use it too.  The HWT people don’t put grades on their materials so that it can be used by anyone.  I find that really kind to the egos of children everywhere.  If you aren’t good at writing you probably know it, but having it broadcast throughout the school isn’t helpful.

This paper is for uppercase letters and to be used with pencils, but I have had children who need the waxy grippy-ness of a very pointed crayon succeed on this paper unless they use too much force.  Pencils are still the best tool for writing in such small spaces.  I frequently have a child use my favorite pencil grip  The Pencil Grip That Strengthens Your Child’s Fingers As They Write. You can address a lot of needs and IEP goals all in one activity if you use Gray Block paper!

The paper comes in the center-starter cues version or the alphabet/numeral copy format shown above, but it also has a blank-box version and a left corner-starter cues version.  Example:  the letters “E” and “L” begin at the top left corner, but the letters “T”and “C” start at the center top.  The dots tell a child where to begin a letter.  The alphabet/numeral page provide correct starting dots for each character.  HWT has given teachers and parents sheets that create a progression from copying a model to independent writing, while still providing clear boundaries for size and control.  More on that later.

Starting letters in the correct spot is a primary goal for legibility.  An uppercase letter that is started at the bottom may look good, but it will be made a bit slower.  Once a child starts writing words and sentences, using an incorrect start can result in being the slowest writer in the class. Starting at the bottom also makes it harder to control your hand for an accurate stop, therefore a child’s letter can be too long or have a straight line that develops a curve as they try to come to a halt with an upswept wrist or finger motion.  When a child starts a letter correctly, the chances of using the correct sequence of moves rises significantly.  The blocks also help a beginning writer avoid reversals.  For example, children cannot reverse the “D” if they stay in their block.  An immediate reminder.  Make “D”s this way for a while, and a child’s brain automatically glides the pencil to the right to make a big curve.  No decisions needed.  It is a habit.  And no parent/teacher correction needed.  I love it when I don’t have to say or do anything to get good results!!!!

So far this magic paper has controlled the start and assisted in getting the sequence of movements correct while avoiding reversing letters.  The size of the boxes and the shading make it very clear how large and how wide the letters should be, supporting correct and consistent sizing.  The boxes are in a horizontal row to help a child identify the baseline, which is correct alignment of uppercase letters.  Sometimes I will take a black crayon and draw a line under the row, making a bold baseline.  I told one child I see for private tutoring that only adults make the baseline, and in true form for him, he insisted that he be allowed to make his own baselines. His letters still wobble a bit, but he always aims for his baseline now.   Another win for both of us!

I have recently seen some preschoolers that I treat privately come home with sheets that look like HWT’s gray blocks, but are actually just rectangles drawn on paper in pre-K sizing (yes, there is a way to know what is standard sizing is, even this early).  These pages sometimes even come from the occupational therapist at school!  OOPS! This make me think that they (or someone at school) has seen the Gray Block paper and thought that they would create them for younger kids.  Sorry, guys: you missed the part of the lecture on why Gray Block paper works and for whom it has the best results.

Preschoolers that are advanced can jump into using gray block paper, but there is an important thing that simple rectangles on a page can’t deliver for children that are not yet ready to control a pencil and not writing without a model.   The shaded block gives a subtle visual cue that four drawn lines do not.  For beginning writers, especially for kids that have visual-perceptual issues, those extra lines can create more confusion than support.  Gray Block paper provides simple visual guidelines for the creation of vertical and diagonal lines without confusion for older children.  A child writing an “N”, for example, traces the left-side edge of the shaded block, jumps back to the starting corner, then makes a diagonal line to the lower right-hand corner, and then traces straight up to the top right-hand corner.  The letter “N” is a tricky one for many preschoolers and kindergarteners, who use all diagonal lines or reverse the letter because they aren’t sure when to jump up and when not to jump.  Gray blocks that are shaded, not drawn, allow them to see their writing through the shaded areas, developing more control and independence.  They aren’t writing within the blocks, they are using the edges to trace lines without a letter model.  You can’t trace a dark edge and still see your own work.  The effect of shaded blocks acting as a bridge to independent writing is one of the things that make this paper “magic”.  Making your own blocks is not going to deliver the same effect.

The blocks are spaced evenly but they are larger than “real-life” writing.  No worries; children will gradually imitate adult writing and make their free writing smaller than the blocks after practice.   The blocks give adults the chance to explain that letters need space.  You can even teach word spacing by always leaving one empty space between them.  It turns out that the correct amount of space between words is the lower case “o” in the size that you use for your age.  Gray blocks deliver again.

So…let’s list the things these little blocks can do for beginning or struggling writers:

  • appropriate for a wide range of ages
  • provides prompts for correct start and sequencing
  • discourages reversals
  • encourages awareness of a baseline
  • develops automatic and uniform sizing
  • promotes awareness of spacing letters and words
  • creates a bridge between tracing and independent writing
  • improves control with fewer confusing lines

Teaching handwriting to young children can be fun, but it can also be complicated.  Out of all of HWT’s products, this is one of the most useful items in my office now.  It gets results so quickly for so many children!


Toddler Demands? Give it in Fantasy!

When a toddler wants pizza for dinner every night or to stay home and play on the iPad instead of going to school, you have to decide what to say.

Your basic choices are:

  • ridicule: “That’s silly!  “I’d like a fancy car, but this is reality.”
  • reason and clever repackaging:  “If you want to grow strong, eat your dinosaur trees (broccoli).”
  • comparison: “Your sister is getting ready now.  She’s not giving me a hard time.  You should be more like her.”
  • threats:  “It’s take it or leave it.  If you want that iPad tonight, you need to get dressed now.”

There is another choice.  Give it in fantasy.

Dr. Karp’s “give it in fantasy” strategy from Happiest Toddler on the Block works best with toddlers and preschoolers about 3-5 years old, who can distinguish from your words that your comments reflect a dream, not your plan.  They still think magically sometimes, but they don’t really believe that their dolls can feel pain or that you can fly.  They have been around, after all.

Giving things in fantasy, using a reasonable amount of enthusiasm, makes you their companion in wishing life were sweeter than it sometimes is.  You wish for a better boss, a cooler car, or a sunnier day; I know that you do!  Share your wish that every night could be pizza night.  Tell him how great that would really be, and your fave would be pepperoni with extra cheese.  Share their wish for something they want, and become part of the dreaming for a moment, not just the person who sets down the chicken instead and walks away.

Deliver your shared dream with warmth and enthusiasm, and extend it long enough for your child to realize your excitement.  Do not extend it too far, as that will suggest that it could happen in reality or that the fantasy is so wonderful that nothing less will do.  Your intent is to share, not fuel a full-blown revolt.  You will get extra points for bringing yourself to eye level with your child, making the experience of sharing a fantasy more complete.

Once the reverie is over, you can say that tonight actually is chicken night, highlight the delicious dipping sauce, or suggest a fun drink choice like lemonade or a special strawberry smoothie for dessert.  You don’t have to transform an experience to make it tolerable, you can just spin reality as actually OK.  Remind a young child that there is the potential for fun at school that he cannot even imagine right now.  What amazing things will you create today?  What new game on the playground could you try?

Everyone has daydreams, and everyone wishes for something wonderful to appear.  Try to give things in fantasy but keep your promises and make your expectations/limits clear and positive.  You toddler could surprise you with his willingness to accept something “in fantasy” instead of whining for what he cannot receive.  This is the season for miracles, after all!


Develop Pincer Grasp With Ziploc Bags

Toddlers love snacks.  OTs love refining a child’s grasp.  Mash the two together and you get….the Ziploc snack bag.  Try serving a tiny portion of your child’s fave crunchy snack in a small bag that has a zipper closure and watch their fingertip control take off!

Here are the important points to make this safe and successful:

  • Use the smallest zipper bag you can find.  If it is large enough to cover their face or head, it is unsafe.
  • Place only a few pieces of the snack inside.  Why?  If I gave you one goldfish cracker you would use your fingertips to take it out.  If I gave you 20, you would reach in and pull out a fistful.  So will your child.
  • Always offer more snack servings,since each serving size is so small.  You will seem like the most generous person they know.
  • Close the bag after filling it.  Children actually enjoy the experience of mastering the little zipper.  It is a little moment of control in a day where everyone is telling them when to go potty, when to nap, and when to get in the carseat.  This is a moment of control!