Tag Archives: hand coordination

Teach Kids How to Cut With Scissors…The Easy Way

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terrific safe scissors for little hands!

As a pediatric occupational therapist, scissor use is something I assess but also something I teach.  And I teach it early.  I also teach safety early, and teach it with a focus on early success.

What makes it easier to teach children to cut with scissors?

  1. Good timing.  Typically-developing children have the visual-motor skills to start snipping with scissors at 24 months.  YUP; that early.  What they don’t have is safety awareness and the ability to select what they should be using.  To teach scissor skills this early, you have to know about fine motor development, child behavior, learning skills, and have access to the right tools.  If a child is unable to attend to your demonstration, unwilling to tolerate assistance of any kind, or unable to use both hands at midline, then 24 months of age is too soon.
  2. Good tools.  My long-time readers know that I use only one type of scissor until a child is 4 or 5:  Lakeshore Scissors for Toddlers That Only Cut the Paper, Not the Toddler  Nothing derails training like needing a bandage!  In addition to the right scissors, beginning to cut is helped when the paper is a bit stiff.  The cheap printer paper most teachers and even therapists use to make copies of cutting sheets is difficult to cut.  We don’t experience it as difficult, because adults have better graded grasp.  We can control the scissor more easily as well.  Young children do much better with card stock or at least high-quality printer paper.  Try getting the administration to pay for it, though.  But if you want success, use the right tools.  My private clients learn using the Kumon “LET’s Cut Paper” series of books, or “Paper Playtime”.  Read more about these excellent books here: Kumon Learn to Cut Books: Paper Truly Worth Snipping Up   . 
  3. Good demonstration.  Some children watch every move you make.  Others are completely oblivious.  Most are somewhere in the middle.  But learning to cut isn’t intuitive.  Not any more intuitive than changing the air filter in your car is.  Could you learn to do it?  Sure, but it would really help if you could watch someone before you tried it.  I make sure that a child is able to observe me, and being that close to a scissor is another reason to use Lakeshore’s brand of safety scissor.  If a child grabs my hand or my scissor, I might not be happy about it, but the will not be injured.  If they ONLY watch me the first or second time I use a scissor in front of a child, that is just fine.  Some kids are risk-averse, and pushing them to try isn’t smart.  The next time I bring the scissors out, they may be more eager to try to use them, and they will have some information stored away about how they work.
  4. Good experiences.  Learning should be fun.  Play should be fun.  Learning to use scissors should be play, not work.  Make it fun.  I will demonstrate cutting on a page that results in something fun to play with.  The “Let’s Cut Paper” books make some cut things.  Another thing that is fun is cutting pieces of paper that fall to the table.  I am doing telehealth during the pandemic, so I am teaching parents to cut 1/2-inch strips of paper and have kids cut across the paper.  They joy in a child’s face when they snip across the strip is wonderful.  It isn’t the same as snipping on the side of the page.  You need to make it fun, or it isn’t going to work.

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Want Your Child to Show Hand Preference (Righty/Lefty?) Where You Place Their Spoon Matters

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I get a lot of questions about this issue, based on my experience as a pediatric OTR.  Starting at 12 months, some children show a strong hand preference and never look back.  Other kids are switching hand use long after 4.  Without the existence of disorders that directly affect hand dominance such as orthopedic disorders, cerebral palsy, or untreated torticollis, hand dominance is hard-wired and emerges naturally.  But there are situations in which it is delayed or incomplete long after the typical window of skill development.

Here is what can be happening, and here is what you can do as a parent or a therapist:

Hand dominance only emerges with the development of refined hand control and the child’s awareness that they need more skilled control for an activity.  I tell parents that I can pick up my coffee cup with either hand to drink, but that doesn’t make me a lefty.  If you paid me $100, I probably couldn’t thread a needle with my left hand.

Children that aren’t practicing refined skills like feeding or assembling blocks, or even intent on picking up every darn piece of lint on the carpet…they don’t need refined grasp, and they probably will not demonstrate hand dominance on time.  Kids that are scribbling wildly but haven’t tried to draw a circle with closure ( a 36-month skill, BTW) also have no need to develop dominance.  The self-starter, the baby and toddler that watches you intently and decides to learn all these skills?  They won’t need much help.  But the child who avoids challenge or gets help because it is easier and faster for an adult to feed them or help them build a tower?  They may lag behind in hand development.

Some kids are very tuned into adult actions, and copy the hand that a parent or teacher uses.  These are the children that are great mimics.  They can see that you are using your right hand, and even if they naturally grab with their left hand, they transfer objects into the same hand you are using.  Adults are naturally inclined to assume dominance as well.  I cannot count the number of times I absent-mindedly handed a pen to a left-handed parent into their right hand.  If you do that to a child under 5 , they assume that you want them to use that hand, and will struggle on.  This is where spoon placement matters.  I encourage parents to place the utensil in the center of the placement or tray, and watch which hand (both of the child’s hands must be free) their child chooses over many trials.

If a child is inconsistent but clearly uses their left hand more often, placing their spoon on that side of the tray should boost use, and with skilled use comes more skill and awareness.  I never pull objects out of a child’s hand.  I don’t need to.  They will drop their crayon or spoon frequently enough for me to have another chance to offer it back to them.

What if I (or a parent) picked wrong?

Dominance isn’t that easy to alter.  Ask your grandmother what the nuns in Catholic school did to alter dominance in lefties (it was considered “the devil’s hand”, and what they did wasn’t pretty).  Children will eventually simply transfer their spoon over to the other hand.

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How Therapeutic Listening Enhances Motor Skills

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My readers know that I am a huge fan of Quickshifts in treatment.  I have had some amazing successes with Quickshifts for regulation and modulation.  Their focus on combining binaural beat technology with instrumentation, rhythm, melody and tone makes these albums effective, and it eliminates the challenges of modulated music for very young or fragile kids.  But many parents (and a few therapists!) think that if a child doesn’t have severe sensory processing issues, then therapeutic listening isn’t going to be helpful.

That indicates that they don’t understand the principles and the rationale for the use of therapeutic listening.

Since every movement pattern has rhythm and sequence, it is completely logical that enhancing brain function with an emphasis on a calm-alert state with music will affect movement quality.  (This includes speech.  Speech is a highly skilled series of very small movements in a precise sequence! )

I am currently treating a toddler who experienced encephalopathy in infancy.  A virus affected the functioning of his brain.  The residual low muscle tone and praxis issues are directly improved by using Gravitational Grape in sessions.  He is safer and shows more postural activation while listening.  Endurance while standing and walking is significantly improved.

Another client with low tone has Prader-Willi syndrome.  Her movements are so much more sequenced with the Bilateral Control album.  Her ability to shift her weight while moving is significantly better during and immediately after listening.

All of us are more skilled when we are in the calm-alert (alpha brainwave) state that Qucikshifts entrain.  For people without motor or sensory issues, alpha states can help us think clearly and organize our thought and movement for higher level performance.  For children with movement control issues, it can improve their safety and stability.  They move with greater ease.  Therapy sessions are more productive, and play or school functioning is less work.

Due to COVID-19, I have been forced to do telehealth and use therapeutic listening with more children, rather than rely on equipment or complex sensory processing activities.  The silver lining is that parents are more involved in my sessions and can see what benefits this treatment is having on their children.   When social distancing retreats, I hope that therapeutic listening will be seen for the powerful treatment it most definitely can be!

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Need to Support A Child’s Independence? Offer to Help Them!

 

irina-blok-192240-unsplashI know; it sounds like I am being sarcastic.  That couldn’t be farther from the truth.  Instead of telling children to “Give it another try” or “I know you can do it”, offering help to a young child can have the paradoxical effect of eliciting more perseverance and attention.

It really isn’t all that complicated:  think of your own responses for a moment.  If you were trying to fill out your tax forms, and ran into difficulties, you might call an accountant for help.  If their response was “Just keep trying; I know you can figure it out!” you probably wouldn’t be excited to try again.  You might feel even more agitated.  I know what I would be thinking:”If I knew what to do, I wouldn’t have called you int he first place!”

If your accountant said “Let me take a look.  Oh, I underlined some of the important numbers.  You got stuck with line 32b, right?” you could see the issue in a new light, and be able to come to a solution without having to walk away or tear up the form.  Your accountant used their advanced knowledge to set you up for success.

We need to do the same thing for children.  Telling them we have faith in them, or insisting that they need to try again when they clearly don’t know how to alter their actions, is not kind or even very educational.  It leaves them feeling abandoned under stress.  Even if we know they can solve for X, they aren’t doing it now.

For the very youngest kids, I have a special solution.  You “wiggle it”.  Young children don’t know how we understand how to do so many things well.  When they get stuck opening containers or assembling objects, I offer to “wiggle it”.  By demonstrating that the container does indeed open, or that the bead will fit on the string, I am assuring them that they could be successful.  More importantly, I am demonstrating the correct grasp pattern and stabilization method.  And finally, I am rebooting their motor plan and their frustration level.  Just handing the object over to me reduces their agitation.  When children aren’t so frustrated, they can think and create better motor patterns.’

All this from a little “wiggling”.

To read more about building confidence and coordination, read For Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance and Why Telling Your Child “It’s OK” Doesn’t Calm Him Down (And What To Do Instead)

Teach Your Child To Catch and Throw a Gertie Ball

 

71rwmnHGrHL._SL1500_These balls aren’t new, but they don’t get the recognition that they should.  The ability to catch a ball is a developmental milestone.  For kids with low muscle tone, sensory processing disorder (SPD) or ASD, it can be a difficult goal to achieve.  The Gertie ball is often the easiest for them to handle.  Here’s why:

  1. It is lightweight.  An inflatable ball is often easier to lift and catch.  The heavier plastic balls can be too heavy and create surprisingly substantial fatigue after a few tries.
  2. Gertie balls are textured.  Some have the original leathery touch, and some have raised bumps.  Nothing irritating, but all varieties provided helpful tactile input that supports grasp.  It is much easier to hold onto a ball that isn’t super-smooth.
  3. It can be under-inflated, making it slower to roll to and away from a young child.  Balls that roll away too fast are frustrating to children with slow motor or visual processing.  Balls that roll to quickly toward a child don’t give kids enough time to coordinate visual and motor responses.
  4. They have less impact when accidentally hitting a child or an object.  Kids get scared when a hard ball hits them.  And special needs kids often throw off the mark, making it more likely to hit something or someone else.  Keep things safer with a Gertie ball.

The biggest downside for Gertie balls is that they have a stem as a stopper, and curious older kids can remove it.  If you think that your child will be able to remove the stem, creating a choking hazard, only allow supervised playtime.

Looking for more information about sports and gross motor play?  Check out Picking The Best Trikes, Scooters, Etc. For Kids With Low Tone and Hypermobility and Should Your Hypermobile Child Play Sports?.  You could also take a look at What’s Really Missing When Kids Don’t Cross Midline?.

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Improve Your Child’s Coordination, Beginning With Fun Finger Awareness Play

Children with low muscle tone, children with spasticity, and children with dyspraxia all struggle with using their hands effectively and efficiently.  Therapy can be super boring, but it doesn’t have to be!  Here are four simple and fun ways to build your child’s awareness of their fingers that will support grasp, pinch and more!

  1. Gentle hand and finger massage.  This is not the same as what your manicurist does when you get all decked out for a night on the town. (remember what that’s like?)  You will be gently massaging each finger from the knuckle to the fingertip.  I like to place my thumb on top of a child’s finger, and the side of my index finger underneath.  The stroke is firm but not hard, and as smooth as you can manage it.  Children tend to move about more than adults during massage.  You may be aware that I am also a licensed massage therapist.  There is nothing I like better than incorporating massage into OT when it is appropriate!
  2. Name each finger during massage, and during play.  Exaggerate finger movements to help them remember the names and pay attention to your description.  I weave finger awareness into every session I do with some children.  I will name their fingers as well.  I describe what they are doing right ” You have your pointer finger right on top; that’s just the right place to….” and why things aren’t working out for them “I think that when you moved your thumb off your pencil, you pushed so hard that your crayon broke”
  3. I especially like talking about what I did wrong.  Children feel a sense of equality and fairness when adults admit to, and even elaborate on, their mistakes.  It takes some of the pressure off of them as young learners.  I will clearly describe to a child what I think I did wrong, and what I am going to do differently the next time.  That allows me to model persistence, one of the traits that help children with delays and disabilities thrive.
  4. Use “Where is Thumbkin?” and other finger plays.  These are not just for preschool.  They are fun for parents too.  Your child may not have been able to keep up with the faster version at school, so this is a great opportunity to practice with an adult that can slow it down and repeat the movements until he gets it just right!

Easy Ways To Build Bilateral Hand Coordination for Writing

Why do we need to use two hands for writing?  After all, you only need one hand to hold a pencil.  Well, did you ever injure your non-dominant shoulder or wrist? Without a hand to steady the paper and move it accurately as you write across a page, an adult will write like a preschooler or worse.  When you write, you are using one hand for writing and the other for balance, posture, paper stabilization and paper placement.  Bilateral hand coordination begins before a child’s first birthday and develops through early childhood.  Without it, handwriting is certain to be a challenge.

So many kids that struggle with crawling and walking as infants and young toddlers will continue to have difficulties using both hands together as preschoolers.  Occupational therapists like myself often observe that that they are not using one hand as a “prime mover” ( grabbing, reaching and writing) and the other hand as a “stabilizer”, i.e. holding a container or paper in a skilled manner.  What does it look like to stabilize a container with skill?  The container is held using just enough force and with the opening angled to allow the other hand to fill it without dumping the contents out. Take a look at my post  Better Posture and More Legible Writing With A “Helper Hand” to explore why that stabilizer hand placed on the table is essential for good handwriting.  Problems with bilateral control are often seen with children with ASD, SPD, and many neurological issues such as low muscle tone, but bilateral control delays can exist without any formal diagnosis.

Most handwriting programs, such as Fundations, do not pay much attention to the underlying physical skills needed for legible handwriting.  Handwriting Without Tears does an excellent job of teaching educational staff to remember the physical aspect of handwriting. Children ideally need good bilateral coordination BEFORE they begin hard-core handwriting instruction, not after.  If a child has identified neurological or developmental challenges that contribute to limited bilateral coordination, working on these skills are essential to prevent compensations and delays in handwriting.

As an OT working with kids over 4, when those basic bilateral control and grasping skills should have been achieved, I have to decide whether to spend precious time in every session on handwriting or on the basic abilities (coordination, strength, visual-perceptual, and sensory processing) that support handwriting.  Usually, I end up doing both, building target skills with intensive and complex treatment plans while I am working on handwriting instruction that gets kids up to speed as quickly as possible.

I am going to guess that if some of my toddlers and preschoolers in treatment had received more daily home and school practice with the following activities, I would have more time to teach great writing strategies.  For every parent that has asked me for some effective methods for early bilateral control skills, here you go:

  1. Do not hold or stabilize toys too much for them while playing.  Let them figure out that they need the other hand to steady a soft but large object or container.  Kids will often ask adults to hold a bag for them during clean up.  Your response?  Place their “helper” hand effectively on the bag and direct them to use the other hand to pick things up.  You did help, but you didn’t enable more dependency.  Safety first, so always support a container that could shatter or injure them if it dropped and broke.  But if the contents of a safe container spills?  That is another lesson in coordination to be learned by the child.  Encourage and reward a good clean-up effort!
  2. Provide good containers that demand bilateral skills. My Ziploc post Develop Pincer Grasp With Ziploc Bags also develops bilateral coordination during snacking (one of my favorite times of the day!).  Another fave?  Store little toys in the cosmetic bags with nice big zipper pulls that the department stores include with free-gift-with purchase events. Ladies, if you love makeup as much as I do, you have a pile of these in a drawer somewhere.  If not, the local drug store probably has a selection.  When a container is soft and collapses, it is a greater challenge to stabilize and open.  Challenge is good.
  3. Encourage your child to turn the pages of a book while holding the book on their lap when sitting on the bottom step of the stairs or a low bench.  With the book resting on their lap with one hand holding it, there will be no chance for the floor to hold the book, or for you to do it.  If it is a really heavy or large book, either give them one finger’s wobbly assistance under the book, or pick a lighter/smaller book.  Some of my clients would rather let me hold the book, so I try to have something in my hands to prevent them from asking for assistance rather than working hard.  I cheer them on, and make sure they have great books to look at every time!