Friday, October 20, 2017

Modifications for Toilet Training

Modifications for Toilet TrainingModifications for Toilet Training

In order for a child to be completely independent and physically ready when using the toilet, it requires a significant amount of higher level gross motor skills.  If a child has delays in gross motor skills that are affecting toilet training, you may need to provide modifications for toilet training.  Here are a few tips:

  1. The child can sit down to unfasten clothing. Use a potty seat on the floor for little ones.  This eliminates the ability to step onto a stool and sitting balance is easier to maintain.  It provides a stable base of support for the trunk to remain upright.
  2.  When using a regular size toilet seat, use a toilet seat insert ring with handles on it.  The child can hold on to the handles to assist with sitting balance.  Make sure a step stool is available to provide a stable base of support.
  3. Place grab bars near the toilet to help with sitting balance and transfers.
  4. If the child uses any assistive devices or a wheelchair, make sure that the bathroom is accessible.  Can the child fit through the doorway and move throughout the bathroom with the assistive devices?
  5. Position the toilet paper close to the toilet.  This will decrease the amount of weight shifting necessary to reach for the toilet paper.
  6. If necessary, provide adaptive seating on top of the toilet to allow a child to relax completely while trying to void.  There are adapted seats available that mount onto the toilet, over the toilet or a free-standing commode style.  The child should have slightly forward positioning of the upper body with the knees slightly higher than the hips to help encourage bowel and bladder elimination (Noble, 2014).

Being able to use the bathroom independently, requires many steps.  If you are a therapist helping a child to toilet independently and need to track his/her progress check out Personal Hygiene Rubrics to collect data on the steps of toileting.  If you need more modification ideas for school-aged children, check out Modifications and Interventions for School.

Read 10 Tips to Help Children with Potty Training.

Read Toilet Training and Gross Motor Skills.

Reference: Noble, Elena MPT. (2014) Achieving Optimal Toilet Positioning for People with Disabilities. Retrieved on 2/16/16 at http://ift.tt/2gxd4za.

If you need more information to help children with toileting check out these resources:

The Practical Guide to Toilet Training Your Child With Low Muscle Tone (digital document) written by CathyAnn Collyer, OTR, LMT,  provides a complete explanation of the motor, sensory, and social/emotional effects that low muscle tone has on toilet training. It helps parents and therapists to understand whether a child is ready to train, and how to start creating readiness immediately.  You will learn how to pick the right potty seat, the right clothes, and how to decide between the “boot camp” or gradual method of training. A child’s speech delays, defiance or disinterest in potty training are addressed in ways that support families instead of criticizing them.  FIND OUT MORE.

Bathroom Social Stories   This digital document created by Thia Triggs, OTR,  provides 7 book covers, 76 separate book pages with a corresponding visual to aid understanding, and eight visual sequence strips for posting. Pick only the pages for your student’s needs. Specific sensory aversions that make it difficult for children with autism or anxiety issues to use new bathrooms are included. Clear, consistent visual expectations, as well as specific accommodations, help make bathroom use successful!  Editable text is available on one cover and four pages so that you can add your student’s name and specific circumstances that are important in your situation.  Available for boys OR girls.    FIND OUT MORE.

Modifications for Toilet Training

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Wednesday, October 18, 2017

Teaching a New Motor Skill? Try Full Immersion

Teaching a New Motor Skill Try Full ImmersionTeaching a New Motor Skill? Try Full Immersion

Are you teaching a child a new motor skill?  Has a child been working on one goal for a long time but still having difficulty?  Try full immersion when children are learning new motor skills.  When we are teaching a child a new motor skill or perhaps working on refining a motor skill, try bombarding the child with the skill.  Here are some examples:

  • The goal is to write a circle.  Overload the child with circles during the therapy session.  For example, cardboard tube slices, tub tops, jar lids, paper plate stencils, hot glue rubbings, salt tray, cut out circles, etc all to practice manipulating and writing circles.
  •  The goal is to jump forward 6 inches with two feet together.  Overload jumping skills with watching videos of children jumping, model the proper jump, play a game with frogs who jump, jump on a trampoline, recite jumping poems and more.
  • The goal is to perform a sit to stand transfer with verbal cues.  Practice sit to stand transfers in many different chairs, videotape the sit to stand transfer and watch it, practice manipulating action figures or Barbie type dolls moving from sitting to standing, etc.

Take the time to discuss with the child the importance of the skill.  By providing all the opportunities and examples of the skill will hopefully teach the child how important the skill is and to help provide the child with internal motivation to achieve the goal.  Read more about intrinsic motivation.

If possible, have the child help keep track of their progress.  Try My Goal Tracker.

My Goal Tracker

My Goal Tracker is a digital download that includes the materials to create a binder for student-generated data collection on his/her goals. There are two versions – Handwriting with Tears® and Zaner-Bloser® Style fonts if you want to practice handwriting skills too!

The student can track his/her goals over time, by monitoring the skills over the course of a day, week, month or quarter. This allows the student to get a visual picture of improvement, decline or maintenance of different skills.  Included in this download is the following: samples of completed forms, goals setting worksheet, improvement ideas worksheet, goal tracking cards (for trials or percentage) and graphs to complete for daily, weekly, monthly or quarterly progress (number of trials out of 10, percentage or minutes).  There is also one blank form for you to label if you are monitoring goals in a different manner.  Complete the goal worksheet, print the necessary forms and place in a binder.  The student can then graph his/her progress accordingly.

By having the students track their own goals they will take ownership of their progress.  It doesn’t get any easier than this to track progress.  FIND OUT MORE ABOUT MY GOAL TRACKER.

Teaching a New Motor Skill Try Full Immersion

The post Teaching a New Motor Skill? Try Full Immersion appeared first on Your Therapy Source.

Tuesday, October 17, 2017

Super Simple Brain Break Tip

Super Simple Brain Break Tip

Super Simple Brain Break Tip

While many of us know that increased physical activity levels are associated with higher academic scores, it can be hard to implement more exercise time during the school day.

Here is a simple tip –  suggest to the teachers to squeeze in a super quick movement break every hour on the hour no matter what they are doing.

Just take two minutes to drop the pencils, stand up and move around.  It can be as simple as doing the same activity every hour ie. stretch and marching in place or as varied as changing the activity every hour or every day.  You could even provide suggestions to perform the movement breaks sitting down such as these free seated stretch breaks.  With kids in school for about 6 hours that would total up to an additional 12 minutes towards the 60 minutes of physical activity per day that is recommended.  Not to mention shake those wiggles out and get kids ready to work.  I know this can not work in every classroom but for some, it might be another idea to add into the school day.  When you make it part of the regular routine it will become more like a habit and students will understand the expectations of behavior following the quick break.  If you do not like the movement every hour suggestion, read how to establish a brain break routine for more ideas.

Need ideas?  Check out 10 Simple Activities to Encourage Physical Activity,    Mini Movement Breaks (print this out to give to teachers to change the activities up – super easy and the breaks require no equipment), go on a quick Imagination Action Journey, perform activities from Roll Some Fun (print and throw the dice to determine what activities to perform) or get an entire collection of brain breaks for all year long!

Super Simple Brain Break Tip

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Monday, October 16, 2017

Finger Fidget or Finger Warm Up Exercises

Finger FidgetFinger Fidget or Finger Warm Up Exercises

Here is a super simple and super cheap do-it-yourself project to make finger fidgets.  These bead finger fidgets can be used to occupy busy hands for wiggly students or to warm up the fingers before fine motor or handwriting activities.  Obviously, do not use these with young children or children who mouth objects because the small beads are a choking hazard.

Supplies needed for the finger fidgets:

  • mesh tubing from the craft store (yards of this are super cheap – I paid $3 for 20 yards of the white mesh tubing)
  • plastic beads that will fit inside the tubing (I used green pony beads)
  • 2 pieces of duct tape or needle and thread

Cut the mesh tubing into a 12″ strip.  Tie a knot in one end.  Slip 4 beads inside the mesh tubing.  Tie off the other end of the tubing to make the length of the finger fidget about 6 inches long.  Duct tape the ends to prevent the tubing from fraying.  You can sew or hot glue the ends if you would prefer.

Have the child slide one bead at a time through the mesh tubing.  Not only is this an excellent fidget it also requires fine motor skills to take only one bead at a time and slide it across the tube.

If you want to make it more difficult of a fine motor task, make the mesh tubing longer.

Watch the Finger Fidget in action –

Need more fidget ideas?  Download the Fidget Spinner Workout, Fidget Spinner Yoga or Dried Bean Stress Balls.

If you need even more ideas for students check out these titles:

Wiggle Worms: A Guide to Alternative Seating for the Classroom digital download which includes all of the resources you need to begin implementing alternative seating strategies in a classroom.  Find out more information.

Cut and Paste Sensory Diet

Cut and Paste Sensory Diet includes 2 sensory diet books, one for home and one for school and over 150 picture word cards to reinforce sensory diets at home and at school.  Find out more information.

Finger Fidget or Finger Warm Up Exercises - make this super simple and cheap finger fidget to keep hands busy or strengthen fine motor skills.

 

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Sunday, October 15, 2017

10 Tips to Help Children with Toileting

Help Children with Toileting10 Tips to Help Children with Toileting

Whether it be toilet training a young child or helping a school-aged child with a bathroom routine, there can be many obstacles to overcome to reach full independence in the bathroom.  There are many factors to toileting such as body functions, age, physical environment, motor skills, communication skills and routines.  Here are 10 general tips to help children with toileting.

  1. Use a visual schedule with pictures to indicate the steps involved in using the bathroom.
  2. Follow the same routines each time the child goes to the bathroom whether at home, school or in the community.
  3. Encourage the child to wear clothing that is easy to manipulate.
  4. Modify the physical environment if needed.  For example, does the child have the postural control to remain seated or does the child need external support?  Does the child prefer his/her feet to be on the ground?
  5. Play calming music in the bathroom to relax the child.
  6. Use timers if needed to encourage the child to sit for a certain amount of time.
  7. Be mindful of sensory preferences regarding noise levels.  The noise of flushing a toilet can be very scary for some children.  Public bathrooms are very loud.  If able, look for a quite bathroom with only one person at a time.  Use earplugs if necessary.
  8. Be mindful of sensory preferences regarding tactile preferences.  Does the child prefer softer toilet paper or warm wipes?
  9. Use a reward chart to earn a prize for independent toileting.
  10. Make sure you and your child are ready and motivated.  Sometimes this can be hard to determine, but it can be very difficult to work on toileting if the child is not biologically ready and motivated.  For children with special needs, independence with toileting can be a difficult task.  Parents and teachers need to be patient as children progress with their skills.

If you need more information to help children with toileting check out these resources:

The Practical Guide to Toilet Training Your Child With Low Muscle Tone (digital document) written by CathyAnn Collyer, OTR, LMT,  provides a complete explanation of the motor, sensory, and social/emotional effects that low muscle tone has on toilet training. It helps parents and therapists to understand whether a child is ready to train, and how to start creating readiness immediately.  You will learn how to pick the right potty seat, the right clothes, and how to decide between the “boot camp” or gradual method of training. A child’s speech delays, defiance or disinterest in potty training are addressed in ways that support families instead of criticizing them.  FIND OUT MORE.

Bathroom Social Stories   This digital document created by Thia Triggs, OTR,  provides 7 book covers, 76 separate book pages with a corresponding visual to aid understanding, and eight visual sequence strips for posting. Pick only the pages for your student’s needs. Specific sensory aversions that make it difficult for children with autism or anxiety issues to use new bathrooms are included. Clear, consistent visual expectations, as well as specific accommodations, help make bathroom use successful!  Editable text is available on one cover and four pages so that you can add your student’s name and specific circumstances that are important in your situation.  Available for boys OR girls.    FIND OUT MORE.

Help Children with Toileting

The post 10 Tips to Help Children with Toileting appeared first on Your Therapy Source.

Thursday, October 12, 2017

Pumpkin Visual Discrimination and Scanning Activity

Pumpkin Visual Discrimination and Scanning ActivityPumpkin Visual Discrimination and Scanning Activity

Here is a fun pumpkin visual discrimination and scanning activity.  Print out the black and white page (get access to the FREE download at the bottom of the post).  Grab a timer and 3 different colored dot markers (or any colored markers).  On GO, students have to use their visual discrimination, visual scanning, visual tracking and visual motor skills to find one pumpkin at a time while they scan from left to right and top to bottom.  Be careful not to mark the wrong ones!  Some of the pumpkins look very similar.

Want more Ready, Set, Scan activities?  Check out the complete Ready, Set, Scan digital download.

Ready Set Scan

Find out more information about the complete Ready, Set, Scan digital download.

Want more timed games?  Check out Speed Match, Motor Minute Challenges and Set the Record.

Need more pumpkin ideas?

Pumpkin Packet - Your Therapy Source

This Pumpkin Packet includes 11 no-prep, FUN activities to get children practicing fine motor, gross motor, and visual perceptual skills. The digital download is great for brain breaks, indoor recess, classroom party and more!  FIND OUT MORE INFORMATION.

 

Sign up to receive our email newsletter to get access to the Ready Set Scan Pumpkin challenge.  If you already subscribe, just enter your email and you will be redirected to the FREE download.

Pumpkin Visual Discrimination and Scanning Activity

The post Pumpkin Visual Discrimination and Scanning Activity appeared first on Your Therapy Source.

Wednesday, October 11, 2017

Research Review on CIMT and Bimanual Therapy for Children with Cerebral Palsy

CIMT and Bimanual Therapy for Children with Cerebral PalsyResearch Review on CIMT and Bimanual Therapy for Children with Cerebral Palsy

Pediatric Physical Therapy published a systematic review comparing modified constraint-induced movement therapy (CIMT) and intensive bimanual therapy in upper limb function in children with unilateral cerebral palsy.  After searching 4 electronic databases from 2009-2015, eight articles met the inclusion criteria with a total of 221 participants who received either intensive bimanual therapy or modified CIMT.

The results indicated the following:

  • both intensive bimanual therapy and modified CIMT improved quality of unimanual movement, bimanual capacity, and movement efficiency.
  • a weak, specific recommendation for intensive bimanual therapy in improving movement quality
  • a specific but weak recommendation favoring intensive bimanual therapy to improve the child’s performance on parent-reported outcomes.

Reference:  Klepper, S. E., Krasinski, D. C., Gilb, M. C., & Khalil, N. (2017). Comparing Unimanual and Bimanual Training in Upper Extremity Function in Children With Unilateral Cerebral Palsy. Pediatric Physical Therapy29(4), 288-306.

Read more about unilateral cerebral palsy:

Motor Learning in Children with Unilateral Cerebral Palsy

Goal-Directed OT Programs for Unilateral Cerebral Palsy

Tactile Function of Children with Cerebral Palsy

CIMT, Bimanual Therapy, and OT Home Programs

Therapeutic Play Activities for Children Download

Therapeutic Play Activities for Children digital download includes 100 play activity pages and 12 tip sheets. The play activities encourage the development of fine motor skills, bimanual skills, rolling, crawling, tall kneeling, standing balance and cruising with a strong focus on children with cerebral palsy.  FIND OUT MORE INFORMATION.

CIMT and Bimanual Therapy for Children with Cerebral Palsy

 

 

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