Category Archives: Occupational Therapy

Sharing, Networking & Learning at ATIA 2018

by Sandy Masayko

From presenting sessions to volunteering and networking, Easterseals of SEPA was an active presence at the Assistive Technology Industry Association Annual Conference in Orlando, Florida at the beginning of February.

Joy McGowan, Melissa Spada and Sandy Masayko presented “Eye Gaze Technology: Supporting Preschoolers in Participation, Play and Communication” to a standing-room-only crowd of over 60 people. The audience asked many questions and shared some of their experiences with the technology as well.  Laurie McGowan joined Susan Tachau of the PA AT Foundation and Kirby Smith of SunKirb to share “Smart Home Technology” to a group that included technicians who install this kind of technology as well as therapists and consumers.  Using easily acquired commercial devices has revolutionized home adaptations and has decreased costs significantly.  The presentation was well received.

As a volunteer, Marcia Leinweber assisted presenters in setting up their sessions and attendees in finding the workshops that they wanted to attend.  Sandy and Marcia also attended a workshop to develop the AT program at Easterseals.

Melissa Spada participated in a workshop where she learned to make adapted toys from low cost materials and picture symbols.  She even won a sample toy to bring back to Easterseals!

Networking was an important part of the conference too.  Our team caught up with Mary Elizabeth McCulloch of Project Vive, who shared her latest prototype of a low-cost speech-generating device.  Mary Elizabeth will be visiting Easterseals soon to explore some new switches and to pick up some of our adapted cars that need repair and additional adaptations.  Sandy visited with Lori Binko of LessonPix to hear about her experience of introducing adapted ride-on cars into her inclusive preschool class.  Easterseals of SEPA actually purchased one of the cars for her program several years ago for engineering students at University of Florida to use as a prototype when the students coached us on adapting the ride on cars.  We donated the completed car to Lori’s program, and it was gratifying to learn how the use of the cars increased her students’ abilities to move, socialize and develop cognitive skills.

Cinnamon-Scented Ornaments

by Alyssa Brief MS, OTR/L & Rachel Rosenblum MS OTR/L

Occupational Therapy activities can multiple therapeutic benefits…in addition to being fun! Below is wonderful activity that is sure to be a hit!

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Materials:

  1. 3/4 cup Applesauce
  2. 2 bottles of ground cinnamon (2.37 oz each)
  3. Parchment paper
  4. Ribbon or yarn
  5. Cookie cutters
  6. Toothpick

Directions:

Mix applesauce and cinnamon into a mixing bowl, stirring or kneading until material reaches dough consistency. Scoop out a handful of dough and place onto parchment paper on flat surface. Place another sheet of parchment paper over dough and flatten until dough is about 1/4″ thick. Peel top sheet off of dough and stamp cookie cutter into dough, peeling away the excess dough around the border. Use a toothpick to make a hole in dough towards top of ornament. Depending on thickness of dough, ornament will need at least 24 hours to dry into hardened ornament. Once dry, thread ribbon through the hole and tie a double knot at desired length.

Sensory benefits of activity: Using the spice of cinnamon stimulates the olfactory sense, or sense of smell. Kneading and flattening the dough provides tactile input through the sense of touch. It also provides opportunity to explore and discuss the texture if it feels sticky, smooth, wet, mushy, etc. Interacting with the dough provides a sensory-rich play experience.

Motor benefits of activity: Pouring in the ingredients works on using graded movements, or knowing how much force is needed to complete a task, to avoid spilling. Kneading and flattening the dough promotes fine motor hand and finger strengthening. Mixing the dough and stamping cookie cutters provide opportunities to use a variety of grasp patterns during functional tool use. Stabilizing the mixing bowl with one hand while stirring with the other encourages bilateral coordination, or using both hands to complete a task.

Cognitive benefits of activity: This activity requires completing steps in a certain order, or a sequence, in order to be complete. This can promote understanding of how a task can be completed start to finish, and can reinforce the concept of “first ___, then ____” while having fun!

Self-Care benefits of activity: A hand-washing routine can be incorporated in this activity such as before and after to work on this skill. Also the clean-up process provides an opportunity to practice cleaning up after oneself such as wiping the table or making a trip to the garbage.

Hope you enjoy!

Seasonal Sensory Success

by Alyssa Brief, MS, OTR/L

Making PlayDoh from scratch with common household items is a tried and trusted OT activity that can provide opportunities to develop hand skills while providing sensory input. With the holiday season now upon us, my OT group at the Philadelphia division’s Approved Private School recently enjoyed a seasonal twist to the traditional recipe- Gingerbread PlayDoh! This is an excellent (and wonderfully scented) therapeutic activity that is safe to eat since it is made exclusively with baking items. Making homemade Gingerbread PlayDoh can literally add some spice into families’ lives during vacation time off from school or on a Snow Day. Fun and safe for all ages and abilities, Gingerbread PlayDoh offers a fun play experience for children who are sensory seekers. This holiday season, I’m feeling incredibly thankful and lucky that facilitating creative sensory play opportunities is part of my job as an Occupational Therapist at Easter Seals.

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Gingerbread PlayDoh Recipe:
1 Cup Flour
1/2 Cup Salt
1/2 Tbsp Ground Ginger
1/2 Tbsp Ground Cinnamon
1 Tbsp Vegetable Oil
1/2 Cup Water
Mix ingredients together and knead until the ingredients reach consistency of PlayDoh. For longer lasting use, keep refrigerated in a sealed container. Enjoy!

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Motor time is more than just burning off steam

by Anna Lassman, OTR/L &  Laura Corbett

Motor play in most early intervention center programs tends to involve unstructured time in a gross motor room, or playground, to let the kids move around and burn off steam; however it tends to be a crazy, free for all kind of period of the day where both staff and students leave frustrated. Many of our students often feel lost when not directly engaged in a structured activity. We were finding an increase in challenging behaviors in our gross motor room due to the lack of planning and structure.

Staff in the Philadelphia Division EI Center noticed this as a problem and began brainstorming new ways to make our gross motor time more effective. The goal is to provide opportunities for our students to practice a variety of skills including general gross motor play, following directions, waiting their turn, turn taking and social play, making and sticking to choices, functional play, requesting, and entering and leaving the room calm and organized.

In January 2015, we were lucky enough to get a recreational therapy intern from Penn State and we knew this was a golden opportunity. With the help and leadership of our Recreational Therapy intern, Kate Shilkitus, wonderful things have happened. Not only are our children “burning off steam,” but also, they are practicing appropriate and functional play while following a routine and here’s HOW we made it all happen.

We started with gathering the classroom staff together and talking about the importance of motor room and all of its benefits. Cindy Goldberg, PT and Anna Lassman, OT provided support through a workshop where we discussed the program we hoped to create in the gross motor room. Together, we talked about responsibilities of the therapy staff and the Teaching staff members to make this all work. The following was discussed in detail:

  1. Use of motor time with a lesson plan that includes strategies to prevent challenging behavior. Some strategies included:
  • Including their interests to keep them engaged and motivated in the gross motor room (i.e balls, slides, pretend play, cars, etc.)
  • The use of reinforcers (bubbles, stickers, etc.)
  • The use of visuals to communicate expectations before they go to GM room.
  • The use of visuals to show the children “what comes next” and the agenda for the session.
  • The use of choice boards and structured smaller groups within the larger gross motor room space to guide play.
  • Bring/push class chairs down to GM room (heavy work that can be calming and organizing) for students to sit on at start, rather than opening the door and kids rushing in.
  • Gradually go from chair sitting to floor sitting as kids become used to new GM room routine
  • Use “clean-up” as part of the session.
  • Ending session with a calming/re-group type activity by the waiting area to build compliance momentum.
  • Use of time during team meetings to make a plan for the week in the motor room based on the above items.
  1. We discussed the properties of the equipment available and various ways to use them to expand play schemes.
  • Obstacle courses can be changed up mid- session.
  • More than one way to use pieces of equipment
  • Staff modeled creative ways to use a ball or a wedge, for example.
  1. What levels of assistance we use and how to fade or increase as needed based on individuals.

Based on ideas and feedback from the workshop, we began to put together visual materials, including a stop sign at door, marked places in the room for waiting areas, and activity and equipment use suggestions, but the prep work alone can be a very timely task. Fortunately having Kate, our recreation therapy intern, who was ready and willing to lead this initiative, we hit the ground running. We believe that what has made this program even more successful from the start is having Kate dedicate her time and energy in that room.

Following our workshop, Kate spent a great deal of time preparing the environment and doing the prep work. She created several visuals and utilized the strategies discussed to create expectations with the use of visuals. Visual supports are crucial for many of our students so in creating these, Kate helped to set our students up for success.

Here’s an example of our expectations upon entering the gross motor room

expectations

Here’s an example of our choice board that is set up everyday. Staff then model the different activities that can be done with each choice.

choices

Once Kate had everything prepped and ready to go, we rolled out the new program and collected baseline data on two skills: (1) Wait time with an expectation of average wait time to be 30 seconds to 1 minute with 2 or less redirections. (2) Following directions throughout the session with 2 or less redirections. Kate has been collecting data daily and the findings are outstanding! We have seen a dramatic improvement in just a short time. The chart(s) below gives you a clear picture that this new program is most certainly working.

data

Kate’s ability to help strategize, plan, and implement a new program is extraordinary. She spends endless time at school and at home reflecting on individual progress and the program as a whole. Unfortunately, Kate has left us as her internship has come to a close, but her hard work and lasting effects in establishing a consistent routine and program in our gross motor room are here to stay. The last three weeks will consisted of transitioning our teachers to lead and implement the program with Kate’s support. The teachers now feel confident in doing the same.

We look forward to continued success with this program and our students. No longer do our teachers need to “burn off steam” after a chaotic session in the gross motor room. We have successfully implemented a new program that keeps both students and staff calm and having fun.

 

Among friends

by Susan Lowenstein

As we approach the gym, we hear laughing and the beautiful sound of children playing. Ajay turns his wheelchair – teenage mutant ninja turtle green in color, by his choice – adeptly to the left and steers it easily into the gym. He sees many familiar faces in the gym – not those of his classmates, but of his school mates, and he eagerly propels his chair towards them, his curiosity peaked. He wants to see what they are doing, and does not want to miss out on the fun.

As I follow him closely, I see that these friends are walking and jumping and climbing and swinging easily and independently in the gym. Ajay quickly propels his wheelchair towards the group of children that are swinging on the platform swing. He loves to swing, and when he first started attending school and missed his family at home, it is the only thing that would console him. So it makes sense that his eyes gravitate towards the children that are enjoying his favorite pastime, so to speak. Or as our OT’s may call it, his favorite sensory experience.

Never was there a better motivator for Ajay than his able bodied peers enjoying the gym, or enjoying a turn on what he might consider his own prized possession, the platform swing! So I know this is my chance to get him to work – and I offer him a chance to swing – but only if he will try to walk to get there. Ajay is up for challenge, so quickly we get to work.

I retrieve his long leg braces and his walker from the hallway, and before long, Ajay is on the floor, cooperating easily with the tedious process of putting these braces on his legs. He is quite familiar with this routine, and I am amazed at his dedication. He does not refuse, cry or complain. He willingly complies with my requests to “scoot down” , “lie back” as I work to carefully don the braces and ensure a proper fit. All of a sudden, Ajay and I notice we have an audience. One little inquisitive boy named Ryan wants to get a closer look at Ajay’s long leg braces and even offers to help with the Velcro straps. Another friend Andrew asks freely “Why does Ajay need these braces?” . Their curiosity is obvious, their questions are matter-of-fact. After a brief explanation of why Ajay needs braces (“His muscles don’t work the way yours do, so he needs extra support to stand and walk”). Ajay’s friends seem satisfied with these answers and turn their attention to more pressing matters – like the fact that all 3 boys are wearing Teenage Mutant Ninja Turtle shirts!!! All the boys seem to agree that Andrew’s shirt is the coolest because it has actual googly eyes glued to it!

After agreement about the coolest shirt, it is back to work (and play) for Ajay. His friends Ryan and Andrew quickly jump up to their feet to head over the swing. Once I ensure that all of Ajay’s brace joints are locked for stability, I help him attain a standing position and he reaches out for his walker. It takes about 3-4 minutes for Ajay to take 10 steps with my help to reach his friends at the platform swing. Each step is a lot of work for Ajay. He has to lean on his walker with both arms and lift the weight of his lower body and long leg braces against gravity so he can swing them forwards. It is no easy task, but with his friends encouraging him from the swing, Ajay remains steadfast in his determination to walk. Little do his friends know how thankful I am to have them in the room – they are providing the motivation for Ajay to get up onto his feet!

True to my promise, I allow Ajay a nice long turn in his swing after he worked so hard to get there!!!! And the icing on the cake is that he gets to share the swing with his friend Ryan! The smile on all of their young faces while they swing together is a true reminder to me why I work at Easter Seals. I love to watch these kids understand their differences in abilities as well as enjoying what they have in common, which today is threefold: 1) loving the swing, 2) wearing their favorite Mutant Ninja Turtles shirt, and 3) enjoying time on the swing with a friend

Halloween Tips

Halloween is upon us and this is a super exciting time for children….and many adults! But for some children, especially those with sensory processing issues, it can be a challenge.

We found a great article that shares some basic tips for children with sensory processing issues on Halloween. We love Halloween at Easter Seals and hope it is safe and successful time for every child! Read the article…

Happy Halloween!

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Why is messy play so important?

by Anna Lassman

Top 10 Reasons!

  1. Opportunity to practice and refine fine motor – hand/finger skills
  • Opportunity to use hands, fingers in a different way. Practice various grasp patterns, pinching, poking use of both hands to push or pull, etc.
  1. The great experiment: Learning concepts and characteristics of substances and how we can impact it. Grading motor control: how do I control the way I touch and handle substances?
  • Learning about different textures, consistencies, density of materials while at play. Is it thick/thin, heavy/light, lumpy/smooth, cool/warm?
  • Exploring different ways to handle materials: What happens if I squeeze it hard/ medium/lightly? What happens if I stroke my finger very lightly over the surface? Can I poke a hole into it? What happens if I push a car through it? What happens if I blow on it? How can I find something hidden it?
  1. Desensitization for tactile defensive kids.
  • Various strategies to decrease sensitivities to messy materials: Start with dry/smooth textures and gradually add texture; can use tools to touch wet messy materials, gradually encouraging child to use their hands, etc.
  1. Learning to follow steps or sequences
  • Have child be involved with creating the sensory material; following a recipe or multi-step directions
  1. Practice use of tools and what they can do.
  • Learn to pour, stir, scoop and use other tools (ie- scissors, rolling pins, tongs)
  1. Task orientation.
  • Work behaviors involve preparation, starting, completion and clean up. All aspects of the task are just as important as the actual play- helps with task focus, persistence, transitions. Also provides opportunity for grooming practice (washing hands).
  1. Provides opportunity for cooperative play
  • Working alongside peers while engaged in messy play fosters social skills.
  1. Opportunity to explore creativity with a non-structured activity.
  • It fosters imaginary play.
  1. Opportunity to explore ways to add structure for pre-academics
  • Writing letters in shaving cream, drawing faces and/or geometric shapes or forming them with play dough
  1. IT’S FUN!!!

Anna Lassman has been an OT for 35 years, working in a variety of pediatric settings in New York, California and, for the past 18 yrs, in Pennsylvania. She has been with Easter Seals in the Philadelphia Division as the OT department head for 7 years. She has special interests working with infants and young children with feeding difficulties as well as working with children with neurological impairment. Her favorite aspect of her current job is the ability to mentor new practicing OT’s as they begin their career in the field. Anna loves the ocean and misses easy beach access, but loves the Philadelphia area.