Tag Archives: Occupational Therapy

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.

 

Meet Nicolas

Walk With Me is next weekend and the energy is really picking up! Nicolas is one of the Honorary Ambassadors we are so excited that he will be part the Walk. Make sure you go here to register so you can be a part of this powerful day!

Meet Nicolas….

Nicolas

Nicolas is a very happy 4 year old! He has microcephaly and has been defying the odds since the day he was born, which explains his sweet smile. His mom was told that he would not be able to drink from a bottle or use a pacifier, but fortunately for Nicholas, his mom believed he might defy the odds…and she was right! He began receiving services at 3 months old and when it time for center –based services, Nicholas came to Easter Seals, just as his parents had hoped he would. Since then, he has become more aware of his surroundings, he loves to be social and his personality is really shining through. Most importantly, his parents know he is loved, which they say makes a huge difference! When he is not in school, Nicolas loves playing with his big brother Evan, and his dog Giselle. He absolutely loves country music! When you meet Nicolas, it will be easy to see why he is so loved!

Meet Shane

Only eleven days until Walk With Me! Have you signed up yet? Do you know who you are walking for? If not, you can register here and learn who your ambassador will be. It might just be Shane.

Meet Shane…

shane

Shane has some serious style, right down to his amazing smile. Shane is a sweet , affectionate, 4-year-old boy with autism. When it was time for him to start center-based services, it was recommended that his parents consider Easter Seals. As soon as they visited, they knew it was the right place. Since Shane has been attending the Early Intervention Program, he has gained more words…he especially loves to sing, and is much better at following directions. When he isn’t in school, you can find him holding his baby brother, Ashai. He also loves watching movies, especially Frozen and Rio! And his all time favorite thing in the world? Cars! Toy cars, real cars, Shane loves cars. And also, just like most kids, he loves to eat, and his favorite food group is candy! All eyes are on Shane, not just because he is so cute, but also because we are excited to see what he will do next!

Perspectives from a Student Teacher

by Elizabeth Anzevino

As a double elementary and special education major at Saint Joseph’s University, I had already experienced seven weeks student teaching in a Kindergarten classroom. I conducted lessons, created assessments, and practiced behavior management techniques. But I knew student teaching at Easter Seals would be an entirely different experience. I did have a background in working with students with Autism and developmental delays from my job as a substitute teacher back home in New Jersey, but I wasn’t exactly sure what to expect on my first day here back in March. But between then and now, as my time as a student teacher is finished, I learned more than I ever could have imagined from my cooperating teacher Megan Guthrie, the staff, and most importantly the students of the Bear Cubs classroom that I got to spend every day with.

After that first day I quickly understood the team effort that went into teaching this group of preschoolers. The coordination and planning between Megan, her assistant Robin, and all of the therapists that came through the door that day amazed me. I always knew that these team members worked together in order to carry out goals of an IEP and to manage a class, but I had no idea how dedicated and involved everyone truly was. As I took more of an observing role the first week or so, I quickly became integrated into the every day activities of the classroom, and I learned that a great deal of planning, structure, and attention to detail had to be given in order to get through the day as smoothly as possible, and in order for the kids to gain as much out of the day as they were able.

Throughout the seven weeks that I was a part of the Bear Cubs I learned more and more about each of the individual students, and it helped me as a teacher. Megan gave me the responsibility to take over circle time as well as whole and small group lessons, and I facilitated transitions from one activity to the next. With my lesson planning I truly got to implement what I had been learning about differentiation for the last four years; and I also saw how challenging it could be. Although I did a lot on my own I truly learned that talking to other teachers and therapists helped with making accommodations and modifications for each of my students. I learned firsthand how the IEP process worked, took and interpreted data on functional routines within our class, and I even got to conduct assessments using the Star Program. Megan and I made many changes to our classroom throughout my time at Easter Seals and it taught me that things will always be ever changing, and as a teacher I will need to be flexible. As much planning as we do, there are always things that pop up unexpectedly that we as teachers are responsible for handling, and in the end it makes us better educators.

The experience I received from Easter Seals is one that I will keep with me always. The environment there is so positive and energetic and made me love going each and every day. Now that student teaching is over and graduation is approaching, I truly miss every second of it, and it makes the time I spent there that much more special. As I start graduate school, I know that Easter Seals has taught me so much I will be able to take with me. I feel more than prepared for my future career because not only did I learn and observe while I was there, but I did it. I was the teacher. I will be forever grateful to Easter Seals and am so happy that I was placed there.

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!

Halloween 055 Halloween 061

Finally it’s SPRING TIME!!!

by Megan Guthrie

We have fully embraced the idea of spring and all that it encompasses in the Bear Cubs classroom. With our Occupational therapist we made a Paper Mache bird house out of a milk jug in the morning class and took our experimentation outside for the afternoon group. As we always say here at the Early Intervention Center, it is more about the process, not the product and being very flexible. As we weremaking our bird house outside we quickly realized that we forgot our Paper Mache materials. To improvise we used grass, sticks, flowers, nuts, and dirt (things that we thought birds would like on their house). The afternoon kids loved collecting the items for the bird house and we made it a more of a nature centered lesson opening the conversation up to talk about what we saw on the ground and what we thought birds eat.

In keeping with the spring tradition of gardening, we have planted carrots and flowers. Each child decorated their pot with stickers, and of course Thomas the Train made it on to most of the pots. Weplaced them next to the window to get the most amount of sunlight and have loved watching them grow and being a part of the process by watering them every day. We have been reading the book, Planting a Rainbow, which talks about planting and growing various flowers. This project really helped our children to better understand what it means to plant.

Painting Bird House Making bird house Painting Bird House 2