Tuesday, August 27, 2013

What's in Your (OT) Closet??

I may be in a bit of denial about summer ending and school beginning in the next couple of weeks.  I love the quietness of the summer; the chance to regroup and prepare for a kids returning for another year of therapy and welcoming new ones to my caseload.  I think I get as anxious as the kids those first few days!  So much paperwork and getting to know new kids, get used to my new schedule and all the worrying about not having a full caseload yet.  Too much for my mind to think about but I guess since it is only two weeks away from happening, I have to start thinking differently and getting excited about it!

A few weeks ago, I was happily forced to clean out my overly stuffed closet since the gym I work at was prepping for renovations.  This is something that I should do more often but avoid like the plague.  I found so many things that I hadn't used in ages because they were buried and others that hadn't been used because they weren't worthy using anymore.  As the new school year begins, I thought I would share my top 5 items in my closet that are consistently used and recommended to others.  I am hoping that I can get some ideas from all of you on your favorites and if there is anything I should be getting for this upcoming school year. I love to use the new school year as an excuse to introduce new things to not only the kids I work with, but to me.  I get bored of doing the same things over and over again and imagine that the kids feel exactly the same way.

Here is my list of things I couldn't live without in my closet along with the goals that are worked on using them.

1.  Theraputty-I think it's safe to assume that all us occupational therapists have at least one or two containers of theraputty in their closets.  I use it daily to work on increasing grasp and hand strength, improving bilateral skills and improve in-hand manipulation skills.  Most of the time, I hide little objects (Mancala animal pieces, Perfection shapes, money, etc.).  For the younger children, I use little pegs and have them place them into the putty and pretend to put candles on a birthday cake.  After they put them on, we working on grasping skills by having them pull them out (I encourage them to use their pinchers to remove them).  I have used the green medium-soft the most from Southpaw Enterprises.  While researching different types this year, I heard about Discovery Putty from Fun and Function.  I am about to place my order for the new school year!  Not only do I love the packaging (so easy to throw in a bag for you therapists who travel from place to place), I love that they already have lots of fun things hidden in the putty.  I have a feeling this could be much more motivating for some of my kids who really struggle with the green theraputty.

2.  Mechanical Pencils-I have experimented with a ton of mechanical pencils over the years but none compare to the Cadoozles Daisies or the Zebra #2 pencils by Zebra.  They are the perfect size for smaller hands and are the right width if you have a child who uses a pencil grip to work on proper grasp.  Mechanical pencils are great to work on improving the amount of pressure kids use when writing.  A lot of the kids I work with have a hard time modulating the pressure they use when holding writing instruments, often pressing too hard causing their hands to tire quickly.  If their hands tire quickly, they will have a harder time writing for longer periods of time which is inevitable as they move through the grades.  When using mechanical pencils, if you press too hard, the lead will break.  It takes a little time, but eventually kids figure out the right amount of pressure to use.  You can order these pencils online or check out local stationary stores.  I know that the toy and stationary store on 72nd Street (between Broadway and Columbus) carries them.  I have also seen them in the bigger stores like Staples and Target but my preference is to support small businesses first.

3.  Kumon Workbooks-as I am sure everyone has noticed lately, there are a million different kind of educational workbooks out there.  I walk into Barnes and Noble and am consistently overwhelmed by the number of choices I have.  In the end, I always end up going with the Kumon books.  I love the variety of subjects that they cover and find that my kids (including my own 3 1/2 year old daughter) are motivated by them.  I discovered them years ago when looking for good cutting workbooks and immediately fell in love with the books.  The pictures are fun and most importantly (for cutting especially), the quality of the paper was far superior than other books I have used in the past.  This is especially important for cutting because if a child already struggles with cutting and the paper is flimsy, they are going to continue to struggle.  Kumon continues to impress me by adding to their lineup of books.   However, I will always suggest the cutting, coloring and pasting/gluing books to parents.  A few years ago, I discovered their Play & Grow Workbooks which are great for older preschool/younger school age kids because they can work on their cutting and coloring skills while making a story.  I found these two books to be really motivating for some of the kids who really struggle with these skills.  As you can see in the image above, there are so many books to choose from.  The other nice thing is that they have books that are totally appropriate for younger kids and once they complete those, they have more challenging books to move up to.  While you can find these books at larger book stores, check out local book or stationary stores as I have found that they tend to carry them as well.  Again, Toy and Stationary World on 72nd Street has a large variety of these workbooks.

4.  Fiskar Scissors-I have tried dozens of scissors in my career, but Fiskars are definitely the best.  They are comfortable for the kids and I rarely hear a child complain that they are uncomfortable.  They can be used for lefties or righties (although they do have dedicated left-handed scissors available) and they come in a blunt or pointed tip.  I find that the pair shown in the image to the left can be used with my pre-schoolers and school age children.  If you happen to have a child with larger hands or work with older school age children, Fiskars does have larger children scissors.  You can easily find Fiskars at drug stores, school supply stores and larger stores like Target and Staples.

5.  Perfection (the game)-out of all of my games, I think Perfection is the one I use the most.  There are so many occupational therapy goals that can be worked on with it and the kids never seem to tire of it.  The most obvious of goals is to improve visual perceptual skills such as matching and visual attention.  I like to put my kids on the net swing and have them lie on their bellies so they can work on increasing upper extremity and neck strength at the same time.  As I mentioned earlier, I also will take the pieces and hide them in theraputty so they can work on increasing grasp strength at the same time.  If you have a child who needs to work on grasping skills, Perfection is a great game to use as the pegs sticking out from the top is ideal for using a pincer grasp.  The funny thing about this game is that I rarely use it the way it is intended to (placing all 25 shapes in the right spot in 60 seconds or less).  Every once in a while I will have an older kid who wants to beat the clock, but for the most part I adapt it to work on other goals so the timer part of the game hardly gets used!  Check out your local toy stores if you are looking for this game.  It's still a popular game and is pretty easily found.

So, here are my top five items in my closet.  I am excited to hear from all of you with your ideas and suggestions.  I would love to start the new school year off with some new and exciting toys, games, supplies that will help to motivate my kids and make them excited about coming to therapy.  Please don't hesitate contacting me if you have questions or want to share your ideas with me.  I am just a click away and love hearing from you all.

And here's wishing you all a happy new school year!

Tuesday, August 13, 2013

Rainbow Brights!

If you have a young girl or know any young girls (or young boys for that matter), I am pretty certain you have heard of the latest craze, The Rainbow Loom.  Thanks to my goddaughter, I learned about the Rainbow Loom in April before it was virtually impossible to find in the stores.  Meghan was wearing the bracelets and showing me her whole setup.  Once she started making one for me, I was sold.  I went home immediately and bought two looms; one for work and one to keep at home for any younger visitors to play with.  Since bringing it to the gym, it has been a huge hit.

If you don't know about the Rainbow Loom, let me tell you about it because it is truly a perfect addition to any occupational therapist's bag of tricks, especially if you work with school age children. Basically, the Rainbow Loom (pictured at the left) is a set to make friendship bracelets.  Using a plastic loom, a hook and a bunch of brightly colored rubber bands, you make an awesome bracelet out of small colored rubber bands.  You place the rubber bands on the loom and then use a hook to weave the rubber bands into a colorful bracelet.  I encourage the kids to use their pinchers (fine pincer grasp) to place the rubber bands onto the pegs.  You have to follow a pattern so this is great for visual motor and visual perceptual skills.  I encourage the children I work with to choose a pattern and follow it from beginning to end to work on planning and organization skills in addition to the aforementioned visual skills.  If you have a child who needs to work on visual skills, this is a great craft activity for them.

Here is the original set.  Perfect for throwing in a bag
for those of you who do lots of home care or running from
school to school
Each set (pictured at the right) comes with the original Rainbow Loom pattern.  As of right now, that is the only one I have used with my kids at work.  However, if you have a child who has mastered the original bracelet pattern and is ready for more of a challenge, You Tube has step-by-step videos for tons of other patterns.  You can also check out the Rainbow Loom website for some links to other videos.  As a child becomes more of a master, you can start seeing how independent they can become learning new patterns by watching the videos.  I guarantee that if a child who has struggled with these types of activities can figure out the different patterns on their own, their confidence and self-esteem will improve by leaps and bounds.  It may even motivate them to try other activities that have been challenging for them in the past.

In addition to what I have already mentioned, The Rainbow Loom can work on the following occupational therapy goals:
This child is using great bilateral coordination
for the completion of her bracelet
Improve Bilateral Coordination Skills-this is a great activity to focus on bilateral coordination skills in a fun and motivating way.  So much of this activity requires the use of two hands.  From putting the rubber bands on the loom, to stabilizing the loom with one hand while the other holds the hook to removing the completed bracelet from the loom with one hand while holding the loom still with the other.  So many ways to address this OT goal in a sneaky way (love tricking the kids into working on goals)!
Improve Grasping Skills-if you have a child who struggles with pencil grasp, this is another way you can work on encouraging a proper grip.  If you look at the picture below, you will see that you should hold the Rainbow Loom hook with a tripod like grasp.  I work with so many children who avoid working on handwriting activities and most of the time it is because their grasp on a writing instrument causes them so much difficulty with the task.  Using the Rainbow Loom can be a sneaky way to work on improving a pencil grasp without the child even knowing it!
Check out the tripod grasp being used in this picture.
This is the grasp that is expected when holding a writing instrument
Improve Focus and Attention-if you are trying to work on increasing a child's attention span and ability to focus, this is a perfect activity for them.  It is crucial that a child has good attention and focus when completing their bracelets because there are a lot of steps to completing each bracelet.  If you take your eyes away and lose focus on where you are, there is a chance you will have to start from the beginning again.  I try and help keep the children I work with who have decreased frustration tolerance by calling their attention to where they are and what the next step is.  Sometimes, having children talk through the next step, they are more successful.  As each child becomes more confident with their looming skills, you can decrease the amount of assistance you give them.  If you look at the picture above, you will see a child deep in concentration....something I strive to see in the kids I work with.  
Do you have a child who needs to work on his/her organizational
skills?  The Rainbow Loom kit above is a great way to
encourage a child to keep their supplies neat and organized.  
 Improve Organizational Skills-for children who lack organzational skills, this is a fun way to work on that.  Instead of having them just pick through the rubber bands while making the bracelet, I have them take out all their supplies first.  If they are following a pattern, they have to figure out how many of each color they need and put them in piles.  When they begin actually making the bracelet, they aren't wasting time digging through all the rubber bands.
Improve Self-Esteem and Confidence-I can still remember making friendship bracelets when I was younger.  I can remember struggling learning how to get it just right and feeling frustrated when it didn't come out perfectly.  But then, I finally got it and finished that bracelet and gave it to a friend and felt so good about myself.  Since this is an activity that is a bit of a fad right now, all the kids want to do it and do it well.  Being able to take their looms and make bracelets alongside their friends will help the kids I work with feel better about themselves and much more confident in his/her skills.  And in the end, if I have helped make a kid I work with feel better about themselves, then I have done what I truly set out to do.
Improves Social Skills-as some of you know, the Rainbow Loom is a craze right now.  I know my almost 8 year old niece and her friends have made hundreds of them this summer at her camp.  They sit together and share their materials, help each other out when they need it and exchange completed bracelets.  I just gave Julia her very own Rainbow Loom Deluxe kit and she is beside herself.  She is on vacation now, but know that she can't wait to show it off to her friends and make more bracelets with them.  This is such a great social activity for kids that doesn't involve electronics and/or screen time which I find to be such a welcome thing for school age kids.

How many of you have memories of making friendship bracelets growing up?  I can clearly remember going to the craft store with my mom and sisters and picking out tons of embroidery thread and spending hours and hours with my clipboard creating bracelets.  It wasn't easy and I had to start over again time and time again, but the satisfaction I felt when I completed a bracelet was awesome.  It made me feel so proud to create something and then be able to give it to a friend or family member.   I am loving watching that satisfaction and pride in the children I am working with.  What I really love is that this is an activity that is the rage amongst so many young (6-10 years old) kids this summer.  So when a child I work with, who typically struggles being able to do things like their peers, masters this, I know they feel good and are more likely to try this with their peers.  Way too often, I see children I work with avoid to do activities that they really want to do because they are afraid to not be as good as their friends.  I love watching them practice and then master something like the Rainbow Loom and then go out and do it alongside their friends.  Not only makes them feel proud, but it makes them feel like they are part of their peer group which is something that many of the children I work with typically struggle with.

If you are wondering where you can pick up a Rainbow Loom kit for your kids, I suggest checking out local toy stores first and seeing if they carry them.  My love of supporting small businesses is no secret.   I know that Stoopher and Boots on the Upper West Side in Manhattan carries them (and the accessories).  The educational store Learning Express carries them as well.  If you have no luck there, check out Amazon.com and see what you can find there.  This is where I found the Rainbow Loom Deluxe kit for my niece Julia's 8th birthday and am pretty certain I have not given her a gift that has made her this happy in all 8 years of her life!

I am excited to hear about your experiences with the Rainbow Loom with your kids.  Do you have a pattern that you have introduced to the kids you work with that has been easier for them than others?  Have you come up with ways to adapt the activity for children?  I would love to hear from all of you about your experiences with the Rainbow Loom.  As always, I am just a click away and really do love hearing from my readers.  


Friday, August 9, 2013

It's All About Teamwork

As a therapist, I wear many hats.  I do all the 1:1 private practice stuff at two sensory gyms in NYC (Heads Up and SAGE).  I am a co-founder of the most amazing after school program, The Meeting House, for school age children with social special needs.  And I run smaller social skills groups with a speech therapist I have had the joy of working alongside for years now.  Professionally, I can't think of a luckier therapist than me.

With all of those different hats I wear, the toys, supplies and equipment I need varies from setting to setting so my eyes are ALWAYS open for new and fun things that would be appropriate for each place.  Yesterday, while walking around the UWS trying to kill some time between clients, I found myself in Stoopher and Boots, a super cute kids store that carries not only adorable clothes but also a great selection of toys.  I'm super excited for the new game I picked up and think that many of you will love it as well, especially you parents of multiple children or therapists/educators who tend to see groups of kids.  Stack Up by Peaceable Kingdom is a perfect game for preschoolers.  It is great across the pediatric disciplines as it covers goals for occupational therapy, speech and language therapy, physical therapy and educational goals!  I can't think of many other games in my very large and overstuffed closet that do that.

Stack Up is a cooperative game that focuses on having all the players work towards the same goal as opposed to being first or the winner.  The object of cooperative games is that you focus on working together and not as individuals.  Nobody is made to feel left out or made to feel as though they didn't do a good job.  The point of the game is that in order for you to win, you need to be part of a group and play with your friends, not against them.  Cooperative games have becoming increasingly popular since I began working in schools about 10 years ago.  I love them because I find that for some of the kids on my caseload, they spend so much time working 1:1 with grownups that they lose out on opportunities to play with their peers outside of the classroom and may present with difficulties playing games appropriately.  I am lucky enough to work in an office with other occupational therapists and speech therapists.  If the kids are appropriate for one another, we will put aside some time to play a game together; this is great for all those involved.  For parents who want to encourage their children to play together more peacefully, this game is perfect!  Sometimes parents tell me they have a hard time letting their kids play games together because it leads to so much fighting and upset when somebody loses.  This could be a good solution to the sibling game-playing blues.

In addition to what I already talked about, here are a few more goals that can be worked on while playing Stack Up:

Improve Eye-Hand Coordination-this is a fun way to work on eye-hand coordination without the kids even realizing they are working on it!  My favorite kind of activity...one that can be super fun but help reach some of those occupational goals.  A child requires eye-hand coordination to put the stick in the hole of the block and then they need to carefully look at where the block goes and how to stack it on top of the other without it toppling over.  Sounds easy but when you have kids do it at the same time, it can be quite tricky for them.
Improve Frustration Tolerance-cooperative games are a good way for kids to work on improving their frustration tolerance.  Not just towards an activity, but in regards to working with another child. This is such an important skill for kids to develop but not always an easy one to work on.  Children who have good frustration tolerance will most likely play better with their friends.  

Improve Color Recognition/Matching Skills-another great aspect about this game is that you can use it for younger children who are still in the early stages of learning their colors.  As you spin the spinner, you land on 1 of 4 colors; you can use this as an opportunity to not only learn colors but to work on matching and sorting colors.  For younger children who aren't quite ready to play the game, you can use the opposite side of the board and have them sort colors onto the right colored square.
Improve Social Skills-I find it is very difficult to teach a child the importance of team work and not always having to be the winner.  So many of the children I work with think that if they win, they are the best.  I love that the concept behind this game, and all cooperative games, is that the way to win is by working together and making decisions as a group, not just on your own.  There are a lot of collaborative games out there but many are geared towards older children and, oftentimes, don't always hold the interest of the kids.  I love that this is easy to understand and even easier to adapt for whatever the group of children are able to handle.  This game is also good for encouraging conversation amongst friends which many of my kids need to work on.
Improve Motor Planning-depending on how you play the game, you can add a physical component to the game.  If you land on a challenge when you spin, you pick up a card with some kind of physical challenge (the whole group should perform this).  For example, my favorite challenge is to do a jumping jack and freeze in a legs open position.  The kids found this to be really funny and we were able to work on a skill that is sometimes hard for them.  Other challenges include standing on one foot, giving a friend a high five and holding it for 5 seconds or making silly faces.  All of these things may sound easy to you but for children with motor planning difficulties, it can be quite challenging and they may avoid trying it.  This game motivates the kids to try it in a really fun way.

I am really excited about trying this game out with the kids signed up for my social skills group in the fall.  I am also anxious to check out a few more of the games that Peaceable Kingdom has created.  The other cooperative games they have on their website look like they will be a lot of fun as well. In addition to more cooperative games, they have regular board games, card games and sticker sets.  I'm impressed not only with the quality of the product but with the thought that has been put into creating the game.  I am sure their other games and products will prove to be equally as wonderful.

Do any of you have cooperative games that you can recommend to me and my readers?  I would love to start the fall with a few new games to use during my sessions at the gym and also for my social skills groups.  Please share your ideas with us all!  While this game is targeted towards the younger kids, I also work with older children both in my private practice and at The Meeting House and would love a few more games for that population.

As always, I love hearing from my readers and am just a click away.  Looking forward to hearing your ideas and suggestions for other fun and motivating cooperative games.