Saturday Seminar: Analyzing Activities for Improving Student Hand Function

Not even an anticipated nor’easter kept 30 hardy New Englanders from attending last Saturday’s seminar at Therapro, Analyzing Activities for Improving Student Hand Function! Marcia Bridgeman, MHA, OTR/L presented an interesting, well paced seminar that engaged her audience fully as she seamlessly mapped hand development from birth to elementary school age, linking the development of hands to functional skills.

Marcia is the author of the newly revised Fine Motor Olympics (2016) that includes a Manual and 64 beautiful color photo cards of children’s hands performing fine motor tasks with instructions on the reverse side of the cards. A Guide to Hand Function, Quick Screening Form, Fine Motor Observation Checklist, Record Form, and In-Service Training Program are included in the Manual. She currently has a private practice through which she provides consultation and direct service to several Massachusetts school systems.

Interspersed within a comprehensive review of motor development and hand function from newborn to age 6, Marcia discussed functional fine motor activities expected at the corresponding developmental stages. For example, around the age of 7 months, many essential new fine motor skills are emerging including finger isolation, open web space, opposition, and thumb isolation.  She matched simple activities to this developmental level, such as tearing paper, turning knobs on an Etch-a-Sketch, and spinning a top, to name a few!

Seminar attendees thoroughly enjoyed breaking into groups and trying out 8 original fine motor activities that Marcia created that are not included in the 64 activity cards included in Fine Motor Olympics.  The activities included activities like creating a spider web in a plastic basket and moving the spider in the web, using a variety of tongs to hunt tiny dinosaurs, balancing marbles on golf tees, and threading straws into toilet paper cardboard rolls punched with holes. The groups engaged in activity analysis and shared their comments with the rest of the group.  Attendees took away new, inexpensive ideas to engage the entire classroom and facilitate development of hand musculature and arches of the hand for optimal function. In addition to the new activities Marcia introduced today, she highlighted a number of fine motor Therapro products she loved, including Wacky Web, Hide ‘n Slide, Froggy Feeding Fun, Wind Up Walking Robots, Boinks, Tall Stacker Pegboard Set, Get A Grip Pegboard, and Magnetic Marbles.  She discussed conventional uses for the materials and also adapted the materials creatively and adeptly to help develop muscles of the hand. Some activities incorporated use of intrinsic muscles in translation activities, for example: moving a small single object fingers to the palm (1.5 – 2 years) and from palm to fingers (2.0 – 2.4).

We couldn’t think of a more fun way of spending a snowy Saturday morning than analyzing both innovative and familiar fine motor activities, and sharing thoughts on how to help develop better hand function in the classroom setting in a fun way.

Take a look at the glowing comments Marcia’s seminar generated:

“Great combination of visuals, interactive experiences & developmental stages. Great workshop for OT rookies or vets!” Karen D., Occupational Therapist

“As a teacher, I’m certainly not an expert on OT issues students may be experiencing. This seminar helped to raise my awareness and sensitivity to these issues. Great suggestions for how I can help these students in easy, quick, fun ways.”  Maura M., Teacher

“This seminar revisited & reviewed a lot of what I learned in school (great refresher) however I’ve had colleagues who did not have pediatric courses regarding this!”  Kelly V., Occupational Therapist

“Very informative; great to be interactive & experience/explore activities!”  Caitlyn D. COTA

“Such meaty well organized info on hand development, screening, and activities to help hand function.”  Alice T., Occupational Therapist

Thank you, Marcia!

Filomena Connor, MS, OTR/L

Saturday Seminar: Sensory Differences and Mealtime Behavior in Children with Autism

Jeanne-Zobel-LachiusaEvidence based practice (EBP) involves the integration of:

  1. Clinical expertise,
  2. Scientific research, and
  3. Patient/caregiver perspective.

The goal of EBP is the improvement of patient outcomes. It holds us accountable for our treatment plans, strategies and outcomes among our peers and other health care professions. According to the AOTA, generating research in the field of occupational therapy is “critically important for advancing the field and ensuring the viability of the profession.”

Jeanne Zobel-Lachiusa, EdD, OTR/L was the featured December Saturday Seminar Series speaker, who shared her research on Sensory Differences and Mealtime Behavior in Children with Autism (AJOT September/October 2015, Vol. 69, No.5).  In summary, the study results helped to identify problem eating behaviors in children with ASD that may be associated with sensory differences. Children with ASD were compared with typically developing age-matched peers. The study concluded that children with ASD who receive occupational therapy that offers sensory strategies might result in less stressful mealtimes.  The findings supported the need for further research in this area of self-care with children who have been diagnosed with ASD.

The seminar attendees were from varied backgrounds, including occupational therapy, speech therapy, special education, social work, psychology, child care, medicine, and parents. They engaged in a lively brainstorming session on sensory strategies in the different sensory domains that might provide mealtimes with less stress for both the child and family. They shared innovative as well as tried and true ideas with the group.

Just a few examples of the many suggestions include ideas for tactile and oral sensitivity:

Hush BuddyFor auditory sensitivity Jeanne suggested:

For children with sensitivity to fluorescent lights that flicker and glare in the cafeteria or classroom, Fluorescent Light Filters, which are magnetic were recommended. Another suggestion was for the student to wear a visor to reduce vision sensitivity.

Jeanne suggested a number of resources for the group including the book, Autism Interventions, and recommended the AOTA website for its user-friendly handouts on mealtime and feeding.

Producing research is essential for validating assessment and treatment strategies. Jeanne shared that her research was motivated by the question of whether interventions are actually effective.  Her current research demonstrated that there was a statistically significant difference in sensory differences and in mealtime behaviors between children with ASD and the typically developing group she tested.  This groundbreaking research paves the way for further studies to investigate specific treatment strategies discussed today for their effectiveness in helping make mealtimes a pleasurable experience for children diagnosed with ASD and their families.

To view Jeanne’s PowerPoint slides, click here.

Following the seminar, attendees provided feedback about the seminar.  Please see a few remarks below:

“It provided an opportunity to review recent literature and share strategies with other therapists.” Kristyn S., Occupational Therapist

“Loved the topic and the format. Jeanne was great!!   Diane H., Occupational Therapist

“Informative, interactive, insightful. It was interesting listening to other OTs experiences and suggestions.”  Sylvia K., OT student

“Helpful to organize sensory treatment with a food tolerance/mealtime behavior perspective.”  Anonymous Occupational Therapist

Thank you, Jeanne!

Filomena Connor, MS, OTR/L

Saturday Seminar: Providing Optimal Services and Supports for Students with Down Syndrome in Educational Settings

Anne Howard“Meaningful inclusion” is a term that supports the premise that all children should receive an education in the least restrictive environment.  To achieve this goal, social barriers must be hurdled and meaningful instruction must occur.  Anne Howard, PT, PhD tackled this issue in her Therapro Saturday Seminar last week entitled: Providing Optimal Services and Supports for Students with Down Syndrome in Educational Settings.

Dr. Howard’s extensive educational background, beginning as a physical therapist, then becoming an educator, to receiving her doctorate in disability policy, has provided the background for pursuing her interest in those with Down syndrome now as a college professor and consultant to families and school systems.  In addition, Anne serves on the Massachusetts Down Syndrome Congress (MDSC) Education Task Force and contributed to the MDSC Educator’s Manual. This manual provides a comprehensive look at the complex learning profile of students with Down syndrome, as well as provides information around educational considerations that are based upon research-proven best practices.

Anne is also the President of the Board of Directors for the Federation for Children with Special Needs.  With her glowing credentials and experience, Anne proved to be a formidable speaker and expert on Down syndrome.

Attendees at the seminar received a comprehensive review of common learning characteristics and associated physical and health care needs specific to students with Down syndrome.   Dr. Howard provided an interactive seminar, inviting attendees to share their perceptions of students with Down syndrome and asking them to determine what they wanted to learn about students with Down syndrome. She discussed strategies to facilitate independence using visual supports and self-management.  Anne reviewed some basics on Down syndrome with some surprising issues that have come to light.  For example, she noted that children with Down syndrome have a greater prevalence of ASD, with some statistics cited that up to 18% of children with Down syndrome have a co-occurring diagnosis of Autism.

Anne discussed encouraging research that shows that fully inclusive education, special teaching approaches that address areas of weakness, and providing opportunities for success can change the typical profile of a child with Down syndrome, citing studies by Buckley, Bird, and Sacks in Down Syndrome Research and Practice, 2006. A chart with “Characteristics of a typical learning profile” with areas defined as Communication, Socialization, Learning and Memory, and Motor was presented along with strategies to address the targeted areas.  For example, if a student has motor weakness characterized by decreased muscle tone which makes writing difficult, along with having shorter fingers, strategies for learning might include providing adequate postural support, with Pencil gripsappropriate seating, motor breaks with tone building activities, and use of adapted materials for handwriting including a slant surface, hand grips, or keyboarding. In addition, she advocated the use of visual supports, which are available for a longer time period for the student, versus using verbal or auditory cues alone. For example, sticky notes, diagrams on the board, photos, calendar, clock /timer, decrease the need for verbal cues. Visual supports are readily available to the student without the need for use of working memory or retrieval of information, which may be difficult for some students.

Finally, Anne provided a Behavior Profile associated with Down syndrome enumerating strengths, learned behaviors, and then identified strategies that support productive behavior in students with Down syndrome. Students can be taught to self-manage with strategies like self monitoring/self-recoding, self-evaluation, and self-reinforcement.  She suggested that the key is to empower the student by letting him/her know what is expected.  By being proactive, negative behaviors can be averted and targeted behaviors can be reinforced.  She noted that the key to developing acceptable and positive behaviors is to build desired behaviors, versus just responding to negative behavior.

Considering the student with Down syndrome and how to help him/her succeed in an inclusion model involves a number of factors.  Understanding the common characteristics and challenges of this diagnosis is a good starting point.  From there, a wide variety of positive strategies can be implemented to help make the educational process meaningful and fulfilling for the individual student.

Anne has generously provided this link to her PowerPoint slides: click here.

Here are some remarks from attendees:

“I really appreciated Anne’s diverse background. She was able to present the information from a different perspective than I might normally consider.”  Micaela C., Physical Therapist

“Helpful as a student to hear real-world application from professionals in practice who were in attendance.  Also great to see theory learned in the classroom reinforced.”  Sam J., OT student

“Clear, relevant, evidence based info/treatment strategies.”  Mary T., Occupational Therapist

“Dr. Howard provided & presented the basic background info for DS well. She provided useful examples for behavior management for children with DS that I hope to implement with my students.”  Anonymous, PT

Thank you, Anne!

Filomena Connor, MS, OTR/L