Category Archives: Occupational Therapy

Saturday Seminar: OT Rubrics for Fine Motor, Visual Motor and Handwriting Skills

Valorie_ToddWhen a group of OTs get together to brainstorm, there’s bound to be some exciting “stuff” that is the outcome. Valorie Todd, MA, OTR/L and her school-based practice colleagues in the New York and New Jersey vicinity had a goal in mind. They wanted to devise a way to monitor quarterly progress in performance skills they identified as “OT goals” or “Areas of Need” on the IEP that was based on normative data. Valorie discussed the rubrics her group developed during her Therapro Saturday Seminar Series workshop on August 22, 2015 entitled:  OT Rubrics for Fine Motor, Visual Motor and Handwriting Skills.

This seminar was the kick-off for the Fall Saturday Seminar Series and attracted about 60 attendees who listened closely, commented freely, and shared thoughts. Valorie and her colleagues were determined to conceive a way to assess a student’s performance against predetermined criteria, in which a student is measured against his own performance.

Valorie’s group identified 7 areas for assessment including:

  • Postural Control
  • Sensory Modulation
  • Ocular Motor Skills
  • Object Manipulation: Fine Motor/Hand Skills
  • Controlled Tool Use: Color, Trace, Cut
  • Design Copy: Graphics/Objects, and
  • Handwriting.

In her seminar, Valorie discussed Object Manipulation, Controlled Tool Use, Design Copy, and Handwriting. Rubrics for Kindergarten and Grade 1 were identified.

Valorie offered a thoroughly researched plan on how to assess function and address the skill through worksheets that acknowledged how a student was expected to progress sequentially in each area.  She made clear distinctions in skills expected of a kindergartner versus a first grader.  For example, when assessing “Tracing,” specifically Pencil Control:

kindergartner would receive a score of 4 if he:

  • “Controls lines with min. errors 90-100%”
  • “Stops/turns at corners (angles/arcs)”

A first grader would receive a score of 4 if he

  • “Has good control within/on lines in all directions (90-100%)”
  • “Starts/stops on dots with 1-2 errors”

Valorie’s rubrics were well-defined and can be easily replicated. She was very enthused about sharing her work, including worksheets, and encouraged therapists to use her rubrics and provide her with feedback so that the rubrics can further be developed with input and use over time. As a result, a meaningful assessment of quarterly progress can be obtained and insufficient areas can be addressed systematically and meaningfully before the student is due for the next standardized evaluation.

Attendees comments were very positive and encouraging:

“It was excellent! So much info, well related to school based OTs. This will be helpful in writing goals, tracking progress, presenting at meetings, and for my Teachpoint eval.”  Amanda B., Occupational Therapist

“It helps so much to have these rubrics to support our clinical observations when IEPs are moving toward data driven/measurable goals and objectives. It will help with tracking and also guide thinking when working on skills.”  Anonymous, Occupational Therapist

“Love the practicality of the Rubrics.  Anything we can take away & use is terrific!”  Amanda H., Occupational Therapist

“Looks at detail of task performance and observation of foundational skills which students have or need to build on.”  Anonymous,  Occupational Therapist

“I would recommend this seminar to a colleague because it was well researched and the information was very comprehensive.  The material is very current and I can readily apply this information.”  Anonymous, Occupational Therapist

Thank you, Val!

Filomena Connor, MS, OTR/L

The 23nd Annual Ohio Institute for OT/PT School-Based Practice Conference

23_otpt_conference1We were very happy to be invited back to The 23rd Annual Ohio Institute for OT/PT School-Based Practice conference in Columbus on August 10-11! This was my 8th consecutive year of attending as the Therapro rep, and I must honestly say that it was just as exciting as my first time. This conference is fresh and innovative from one year to the next. Attendees came in droves (650 of them!) from Ohio and surrounding states in anticipation of two days filled with invigorating workshops to ready them for the opening day of school.

23_otpt_conference2Therapro author of the Drive -Thru Menu Suite of Exercises, Tere Bowen-Irish, OTR/L, was a conference presenter this year. Her dynamic, fun presentation, On the Floor and More, Movement and Yoga…Empowering Students Towards Mindfulness and Relaxation, had therapists raving about her workshop. Her Drive -Thru products including cards, laminated posters, Preschool & Kindergarten and Body Challenge card sets were difficult to keep on the shelves. Therapists loved her book, Yoga & Me, Come Be a Tree and the introduction of her new CD, My Mindful Music.

Another distinguished therapist from the Boston area, and a renowned Therapro Saturday Seminar speaker, Teresa May-Benson, ScD, OTR/L, FAOTA, was also a conference presenter this year; her talk was titled: Advanced Intervention for Ideational Praxis – Affordances to Executive Functions. She is an author for the critically acclaimed publication, Autism Interventions.

23_otpt_conference3As therapists, teachers, and parents stopped by the Therapro exhibit, it was exciting to hear lots sharing of information about Therapro and its products. Therapists eagerly traded information about products they loved including: Therapro originals: TracKit, Letter Treasure Hunt, Sensory Stories: Strategy Card Decks and Novenops. All loved the opportunity to examine and try out new products like Ultimate Fidget Fidgipod, Bouncy Bands for Chairs and Desks, and the Goal-Oriented Assessment of Lifeskills (GOAL). A whole array of new chew products was popular, including: Army Dog Tag Pendants, Zen Rocks Chewies, and Flip Flop Chew.

Filomena Connor, MS, OTR/LThank you to Mary Kay Eastman, PT, MS and Molly Dodge, OTR/L, committee co-chairs, for planning and executing a terrific and relevant conference. Conference coordinator Holly Bartholemew kept things running like clockwork prior to, during, and following the conference. Your team’s talent for executing a seamless, meaningful conference is appreciated by us all! I look forward to returning again in 2016.

Using Movement to Motivate and Develop Hand Skills

By Barbara Smith, M.S., OTR/L

usingmovementtomotivate1Movement, whether on a horse, swing or trampoline, provides sensory stimulation that nourishes the brain and in turn promotes attention and learning. Movement can also be used therapeutically to motivate children to engage in hand activities.

As an Occupational Therapist working at Ironstone Therapy in Andover, MA, I am able to use a horse as a treatment tool to work on traditional objectives such as improving bilateral coordination.

Hippotherapy is often very effective because children love bonding with the horse. Instead of in an office, this kind of therapy takes place in a happy environment where simply sitting on top of the animal is the first of many small successes.

Let’s begin by looking at Amber, a hippotherapy client. When I first met two-year-old Amber she arrived singing “Old McDonald Had a Farm.” She continued to sing while mounting and riding. She never looked at me, and seemed unaware of what her body was doing, and also unaware of the people around her.

Fortunately, Amber loved movement. She didn’t like it when I stopped the horse. I began singing “If You’re Happy and You Know It…Clap Your Hands/Pat the Pony/Blow a Kiss,” etc. At first I used hand-over-hand assistance to help Amber perform the hand movements. When she ignored me, I stopped the movement. Amber soon learned that by engaging and using her hands, she could avoid stopping.

This example describes how movement can be used as reinforcement. A “reinforcer” is anything that makes a person want to repeat a behavior. Examples of reinforcements can be hugs, stickers, special treats, and even paychecks that motivate one to keep going to work.

Movement can function as a “sensory reinforcement” when it:

  • Motivates the child to repeat the desired behaviors (i.e. clapping hands)
  • Provides sensory input that organizes the brain

An important aspect of developing hand skills is learning to tolerate touch. Children receive deep pressure stimulation to joints and muscles as the horse gently bounces up and down during the walk.

usingmovementtomotivate2During hippotherapy, children are encouraged to engage in simple hand activities such as giving high five while prone (on the belly).

Children may assume different positions, such as facing backwards while bearing weight on forearms or hands. Bearing weight helps to decrease touch sensitivities (i.e. tactile defensiveness) so that the child is more willing to grasp and manipulate objects.

Occupational and physical therapists often position children in “prone” position (on the belly) using swings, therapy balls or a scooter board so that children:

  • Develop postural control
  • Strengthen trunk, shoulders, neck and eye muscles
  • Bear weight on hands to decrease tactile defensiveness
  • Receive vestibular (movement that stimulates the inner ears) sensory stimulation that organizes the brain
  • And of course, are motivated – because movement is fun!

usingmovementtomotivate3The smart mom at We Can Do All Things explains how her daughter developed postural control by working on fine-motor activities while on the swing. The movement also made puzzles and ring stacks extra fun.

Scooter boards can also be used to develop sequencing and bilateral coordination as children “scoot” to a desired activity. The child might also be asked to scoot back and forth to bring game or puzzle pieces to a board. The clever mom at Fumbling Thru Autism motivates her daughter by integrating movement activities throughout the day.
usingmovementtomotivate4

Children can engage in a variety of hand activities while on a horse or other movement apparatus to develop basic skills such as reaching and grasping and more advanced skills such as:

  • Stabilizing with one hand while manipulating with the other
  • Orienting shapes to fit through openings (developing visual perceptual skills)
  • Sequencing several steps

For example, the client shown in this photo is inserting Lotto cards into the slots I cut into a detergent bottle. The slots are cut in vertical, horizontal and diagonal orientations so that she can practice positioning the cards to fit. Some of my more experienced clients can use this activity while kneeling or standing on top of the horse!
usingmovementtomotivate5

This child is using a magnetic Bingo wand to catch the goldfish while developing visual attention, postural control and sequencing skills as he removes the fish to place in an attached basket. The fish is cut out of a detergent bottle and has a paper clip attached so that it can be used in magnet games. This activity also helps children to coordinate using their hands together as they remove the fish from the Bingo wand.
usingmovementtomotivate6

Most therapists and parents do not have a horse available to use for sensory stimulation and reinforcement. However, the principles are the same when using other movement equipment – or no equipment at all. Young children may be twirled around after putting rings on a stack and older children may enjoy performing jumping jacks as they spell words. Most children of any age or ability level love to move and are motivated to communicate “go” with gesture, pictures or vocalizations. So what are you waiting for? Let’s get moving and developing hand skills!

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Barbara Smith, M.S., OTR/L has worked with children and adults with developmental disabilities in a variety of settings over the past 30 years- including early intervention programs, public schools, special education collaboratives, day habilitation programs and community residences. She is the author of The Recycling Occupational Therapist, 2nd edition (RecyclingOT.com, 2012) and From Rattles to Writing: A Parent’s Guide to Hand Skills (Therapro, Inc, 2011).

Check out Barbara’s website for information and resources at: RecyclingOT.com