Category Archives: Community-Based Practice

Learn about tools and strategies for providing therapy in community environments such as recreation centers, job sites, and public spaces. Focus on building independence, social participation, and generalization of skills beyond clinical or educational settings.

Bean Bag Chair

Enhancing Sensory Experiences in the Home Daycare Setting

Porch, the home services platform, reached out to Therapro for help with their latest article, Safeguarding Your Home Daycare: What Experts Have to Say. The question posed to the Therapro team was: How can home daycare providers utilize therapeutic and educational resources to enhance sensory experiences and cognitive development for children in their care? Therapro’s team of experts had a lot to say on this topic! Read our latest post to see what Therapro shared and be sure to check out the full article for additional information!

Home daycare providers can greatly enhance sensory experiences and cognitive development for children in their care by incorporating therapeutic and educational resources from Therapro, among others. In this post we are covering several strategies and Therapro resources that can be used to enhance these experiences.

Tactile Search & Match a tool used to enhance sensory experiences

Sensory-Focused Environments: Creating sensory-focused environments within your home
daycare is a great, all-around way, to enhance sensory experiences. This can be accomplished simply by utilizing sensory tools, like fidget toys, or sensory integration equipment like therapy balls. These resources can stimulate children’s tactile, proprioceptive, and vestibular senses, promoting sensory exploration and integration.

Create And Play Sensory Beads (6 Pack); a set of 6 beads with various textures to enhance sensory experiences

Sensory Bins: Therapro offers various sensory bin materials, like mini animals or sensory beads. These bins can be customized to match educational themes and provide opportunities for tactile exploration, improving fine motor skills and cognitive development.

Waddle Plastic Balance Board

Fine and Gross Motor Activities: Tools like therapy putty, sensory beads, and balance boards. are examples of therapeutic resources that can be integrated into activities to enhance sensory experiences. For instance, swap therapy putty for traditional playdough activities to bring in grounding proprioceptive input. Add a balance board to traditional circle time activities to add vestibular stimulation that can increase alertness. 

By integrating therapeutic and educational resources into your home daycare setting, you can create an enriching environment that fosters sensory experiences and cognitive development for the children in your care.

child playing with blue sticky object

Keeping Skills Sharp All Summer Long: Summer 2022 Edition!

Allyson Locke M.S., OTR/L & Sarah Glovasky M.S., OTR/L

Summer is fast approaching but that doesn’t mean kids need to lose the skills they developed over the last academic year! Last year, we posted a blog filled with summer activity ideas geared toward preventing the “summer slide”.  As therapists, we know summer activities provide numerous opportunities to develop and keep skills sharp for the upcoming school year.  So we are bringing back the topic with this new post.  New this year are more activity ideas and contributions from Sarah Glovasky M.S., OTR/L! As always, appropriate supervision is recommended!

Get Messy!

Messy play is a great way to develop the sensory skills needed for important school tasks like handwriting and social interactions.  Summer is the best time for these messy activities because they can be done outside leaving the mess outdoors. An added bonus is that it is usually warm enough for a quick wash with the hose before going back inside.  A few ideas to try:

  • Hide objects (like rocks, sticks, or mini animals)  in a pile of mud, shaving cream, or leaves. How fast can you find them? How many can you find in 10 seconds? Not only is this a great sensory activity it helps strengthen the visual perceptual skills needed for academic tasks like reading! 
  • Stomp in rain puddles, roll down a grassy hill, or skip through a soft patch of dirt. These big body movements help develop the vestibular and proprioceptive systems which are so important for self regulation! 

When it is too hot or too rainy to go outside there are still plenty of opportunities for sensory exploration that are a bit less messy! 

  • Make a sensory collage with items found in the recycling bin or use the Sensory Collage Kit! How many different textures can you incorporate? What textures do you like to feel? As a bonus, ripping, crumpling and rolling paper, tissue, and cardboard are all great ways to strengthen the muscle of the hand.  For more ways to use recycled materials check out Second Hand Therapies
plastic container scooping water and dumping it into a yellow bin filled with water, an example of an activity for keeping skills sharp in summer
Jug Scoop
From: Second Hand Therapies: Recyclable Strategies & Useful Tools

Make Art!

Art projects afford great opportunities to develop the small muscles in the hand.  This muscle development is critical for academic tasks like writing with a pencil and cutting with scissors. Get creative with your art projects, try:

blue turtle made of playdough with a green shell and colorful dots- an example of an activity for keeping skills sharp in summer
  • 3D Art.  Three dimensional art helps kids build form and space concepts.  Building a fairy castle outside is a great way to learn about size concepts.  Inside, building with blocks, clay or even pillow cushions is a great way to explore how these concepts work.  To add a sensory component try using scented dough
  • Tie-Dye Prints: This is a great outdoor activity! First color an old bed sheet or large piece of paper with washable markers. Next use a spray bottle, filled with water, to squirt the drawing. Watch the colors mix and swirl together! Using a spray bottle not only helps build the muscles in the hands it is also great for bilateral coordination! For a smaller scale version, use an eyedropper to wet the paper! 
  • Draw pictures in the dirt or other mediums like pudding (great for kids who like to explore with their mouth!) Use a stick, rocks, or fingers to draw with! We still love the Ed Emberly drawing books when you need drawing inspiration, stencils are another helpful tool! Drawing is so important for early writers and is great for visual perceptual development!

Play With Bubbles!

Many skills can be targeted with simple bubble activities. Eye hand coordination and oral motor development are just a few!  Blowing bubbles is also great for attention and regulation; to learn more about this check out the book M.O.R.E.: Integrating The Mouth With Sensory And Postural Functions. For fun with bubbles, try:

  • Making Bubble Art!  Make bubble paint by putting a small amount of bubbles and a dab or two of food coloring in a bowl (use different bowls for different colors). Use a bubble wand and dip it into your favorite color. Blow the colored bubbles right at plain paper and watch the designs come alive! 
  • Play Catch! Chasing after, stomping on, and catching bubbles are great ways to get some extra energy out. It is also a great way to develop eye-hand coordination and the visual skills needed to complete academic tasks like copying from the board.  To make bubbles easier to catch try using Touchbubbles
  • Make A Mountain of Bubbles! For a fun indoor activity, fill a small dish bin or other similar size, shallow bucket with lots of dish soap and a few inches of water.  Use a straw to slowly blow into the water to make a mountain of bubbles.  To really work the muscles in the mouth try a long straw or one with lots of twists like the Krazy Drinking Straws or Connector Straws

With these fun activity ideas the learning doesn’t have to stop when school is out. Keep skills sharp and be ready for the upcoming school year! 

Hippotherapy Activities that Help Build Hand Skills

 

Hippotherapy is a specialized treatment area used by occupational therapists, physical therapists, and speech and language pathologists.  It involves utilizing the sensory-motor aspects of horses to achieve therapeutic goals such as improving sensory processing to tolerate touch and motor plan sequential movements. Although the horse functions as a therapy tool, it is obviously much more exciting than a swing or therapy ball, offering opportunities to develop an emotional bond, communication and social skills.

Let’s look at the basics of hippotherapy

child on horse

Although the healing power of horses has been recognized for thousands of years (Hippocrates mentions it in ancient Greek writings), hippotherapy only developed in Europe in the 1960s and soon after in the United states as an adjunct to physical therapy. Therapeutic goals might have included improving the rider’s strength, postural control, balance and coordination. Hippotherapy’s versatility as a treatment tool gradually expanded as SLPs used it to improve communication skills. Occupational therapists recognized the power of sensory stimulation in promoting engagement and functional hand skills, such as manipulating fasteners. For example, this rider enjoys opening the zipper on my glasses case and then handing me the sun glasses. She loves to help out and make both the horse and me happy!

Hippotherapy is a type of Animal Assisted Therapy

Please note that “therapeutic riding” (TR) is a different type of animal assisted therapy (AAT) that is offered by certified therapeutic riding instructors who teach riding skills to people with disabilities. A TR instructor may or may not be an OT, PT or SLP. However, hippotherapy is ONLY performed by a licensed OT, PT or SLP practitioner. Training and certification requirements vary at facilities and many require that the therapist have certification in both TR and hippotherapy. As an OT, my goal is not to teach my client how to ride a horse, although frequently that is the result and many children transition from hippotherapy to do TR and eventually earn medals at the Special Olympics.

Why are horses special therapeutic friends?

Well, many animals are special in their ability to connect with people nonverbally and provide unconditional love. Cats and dogs also provide great heavy pressure and tactile sensory stimulation as they lie on laps and cuddle. However, a child with cerebral palsy may improve range of motion by straddling a horse and the repetitive, smooth vestibular movement can gradually reduce muscle tone. A horse’s gait is similar to the human gait in terms of timing. Clients who have never walked or have an abnormal gait can kinesthetically experience what normal pelvic movement feels like.

I have primarily worked with very young children who received services through their early intervention programs. Many had developmental disabilities, including Down syndrome and autism spectrum disorders. My goals often focused on decreasing sensory defensiveness while increasing engagement, postural control and hand skills. Of course, this involves using a variety of reaching, grasping and manipulation hand activities.

Hippotherapy Provides controlled and graded Sensory Simulation

Simply being on a horse provides sensory stimulation. Actually, as soon as a client enters the hippotherapy facility, they are impacted by happy sounds, smells and scenery. Bouncing on the horse while walking and bouncing even more when trotting provides heavy duty proprioceptive and vestibular sensory input. I control and grade the sensory input with choices such as whether to:

  • walk slow, fast and for how long before stopping
  • walk in straight, curved lines or in circles
  • walk uphill, downhill or only on flat surfaces
  • the child faces forward, sideways, and backwards or rides in a different position such as in quadruped or kneeling.

child with ball
Using Sensory-Based Materials

  • Hipppotherapy horses are selected for many specific attributes including tolerance for riders who may hit, kick or scream. I also use a variety of sensory materials that must first be introduced when there is no rider so that the horse becomes desensitized to materials such as:
  • rings tossed onto Color My Class Game Cones
  • rings placed on top of a vibrating ring stack (see photo)
  • toys and Sound Puzzles that make funny sounds or vibrate
  • bubbles like Bubble Bear or No-Spill Bubble Tumbler
  • clothespins clipped onto or removed from the mane (this does not hurt the horse)
  • ball play, playing catch with toys like Gertie Balls
 
child on horse

The little girl in the photo is facing backwards while her hands bear weight on top of a vibrating cushion like a Senseez Vibrating Pillow. This helps to decrease her tactile defensiveness before asking her to engage in more complex fine motor tasks.

 
Hippotherapy hand skill activity: ring stack

This vibrating ring stack is made by inserting a motorized pen, like a Squiggle Wiggle Writer Pen inside a swimming noodle.

child on horse

Adapting activities to vibrate is one of the many sensory strategies described in my book From Flapping to Function: A Parent’s Guide to Autism and Hand Skills.

Hand Activities to Develop Postural Control

Clients may work on postural control while reach to touch body parts on the horse or therapist. I like to offer sensory materials to pull or squeeze such as Panic Pete (AKA Martian Popping Thing) while the client maintains a quadruped or kneeling position. The child in the photo squats to take rings out of the bag and stands up while stringing them. He typically has difficulty visually attending but it is difficult NOT to focus and be in the moment when standing on top of a large animal!

 
child on horse during a hippotherapy session

The girl in the photo reaches for rings positioned in front of her before rotating her body to place them over a ring stack. This “ring stack” is actually a cat toy and the mouse on top of a spring squeaks when moved.  The sensory aspects of this activity help her to visually attend while developing postural control.

 

Hand Activities that Develop Cognitive and Manipulation Skills

In my book – From Rattles to Writing: A Parent’s Guide to Hand Skills I describe many simple adaptations that make it easier for children with and without disabilities to develop manipulation skills.  For example, lacing boards can be cut out of cardboard and made to have just a few, big holes and thick cord that are easier than string to control.

lacing board used for hand skills in hippotherapy

During a typical Hippotherapy session, I spend time walking and trotting, followed by stopping to complete a simple hand activity such as this lacing board. When finished I encourage the child to say or sign “go” to continue movement. Most children are eager to resume movement.

 
A hand skill activity uses a pizza box and velcro during a hippotherapy session

A horse’s rear end is wide and functions as a convenient work surface. I adapted this puzzle by attaching the pieces with Velcro to the box cover. I encourage the child to use one hand to stabilize the box lid while pulling them off.  Of course, this activity also teaches children to identify animals and imitate sounds. The Pizza Party is another activity that would be fun to use in this position.

 

Creating Functional Hand Skills Objectives

buttons

It’s a good idea to create OT objectives to improve functional skills such as opening and closing buttons because:

  • occupational therapy is all about increasing independence
  • this skill is measurable
  • insurance companies prefer work on functional, achievable daily living skills rather than abstract goals such as improving coordination

Therefore, I provide activities such as:

  • opening and closing extra large fasteners
  • opening bags and other containers (like my sunglasses case)
  • putting the helmet and gait belt on and off
  • unbuckling and putting away the reins, neck strap or other equipment

Video Time!

Video: Sensory Pull Activity for Children with Autism or Sensory Processing Disorders

The first video shows how I made and use the “Sensory Pull Toy” (that I designed)  during Hippotherapy to develop:

  • reaching, balance and postural control
  • hand strength
  • visual attention
  • eye-hand coordination
  • color identification
A toy used in hippotherapy made out of detergent bottles and a strip of fabric for hand skill activities

This toy is made out of detergent bottles and a strip of fabric. It’s simple to use – the child pulls the handle while in various positions.  It can also be used during non horse activities to work on many skills.  Please check out my book The Recycling Occupational Therapist for many other easy to make therapeutic activities. You can also try Stretchy String as another sensory toy.

Video: Hippotherapy with Children with Autism or Sensory Processing Disorders

The second video shows a few of the exciting ways therapists can use hippotherapy to develop hand skills. It is truly amazing how motivated children are to focus and engage in challenging hand activities because they love being cowboys and cowgirls!

 
Barbara A. Smith

Guest Blogger: Barbara A. Smith.

Barbara A. Smith has worked with children and adults with developmental disabilities for over 40 years! She is the author of the Recycling Occupational Therapist, From Rattles to Writing: A Parent’s Guide to Hand Skills and From Flapping to Function: A Parent’s Guide to Autism and Hand Skills. Learn more about her work at RecyclingOT.com.