Tag Archives: Occupational Therapy

Attachable FootFidget® Footrest

Flexible Seating Options in The Classroom & Home Learning Environments

Allyson Locke M.S., OTR/L

In this post we take a dive into flexible seating options that are available for classroom and home  learning environments.

First, What Does Flexible Seating Mean?

Sometimes called alternative seating, flexible seating is simply a seating option that is different from ‘traditional’ seating arrangements and is often used to address a sensory need. Traditional seating arrangements may be things like the desk chair students use in a classroom, the dining room chair at the eating table or the office chair at a work desk. Flexible  seating arrangements  may be a therapy ball in place of an office chair or it may be a beanbag in place of the traditional student desk setup. Read on to learn more!

Next, Understand the Importance of Flexible Seating Options in Learning Environments.

Having a variety of seating options helps to ensure all learners have a setup that is most effective for their learning style. Some options may help to address underlying sensory needs while other options  provide the movement that has been shown to be preferred by students when learning (Cole et al., 2021, 72).   Having just the right seating arrangement can make the difference between a successful learning experience and one that is full of distractions, position changes, and learning sessions that don’t  last as long as they should.

Finally, Pick the Right Seating Options. 

Understanding the need (or needs) you are trying to address will help you determine the best seating option(s).

For the wigglers, movers, and bouncers who just need a little extra sensory input to focus and sustain attention, try a seating option that provides movement (vestibular) or light touch (tactile) input. A seating option that provides tactile or vestibular input will help the sensory system that is seeking movement, get it in a way that is more conducive to learning and working. 

chair with wobble feet attached

Wobble Feet: These are simply four, rubber domed shape ‘feet’ that slip onto a standard chair leg.  The Wobble Feet provides a subtle rocking and a soft bounce feel.  These are especially popular for users who are looking for a “low profile” option; they can be slipped onto a regular classroom chair and are small enough that they are not very noticeable in the sea of classroom chairs. 

red and blue senso spot seats, round disks to sit on with a textured side

Sensory Spots: Spot Sensory Seats and Senso Seat Pads are flat pads that have a textured side.  This textured side provides subtle sensory input without much challenge to postural stability. They can be used in just about any seating situation and can easily roll up when moving seats.

wiggle seat sensory cushion, butterfly shape, basketball shape, flower shape, and monster shape

Cushions: Air filled or foam cushions can be added to just about any chair, bench or even used on the floor.  They are usually round or wedge shaped but newer versions now offer fun shapes like monsters or flowers.  The amount of air, that can be added, to the air filled cushions is typically adjustable allowing for users to increase or decrease the amount of movement offered.  Cushions are generally portable making them a great option for those who change work areas throughout the day.  For even more convenience options with handles are now available!

Wobble Stools: The Kore Wobble Chair offers a seating option much like sitting on a stool with the exception of the innovative rounded bottom that allows the user to rock in all directions.  In addition to the rocking movement the stool shape allows more freedom to move the legs in different positions.  

the alert seat a large round ball inside a metal base with wheels for sitting

Ball Chairs: Ball chairs come in all shapes and sizes. At the most basic level a large therapy ball is used in place of a chair. This is a great option for users who need a lot of input but therapy balls are unstable and can be difficult for users with poor postural control.  A base can be added under the ball to help prevent the ball from moving out of position.  Another option is to use a peanut or egg shaped ball; these balls have an elongated shape that increases stability for the user.  The  Alert Seat puts the traditional therapy ball on a wheeled base allowing for more mobility.  The Ball Chair Deluxe  takes the shape of a traditional office chair but replaces the seat with a large inflated ball.

For the fidgeters, hair twirlers and those with a little extra nervous energy try a seating option that provides deep pressure input or gives the big muscles a chance to work. This type of input can help calm an anxious or overstimulated sensory system. Try:

foot swing, a small plastic stand that goes on the floor under a work space. it has two pedals to place the feet. the peals move back and forth

Body fidgets. Unlike smaller, handheld fidgets, body fidgets allow other parts of the body to interact with the fidget leaving the hands free for work.  Foot fidgets can be attached to chair or desk legs, allowing users to kick, push and pull the heavy elastic bands with their feet.  For users who frequently change work spaces portable foot fidgets are available; these can be placed under the workspace and interacted with in the same manner. The footroller is a unique body fidget; fidgeters place their foot on the roller, spinning it forward, backward or both ways. Another unique option is the Foot Swing; the foot swing allows for a silent swinging motion of both feet, independent of each other. 

boy sitting at a desk with ta weighted neck wrap around his neck and resting on his shoulders

Weight. Adding weight to the lap or shoulders is a great way to center, orient and calm an over responsive or anxious system. An added bonus, many offer textured covers for additional tactile input.

For those who just need a change of scenery, setting up an alternative work spot is a great way to refocus.  Some options include: 

  • Standing at a counter height work space or taping work to a wall are options to allow for standing positions while working. To add a little dynamic movement try standing on a foam wedge or air cushion.
  • Laying Down.  Working while laying on the stomach is a great way to provide proprioceptive input through the shoulders joints (perfect for those needing calming and organizing input).  This position also gives students who are struggling with postural instability to get more support so they can focus on their work and not on staying stable!  Use yoga mats or cushions to provide comfort and a clipboard or slant board as a work surface. 
  • Get Cozy.  Another option for a position change is sitting in a bean bag, Howda Designz Chairs or the Comfy Cozy Peapod Chair.  While not the best option for all types of tasks these options are great  when the activity involves reading or listening. The deep pressure input provides calming and organizing input.

Having a  variety of seating options available in any learning space is a sure way to increase focus and attention.  Identifying options that are appropriate for the user and the environment are keys for successful implementation. 


Cole, K., Schroeder, K., Bataineh, M., & Bataineh, A. (2021, April). Flexible Seating Impact on Classroom Environment. The Turkish Online Journal of Educational Technology, 20(2), 62-74.


Trunks! Adapted For Use Across All Ages & Abilities!

Sarah Glovasky, M.S., OTR/L

Trunks® is an engaging, interactive game developed by Diane Long, EdD, MOTR/L  and published by Therapro. Trunks® has gameplay challenges for all abilities!

How Do You Play?

In this game players move their bodies, make sounds and perform actions from memory! Gameplay involves picking an Action Memory Card and performing the action depicted. Six categories of actions are involved:

  • Musical You: Encourages creativity with motor actions that produce sounds.
  • Animal Sounds: Players mimic animal sounds.
  • Animal Motions: Players move their bodies and demonstrate how animals move.
  • Sound Like: Players recall and reproduce commonly heard sounds.
  • Pretend To: Encourages imagination as players pretend to be like someone else.
  • Show How: Involves a step-by-step demonstration of an action requiring the player to create an original sequence.

Trunks involves remembering and performing motor sequences. Players draw a card, look at the given action from the six categories previously mentioned, turn the card over and perform the action from memory. There are visual pictures as well as words on each card. On their next turn they would draw an additional card and perform both actions in their memory sequence, without looking at the cards. When an action is performed correctly, the player gets to keep their card and continue to work toward building a “trunk” (a series of 4 cards that, when combined, create an elephant’s trunk). 

The ability to perform individual actions may differ from child to child. Furthermore, the ability to memorize subsequent actions or sequences may vary as well. For this reason the game was created with many variations that afford enjoyable game play for all ability levels.

What Skill Area Does Trunks! Target?

Working Memory! Working Memory is a necessity for engaging in a variety of everyday occupations including learning, socializing and task completion. Sequencing naturally falls under the broader category of working memory.  Inherent to the game is the pairing of multi-modal forms of input (visual cues, reading cues, motor engagement, etc.). Read on to learn how to adapt and modify this game to target other skill areas! 

How Can Trunks Be Adapted?

Preschool. This game can be used to target motor planning development for kids in preschool. Choose a card from the deck and ask the kids to complete the action. Things like pretend to lift weights, leap like a frog, and pretend to lick a drippy ice cream cone are good activities to choose. You can also use the Sounds Like cards for the kids to use their voices to participate. This is also a great option when working on oral motor and language skill. What does a train sound like?, snort like a pig, and hoot like an owl are sounds that preschool kids should be able to perform. Having their peers guess the sounds and or actions turns it into a whole group game everyone can participate in. Pro Tip: Pre-picking cards targeting the specific skill or development level of the group is always a good idea! 

Early Elementary Age. Working memory develops as kids age. Building a trunk of 2-3 trunk cards can make the game achievable for the younger crowd. The pictures on the trunk cards are helpful for the non-readers at this age (which many of them are)! Again preselecting cards can be key. If you are working with students who are nonverbal, take the sound cards out. If you are working with children who have limits in mobility, take the jumping and balance cards out. Pro Tip: For students struggling with motor planning, pre-teach and practice the actions on the cards prior to the whole group activity to help bolster confidence!

Later Elementary and Beyond. Target teamwork, this can be a difficult skill for some! Have the kids build the entire trunk, working in teams or as a whole group. Pro Tip: If you need an additional challenge, have the players remember the sequence both forwards and then backwards!

Other Helpful Tips

  • Use as many trunk pieces or make as many trunks as you have time for! For a 10 min group use 2-3 pieces or just complete one trunk. If you have a longer amount of  time, make multiple trunks!
  • Use the extra action cards or don’t! You know the players best. Is the extra challenge needed or will it be too much?
  • Playing the game Trunks is a great opportunity for co-treatments! Physical therapists, speech language pathologists, occupational therapists, and teachers all have skills that can be worked on during this game!

Trunks is a great option for targeting many key skill areas. It’s versatility makes it a great choice for a wide range of ages and ability levels. Check out Therapro’s handy guide, Gear Up for Games, for more great game adaptations and modifications. 

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.

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!

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.

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!

* * *

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