Tag Archives: physical therapy (PT)

Discover evidence-based physical therapy resources, equipment, tools, strategies, and professional insights to support physical therapists in enhancing mobility, strength, coordination, and overall functional outcomes across the lifespan and in diverse settings.

Modifying Games to Address Therapeutic Goals

December 15, 2020Gamesexecutive functioning, handwriting, movement breaks, occupational therapy (OT) tools, physical therapy (PT), speech therapy tools, therapeutic toysAllyson Locke, M.S., OTR/L

Games are a useful therapeutic tool; they are versatile, engaging, and so much fun! WIth a few simple modifications games can address a wide range of therapeutic needs. A few simple modifications can be used for almost every game:

Add Visuals. Visuals can be anything from simplified directions to communication aids, like “your turn” and “my turn”. Visuals can help those who struggle with sequencing, memory, or communication participate more independently in game play.
Change the playing position. Playing games on the floor, at a countertop, or with alternative seating helps to increase participation and access. Playing a game on the floor allows players to play in alternative positions, like laying on their bellies. This position is great for those with postural instability, and helps increase their focus and endurance. Another option is to use a therapy ball (add a base for stability), Alert Seat, Ball Chair, or air filled cushion instead of a traditional chair. These types of alternative seating provides movement input which may allow those with shortened attention spans to participate longer and with more focus. Some games like, Left Center Right, have few manipulatives making these great games to use on scooter boards or swings.
Modify the Manipulatives. Some game pieces are just too small, too big, or too difficult for students to access. One quick fix is to swap out the game tokens for something more manageable like a jumbo dice. Another option, insert game pieces into putty for a bigger gripping surface. Other modifications include using a card holder or book holder.
Manipulating the manipulatives to target hand skills. To encourage a pincer grasp, place smaller game pieces into an egg carton (or similar small container); the smaller space allows for only a few fingers to access the piece, encouraging a two or three finger grasp pattern every time the player picks up the game pieces. To incorporate hand strengthening and bilateral coordination, use a tennis ball with a small slit cut into it. Players must squeeze the tennis ball with one hand while using the other hand to insert or remove their pieces. To target fine motor manipulation with insertion, use plastic containers (your recycling bin is a great resource); cut a slit in the lid and work on inserting game manipulatives into the containers.
Change the game rules to address specific therapeutic goals. If your focus is social interactions, team building, or cooperative problem solving, change game play so players play as a group instead of competing against each other. If you are doing individual treatment sessions instead of group sessions, change gameplay to make it a single-person game. When time is limited or you have participants who struggle with extended attention and focus, add a time rule where gameplay ends after a set amount of minutes. When the game is too hard or too easy for players, add more complexity or decrease the complexity.

Example of modifying a game; tube with cover

Example of modifying a game; coins in a clear tube

A tennis ball with a slit and a coin inserted

With a little bit of creativity, most games can be changed, adapted, or modified in order to use them as a therapeutic tool. Check out Therapro’s handy games guide to see these modifications applied to some of our great games!

Motor Interventions in Autism: Enhancing Participation and Function

January 12, 2019Events & Conferences, Motor & Movement, Therapist Resourcesautism, physical therapy (PT), saturday seminar recapsTherapro

Dr. Jennifer Colebourn, MSPT, DPT and Dr. Julie Goff, MSPT, DPT presenters of The Role of Motor Interventions in Autism Spectrum Disorder.

The 2019 Therapro Saturday Seminar Series was launched by school-based physical therapists, Dr. Jennifer Colebourn, MSPT, DPT and Dr. Julie Goff, MSPT, DPT with their presentation: The Role of Motor Interventions in Autism Spectrum Disorder.

Jenn and Julie met at Northeastern University where they were pursuing their doctoral degrees. Jenn’s research focuses on motor interventions for Autism Spectrum Disorders. Her most recent work has been published in the journal, Pediatric Physical Therapy: A. Colebourn, Jennifer & C. Golub-Victor, Ann & Paez, Arsenio. (2017). Developing Overhand Throwing Skills For a Child With Autism: A Collaborative Interdisciplinary Approach In School-Based Therapy. Pediatric Physical Therapy. 29. 262-269. Julie’s research on improving gross motor skills in children with Autism Spectrum Disorders received Northeastern’s RISE award in 2016. In their practice, both therapists focus on a collaborative team approach to improving motor performance in children with ASD.

Attendees were given a comprehensive review of Autism Spectrum Disorder, including the DSM-V (2013) diagnosis as a Neurodevelopmental disorder. We learned that ASD is no longer classified on a “spectrum” but with levels of severity. The term “Asperger” is no longer used, but individuals with the characteristics formerly attributed to Asperger are now considered to be “high functioning Autism.” An alarming statistic they revealed was that currently 1.5 billion children in the US have an autism diagnosis. Jenn and Julie cautioned that diagnosing ASD is complex and in the past 5 years, neuroimaging has provided startling information about the difference in the brain of the child with ASD from a typical child, i.e. “neuro over connectivity” that impacts function.

Jenn and Julie addressed the fact that motor function of children with ASD is affected, usually with simple motor tasks being intact, but with complex tasks and motor planning being impaired. Motor difficulties are now considered a “Core Deficit.” Screening for motor deficits is important for all children with the ASD diagnosis. The PT’s role includes recognizing if a motor impairment interferes with function. Julie and Jenn cited a number of studies that examined how core deficits affect a child’s participation in physical activity across many dimensions. What we might see is a child who prefers simple, sedentary activities and who doesn’t participate in complex social activities such as organized sports. In summary, motor deficits affect a child’s ability to participate in play.

When providing treatment for the child with ASD, Julie and Jenn advocate strongly for a team collaborative approach that includes the child’s family members. They noted that the ABA therapist would be a strong, valuable ally because they can provide behavioral support to motor intervention. They discussed ways to design the environment and treatment sessions in order to help ensure success and motor learning. A few examples they gave were: promote positive transitions, simplify choices, and have a predictable space and schedule. A few materials they recommended include: Body Awareness Fun Deck, Upper Body and Core Strength Fun Deck, Magicatch Set, Rainbow River Stones, Learn to Move, Move to Learn!, and ABC Yoga Cards for Kids.

We are grateful to Jenn and Julie for sharing their passion and expertise for improving motor performance of children who have an ASD diagnosis. With improved motor skills, it is likely that other areas of function will be affected in a positive way as well. With the high incidence of ASD worldwide, Autism will affect us all. The need for continued research is critical to help our understanding and ability to treat children with ASD effectively.

Here are just a few of the attendees’ positive reviews of this seminar:

“Incredibly informative and relevant! Felt so empowered from the seminar. Helped to give me better direction in my practice as well as increased confidence in my recommendations to families & school staff.” – Laine F., Physical Therapist

“The two presenters were so knowledgeable in their area – facts were most interesting.” – Rolene K., Teacher

“Great overview of school PT and best practice for collaboration with all members of the team.” – Micaela M., Physical Therapist

“Presenters were professional presenting evidence based practice to help improve functional skills for students with Autism.” – Alice T., Occupational Therapist

Thank you, Jenn and Julie!

Filomena Connor, MS, OTR/L
January 12, 2018

The Value of Therapy Balls and How Best to Store Them

March 26, 2018Therapist Resourcesoccupational therapy (OT) tools, physical therapy (PT), therapist resourcesTherapro

I’ve had the joy of working in four different countries and across a variety of clinical settings. No matter the environment or the age of the client, certain tools remain universally valuable—and therapy balls are one of them. I’ve successfully used therapy balls with individuals recovering from head injuries or strokes, as well as with children with learning challenges and even clients with visual impairments.

I think balls of various sizes, textures, and shapes are a tell-tale sign that you have stepped into an OT room or department. Therapy balls are valuable in meeting so many goals and certainly show how dynamic OT is and how creative we need to be with every treatment plan and session. Let’s face it, balls are fun for most ages. They are colorful and versatile. Being round means that they are dynamic, resulting in the ability to grade therapy sessions by working on an unstable surface.

Therapy balls are valuable for improving:

motor control
muscle tone
trunk control or strengthening core muscles
upper limb function for clients with orthopedic or neurological disorders
introducing fun games and exercises into therapy
eye-hand coordination
righting and balance reactions
weight shift

Balls can encourage a child to feel excited to come into a treatment room or to prepare a blind child for hippotherapy. Balls can be just as important to an older woman needing to reduce internal scarring from repeated abdominal surgery.

There is one problem with therapy balls: storage. Without due care, your therapy room can quickly become messy, cluttered, and a potential safety hazard. We don’t want our clients tripping over equipment!

If you’ve ever worked in an OT department or been involved in developing a therapy department in limited space, then you can appreciate the need to organize physio/Gymnic balls. There are times that facilities will look into securing a suitable shelf, setting up a hammock specifically for therapy balls, or acquiring an array of other wall or ceiling fittings.

But what can do you do if your practice is in rented space that doesn’t permit attaching anything to the walls or ceilings? Or if your OT room is in a building with prefabricated walls and ceilings, reducing the strength and stability of the internal structure?

When I started in private practice, one of the first pieces of equipment I obtained was a large therapy ball with bells inside. Amongst my first private clients was a child who was blind from birth and severely sensory-deprived, hence the bells within the ball. It was wonderful to introduce a ball game in which he could participate because he could hear where the ball was.

The problem was how to store the therapy ball. I grappled with this dilemma until I discovered the wonderful Ball Stacker. It looks professional and neat and makes a good impression when a parent comes into the therapy room for the first time. Now you can use therapy balls even if you can’t attach brackets, shelves, or hammocks to the wall or ceiling.

Another valuable accessory to the therapy ball, is the Ball Handpump which offers the freedom to alter the pressure in the ball according to the goals of your client.

Guest Blogger: Shoshanah Shear

Shoshanah Shear Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer, author of “Healing Your Life Through Activity – An Occupational Therapist’s Story” and co-author of “Tuvia Finds His Freedom”.