Is handwriting really that hard?

If you are anything like me, your experience of learning to write will be a distant memory.

I don’t remember a time when I could not work out which way around a ‘b’ went -- athough there must have been such a time -- as letter reversals are quite common for children up to age seven.

Handwriting is actually a complex task that involves a multitude of skills.

FOUNDATIONAL SKILLS FOR GOOD HANDWRITING

Core strength

Good core strength and posture form the ‘anchors’ on which your child’s hand skills can develop. It is very hard to control your hand if you are finding it hard to stay upright in your chair.

Suggestions: Play games outside that encourage your child to climb, swing, jump and balance. When inside, play activities in a variety of positions e.g. getting your child to lie on their tummy on the floor while supporting their weight on their forearms and lifting their chest off the ground or working against the wall whilst kneeling on a pillow.

Hand skills

This includes having a well-developed hand dominance, enough strength in the hand to hold the pencil in the first three fingers (called a tripod grasp) and dextrous finger muscles to allow the fingers to move the pencil in a controlled way.

Suggestions: The internet has millions of creative and fun activity ideas to develop “fine motor skills” but daily practice and repetition is a wonderful way to strengthen your child's abilities. Encourage them to use their hands during dressing, tidying up, washing and food preparation activities.

Eye skills

This includes the ability to switch focus between near and far, to look between a whiteboard and a desk, using one's eyes (together) to focus on what is in front of you and the ability to scan a page from left to right.

Suggestions: Move away from 2-dimensional screens and play games that encourage your child to follow moving objects such as balls, marbles, balloons, dice, cars etc. in three dimensions.

Have your child’s vision checked by an Optometrist to ensure that they have proper vision.

Perceptual skills

Visual perception is the ability to make sense of what you are seeing. The ability to recognise similarities and differences, to find things in a busy background or manipulate objects in our mind.

Suggestions: Play 3-dimensional games that encourage your child to “figure out” a visually presented problem. These include puzzles, construction activities, matching activities and board games.

Motor skills

You need to be able to plan where to place your pencil to “start” the letter, which direction to move in and where to “end”. This involves moving your eyes and hands together, at the same time and in a controlled manner, to position letters on or within the lines provided.

Suggestions: Pre-writing skills such as cutting, colouring, tracing, tearing and sticking help to develop good motor control. Encourage your child to be creative: drawing the things that they see in their environment or in their imagination and building or constructing items with recycled materials.

Attention

Children need to have good attention to be able to remain still in their chairs, concentrate on instructions from the teachers, as well as to visually focus on the work in front of them.

Suggestions: If you know that your child is finding handwriting or tabletop tasks challenging, allow more frequent breaks during the time that they engage in these tasks. Make the tasks as fun as possible and praise them for their efforts.

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For some children, difficulties in one or many of the abovementioned areas can result in handwriting that is slow, difficult to read or even painful to produce .... but thankfully all is not lost ...

An Occupational Therapist will be able to assess your child, to identify the areas of difficulty that are affecting their handwriting. Typically, the Occupational Therapist will then be able to work with you to improve your child’s handwriting - ultimately leading to greater success at school.

Bathtime struggles

WHY YOUR CHILD MIGHT BE GETTING UPSET AT BATHTIME

1. Transitioning

Finishing one activity and moving to another can be really difficult for kids and they benefit from preparation and warning before this happens.

Create predictability by having a set "nighttime routine". This will help your child understand what happens before and after bath time, making the transitions easier. Children are often engrossed in a TV program or playing a fun game when they are asked to go bath.

Younger children struggle with the concept of time and saying something like: "two more minutes before bath time" is an abstract concept to them. Showing them a visual countdown timer will help them understand when their current activity will end. In the same way, you can count backwards to zero or use a transitional sound or song to move from one activity to the next.

Make bath time as fun as playtime, by adding bubbles, water sprayers and pouring cups to the activity.

Add colour or foam to your bath water and allow children to play with sinking or floating toys. Children love drawing on the tub with bath crayons or sticking foam letters, numbers or animals on the wet tiles.

2. Avoiding bedtime

Many kids may realise that after bath time comes bedtime. If this is true for your child, think about mixing things up a bit. Move bath time to early mornings or to late afternoons.

3. Soap in their eyes

If the idea of soap in their eyes or water on their face is a tantrum trigger think about investing in a bath visor or allowing your child to wear goggles during bath time.

Have a dry cloth or towel on hand and offer it to your child should you see they feel uncomfortable or distressed by the splashing. Choose wash cloths with fun characters, puppet washcloths or even soft toys that can get soaked to "help" clean faces and tricky places.

Using imaginary or pretend play is a lovely distraction from the reality of getting clean.

4. Sensory sensitivities to touch

Bath time involves many textural and temperature changes from removing one's clothes, being immersed in warm liquid, touched and washed by different cloths and sponges, splashed by water and dried again with different fabrics.

Giving a child with sensitivity to touch as many choices as possible during this time, helps them to feel more in control e.g. "which item of clothing are we going to take off first?" "Should we wash with the loofa or the sponge?" "Are we going to use the bar soap or gel soap?"

Wrapping them up tightly in the towel when they are done may also provide some much-needed deep pressure. Using firm strokes or squeezes to dry them is preferred to soft, fast strokes of a towel.

5. Sensory sensitivities to sound

Bathrooms tend to echo or distort sound which can be very dysregulating to some children. The noise of rushing water or a flushing toilet may be a sensory trigger for others.

Filling the bath before your child gets there or only emptying it after they leave, may assist with the lowering of sound levels in the bathroom. Dressing or undressing in a different room can also help to decrease the time spent in the bathroom.

6. Sensory sensitivities to smells

The bathroom is filled with pleasant and unpleasant odours, but to some kids, it is all just too much.

Pay attention to your child's preference for certain soap flavours or smells and try to use the ones that they prefer.

Odourless options may also be a good idea.

7. Irrational fears

When imagination takes flight, things like "water monsters or bugs" might be lurking in the bath. Some children may be scared of slipping or getting stuck in the drain.

Creating positive associations with bath time will help your child to overcome their fears.

Respect instead of force is key to breaking the chain of negative ideas. Add toys that you can catch or scoop out with a net and pretend that you are removing all the bugs from the bath.

Bring out the dinosaur toys or your child's big shark toy to gobble up the other monsters so that it will be safe for your child can get in.

Playfulness, fun and laughter can help them relax and make them much more willing to have a bath.

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The challenge is to not see your child's refusal to bathe as a "naughty or bad behaviour" but rather to seek to understand the reasons for their avoidance. This way you can support them and still get it done!

Should difficulties in establishing and following daily routines or activities remain a challenge in your home, seek out support from an Occupational Therapist.

The Benefits of Active Seating

"Sit still", "stop fidgeting" or "sit down" are commonly heard phrases around the dining room table, in the classroom or at the homework desk.

The idea that children will actually learn and focus better when they are moving, is a foreign concept to many parents and teachers.

However, changing positions and adding a little wiggle, bounce or wobble to everyday activities, can make a world of difference to a child's behaviour, attention, overall blood flow and core muscle strength.

Active seating involves moving away from "traditional" seating options and exploring alternatives:

1. Movement breaks

Create regular opportunities to get up off the chair to stretch arms and legs, shake bodies, dance, exercise, spin, swing or run.

These breaks do not need to last long and can be structured at specific times with set activities, something as simple as a surprise musical statue midway through a lesson!

2. Tummy time

This is typically a word you first hear when you have a baby but encouraging your child to continue engaging in activities whilst lying on their tummy on the floor can also be beneficial.

Ensure that children prop themselves up on their forearms, with their elbows under their shoulders, keeping their chest lifted off the floor. This is a great position for story time, drawing or puzzle building.

3. Vertical work

Standing and working on an easel, blackboard or kneeling and working against the wall is a great alternative position that builds strength in the upper limbs and trunk.

Try these "vertical working" alternatives when revising work or practising for spelling tests.

4. Theraband

Tying resistive exercise bands or even stockings around the legs of your child's chair, will allow them to bounce their legs or push with their feet against the band or tubing whilst working or listening.

This will offer an opportunity to get additional muscle and joint (proprioceptive) feedback without having to get up.

5. Air cushions

Light, rubbery pillows that the child can sit on and that allow for wiggling and rocking whilst being seated. They can be easily transported or moved between chairs and classrooms.

They can be used during structured table time activities, or while sitting on the floor during the morning ring.

It is important to note that these cushions should not be used all day and that they should preferably be offered at specific times or intervals.

6. Balls, adapted chairs & wobble stools

There are multiple online suppliers of specifically designed chairs for alternative seating. Remember to check with your child's Occupational Therapist (OT) or teacher before ordering these larger pieces of equipment.

This should not stop you from purchasing a therapy/gym ball or exercise trampoline for use at home, as these offer wonderful opportunities for movement.

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Multiple seating options will offer your child alternative ways of having their sensory needs met while learning and growing.

Ask your OT for specific home-based exercises or activity ideas suitable to your child's abilities.

This will enable your child to complete their work without adults scolding or constantly disciplining them, ultimately leading to a happier and more confident little human.

The unexpected advantages of Teletherapy

Amidst the Covid-19 pandemic, the Health Professions Council updated their guidelines and regulations regarding telehealth services to include: "Telemedicine which involves remote consultation with patients using the telephone or virtual platforms".

This created a window of opportunity for clients and therapists that were willing to adapt, by embracing technology.

Don't get me wrong ....... it was incredibly daunting. Daunting for parents who needed to find the time and energy to become active participants in their child's therapy sessions, and for the Occupational Therapist who was used to working in a therapy room full of toys, educational materials and specialised equipment and who was experienced in "hands-on" therapy.

The ones that we were most concerned about, the kids, surprised us all by being the most resilient and quickly adapting to online therapy methods. From their point of view: what is there not to like about having two adults' undivided attention for 30 minutes whilst having fun?

Children are motivated by newly designed audio and visual onscreen input that make these virtual sessions even more interactive and rewarding. Not to mention that they were missing their regular OT sessions and in this way, they at least got to "see" and interact with "their" OT.

We quickly discovered that the typical, pre-covid therapy session of 45 minutes, was too long and "hectic" for an online session and reduced our sessions to 30 minutes which works for the children, the parents and the therapist.

In addition to the benefits of lower therapy costs (shorter sessions), less travel time, reduced travel costs and no risk of infection, most parents have also reported that they feel more "empowered" as they have learned and developed skills to play, grow and interact with their child while making use of their home resources.

Many parents have opted to share video recordings of online OT sessions with their partners, family members and nannies which has led to greater involvement of the child's caregiver network in the child's therapy. 

Parents have also reported an improved understanding of OT jargon and better carry-over of OT goals into their home setting.

As almost all sessions take place in the comfort of the home, the therapist has been able to develop a better understanding of family dynamics, resources and the home environment, to make child-specific recommendations about toys, equipment or structure in the household. This has not only benefited the children that are in therapy but also their siblings.

Even though we all look forward to returning back to hands-on, face-to-face therapy, Telemedicine has added a new and exciting dynamic to the Occupational Therapy process.

Based on these positive outcomes and if the Health Professions Council allows, I hope to include teletherapy as one of my "new normal treatment options, even after Covid-19.

Learning with Lego

Assuming that most families will have a version of Lego, Duplo or blocks at home, I'm going to share some "out of the box" Lego learning activities with you in order to help alleviate the stress, boredom, frustration and guilt that you may be feeling during your family's lockdown or quarantine period. I will also be sharing some wonderful and inspirational websites that you can visit for more daily activity ideas.

1. LEGO MAZE or MARBLE RUN

@play.and.learn.activities on Instagram, Hannah demonstrates how you can use the Lego building board to design a maze that your child tips from side to side in order to roll the marble or ping-pong ball through the maze. Make this task more challenging by getting the child to try and complete the maze whilst standing on their knees or balancing on one leg.

2. LEGO HOOP TOWERS

@preschool_mama on Instagram, Amanda shared an idea of how to expand on all kids' favourite activity: Tower building. Place the towers at a distance and use bracelets, pipe cleaners tied in a hoop, bent straws or cardboard ring cut-outs to throw at and hook around the towers. Allocate points to the towers and see who can get the highest score!

3. LEGO HIDE AND SEEK

@playroomstories on Instagram, Jana demonstrates how you can use simple colour fabrics or even just items of clothing from around the house to play a colour sorting game. Hide a set number of Lego pieces around the room and get your children to look for and then sort them onto the matching colour fabric. For toddlers simply place the Duplo blocks around the room but our for pre-schoolers Lego can be hidden out of direct sight. Add a fun listening component by using the term "hot" when they get close to the blocks and "cold" when they are far away. 

4. PLAY DOUGH LEGO ART

At artfulparent.com Jean Van't Hul shares some ideas and inspiration on how to enjoy art with your kids. One of my favourite activities is using Lego pieces as stamps in order to make a picture. The same concept can be applied when practising letter and number formations e.g. using dots to outline a large letter "b" in the playdough and encouarge your child to use the lego stamps to complete the dot to dot.

5. LEGO PAINTING

Search online for domesticmommyhood.com where mother of two Bekki, shares her love for cooking and crafts. Add a messy play component by dipping the blocks in the paint before stamping them onto a blank page. This activity can also be used to teach colour concepts, size differentiation or counting e.g divide the page in half and write the number 4 on one side and 7 on the other, indicating the amount of stamps the child has to make in on each side. Encourage pre-schoolers to stamp out their spelling words using the blocks and paint.

6. LEGO MATHS AND LITERACY

There are multiple printables and picture inspiration available on Pinterest so please make of use of this when finding Lego maths and spelling inspiration.

Use the blocks as "counters" during maths activities or incorporating a dice into your tower building activity and only adding the amount indicated on the dice to your tower.

Write letters on the side of the lego and use them to build words. This can be completed in a tower format or a wall. For a bigger challenge, write words on the side of the blocks and try to gather as many rhyming words as possible.

7. LEGO SECRET CODE

@sarahfrugalfunforboys online and on Instagram - Sarah specialises in Lego building ideas and STEM (Science, Technology, Engineering and Match) play activities for active kids. She shares wonderful ideas for children of all ages but one that really caught my eye was the coding activity which is mostly for kids ages 8 and up. By allocating a letter of the alphabet to different blocks you children can write and decode secret messages made with the block sequence they are given or created.

OCTOBER 2019

Families and Occupational Therapy - A Team Effort

A common reason that children start therapy at a later stage then they should, is that parents are afraid, resistant or reluctant to acknowledge that their child is experiencing difficulties.

Whilst these emotions are completely normal, would it not be helpful to know that the Occupational Therapy process can be empowering for a child's family members?

When I first started practising as a paediatric OT, I quickly realised that my “clients” were not only the children that I was working with but also their parents, caregivers and teachers. 

To ensure the progress of each child, I had to involve as many of their “team” into the therapy process as possible. After all, OT sessions last only a few minutes per week compared to the hours that children spend at home or at school.

So for a moment let’s shift our attention away from the little humans in our lives, to the moms, dads, grandmothers, grandfathers and caregivers that make the time and effort to be a part of the OT journey and often move mountains to sit in on their children’s therapy sessions.

Here is what some parents whose children are currently receiving OT at KidzCan Durban, had to say when I asked them: "What has OT meant to you as a parent?"

“OT has been vital in assisting us with understanding and communicating with our son.”

“The OT experience has taught me that activities that seem like games are actually an important part of stimulating learning.”

"OT has helped us to understand how to interact with our daughter. We now have a better understanding of her strengths and weaknesses and this has guided us to make the right decisions for her schooling which has helped her grow into a confident and responsible young lady.”

“OT has helped us understand and harness our child’s special sensory needs and the therapy has taught us fun activities that help him cope, improve and excel.”

“OT has certainly taught me a few new things. It is relaxing for me as I get to watch my child have fun whilst learning.”

“OT has meant a second teacher, mentor and friend for my child. It has been a positive, eye-opening experience as it has enlightened me on how to deal with my daughter.”

“OT has been beneficial to our son but even more so to our family. We have all learnt so much as we are encouraged to ask questions that will equip us to better help our son at home. Out of all the therapy we have tried, OT has had the biggest influence on the quality of our son and our family’s life.”

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I hope that these examples will assist parents who might feel uncertain or confused, to consider Occupational Therapy as a collaborative treatment option for their child.

DECEMBER 2018

As we wind down the school year and start planning for 2019
it is good to reflect on the year that has passed.
2018 has been an exciting and successful year at Kidzcan Durban

Our OT practice has been supporting children and families with sensory integration, concentration, play and social development, handwriting, reading, spelling and motor development.

As we believe in evidence based results, we encourage children to engage in a goal setting process where they identify and then work towards specific outcomes. Children score their ability before their first therapy session and then again during the final therapy session when the therapy intervention is concluded. Here are some of the results:

• “Learning to tie my shoelaces”, “Skipping” or “Throwing and catching a ball” improved
  on average from 6 out of 10 : to 9 out of 10.
• "Writing neatly” and “Finishing my work on time” improved on average from 5 out of 10
  to 10 out of 10.
• “Writing a story” or “Getting my ideas on paper” improved on average from 4 out of 10
  to 7 out of 10.
• “Concentrating when it is noisy” and “Remembering what my teacher said” improved
  on average from 4 out of 10 : to 8 out of 10.

Due to difficulties with communication, our kids with Autism find the goal setting process a bit more challenging. In these instances we work closely with parents and care-givers to identify goals that will make everyday activities, outings and interactions more manageable and meaningful.

In addition to my private practice, I have also been the lead Occupational Therapist at Whizz Kidz Special Needs Centre. Here I work with a multi-disciplinary team supporting children with autism, cerebral palsy and other developmental disorders.

In conjunction with other therapists and Sid’s wooden furniture, we have designed a specialised school chair that provides good seating and support for our kids throughout the school day, at a fraction of the price of the imported alternatives.

I am part of a team of therapists developing and presenting a training course for care-givers of significantly, physically disabled children. The Nakekela training course aims to provide care-givers with the basic knowledge and understanding of Cerebral Palsy as well as to equip them with the skills to manage a daily physical program, to feed, communicate and to play with the children.

Friends and the parents of the kids I work with, often ask for advice in choosing the “perfect” gift for their little ones. My suggestions always include age appropriate, interactive and educational activities.

Educational activities are often just as much fun but less expensive, than what we get bombarded with through advertising in the festive season.

1. Peg Board - Cost R 184 - Age 4+

   

   Develops: Fine motor skills, pre-writing skills, copying skills, visual attention, eye hand coordination.

   Description: This game requires your child to pick up one small coloured peg at a time and place it in the right hole on a peg board in order to build a complete picture – almost like a mosaic. The set comes with picture example cards and a variety of pegs in primary and secondary colours. You can buy an extra peg board for approx R20 which means siblings or friends can build together.




2. Finger Fun - Cost R 72 - Age 5+

   

   Develops: Fine motor skills, bilateral integration, copying skills, spatial planning, social skills.

   Description: Comes with 2 sets of finger boards and picture cards. Finger board is held horizontally while your fingers poke the holes in the bottom of the board to move the coloured marbles around. The aim is to match your coloured marbles to the pictures. As there are two boards it is a great game to play against a partner.




3. Rush Hour - Cost R 275 - Age 5+

   

   Develops: Copying skills, spatial planning and problem solving.

   Description: Place the trucks and cars in allocated slots to create the traffic jam shown on the picture card. Move the trucks and cars, one at a time in order to relieve the congestion and create a path for the ice cream truck to exit. Practice your listening skills by playing with a friend or family member: read instructions on the back of the cards so that the driver can navigate their way out of the traffic jam.




4. Zingo - Cost R 295 - Age 4+

   

   Develops: Visual attention, picture and word recognition, social skills.

   Description: Slide the card dispenser back and forward to reveal a picture and word card. All players (2-6) check their “bingo” card in front of them to see if they have a matching picture. If you do, place the picture card on your board. The aim of the game is to get a full row of picture cards and shout “ZINGO!





5. Brainy Blocks - Cost R 80 - Age 3+

   

   Develops: Fine motor skills, visual attention, visual perceptual skills, shape recognition.

   Description: Learn about big versus small, shapes and primary colours. Use the 3 dimensional shapes to build a picture by filling in the open spaces on the picture card.




6. Tack Zap - Cost R 250 - Age 3+

   

   Develops: fine motor skills, copying skills, visual attention, visual perception, eye hand coordination.

   Description: A more modern version of hammer tap, in Tack Zap you choose between many wooden pieces to find the right parts of a robot or construction vehicle shown on the picture card. Nail the parts into place on the cork board using the nail and hammer.





7. Brain Box - Cost R 210 - Age 4+

   

   Develops: Reading and spelling, visual perception, listening skills, memory, concentration, social skills.

   Description: Fun for all ages and a variety of topic boxes to choose from. Each player has a few seconds to look at and remember the picture, words or sentence at the front of the card. The player then rolls the dice and gets asked one question (matching the number on the dice) from the back of the card. Play in teams or alone.




8. Little Engineer - Cost R 258 - Age 5+

   

   Develops: Fine motor skills, spatial planning & problem solving.

   Description: This constructional game allows the child to build a variety of cars, houses and characters shown on the pamphlet. It involves screwing nuts and bolts onto flat plastic pieces and even has a cool tool to help with fastening the items. For the more advanced engineers ask your stockist about Play Stix.

I buy most of my OT educational toys from Compendium Educational Games located in Westville. Contact Heather Maxwell direct on 083 420 6395 to arrange a time to visit her home-based shop or visit her website: www.compendiumgames.co.za for other products and prices. No noise, no fuss and dozens more educational games to choose from.

Wishing you happy shopping and a joyous festive season.

Elsje.