Wednesday 3 May 2023

Extend therapy Beyond the therapy room

Therapy should not be limited only to the therapy room, but should always extend in the world outside of the therapy center. The motor learning principle postulates that in order for the brain to learn anything,

  •           it requires many repetitions of the task.
  •          and the same task performed in various ways.

The required repetition and the variation necessitates that therapeutic tasks should be incorporated as a part of daily life and in the real world. For children, work is play. Every child deserves to have fun. At the same time, every child needs to learn many daily functions of life as a preparation for participating in the world. Hence play, fun, and function, all need to be included in therapy. When a task is learnt through play, it requires less repetitions to learn. Therefore, the point is to learn tasks through play at home and elsewhere in the external world. This is known as carryover of therapy in the world of physiotherapy and occupational therapy.

Tasks or activities will heavily depend on the age and capacity of the child. There are various activities that can be incorporated into the daily / weekly routine that would provide the necessary meaningful movement and sensory input. Additional benefits would be a sense of accomplishment, increased confidence, and self-esteem.

 


Do activities that are suitable for your child.

Ensure SAFETY and SUPERVISION to prevent

  •         mouthing or swallowing small objects
  •        prevent falls that can lead to serious accidents such as fracture or head injury.

 

Do remember to watch the YouTube videos on

https://www.youtube.com/watch?v=TfljcTYjfeo&t  So many therapeutic activities are possible in the form of play to enhance a child's sensory-motor capacities. These are not a replacement for therapy administered by a professional therapist. Based on Dr. Ushma's clinical activities and suggestions, they have been performed at home by parents who avail therapy for their child at Activ Kaarya.

https://www.youtube.com/watch?v=EyjHNmxGRoY&t=45s  A variety of material such as bubble wrap, brown paper, rice flour, can be used to have fun. Work on the smaller muscles of the hand by using the pipe-cleaner and single-hole puncher.

https://www.youtube.com/watch?v=dy1Iro0GmCI&t=73s  Simple rubber band activity for young children.

https://www.youtube.com/watch?v=Tbr0da596-w  this is a video on making playdough at home. You can make it in larger quantity, it is less crumbly, and children can roll, poke, squeeze, and press – great muscle work for hands and fingers.  

 

Functional activities that provide therapeutic value and instill a sense of responsibility

Use the Indian ingenuity, also known as ‘jugaad’ to find items in your own home so that your child is occupied in meaningful tasks and is receiving sensory input at the same time.

1.     My favorite task for children is removing wet clothes from the washing machine. Wet clothes are heavy, sometimes tangled, and need to be pulled with two hands. There you are working on bilateral coordination, tactile, and proprioception. Not to mention balancing task whether the child is standing on the floor or standing on the stool and bending over a top load machine. Once all the wet clothes are removed and placed in a bucket, pushing the bucket to the dryer stand is another proprioceptive task that also provides visual-spatial awareness.  

2.      Push the bucket containing wet clothes towards the balcony or drying rack.

3.      Dry clothes on a rack.

4.      Park all your groceries at the main door of the home. Let your child carry each item from the main door to the kitchen. It could be small bags of grains, fruit, vegetables.

5.     Teach them to drag the 3 kg or 5 kg atta bag while walking backwards.

6.    Have your child play in plant soil, dig, and pick up soil with hands. Working with soil / gardening serves as an anti-depressant. Micro-organisms found in plant soil, compost, and leaf mold can help release serotonin which is a feel-good neurotransmitter.

7.      Use a spray bottle filled with water to squirt on plants and bathroom walls.

8.      Scrub bathroom walls using scrubbers – rotating in various forms such as plastic, coir, utensil green scrubber.

9.      Wipe tables after a meal using a small wet towel.

10.  Wring / squeeze towels with both hands.

11.  Pour water on self while using a mug during bath time.

12.  Give them a coir loofa to scrub themselves during bath time.

13.  Give 3-4 size containers such as small medicine cup, plastic glass, squeeze bottle to pour water from one container to another.

14.  Do not hold the banana for the child. Have them hold a banana with 1 hand, peel it with another hand, eat, and then throw the peel into the dustbin. Speak to them about the different actions and you end up teaching them a whole task.

15.  Teach them peeling oranges too.

16.  Use a small pestle-mortar to pound peanuts.

17.  Churn buttermilk using a wooden tool.

18.  Pour half kg to 1 kg of rice-dal packets into a jar.

19.  Place a beach ball into a pillow cover, tie it up into a potli, and suspend it from the ceiling.  Tap the ball back and forth using 2 hands.

20.  Similarly, place a tennis ball in a sock, tie it up, suspend it from the ceiling. Let your child hit it with a plastic bat.

 

Pre-writing Activities

1.     Scoop grains like rice, dal, and beans using 2 hands, small cups, and pour the same in another container.

2.      Tear paper and crush pieces of paper into a ball prior to throwing in the garbage.

3.      Finger painting and Vegetable printing.

4.      Sort vegetables such as potatoes, onions, lemons, tomatoes etc either using tongs or hands.

5.      Use at least 2 different sized tongs to pick up objects. You can buy them at a local store.

6.      Peel boiled potatoes, mash them if needed.

7.      Let your child pick up large pieces of watermelon with fingers. Let them use fingers to pick up pieces of fruit, salad vegetables, dosa, paratha.

8.      If your child can handle a fork, let them poke into pieces of fruit with a fork.

9.      Cut boiled or firmly boiled vegetables such as carrot, pumpkin, sweet potato----use a plastic knife.

10.  Use plastic tools such as knife and spatula to manipulate/ cut/ lift playdough.

11.  Hide small treasures such as coins, beads, bottle caps etc. into playdough or therapy putty and let your child find it.

12.  Use an eye-dropper to drip colored water.

13.  Pick up tooth-picks and insert them into a salt-pepper shaker. Make sure that the child is holding the shaker with 1 hand while using the other hand to insert toothpicks into the holes.

14.  Pull and fix rubber bands around a steel glass or cardboard cylinder.

15.  Fix clothespins on a chart paper.

16.  Have your child write large letters in shaving cream, flour, sand.

17.  Writing/drawing/painting on a vertical surface—stick a large chart paper on the wall a little above eye level. This helps stability of shoulder and wrist.

18.  Place a large chart paper on the floor and let the child color in crawling position.

19.  Write/ color on a slate, or blackboard, or driveway with chalk.

20.  Focus on drawing shapes such as circle, square, cross, diamond, etc. prior to writing letters.

21.  Trace a letter on your child’s back and have them identify it.

 

Cycling

Many parents purchase a bicycle with training wheels / side wheels, only to find that their child is having difficulty with peddling. Peddling and balancing when the bicycle moves is not as easy as we think.

At home, you can place old shoes under the side wheels. Now you have converted this into a static bicycle. Your child can sit on it and practice peddling, but the bicycle will not move.

At Activ Kaarya, we use the peddler to practice peddling. Please read the following blogpost.

https://sensoryintegrationbangalore.blogspot.com/2016/03/peddler-in-pediatric-therapy.html

Learning to cycle may take a few weeks or months. In some cases, children have learnt to ride a bicycle with side wheels within a few sessions.

 

Outdoor Activities

1.    Go to the park 4-5 times a week, sometimes to indoor play areas that offer so many opportunities for climbing, jumping, crawling, and balancing.

 

2.    Go for frequent walks with your child, have them carry a weighted backpack which is 10% of their body weight.

 

3.      While travelling, let your child pull the wheelie bag as and wherever possible.

 

4.   Take your child to the street market / desi market with you. Let them experience the colorful atmosphere of the market, look at the sarees hanging in the stores, the heaps of colorful fruit and vegetables, the smell of food being fried in small shops, and much more. Carry a bag or a bag pack to fill up and walk back home. 

 

5.      Push a heavy cart in the super market.

 

6.      Carrying weighted bags home from the market.

 

7.    Go for walking in natural enviroments. Bangalore is gifted with natural sites around the city – Nandi hills, LalBagh, Cubbon park, Banerghatta zoo, that offer walking and climbing. 

 

8.      A day can be spent on a farm where the child can play in mud, splash in water, and much more.

 

9.    Swimming can be learnt gradually. But first let the child just float in water wearing the safety gear. A parent can also get into the pool with the child.

 

10. If you are planning a vacation, go the beach. The beach offers a natural sensory environment – the different textures of the sand on various parts of the beach, the sound of the waves, making a sand castle that involves scooping, digging, pouring, and pressing.

 

https://www.youtube.com/watch?v=yZT5nfhnOjA home as well as open gym exercises can be done by children 5 years and older.

https://www.youtube.com/watch?v=X-u1W7cOCp8  simple activity with balls and cups to enhance reaction time, attention, cognition.

https://www.youtube.com/watch?v=n55pNvYiQw0 rubber band activity for children 5 -6 years and up, for finger strength. You can do them during travels also.

https://www.youtube.com/watch?v=nprmd3l8Nmc&t  to improve single-leg balancing, timing & sequencing to an auditory beat, figure-of-8 walking. Please watch and follow 16:00 onwards on this video.

 

Have Fun with your child! Include Play & Language in all the activities that you do. Connect with child. Give up the screen and be present with your child in the moment!