Milestones Achieved – Is it Enough?

It can be quite puzzling to parents when their child of 3-4 years demonstrates issues with communication, behavior, and may have difficulty settling in nursery school. There are a number of children who have well developed speech and yet display impulsiveness or lack of attention or anxiety, that become a barrier to academic learning.

As a sensory-motor therapist, I have many questions for parents when I first see a child of 3-4 years, with a diagnosis of autism or yet no diagnosis at all. There is a certain pattern of responses that I hear from parents; something that conveys to me that parents need more explanation about what they see in their child. Most parents report that their child is walking, all milestones were achieved, and all motor development is fine. But speech is the only concern; there has been difficulty with attending a nursery school due to atypical behavior.

I urge parents to think beyond this superficial knowledge of motor development.  It is important to know that achieving milestones or certain positive behaviors is not adequate. Remember that development is much more than checking off milestones. The list of milestones should be used only as a reference that the child is developing appropriately. Just as you need to ‘read between the lines’ in a paper, a parent should observe the child in subtle ways regarding their eye contact, comprehension, and feeding. Besides these, a skilled therapist observes many other components such as quality of movement, how’ are the motor skills accomplished, behavior, and cognition. In a nutshell, the therapist is assessing the child’s sensory-motor development.

My child crawled a lot during childhood.  Although the CDC (Center for Disease Control and Prevention, USA) has removed crawling as a milestone in 2021-22, it does not mean that we give up on crawling. Crawling can be done as a form of meaningful activity, even if the child is little older. Experienced therapists (including myself) see crucial values of crawling such as better reflex integration, improving core strength, depth perception, cognition, and hand arch development that impacts their writing in UKG.

 

My child can do all movements.  Does the child squat, bend, or engage in various movements frequently through the day to pick up objects and toys from the floor? Just because he squats or bends occasionally to retrieve objects from the floor, doing the same is not finished.  Think about your own life as an adult, each of us has learnt to walk decades ago, but we still need to continue to walk daily, consistently, and on different surfaces.

The same with children. If they have learnt one movement, it is not over. They need to engage in that movement in various ways, many times a day, over months.

 

Eye contact is good with mother at home, but not with people outside of home.  Since the mother is with the child all the time in a safe place called home, this is likely. Although eye contact can be better in the home environment with parents, it cannot decrease drastically when the child steps outside of home. Also, mother is not going to be with the child forever and everywhere. More importantly, remember that eye contact is a reflection of the vestibular-visual systems.

 

My child will eat by herself if given snack items. She understands everything, she will climb to the kitchen counter when she wants juice and biscuits.  Snack items cannot be counted as ‘real food’ because they have poor nutritional value and should not be consumed daily and frequently. As a clinician, I look into whether the child is touching mushy foods, using fingers or a spoon, bringing them to the mouth, chewing it or just gulping down. The Indian cuisine abounds in a large variety of foods that are cooked consistently in every family. Is the child consuming various food textures? It gives me an outline of their oromotor area functions, in terms of tactile sensitivity, proprioception, and vestibular system.

Reaching out for snacks and juice does not mean the child understands everything. She is only reaching for the food items that she likes. Human babies and children cry or display a tantrum when they are hungry. They will look for foods that can be gulped down easily. This is a need for survival.

My child climbs and is not afraid.  Is the climbing meaningful? Do they climb a ladder in the park? Do they engage in stair climbing at home on a daily basis? If they are climbing on sofas, furniture, or a parents’ lap constantly – it is not meaningful. It is a proprioceptive seeking behavior, which means that their proprioceptive system has not been well developed, and they will demonstrate decreased body awareness, decreased body spatial awareness, and cannot gauge the force with which they are holding objects.

My child has good balance, never falls.  Not falling is not a sign of good balance. The child may not be challenging themselves adequately, which is required for development. Good balance is when they walk on a balance beam, walk on uneven surfaces, climb various surfaces at home and in the park.

 

My child does everything, physical development is very good but doesn’t speak.  Although your child is walking and major milestones may have been achieved, they may still present with low muscle tone, poorly integrated reflexes, and decreased balance. They may not readily bend their body or have a good trunk rotation. These are all suggestive of an immature nervous system.

If the child is minimally speaking random words or is nonverbal, the best place to start is sensory-motor therapy. A good program of sensory motor therapy improves their understanding / comprehension of the relationship between their body and the world around them. This comprehension is one of the basic steps of communication.

My child knows the basic colors and can fix puzzles.  Is the child matching colors to a board, matching in different games (not just 1)? Is the child matching and orienting puzzle pieces without too much prompting?

Is the child engaging in different varieties of puzzles?

All of these reflect vision-perception and fine motor abilities.

                                                                                                              

 

My child is very smart because he can remember car models and nursery rhymes. These may not necessarily be an indication of high cognition. Remembering and knowing certain things can be accomplished by rote learning too.  

The child needs to be looked through a ‘whole’ perspective that involves many components of development.

My child can write 1 to 100, and do addition on a tab.  In my long years of experience, I have seen many children with autism who are not able to put 10-20 objects from 1 basket to another, although they write numbers. That means that they have learnt to write 1-100 when it is done consistently but have not understood the concept of numbers.

Concept based learning has to develop. Also, fine motor skills of tearing, cutting, buttoning have to be developed before schoolwork. Ample research shows that fine motor skills are related to academic learning.

My child knows everything, so can be enrolled in regular or inclusive school.  There is a difference between knowing and applying in the real-world situation. Moreover, behavior of the child matters a lot. Sensory and motor issues at home or clinic may seem mostly resolved. But the issues become magnified if the child is in a noisy and busy classroom of 25-30 children, and more academic demands are placed on the child. This leads to behaviors of throwing objects, crying, roaming around, and tantrums are observed to resurface.

Therefore, school enrollment has to be well thought over on a case-to-case basis, and during different time periods. Presence of a shadow teacher helps but may not always be the case.

 

Summary

Most issues with behavior and communication are rooted in sensory processing differences (SPD). Lack of adequate sensory development leads to poor motor abilities.

 

It is important to know what and how therapists observe / test and analyze the child’s performance in relation to sensory-motor systems. And what parents need to understand at their end.

A thoughtful discussion based on parent’s thoughts and reports combined with therapist observations becomes imperative in knowing the strengths and weaknesses of the child and becomes a place to start a good therapy program.

 

 

#behavior #sensory #motor #development #speech #communication #child development #cognition

Hands & Fingers – Our Versatile Tools

The functions performed by our hands are diverse and complex; ranging from holding and manipulating objects, to kneading dough, cutting foods, tying, and writing. 

Our hand is a manipulator of objects as well as a communicator. Hand is waved in bye-bye, or thrown up in anger, or used tenderly to pet a baby. Hand is a functional tool that we use for pressing, pushing, and pulling. And we use external tools with our hands such as scissors, hammer, and pestle. 

Most children seen at my clinic present with poor use of hands, sensitive hands, and weakness of hand muscles. These children have a range of diagnoses, such as autism, developmental delays, slow learner, and sensory processing difficulties. And there are a number of grade school children who present with difficulties in fine motor skills, handwriting, and attention. Regardless of the diagnosis, I find that children have a weak grasp of objects, a weak pincer grasp, and therefore have difficulty with using hands for a variety of functional tasks. 

Our finger tips contain the highest density of touch receptors, that help us appreciate and discriminate various textures, shapes, temperature, and pressure. Therefore, the tactile / touch input through the hands and fingers becomes crucial in the process of learning about the immediate environment in a child’s course of development.

Writing -- As parents of preschool and grade school children, it is common to have concerns about writing. However, before holding a pencil and starting to write, a child needs upper body strength, stability of multiple joints such as shoulder, elbow, wrist, strength of hand and finger muscles.  The hands should engage in climbing, digging, pinching, pressing, pulling, scrunching, and twisting with a wide variety of material.

All of these develop through prewriting activities of using hands in a variety of ways. Besides these, a child will be ready for letter formation only after they are able to copy prewriting lines and shapes such as vertical, horizontal, circle, etc. Also visual skills and cognition are required for writing. Hence, there is immense prep work needed prior to just giving a pencil and expecting the child to start making letters.

Fine motor skills are accomplished by using small muscles of the hand and fingers in coordination with the eyes. Young children need a lot of practice in manipulating objects of various sizes, shapes, and textures in order to develop finger strength and control.

 

Following are the videos that demonstrate many activities that are simple and can be done at home.  

Punching on paper – use 2 types of hole punchers to make holes on paper. The simple punching machine can be used in 2 ways as shown in the video.

https://www.youtube.com/shorts/fuyv61UHb70

 

Paper tearing --Have your child practice tearing a variety of paper that you are going to discard. These can range from regular paper to thin tissue paper to slightly thicker sheets. Your child can tear and crush the paper pieces.

Tearing paper is a simple, but important exercise in improving bilateral coordination.  It also improves hand-eye coordination, precision grip, intrinsic hand muscle strength, and shoulder stability. Moreover, it provides proprioceptive input to the hands and fingers.

 https://www.youtube.com/watch?v=xX1TWIFSWHU&t

https://www.youtube.com/watch?v=YSsw-2Iuy1g&t

Pincer grasp - use toothpicks and a small spice bottle to work on your child's pincer grasp. 

https://www.youtube.com/shorts/39ljmd--NPY

 

Rubber band activity – working with rubberbands provides tactile and proprioceptive input. It involves complex movements of the hands and fingers.

https://www.youtube.com/shorts/QDEepN3oTXI

https://www.youtube.com/watch?v=Mxg9sWG2Bt0

 

Various finger movements using small objects, paper, and bubble paper to work on pincer grip.

https://www.youtube.com/watch?v=hL1NdUiSC8s

 

Variety of fine motor activities are shown in this video, that can be done with material found at home.

https://www.youtube.com/watch?v=EyjHNmxGRoY&t=10s

 

Translation of small objects and coins within the palm. This occurs in 2 directions – from fingertips to palm or viceversa. This activity contributes to arch development and strengthening intrinsic muscles of the hand that are so important in all fine motor skills.

https://www.youtube.com/shorts/UXAPsKob8Tg

Have Fun with your child!

Movement – misunderstood & under rated

We have children with special needs where the primary concern of parents is ‘lack of sitting tolerance’ i.e. the child is always moving and walking around. Except for the sitting tolerance, the parents feel that their child is active and there is no problem with moving. As a sensory-motor therapist, my observation is that the child is moving around the room aimlessly and without any purpose or meaningful exploration. Most of the children demonstrate clumsiness of movement. And there is no variation in movement; either the child walks around or tries to climb short furniture in the therapy room frequently.

These atypical behaviors of moving around aimlessly and frequent climbing indicate that their vestibular & proprioceptive systems are not functioning adequately and optimally.  

Movement is a function of our vestibular system. The vestibular system is 1 of the 4 power senses that are foundational to all development.

 Why should we move frequently and variedly?

Humans were designed to move in space, just like we did so until 3-4 decades ago, prior to the advent of conveniences in life. In the first 5 years of life, children engage in active exploration of their surroundings, that leads to problem-solve and learning. They are required to move their head and body in various ways so as to provide input to their vestibular system. Variety of movements include bending down to pick up objects, getting down on all-fours, transitions between stand and squat, look up to reach and retrieve an object, climb up on different heights, walk on uneven surfaces, and the list goes on. Movement should also include effortful work such as push, pull, lift, carry, and drag.

 All such movements should be frequently done, not just on occasion. Let your child carry their own backpack, climb stairs, pull a small wheelie bag during travels, clear the table after a meal, wipe the table, make your bed, pull out wet clothes from the washing machine. Such tasks lead to increased visual-spatial awareness, problem-solving, and learning. These are skills that the child will need throughout their life; it is work that boosts self-esteem and self-confidence. When a child learns a new task, although with some struggle, the process of learning entails ‘figuring it out’ that consequently leads to neuroplasticity and better cognition as well.

https://sensoryintegrationbangalore.blogspot.com/2015/09/movement-part-1.html

https://sensoryintegrationbangalore.blogspot.com/2015/12/movement-part-2.html

As a course of development, gross motor movement leads to fine motor abilities. In order for our distal muscles to work, our proximal larger muscles need to be strong and efficient. If we expect a child to perform fine motor skills such as cutting, coloring, buttoning, and writing, they also need to have strength and control of the muscles surrounding the elbow, shoulder, upper body, and the core muscles. This strength and control of larger proximal muscles comes from using the body in various ways other than only walking.

The following video shows some ways in which opportunities for meaningful movement are provided at Activ Kaarya during therapy sessions—

https://www.youtube.com/watch?v=oFfTgbIFweQ

 It is a little paradoxical that meaningful movement is needed to improve attention, engagement, and participation in tasks.  Attention cannot develop while doing table-top tasks. Rather, attention improves when a young child actively moves through space, explores, and meaningfully interacts with their environment.

As an adult, think about how good you feel when you play a game of tennis, or go for a brisk walk, or clean up your room. This is because you have engaged in movement and exercise that release good neurochemicals in the brain. If you engage in various movements and exercise frequently and regularly, you will find yourself sleeping better, and will have more focus and attention towards your work. The same is for our children. Young children do need physical exercise in the form of activity and function.

 

Contemporary way of life

In our chase for convenience and the coverup of fast living, we forget to move our body in ways it should. Many of us rarely climb a ladder, or squat down to the floor, or sit on the floor even briefly. If adults moved frequently and in various ways, they become a role model for their child. Eg. climb 1-2 flights of stairs daily. It is good for you and your child.

https://sensoryintegrationbangalore.blogspot.com/2021/12/the-humble-staircase.html

 

 

In my clinical experience, I have seen children from grade schools who have anxiety, difficulty following instructions, struggle with attention in the classroom, become upset easily, and show aggression frequently. All of these issues are rooted in their vestibular, proprioceptive, and visual systems not developed adequately to help them cope up with the external world outside of home. As soon as we provide them with meaningful movement, effortful work, and functional visual activities in therapy sessions, their behavior and performance in classroom improves. My consistent suggestion to all parents has been to involve your child in age-appropriate house chores – making their own bed, folding clothes, sweeping and mopping, setting the table. Such tasks boost the child’s visual-spatial awareness, working memory, sequencing and organization of actions. More importantly, such chores allow body movement in a variety of ways that provide input to the vestibular system, that further boosts self-regulation and behavior.  

 

https://sensoryintegrationbangalore.blogspot.com/2024/08/moments-of-learning-in-natural.html

 

https://sensoryintegrationbangalore.blogspot.com/2016/10/home-choresessential-functional-training.html

 

 

All parents need to seriously reflect on ‘how much’ and in ‘what ways’ is your child moving throughout the day.  A child’s routine involves traveling to school and back, attending 1-2 structured classes, doing homework, and the day is over. Structures sports and activities are good, however, they do not provide the cognitive benefits of free play and unstructured tasks such as house chores. In my experience, children who are occupied in too many activities after school demonstrate fatigue and irritability. Therefore, it is wise to minimize multiple structured activities after school, and replace them with free play, house chores, and spending quality interactive time with your child.

Bridging Sensory and Motor Components in Pediatric Therapy

Dr. Ushma Goradia discussed the critical importance of bridging sensory and motor components in pediatric physical therapy, emphasizing the pyramid of learning framework developed by Kathleen Taylor and a special educator. This framework identifies eight sensory systems as the foundation, with particular focus on the “power senses” of vestibular, proprioception, tactile, and visual perception, which work together to influence motor output, behavior, and cognitive responses in children.

The integration of sensory and motor components requires a holistic treatment approach where therapeutic activities like prone weight-bearing, trunk rotation, and gait training provide dual benefits by addressing both motor skills and vestibular function simultaneously. Physiotherapists must recognize that movement is crucial for development across multiple domains and should consider sensory integration when treating children with neuromotor impairments, distinguishing between sensory issues that show observable physiological responses and purely behavioral problems.

Parental involvement, particularly from mothers, emerges as a critical success factor in pediatric therapy, helping to build trust and comfort while addressing potential child discomfort due to touch hypersensitivity. Parents need education about therapeutic processes to support their children effectively throughout treatment. Clinicians should watch for specific red flags in conditions like hemiplegia and cerebral palsy, including asymmetrical posture, balance issues, body awareness problems, vestibular and proprioceptive concerns, and tactile defensiveness.

Treatment strategies for sensory processing issues involve gradual exposure to different textures, emphasis on movement therapy, systematic approaches to tactile defensiveness, and holistic methods that combine sensory and motor elements. The fundamental clinical insight is that physiotherapists must understand how sensory processing impacts motor development, as this connection is essential for creating more effective pediatric interventions that address the whole child rather than isolated symptoms -- Dr. KD Mallikarjuna, PT

Ushma ma'am, your emphasis on adding sensory integration gives the exact perspective to paediatric Physiotherapy needed. Humans are sensory beings. So taking into account all their sensory experiences and understanding their implications on therapy was well explained -- Dr. Vidhya Venkatesh, PT

Dilemma of the Dominant hand

The right hand holds a significant importance in Indian culture. Not only the right hand, but also the right foot. Giving money to a vendor or an autodriver, accepting ‘prasad’ at a temple, to making the first step in a new home are all done with the right side of the body. Some regions of the country call the right hand as ‘seedha haath’ meaning correct side and the left hand as the ‘ooltaa haath’ or the wrong side.

Being a physical therapist and having lived in the USA, the right hand being sacred and the left believed as unholy truly baffles me. The USA has a much larger number of people who are left dominant. In contrast, in urban areas of India, the left dominant child catches negative attention and is perceived as something wrong. My son is left-handed; he writes and eats with his left hand. During his preschool years, many people asked me to correct his dominance! But I taught my son to remain cool!!

A 7 years old girl was brought to my clinic due to behavioral and anger issues. (A diagnosis of autism was doubted by parents and past professionals at the time). She was also emotionally distraught in that she would cry without any reason, hit another child, and had poor sitting tolerance. Careful history revealed that parents were unsure about their daughter’s dominant hand. The child’s grandmother insisted that she use her right hand for eating, and hence the parents tried to insist on the same. Besides the sensory-motor therapy that was indicated for this little girl, my first priority was to educate parents on not forcing use of a particular hand and to let the child just ‘be’. In a few weeks, the child started calming down, following verbal instructions fairly well, and more importantly participating in fine motor skills and using the left hand for writing. Therefore, I strongly urge parents to not force your child into using the right hand only. 

I have had several children with delayed speech and poor fine motor abilities, who were forced to hold a crayon and eat their food using the right hand because the grandmother said so. 

Beginning at age 6 -12 months, a child uses 2 hands together and gradually shows preference for either hand around age 3-4 years. Dominance is generally established by 6 years of age. 

The other important point for parents to realize that we perform majority of tasks such as buttoning and tying shoelaces using both hands together in various ways (bilateral integration). Tasks such as opening or closing a bottle requires that you hold the bottle with 1 hand (non-dominant) and open or close with the other  hand which is the dominant one. You hold the paper with non-dominant hand and cut using the dominant one. So the non-dominant hand becomes the helping hand that provides stability, while the dominant hand is the working hand that performs the task. As you go through your day, try to consciously think when and how do you use your hands. 

I am trying to emphasize that development of both hands is crucial as the development of a child progresses from the first year of life to school years. As parents, offer objects to your young child somewhere in the center of their space and let them pick it up with any hand. Observe during many occassions as to which hand the child advances to pick up or pull something first. But do not force or insist on using the right hand only. 

Floor Sitting

Do you sit on the floor at least once a day? Does your child sit on the floor for activities such as art & crafts, or for eating snacks and meals? 

Do you sit on the floor multiple times in a day? How long do you sit on the floor each time?  When was the last time you sat on the floor? I urge all young adults and middle-aged individuals to reflect on these questions. With older adults, and people with joint issues (hip-knee-ankle-low back pain), it becomes a different scenario.

Why do I emphasize sitting on the floor frequently or often through the day? The number of times you rise from the floor, with or without hand support, has a positive effect on your heart and lungs. The capacity to engage in physical work in terms of frequency and duration is known as endurance, and reflects the health of your cardiopulmonary system. The number of times you get down to the floor and rise up into standing reflects your endurance.

Multiple benefits of sitting on the floor Sitting on the floor for work or sitting on lower surfaces that are shorter than regular chairs provides a different feeling or emotional groundedness. This is something that cannot be described in words, but is an experience to be realized. 

Better flexibility in all the joints of your lower body is a huge plus in a few days after you periodically get down to the floor and later rise up. 

Regular habit of sitting on the floor positively influences your gut health and the digestive system, and provides a deep sensory input to your abdominal cavity.  

You will feel lighter in your body and supple in your general movements.

Benefits of floor sitting will take you a long way physically and emotionally.

                                              Photo Credit : Freepik.com 

Individuals who have no joint problems and wish to start floor sitting, need to do it gradually. You can start by sitting on lower surfaces such as a 12” height stool or a ‘peedah’ or ‘modha’ that are old-style furniture still seen in many Indian homes. For work, you can put your laptop on the center table or coffee table.

In my practice, I see so many children in grade school who either have difficulty with sitting on the floor or can’t sit on the floor for at least 8-10 minutes. These difficulties are either due to decreased flexibility of hips & knees or due to lack of habit (practice) or both.

 

Myth: Sitting on the floor is not important anymore, we don't need it.  In the contemporary world, we think about anything through the objective lens, trends, and scientific evidence. We quickly accept or reject something based on a bunch of papers and numbers. As a physical therapist, I wish to point out the value of sitting on the floor, it is a topic that is debatable and holds limited scientific evidence. However, when viewed in a different perspective, sitting on the floor has been a common practice across all the ancient cultures of the world. In India, we sit on the floor for all our religious functions. Although the Indian toilet that required squatting has disappeared from the middle and upper classes, the squat position is commonly used by laborers, farmers, and domestic helpers. 

Look around in your immediate environment. The domestic helpers, cooks, and gardeners may be older than you, but are able to get down to the floor with ease. It is because they do so frequently in their life throughout the day. This is called ‘practice’ or ‘repetition’ or being used to it. 

So remember to sit on the floor if you still can,  or sit on a pillow or a cushion, or sit on a lower height of 10-12”.  There is nothing wrong in taking hand support of any furniture while getting up. But do not give up on floor sitting while you are in your 30s and 40s. If you do have pain in any joints, contact a physiotherapist and take charge of your flexibility. Do not forget the habit of sitting on the floor. 

More importantly, get your children to sit on the floor for many tasks. Make it a habit - frequently throughout their time at home. They can sit on the floor in various ways, but not in W-sitting! Remember that frequently sitting on the floor provides you with a feeling of connection to gravity, to Mother Earth! It is a great feeling that is fast being forgotten. 

Moments of Learning in the Natural Environment

Just as a young child needs to learn how to take a bath, use the toilet, wash hands, feed, and dress independently; they also need to learn some basic chores at home.  I have advocated for engaging children in house chores to so many parents – regardless whether the child is on a typical progression, has autism, or has sensory processing differences, or diagnosed with attention deficit, or demonstrates handwriting issues.

Creating Opportunities  Home is the natural environment for a child, where they spend the most time with family, while engaging in daily routines. Everyday tasks that seem mundane to many of us, but yet need to be done, can provide learning opportunities for young children. These learning opportunities can be rich and varied, 2 components that are so important for motor planning and motor learning. 

The best part is that the child can learn within the house. Don’t miss out on creating opportunities of learning for your child right at home!

In the contemporary fast-moving world, doing house chores is looked down upon, under rated, or thought unessential. However, as a mother of 2 children and as a pediatric therapist, I always believed in the value of learning basic chores early on in life.  These tasks are functional, and are important  survival skills that are required to be done daily or frequently--

• ·       Carry plates and utensils to the sink after a meal.
• ·       Wipe tables.
• ·       Water the plants.
• ·       Fold clothes and towels.
• ·       Dry clothes on a rack.
• ·       Clean up own room.
• ·       Peel boiled potatoes.

Family time & Bonding  Home chores are shared responsibility where family members can work together, thus spending quality time that leads to bonding. You can use the time to communicate with your child while doing the task. For your child, the bonuses are elevated confidence, increased self-esteem, and learning to take responsibility.

While consistently engaging in tasks frequently and consistently at home, your child learns problem-solving and motor planning.  A little progress each day or week, adds up to big changes in life such as providing a sense of accomplishment and boosting self-confidence.

This may come as a surprise to many parents, that the longest study at Harvard found a strong connection between doing house chores in childhood and happiness and success in later life.

https://mcc.gse.harvard.edu/whats-new/chores-caring-kids

Value based Tasks There are logical and scientific benefits of learning basic chores - primarily the variation in movement as well as the demand to problem-solve -- factors that lead to neuroplasticity in the brain, that is the purpose of any therapy provided to children with special needs.  In other words, creating changes in the brain and building neural networks in response to experiences.  This is akin to learning a new language or playing music. Please read my blog post

https://sensoryintegrationbangalore.blogspot.com/2016/10/home-choresessential-functional-training.html

Pulling wet laundry out of a washing machine, putting the heavy wet clothes into a bucket, and pushing the bucket towards the drying rack are all examples of tasks that provide proprioceptive, vestibular, and tactile input. Combining all of these tasks becomes a house chore as a whole.

Watch the following video that shows Activ Kaarya kids engaging in various tasks at home. Each of them has autism. 

All the children in the video had motor difficulties, tactile defensiveness, repetitive stimming, restlessness, lack of sitting tolerance, and poor ability to follow commands.  After a time of 12 – 18 months of therapy at Activ Kaarya, each of them gradually started engaging in small chores at home. 

It is so heartwarming to see the children work in their natural home environment as a process of learning. 

Parents also deserve credit because they took the effort to work with their child at home based on therapist suggestions. 

• ·       pulling off dry anjeer / dry figs from its string
• ·       putting items in the refrigerator
• ·       peeling boiled potatoes
• ·       pulling clothes from a drying line
• ·       squeezing orange juice manually
• ·       organizing washed utensils
• ·       folding clothes
• ·       picking greens
• ·       cutting string beans

Children with special needs take a longer time and many more repetitions to learn any task as compared to children on a typical developmental course. 

Sensory-motor tasks practiced during therapy sessions can be carried over at home in the form of house chores.  Early on at the commencement of sessions, we encourage children to put away equipment such as pillows, scooter board, mats, heavy bean bags etc…providing some physical assistance as needed. Samples of such sensory-motor tasks during therapy sessions at Activ Kaarya are shown in the following video –

Home chores are functional, and require movement of head & body in various directions, turning the head and body, reaching, bending, squatting, using both hands together. Hence the child receives various sensory benefits while learning tasks that are functional and essential. 

Do not miss out the value of learning tasks at home!

#bodyrotation #bilateralintegration #childdevelpment #sensorydevelopment #sensoryintegration #tactile #proprioception #movement #functionaltraining #learning #homechores #housework #tasks