Telehealth is an adventure in which therapists encounter many new opportunities and challenges. It requires flexibility, creativity, and open-mindedness. In this podcast, Jenny offers some ready-to-implement activity ideas from her experience in telehealth to help make the telehealth adventure easier to navigate.

I know it is very scary to tackle teletherapy for the first time. I was nervous when I started practicing teletherapy 3 years ago. I needed confidence that I could navigate the technology pieces. I needed reassurance that I could be creative with limited resources. I learned a lot about how to effectively implement teletherapy, but it took courage and a sense of adventure.

So I ask you, what would Winnie The Pooh do during this time of COVID-19? Pooh bear is a simple bear with a childlike personality, full of wonder and exploration. He takes things as they come and lives life in a fun and spontaneous manner. And when he lives his life this way, it always turns out just fine. Remember to be like Winnie the Pooh so you don’t get stuck in the mud like Eeyore!

Telehealth truly is an adventure! You will encounter many new opportunities when using telehealth service delivery model for pediatric therapy. You will develop resiliency, just as the children with multiple challenges do in their lives daily. Be flexible, creative, open-minded and expect the unexpected.

Here are some ready-to-implement activity ideas to help make your telehealth adventure a little easier to navigate.

Ready-to-Implement-Activity Ideas

Activity ideas using a paper bag and crayons

• Tear edges of bag to make fringe
• Go on a scavenger hunt with paper bag
• Locomotor actions – pick up a crayon and move across room to place in bag
• Trace hand on paper bag with crayon
• Identify objects inside bag without looking

Activity ideas using a couch, pillows, chairs

Good for proprioception input, motor planning and following directions.

• Hop over a pillow
• Jump & stop activity on couch
• Bear walk, crab walk over pillows
• Pretend turtle with pillow on back while crawling
• Imitate Ninja moves with pillow

Activity ideas using pipe cleaners

• String cereal
• Twist together and jump over
• Copy design for visual perception
• Wrap around finger
• Minute to win it, how many can you pick up in 1 minute

Activity ideas using a playground ball

• Roll over bowling pins (could be empty plastic bottles)
• Ball wall walk, don’t let it fall
• Crab kick
• Spell words for each catch
• Over under game with adult assistant

Activity ideas using cotton balls

• Draw a sheep or cloud on paper and glue cotton balls
• Sponge painting with cotton balls
• Pretend feed cotton balls to plush animal
• While supine, pick up cotton ball with toes and bring to hands
• Throw and catch cotton ball

In this podcast, Jenny shares tips and strategies for helping children experience nature! Outside time reduces anxiety and depression, improves cardiovascular health due to increased physical activity, improves academic performance, and heightens attention. Research shows that exposure to green space (grass/trees) and blue space (water) have a positive effect on a child’s health. Kids who get outside are happier, have better problem-solving skills, enhanced creativity, and more opportunities for social interactions with others. Spring is just around the corner and it’s time to get kids outside to experience all the sensory wonders of nature.

Nature deficit disorder is a term coined by Richard Louv in his book Last Child in the Woods. It refers to the idea that children are spending less time outdoors resulting in a wide range of behavioral problems. There is an epidemic of lack of exposure to nature because children are choosing screen time over playing outside. Research reveals that the average amount of time spent on electronics is 44 hours per week, and as much as 7 hours per day. Exposure to elements of nature contributes to healthy childhood development. Research shows that exposure to green space (grass/trees) and blue space (water) have a positive effect on a child’s health. Outside time reduces anxiety and depression, improves cardiovascular health due to increased physical activity, improves academic performance, and heightens attention. A study published in the American Journal of Public Health examined the impact of natural settings on Attention Deficit Hyperactivity Disorder symptoms and found that “green outdoor settings” reduced symptoms in children with ADHD. Natural environments engage the mind effortlessly thus helping with attention restoration, giving the brain a break from “deliberate direct attention”. Kids who get outside are happier, have better problem-solving skills, enhanced creativity, and more opportunities for social interactions with others. Let’s explore some creative ways to connect children to nature that help develop gross motor skills, balance, bilateral coordination, fine motor skills, visual motor and perceptual skills, and of course sensory regulation with heavy work and movement:

• Go to the playground. Swing, climb on the monkey bars, just run around.
• Take a hike. Find a local trail that is easy to access.
• Go for a bike ride in your local park or on the school playground
• Join scouts or 4-H. Tons of nature to be explored with these classic organizations.
• Visit a National Park and be a Jr. Park Ranger. Collect all the badges as your child learns about the world around them.
• Make a Fairy garden with miniature plants and small fairy items to decorate
• Plant a small container garden, or just plant a seed in a cup. Perhaps the school has a community garden.
• Collect nature items and make a sensory colleague with nature textures and scents or do a leaf rubbing with a crayon and paper. Great to increase finger strength.
• Try Geocaching, a modern-day treasure hunting activity (more at https://www.geocaching.com/play
• Try out painted rocks. Paint a rock and place them in a park or on a trail for someone to find and keep or re-hide. I have my own painted rock Facebook page. Check it out at FB Dolphin65
• Explore a nature scavenger hunt. Have a list of nature items to find and check them off as you find each item.
• Pet an animal; go to the pet store or the Humane society. Try animal-assisted therapy.
• Hug a tree, climb a tree, feel the tree’s bark texture
• Listen and locate bird sounds outside
• Look for birds flying in the air and perching on an object
• Make a pinecone peanut butter birdfeeder – great for the human senses to experience and food for the birds. A win-win for all!

Research shows that as many as 20% of school-age children have problems with handwriting.  Illegible handwriting, also known as dysgraphia, is the primary reason for referrals to therapists practicing in school-based settings. This is a significant problem because handwriting is important for many functional life skills, such as completing homework and school assignments. Dysgraphia is common in children with sensory processing disorder and children with autism. In this podcast, Jenny shares insights into handwriting problems and offers simple but effective strategies to support students with dysgraphia.

To purchase Letter Treasure Hunt handwriting game click here.

Research shows that 10%-20% of school-age children have problems with handwriting. Handwriting is important for many functional life skills such as: Complete homework, school assignments, achievement tests for getting into college, writing letters, completing a job application form, and writing checks just to name a few. Illegible handwriting, also known as dysgraphia, is the primary reason for referrals to therapists practicing in school-based settings. Dysgraphia is a neurological disorder in which a person experiences handwriting difficulties. Letter formation may be acceptable in very short samples of writing, but this requires extreme effort and an unreasonable amount of time to accomplish. Overall, written work is not readable, even if copied. Some Signs & Symptoms of dysgraphia:

• Cramped fingers on writing tool causing hand fatigue
• Excessive erasures
• Mixture of upper & lowercase letters
• Reversal errors (typical through first grade)
• Inconsistent letter formation & slant
• Irregular letter sizes & shapes
• Misuse of line & margin
• Poor organization on the page
• Inefficient speed in copying

Here are some simple and effective strategies to support students with dysgraphia:

Let’s consider compensatory strategies:

• non-sitting positions during handwriting such as prone on the floor, tall kneeling, or standing to assist with posture
• Ball chair or air-filled cushion for sensory input
• A slant board helps support the forearm and wrist during writing and positions the paper at just the right visual angle
• Pencil grips can support and position fingers for the most efficient grasp
• Adapted handwriting paper such as 2 lined paper to eliminate visual confusion, raised line paper to give a tactile cue for the baseline, or highlighted paper for easier visual target when writing

Here are some accommodations to consider:

• Change demands of writing rate: Allow more time for written tasks
• Change volume: Reduce copying by providing math worksheet with problems written 
• Change tools: Graph paper for math problems, pencil grippers, adapted paper
• Change format: Do not grade spelling on some assignments

Let’s look at some intervention ideas:

• Theraputty to increase grip strength
• Hand and finger warmups to handwriting such as finger thumb touching and squeezing the hands
• Kinesthetic activities for handwriting such as practicing spelling words in shaving cream
• Letter Treasure Hunt handwriting game from www.Therapro.com This is my original invention and kids have commented how fun handwriting is when they play this game!

In this audio-cast, Jenny discusses tools that can be used by teachers, therapists, and parents to help children develop visual perception.

Jenny offers presentations, webinars, and workshops for teachers, occupational therapists, speech therapists, and physical therapists. If you are planning a conference and you are looking for a speaker on SPD, please contact Jenny today.

Visual perceptual skills are the foundation skills necessary for reading, writing, and math. There are seven visual perceptual skills that impact learning. A student can have deficits in one or more of these subskills. I would like to share with you a description of these visual perceptual skills, how they might impact children in school, and activities to help improve each area of visual perception to enrich learning ability.  

Visual Discrimination: The ability to discern slight differences between letter shapes, sizes and fonts. This can affect reading comprehension.

Activities: Matching game such as Old Maid, Go Fish, scrabble.

Visual Memory: Important skill for copying from the chalkboard or spelling.

Activities: Memory card game, practice spelling words using a scented marker, then smell the marker just before the test. The olfactory system is linked to memory.

Visual Spatial Relationship: Enables discerning between b-d-p-q. It is important in preventing letter reversals and manipulating columns of numbers.

Activities: Puzzles, parquetry, tanograms.

Visual Form Constancy: It is important in discriminating similar font styles when reading. Can lead to poor reading comprehension and recall.

Activities: Find and circle all of the letter “a’s”  on a magazine or newspaper page. Then find all of the letter “b’s” etc.

Visual Sequential Memory: Affects reading comprehension and spelling. It is important in written organizational skills for creative writing. VSM difficulties may mean that class performance exceeds exam responses.

Activities: Use a hand-held electronic speller. Spell words using magnetic letters. Spell words in modeling clay.

Visual Figure-Ground: Difficult to focus on tasks without being distracted by extraneous input. May lose things easily in desk and would therefore benefit from organizational aids. May lose place on page when reading.

Activities: Use a window guide when reading. Here is one example (Reading Helper 954-752-3692). Hidden picture activity pages such as Highlights magazine, Where’s Waldo or I-Spy books.

Visual Closure: Difficulties may affect word identification, seeing words “spl-it”, or omitting letters when reading.

Activities: Finish the picture activity books, dot-to-dot (ask child what the picture is before completing it).