Pediatric Occupational Therapy
Gross & Fine Motor Skills
Balance & Coordination
Pediatric Occupational therapy treatment focuses on helping your child achieve independence in all areas of their lives. It can improve their cognitive, physical, and motor skills, thus enhancing their sense of accomplishment and improving self-esteem. Occupational therapy activities are designed to develop balance, coordination, strength, dexterity, and endurance which all has a direct impact on everything from walking or hopping to holding a fork or drawing.
Attention refers to the ability to maintain focus while engaging in a task. When a child is capable of maintaining attention, he is able to focus and complete tasks that are asked of him.
Children who struggle with maintaining attention may be unable to follow directions or fully complete work. They may not be able to focus on tasks at hand and may not pay attention when spoken to. They may also tend to produce lower quality work due to hurrying or daydreaming during tasks, as well as, fidget in their seat, doodle, or play with a pencil or pen.
Through occupational therapy at Shine Bright Therapy, we use remediation and adaptation techniques to help your child become more focused and attentive at home, school, and during everyday activities.
Arousal Arousal is your level of alertness at any given moment. Our arousal levels dictate how capable we are at paying attention and responding appropriately to what is happening around us. All these levels of alertness are important because they are necessary for survival. When danger is imminent, high arousal and hyper vigilance are what allow us to defend ourselves successfully against predators. Low arousal is what allows us to transition into sleep so that we can rest and repair our bodies. Most children with arousal issues It is a common misconception that when a child is vey active that they have a “high arousal level”.
Arousal is also important to learning. Maintaining an optimal level of arousal creates an atmosphere of perfect flow between a child and the task. Therefore, it is important to utilize sensory elements in the environment to promote self- regulation. Some of the ways that we assist children in self-regulating is by modifying the environment (altering lighting or sound, providing proprioception or vestibular input), and by providing preferred objects and activities to increase interest and arousal in the task.
At Shine Bright Therapy, we use sensory integration, preferred objects, and meaningful therapeutic activities, such as play, to increase your child’s interest and arousal. By using therapeutic activities that the child enjoys, we can increase your child’s learning ability. Furthermore, by using sensory integration, we can apply different multi- sensory techniques to increase the child’s interest, motivation, and focus in tasks that occur at school, home, and in life. Lastly, by incorporating environmental modification through sensory input, we can use the environment to help the child self- regulate to prepare to engage and focus on activities.
Sensory Modulation refers to the child’s ability to respond appropriately to incoming sensory information, such as sight, sound, smell, taste, touch, vestibular (movement and gravity), and proprioception (location and position of the body). When a child is capable of sensory modulation, he is able to function well in their environment, despite what sights, sounds, or smells are going on around him. In fact, the ability to modulate sensory information is important in that it affects everything that we do throughout our lives. For example, when a child is overly sensitive to auditory (sound) stimuli he may not like to go to loud places, such as the playground. By avoiding the playground, the child may not develop gross motor strength appropriately, which effects fine motor strengthening, which is responsible for developing pre –academic skills such as grasp and handwriting. Furthermore, by not playing on playground equipment, the child may not develop proper balance which effects body awareness, posture, ability to focus, and ability to learn. These also have an impact when the child starts going to school or playing sports. Therefore, it is important that we are able to modulate and control how we react to sensory information.
Everyone is born with a sensory threshold. How we experience life depends on how high or low that threshold is. Basically, our sensory threshold refers to our ability to detect sensory information. When we have a high sensory threshold, incoming sensory information needs to be strong for us to sense it. When we have a low sensory threshold, incoming sensory information requires information that is not as strong. In fact, when we have a low threshold, strong sensory information can be overwhelming. On the other hand, when we have a high threshold, weaker sensory information cannot be sensed.
Therefore, when a child cannot sense sensory information, he may show signs of being under-responsive(hypo-responsive), due to his high sensory threshold. In this case, he may not be able to register what is going on around him. For instance, a child who is hypo- responsive to auditory information may not be able to hear a police car’s siren or when mom is speaking to him.
However, when a child over-reacts when he comes in contact with certain sensory information, he may show signs of being over-responsive(hyper- responsive), due to his low sensory threshold. In this case, the child may become overwhelmed by seemingly typical sensory information. For instance, a child who is hyper- responsive to auditory information may think that normal sounds are too loud. He may experience discomfort, anxiety, and distractibility. He may cover his ears, cry, and try to get away from the noise.
Some children can be both over-responsive and under-responsive to different sensory information. One child may be over-responsive to touch and under-responsive to auditory information, which means that he may be super sensitive to different textures of cloth, but he might also be unable to hear a referee’s whistle.
At Shine Bright Therapy, we can help your child to learn how to modulate sensory information through sensory techniques, which build tolerance to sensory information that may be too strong and create sensory recognition to sensory information that may not be strong enough. Other types of sensory techniques that are used at Shine Bright Therapy include proprioception, linear, and vestibular movement techniques. Proprioception and linear techniques are used to calm when a child is unable to focus and participate in tasks due to over-arousal and hyperactivity. Vestibular techniques are used to stimulate children when they are under-aroused to be able to focus and participate in tasks.
Gross motor skills refers to a child’s ability to use the large muscles of the body, such as the muscles in the back, legs, and arms. When a child is able to efficiently apply gross motor skills, he is able to engage in activities that require strength, endurance, coordination, and balance. A child who lacks in gross motor skills may show decreased ability to engage in these tasks. For instance, a child with decreased gross motor skills may tire easily, be unable to maintain good posture while seated for long periods of time, and may be unable to run, jump, climb, or keep up with other children their age during play. Furthermore, when a child displays decreased gross motor skills, he may also be unable to reach his developmental milestones, such as learning to sit, crawl, walk, run, and fully engage physically and mentally during tasks.
At Shine Bright Therapy, we help increase children’s gross motor skills through strengthening, endurance, coordination, and balance activities, which will also help your child to reach their developmental milestones.
Fine motor skills refers to a child’s ability to use the small muscles of the body, such as the wrist, fingers, and thumb. A child’s ability to interact with the environment is related to their fine motor ability. When a child is fully able to apply fine motor skills, he is able to write, pick up small objects, such as cheerios, and manipulate small objects in one hand. When a child has decreased strength and motion in his fingers, he may be unable to pick up small toys, food, or beads and may be unable to use a paintbrush, crayon, or pencil.
The ability to use fine motor skills to grasp is important in development. Without them, we would not be able to participate in our environment. Power grasp and precision grasp are the two main types of grasp that influence how we interact with the world. Power grasp includes the ability of the whole hand to grab and hold items. This includes: power grasp, hook grasp, spherical grasp, cylindrical grasp, and disk grasp. Together, these types of grasps help us to grasp things from a suitcase, to a ball, to a jar lid. Additionally, precision grasp includes the ability to use the fingertips and small muscles of the hand to grab and hold small items. These include: three- jaw chuck/tripod grasp, lateral pinch, pincer grasp, and tip pinch. These types of grasp help us to hold needles, car keys, beads, and coins.
Lastly, our ability to manipulate objects within our hand is one of the ways that we are able to functionally operate in our environment. Our ability: to move objects from our finger to our palm and from our palm to our finger, to shift objects within our fingers, and to rotate objects within our fingers are how we put coins in vending machines and rotate our pencils from lead to eraser.
At Shine Bright Therapy, we incorporate fine motor strengthening and coordination activities to prepare children for feeding, writing, and everyday activities.
Posture: The ability to maintain good posture is important to developing good trunk, arm, head, and hand strength. It’s also vital to promoting good body mechanics, maintaining focus, and learning hand skills, such as handwriting. When a child is unable to maintain posture, he may show increased sluggishness, increased discomfort during seated or physical activities, decreased focus, decreased balance, and decreased strength throughout the body. Another sign of poor trunk control is when a child engages in “w” sitting, when a child sits on the floor when both knees are bent with the legs rotated behind them in the shape of a “w.”
At Shine Bright Therapy, we use muscle strengthening techniques in order to build up the core and trunk to prepare for good posture. We promote 90 – 90 – 90 seated posture, where the hips, knees, and ankles are bent to 90 degrees while seated in a chair, as well as, Taylor sitting (criss – cross applesauce) when seated on the floor.
Muscle Tone: Having appropriate muscle tone is important to accomplishing everyday activities. Muscle tone is important for body strength, endurance, motion, and good posture. When a child has normal muscle tone, he is able to undertake a variety of activities while being able to determine the appropriate amount of flexion or extension that is required of the targeted muscles. When a child reaches into the cookie jar to grab a cookie, he must be able to appropriately flex and extend his shoulder, elbow, wrist, fingers, and thumb to be able to grasp the cookie and must be able to control the amount of muscle tension in order to be able to grab and pick up the cookie.
Sometimes, children have difficulty controlling the muscles needed to complete a task. A child can either have high or low muscle tone. Children with high muscle tone(hypertonia) have very tight, tense muscles, which makes it difficult to stretch them. It may be difficult to stretch his arm out straight to grab an ice cream cone that is offered to him. When a child has high muscle tone, his movements may be jerky.
A child with low muscle tone(hypotonia) has weak, flaccid, loose muscles. He may lack muscle strength, control, and coordination. When a child has decreased coordination due to low muscle tone, he may try to move more quickly or use the large muscle of the body to do a small muscle movement. Furthermore, when a child with low muscle tone tries to sit up straight for long periods of time, he may be unable to hold his body up and may slump over or lean on something to help him.
Shine Bright Therapy incorporates strengthening, coordination, stretching, splints, heat, and cooling methods to help regulate muscle tone.
Balance is important to a child’s ability to engage in stationary and movement activities. Good balance increases a child’s ability to play, while decreasing his risk of injury. Inability to maintain balance may be affected by a child’s inability to motor plan, abnormal (high or low) muscle tone, or decreased strength and endurance.
Children who have decreased balance abilities may have difficulties with coordination. They may fall or trip easily, may move slowly and stiffly, and may be unable to navigate different environments, especially with eyes closed or occluded. These may interfere with child development, play, and school activities. When a child has decreased balance, he may be slow or trip while going up and down stairs, getting dressed, getting in and out of the tub, or playing on playground equipment.
At Shine Bright Therapy, we integrate vestibular motor activities to increase your child’s balance and coordination abilities. By targeting balance, we can help your child to increase their fluidity of movement and navigate their environment more safely.