Department of Special Education and Related Services Occupational Therapy Programs Table of Contents Content Page Content Page Introduction 3 Spacing 30 How Can School Based Occupational Therapy Help? 4 Letter Formation and Reversals 31 Considerations Prior to Making a Referral 5 Reducing Pressure 32 Stages of Development 6 Increasing Pressure 32 Intervention Guidelines 7 Near Point Copying 33 Sensory 8 Far Point Copying 33 Attention 12 Scissor Skills 34 Ability to Cross Midline 13 How to make Spring Loaded Scissors 35 Bilateral Coordination 14 Dressing 36 Body Stability 15 Backward Chaining 36 Arm and Hand Strength 16 Buttons 36
Visual Perception and Integration 17 Zippers 37 Fine Motor Coordination 20 Helpful Classroom Tools 38 In Hand Manipulation 21 Helpful Web Resources 37 Handwriting Introduction 22 Appendix 40 Pre-writing Skills 22 Does Your Student Have Sensory Processing Challenges? 41 24 Sensory Activity Tracking Form 43 Hand Dominance 26 Symptoms of Poor Visual Perception 44 Left Handed Children 27 Activities to determine Hand Dominance 45 Sitting Posture 28 Data Collection Intervention Form 46 Position 28 Occupational Therapy Referral for Evaluation 47 Letter Size 28 References 49 Line 29 Introduction The purpose of this manual is to provide a brief description of what Occupational Therapy (OT) is and intervention strategies that may be used by a classroom teacher or parents. The intervention suggestions are provided in this manual may be used by classroom teachers for students who may have fine motor concerns which interfere with the student’s ability to perform basic school tasks. The manual covers several skills, all of which are needed to perform the occupation of being a student. This guide also consists of a basic review of the motor milestones of a typically developing child. Multiple strategies and interventions should be utilized to assist the student with developing age appropriate skills. The following interventions should be attempted for approximately two (2) prior to referring a student for a formal occupational therapy evaluation. During this intervention time, consult with your school’s Occupational Therapist to discuss progress or
Outdoor Indoor Sidewalk Chalk Play doh Blow bubbles Twister Rock climb on playground Sensory table Monkey bars Sensory PE Activities: Crab walk Weighted ball toss Scooter board relays Army Wheelbarrow walk Parachute Push ups Sensory Snacks Chewy Resistive Sucking Dried fruit Drink with crazy straw Gummi bears/worms Sports bottle with long straw Licorice Lollipops Beef jerky Popsicles Bagels Drink milkshake with straw Cheese Hard candies Granola bars Peanut butter Gum Kool-Aid bottles Raisins Suck apple sauces/yogurt through straw Taffy Gogurt Soft pretzels Freeze pop popcorn Sensory Classroom Activities adapted from: http://missallisonsclass.blogspot.com (For More Info. See Appendix: “Does Your Student Have Sensory Processing Challenges” & “Sensory Activity Tracking Form”)
busy visual environment. out other words around it. Difficulty locating a friend on the playground or finding a specific item in a cluttered desk. Difficulty sorting and organizing personal belongings Keep desk of distractions Place only one activity on a page Use colored placemat under the materials they are working on Use a different colored marker to outline boundaries for coloring, mazes or cutting tasks. Form Constancy -ability to see a form and find it other forms, although it may be sized different or rotated. Makes reading difficult as the student might not recognize familiar letters when presented in different styles of print (ie fonts, size, color). Can result in being slower to master the alphabet Can cause confusion between “p, q, and g”, “a and o”, “b and d” Difficulty recognizing things that should be familiar when environmental conditions change. Practice building block designs according to a model Try to limit the amount of different fonts student is exposed to. for a kinesthetic approach to learning by having student be able to touch, move, and manipulate objects when teaching new material. Sequential Memory -ability to recall a series or sequence of Can affect reading comprehension Difficulties in spelling, near and far copying, remembering the alphabet in sequence, and with the ability to sequence letters or numbers in words or math problems. Make patterns and have student copy them. Word search puzzles Provide auditory with the visual input (ie spelling outloud and then writing it) Visual cues (ie visual schedule or sequence of events) Allow student to have a copy of peer or teacher notes Visual Closure -ability to know what an object is even when the object is only partially visible. Difficulties with copying if complete presentation cannot be seen. Difficulty using worksheets or test forms that are poorly photocopied. Seat student close to white or smart board Present cleanly photocopied worksheets and test forms. Provide student with an example of completed project for a novel project. Complete dot to dot or jigsaw puzzles.
Without sufficient in-hand manipulation a child may be slow, clumsy, or unable to complete certain fine motor activities. They may also use two hands for the manipulation of materials, when using one hand is much more efficient. Classroom Activities: Cut play dough with scissors or plastic knife, then role play dough into tiny balls. Flatten play and cut with a pizza cutter. Practice manipulating buttons or snaps on shirt. Open and close Ziploc bags. Lacing activities or lacing shoes. Have children open/close various size jars and lids, particularly lids that can be twisted off. Moving coins from palm to finger tips and place them in a slot container. Dice games. Lay out coins or buttons on the table and have a contest to see who can flip the coins over the fastest (without moving coins to the edge of the table). Use large tweezers to pick up fruit snacks or small marshmallows. Play “Bed Bugs” game or “Operation.” String beads, noodles, buttons, and cheerios. Remove key from key ring with both and place it into a lock with one hand. Play Connect Four – have child pick up three pieces at a time and hold them in his or her hand. Handwriting Introduction Handwriting is an important form of communication and expression for people of all ages both academically and outside the academic world. Because of the fine motor skill and precision required for handwriting it can be a difficult and frustrating skill for children to develop. Several skills are required for handwriting which can be difficult for children to manage all at once. Some students may only be able to focus on one handwriting rule at a time. The following are aspects that may present as difficulties while writing: Line adherence Spacing between letters and words Letter formation Letter reversals Organization of page Appropriate letter capitalization Sizing of letters Pencil grasp Stabilization of writing hand Stabilization of with supporting hand Ability to copy from near or far distance
Sensory Activity Tracking Form Student Name Date Teacher . TIME Start TIME Ended Behavior student was engaged in prior to break (1-10) Sensory or Movement Break Activity (A – F ) Student’s Behavior AFTER the break Green, Yellow, Red Observations/Notes/Other concerns Green Yellow Red Behavior student was engaged in prior to break (1-10) Sensory/Movement Activity Student’s Behavior AFTER the break 1 - 6 - 2 - 7 - 3 - 8 - 4 - 9 - 5 - 10 - A – B – C – D – E – F –
0 Remained at baseline 1 Slightly increased Proficiency 2 Moderately Increased Proficiency 3 Significantly Increased Proficiency Please use the following table during the two week data collection period. Please try at least 2-3 interventions for each area of concern. : (it may be necessary to attach progress monitoring data) Identify the intervention (Consult with the OT as needed) Date Date End Scale (Circle One) Comments (Attach additional paper if needed) 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 Davis School District Occupational Therapy Referral Form