Occupational & Physical Therapy

Tips for Families

Occupational Therapy Parent Tips
Things to look at prior to doing a writing task:

1) Posture and Stability:

  •  Look at correct sitting posture and appropriate chair and table heights. A child’s feet should be flat on the floor and the desktop should be 2 inches above the bent elbow.
  • Use the 90 – 90 – 90 rule. Ankles, hips, and knees should be bent to a 90-degree angle for appropriate sitting posture.
  • If table is too high, elbows will be up and out to sides. If table is too low, the child will slump in their chair or rest their head on their hand.
  • Use footstool to support feet if the child’s feet do not rest flat on the floor. Allow students to work in various positions other than seated (standing at a vertical surface, lying on the floor propped on elbows).

2) Pencil Grasp

  • There are two types of grasps: efficient and inefficient. An efficient grasp the pencil is held between the pads of thethumb and index finger while resting on the middle finger. An acceptable variation of this is when the pencil is held between the pads of the thumb and index/middle fingers while resting on the ring finger. If a child is using an efficient grasp, their thumb and index finger should form a circular shape.
  • An inefficient grasp can include any of the following: fisted grasp, pencil held between the pads of the thumb and all four fingers, thumb wrapped over the top of the index and middle fingers, thumb tucked under the index finger, the hand held in a thumb down position, index and middle fingers wrapped around the pencil, or thumb pressing the pencil into the side of the index finger (thumb and index do not form a circular shape).

3) Paper slant

  • To best align paper, have student clasp hands in front of him/her and lay them on the desk. Their arms and bottom edge of desktop should form a triangle. The paper should be aligned parallel to the arm of the dominant hand. The paper should be at an approximate 45-degree angle.
  • The non-dominant hand should be used at all times to stabilize the paper.

What do I do if my child still having difficulties writing after I complete the above ideas?  If your child is having difficulty sitting try doing some sensory exercises prior to writing. These are simple calming activities that may help:
• Bear hugs
• Deep massage or rub lotion on body
• Therapy putty
• Fidget balls
• playing outside, going for a walk
• Roll out the cookie dough by rolling a big ball firmly over the back and limbs
• Pillows to make a pillow area

If your child is having difficulty writing with a regular pencil try the following:

  • Use pencil grips on pencils to teach and practice correct finger placement.
  • Have student hold a novelty eraser tucked under the ring and little fingers while writing, cutting, drawing or using manipulatives. This promotes the use of the thumb, middle and index finger for skilled movement and the ring and little fingers to support the hand.
  • Sharpen or break pencils down to about 2 inches in length to encourage efficient pencil grasp and better control of the pencil.
  • Place cylindrical foam sleeves that are approximately an inch long on writing utensils to increase the diameter and promote proper finger placement.
  • Use large/chubby writing utensils such as large sidewalk chalk broken into 2-inch pieces, Jumbo Crayons broken into two inch pieces

If your child is having difficulty holding the paper down or keeping their hand and wrist down when writing try the following:

  • Use masking tape outline on the desktop to indicate how paper should be slanted.
  • If a student writes with a “hooked wrist”, have them do written work on a vertical surface just above eye level
  • Working on a vertical surface promotes the wrist extension and shoulder stability necessary for control of the fine movements involved in writing.
  • When working on a vertical surface, paper or work should be positioned just above eye level.
  • Examples of ways to incorporate vertical surfaces into your home:
  • Let the children write/draw on easels, white boards and/or chalkboards.
  • Desktop slant boards can be used for individual work at the desk.
  • You can also place a 4-5 inch empty 3-ring binder on the desk for incline. Position the binder with the rings toward the top of the desk and the slant toward the child. Then rotate the binder to a 45-degree angle.

Consult with your occupational therapist on any questions you may have.

Occupational Therapy FAQ

Occupational Therapy Frequently Asked Questions

 1) What is occupational therapy?
Occupational therapy is a “..supportive service required to assist a child with a disability to benefit from special education…” Students who receive occupational therapy services in the school setting have been determined to need occupational therapy in order to benefit educationally. Occupational therapy combines the art and science of providing and directing activities that serve to restore and enhance performance of skills needed for functional daily living. The occupational therapist uses  a variety of tasks and exercises in the areas of self-care, work and play to increase functional independence, enhance development, and prevent disability. The task or the environment may be adapted to promote maximum independence and improve quality of life.
2) How does this relate to occupational therapy in the school setting?
One of a child’s roles is to be successful both academically and socially in school. Some children require a modified curriculum and/or additional  assistance to achieve mastery in these areas. Through the use of adaptation, teaching, therapeutic exercise and play, an occupational therapist may support a child in reaching their curriculum goals.
3) If a child qualifies for occupational therapy, how often will he/she receive services?Occupational therapy services can be provided in a variety of ways as determined by the IEP team. Based on educational needs, time may be used to work directly with the student, consult with the teaching staff  or parent, and/or to address equipment/modification needs. As an example, one child may require weekly intervention to support his/her IEP goals while another child may require support once a semester to ensure  that feeding and/or equipment needs are being met.
4) What areas do occupational therapists address with their students in the school setting?

  • Fine motor skills:  hand development, hand strength, grasp patterns, pencil grasp, handwriting, dexterity, scissor skills, shoulder/trunk strength and stability.
  • Self-help skills: manage clothing in the school  setting (i.e., buttons, zippers, snaps, tie shoes), feeding skills, and use of adaptive equipment.
  • Sensory awareness and processing: recommend sensory strategies to optimize student’s learning potential.

5) Why doesn’t occupational therapy routinely provide services to the student on a daily basis?

Because occupational therapy is a support service, one of our main goals is to assure that the child receives recommended programs and adaptations throughout each school day. To accomplish this, the staff is  trained by the occupational therapist to carry out these programs in all areas of the child’s educational environment. Working together as a team, the occupational therapist and school staff are able to provide the optimum means of achieving the IEP goals. Federal law mandates that each child should be served in the least restrictive environment. This often means that the child is working daily with his/her classroom teacher  on a program recommended by the occupational therapist.