Friday, April 1, 2011

Occupational Therapy: Sensory Integration Warm-Ups for Special Needs Children/Disabled Kids

As an occupational therapist working with special needs children I find that sometimes it is very difficult to find fine motor activities that cognitively impaired kids can not only understand but enjoy.  As with any other population when working on improving fine motor skills with special needs children I always use the same formula.
  • Begin with a warm-up activity.  Warm-up activities usually include sensory integration, gross upper extremity activities and move into fine motor warm-up activities prior to working on fine motor goal work.
  • Try to incorporate neurodevelopmental techniques (NDT) into activities.
  • Fine motor skills/activities that are functional.
This post will focus on sensory integration warm-up activities for special needs kids.
 When working with moderately impaired special needs children on improving fine motor skills occupational therapy always begins with a sensory integration warm-up usually in the hall on the way to therapy.   Following are sensory integration warm-up ideas, of course the activity should be based on the child's alertness level.

Sensory integration activities for hyperactive kids:
  • Scooter boards of course.  If the child is not physically capable of moving the scooter board themselves longer scooter boards work with the child holding onto a handle or rope and then pulled down the hallway.
         Scooter boards are heavy work, vestibular and a great upper extremity warm-up.  Scooter 
         boards warm-up the larger muscles of the arms when the child utilizes their arms to propel the
         scooter board or if the child is being pulled holding onto a handle or rope assists in warming up
         the larger and smaller muscles of the arms/hands.

          Scooter boards are also a good warm-up for the hands by providing tactile and heavy
          work/resistance directly to the hands.
  • Jumping or galloping down the hallway.  Many special needs kids have difficulty jumping or galloping and of course you can't explain to them what you want them to do.  Holding hands and role modeling jumping or galloping often while singing a song to assist them with coordination and 'rhythm' for their movements is a fun way to increase tone, get rid of extra energy and provide proprioceptive (joint compressions) input.
  • Wheelbarrow or animal walks down the hall to therapy again good warm-up for the upper extremities, heavy work, vestibular and proprioceptive input.
  • Spinning and twirling down the hall or any other gross motor movement the child wants to engage in.  Sometimes I'm holding the child and spinning around-be careful with this one.
  • Tactile activities- some kids especially special needs kids with autistic tendencies find playing with beans and rice not only calming but focusing.
  • Swinging- most kids love swinging.  Net swings are great and can accommodate kids with a variety of physical abilities.  Swinging rhythmically in a linear motion is very calming.  Swinging a child fast, high and jerky is alerting.  
          Swinging is a great way to begin therapy with severely impaired children who are wheelchair
          bound and have limited movement.  All kids require vestibular movement to develop a sense of
          where their body is in space and to develop control of their bodies.  Children without physical
          disabilities are able to get the input they need for their brains to develop, kids in wheelchairs
          require movement for their brains to develop as well, swings are great ways to give them the
          vestibular stimulation they need.

          **Vestibular stimulation is very powerful.  You can tell a child is over stimulated if you
          look at their eyes and their eyes are moving side to side very fast (nystagmus.)

The goal may be to calm the child, many times occupational therapists and special needs teachers will turn to the standard calming techniques-slow movements, slow swinging etc.  I find that before I can incorporate activities to slow a child down first I have to meet the child at their level and bring them down with me.

For instance, for a child who is bouncing off the walls they may love the swing and anyone trained in sensory integration knows that slow, steady, rhythmic, movements are calming.  But for a child that is bouncing off the walls these movements are not calming they're boring and the child will not cooperate.

When I have a child bouncing off the walls and I use the swing to calm them I begin with fast, high movements of the swing.  The child is moving fast they love the feeling of flying with the swing so I give them the stimulation they want, then I slowly reduce the speed of the swing maybe lower the lights and start bringing them down to a more 'ideal' level so we can focus on other activities.

The only way to be an effective therapist with any kids, especially special needs kids who for the most part do not respond well to verbal commands and instructions is to meet them where their at 'sensorywise' and bring them to where they need to be and have fun doing it.  Unfortunately, sometimes it takes a few tries to figure out what is fun for them.

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