Friday, May 26, 2017

Give the Gift of Origami

An origami bouquet in an origami container with origami accents---perfect!

Students have to be very patient to make these precise creases and folds for the flowers, container and extra decorations.  What a great way to explore spatial relations, sequencing and improve fine motor skills.

Students sold their creations at an in-school fair, which allowed them to practice social skills and money math.

Barbie Bistro Set

Need more furniture for your Barbie house?

Or maybe for your troll dolls?

This table and stool set was made by middle school students with autism, during their tech study class.  No, not "keyboard" tech but the kind of tech where you make things without the aid of a 3-D printer.

If you're beyond the Barbie stage of life, consider that with the trending of fairy gardens these days these n'little pieces of furniture would be very popular as gifts or maybe as an item for sale in a hobby-business?

Thursday, May 18, 2017


This morning I was talking to the social worker for one of my high schools, about a situation between teens I had seen earlier in the week after school.  She mentioned how the school was planning to set up a "safe zone" of sorts, for students to go to when they are feeling overwhelmed.  My co-worker said the stress level among many students at the school was very high and the school wanted to develop a wellness program that includes managing stress.  This particular school is very competitive, academically, and there are all kinds of pressures that students put upon themselves in addition to the standard teen trials of life.

I asked her if she thought the students came to school--this school--with good resilience.  Her straightforward answer, "No."

I think of resilience as meaning, how do you deal with set-backs, with horrible things that happen to you or with just being disappointed.  It probably means a whole lot more.  As OTs I think we already have lots of ideas for helping students develop resilience and maybe we'll be called upon to be involved with school programs more and more.  Here's some background info; well, it's really a lot of info!


Tuesday, May 16, 2017

Sensory Pouch Report

Those hair gel bags we created a week or so ago Sensory Pouch How-To are holding up pretty well:

Some of the small items inside tend to clump together, like the tiny confetti.  Other materials stay separated and are fun to move around with your fingers, like the flat marbles and beads.  If you have students who like to bite into bags, this is not the fidget item for them!

Wednesday, May 10, 2017

Flower Cards for Mother's Day

Today our group of middle school students with significant cognitive disabilities made some personalized Mother's Day cards, based on ideas from this great blog post:
Flower Cards for Mother's Day

Our patient speech-language pathologist (SLP) took about 15 black & white photos of each student and chose the best one of each student.  These were printed onto half a sheet of 8.5 x 11" photo paper prior to the group this morning.  After drying, they were folded in half to create a card.

Students used their communication device or pointed to choose which paper color they liked for making flowers, then randomly decorated the paper with magic markers.

Even adapted scissors are a little tricky, and oftentimes downright hazardous, in the hands of these students--even with hand-over-hand guidance from adults.  All the staff joined in to cut small flower shapes from the students' artwork.

Then, students chose which flowers to use for their cards and the flowers were taped around the borders of their beautiful pictures. 

The inside of the cards was too slick to write or stamp a message, so we used small pieces of leftover "flower" paper to stamp a greeting and then taped it inside the cards.

"What comes next?"

 By using b/w photos we found that the colorful accent flowers made the students' faces really pop.

Press the flower down nice and tight.

 Gorgeous gifts for the families.

Tuesday, May 9, 2017

Visuals for Self Regulation

One of my high school teachers for students with autism has tons of visuals all around her room, to help students identify and communicate their internal states and needs:

Teachers Pay Teachers is the place to go for visuals! 
Bin also contains some favorite fidgets and visual toys.

And, lots of cool activities and environmental aids for self regulation:
Mulch-ish dirt--very little scent.

Water table on wheels

Softest sand you ever felt.

Making those glaring lights more bearable.

Monday, May 8, 2017

Handwriting for Heroes

One of the authors of this book was interviewed in Wired magazine, discussing handwriting.   Interesting that she and co-authors have the book in its third edition:

What Do You Like About Your Teacher?

A fellow OT was telling me about her daughter's wonderful school and how the school emphasized social-emotional development, throughout the grades.  Recently, she asked her daughter about her teachers and what they did to help her keep moving forward, past the rough patches in her day.

Her first-grade daughter's answer:  "They don't let me live in my bad day; they help me move on to my next day."

Sounds like a wise kiddo to me!

Gel or Goo?--Students Want to Know What's in Their Sensory Bags

Ziplock bags, hair gel, food coloring, small items, duct tape and a communication board/sheet--we're all set to
make sensory bags.  Thanks to my SLP buddy for all the work on creating the communication board. 
Students also used their augmentative communication devices to request items.
This morning, one of our students would not touch the bottle of hair gel because she thought it was hair goo.  Once we convinced her it was gel, life got a lot better and she felt comfortable enough to participate in the activity.  Mind your descriptive words.
Don't fret about how neatly the duct tape is applied to the edges--it'll all work out in the end.

Tearing the tape can be a four-handed job.  Pulling the tape off the roll is a lovely activity for motor planning
and pinch strength.  Oh, and tolerating the smell, sound and stickiness of the tape.

Want some confetti in your sensory bag?  You'll have to pinch very carefully to pick it up.

It's a little hard to see the pretty shells and other items in the bag when you squirt a boatload of deep purple food coloring inside, but it still feels nice when you squeeze and explore the sensory bag.  Be sure to add a final edge of duct tape across the zipper, so the gel doesn't all ooze out over time.

Bags like this would feel nice and soothing on a hot day.  Try keeping some in the refrigerator to hold after a sweaty physical education class or walk outside the building.

Thursday, May 4, 2017

Wednesday, May 3, 2017

Keeping Safe at School

Have you worked with a student and started to realize that, maybe, you might not be safe?

Maybe it's a student with autism who unexpectedly comes up behind you and puts her chin on your shoulder, then starts rubbing her face across your sleeve.  She hasn't tried to bite you before and she seems calm and self regulated, but you just get this weird vibe.  You don't want to startle her by standing up too quickly, but you have this feeling in your gut that you better change your position fast.

Perhaps it's a high school student who uses everything as a drumstick or a drum--the table, his fidget tool, the therapy ball, sometimes your hand.  You're working side-by-side and he suddenly takes  your forearm and starts using it as a drumstick against the table edge.  He's "drumming" faster and with more force.  Do you pull away and risk upsetting him or do you wait a few seconds longer while you attempt to redirect him?

It might be a student who won't stop touching you while you sit at a little elementary table and work on fine motor skills or self feeding.  She's touching your arm, your leg and sitting closer and closer to you throughout the session.  You keep nudging her chair back to its original spot and clarifying her need to ask "permission to touch other people" but now you find that she's putting her hand in your pocket--to look for those gummy bears???  Maybe not.

Many readers will be surprised at what predicaments we hyper-friendly, gushingly-compassionate OTs get ourselves into.  Go ahead, sink your teeth into us, smack us, pull our clothes--we bear it all for the sake of helping a student improve their skills.  No kidding.  Teachers are as tolerant of this as we are.

Teachers get injured by students and we do, too.  Listen to your instincts and follow them.  Work with students in places where you can get help quickly.  Make sure other adults have a clear line of sight to you and your student during sessions, in case any questions arise concerning an "event."

But, don't put yourself in a bubble.


Friday, April 7, 2017

Creating Sensory Bags

Just found this wonderful blog while looking for activities to use with middle school students who have significant cognitive impairments:

Making Sensory Pouches

Great video for step-by-step demonstration.

Thursday, April 6, 2017

Let's All Take Turns Now

About 8 more weeks of work left in the school year—sounds excellent to me!

About this time of year I start wondering, “What have I left undone?  What should I do differently between now and when that happy, final bell rings?”

So, I look at my students’ goals and objectives once more, to see how I can help them be more independent with what they need to do in school.  My calendar gets a thorough review, to find things I have left undone, and then schedule when I will do them.  I ponder whether or not I’ve recently helped my fellow therapists on staff, to share ideas for summer home programs or great resources for therapeutic activities.

There’s another area I don’t consider very often but it does come to mind during our staff meetings when we discuss continuing education or policies and procedures—how much am I contributing to our group discussions?  This may seem like small change in the big picture of working in public schools, but it has a lot to do with being a good team player.  Frequently I look around and notice that several therapists share information in almost every staff meeting yet many other therapists rarely say a word.  The latter folks are the very ones I go to when I have a question about how to help a particularly needy student, and they always have good advice.  They are also the ones who produce top-quality, relevant classroom and home programs.  Why don’t they participate more in our group discussions?

I think there are many reasons for their silence.  First of all, they are using some of the time to write their progress notes.  In any discussion there is some down time, and that’s when I see them hard at work finishing up their notes.  Second, they tend to not be the type of person who anxiously waits to interject their comments into a discussion.  They’re happy to let others do the driving.  Finally, they want to help our boss keep the discussion down to a reasonable length of time and they know that by offering their thoughts, it may send the more loquacious members of our staff into new tangents.

So, am I offering too much input into staff meetings, too little or is it “just right?”  Am I doing my fair share or perhaps taking turns away from others who have something to contribute?  There’s a simple way I’ve used during meetings to find out.

When the meeting gets underway, I wait for the first comment and write down that person’s initials.  Later on, when they make their next comment—even a brief one--I start a tally next to their initials.   This continues with each person, except my boss, who speaks during the meeting.  I figure my boss can have as many turns as she needs.

At the end of the meeting I tally up how many turns I’ve had and compare the sum to the average number of comments made by everyone present at the meeting, including the folks who made zero comments.  That way I can see if I’ve been a little too talkative or if I might have contributed more.  Not every meeting topic is the same so it would be crazy to think a person would offer the same amount of comments at every meeting, right?

Where would you fall if your number of comments was ranked this way?  Are you speaking up and sharing your experiences and concerns?  Are you dominating the discussion?

There are all kinds of ways for us to continue developing our teams and our professionalism.  I challenge you to count your “turns” in a meeting you frequently attend and analyze your input—not just frequency but quality.  Your colleagues just might appreciate it.

Spin Some Beautiful Decorations for Spring

Our highschoolers with autism created some lovely decorations for prettying up their classrooms:

You'll need small pieces of paper, some paper clips or poster tack, washable paint and a salad spinner.
After you clip or stick your paper inside the spinner, add some paint and a few marbles or similar objects.  See if your students can figure out how to place the lid on the spinner--possibly a challenging task?

Some spinners have a knob to grasp for spinning round and round, but this one has a plunger.  It takes quite a bit of force to get it going and, with the marbles we placed inside to make the paint fling around, it gets noisy and provides
a lot of vibration. 

Why is the pencil being held at the base of the plunger?  Because, otherwise, the plunger kept getting stuck in
the down position--grrrrr!

Sometimes the paint spread in a splatter and sometimes it looked more like thick streaks of color.

It will take several hours for the paint to dry before we can string the pieces to make a garland. 
The rectangular pieces will be cut into egg shapes before stringing.

Each trial was different, making the activity all the more interesting.
This activity provided opportunities to practice:
  Fine pinch to use the paperclips
  Practicing use of augmentative communication for choosing which shapes and colors to use
  Tolerance of paint smell and texture
  Maintaining grasp on plunger and using sufficient force to press it down

We're on Spring Break next week--yippee!   I'll be remembering Good Friday and looking for the glory on Easter morning!

Ode to Chihuly Art

This morning I was trying to find a quiet spot to write progress notes, to avoid the roar of students practicing their music for tomorrow's "International Day"at school.  Lo and behold I came across this mesmerizing tribute to the work of the artist, Chihuly, in one of the resource rooms:

As far as I know, the students "painted" the outside of empty, ribbed water bottles with permanent markers and then cut spirals of varying widths from the bottles.  Use invisible fishing line or any string you have on hand to attach the "mouth" of each of the spirals to a firm surface.

Can you believe how beautiful this is?

Never heard of Chihuly?

Tuesday, March 28, 2017

We're Going To Be Friends + Autism

A teacher for elementary-age students with autism uses this music during arrival time to promote a positive day:  We're Going To Be Friends

Researching the music by the artist, I found another version of the same song, with the most relaxing pictorial accompaniment:

Thursday, March 23, 2017

Complex Regional Pain Syndrome

Spoke with a mom whose daughter I've known for years, long before she developed complex regional pain syndrome (CRPS).  Her daughter was in a trial with this med and has found improvement:

More research trials are being done and one day many people may benefit from this med.  If you have questions, ask your doctor.

Wednesday, March 22, 2017

Beautiful Garland to Make for Spring Activity

This egg-shape garland is so pretty I can hardly stand it.

What a great idea to use a salad spinner if you don't have one of those electric spinners on hand.  If you do have an electric spinner you can use a Power Link and a switch to activate the spinner.

We're going to use it with middle school students who have significant intellectual and physical disabilities.  Students can choose which color paper they'd like to use, which paint they'd like to try and a couple of the students can do the spinning.  Won't the "eggs" look beautiful hung in the classroom or decorating a student-created greeting card? 

Sesame Street Does It Again

Hats off to Sesame Street for including a cool, new member of the neighborhood:

Tuesday, March 21, 2017

St. Patrick's Day Treats--Planning for 2018

Thanks to Ms. Steinruck, teacher for elementary grade students with autism, for this cool photo:
Sour apple juice (diluted to taste), cupcakes with Airheads Rainbow Candy pieces, green Jello, green grapes and green Rice Krispie treats in shamrock shapes--can you say sugar central?  Sounds like a delicious time to me!

Friday, March 17, 2017

Leprechaun Gold in Them-There Rocks

One of my teacher buddies created some lucky rocks today--full of gold--for students to explore.

She mixed baking soda, water and green food coloring into little mounds and froze them several hours.  Oh, she also hid a little "gold" inside.

At the appointed hour she pulled out the pan of frozen rocks and had students pick a favorite to set inside a shallow basin that had previously been "greased" with dish soap.  Once the rock was in the basin the students used long straws to transfer small amounts of white vinegar for dripping over the rocks--foam city!!!  The dish soap enhanced the foaming effect and it kept growing and growing as each successive student took their turn.

The gold inside gradually showed up as the rocks melted away--lucky gold for St. Patty's Day!

The rocks turn blue in the freezer, then revert to green when they warm up.

Drip small amounts of vinegar onto the lucky rocks.

Wait for the magic foam to dissolve the rock and reveal the gold.

Okay, the gold turned out to be a tiny bell.  It's hard to find lucky gold coins at the store the day before the holiday!

What a great texture to explore, and so cold!
Decorating fun for the classroom:

Same materials--three different student styles.  For this version the student dipped the eraser of a pencil into the paint for a stippled effect.

Sponge painted.

Looks like wide brushstrokes.

Happy St. Patrick's Day to all!  I'll be wearing the green all day!

Wednesday, March 8, 2017

Crazy Straw Fidget & Fine Motor Challenge

Our COTA-student, Kaylin Blackwell, created these inexpensive items for fidgeting and fine motor fun:

"So this is my crazy straw activity. I've made two different versions and attached pictures of both below. I used them to work on motor planning, sequencing, and coordination, but the maze version would also be useful for wrist extension/flexion."  K.B.

Add a washer or another item to slide through the straw "maze" and use pieces of tubing or an old pencil gripper at the ends.

This would be a nice, quiet fidget toy.  Or, a soothing fine motor coordination activity, with that soft material.
Thanks for sharing, Kaylin!

Tuesday, February 28, 2017

Help for Handwriting--Alphabet Beats

This morning I joined a class session for handwriting training.  There were about six elementary-age students with autism and five adult helpers in the room--whew!

This DVD was used to learn how to write the lower case letters "f" and "g":

Alphabet Beats DVD

I found the demonstrations a little slow paced but the kids were mesmerized, at least for the first letter (about 10 minutes), and then they naturally got a little "wiggly."

My OT buddy who ran the session uses it on a weekly basis with the students and says that the students really pay attention.  When I was there they were chanting along with the letter talk and participating in the activities just fine (for the first 10 minutes!)  All the adults were chanting along and participating, too.

Using a solid program, like Handwriting Without Tears, is very successful.  The Alphabet Beats video kept the students' attention and engagement for a good 10 minutes, which is pretty much a record in our attention-span compromised world.  I think using both programs will be a smart move for those of us, and for our teacher buddies, who have students with significant letter writing concerns.  

Thursday, February 23, 2017

Online Keyboarding Programs and Apps

One of my OT buddies just forwarded this resourceful link to our staff.  The post is from 2014 but I bet many of these recommended sites & apps are still active, maybe even improved!

Music Therapy story

Thanks to Ms. Carlson, teacher for students with autism, for sharing this great story with me:

A Boy and His Guitar

Thursday, February 16, 2017

Have You Looked at GoNoodle Lately?

I've been recommending videos from to several of my teachers lately, from elementary school through high school.  Check it out yourself and see which videos might be helpful for your students, then pass the link along to your teachers.

Here's an interesting post from the GoNoodle blogsite.  I don't agree with every word but there're lots of good ideas:

Friday, February 10, 2017

Middle + High School Students With Significant Intellectual Disabilities

Ideas for OT Consult/Intervention
for Students with Significant Intellectual Disabilities*

Depending on the educational and related service goals and objectives of your students, this is what a school year might look like for many occupational therapists.
Intellectual + Physical Disabilities
Intellectual Disability + Autism
Observe feeding--any adaptive equipment needed?
Take photos of each student’s feeding equipment. What equipment is on hand in classes, kitchens.
Need timer to pace intake?
Prep feeding guidelines for individual students.
Initiate or update feeding forms on annual basis, or after hospitalization affecting feeding status.

Obtain photo permission from parents, for use in therapy records and training staff.
Take photos of UE splints and other specialized equipment, for OT file.
Observe during snacks, lunch.  How wide/how narrow are their food preferences?

Note fine motor skills and grasp patterns during utensil use or finger feeding.
If needed, provide photos of typical grasps for visual models to use with students during mealtimes.

Address immediate needs for self-regulation strategies and activities. What was used in the past?  Review former therapy records in student’s school confidential file.
Document what assistive technology is in place.  Take photos of mounting systems for AT and mark wheelchair or other equipment for best sites to attach AT.

Visit physical education to observe students out of wheelchairs and note gross motor skills and UE skills in more dynamic environment.

Observe students in school environments (lunchroom, assemblies, transition in hallways, art class, school jobs…) and consult on adaptations for promoting fine motor skills and independence.

Observe students in school environments (lunchroom, PE, assemblies, transition in hallways, art class, school jobs…) and consult on adaptations for promoting fine motor skills and self-help skills.

Explore primary classroom environment (lights, seating, noise level, computer placement, window glare) and items in place for self regulation.
Provide written recommendations to teachers and, possibly,  additional items for trial periods (fidget mat, light diffusers, standing desk, other).
Offer team in-service for creating items that have been successful with students.  
Use therapy session to model creating simple items to use in class--have students participate (such as rice-sock fidgets).  Include precautions.

Assess classroom inventory of materials for sensory exploration and individual leisure skills.
Create set of materials for students on OT caseload and train teachers & classroom aides on using items for alerting/calming to aid self regulation & readiness to learn.  Include precautions and symptoms of over-stimulation.
Do students have preferred activities for self regulation?  If so, help students and staff create a personal menu of preferred activities they can select from on a regular schedule through the day.  Enlist the school SLP to use visuals in the schedule.
Use seasonal weather and holiday traditions to expand group activities (ice maker for snow, cinnamon-nutmeg or
peppermint to salt/flour/water
dough for olfactory & texture exploration.
Use highly-textured materials (pinecones, gumballs, holly leaves) and other natural materials to create small gifts for families and school staff.

Students can create gift tags (tracing/cutting), write greetings then deliver gifts to school personnel during group sessions.
Review progress in self-help skills:
  • Self feeding
  • Food prep (cutting)
  • Utensil grasp
  • Independence in lunch line
  • Self dressing
  • Managing fasteners
  • Shoe tying

Provide adapted materials, as needed, to supplement classroom items.  (shoe laces cut in half and re-tied in contrasting colors)
Same as column to left.


Schedule visit with school-based SLP for shared students using augmentative communication devices.  Observe and collaborate on best access for switches/devices.
Schedule visit to off-campus work sites or adapted sports (skating, Medford League games, Special Olympics).
Observe student’s response to environment and need for any modifications needed at site.
Observe students during school-based jobs (washing windows, watering plants, working in school store, stationery business, café cart).
How have their fine motor skills and self help skills increased since October?

Refresh any customized “sensory kits” for students with seasonal items.
Observe students during school-based jobs (washing windows, watering plants, working in school store).
How have their fine motor skills and independence with self help skills increased since October?

Refresh any customized “sensory kits” for students with seasonal items.
Update materials for practicing self-help (bubble wrap for snaps).  Send home parent handout on tips for increasing independence at home.
Update materials for practicing self-help (bubble wrap for snaps).  Send home parent handout on tips for increasing independence at home.
Incorporate water and other outdoor activities into group sessions (reaching into water-filled basis to grasp objects).

Send thank-you notes to donors, describing how $$$ or materials were used to help students.
Improve hand strength for greater endurance in school jobs and work settings via carrying different sizes of water for outdoor plants, bringing heavy water bottle on outside walks.

Send thank-you notes to donors, describing how $$$ or materials were used to help students.
Meet with teachers, SLP, PT to determine what intervention strategies  to repeat and what to change for the next school year.
What feeding precautions need to be in place on the first day of school next year?  What equipment?  What self regulation strategies?
Meet with teachers, SLP, PT to determine what intervention to repeat and what to change for the next school year.
What feeding precautions need to be in place on the first day of school next year?  What equipment?  What self regulation strategies?

"Intellectual disability is a below-average cognitive ability with three (3) characteristics:

  • Intelligent quotient (or I.Q.) is between 70-75 or below
  • Significant limitations in adaptive behaviors (the ability to adapt and carry on everyday life activities such as self-care, socializing, communicating, etc.)
  • The onset of the disability occurs before age 18." 

Great Group Ideas from our Recreation Therapy Colleagues

Oodles of Activity Ideas

In many of my schools I work with teachers and speech-language pathologists who enjoy doing groups together to help students develop their academic, communication, social, fine motor and self-help skills.  Doing monthly groups with them lets me see:

1.  Communication skills I never knew my students possessed,
2.  Gaps in their fine motor and self-help skills that I need to address,
3.  How thoroughly other staff members know the ins and outs of my students' personalities,
4.  Excellent motivational methods for working with my students when they are having behavioral

Because we have everyone from the class participate in the group, either as a whole group or in smaller groups, I end up working with students who are not on my caseload and the SLP sometimes ends up working with one of my students who is not on her caseload--no biggie.

Here's an activity ("Hunt the Heart") I gleaned from the Recreation Therapy site, adapted for a group of middle schoolers with significant intellectual and physical disabilities:

We can create the hearts on construction paper or other paper.  To make it more interesting they may color the hearts in colors other than red, or stick with the traditional color.

We can "color" the hearts in many ways:
1.  Put drops of glue inside the heart outline and sprinkle glitter to make polka dot hearts.
2.  Put the paper over a textured mat to make a rubbing as the "color"
3.  Take shredded color paper and glue it to the hearts.
4.  Put drops of glue inside the heart outline and sprinkle cinnamon and glitter together.

An adult and student helper can place the paper hearts throughout the school for students to find, using their communication devices to announce, "I found a heart!"  The students can collect the hearts to decorate their room.

Thursday, February 9, 2017

Heart-shaped Valentine Treats for the Birds

It's been a bird seed kind of week.  Our high schoolers with autism molded three kinds of bird seed into heart shapes and plan to give them to their feathered friends next Tuesday.  Most of the students in both classes were "OK" with touching the dry seed and also when it was mixed with the water and gelatin to make it moldable.  Some students could measure and mix but not touch; that's okay, too.

This is how the seed cakes look after a day of air drying--still moist inside.

We ran out of heart-shaped cookie cutters, but I think the birds won't mind.

Either coat the inside of the molds with cooking oil or line them with foil.

Pre-mix the boiling water with unflavored gelatin--I doubled the amount of gelatin listed in the recipe. 
After you mix it together you've got about 20 minutes before it starts to set up.

Sunflower seed, nyjer thistle seed and tiny, inexpensive seed.

Our speech-language pathologist did her communication board magic.

The recipe

It's not easy to spoon the mixed seed into small hearts.  Concentration and precision and great tactile input
picking up the gooey stragglers and pushing them into the mold.

Press the seed in firmly, then twist a large diameter straw around in the middle to create a
passageway for the string.

Scooping a level cup or spoonful was a fine motor challenge for some students.

The seed was fun to explore before adding the gelatin + water mixture.

Pretty cute, eh?
Here are more ideas for Valentine's Day activities: