Recycling O.T. Therapist: Favorite Adaptations for Developing Hand Skills

As an occupational therapist (and parent) I have discovered that all children can benefit from adaptations that make developing hand skills fun and successful. Adaptations might make toys easier to manipulate and provide stimulation that motivates and meets their sensory needs.

Let’s begin with my favorite adaptations-favorite because they are so easy, yet so effective in helping children with coordination difficulties. It is much easier to manipulate materials that are large and not flimsy. Stringing large donut shapes using thick cord can be taught before attempting to teach children how to string beads using a flimsy lace. I cut shapes out of detergent bottles using leather shears but you can use any large rings, rolls of tape or slices of cardboard tubing.

Lacing boards

Lacing boards with extra-large holes are easier to use than the ones sold with many small holes and they are easy to cut out of a piece of cardboard.

I attached a picture of horse since I use horses as therapeutic tools when I perform occupational therapy. This specialty area is called “hippotherapy” and involves using the sensory qualities of the horse to develop skills such as coordination and eye-hand coordination. After my clients use a fine-motor activity while sitting on the horse- I reward them with a walk or trot.

A child with a short attention span may require the sensory stimulation after stringing only one shape or lacing through only one hole in the lacing board. If the child is sitting in a swing-give a push after each step is completed. Children with longer attention spans might be able to complete an entire activity before the movement reward. I often use these same behavioral reinforcement techniques to encourage my hippotherapy clients to vocalize sounds.

Shape sorters

Shape sorters can be simplified to have only one or two openings-unlike the ones in stores that have several shapes to match. By cutting a square opening in a container and providing lots of blocks-children can repeatedly practice fitting the one shape-and practice is critical for kids with visual perceptual learning challenges.

Many toys can be purchased that make fun sounds or have flashing lights. Some of these are great in motivating kids with attention challenges. I have found that many children with autism love vibration so I adapt shape sorters and other insertion activities using the motor from an electric toothbrush or motorized pen. The activity in the photo requires the child to stabilize the container while inserting cards through the slit opening in the lid.

Children also love the feel and sound of Velcro “ripping”. Attach small toys to the bottle that they can remove and insert. Use age-appropriate objects when working with older children with cognitive delays-such as keys or erasers and encourage naming them as they are removed.

Musical ring stacks

Musical ring stacks often holds a child’s attention, but a vibrating one is particularly beneficial in facilitating bilateral hand skills. I inserted a Squiggly Wiggly pen inside a swimming noodle (after removing the pen point). I attached the noodle to a horse, but you can wedge it inside a cardboard box opening so that the rings don’t fall off. The rings shown in the photo are cut out of large yogurt containers.

I have always been amazed at how simple adaptations can make all the difference between success and failure with children of all ages. The early manipulation success that very young children experience helps prepare them for the two dimensional world of reading and writing.

Barbara Smith. M.S., OTR/L is the author of The Recycling Occupational Therapist and- From Rattles to Writing: A Parent’s Guide to Hand Skills (winner of 2012 NAPPA award). Please visit Barbara’s web site for more information at: www.2019.recyclingot.com/.

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This post originally appeared on our September/October 2012 Magazine