School OT and Transition: 6 Steps to Expand Options for Students

Guest post by Michele Morgan,  OT MAEd

from the Creative Occupations blog

Michele Morgan Pen and Case Pic

Today we are honored to share a guest post by Michele Morgan, a School Occupational Therapist from Michigan. Michele has been able to expand her school practice into unique areas of machining and urban farming, among others, to address the pre-vocational needs of her students. I know you will enjoy reading about her motivation, process, and outcomes. Take it away, Michele!

Michele Morgan Coasters Pic
Student made coasters

As a school-based OT serving as a transition coordinator I am acutely aware of the challenges facing my students after they age out of special education programming.   For OT’s working in elementary and middle schools, pre-vocational and soft skill development needs to be addressed alongside sensory processing, motor, and visual- perception goals. According to the U.S. Bureau of Labor Statistics, 17.1 percent of individuals with disabilities are employed compared to 64.6 percent of the employment-population ratio without a disability.  In an income driven economy, many of my students are competing for jobs with pacing and productivity demands beyond their capabilities both emotionally and physically.  I feel an obligation to take an active role in training my students for viable non-traditional employment pathways with an emphasis on micro-enterprise. I am an OT- not a machinist, coder, programmer, farmer or woodworker.  To create this type of program I needed to figure out how to understand and teach complex topics and weave them into my practice. That journey led me back to good old activity analysis. 

Michele Morgan Wooden Spoons pic
Spoons made by students

To get off the ground, my colleague and I dug out our faded copy of uniform terminology and created an analysis of the steps required to turn and finish wood.  To our delight, we discovered a treasure trove of sensory, motor, and perceptual connections, direct applications to academic concepts, and pre-vocational skill development.  Students embraced the program, our math teacher appreciated the direct connections to classroom concepts, and the community supported our efforts by purchasing student made pens. Proceeds from sales of the pens were directly applied to the purchase of a CNC router. With no prior experience in programming or machining, we deconstructed the activity into its component parts, observed local machinists in the field, and repeated that process for 7 years. We added a laser engraver, vinyl cutter, 10 needle CNC embroidery machine, arduino microcontrollers to teach foundation skills in prototyping, snap circuits to increase accessibility to machines, and a commercial sandblaster (for details check out next month’s post on my blog). The same strategy was used to develop an urban farming program with emphasis on breeding and hatching quail, breeding and selling worms, animal-assisted therapy, and an aquaponics program.  The best recent development is the expansion of our traditional OT program into a 4 week summer program for at-risk youth who are not eligible for  OT services during the school year but who demonstrate significant barriers to competitive employment.  These students can now slide into apprenticeship programs and direct employment with an OT designed and managed training program! 

Michele Morgan pens pic

Perhaps the process of transforming employment opportunities for our students begins with expecting more from yourself and your programming.  Break down a task that seems out of reach, assemble a team that supports your vision, and prepare for your students and clients to exceed your expectations.  

Michele Morgan circuits pic

Here are 6 steps to consider once you find your “shoot for the moon” idea:

  1. Print a copy of uniform terminology to isolate functional, academic, pre-vocational benefits.  Be prepared to “sell” this idea to administrators and funding sources by clearly articulating how this project will positively impact your school culture, local community and students.  Think beyond reaching the goals of individual students.
  2. Assemble a team.  Find team members who “complete” you.  Think outside of your therapy world.  If you are writing documentation, you can write grants.  If you’re an extrovert, explore marketing, sales, and developing partnerships with local businesses. If you’re more of an introvert, select a partner who fills that role.  Grants designed for teachers may cover occupational therapists in educational settings.
  3. Find an initial funding source.  Divide and conquer.  Write a grant for a portion of your project and ask a school group to pitch in for the balance.  If you’re creating something that can be sold, offer your items to supportive organizations when they need to build fundraising baskets.  Don’t be afraid to tell them what’s in it for them from the beginning. They all want to know.
  4. Connect with the media.  Start local with high school TV-production classes or on-line high-school journalism classes.  They can provide documentary style footage and photography you can use in presentations or on YouTube (Check out Pepper our therapy bunny at 6:37!  Filmed by 1st year TV production classes). Local newspapers love a good collaboration between therapists and businesses or general education students.  If your items land in retail outlets, television stations will often come out to highlight student work.  You need to promote your work and ask print and news media to cover your story.  Don’t wait to be discovered.
  5. Name your program and get out there with your project and message.  Speak at local community colleges, professional development sessions and state conferences.
  6. Consider becoming a level II fieldwork site for OT’s or OTA’s to manage your growth and share your expertise.

 

Michele Morgan Margaret Mead quote

 

Michele Morgan PicMichele Morgan has been an OT for 21 years in a variety of settings including early intervention, mental health, outpatient, skilled nursing, and acute care.  For the past 11 years, she has provided services at the elementary and high school level.  Along with her colleague, she has provided professional development sessions for local school districts, and provided presentations at the community college and university level as well as special education conferences.  Student made work from her department’s technology driven industrial-arts program is currently in 8 retail locations throughout Michigan with items shipped internationally as far as Australia, Italy, and Germany.  The urban farming program boasts a variety of worms, bred and sold to area feed and pet stores. The program has been featured in the Detroit News, on WXYZ Channel 7, and in “Advance for OT”. The program was recognized as 2017 Entrepreneurial classroom of the year by the Council for Exceptional Children.  Michele enjoys grant writing, re-purposing, and collaborating with individuals passionate and optimistic about reconstructing employment models for a non-traditional workforce. You can connect with Michele on Twitter @MicheleMorganOT on her blog at creativeoccupations.wordpress.com and at wwtot.weebly.com

School OT and Transition: 6 Steps to Expand Options for Students

10 Fine Motor Tools You Can Find at Target!

 

10 Fine Motor Tools You Can Find at Target (1)

by Stacy Turke, OTR/L

“Just where DO you get all that amazing therapy equipment you use?”

 

As a School OT, I hear that ALL. THE. TIME. See, in my job, I get to play…er, work…with kids most of the time, and although we have important therapeutic goals we are working on, we have to make it fun and meaningful for the students or we will get nowhere fast. I always have a bag full of fun, enticing materials and equipment that I carry in and out of the schools I serve because I want kids to think, “Wow that looks like FUN!” There are all kinds of great companies that sell therapy stuff like alternative seating options, adapted writing tools and grips, specialized writing paper, mats to encourage reluctant eaters, and things like that, and I do use those catalogs and websites. But honestly, most of what I use during sessions with students I get at local stores, like Target.

 

This is not an advertisement for Target. I’m not an affiliate…I’m just a big time Fan. With a capital F.

 

You see, as a school OT, Target “gets” me. They know that I cannot resist that seasonal dollar section at the front of the store, where I might be able to find adorable little erasers in shapes that match the season or upcoming holiday that we can use for sorting. Target knows that I cannot pass by the wonderful office/art supply section, where I can find several different size and shapes of crayons, or super cool erasers that will ease the pain of having to “edit” work. And the toys. Don’t get me started on what can be found in the Toy Department. Cuz once I start I can’t stop.

 

I was recently at Target. I went because some of my Twitter friends had tweeted about a cool fidget ball they found at Target, and I just had to get myself one. If  you are a school OT, you know you can never have too many Fidget tools that are both engaging and useful! My plan was to go in, locate the needed ball and then head DIRECTLY to the check out and for the low low price of $3.18 I would have a new tool for my students. However…while there, Target’s amazingly enticing array of stuff drew me in and I left with a cart FULL of new tools to add to my every growing bag(s) of tricks. None of which is official “therapy equipment” yet all therapeutic and readily available. And I thought I would share it here for all my friends, colleagues, and students’ parents who wonder, Where can I get THAT?

 

From that Irresistible Dollar Section

  • Super Squishy Blob BallSuper Squishy Blob Ball: I am not kidding, it is actually called this! For $3, you get a gel ball inside a threaded mesh cover that allows the ball to squish through the mesh when the ball is squeezed. Super fun, and can be used both as a fidget tool and as a means of strengthening the muscles of the hand. Not for kids who might mouth or bite it, nor for a child who might poke it with a sharp object. For everyone else, super fun, as evidenced by the number of OT friends who were tweeting about it!

 

  • Squishy FishSquish-A-Fish: This ultra sticky, squishy fish is filled with what seems to be water beads and a blinking light that starts when the fish is squeezed. I searched carefully through the bin of different colored fish to find one with a broken blinky light, because in my experience blinky lights are very annoying in classrooms! Plus, there is a risk that a strobe-like light can trigger headaches and seizures, so I try to avoid those. Cost for this guy? $3! He’ll make a great fidget tool because it’s quiet and interactive, and it will provide a nice finger/hand wake-up before writing tasks. That’s a lotta bang for $3.

 

From the Office/Art Supply Aisles

  • Yoobi PencilsYoobi 24 Pack Mini Colored Pencils: These pencils are adorable, people! They are the size of golf pencils, so they encourage a “tripod” pencil grasp because they are just too small to hold in a full hand grasp. While markers offer a smooth, low-resistance feel when writing or drawing, pencils give the brain more feedback about what the hand is doing. And because most kids are expected to use pencils for most of their school work, using pencils for drawing and coloring helps support learning pencil skills. Kids have fun while learning and growing. That’s a win. Teachers and parents have kids who willingly work on improving skills (even though they may not know they are “working”). Another win. Everybody wins, including my wallet, these are just $4.

 

  • Yoobi Pretzel ErasersYoobi 4 Pack Pretzel Erasers: “Good writers edit their work.” Just about every one of my students hears me say this each and every time we get out a writing task. It’s a reminder that the “rough draft” is a real thing, and that only through fixing errors and rewording do we come up with a final draft we can be proud of. But try convincing a reluctant writer that writing isn’t done yet-and we need to erase work YOU’VE ALREADY DONE to do it again? Or a student with a strong perfectionistic streak that their work wasn’t perfect the first time! UGH! So I find that when I have interesting, enticing erasers available, kids don’t mind fixing their work as much. In fact, finding things to “edit” might actually be fun. And the sting of  work that might be less than perfect is lessened. These pretzel erasers have an added bonus: they can double as a fidget tool in a pinch. All for the low, low price of $1.50. One tip I learned the hard way: when these things are left in the car in the winter, they get hard. And then when they get hard because they are frozen, they break like dry twigs. And then the OT is sad. So don’t leave them in the trunk of your car if you live somewhere that gets cold in the winter. You’re welcome.

 

  • Yoobi Binder ClipsYoobi 6 Pack Binder Clips: Yes, I realize this feels like an advertisement for the Yoobi line of products. It’s not, unless gushing over products my students and I love is considered an advert. I’ve always loved these binder clips for kids because they are so intriguing, and they require good finger strength and bilateral coordination (both sides of the body working together) to make them work. This particular set has emoji faces on them, and anything with a face seems to draw kids in (have you seen Shopkins???). And these have a cool added bonus, GOOGLY EYE STICKERS! Honestly, there are some kids who would do absolutely any fine motor task I ask of them, no matter how challenging, if Googly Eyes are involved! Cost? $3.

 

From the Party Supply Aisle

  • Spritz Maze PuzzlesSPR!TZ Handheld Puzzles (pack of 18): For $5, this is almost a classroom pack! These are little marble run type puzzles of assorted designs. I’ve already put several into a lunch sack, and had a child reach in and pull out one. His friend with him also pulled one out of the bag, and then they worked to move the marble from the beginning to the end. The bag fed into my students’ natural curiosity, and made working on a visual processing puzzle more fun.

 

  • Spritz Mini ErasersSPR!TZ Mini Erasers (pack of 24): These erasers are not only erasers of cute foods, like slices of cake, ice cream cones, popsicles, sandwiches, and hotdogs, but they are also puzzles! Yes, the pieces pull apart and push back together…at least initially (they will wear out). So not only are they tools to help ease the harsh reality of “editing,” but they are also quiet fidget tools that are socially appropriate and even desirable. And cute, did I mention how cute they are? I paid $5. For 24 tools. Roughly 21 cents each.

 

From the Gilded Aisles of Toys

(Okay, it’s Target, so the aisles in the toy section are as red as the aisles in every other section. But just go with it…this section is special for School OTs.)

  • Grabber PicRobot Claw!: My absolute favorite item purchased this trip? Hands down, it was this $5 grabber that makes a cool ratchet-like sound when you squeeze the trigger-like handle. So far, 13 of 13 students have ADORED this new toy that acts like an adult reacher and strengthens hands and grasp skills along with eye-hand coordination while being really fun. This was the best $5 I’ve spent this year, and that’s saying a lot because there’s this coffee roaster in town that makes a WICKED good pour-over coffee from beans they roast themselves…but I digress. Seriously, you’re going to find that this toy can be used for all kinds of functional tasks while making the task feel like play. And did I mention only $5???

 

  • Feed The WoozleFeed The Woozle: This was a bit more costly, $20. But the options for this game were great so I gave it a chance. It was a good decision. Don’t let the “for little kids” reference scare you off. Many of my students struggle with games that require more strategy than action, or that are heavily language based, and this game can be played in a way that minimizes those challenges. The object of the game is to cooperatively feed the Woozle Monster from a variety of snacks that come with the game (or that you add yourself). The child rolls the dice on his or her turn, and using the enclosed spoon (or, again, any tool you want to select from your arsenal of tools), you place the food into the Woozle’s mouth. It involves counting, balancing items on a spoon, moving items from one spot to another while seated or when moving (if the Woozle is placed across the room). You can divide the food items up and the first child or team of children to run out “wins,” or you can eliminate winning and losing by simply ending when the food runs out. Cooperative play, turn taking, simple counting, gross and fine motor skills, eye hand coordination…lots of learning happening while playing this game.

 

  • Amazing Color Changing Putty.jpgAmazing Color Changing Putty: Back to the steals (well not literally,) this silly-putty like material changes colors when squeezed. So obviously, we will be working on all the usual “putty” activities including strengthening the muscles of the hand, enhancing or activating the tactile sense when we hide small items like plastic beads in it, motor planning skills, etc. Oh and remember using silly putty to “copy” comics in the newspaper when you were a little kid? (No? Maybe you’re not as old as me?!) You can recreate that memory using this little tip: draw a small box, say 2 inches square. Inside it, draw a simple smiley face using very dark pencil lines. Place the putty on top of the design and push down. Have the child count slowly to 5. Carefully peel the putty up and you will have an exact copy of your smiley face, which can now be pulled and tugged into all kinds of funny distortions. Now that your child has seen the process, you will not have any trouble getting them to try it on their own. Instant magic. Oh and the cost? Just $6.

 

Full Target CartI wish I could say that I walked out of Target that day with these 10 items only. But alas that would be a lie! Still, I considered this to be a major haul at $55.50 for 10 items, each of which will be fun for kids, serve multiple purposes, and boost my creative juices for the remainder of the school year.

 

Please note: Unless you have money burning a hole in your pocket and you simply MUST part with it, there is no reason why you would EVER need to buy all 10 of these items, even if your child is getting Occupational Therapy and needs to work on all of these skills. But I hope that these examples show you how easy it is to find interesting and fun “tools” to support your child’s natural inclination for play while working on developmental skills. You don’t have to have the latest therapy equipment catalogs. It’s as easy as a trip to your local Target.

 

Have you found fun and interesting toys and tools at a store near you? Share your finds in the comments below! It’s so much fun to share 🙂

 

Profile Pic from WhartonStacy M. Turke, OTR/L: “On the Road with @stacyturke OTR blog.” Stacy has been a school OT for 31 years with the same intermediate school district in Michigan in what she describes as “my dream job.” Her career has ranged from working in a “center-based” school to working in public and private schools throughout the county, including those in the rural, suburban, and urban areas. She has experience working with students with a wide range of educational needs, to include cognitive impairments, Autism Spectrum Disorder, physical challenges, sensory processing needs, and many other learning challenges. She expresses her enthusiasm when she says “This career has been fulfilling, always presenting new and interesting challenges, and is NEVER boring!” You can connect with Stacy on Pinterest at https://www.pinterest.com/stacyturke/ and on Twitter at @StacyTurkeOT.

Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources

10 Fine Motor Tools You Can Find at Target!

After the Parent-Teacher Conference: Tips from a School OT

 

Coloring book and crayons

After the Parent-Teacher Conference

Tips from a School OT

by Stacy Turke, OTR/L

You’ve been to your child’s parent teacher conference. No doubt you learned about your child’s reading scores, you saw samples of math curriculum activities, maybe even had a chance to sit on a chair that looks nothing like the chairs of your own elementary-school experience. You may have come away with ideas to support a little extra after school reading, and math practice that will be so fun it will be part of the weekend activities in your home. And it is also possible that your child’s teacher talked about non-academic skills that have a strong impact on school success. Things like the ability to attend and focus, maintaining work endurance, using fine motor skills functionally for writing and coloring, among others. If your teacher mentioned concerns in any of those areas, you might be wondering how to support your child at home. There are tutors to support math or reading skills, but how does a parent support fine motor development, or “sitting and attending,” at home?

School Occupational Therapists have all kinds of ideas that just might provide help for you and your child!

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Sloppy Handwriting? You might try these:
• Ask your child’s teacher for handwriting practice sheets. If your child’s school or teacher uses a specific handwriting program, you’ll want to get copies of that one specifically. If they don’t use a specific program, try buying a handwriting practice book from the local teacher store or even Target. Pro tip: Also buy a 3 ring binder, page protectors, and dry erase markers when you pick up the handwriting practice book. Tear the book apart and put the pages into the page protectors, then store the pages in the binder. Now your child can practice each page over and over!
• Strengthen the hands by playing with playdough; you might even want to try making it. Here’s an easy recipe for homemade playdough you can make at home that will feel wonderful on the hands and last at least a month if you keep it in an air tight container.
• Pull out the legos and build both from a model and free-style it too! Pressing the bricks  together and pulling them apart will strengthen the little muscles in the hands and fingers, making grasping the writing tool easier over time. Legos offers their own model instructions, and many blogs include Lego pattern cards you can print for your child to imitate.
• Paint on an easel: this will strengthen the shoulder muscles, which are needed to stabilize the arm when your child is writing and coloring.
• Grab a coloring book and some crayons and go to town! Staying in the lines and filling in the spaces completely with color are great skills to practice and will strengthen handwriting over time.
Print off some dot-to-dots sheets: Kids forget they are “writing” when they are doing dot-to-dots, and practicing the planning needed to move from one number to the next helps sharpen eye-hand coordination. And then there’s that magic at the end when the shape appears.
• Make a simple word search or cross word puzzle with this week’s spelling list online!
• Pull out the scissors and coupon section of the Sunday newspaper (see last month’s post)

balance-ball-chair-gaiam
Yoga ball chairs can help keep your child alert and upright

Difficulty sitting upright for the length of a work task? Think about some of these ideas:
• Make sure your child is getting enough sleep. It is hard to sit up when working if the body is tired. A tired child will have tired muscles. Check out these sleep recommendations to see if  your child is getting enough sleep based on his or her age.
• Is s/he drinking enough water and eating well? We just can’t underestimate the importance of staying hydrated and nourished when thinking about work endurance. While the work at school isn’t as physically strenuous as a workout at the gym, the mental work sure is! Keeping the body and brain in top condition will support work endurance at school.
• Try a yoga ball for a chair during homework and play time. Sitting on a yoga ball helps keep the mind alert, which helps keep the body alert.
• Go to the park and play! Just like going for a run might help you wake up and focus, playing on swings, climbing on slides, and running to catch a frisbee will do the same for your child.
• Try Cosmic Kids Yoga or a similar yoga program, because yoga can support strength and endurance. And flexibility and mindfulness and good breathing and so many other good things.
• Try to aim for 30 minutes of strenuous exercise or play at least 5 days per week. Outdoors preferably!
• Play for 5 minutes or longer propped up on elbows and forearms to increase shoulder strength and stability, and over time endurance will grow too.

 

writing-711281_960_720
Defined, distraction-free work areas can help your child focus on work!

Paying attention at school and/or at home is tough? These ideas may help:
• Use visuals to support your directions/request and to help kids with sequencing. Ever notice that you say something to your child only to have to repeat it again and again? Spoken words are gone once you finish saying them. But a visual representation of your request will stay in front of the child until you or they move it. Want the kids to practice their spelling words? Show them a picture of what that looks like! This company makes free printable visuals for typical sequences your child likely engages in, such as Hand Washing and Morning Routines. Check it out!
• Break tasks into smaller parts. Asking my child to “clean her room” was sometimes overwhelming because many different jobs are accomplished when “cleaning.” I got better attention to detail when I gave smaller instructions. Put the books on the shelf. Put the laundry into the hamper. Put your shoes in the closet. The room got cleaner because the tasks felt manageable.
• Give your child a sticker chart to keep track of what they have done and what still needs to be done. Sometimes using a sticker to keep track of the little jobs that make up the big job can be really motivating and may help your child learn to sequence the tasks in order.
• Clearly define work areas, and reduce distractions in the work areas. It will probably be hard to pay attention if the only place to work is in the same room as the TV or the toys. So if possible, find a quiet, well-lit spot for work that is away from the distractions. And if there isn’t a spot like that in your home, then try hard hold firm to homework before play.
• Use timers to define the amount of time on task. This acts like a visual, reminding your child that it is work time. When the timer goes off, even if work isn’t finished, offer a break.
• Give breaks frequently, and encourage big movements like “brain breaks” You know how you have to get up and walk every so often when you have been sitting at your desk too long, just to wake up your mind? Your kids need this too. It’s likely that your child is engaging in brain breaks at school; ask your child’s teacher how to access them at home.
• Figure out what tools help YOUR child pay attention and use them. Some people need quiet music, some need silence. Some folks need to chew on gum, others need to drink lots of water. If one or more of these tools will help your child focus and pay attention to the jobs they have at home, whether school work or housework, then use them! Remember that a “tool” is something that helps you get your work done, so just like a pencil helps you write down your spelling words, gum may help you stay alert and focused. If you notice the child playing with the item instead of working and focusing, then that is not the “tool” for them. Find another one.
• Remember that kids are children, not mini-adults, and keep your expectations for focus and attention appropriate to their age.

While there are many different reasons why a child may have problems in these areas, some which may require specialized evaluation and support, many kids will benefit from these general suggestions. Think about which strategies seem feasible for you and your family, even run them by your child and see what sounds fun to them. Your child worked hard at school all day, practice at night should be Fun with a capital “F.”

 

Stacy M. Turke, OTR/L: “On the Road with @stacyturke OTR blog.” Stacy has been a school OT for 31 years with the same intermediate school district in Michigan in what she describes as “my dream job.” Her career has ranged from working in a “center-based” school to working in public and private schools throughout the county, including those in the rural, suburban, and urban areas. She has experience working with students with a wide range of educational needs, to include cognitive impairments, Autism Spectrum Disorder, physical challenges, sensory processing needs, and many other learning challenges. She expresses her enthusiasm when she says “This career has been fulfilling, always presenting new and interesting challenges, and is NEVER boring!” You can connect with Stacy on Pinterest at https://www.pinterest.com/stacyturke/ and on Twitter at @StacyTurkeOT.

Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources

After the Parent-Teacher Conference: Tips from a School OT

Using Scissors to Help Handwriting

By Stacy Turke, OTR/L

school-1555907_1280
photo courtesy of pixabay.com

So how many of you like to color and cut?

My guess is that many of you reading have fond memories of coloring as a child, whether as illustrations for your writing assignments or as fun leisure activities at home. You probably had crayons and coloring books from the time you were pretty small, and I am also guessing that you may have returned to coloring as the world of “Adult Coloring” has blown up in recent months. Coloring is known to be a calming activity that helps soothe and refocus the brain in the way many mindfulness activities do.

I’m also guessing that you remember using scissors as a child, with snipping early on advancing to cutting on lines, around shapes, and probably to cutting snowflakes. (Caveat: I grew up in Michigan where snow is an automatic part of every winter. I’m curious, if you grow up or live in a place that never has snow, do you ALSO grow up cutting out snowflakes?) Cutting with scissors is a great means of working on improving fine motor and visual motor skills without using a pencil or other writing tool, so if you have a child whose writing skills are worrying you, consider mixing things up a bit and trying some cutting activities.

But wait, you are probably thinking, How can I help my child improve handwriting by using scissors?

Let’s explore some possible answers!

Let’s start by helping your child use scissors successfully.

If your child cannot use tongs or tweezers to pick up small objects, you will want to start there. Using tongs requires the thumb to work in opposition to the fingers, in an open and close pattern, and tongs are perfect for this. I like to use tongs to pick up pompoms, cotton balls, and small erasers at first, and when kids get really good then we graduate to picking up beads and the ever so motivating M&Ms! Pick up the items with the tongs in the dominant hand, and place them into a container being held by the non-dominant hand. This will help train the fingers that need to be operating the scissors, while training the body and brain to do two separate things with both hands simultaneously.

Another great preparatory activity involves playdoh. Roll playdoh into fat logs and use the non-dominant (or “helper”) hand to stabilize it on a table. Use the dominant (or “worker”) hand to pinch a bumpy ridge onto the log using the thumb in opposition to the fingers. This will help train the open and close pattern while helping to strengthen the muscles used.

fiskars-blunt-tip-scissors

And please make sure you have some kid-friendly scissors available that will actually cut. Maybe this will be controversial among my OT colleagues, but I always recommend giving your child scissors that will actually cut paper, which most of the “beginner” scissors won’t do. My favorites are the round-tipped Fiskars scissors. They are sharp enough to cut well, and the blunt tip helps keep everyone safe. (Not a paid endorsement, just a fan!)

I get that you may be worried your child may cut themselves, or their hair, or the dog’s fur, or the curtains. So that’s why you need to directly teach safety skills, such as how to carry scissors safely, sitting still while holding and using scissors, what’s okay to cut and what is NOT okay to cut. Keep the scissors in a safe location, out of the reach of your child, and always ALWAYS directly supervise them.

Improve hand strength and by extension work endurance

Hands need muscle strength to be able to hold the writing tool and form letters, numbers, and pictures. Using scissors to cut paper, card stock, or playdoh snakes will help to improve the little muscles of the hand and make grasping the writing tool easier. Eventually, your child’s improved strength will increase their ability to keep working for longer periods of time, which we sometimes refer to as work endurance. This will directly support their ability to finish whole writing assignments in class.

Improve bilateral hand skills

In order to write or draw successfully and legibly, a child must stabilize the paper with their “helper” hand while using the writing tool with their “worker” hand. Their hands are actually doing two different things at the same time, and both hands are working together to help complete the task successfully. This obviously is required when using scissors too. The child will hold the paper or playdoh with their non-dominant hand, while using the scissors with their dominant hand. Both hands doing different things and working together to complete a task…just like when they are writing!

Focus on visual motor skills

Cutting on lines requires good eye-hand coordination, which kids also need when they are writing and drawing, so working on cutting near or on lines is actually helping prepare them for tracing, copying, and writing. When kids first hold scissors and try to cut, they actually “snip” the edge of the paper, kind of like making fringe. Later, students learn how to cut on lines that are one inch long, and eventually how to advance the paper with their non-dominant hand while cutting repeatedly with their dominant hand. You can help your child by making the lines to be cut wide, or even highlight the line with a high contrast color. As kids learn to cut near or on lines, they are improving their ability to coordinate their eyes and hands together, but in a way that doesn’t feel like writing…because it obviously isn’t writing! If you are interested in exploring the development of cutting with scissors, Christie at Mama OT blog has a great post that addresses it in detail. Head over there to check it out.

Some other great scissor practice ideas

If you want to get your child paying attention to cutting instruction and giggling at the same time, break out the drinking straws and have your child cut “beads” that can be strung onto pipe cleaners or yarn. When the child snips through the straw, typically the straw piece will fly a distance away, and it’s really quite amazing. If your child wants to gather up each piece as it is snipped, make sure that they put the scissors down each time. Or just have them wait to gather all the pieces once the straw is fully cut up.

cutting-straws

When my kids were little, I let them use the Sunday comics and coupon sections from the newspaper to cut. Both sections have very clear, bold lines and dividers on which to cut, making it easier for my girls to cut carefully. I took out the coupons I wanted first until I could trust they would cut them well enough for the UPC code to be read at the store. My kids felt like they were helping our family save money by cutting out the coupons carefully, and that really motivated them.

So if your little one needs a little extra work to improve their handwriting, branch out and try using scissors. Maybe you’ll enjoy it too…after all, remember those snowflakes from childhood? They are even more fun now that you possess stronger motor skills!

Snowflake.jpg
I still love cutting snowflakes, don’t you?!

Stacy M. Turke, OTR/L: “On the Road with @stacyturke OTR blog.” Stacy has been a school OT for 31 years with the same intermediate school district in Michigan in what she describes as “my dream job.” Her career has ranged from working in a “center-based” school to working in public and private schools throughout the county, including those in the rural, suburban, and urban areas. She has experience working with students with a wide range of educational needs, to include cognitive impairments, Autism Spectrum Disorder, physical challenges, sensory processing needs, and many other learning challenges. She expresses her enthusiasm when she says “This career has been fulfilling, always presenting new and interesting challenges, and is NEVER boring!” You can connect with Stacy on Pinterest at https://www.pinterest.com/stacyturke/ and on Twitter at @StacyTurkeOT.

Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources

Using Scissors to Help Handwriting

Snow Magic!

By Stacy Turke, OTR/L

jayden-and-his-finished-snowman
Jayden, 3, standing proudly by his very first home-made snowman!

It’s January in Michigan. Typically that means snow, lots and lots of it, so School OT folk here naturally think “Snow!” when looking to plan fun and interesting activities that target student goals. Families wanting to support fine motor and handwriting goals at home can look to playing in snow because of all the great benefits. How? You may ask…Well let me share some thoughts on Using the Magic of Snow(people) to Improve Fine Motor Skills.

jodie-and-jayden
Jodie, OT Mommy extraordinaire, Jayden, and their snow friend

My friend Jodie is one of my OT colleagues at Ingham Intermediate School District. Jodie has a three year old son, Jayden, who is the light of her life. He is also one lucky little dude, because his OT Mommy plans the coolest, most interesting activities for after school and weekends, and then she shares them with her friends and family on Facebook. (I’m secretly hoping she shares some of these in an upcoming Guest-Blog Post…though hmm guess it’s not so secret now!) We had a big snowfall recently, and Jodie shared some of the most adorable pictures of the two of them with Jayden’s first homemade snowman. Lucky you, because Jodie has given me permission to share them for your viewing pleasure!

Playing in snow brings a treasure trove of benefits to kids. From a tactile perspective, snow is cold to the touch. Hopefully that doesn’t surprise you! But something you might not know about snow is that not all snowfalls feel the same in terms of the texture. Some snowfalls are very light and airy, and the snow does not form balls or snow people because it won’t stick together. But it’s great fun to lay in to make snow angels, or to sled or ski in. Some snowfalls are heavy and soggy, and it feels heavy to walk in and to try to move. This snow sticks together well and makes wonderful snow people and snow forts, and sends you inside with soggy clothes and pink cheeks.

Snow is a great medium for building strength and endurance, and has other health benefits as well. Playing in snow is hard work, whether you are sledding or snowshoeing or building snow people. Moving against the snow uses more muscle power, much the way walking on sand or walking in water does. Skiing and sledding and shoveling increases the heart rate, and can even become an aerobic activity. Lifting the snowballs to stack them can be tough, because snow that sticks together weighs a lot. But kids don’t seem to notice how hard they are working because they are too busy having fun!

And then there’s some of the more cognitive and social aspects of playing in snow. Building a snowman helps support body scheme and awareness, because you gotta know where to put the eyes and the arms. It works on visual memory skills, because rarely do we take pictures of snowmen outside to support our play, we just start rolling those snowballs! We work on cooperative skills, deciding together how big to make the bottom snowball, and what to use to make the eyes and arms. We work on spatial concepts of above, below, biggest, middle, next to…and so many more.

jayden-with-snowballer                  jayden-paints-his-snowman

Now my friend Jodie, she really knows how to up the snowman game! She and Jayden took a  Flexible Flyer Snowball Maker outside, and this giant tong-like tool uses both hands together to push snow to make baseball-sized snowballs. And then because that wasn’t enough, they used a spray bottle with colored water to “paint” their snowman. Jayden worked on hand strength and eye-hand coordination while playing in the snow, and I’m guessing he totally missed all the lessons. He just had fun…and from the looks of things, so did his Mama!

But even in Michigan there are times when there just isn’t enough snow to play in, or when the temperatures are too cold to allow for outside time. My students just hate missing out on the magic of Snow People, so as a School OT, I like to bring the snowmen right into the classroom. I make white playdough with my students, with white glitter added to mimic the sparkle of snow, so we can make snowmen while working on imitation skills and hand/finger strength. We lay on the floor or sit at a table with a towel covering it, and use a jumbo pushpin to “poke” the outline of a snow man or snowflake, which addresses not only eye-hand skills but also shoulder and arm strength and joint stability. I made a snowman out of felt, and added buttons to the body. My students are able to work on buttoning practice and finger strength by adding the body parts that color-coordinate with the buttons. And since all of the pieces are separate, the students also are able to assemble the snow person like a puzzle.

felt-snowman
My homemade felt snowman

All in all, snow is lovely and fun, whether real or pretend. Make sure you take advantage of all that snow has to offer, and get your kids playing. Their motor skills, and so many other developmental areas, will benefit and so will you! And please don’t forget to make hot cocoa when you come in!

Please note: Jodie kindly shared her pictures for us to look at, but she did not give us permission to use them beyond this blogpost. Please do not “borrow” her pictures unless you are sharing this whole post! Thank you.

Stacy M. Turke, OTR/L: “On the Road with @stacyturke OTR blog.” Stacy has been a school OT for 31 years with the same intermediate school district in Michigan in what she describes as “my dream job.” Her career has ranged from working in a “center-based” school to working in public and private schools throughout the county, including those in the rural, suburban, and urban areas. She has experience working with students with a wide range of educational needs, to include cognitive impairments, Autism Spectrum Disorder, physical challenges, sensory processing needs, and many other learning challenges. She expresses her enthusiasm when she says “This career has been fulfilling, always presenting new and interesting challenges, and is NEVER boring!” You can connect with Stacy on Pinterest at https://www.pinterest.com/stacyturke/ and on Twitter at @StacyTurkeOT.

Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources

Snow Magic!

5 Places to Find Money (to fund your School OT Practice)

money-1015277_960_7205 Places to Find Money to Fund Your School OT Practice

by Marie Toole, MS OTR/L

on the School Tools From Your Pediatric Occupational Therapist Blog

 

Recently I wrote a grant for sensory supplies.  I put some pictures up on my School Tools for Pediatric Occupational Therapists Facebook page and I got lots of responses from others wanting to know how they can get funding too.  I don’t have the magic pill…and you too can ask for money for supplies.  Here are 5 ways that I tend to find money.  Know that I can be tenacious and will keep asking until I get what I need for my students.  It is not begging…I call it advocating for my students.  Here is how I advocate!

Your Principal

Your first stop should be your principal or assistant principal to ask them to fund items that you need for students.  I find if I go to my principal with a specific request and a PO all filled out with a specific amount they sometimes can find money in their discretionary budget.  My greatest success rate is when it is for a specific piece of equipment for a specific child (ie Joey needs a pressure vest, size small) and when I can a) demonstrate the need, b) demonstrate that research backs this up and c) let the principal know that I will take data and train the parapros/TA’s to use the equipment properly and at the correct times I often get the funds.

office-unsplash-pixabay

PTO

Sometimes the principal’s hands are tied and their budget is frozen.  My next step is to go to the PTO group.  They often fund many extra items that are not typically in the school’s budget.  If you can demonstrate the need and the benefit, they can sometimes find some money.  I feel like my biggest success with PTO group is for items that many students will benefit from.  I recently put together sensory bins for each classroom.  PTO helped me out with additional supplies for 24 sensory boxes.

calculator-stevepb-pixabay

Medicaid to Schools Funds

This is a new one for me.  In my old district the medicaid funds went into a general fund that the Special Education director used.  In my new district I can request funds for a specific child or a group of children who are identified and have IEP’s in place.  The process was easy for me to request a dizzy disc for the Autism program I work with.  I am not at that school every day and I really did not want the TA’s to be using the swing without OT supervision so I thought a dizzy disc would be a great alternative.  I had one in my old school and it was used frequently.  I put the paperwork in and a few weeks later it arrived.  It certainly would not hurt to ask if there is a way to use Medicaid to Schools funds for equipment that you need.  Of course that means that you actually need to do your Medicaid billing!

Education Foundation

In both school districts I have worked in there has been an adjunct Education Foundation that raises money for teachers to use for special projects, to go to expensive continuing education programs or try specific curriculum units that need to be funded.  This is the program I used to write my $1000 grant for sensory supplies for each classroom in one of the buildings I work in. There are generally guidelines on that foundation’s website, and sometimes they will even help you write the grant.  Watch for emails from the education foundation in your district about grants and the deadlines you will need to follow.  Find a mentor to help you write the grant or ask the foundation directly for help.  They honestly want to give the money away for great projects that help students succeed.  It is an awesome opportunity to expand the Education Foundation’s awareness of “related services” and OT in particular.  Maybe you can write a sensory grant with your speech pathologist or social worker.  Collaboration between disciplines often get funded before single service providers.

conference-room-unsplash

Outside Philanthropic groups

As a last resort I have gone to outside groups in the town where the schools are to ask them for money.  Let your principal know that you are doing this as principals generally do not like to be caught blindsided by these type of requests.  Does your town have a Rotary/Lions/Kiwanis group or a Men’s/Women’s group in town that gives scholarships away?  Maybe there is a church group or another community service group in town that has money to give away,  Look in your small, weekly local paper for those type of groups.  Find out if they have money to give away.  You may have to go to their meeting and do a short presentation, answer questions etc but it is certainly worth it.  Be considerate of how often you ask the same group for money.  Spread the wealth…and the public relations of talking about Occupational Therapy to all of these groups all over town.  Look at it as an opportunity to share your passion for OT and remember to mention our Centennial year–100 years as a profession this year!  How awesome is that?

Whenever you do get funds from a group remember to send a thank you note and pictures. They will often put them on their website as further PR for OT and your school.  Maybe you can start a partnership with this group for additional volunteer opportunities at your school for its members!

If you need funds for additional equipment or supplies for your students do not be afraid to ask. What is the worst thing that could happen? They say they do not have any funds at this time.  So move on to the next group and ask them. As you continue to advocate for your students you are subsequently advocating for Occupational Therapy and raising awareness.  Look at this as an opportunity to practice your OT Month PR pitch as often as is needed!  I look at this as me asking for needed supplies/equipment AND promoting Occupational Therapy to a wider audience. Doesn’t get much better than that!

Money Picture: https://pixabay.com/en/money-euro-profit-currency-1015277/

Office Computers: https://pixabay.com/en/office-two-people-business-team-1209640/

Calculator: https://pixabay.com/en/calculator-calculation-insurance-1680905/

Conference Room Table: https://pixabay.com/en/conference-room-table-office-768441/

MarieToole, MS,OTR/LMarie L. Toole, MS, OTR/ L, is a pediatric occupational therapist with 28 years experience in NICU, Early Intervention, and private practice with the last 20 years spent working in public schools. She is NBCOT and SIPT certified as well as a member of AOTA, NHOTA, and OTAC.  She now lives in Colorado and can be reached at mtoole3@cherrycreekschools.org.  Follow her on Twitter @MarieTooleOTNH, on Pinterest marietooleNHOT, and on School Tools for Pediatric Occupational Therapists  where she tweets, pins, and posts about OT, education, autism, and sensory integration, as well as other school related topics.

 

Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.  
Photos are the property of the photographers at Pixabay and their use should include the link provided to the contributor’s source.
5 Places to Find Money (to fund your School OT Practice)

Last Minute Sensory-Based Gifts

Image 1
Mini Mat by ezpzfun.com

Last Minute Sensory-Based Gifts

by Stacy Turke, OTR/L

Tis the Season of Giving…and it seems that many folks are wondering what they should be giving to their friends and family members who are “Sensory” kiddos or grown ups. This year more than any other, I’ve been asked what a sensory seeker might like for Christmas, or what that anxious niece might like to open on the first day of Hanukkah. It is a good sign, I believe, that these questions are coming up more frequently, because I think it means that folks are generally more aware that these sensory processing challenges not only exist but also can and should be lovingly supported.  And because there have been so many questions about this topic in the last few weeks, this month’s post will help you decide “What should I give my special someone who has “Sensory” needs?

First a caveat. Everyone is unique, so this is NOT a one-size-fits-all list. I encourage you to consider your certain someone’s preferences, age, and living situation when you consider gifting. For example, a 10 year old child who lives for banging and loud sounds might LOVE a drum set…but the neighbors in the apartment upstairs might not think that’s particularly awesome! And while we know that research shows endless benefits of owning a kitten or puppy for mental and physical health, rescuing a kitten from a shelter should NEVER be done without full, enthusiastic consent of your particular giftee!

And without further ado, here are my Gift Giving Ideas, in no particular order of importance.

For that picky eater

ezpz Happy Mat and/or Mini Mat: Oh my goodness people, I am totally in love with these products for several reasons. They are aesthetically pleasing. The mats are made of dishwasher and microwave safe silicone that feels soft and smooth to the touch. The colors are kid-friendly and engaging. They suction to the table so food doesn’t go flying…well, at least not from a flying bowl or plate. And for goodness sake, their Happy Mat and Mini Mat SMILE AT YOU WHILE YOU EAT! Plus, the dividers in the mat themselves help to separate food so that things don’t touch (if you have to wonder why food that touches is a problem, ask a picky eater!). They help provide portion control for those who may want lots of only one thing. The fact that there are three different sections imply there should be three different things on the plate, so maybe you’ll even get an extra bonus of increasing food tolerances over time. The silicone keeps mealtime quieter than normal because there isn’t any “clink clink” of the silverware on the plate. And just think of all the fun you can have using these mats within the realm of fine motor skill development! Cheerios, chunks of meat, small pieces of fruit…all of these things will sit patiently for your little one to practice their pincer grasp when they pick them up with their fingers. The raised sides of the sections will provide a little support with utensil use. Check out the ezpz website for lots more great ideas in their shopping section and on Ms Dawn’s blog! (If this seems like an unpaid commercial for a really great product by a really great company it’s because I love them!)

For the Sensory Seekers

You know these kinds of people. We are folks who seek lots and lots of input. We move a lot. We chew on our fingers and clothes and gum (if it’s allowed). Some of us seem to be able to crash into things without apparent harm or ouches. So consider any of the following:

Compression clothing: these items can be worn under street clothing or just as the shirt! My favorites for kiddos are the Hug Tees from funandfunction.com, but you can find cool compression clothes at most sporting goods stores. Make sure the label includes the word “compression” and be aware that the shirt may look a little small. That’s okay, you want it to feel snug like a hug!

Body Sox: don’t knock it til you’ve tried it, really! These fun tools offer moderate to heavy deep pressure input while also giving a child a reduced-sensory environment. This picture shows a person completely INSIDE the “sox;” some of my students enjoy placing the top of it over their shoulders instead of hiding totally inside it. Try adding it to your before bedtime-routine, maybe even during that bedtime story. If your child enjoys playing in the sox, just be aware that it can be a little slick when walking on uncarpeted surfaces, so use with supervision.

Yoga Ball: there are so many uses for Yoga balls besides just yoga! One of my favorites is to roll the ball over the child from head to feet, slowly and with moderate pressure, and pretend you are rolling out cookie dough. The pressure of the ball will be calming, and the playtime will be fun. A yoga ball and this cool set of Therapy Ball Activity Cards would make a great gift!

Weighted tools such as pillows or stuffed animals: You can buy a weighted toy, or weight your own by opening the seam of a favorite stuffed toy and adding a small, reinforced Baggie of dried beans. I really like these pillows that are filled with cherry pits from hotcherrypillows.com. They weigh approximately two pounds, and have the added advantage of being able to be warmed in the microwave. So soothing, and lots of senses touched through the use of this tool.

For the Anxious among us (and really, who isn’t from time to time?)

Oil, Rose, Aroma, Aromatherapy, Essential, Flower, Spa

Aroma therapy: Essential oils are a really hot gift item in my part of the country right now. Small bottles of oils and lovely diffusers are available even in my local grocery stores, and it seems everyone has a favorite brand or scent. It’s important to remember that not everyone loves the intensity of the various smells associated with essential oils, so tread lightly at first and even consider cutting the intensity by diluting the oils with a few drops of a neutral smelling oil like a light olive oil. Your anxious child may benefit from the use of lavender oil; I know it works for me! But check with your local health food store or other knowledgable vendor for recommendations regarding which oils to try. Recently the parent of one of my littlest students contacted me to say that they had added lavender oil to their bedtime routine. Mom mixes a couple drops of the oil into a little bit of coconut oil and massages it into her son’s hands and feet before bedtime. She said that as soon as she brings out the bottle each night, he goes to the massage location and lays down, because he knows it feels good. She also told me that his sleep has improved since they started using the lavender oil massage. Gotta love those kinds of success stories, right?

Small tent: These are functional for so many reasons! They help provide a small space for homework, a spot to calm and settle, a quiet place to play during a busy holiday family event.

Compression tools: The same compression clothing and body sox that help sensory seekers also help folks who are anxious. Because compression items typically fit close to the body, they add a neutral warmth that is soothing for most folks. Pay attention to overheating and remove them if your loved one gets too warm.

Weighted tools: Weighted tools are soothing and calming overall. They can include stuffed animals, pillows, vests, even blankets. You can weight a backpack with a few books for a  young child. Whatever weighted tool you use, please use them with supervision.

Quiet time: You can never underestimate the importance of giving everyone opportunities to retreat to a quiet spot, especially during the busy family events that accompany the holidays. Anxious folks among us often need time to warm up, to ease into gatherings, along with time to themselves. Try to honor that when possible. And consider offering a pair of noise dampening headphones, especially when you know the festive events will have the potential of being noisy or loud.

Word Cloud, Compassion, Joy, Connect, Words

(Compassion word cloud courtesy of: https://pixabay.com/en/word-cloud-compassion-joy-connect-936542/ )

For all

Give the gift of understanding and compassion. Try to honor schedules and routines that are important. Take time out to recharge and refresh. Have familiar foods on the table during those big meals so that picky eaters don’t feel pressured to eat things they don’t like or haven’t tried. There will be other times to work on stretching food preferences or sensory tolerances. During the holidays, remember to enjoy the people you are with for who they are, and they will love you for it.

Stacy M. Turke, OTR/L: “On the Road with @stacyturke OTR blog.” Stacy has been a school OT for 31 years with the same intermediate school district in Michigan in what she describes as “my dream job.” Her career has ranged from working in a “center-based” school to working in public and private schools throughout the county, including those in the rural, suburban, and urban areas. She has experience working with students with a wide range of educational needs, to include cognitive impairments, Autism Spectrum Disorder, physical challenges, sensory processing needs, and many other learning challenges. She expresses her enthusiasm when she says “This career has been fulfilling, always presenting new and interesting challenges, and is NEVER boring!” You can connect with Stacy on Pinterest at https://www.pinterest.com/stacyturke/ and on Twitter at @StacyTurkeOT.

Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

Last Minute Sensory-Based Gifts