The Who, What, Where, Why, and When of Self-Regulation in School

Open ClipArt Vectors PixabayThe Who, What, Where, Why, and When of Self-Regulation in School

by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

 

In my earlier years as an Occupational Therapist in public schools, school OTs talked quite a bit about Sensory Integration and Sensory Processing.  We worked with kids who had genuine challenges tolerating and utilizing information coming in through their senses; and we created elaborate and precise, almost prescriptive “sensory diets” which gave teachers and parents a plan of inputs to do with their students and children a certain number of times per day.  Usually these “diets” required the student to leave the classroom, go to a separate spot, and engage in a series of activities designed to “fix” the kids so they could return to the classroom ready and able.  At least that was the goal.  I’ll be honest, there was little connection in the sensory work we were doing outside of the classroom to the curricular work happening in the classroom.  But that was okay, we reasoned, because we had our out-patient clinical colleagues success with this model guiding us; and we had the belief that kids could only benefit from the instruction in the room if they were made ready outside the room.

A few years later…okay, MANY years later…the focus on meeting sensory needs changed quite a bit in public school systems in my area and across the nation.  We still work with students who struggle with sensory processing, no doubt, and in fact we may actually be seeing more of these concerns across any given classroom.  But to the extent possible, we try very hard to only remove kids from the classroom to meet their sensory needs as a last resort, and preferably during natural breaks in the action.  We now pay careful attention to keeping kids IN the classroom during instruction because it’s hard to learn content when you aren’t there to hear and/or see it being taught.  And for the most part, we talk about these needs as helping kids with self-regulation rather than “sensory processing.”  So what does this change look like, you may ask?  Let’s explore!

 

Who can use help with self-regulation in school?

Akshayapatra pixabay

EVERYONE.

Too simple an answer?  Okay, so let me explain.  First, a definition of Self-Regulation:

“Self-regulation is the ability to attain, change, or maintain an appropriate level of alertness for a task or situation” (Williams & Shellenberger, 1996)

We operate from the perspective that everyone needs to regulate their emotions, energy level, and ability to focus or concentrate.  All. The. Time.  What we do to regulate, and for what purpose, varies depending on what we are regulating for.  (Keep reading, I promise this will make sense.)  And some of us are able to regulate ourselves to be in the “just right place” more easily than others.  As a school OT, I try to help everyone in a classroom understand what “tools” they need to help them regulate and how to use them effectively as a responsible, productive student (or teacher!).

 

What does self-regulation look like?

When people are self-regulating successfully, they are able to optimally attend to and participate in the task at hand.  But what that looks like varies depending on the task. Let’s say students are in physical education class playing a game of basketball.  In this scenario, their bodies and brains need to attend, listen, observe, and physically respond quickly and with control when the ball comes their way. This is an active, physical state and children who are self-regulating successfully during a basketball game will reflect that.  If a child is feeling sluggish, his or her response time may be too slow to catch the ball or defend the basket.  If the child is overly active and not paying attention, a pass to a teammate may be way off mark or a slide to defend may result in a clumsy foul.

Now let’s put those same children into the classroom for a language arts lesson, immediately after that exciting basketball game.  Their bodies and brains need to attend calmly, listen intently, and connect this new learning to their previous knowledge so that they can write some amazingly structured paragraphs about the zoo lesson they’ve just completed (or whatever the lesson may entail).  Initially, many of them may be too energized to slow down and attend to the lesson because they were regulated for a more physically active task.  Often a teacher will lead these students into activities that will help calm and organize their growing brains so that they can be ready for this calmer state.  It can be a simple strategy, such as having the class pretend to be walking on a tightrope all the way back from the gym to the classroom.  This will slow them physically and help them get ready to focus and attend when they get back to the room.

As a school OT, I work with teachers and students to develop an awareness of the self-regulation tools they can use (and likely already are using) to get to that just-right place. For some kids, using a seat cushion gives them the movement needed to allow them to stay in their seats and complete the math assignment.  Some students need more movement than a cushion provides, so we may look at other classroom design options, such as a second work space near the back of the room that allows them to stand while working.  Some of my students do well with a fidget tool, which can be just about any small hand-held object that they can move within their hands while attending and learning.  Gum is another favorite, and even teachers tolerate this well within the classroom after their students are taught how and why to use this tool.  And some kids will enter the room, grab a drink of water, and be ready without any extra tools or strategies.  There are even programs designed to help individual and groups of children learn to check their engines or attend to their Zone to aid in regulating.  What I hope teachers understand is that bodies regulate differently, and that is ok.

 

Checking Their Engines with The Alert Program
Checking Their Engines with The Alert Program

 

Checking Their Zones with The Zones of Regulation Program
Checking Their Zones with The Zones of Regulation Program

 

 

 

 

 

 

 

 

 

Where do students self-regulate in school?

Everywhere!  Regardless of where we are, we always need to be in control of our bodies, brains, and emotions; and we need to align our thinking and actions to the task we are attempting to complete.  Kids need to be able to listen to the directions given and then correctly respond when called on in class.  They need to be able to run and play and giggle Cherylholt pixabaywith their friends at recess, without becoming overly-aggressive with peers.  They need to sit calmly at the table and eat in the cafeteria during lunchtime,  Workandapix pixabaywhile quietly
chatting with their classmates.  So it is important that we work with students and teachers wherever children are having regulation challenges so that they can be as successful as possible.

 

When do students need to regulate?

If you are still reading this post and you’ve gotten this far, you already know the answer to this question…so repeat this with me:  Students need to regulate All. The. Time. Not just during math.  Not just at recess.  If we need to regulate for all tasks, then we need to regulate all the time.  As a teacher, or as a parent, you will want to remember that some of our students/children will have an easier time moving from one task to the next because they regulate more readily.  Some of our students will need a little more help.

 

Why work with the whole class?

Teachers will probably tell you that most of their students don’t need help regulating their bodies on most days, and that’s probably true.  Teachers at the younger levels use a lengthy class building process at the beginning of each school year; and then they revisit that teaching frequently, to make sure their students learn to sit, attend, focus, follow procedures, behave kindly…and all the other non-academic skills needed to be a successful student.  But even in the best “behaved” class, the students who are able to focus and concentrate and follow procedures may struggle on indoor recess days.  Or the day after a holiday or when they witness the first snow of the season begin to fall outside their window.  Sometimes the whole class needs a common language for learning to take responsibility for their learning, so that when things start to get a little noisy, or wiggly, the teacher can say, “I’m hearing a little more noise than necessary.  Can someone name a tool we can use to get quiet again?”

But let me tell you why I work with whole classes of children when many can already regulate on their own.  It’s because some of our students really cannot get their brains and bodies to a “just right place” on their own and they need help. They need to be taught; and they need to have opportunities to practice their new learning, even with regulation strategies.  When we teach a whole classroom of children that there are tools that can help us pay attention and get our work done, and that not everyone uses the same tool and that’s okay, then we are normalizing these actions for our students.  We are helping those kids who need slightly different “tools” to use them proudly because they and their classmates understand what they do and why they are being used and that it’s the responsible thing to do.  Kids can feel more in control of their own learning ability.

 

Bonus question:  How  can I help a whole classroom self-regulate?

There are as many ways to support self-regulation as there are teachers and students, so there’s no one “right” way.  In general, I begin by talking to a classroom of children about tools, what they are, and what they do.  I ask kids to name a tool a cook would use.  We talk about tools that a fire fighter needs.  We discuss that tools are things that help us do our jobs.  We talk about the tools kids use in the classroom.  And I demonstrate.  I show them a pencil and ask them “Thumbs up or thumbs down” if they agree a pencil is a tool.  Of course the thumbs all go up.  And then I toss the pencil up and catch it repeatedly and ask, “Is it still a tool or has it become a toy?”  Everyone agrees it’s a toy now because I am now playing with it and it’s distracting me.

This simple demonstration and discussion of tools and toys helps bring home the idea that it’s not the items themselves but how we use them that either helps or distracts us from getting our work done.  We expand on the conversation from handheld tools (hand fidgets are included in this discussion) to look at our seating.  Where we sit, next to whom, on what equipment, can change how well we get our work done.  If it’s lunchtime, we want to sit by our friends with whom we love to talk and giggle.  When we get home and want to chill after school, we might flop down on the couch.  But what about when it’s time to concentrate?  Should we sit by a friend we like to chat with or should we choose a spot where we will be better able to concentrate?  Helping children think about choosing and using tools to get work done is one way to help them begin to self-regulate.

 

Geralt pixabayOne final note.  Although these types of strategies and supports can work for all kids, there will still be some children who need extra supports, and extra opportunities to practice, and perhaps a few different tools or even locations. You just might call in your school OT to help you support those children.  But by setting up your classroom space in a way that encourages using tools to self-regulate, you will establish your location as a safe space for learning to take responsibility for learning.  You will help children recognize that we may have different methods, but we all have the same needs to learn to pay attention and get our work done.  And your students will be grateful for this life-long lesson.

 

 

 

Stacy M. Turke, OTR/L: “On the Road with @stacyturke OTR blog.” Stacy has been a school OT for 30 years with the same 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 @stacyturke.

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.

 

 

Reference:

Williams & Shellenberger, 1996, How Does Your Engine Run?  A Leader’s Guide to the Alert Program for Self-regulation.

Picture Credits:

Photos are the property of photographers or site owners and their use should include the link provided to the contributor’s source.

 

 

The Who, What, Where, Why, and When of Self-Regulation in School

Taking Care of YOU

Turke empty cupTaking Care of YOU

by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

 

 

I’m writing this in late August, and I can already feel “it.”

I’m not talking about the nip in the air that we here in Michigan feel when we open our doors in the morning, and that chilly “Oh, yeah, fall is coming” feeling hits.  I look forward to that feeling because the haze of summer is leaving and the cool, almost surreal clarity of the sky is nearly upon us.

I’m not talking about the excitement some of us feel as we near the high school and college football seasons and our weekend wardrobes begin to take on the unmistakable Green and White (feel free to insert your favorite team colors here) of our collective cheering sections.

What I’m already starting to feel, and I am betting I’m not the only one, is that dread of the stress of moving from the somewhat slower pace of summer into the frenetic pace of Autumn. You know the drill, the loonnngggg work days that form the beginning of the school year.  All the extra meetings and trainings that happen in the first few weeks. Trying to be at all of my schools on the first day to support all of the kids and all of the teachers all at the same time, which is of course impossible and…(pause for a breath here).

All that.  I am feeling…and dreading…all that.

And I don’t even have kids living at home anymore!  Many of you are getting the kids to and from day care and after-school activities or sports, moving bedtimes back to accommodate the darned alarm clock, rearranging the house to recreate the homework stations of the year before, refiguring how to get laundry done and groceries into the house and lunches packed and dinners made and get to all the events that are on the calendar.  You don’t need me to tell you how tough this time of the year can be on a family, do you?  So you are probably wondering, as we step into September, “How can I make this year different?”  How can I tackle all of my (child-care) (teaching) responsibilities while still taking care of me?

As an Occupational Therapist, I understand the importance of balance.  I know that I can’t strengthen my biceps without also strengthening my triceps when I lift weights. Both are needed for my arms to be in balance.  If I only work on my biceps, I won’t be able to use my arms with full functionality, and eventually I won’t be able to move them out of flexion at all. Balance is needed.

Balance is also needed to sit and move with good stability.  Without balance, I might fall out of my chair while sitting to work or eat.  I might fall when walking through the house or going downstairs to do laundry.  And heaven forbid I should try to walk outside in the winter, on ice and snow, if I don’t have balance.  With both of my pregnancies, my balance was off because my body changed so rapidly, and my wipe-outs on the ice were legendary!  I was not balanced, and man did it show.

And just as balance is needed physically, recently there is increased awareness in our society that work-life balance is also needed in order to be fully happy and healthy humans.  To support its Centennial Vision Statement, the American Occupational Therapy Association recognizes that Health and Wellness services are a growing area of practice, due in part to “imbalances in life roles.”  We are overworking ourselves and allowing our children to be over-committed, and we are feeling the stress of it as a society.  We are allowing ourselves, and our families, to be out of balance.

So I’m writing today as a reminder, with autumn approaching in the early days and weeks of the new school year, to try hard to allow time for those activities and behaviors that fill YOU up as a human, not only your work ethic but also your body, mind, and soul. Take time for YOU so that you have something to give to your children and your students.

 

Try* to:

  • Eat healthy portions of healthy foods  You know what this looks like:  Eat protein with every meal.  Reduce sodium, fat, refined flour and sugar.  Eat as many different colored veggies and fruits each day as you can.  Drink water.  Eat Turke healthy foods clip artenough and not too much. Keeping your diet in check will help you stay healthy, and a healthy parent or teacher will be more effective with their kids and students.

 

 

  • Exercise  Most sources say that adults should aim for five 30-minute activity sessions per week that get your heart rate up.  See your doctor to make sure you are healthy enough for this level of activity before starting.  Can’t fit in 5 exercise sessions per week?  Start with one.  Work up to more as you develop the stamina. Once you see how good you feel, you will likely build in more because you will be motivated.  Staying active will keep your muscles and joints in good health, making the work and play with kiddos easier and more pain-free for your body.

 

  • Get the recommended amount of sleep for your age group  How much you need is variable and dependent upon a number of factors, with age being key. Try to get enough rest, not only for your health but also for your mood and mental clarity.  A rested adult will be a calm, focused adult when the kid stuff is swirling around your feet!

 

  • Engage in a hobby  I’ve always been a voracious reader; and as an adult I’ve added running, cupcake baking, and gardening to my list of preferred hobbies. My youngest daughter, a college student, loves adult coloring books and painting molecular structures such as this image she created of various components of tea (hey, whatever makes you happy).

Turke molecular structures picture

 

My oldest daughter has become a gourmet cook over the years, adding to her recipes and cooking strategies during her many work-related world travels.  I have friends who hunt Pokemon…knit afghans for foster children…play various strategy and board games…you name it.  Find something to enjoy.  Balance your work-life responsibilities with something that feeds your soul and nourishes your creativity and sense of purpose.

  • Spend quiet time with your pets  Research shows that pet ownership brings a host of health benefits including reduced blood pressure, cholesterol, and feelings of loneliness while increasing your activity level and opportunities for
    Turke beautiful Prince Marius
    Stacy’s magnificent Prince Marius!

    socialization. Having a pet in the home or classroom helps children develop a sense of responsibility as they nurture and care for the little furry/scaly/feathery companion.  I personally can feel my stress melting off when my gigantic cat climbs up onto my lap and begins purring.  And how cool is this, there is actually research that found the sound of cat purring helps promote bone strength when healing!  Go get a cat! (As long as you aren’t allergic!)

 

 

 

  • Aim for reduced screen time  Government recommendations suggest no more than 1-2 hours per day for kids, and we know that our behavior models what is acceptable.  Try, especially in the couple hours before bedtime, to cut back and/or eliminate screen time entirely.  You will improve the quality of your sleep, have more meaningful time with your family, and have more time for your non-tech based hobbies.  Your kids and your pets will thank you!

 

*By “Try” I literally mean make an attempt.  Gently.  With intent but without pressure.  Aim to hit these types of goals, without beating yourself up if you can’t meet them each day or week.  Balance is important even when working toward new goals, behaviors, and habits!

 

Work-Life Balance, often referred to as “Occupational Balance” by occupation-oriented therapists, is complex, and it “forms the foundation of who we are and how we see ourselves.”  And it’s important.  Do your best to remember YOU as this school year progresses.  If we are running on “empty,” it’s hard to have anything to share with those children and activities that are important to us.

 

 

Stacy M. Turke, OTR/L:   “On the Road with @stacyturke OTR blog.”  Stacy has been a school OT for 30 years with the same 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 @stacyturke.

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.  

Picture Credits:  

Use of photos that are the property of the author should include a link back to this block,  Those that are the property of photographers or site owners should include the link provided to the contributor’s source.

 

 

 

Taking Care of YOU

Fun with Food!

 

Fun with Food!

Turke July Intro Pic

 

by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

 

 

 

 

When I was growing up, mom insisted that we could not play with our food.  I’d bet lots of you heard that growing up, too.  As a kid, I never really understood why “playing” with my food was a problem, as long as I ate it and didn’t make too much of a mess at the dinner table.  I understood that Mom didn’t want us to waste food, certainly, and she wanted to be sure that we had adequate nutrition.  But what was the problem if my carrot sticks first became a “paintbrush” to make designs in the ketchup that was inevitably on my plate?

And now I’m a School OT and I encourage playing with food!  There are so many reasons to try using food items in non-traditional ways with kids, and all of them are fun. So this month we answer the question:  Should I let my kids play with food?

The answer: Yes!  Yes you should!

 

Working With Food For Fun

This summer, I am working in a school setting that provides Extended School Year services to students from all over our county.  One group of children on the Autism Spectrum have goals that focus on visual-motor development, ranging from using both hands together to complete a task (bilateral hand skills) to writing their first names from memory.  I could grab the crayons, paints, and playdoh and create a fun task that would address the kids’ goals.   And that would be fine.  But because I know that several of the children have significant limitations in what they will eat, I decided that this summer we would address goals through the use of food items.  And so far we’ve had FUN!

It is important to point out that while we are using food as the medium, the actual “eating” of the food for this group of students is a secondary goal.  In fact,  we do not even mention eating with them unless they indicate in some way that they want to munch on the materials.  We want to reduce anxiety around food for our students who are very limited in their food tolerances, and we stress the process rather than the product.  While it’s not always possible, I try to avoid working in the same area where the kids normally eat to differentiate this from snack or mealtime.  We fully allow tasting the materials; and if any of the students want to eat more than a taste, we keep handy a visual that says “First work then eat” so they know that actual snacking can happen when the work part of the task is finished.

Fun Food Projects To Try

 

Fruit Kabobs

Fruit Kabobs

 

Last week, we created Fruit Kabobs with a 4th of July slant.  I found the idea on Pinterest.  (How did we ever function before Pinterest?)  We loaded bamboo skewers with blueberries and added a watermelon star at the top.  After making these cute kabobs, we recreated them on paper. This was a really simple process for the students, all of whom could participate with minimal adult support.  In advance, I prepped the watermelon by slicing it into thin slices so that each child could have their own piece.  I made one sample skewer, giving my students a visual prompt they could use as their model.  The kids used star-shaped cookie cutters and pressed them into the watermelon slice to make the stars.  And then we put them together. Really that simple.

And what therapeutic benefits did the students receive?  Well, for starters…

  • Great sensory input including tactile, olfactory (smell), visual, and taste (for those who braved tasting!)
  • Motor planning while completing the observed tasks
  • Completing multi-step tasks from a model
  • Bilateral hand practice when placing the blueberries onto the skewer
  • Eye-hand coordination, not only while placing the blueberries onto the skewer, but also when we recreated them on paper
  • Visual tracking and eye-gaze shift while “stringing” and referencing the model

 

Pretzel/Pudding Painting

Another task we completed this summer was Pudding Painting.  As a group, we made pudding from an instant pudding mix and added blue food color to make it resemble the color someone might use to paint a water scene.  We used a little more milk than the recipe called for so that the texture was closer to paint.  Wow, did we have fun!  While the pudding set in the refrigerator, the kids glued a pre-cut yellow circle onto the top of a piece of paper then added vertical, horizontal, and diagonal lines around the “sun” to resemble sun rays.  And then we “painted” the blue water on the bottom of the page using fingers or pretzels as our “paintbrushes” and a simple paper plate as their paint palette.  Such a simple task, yet so many therapeutic benefits!

Pretzel Painting1

Pretzel Painting2

 

 

 

 

 

 

Adaptations For Making Messy Play Fun

Playing with food can be messy, and for many kids that is half the fun!  But what can you do if your child doesn’t tolerate messy play?  Well, just offer some simple tools and accommodations!  For example,

  • If finger-painting is the focus but your child won’t get his or her hands into the pudding, grab a painting tool.  You might need to start with a long-handled paint brush so the child can see that there is almost no chance of getting his or her fingers messy.  Move to a shorter handled tool once the longer one is easily tolerated.  Maybe even introduce a small truck or car to make wheel marks on paper or across a cookie sheet.  Or how cute would it be to make footprints with small plastic animals?!
  • A specific example of an accommodation made with this summer’s group of children allowed a child to work slowly toward tolerating portions of the task.   One of my students did NOT want to hold the blueberry at first, so loading them onto the skewer was frustrating for him.  Instead of making this a frustrating bilateral task, we allowed him to stab the blueberry on the plate and then an adult helped him move it down the skewer.  After doing a bunch that way, this little guy eventually tried to move a couple down the skewer himself using one hand to hold the stick and the other to hold the blueberry.  (Hint:  that made it a bilateral task!)  He was still addressing so many therapeutic goals by stabbing the blueberries, and eventually was able to tolerate the whole task.
  • Allow the child to wear plastic gloves if those are tolerated but messes are not.
  • Keep paper towels or wipes handy, and reassure your students that washing hands is always an option.

 

Other Considerations

Before you begin using foods as a medium for therapy, it is important that you know if your students have any food allergies or restrictions.  Even if you believe you know for sure that a child won’t try eating whatever you are using, you must be sensitive to cultural or religious food exclusions, and certainly stay away from any food items to which your students are sensitive or allergic.  If you are unsure, communicate with the families of your students before embarking on fun with food.

However you play, make sure it is a fun and no-pressure environment, and you will ALL have a good time!

 

 

Stacy M. Turke, OTR/L:   “On the Road with @stacyturke OTR blog.”  Stacy has been a school OT for 30 years with the same 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 @stacyturke.

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.  

Picture Credits:  

Photos are the property of the author or site owners and their use should include the link provided to the contributor’s source.

Fun with Food!

Using Bubbles to Support Handwriting? Really?

Using Bubbles to Support Handwriting? Really?

by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

soap bubble platinumportfolio pixabay

Another amazing school year is about to come to a close in my county, and staff and students are looking forward to some well-deserved time off. We will spend the summer wrapping up year-end paperwork, planning for the next school year, and hopefully getting a few moments off with our families to refresh and reconnect.  Some of us have to-do lists longer than there are days in the summer, which we will tackle with various levels of intensity and focus.  All of us will find the time flying by too quickly without a doubt!

At this point in the year, parents are asking School OTs what they can do over the summer to support their children’s handwriting and fine motor growth and successes so that they don’t lose too much of their skill during this down time.  I  know most are expecting to be provided with a list of “homework” looking activities, such as practicing grasp patterns using tongs to sort tiny objects, hunting for seasonal words in Word Search puzzles, and using handwriting books to practice correct letter formation. These are certainly favorites of mine and are important components to include in a summer program designed to support improved visual motor skills.  But I don’t like to ask families to do these kinds of things exclusively.  Summer is a time off from the usual demands of the school year and busy families often find it challenging to get their kids to do the more “schooly” looking tasks.  I remember well trying to get my own kids to use the practice materials their teachers sent home at the end of the school year in an effort to reduce lost skills…and it wasn’t pretty!  So when parents ask “What should I do with my children to help improve their visual motor skills this summer?”, I suggest the tongs and the letter formation practice, and I add this sure fire way to get kids engaged:

Play with bubbles! Seriously!

Bubbles

 

I’ve never met a kid who doesn’t love bubbles, so this will be an easy one for you. There are so many benefits of bubbles, all of which contribute to improved focus, visual tracking, and eye-hand coordination. First, let’s talk about the more standard types of bubbles, the ones in which children hold the bubble bottle (of various sizes and shapes) in their non-dominant hand, Bubble Wandsthen dip the bubble wand carefully into the bottle to load it with the bubble solution using their dominant hand. To begin, the children use fine motor skills to grasp and twist open the top of the bottles, which requires strength and coordination of the shoulders (for stability) and hands. Kids have to dip carefully or the solution will spill, and in order to do that they are using eye-hand coordination and bilateral hand skills. Bringing the loaded wand to their mouth involves visual-motor coordination using both eyes together and good visual tracking so that they don’t stick the wand over their noses or in their mouths (which I’ve done on many occasions…yuck!).  Kids must grade and control their breath to gently and continuously blow to allow for as many bubbles as possible to come out of that wand.  And then the visual tracking that happens when they watch (and chase!) the bubbles as they move away is where the magic happens, right?

 

So think about this.  When kids are using standard bubbles, they are working on or getting:

 

  • Upper extremity strength and coordination
  • Bilateral hand skills
  • Motor planning
  • Grading of movement
  • Grasping skills
  • Eye-hand coordination
  • Visual tracking
  • Convergence (eyes working together)
  • Focus and attention
  • Focused breathing
  • Aerobic exercise (as they chase the bubbles)
  • Tactile and olfactory input from the bubble solution

 

I love using different kinds of bottles of bubbles with kids, even in the same session.  I’ve used the more typical bottles, that hold 4 ounces or so of the bubble solution, but I also enjoy bringing out the tiny bubbles that you find in the party section of discount stores because the fine motor and visual motor skills needed are different. And who doesn’t love the bubble wands that look like long, colorful tubes and have really large bubble openings? These are especially great for bilateral control.

 

But if my students love standard bubbles, they ADORE this next method of bubble delivery (to sound scientific!). This is so simple, you probably have all of the materials needed for this bubble process in your house already. There may be a more official name, but we call them Bubble Cups because, well, we make them out of cups!  For each child, you will need:

 

  • 1 Disposable plastic cup
  • 1 (or more) Straw
  • 1 piece of an old towel or wash cloth, just large enough to completely cover the top of the cup
  • 1 rubber band
  • 1 pie pan (or similar dish for dispensing the bubbles)
  • Bubble solution

 

Bubble Cup1

Bubble Cup2

To make the cup, simply make a hole approximately 1 to 1-1/2 inches from the top of the cup using a sharp scissor.  (Please do this for your child in advance of the activity so they don’t hurt themselves).  Cover the opening of the cup with the piece of washcloth and use the rubber band to secure it so that it’s snug across the top.  Invert the cup and dip it into the bubble solution (in your pie pan) until the cloth is soaked, then lift and allow the extra to drip back into the pan.  Invert the cup again so that it is right side up and insert the straw into the hole.  Blow into the straw (making sure that it is not pressed against the side of the cup or nothing will happen) and you will see the coolest bubble rope develop. Your child will be amazed as will you, especially when you look at your watch and notice all the time that has gone by!

 

 

 Bubbles3

 

Using bubbles can be a great precursor to a more traditional handwriting practice activity because you will have helped your children prepare their minds and bodies for the focused work that comes with writing or coloring. The whole body will have been engaged by way of motor skills, visual processing and visual tracking, and self-regulation support.  And the child will have had a chance to enjoy and wonder at the beauty and simplicity of bubbles while getting fresh air outside. This will be the kind of “homework” that everyone wants to complete!

 

A hint about bubble solutions:  Add a little bit of glycerin (available at most pharmacies in the diabetic supplies section) to make the bubbles super bubbly!  I add a teaspoon or so to the large bubble wands and maybe that much to the pie pan when I add the solution for the bubble cups. You’ll notice that the bubbles coming from the wands and cups have greater staying power and your child will likely have greater success blowing lots of bubbles.

 

Do you have a favorite way to play with bubbles? Please share in the comments section!

 

 

Stacy M. Turke, OTR/L:   “On the Road with @stacyturke OTR blog.”  Stacy has been a school OT for 30 years with the same 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 @stacyturke.

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.  

Picture Credits:  

Photos are the property of the author or site owners and their use should include the link provided to the contributor’s source.

 

Using Bubbles to Support Handwriting? Really?

5 Tips to Help Distractible Kids in Your Classroom

KeepCalmStudio.com-[Smile]-Keep-Calm-And-Stay-Focused5 Tips to Help Distractible Kids in Your Classroom

by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

 

 

 

If you’ve met more than a child or two in your day, you know that they come in various models, some of which are more distractible than others.  There are some easy generalizations, such as the younger the child, the shorter the attention span.  But overall, some just are more fidgety and distractible than their classmates.  As a School OT, I am often asked by my teacher colleagues to help support those students who struggle to pay attention and focus through the long school day.  And while there may be differing reasons why, there are some strategies that can help pretty universally.

So let’s talk about:

How can I help distractible kids in my classroom?

 

Reduce Distractions

This may seem overly obvious…but you’d be surprised.

  • Our classrooms and hallways are full of posters reminding the students of behavioral expectations and supports.
  • We hang student work from the ceiling.
  • We label lockers with names and decorate them for celebrations.
  • We have bulletin boards with coordinated borders that help set the stage for the work happening in the classrooms.

While all of these examples have a true purpose within the school and help create a feeling of belonging and ownership, some kids can become overly distracted by all of the “stuff.”  I’m not advocating for a sterile, unwelcoming environment.  Warmth and comfort have their place for sure.  But consider removing the extra stuff that just hangs out as the year progresses, and especially think about taking down the work and decorations that hang down and move in the breeze created by an open window or the furnace fan.  The constant movement of things hanging overhead may provide a constant distraction for your students, making it very hard for them to attend to your activities. Giving your students a clean, focused environment helps prepare them for the work you will be asking of them. 

 

Try adding a Calm Corner

Many teachers I work with have a designated “Calm Corner” in their classrooms where students can go to work when their brains and bodies are struggling to slow down and pay attention. This doesn’t have to be a big space nor is there any specific equipment needed. Calm Corner TurkeIt’s usually a spot that is a little out of the flow of traffic and may have slightly lower lighting. Bonus, in fact, if there is natural lighting in the area so an overhead fluorescent isn’t even needed.  But if you don’t have this kind of space in your classroom, you can create a mini-oasis by turning a table or desk away from the flow of the room or use a study carrel made from file folders laminated together.  Add a set of sound-dampening headphones Headphones Turkethat can be found year round in the hunting section of discount stores.  Fair warning:  you may find yourself wanting to work in that corner at times during the day too!

 

 

Fill ’em up with inefficient movement

Kids need to move…so instead of trying to keep them in their seats, give them times and reasons to move!  In OT school we are taught to think about “energy conservation” and “work simplification” to improve efficiency and reduce extra energy expenditure.  But in schools, I advocate becoming models of inefficiency when you’ve got students who need to move!  Instead of keeping work tools at every table or station, consider keeping them in a location at the edge of the classroom so that kids have to move to one spot to get their writing tool and then to another spot to get their notebooks, before returning to their own work spaces.  This gives kids permission to be moving with purpose.

Files Turke

 

Have kids try new learning tools 

Fidget tools have their place…in kids’ hands or at their feet!  I’ve talked about these before, mostly because when they are well-used, they can make the difference between a wiggly, inattentive child and a focused, productive student.  Check out my post in March 2016 for some of my all-Fidgets Turketime favorite fidgets of both the hand and foot variety.  Also consider adding seat cushions…or yoga ball seats…standing desks…or even a new style or color writing tool.  New and novel can create new interest and focus.

 

 

 

 

Feed the Fidgets

Growing bodies need good, steadily-provided nutrition and fluid intake to run optimally. Many of the elementary classrooms I work in have either a scheduled snack time or a “snack when you need to” policy.  Many teachers have their students bring a water bottle into the classroom to increase water intake and oral input (plus extra water means extra bathroom breaks, which creates natural movement opportunities). Try chewy or crunchy foods with healthy dips for snacks.  For example, provide apple slices with flavored yogurt to dip or celery with hummus.  Strong flavors, such as medium salsa with tortilla chips, strong-flavored meat jerky, or Chex mix, can also boost oral input and increase focused attention.  Feeding a hungry child or offering water to a child whose brain needs a quick boost may go a long way toward decreasing fidgetiness.

Water Bottles Turke

 

 

Have any great tips for helping kids focus in the classroom? Please share in the comments below and share the wealth!

 

 

Stacy M. Turke, OTR/L:   “On the Road with @stacyturke OTR blog.”  Stacy has been a school OT for 30 years with the same 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 @stacyturke.

 

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.  

Picture Credits:  

Keep Calm, Calm Corner, and Fidget pictures are the property of the author and should not be used without the appropriate link to this blog post.  

All other photos are the property of the linked site and use of those photos should include the link provided.

 

 

5 Tips to Help Distractible Kids in Your Classroom

Three Easy Ways to Thank a School OT!

 

 Three Easy Ways to Thank a School OT!  by Stacy M. Turke on the On the Road with @stacyturke OTR blog

 

Three Easy Ways to Thank a School OT!

 by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

 

 

If you are reading this blog post in April, are you ever lucky!  April is Occupational Therapy Month, and had you waited to read this in May, you’d have missed the opportunity to say “Thanks!” to your School OT for the work he or she does to support the students in your school and in your life during “our” celebration month.  I feel so blessed to have been able to work alongside the intelligent, creative, authentic OT staff at Ingham Intermediate School District over these past 30 years, who daily support my growth as a clinician and as a human.  In this post I say thanks to them and offer suggestions for creative ways to say “Thanks” to your own school OT staff!

(Caveat: we will accept cards, flowers, and chocolates at any point during the month of April in celebration of OT Month!  However, keep reading for cheaper and more meaningful ideas…)

 

Thanks Turke

Three Easy Ways to Thank Your School OT

 

Perhaps you have a student who struggles to complete written work or to copy sentences from the board.  Or maybe you’ve noticed that one or two of your students have more difficulty than their peers staying focused during large group lessons, especially on “indoor recess” days.  So you’ve called your School OT for help.  After offering several possible fixes for the challenge, your OT goes on to the next classroom or school and you embark on trying out these ideas within your classroom.  Saying thanks for these efforts is easy.  After agoal-clipart-stickguygraphrgb week or two, simply share your feedback with your OT about how things are working out!  You have no idea how much we appreciate getting this kind of feedback from our teachers and parents!  Truly, hearing that a strategy is the answer that you’ve been looking for really warms my heart and is all the thanks I need.  And if the strategies AREN’T working, or if part of the problem is resolving and you want to bounce new ideas off your OT, please share that feedback too.  We have access to all sorts of Evidenced Based Practices and often know what typically helps most challenges that kids face at school.  But we don’t work with cookie-cutter students and neither do you. The data you collect and the feedback you offer helps us to help you and other kids like your students.  Help us help you and WE are the thankful ones!

 

 

Therapy Room TurkePlease invite us into your classrooms!  This can be as simple as asking us to observe how a particular student is engaging with a piece of equipment or learning tool that we provided.  Maybe one of our mutual students has just experienced some type of breakthrough and you want to share.  Or you might want to bounce an alternative seating or classroom arrangement idea off us.  Oh my goodness, do we ever love these kinds of opportunities!  I have worked with several schools this year, at their request, to assess and help redesign classrooms to increase movement opportunities and enhance learning for kids.  I was initially overwhelmed with the thought of getting into all the classrooms and providing inservice to an entire school staff given the high workload already in place.  But the impact that this service had on the school cannot fully be measured in time or in increased test scores alone.  I’m able to support many students in a rather short amount of time and I’m feeling valued as an OT and as a colleague.  A “thank you” coffee is nice…but valuing someone’s work goes such a long way.

 

How about that student in your room who has Direct OT services and who has suddenly smile and chalkboard geralt pixabaystarted to soar using the strategies you and the OT have mutually put in place?  PLEASE share copies of that student’s classroom work with the OT so that we can share in the joy of success too!  I recently had just such a thing happen and I will not quickly come down from that heartwarming experience.  I have a third grader on my caseload who has always been a very reluctant writer for a variety of good reasons.  This child has been on caseload for several years, and while the work within the OT setting has improved, this has not transitioned easily to the general education setting.  This child has been very reluctant to give up the one-on-one time to allow “push in” services, again for a variety of good reasons.  Typical classroom-based writing assignments for this child yield a page of writing at most, though usually the work completion was much shorter than that.  So imagine my surprise when this teacher colleague of mine approached me a couple weeks ago with a paper in her hand and a twinkle in her eye.  She said, “You’ve got to see what our student wrote for me today!”  I glanced down at the stapled pages in my hand and saw this particular boy’s name at the top and his very familiar writing all over the page.  I flipped through ALL 5 PAGES, completely full of text, and looked up at the teacher who was just beaming.  I checked out the title of his paper and immediately felt tears come to my eyes.  The title? “Working with Ms. Turke!” This boy wrote 5 full pages about what going to OT was like.  He described in (mostly accurate) detail what we do and why, and he ended it with, “She is always nice to me, and I love her!”  I think this teacher knew what a tremendous impact this paper would have on me.  Her smile and hug said it all.  Celebrating this child’s new found confidence with his teacher was one of the greatest “thank you” gifts I have ever received.

 

I’ve been blessed to work with some of the most generous, knowledgeable, creative OT colleagues over the years, all of whom have contributed to my ongoing growth as an OT.  The folks I work with are quick to share therapy activity ideas and information on current research articles.  Without sharing identifying information, we consult with one another when a student isn’t making the progress we had hoped for and we are looking for other intervention ideas.  We mentor one another in district procedures and processes.  We celebrate successes together.  And we do what OTs do best:  we help each other complete the occupations of the job with greater ease and efficiency.  To Jennie, Jane, Cindy, Angie, Donna, Jodie, Mya, Ellen, Paula, Trish, Sue, Leanne, Liz, Cheryl, Amy, Allison, Kari, Ken, Tammy, Kelly, Jessica, and Marge, (and any others who worked at Ingham but whose names I’ve missed), I say Thank You.  From the bottom of my heart.  Happy OT Month, Friends!

Group Picture Turke

 

 

Stacy M. Turke, OTR/L:   “On the Road with @stacyturke OTR blog.”  Stacy has been a school OT for 30 years with the same 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 @stacyturke.

 

 

“Thanks” image courtesy of Stuart Miles at FreeDigitalPhotos.net.

“Stick Guy Graphing” image courtesy of Clipart Panda.

“Chalkboard Smile” image courtesy of geralt on Pixabay.com.

 

 

 

 

Three Easy Ways to Thank a School OT!

Why School OT? Why Not!

Why School OT? Why not!

 

Why School OT? Why Not!

by Stacy M. Turke

on the On the Road with @stacyturke OTR blog

 

 

 

This past week, I found myself in the middle of a therapy session watching the joy of a kindergarten student on my caseload as we gathered snowflake-shaped beads that had been strategically scattered over the floor of the therapy space.  Because he loves wolves, we were pretending to be wolf pups, playing on hands and knees in the “snow” and he was having a blast. I giggled because his joy brought me joy and he suddenly looked up at me and said, with wonder in his eyes, “I made you laugh!” He went on to complete a little more of our “work,” stringing the beads onto matching colored pipe cleaners, and then he looked back up at me again and said, “I’m gonna’ make you laugh AGAIN!”  My supervisor was looking on at all of this because she was observing me that day.  Quietly I said to her, “I get paid to PLAY!”

 

I’m often asked “Why OT?  Why did you become a School OT?” and I sometimes find myself stumbling over my words because there are so many reasons. After 30+ years working with school-aged children, their parents, and their school staff, I can honestly say that this was one of the two wisest decisions I ever made (becoming a mom to my two daughters is the other). So what makes being a school OT such a great career? Here’s my 3 top reasons:

 

Scooter Boards Turke

1. School OT is FUN

It is true that we have paperwork and meetings and other “adulting” kinds of activities that are not always fun.  However, the real work, the reason we are in schools, is to support student success.  And since the work of a child often boils down to play…School OTs get paid to play! The play is carefully orchestrated to address specific skills, certainly. it’s not a free-for-all and it takes all kinds of planning to make it look and feel like a playful session for the child.  Relay races, games, puzzles, playdoh, Legos, peg boards, yoga balls, scooter boards, pipe cleaners and beads…these are the pieces of “equipment” that school OTs use every day to meet student goals. All of which are FUN!

 

Lego Cards Turke

 

 2. School OT is NEVER BORING

Yes, I have a weekly schedule that brings needed structure and routine to my work, and that helps with me plan and prepare for whatever may be ahead. However, because we work in the dynamic environment of the school system with living, breathing children, school OTs never really know what each day will bring, and that can be exciting. A typical day will take me to at least two different schools, sometimes even more, and my students can range from age 3 to post-secondary. I may work on strength and endurance with one child, which might look like push-ups, crab walks, and therapy putty activities. Another child may need to work on visual processing skills, so we may play with Legos and complete word search puzzles. Another child may be learning to regulate strong emotions and becoming familiar with sensory processing tools, so we might study the Zones of Regulation to understand tools that might be useful for calming. An older student may be working on pre-vocational skills on a job site, needing to learn to tie off a trash bag with the use of only one hand. You just never know what the day may bring, and that keeps things fresh and exciting.

 

 

3. School OT is INSPIRING

Our roles as client-centered service providers and consultants can make a big impact in schools –  sometimes just one child or family at a time and sometimes with a whole class all at once. Our training in task analysis helps us break down barriers that interfere with student success while considering the whole child and his or her needs and interests. A recent experience has driven this home for me in a powerful way. Several years ago, a boy with a physical disability entered my school as a kindergartener. At that time, research that was available to me suggested that, since his physical challenges would slow the learning process considerably, he needed to move directly to technology use so that he’d have ample time to learn the technology while learning the academics.  As the OT on his team, it was my job to help identify what technology his little hands would be able to manage and begin the training process while helping him continue to develop his fine motor skills as best as possible.

 

But there was a problem with this research-supported approach. This little guy was too young to read that research!  He wanted to draw the snowmen his friends were drawing.  He wanted to write his letters and numbers and name because he had stories to tell! None of his friends were doing that stuff using technology, so it didn’t make any sense to him at all that he should be using a device instead of a crayon. So our team faced a dilemma:   honor the (then) current research…or this little face smiling up at us who was reaching for the writing tools. We pulled together and honored his desire to learn to write and draw. We assigned the Resource Teacher to provide daily handwriting practice following the Handwriting Without Tears curriculum that was adjusted to meet his speed and progress. My role as the School OT was to develop and provide data collection materials to the team and to assess the weekly progress to determine where to go for the following week. The team met many times during that first school year to assess where he was in terms of progress and to try to determine WHEN to introduce technology, as we all assumed that would be the ultimate outcome.  And then First Grade came…and this little guy was still looking like a future hand-writer!  So we repeated the process, advancing the handwriting instruction to the first-grade level, continuing the daily practice and the monitoring and the meetings…and he continued to learn and progress and feel empowered as a learner through the next several years. Recently, in late elementary school, his ability to neatly write the multiple-page stories he has in his imagination began to suffer and both he and his teaching staff decided it was time to look at technology.  I am pleased to report that he is CRUISING through learning to use technology meaningfully and successfully. Last week he produced writing at a rate of just over 50 WORDS PER MINUTE!  We waited until it was the right time for HIM, and interestingly the research available now supports we made the right decision academically as well.  Kids who use handwriting develop stronger language arts skills, even if their legibility through that process isn’t perfect.  This child’s progress continues to be an inspiration to his educational team,and we look forward to watching his continued growth.

 

 

It all boils down to this…As a School OT I get to work with one or two children (typically) at a time, and we giggle and color and do puzzles, all carefully selected and designed activities that have specific purpose. We talk about things that are important to the child and we problem solve ways to make school easier and more fun. We get to honor the children before us and are inspired by their drive and determination.  All while we are helping overcome challenges, often through play.  School OT ROCKS!

 

 

 

Stacy Bio pictureStacy M. Turke, OTR/L:   “On the Road with @stacyturke OTR blog.”  Stacy has been a school OT for 30 years with the same 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 @stacyturke.

 
 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 that include a link to an originating site are the property of that site and their use should include the link provided.
Why School OT? Why Not!