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Smile n write ied.by najma adam
1. Smile N Write
Najma Adam
Occupational Therapist/Special Educator
South City Hospital
2. Out line of work shop
At the end of the workshop you will be able to know:
•Role and signs a child needs Occupational Therapy.
•What is hand dominance?
•How does handedness develops?
•How do determine hand dominance.
•What are the easy ways to make handwriting instruction multisensory?
•What is coordination?
•What is bilateral coordination?
•Why crossing the midline so important?
3. Out line of work shop
•Why correct grip?
•Classroom strategies and intervention for students having difficulty with writing and class tool use.
•How to teach children the right way to right.
•How to hold scissors correctly
•How to cut with scissors correctly
•The lLeft handed child in a right handed world.
•Special provision for left handed child.
4. 10 SIGNS A CHILD NEEDS OT:
1.An observer in the playground/rarely tries out the equipment independently.
2.Poor posture while sitting in a chair/during situations of unsupported sitting, e.g, during circle time the child is observed to roll or move around a lot on the floor.
5. 10 SIGNS A CHILD NEEDS OT:
3.Appears to be irritated by touch from other people but frequently touches things themselves.
4.Frequently chooses the same familiar games/avoids learning new motor activities.
6. 10 SIGNS A CHILD NEEDS OT:
5. Avoids fine motor activities. scissors, abnormal pencil grip, hand tires easily and writing difficulties.
6. Difficulty putting on their coat, tying shoes, and buttoning.
7. 10 SIGNS A CHILD NEEDS OT:
7. Trouble putting together puzzles or finding a specific object in the classroom.
8.Frequently runs into things in the classroom, falls to the floor, or purposely crashes into things or people.
8. 10 SIGNS A CHILD NEEDS OT:
9.More trouble than their peers writing in their assignment notebook, keeping their desk and folders organized, and turning in assignments on time.
10.Excessive risks taker/frequently demonstrates decreased safety awareness.
9. Seek out an Occupational Therapist for:
•Activities of daily Living (Self care).
•Fine motor skills.
•Sensory Issues.
•Behavior modification.
•Academic success.
10. Why Correct Grip ??
•Good habits that begin in early years will last a lifetime.
•Holding a crayon or pencil correctly is a very important habit.
•Handwriting is a necessary daily skill and a direct reflection of who we are.
•The foundation starts with general upper body strength and fine motor skill activities.
11. Why Correct Grip ??
•This sets him up for a lifetime of poor posture and bad habits.
•Children who cannot write easily and legibly struggle in school.
•For a child to be able to write well, he must be formally taught how to do it.
12. Why Correct Grip ??
•Children who do not take part in appropriate fine and gross motor activities in their early years may also struggle to use a proper pencil grip.
•Physical coordination activities in classrooms can be used to organize the brain for reading.
13. Great Expectation
•Children are expected to be able to write at the age of 4.
•This is 2 full years before they are developmentally ready.
•Forcing a child to learn to write before these underlying skills are solidly in place is counterproductive.
14. Incorrect Grip
•Awkward grips can cause fatigue, cramping, and even pain—making writing difficult.
•This problem can be prevented.
15. Requirement for hand writing Readiness
•Fine motor control.
•Visual motor coordination.
•Attention span.
•Frustration tolerance.
•Ability to hold a pencil correctly.
•Strength and stability of the trunk.
•Strong, sturdy body for the controlled movements of the hands and fingers.
16. Follow these four steps!
1.Determine Handedness.
•Notice which hand the child uses more often during activities requiring hand use.
•Collaborate with teachers, parents, and therapists, so they too are watching too and can help you decide.
17. What is hand dominance/hand preference??
•One hand is consistently used more than the other hand.
•Is more skilled at tasks than the other hand.
•Begins to emerge b/w ages 2-4 years.
•Entering K.G have established a definite hand preference (age 5-6).
18. How does handedness develop?
•Genetics
•Bilateral coordination skills have a huge impact on how your child’s handedness develops
19. How to Determine Hand Dominance??
•If the child is definitely left-handed,use that hand in writing.
•If, in doubt, there are several simple ways of determining which will be the hand to train.
•Do not tell the child that he is being tested.
•Work with only one child at a time.
•Keep a record as to which hand is used for each specific situation.
20. How to Determine Hand Dominance??
•Let the child pick up the testing materials.
•Keep a tally of the procedures. If the child indicates true ambidexterity, it is probably better to train the right hand.
•Simple play situations will be helpful for determining hand dominance.
21. How to Determine Hand Dominance??
•Hand puppet
•Key and lock
•Hammering nails
•Screwing lids on jars
•Throwing a ball
•Holding a spoon
•Cutting with scissors
22. Follow these four steps!
2.Teach correct finger placement.
Tripod grip:
Thumb, index finger and middle finger
work together.
Quadropod grip:
Four fingers work together to stabilize.
The pencil rests on the ring finger which
provides additional support.
23. Follow these four steps!
Dynamic tripod Grip:
•Most comfortable, efficient grasp.
•Arm and wrist stay still.
•Fingers move in and out of the palm.
24. Follow these four steps!
Tips for Grip:
•Keep the little finger and ring
finger in the palm.
•Use the rubber band trick.
•Sing a song. "Crayon Song"
25. Follow these four steps!
3.Use small tools.
•Use golf size pencil instead.(4”)
•Primary size pencils are not recommended as
26. Follow these four steps!
4.Play! Provide creative opportunities to develop fine motor skills that are necessary for correct grip.
27. Pre-writing skills
•Use play-Dough
•Use clay to strengthen little hands and fingers.
•Lacing
•Beading
•Craft projects to develop eye hand coordination.
28. Easy Ways to Make Handwriting Instruction Multisensory
•Help engage all of your students’ senses in a fun, interactive way.
•Creates a dynamic classroom environment.
•All children succeed, regardless of learning style or background.
29. Visual
•Use large step-by-step visual directions to teach letter formation.
•Use board or easel for large arm movements.
30. Tactile
•Wet–Dry–Try activities on a blackboard for repetition and fun without boredom.
•Finger tracing and coloring.
•Encourage building activities that teach letter formation and promote motor skill development.
31. Auditory
•Use consistent, child-friendly language for memorable lessons.
•Incorporate music and different voices.
•Play Mystery Letter games with your class to delay auditory letter cues and break bad habits.
32. Kinesthetic
•Incorporate music and movement to teach:
a.Letter formation.
b.Social skills.
c.Body awareness.
d.Motor skills.
e.Coordination.
•Use multisensory instruction with any letter, word, or sentence lesson
•Captivate your students and encourage them to participate.
33. Classroom Tip:
The Hand Activity
•Beginning printers are still figuring out letter size.
•They are still learning the difference between capital and lowercase letters.
•They write “cows” like this: “cOwS” or “Jacob” like this “JaCOb.”
•You see that when they float a descending letter like "g" or "y" or "p."
34. Classroom Tip:
•Hand activity for teaching correct size and placement of capitals and lowercase letters.
•Fun for a child or a whole class.
•It captures their attention and gets them moving.
•You can see them mastering letter size and placement!
35. Directions for Letter Activity:
1.Point to the Wall Chart to show the letter (Any letter – Aa, Dd, Gg for example)
2.Children hold up the right hand for the lowercase
3.Make a fisted hand for small letters (a, c , e, i, m, n, o, r, s, u, v, w, x, z)
4.Point the index finger up for tall letters (b, d, f, h, k, l, t)
5.Point the thumb down for descending letters (g, j, y, p, q)
36. Teach Your Students the Right Way to Write
•Use large, clear illustrations.
•Start all of the letters from the top.
•All letters from left to right (English).
•The hand traveling in the same direction.
37. Teach Your Students the Right Way to Write
•Tape the paper for those having trouble with bilateral work.
•Wait until all the letters are formally taught.
•When writing becomes automatic in nature then switch to compositions.
38. Teach Your Students the Right Way to Write
•Say NO to fat markers, crayons, chalks and giant paintbrushes.
•Say YES to one inch nubs of chalk and crayons, and cracking off the handles of the paintbrushes.
•Standing at easels strengthens and stabilizes the shoulders, elbows, and wrists.
39. Teach Your Students the Right Way to Write
•Old fashioned chalk boards are an excellent way to practice letters and draw pictures.
•Plain double lined paper is the best.
•It teaches correct sizing and keeps his work very neat and organized.
40. Brain exercises and physical coordination are benefits of physical education
•Mind and body are connected.
•Certain physical coordination and OT activities support learning, especially reading fluency and comprehension.
•This is why physical education is so important in schools.
41. Brain exercises and physical coordination are benefits of physical education
SKIPPING children who can skip read better than those who can't.
If a child can't skip, he can't read. Why?
It requires the right and left hemispheres of the brain to work together
•The right brain controlling the left foot and the left brain controlling the right foot.
•Learning to skip builds connections between the two hemispheres across the corpus collosum which divides them.
•These connections, when established and strengthened by skipping, can then be used for reading.
So skipping is really a brain exercise! Who knew?
•Reading requires the same cooperation between the two brain hemispheres.
•To start reading a line of text on the left, the right brain is in control.
•At the midline, it must hand off to the left brain to continue reading to the end of the line.
•Skipping is a critical skill for developing connections in the brain which may be used for reading.
42. Coordination Skills
Arms and legs to work together effectively!
Games, sports or doing schoolwork, coordination skills are a must.
It also requires:
1.Plan
2.Time their movements
3.predict
4.React
43. Coordination Skills
Coordination
Bilateral Coordination
Symmetrical bilateral coordination (same movement with each hand/leg )
Asymmetrical bilateral coordination
Eye hand Coordination
44. Bilateral Coordination
•Bilateral integration skills are vital for many areas of your child’s life.
•Good bilateral coordination is vital for handedness to be established
•Begin to emerge in early babyhood.
•Jumping and clapping hands in older children
46. Bilateral Coordination
Alternating Movements.
Use first one hand/leg and then the other, when you pull in a rope hand-over-hand.
Reciprocal Movements .
In crawling, baby use each side of the body in a rhythmical way, first one side and then the other.
It gives the baby tremendous opportunities to develop good bilateral coordination in preparation for handedness.
47. Bilateral Coordination
•Child does not have to master symmetrical movements before moving on to alternating movements – you can combine different kinds of movements as he progresses.
•A child will usually learn to coordinate the use of his arms before the use of his legs, and obviously, the hardest thing is for a child to use his arms and legs together in a coordinated way at the same time (star jumps/jumping jacks).
48. Bilateral Coordination
•The vestibular system (which is situated in the inner ear and helps the brain to process movement information) plays a vital role in a child's physical development. Children with poor vestibular processing may well have delayed bilateral integration abilities. For this reason, many occupational therapists use movement activities in their therapy sessions to boost bilateral coordination skills.
•Try and use a “moving” activity before each session. Examples are: jumping on a trampoline, rolling on the grass, going down a slide, and doing somersaults.
49. Asymmetrical bilateral coordination:
Both sides of the body are working together, but they are doing a different, yet complementary task.
Eg. Scissor cutting, coloring , drawing on paper, kicking a ball… (one hand or leg is “active” while the other hand or leg “assists”. )
By age 4, most children have achieved some measure of proficiency in developing this skill.
50. Poor Bilateral Coordination Skills
•Poor gross motor activities
•Poor fine motor activities.
•Use one hand alone.
•Awkward in certain tasks.
51. Activities For Bilateral Integration
The rope needs to be long enough to get the ball level with your child’s chest. For younger children, use a larger plastic ball. He has to watch it carefully to catch it again with both hands together, and to not let it bang against his chest.
52. Activities For Bilateral Integration
Good old Springs – shifting the hands just enough to get the sling to move back and forth between the hands is great fun and a good coordination challenge.
53. Activities For Bilateral Integration
Pulling on a rope is a good way to get the hands working rhythmically together.
54. Activities For Bilateral Integration
Roll large balls of play dough between the palms of his hands. Use the balls to make the segmented body of a caterpillar.
55. Activities For Bilateral Integration
Try moving noisy hammers, musical shakers up and down together or alternately in time to music or your clapped rhythm to get a great bilateral coordination challenge
56. Activities For Bilateral Integration
Getting legs to move together is hard work. Start by having your child jump over a line and back again, one jump at a time. As you see him start to get the hang of it (maybe only a few days later), try asking him to jump 2, 3, 4 times without losing his two-feet landing gait.
57. Eye Hand Co-ordination
Is the ability of the eyes to guide the hands in movements.
•Good hand-eye coordination can also help a child’s handwriting and also needed for reading
58. Crossing the midline
One hand spontaneously moves over to the other side of the body to work there.
59. Why is midline crossing so important?
•When child spontaneously crosses the midline with the dominant hand, it develops good fine motor skills.
•If he avoids it, then both hands will tend to get equal practice, and child’s true handedness may be apparently delayed.
60. Why is midline crossing so important?
To do well at learning to write, there has to be a dominant hand that becomes specialized at doing the job of controlling the pencil.
61. How does crossing the midline develop?
•Midline crossing emerges as your child develops bilateral coordination skills.
•As child learns to coordinate a strong hand which is doing something skilled (eg cutting) and an assistant hand which is helping (eg holding the paper), the ability to spontaneously cross the midline develops.
•Another vital factor in crossing the midline,is trunk rotation.
•If the child is moving the body as a unit, then this may affect crossing the midline.
62. What can I do to develop midline crossing skills?
•Do some bilateral coordination activities at home/school.
•Incorporate some midline crossing activities into his play.
•Work on core stability and trunk rotation during play.
63. This girl has turned the paper sideways so she can write from bottom to top, instead of reaching over to her left side with her right hand to write from left to right.
This girl has turned the paper sideways so she can write from bottom to top, instead of reaching over to her left side with her right hand to write from left to right.
No midline crossing
64. Boy has shifted his body way over to the left, so his right hand does not have to reach over to work on his left side!
No midline crossing
65. No midline crossing
The child has turned the lower body with the upper body, so the shoulders and the hips have both turned. There is no trunk rotation, and no midline crossing! So, if there is poor core stability and a lack of good trunk rotation, then midline crossing will be affected.
66. Crossing the midline
The child’s upper body has rotated, while the lower body (hips and legs) remains facing forward. There is some trunk rotation and the child is crossing the midline with the dominant hand.
68. Interesting facts about scissors cutting
•Most children become interested in scissors around age 2 ½ or 3.
•One short snip at a time develops around 2 years old.
•Several short snips in a row along a line develops around 2 1/2 to 3 years old.
•In preschool, it gets more advanced.
70. Strategies for Building Scissoring Skills
A child must be able to integrate his body in the following ways:
•Balanced seated position.
•Arm control.
•Visual Motor Integration .
•Attention to task.
•Direction Following .
•Holding the Scissors.
•Fine motor precision.
•Bilateral skills.
•Grasping.
•problem solving skills.
71. How to hold the scissors correctly!!
•Think "thumbs up."
•Give the scissors a “hand shake”.
•Thumb is placed into the smaller hole.
•Index and middle finger into the larger hole.
•Place a sticker on top of the scissor thumb loop to provide a visual cue.
72. How to hold the scissors correctly!!
•Place a sticker on kids’ thumbnails to indicate which way to orient their hand.
•Practice holding the scissors.
•Pick it up then put it down as many times as he wants.
•Spread index finger and thumb as wide as possible to open the blades of the scissors
73. How to hold the scissors correctly!!
•Show him how he needs to close his fingers to close the blades of the scissors.
•The wider he opens his fingers, the longer his cuts will be.
•Use the thumb of the helper hand on top of the paper.
•Shoulders should be relaxed.
•Begin to cut AWAY from the body.
Bad habits form quickly!
74. How to teach Scissors cutting:
•Have patience
•Child cut through it a few times without worrying about using his non-dominant hand to steady the paper.
•Begin by snipping paper.
•Followed by cutting across the entire sheet of paper.
•Begin with a stiffer paper like thin card board.
•Introduce thick, straight lines.
•Moving on to curved/wavy lines.
75. How to teach Scissors cutting:
•Cutting out large circles and squares.
•Lastly smaller circles and squares, and more complex shapes.
•Remind your child to turn their paper rather than turning the directionality of their scissors.
•Make the item to be cut motivating and fun for the child.
•Colored tape to give the child a visual border around the line to be cut if needed.
76. How to teach Scissors cutting:
•The dominant hand moves the scissors forward in a straight line.
•Initially the non-dominant hand will hold the paper still.
•Eventually, though, the non-dominant hand will need to move and turn the paper as the dominant hand opens and closes the scissor blades.
77. How to teach Scissors cutting:
•Stay nearby .
•Give verbal clues
•Until child is comfortable with the correct scissors grip, he may revert to an incorrect grip.
• Incorrect approaches will likely produce a snip in the paper, but they are inefficient.
78. Role of an Adaptive scissors
•Spring/loop scissors.
•Sense of accomplishment.
•Gain Confidence.
•It provides increased feedback when closing them.
79. One Tip For Introducing Scissors: Use Play dough!
80. Why Play dough??
•Ideal medium.
•Familiar.
•Comfortable.
•Can control the size and shape of the piece to be cut.
•Less messy.
•Smash it and make a new creation once they’re done.
81. Why Play dough??
•It can be easily used by everyone.
•Doesn't not discriminate between right- or left- handed snippers (unlike paper)
•Provides a good deal of feedback to children’s hands.
•How much resistance there is.
•How much pressure to use in snipping.
•An important contributor to the development of fine motor strength.
82. Why Play dough??
•Overall skilled use of the hands.
•Nice introduction to bilateral coordination.
•kids pretend they’re making food for their animals or dolls.
•2-3year olds are great at pretend play.
•Adult — join in and make outrageous “eating” noises.
84. CLASSROOM STRATEGIES & INTERVENTIONS FOR STUDENTS HAVING DIFFICULTY WITH WRITING & CLASSROOM TOOL USE
85. LETTER REVERSALS
•Teaching letters in groups.
•c,d,g,o,q are the "magic 'c' " letters to teach together;
•t,l,f,h,b are the "firepole" letters to teach together
•Use different colors to visualize differences in strokes
•Trace letters using color-changing markers
•For right-handers with number reversals, use left hand as anchor on paper to show how numbers like 3 and 5 go around index and/or middle finger
86. POOR LETTER FORMATION
•Use adapted paper (raised line, only dotted middle and baselined, drop spaced) or graph paper underlays
•Tape letter formation models to desktop
•Practice accurate multisensory formation
•In the air with a "magic wand"; with finger against a ziplock bag filled with colored glue or hair gel; with playdoh snakes; with foil rolls; on chalkboard; on magna-doodle; on dry erase board, in cookie sheet covered with thin layer of sand
•Trace over letter models with tracing paper
87. POOR SPACING
•use graph paper--one letter or space per box
•Use popsicle stick spacers (can decorate)
•Use non-writing hand index finger as spacer
•Highlight spaces in between words of text student is copying
•Highlight margins to increase visual impact of where writing begins and ends
88. ERASES OFTEN OR PRESSES TOO HARD
•Try variety of pens, mechanical pencils, fine point pens with no erasers
•Encourage structured error repair (EXAMPLE: do not fix mistake until entire sentence is complete)
•Put something soft or textured under paper, like thin sheet of styrofoam, sandpaper, padded notebook, carpet square
•Allow for spelling errors
•Write on tracing paper or carbon paper
•Tape paper to wall and have student stand to write in vertical plane
•Have student hold small ball in writing hand while writing with ring and pinky fingers
89. OFTEN DOES NOT PRESS HARD ENOUGH
•Put sandpaper under writing paper
•Have student write with a squiggle pen
•Have student write with markers
•Try a #1 pencil (has softer lead)
90. AWKWARD GRASP ON WRITING UTENSIL
•Try a very short pencil
•Try a variety of pencil grips, pencil girths, and grasp styles
•Write on slantboard
•Use rubberband on wrist and hook on end of pencil to pull down into webspace
91. SLOW, LABORED, OR MESSY WRITING
•Increase time allowed for completion of work
•Reduce amount of work
•Space work sessions with short breaks
•Set time limits for specific writing tasks
•Allow use of either manuscript or cursive
•Set mutually agreed upon expectations for neatnes
•Accept key word responses vs. complete sentences
•Reduce amount of copying from board; provide written version of board content
•Allow student to type or give answers orally
•Use appropriate height chair and desk; if chair is too high, place prop under feet
•Use dycem or non-skid material under elbows
92. CHOPPY, MESSY SCISSOR USE
•Remind student to hold scissors in "thumb-up" position all the time--the scissors do not change direction, the paper being turned by the non- cutting hand is what turns
•Encourage student to cut as slowly as possible
•Pretend scissors are alligators and they only like to "eat" the line
•Use child-size scissors
93. COLORING OUTSIDE THE LINES AND/OR NOT COLORING IN COMPLETELY
•Make the outline thicker and/or darker
•Encourage child to use finger vs. arm movements to move the crayon
•Encourage child to “make all the white disappear”
•Encourage child to watch crayon as it moves
94. SLOPPY FOLDS OR INCOMPLETE CREASES WHEN FOLDING PAPER
•Ensure that child understands what it means to match corners or edges
•Put dots on corners/places that need to meet, and tell them to “make the dots kiss”
•Have child use side of pencil to smash the crease
97. Slant board or inclined work surface
For a child with fine motor difficulties like:
•Holding writing tool straight up
•Not resting wrist on the surface
•Neck, back, or eye strain
•Incorrect wrist posture
98. Stamps
Some items that make good handles are:
•Popsicle sticks
•Hair rollers
•Empty film canisters
•T-grip built from hot glue sticks
99. Alternate tools for painting
•Playtex sponge gloves
•Puff shower scrubbers
•Roll on deodorant containers filled with paint
100. Adapted scissors for severely physically less able child
•Battery operated scissors (on/off function)
•A helper is need hold the paper and turn the scissors
101. Stencils
•Fun way to extend painting activities.
•Child create something they and others can recognize.
102. Computer software to draw
Early childhood software having drawing/painting activities
103. The Left-Handed Child in a Right-Handed World
•We live in a right-handed society.
•The number of left-handed children seems to have increased in recent years.
•children who show early preference for the left hand should not be changed.
•Estimates range as high as ten to 15 percent of the population.
104.
105. Positions for Writing
•Paper Position
For manuscript writing, the left-hander should position the paper with the lower right corner a little to the left of the midsection. For cursive writing, the paper is slanted less, with the lower right corner pointing toward the midsection or just a little to the right of it. The strokes are pulled down toward the left elbow, whether manuscript or cursive is being written.
•Pencil Position
The writing instrument is held between the thumb and first two fingers, about an inch above its point. The first finger rests on the top of the pencil or pen. The end of the bent thumb is placed against the writing instrument to hold it high in the hand and near the large knuckle. The top of the instrument points in the direction of the left elbow. The writing should take place within the left half of the desk surface, i.e., to the left of the midline of the body. The paper should be shifted to the left as the writing progresses across the page.
106. Special Problems
•The Hooked Position
The hooked wrist is caused by incorrect paper position. In an effort to see what she or he is writing, the left-handed child often adopts the hooked position. This is a problem that should be dealt with early in the child's development, since twisting of the hand or wrist can be detrimental to legibility and fluency. A valuable aid in correcting the problem, once the habit has been formed, is the Zaner-Bloser Writing Frame.
•Reversals
The problem of reversals is common to the left-handed child. Most errors result from confusion between the lowercase manuscript d and b and p and q. Awareness of the problem and concentration on the formal teaching of left to right progression and forward and backward circles before introduction of the teaching of the manuscript letters b, d, p, and q result in fewer reversals of these letters.
•Chalkboard Work
Chalkboard practice is important because it lends itself to full, free arm movement and allows both the student and the teacher to easily spot incorrect habits. The position at the board for left-handed writing is similar to that for writing with the right hand, except that the eraser is held in the right hand and the chalk in the left, and the left-hander stands to the right of where the writing takes place for both manuscript and cursive. This is not true of the right-hander. The right-hander stands in front of his or her manuscript writing, but stands to the left of cursive writing because the downstrokes are pulled toward the body's midsection.
107. Special Provisions
•Left-hand scissors.
•Desks for Left-handers.
•Before students begin to write, demonstrate paper and pencil positions for the left-hander as well as the right- hander.
•It is often helpful for the left-hander to hold his pencil a little higher than the right-hander.
•The pencil points toward the left elbow, not toward the shoulder as the right-handers do.
•When given the proper attention and instruction, left- handers will write as well as right-handers.
