Sunday 21 June 2020

Play Doh Hide and Seek


This activity has been originally taken from one of the most popular and user-friendly guides, the Out of Sync Child Has Fun. I have done a couple of modifications according to own working experience. You may follow the book link to know more about Sensory Activities where there are great fun and learning activities have been described. 

This is a fantastic activity especially for little ones however teens would also enjoy it. It improves motor planning, fine motor skills as well as bilateral coordination (ability to synchronise both right and left sides of the body, for example, making a sandwich or playing throw ball). 

It improves the ability to discriminate objects with and without vision (tactile discrimination), proprioception sensory processing skills, midline crossing, and fine motor control, along with visual perception skills. Mainly it improves sensory awareness in the fingers required to provide information about the grasp of the tools, toys and surface. Reduced sensory awareness will require greater visual monitoring. 

The activity also improves attention span and concentration on the given task, along with hand and intrinsic fingers strength. Feeling, recognising and understanding about physical characteristics of objects (size, shape, density, texture, and weight) is an integral part of tactile discrimination which can be difficult for our kids with sensory issues.

We aim to make their fingers ‘feel’ of different textures in a fun way and improve their learning about various objects even when they are not seeing them! So let’s start!

Activity Requirements:

Plastic or rubber toys (such as Lego, plastic apple, small-sized ball)
Large and small buttons
Safety pin or hairpin
Different size coins
Rice or Lentil Box 
Container for sorting- Cup or jewellery box



1. Wrap the Play-Doh around the toy to make and make sure that it is not completely covered. The child should be able to see the colour of the toy which will work as a clue for her to recognise it easily. Once the toy is covered you may ask the child, “Do you know which toy is it.

2. Once the child is master in the above-mentioned task we can switch to the next level of effort. This time to increase the level of difficulty, pack the toy thicker and leave a small portion unpacked to grade the activity to the next level. Once the toy is packed you may ask the child, to recognise the toy using his fingertips and visual sense. 

3. The further variation could include covering small objects in the Play-doh such as coins, hairpins, beads, buttons and asking the child to feel the shape of the object covered with Play-doh and guess what it could be. These objects can be,

  • Different sized buttons
  • Safety or hairpins (make sure it does not injure him)
  • Different sized coins
  • Rubber
  • Small Lego pieces
  • Pen caps

  • Pack these objects fully. Now we can play treasure hunt. Hide the packed things in a box of rice or lentils. Initially, he can recognise and discriminate them without being time farmed or blindfolded. Later, on mastery of task gradation of activity will be great fun and challenge too! 

Activity Gradation:

Time Framed:
The activity can be challenged by grading it according to time. An adult may ask the child to recognise the toy within a set time limit such as 60 seconds or two minutes. Time should be allotted depending on the child’s abilities and needs. It is important to understand that activity should enhance his level of motivation to peruse and complete the given task successfully.

Target should be achievable. The child might lose interest in activity if she is unable to complete the task within the time frame. So make during the first attempt child should be provided sufficient time to complete the activity successfully. This will increase his level of motivation and self-confidence.

Time can be reduced, gradually, say, from 3 minutes to 30 seconds.

Once the toy is packed, leaving a small portion as a clue, ask the child whether she would like to do this activity being blindfolded.
If both child and parent think, it will be achievable, to recognise the toy, then go further and blindfold him. The child might take longer than usual time to recognise since his visual sense has been occluded. Parents should encourage her to use his fingertips sliding them around the edges and corners of the toy, to learn about shape, and size of it.

Help her to feel the toy where it is unpacked. This will help in improving tactile recognition and discrimination of the object. On the repeated practice of feeling different shapes, sizes, textures, density and weight (physical characteristics of objects) child’s touch discriminating abilities will improve to the maximal possible extent. At this level, pack the toy completely and thicker to increase the level of challenge.


· Tactile Discrimination: Playing with different textures which have varying viscosities increase tactile perception, exploration and discriminatory sense as well as visualisation skill along with In-Hand-Manipulations skills which involve translation.
·  Vast Tactile experience = Improvement in Tactile perception + discrimination 
·   Visualisation Skills
·    Body Scheme
·  Speed, Accuracy and Precision 
·  Fine Motor Skills
· Self-Esteem

Wednesday 22 April 2020

What is Motor planning?

Running, hopping, jumping requires a high level of Motor Planning 

Picture Credit: Google 

The ability to order, plan, sequence and execute a series of intentional motor actions. It is the ability to learn a new task, following all its sequential steps. It requires a person to be attentive.

Consider, when we try a new recipe for the first time, how much attention is needed to follow all steps. We are conscious about ingredients, water, salt, baking duration and all the other aspects to make the perfect dish. The way we react towards the above process is called as motor planning. Our brain is learning a new task, therefore, we need to pay more attention as compared to doing it for a second or third time.

We can frequently see infants doing motor planning process. A child perceives, hold, and explores spoon or rattle at 7 months, mouths it at 8 months and bangs it on different surfaces (table, floor) to hear different sounds. So here, the brain first learns to hold the spoon than to put it in the mouth and later banging. This process needs attention. More he learns to move his body in different directions, better is motor planning. Since planning involves conscious attention, therefore, it is connected to metal and logical functions.

A child initiates crawling at 7 -8 months and starts to enjoy it as soon as he masters it. He uses large joints which are essential for the development of higher brain centre’s functioning and motor planning abilities. Crawling, kneeling, standing, walking are all components of developmental milestones that require a child’s attention to developing postural balance and control. Initially, child plans and then executes actions slowly in sequential order, which is later called as developmental progression and locomotion.

Brain prepares messages and sends them to a different group of muscles in the upper and lower body. This causes muscles to contract and relax. Further to this, the joint movement takes place to perform the desired action. Different day to day chores which we perform without thinking much needed a lot of attention when we learned in childhood. Putting on clothes, holding knife or spoon, making a cup of coffee, doing laces or ties, time-telling are examples of tasks which a person learns in childhood with much attention and practice, however, once understood it becomes the neural memory for future times. On repeated practice, it is called as Motor Skill.

If the child has poor motor planning, he may be Dyspraxic.
He might not able to get an idea to perform, plan, and execute any task on his own. In such cases, teachers and parents need to provide cues for given tasks. Encouragement, supervision, and consistent practice are key to teach any tasks, such as handwriting and tooth brushing. Following all the steps in a sequential manner is important for a child to learn this task.

Handwriting skill requires a high level of motor planning, planning and execution of actions.

Let’s contemplate an example of poor motor planning, during one of my OT sessions, I asked a pupil to take off his shoes and sit on the mat. I got engaged in other tasks and observed him from another corner of the room. He untied the laces with hit and trial method and then stopped. I asked, “you okay?” He politely responded, “what do I need to do now?”

The poor little lad did not have any idea, how to take off his shoe from the foot. His brain couldn’t do the sequencing of actions, that after untying lace he needs to pull off the shoe from feet.

Climbing and descending stairs need complex motor planning and children with poor skill show anxiety to use staircase or escalators. Fear of falling or tripping makes them avoid stairway. Doing practice on climber frames is one of the ways to reduce anxiety. Making staircase of different size mattresses can be safe, appropriate and fun ways. 

Classroom Strategies for a child with poor body planning Intervention Strategies:

Star Jumps: These are good to involve whole-body coordination.

Animal Walks: Walking like bear, the elephant will improve body sense

Marching: This also involves coordination between both sides of the body, can be difficult. Initially start with feet marching, once mastered, then include arms.

Play Hopscotch: This will give distance and space judgement.

Commando Crawling: Involving both hands and feet.

Body Paint: Ask the child to paint his particular body parts such as a right-hand or left-hand index finger.

Body Image: Ask the child to draw around his partner’s body on the large sheet and label body parts.
Swimming: Will give tactile and proprioceptive input.
Obstacle courses: Make obstacle courses and ask the child to complete them in different positions (supine, prone, kneeling) while sitting on a scooter board.

Target Games: Activities involving trunk rotation and both sides of the body should be incorporated such as throwing bean bags while picking from the left and throwing them to the right side. Throwing them in hoops, buckets or bags can be done.

Hiding Objects Games: Hide different objects in the room and ask the child to find them. Two things can be hidden together such as lock and key.

Involve in-home chores: an Involving child in kitchen activities asking him to give you different items needed will help to develop under-over, left-right concept. You may ask him to put the cake for baking in a lower-most shelf of the oven.

Tunnel Games: Crawling in the tunnel is a

fun activity.
Climbing Activities: Climbing frames, monkey bars, ladders, ropes or slopes.

Friday 23 June 2017

What's wrong with W-sitting?

W-sitting is when a child sits on their bottom with their knees bent and feet positioned outside of their hips. In this position child sits on his bottom and knees are bent, feet tucked under and legs are splayed out to side, what looks a “W”.

In this position child’s base of support (BOS) is wider and his centre of gravity (COG), is lower allowing for increased stability through the pelvis and trunk.
Children find this position convenient for play as they do not have to work on maintaining their balance while concentrating on the game or task in hand.

                     Why is W-sitting problematic for children?

While sitting in this position, children cannot achieve active trunk rotation, and cannot shift their weight over each side. Weight shifting and trunk balancing are important aspects for developing core strength and midline crossing skills (essential for handwriting and hand dominance).
Due to affected midline crossing development, bilateral coordination is also affected, the skill essential for doing two handed activities such as skipping, throwing, catching, kicking, buttoning, doing laces or ties.

                               Consequences of W-Sitting

•    Hips and leg muscles to be shortened and tight.

•    Back or pelvic pain

•    Pigeon toed walking or in-toeing (feet turned in while walking)

•    Flat foot

•    Difficulties performing two-handed activities (e.g., buttoning)

•    Poor hand preference or dominance (e.g., handwriting difficulties)

•    Lack of cross body movements (e.g., throwing, catching)

•    Limited trunk movements (e.g., copying from the whiteboard)

•    Likelihood of hip dislocation (if child has hip problems)

                             Strategies to prevent/improve W-sitting

Children do W-sitting when core strength is an issue. Reduced core strength causes poor posture and over-compensation of other muscle groups.

The following strategies can be helpful minimising W-sitting posture: -

1.Encourage a child to sit in different ways, such as: -
•  Prone position (on stomach and forearms)

•    Criss-Cross Sitting (Crossed Leg Sitting)

•    Side Sitting (alternate sides)

•    Long Sitting (feet straight out front)

2.Ask the child to get up and bring something from next room such as cushion, favourite toy or game.

3.Remind the child to “fix their legs” whenever you see them sit in a W position.

4.Alternate ways to sit such as a beanbag, low chair, pillow, to sit on, or suggest him to lie on his tummy.

5.Exercises such as stomach crunches, the plank can be beneficial in improving core strength.

6. Anticipate and catch it before the child tries to sit in W-sitting.

7.Offer the child a small chair or stool as an alternative to sitting on the floor.

We should expect young children to move in and out of positions when sitting on the floor - that is natural and the way kids stay alert and learn to manage their bodies in space. Just as one size does NOT fit all, one sitting position will never accommodate the sitting needs of all children. Young children learn best when their bodies are safely and comfortably positioned!


American Journal of Occupational Therapy:

The Pathways. Org:

Image source: Google images

Sunday 5 March 2017

Body awareness: Why is it so important?

Poor Body Awareness = Poor Motor Planning =Poor Gross & Fine Motor Skills

Body awareness is about understanding where our bodies are in space, as well as where and how we move them.
It is the internal awareness sense of the body, and its function is to make our body aware about, where it is, in relation to the environment.Body awareness is developed through proprioception sense and kinaesthesia. 
Moreover, it can be explained as knowledge of the boundaries of the body and its movements within space.For instance, it lets us know where is our right hand or left leg and what is the relationship between the two.
This develops since 9th -12th months in an embryo and completely develop by the time child is 5 years. Infants learn about their bodies and its relationship to surrounding on them during the normal course of development. Exploring, and manipulating objects is a process of developing body scheme. As they grow they learn about distances and sizes.

How does body awareness act on our body?

Our brain has body “maps” which carry information about every body part and its relationship to each other.

These maps support person to realise how his own body feels like when vision is blocked. Body awareness tells about the "doing sense" of the body without looking at different body parts. For example, scratching our back when it itches or wiping face when it has dirt on it. There are so many actions which are taken as for granted by us however our brain and body works phenomenally to process sensory information from the brain to various sensory systems. 

In above face wiping example, the brain sends messages to elbow so that specific muscles can contract and relax to bend elbow joint and hand can go up to face to clean the dirt. Related hand muscles also contract and relax.

We are able to put the lid on water bottle or pen without looking at it, control tap faucet while talking to someone, are some of the examples of body's "doing sense" while we are busy focusing on primary tasks. 

Our body's ability to change its posture unconsciously, when muscles of the particular group are fatigued in one position is a strong example body awareness.This process happens automatically while are sleeping or awake. 
Our proprioception receptors update these body “maps” (precepts) which helps the
brain in sending messages to needed body part for further actions. 

In children with the poor body awareness, the relationship between body actions and these “maps” do not work well. Due to poor functioning of body percept, the brain is not able to plan actions leading to poor motor planning. This is the reason children with Dyspraxia are disorganised, forgetful and clumsy. Their brain is not able to do motor planning causing them not being able to judge speed, weight rate, the direction of any object or task. 

Moreover, these maps also contain memories related to environment such as gravity. For example, while sitting on swing we know our upper body is on swing however legs are swinging. 

Another common example is while swimming whether our body is in deep or shallow water. In both the situations, body maps help the brain to plan the movements according to the state of the body.

Signs and Symptoms: 

1) Might bump into other people or stand in very close proximity to other people when interacting with them.

2) May have organisational difficulties in the classroom as well as home.

3) The concept of right and left, up-down, under-over, in-out is confusing for children to understand and learn therefore following directions is a difficult task.

4) For children with poor body awareness subjects like mathematics, physics are difficult to understand. Geometry, shapes, volumes, calculations are hard to understand.

5) Copying from the blackboard is a struggle for them due to midline crossing difficulties.

6) There may be difficulty while playing football or cricket. Judging distance and speed of ball can be an issue.

7) Body Awareness also interferes with learning since child’s brain is not able to do motor planning resulting in poor control over tasks. e.g. self-care. Usually, these children also have laterality and coordination difficulties. They can be ambidextrous.

Tips for improving Body Awareness

1) Visual Feedback: Learning new task is challenging for them, especially, gross motor skills such as jumping jacks, synchronised opposite sideways or same side jumping, or skipping. Most of the gross motor tasks require proprioceptive input, received through muscle and joint receptors, however, due to poor proprioceptive sensory processing, the child faces  difficulties in performing new dance steps, actions or exercises. These children should be given regular visual feedback through a mirror which can support them seeing what they are doing in order to learn and manipulate their body in the correct manner.Moreover, repetition of novel tasks is important.

2) Heavy Work Activites (Proprioceptive Input): Pushing and pulling heavy objects such as barrels, cart, large bean bags, pile of chairs or pushing another child on swing will provide muscles and joint receptors information about position of body parts (leg, arms, head and trunk) in space and in relationship with other objects.These activities provide deep pressure to muscles, joints, ligaments and key points (shoulder, pelvis and hips) to the tactile defensive child.Moreover, living movement break will support the child to concentrate better in studies such as sending him to the office to handover papers or asking him to distribute assignments in the classroom.

Hippotherapy: This therapy is used under the supervision of an occupational therapist. This process involves riding a horse with simultaneous involvement of a variety of therapeutic activities. Riding a horse provides various kinds of sensory information including, tactile, visual, proprioceptive and vestibular.Maintaining positions, staying alerted while riding, facilitates postural control and balance. This therapy helps in developing balance, core body strength (changing different positions, supine, prone, quadruped), as well as midline crossing, weight shifting and upper and lower body control. Resource

4) Obstacle courses: Make obstacle courses and ask the child to complete them in different positions (supine, prone, kneeling) while sitting on a scooter board.Engaging children into creating obstacle courses will support Dyspraxic children in developing ideation, planning and execution skills. Moreover, moving on the swing, through the tunnel, over the bench will help in developing spatial awareness concepts in relationship to the environment.

3) Animal Walks: Walking like a bear, the elephant, a duck or a seal will improve body sense.It will help in developing body's internal awareness. Additionally, animal walks provide proprioceptive-vestibular inputs activating sensory processing systems. Along with this, core body strengthening, balance, postural control of upper and lower body develops supporting the child to perform better in gross motor and fine motor skills.

5) Involve in home chores: Involving the child in kitchen activities such as asking him to give you different items needed will help to develop under-over, left-right concept. You may ask him to put the cake for baking in the lowermost shelf of the oven or put in dishes within the dishwasher. Doing work like car washing, vacuuming, cleaning, mopping will give proprioceptive feedback. Tasks like preparing to dine  (putting cutlery on the table, with correct position of utilities) will help in developing left, right, top, bottom concepts.

6) Target Games: Activities involving trunk rotation and both sides of the body should be incorporated such as throwing bean bags while picking from left and throwing them to the right side. Throwing them in hoops, buckets or bags can be done for proprioceptive input.Moreover, throwing balls, rings, darts at targets from various distances can be helpful to improve visual motor skills.Activities, like tossing balls and playing bat ball, will improve eye-hand coordination too.

7) Body Paint: Ask the child to paint his particular body parts such as right-hand or left-hand index finger. This can be a great fun activity for sensory seeking seekers and children with tactile discrimination difficulties. Drawing different shapes, letters and numbers on hand, leg and back will help in improving body awareness as well as self-concept.

8) Hiding Objects Games: Hide different objects in the room and ask the child to find them. Two things can be hidden together such as lock and key.Throwing balls ring darts, at the target. 

9) Confined Space: Children should be given small, organised spaces to work in as they feel secure and confident in confined spaces compared to large space areas.

10) Handwriting difficulties: This is a concern for children with poor body awareness. To know more, read the article.  

Friday 6 January 2017

Why should we use Visual Support System?

Many children with ASD, ADHD, SPD respond positively to schedule charts, sign posters, and other visual strategies. This form of information presentation encourages them to communicate appropriately and helps to develop language and process information. Thus, it helps them to be more independent and self-confident to verbalise or make other understand their own feelings.

Visual strategies can be purposeful for expressing and understanding feelings and emotions, while going through transitions or changes, visiting a new place or meeting a new person.

A visual schedule is a representation of what is going to happen throughout the day or within a task or activity. It helps in carrying out life skills activities or task in hand in a planned manner and reduces high levels of anxiety 

It encourages structure and organisation in daily routine.

It can be in form of timetables, behavioural sheets, safety charts, activity sequencing for self-care skills (example-tooth brushing) or independent living skills (driving, sex education), emotion’s chart, social skills, instructions or reminders.

Marlene J. Cohen and Donna Sloan are authors of book Visual Supports for People with Autism: A Guide for Parents and Professionals (2007) which highlights the significance of visual support strategies for children and adults with autism.

Children with ASD often display anxious behaviours or act out when their routines change or they are in unfamiliar situations. Visual reminders can support them understand what to expect and what will happen next to reduce the anxiety. They help them to pay attention to details and understand situation visually in a better manner.

One of the main problems of people having ASD is social interaction, using language and repetitive behaviours. They have difficulties understanding instructions and display limited interests in activities. A visual support system helps in countless areas helping the child to work systematically and rationally.

Finally, some children with ASD are anxious or act out when their routines change or they are in unfamiliar situations. Visuals can help them understand what to expect and will happen next and also reduce anxiety. Visuals can help them pay attention to important details and help them cope with change.

Often ASD children get anxious due to changes in routine, classroom schedule, while meeting new people, and in unfamiliar situations. Visual support strategies can help them understand what to expect and when will it happen. Rather than getting panicked, agitated, angry, and anxious these children can look into the picture cards, or visual charts and follow the plan.

Moreover, parents’ teachers can easily communicate with them using visual reminders. This decreases frustration and may help decrease problem behaviours that result from difficulty communicating. Visuals can promote appropriate, positive ways to communicate.

The visual schedule breaks down the activity into multiple steps so that child can understand, plan and execute the task easily and complete the task (e.g. life-skill, such as brushing, shoe lace tying) successfully with reduced anxiety levels. According to Zigmond et. al (1999), anxiety caused by any reasons can aggravate sensory defensiveness in children with sensory modulation difficulties. Therefore, to minimise the sensory issues, caused due to raised levels of anxiety and stress visual reminders can be a helpful tool to a great extent.

Furthermore, anxiety resulting due to lack of information or fear of unfounded apprehension results in concentration difficulties, restlessness, hyperactivity, distractibility as well as learning abilities.

The manifestation of anxiety has been found to be associated with complex brain structure, known as limbic system and components of the reticular system.
It is better to have a portable schedule such as on a clipboard or a   binder or it can be fixed to a permanent place such as child’s bedroom or washroom wall or refrigerator. 

Fundamentally, the schedule should be visible to a child frequently and easily so that he can access it before or while performing planned task. Initially, verbal cues such as “check your schedule” can be prompted if a child gets baffled to perform any task.

Resources for Using Visual Supports: 
Eckenrode, L., Fennell, P., & Hearsey, K. (2004). Tasks Galore for the Real World. Raleigh, NC: Tasks Galore. 


Autism Speaks (

National Autistic Society (

Bernard-Opitz, V, and Häußler, A. (2011) Visual support for children with autism spectrum disorders: materials for visual learners. Shawnee Mission, Kansas: AAPC Publishing  Bondy, A. and Frost, L. (2011).

A picture’s worth: PECS and other visual communication strategies in autism. 2nd ed. Bethesda, Maryland: Woodbine House  Cohen, M.J. and Sloan, D. L. (2008) Visual supports for people with autism: a guide for parents and professionals. Bethesda, Maryland: Woodbine House