1. Hands In Motion Laura Turner, OT ELAWR Conference October 13, 2012

2. Learning Objectives Review the prerequisite skills for learning to print and to use scissors Discuss considerations for success Outline approaches for Exceptional Children Troubleshooting, Show & Share, Discussion

3. Hand Skills 101 Our hands are the tools that facilitate interaction in complex ways with the environment: allow us to engage in work and play, and to accomplish activities of daily living Effective use of our hands is a complicated process that relies on a complex interaction of: hand skills, postural mechanisms, cognition and visual perception

4. Hand Skills 101 Patterns of hand skills include: reach, grasp, carry, voluntary release, in-hand manipulation & bilateral hand use Social and cultural factors can play important role in acquisition and use of hand skills: e.g., limited exposure to tools and materials, cultural importance of objects and of play, safety concerns, familial preferences and perceptions related to child development (Case-Smith & O’Brien, 2010)

5. Are You Ready? The basic developmental prerequisite skills for printing and using scissors are: The ability to balance without the use of your hands The ability to grasp and release an object voluntarily The ability to use your hands in a lead/helper fashion

6. Are You Ready? The ability to interact with the environment at the stage of constructive play The ability to coordinate eyes and hands in an appropriate perceptual/motor fashion Previous exposure to a variety of sensory and motor experiences

7. Development of Printing Skills in Children TRACE, IMITATE, COPY, MEMORY 4-5 years of age: copies cross, square, left diagonal, right diagonal, some letters and numbers and may be able to print name 5-6 years of age: copies triangle, prints name, copies most upper and lower case letters

8. Considerations for Success 1)Is this a ‘just-right’ challenge? Skill level of an activity: goal is to provide a ‘just-right’ challenge (i.e., a good match between a child’s current abilities and the activity, with an appropriate level of challenge)

9. Considerations for Success 2) Does the child understand the sequence of events and/or what the finished product is to look like? Visual schedules, ‘to do’ list, example of finished product, support with transitions

10. Considerations for Success 3) Is the child in a position that is comfortable, supportive, and free from distractions? Ideal position: sitting in a chair with feet flat on the floor, back supported, appropriate table height alternate seating options will need to be explored for children with exceptionalities

11. Considerations for Success 4) Are the methods of getting and maintaining the child’s attention working? Paying attention to the first three considerations for success will promote attention to the activity at hand. decrease distractions, provide appropriate physical, visual and verbal cues, provide multi-sensory activities, be realistic about length of activity

12. Considerations for Success 5) Are the child’s efforts being reinforced? Is there motivation for the child to complete the activity? Addressing the first 4 considerations for success, turn-taking, model steps, verbal praise, rate own performance, show off final product

13. Approaches for Exceptional Children Developmental delays -work at the child’s developmental stage; make sure that expectations are realistic (name stamp) Motor planning issues -multisensory approach; consistency, repetition, 1:1 guidance and coaching

14. Approaches for Exceptional Children Developmental Coordination Disorder -Cognitive approach (CO-OP: Cognitive Orientation to Occupational Performance; CanChild resources) Physical disabilities -adaptive equipment; augmenting written communication with technology

15. Troubleshooting: Printing Printing IssuePossible Solutions Awkward/inefficient grasp of writing tool Use shorter writing tools (e.g., golf pencil, small pieces of crayon or chalk) Tuck small object between ring and pinky fingers and palm Position pencil point towards student and model picking pencil up Work on vertical surface Light pressure on writing tool Warm-up activities (squeezing, playdoh) Explore different objects using a light and a hard touch and discuss the difference Weighted pen Prang crayons

16. Troubleshooting: Printing Printing IssuePossible Solutions Tight grasp/hard pressure on writing tool Squeezing activities as warm up Explore different objects using a light and a hard touch and discuss the difference Use a mechanical pencil (lead will break if pressure too hard) Try printing on kleenex, tissue paper, napkin Not using helper hand Decorate tracing of helper hand and use as visual cue Warm up with bilateral activity (e.g., opening a container, pulling lego apart) Reluctant printer Review considerations for success If struggling with letter formation, implement printing program including multisensory activities, and variety of tools

17. Troubleshooting: Cutting Cutting IssuePossible Solutions Difficulty picking up scissors and orienting on hand correctly Song: Thumb in the little hole, fingers in the big hole... Colour code with stickers for thumb and finger Difficulty holding scissors Try alternate scissor styles: looped, automatic, mounted, padded Fiskars Difficulty opening & closing blades of scissors Warm up with squeeze play activities such as using games with tongs, spray bottles, playdoh, clothespins Use verbal cues “open, close” offering physical assistance as needed Practice: Snipping box Try spring-loaded scissors

18. Troubleshooting: Cutting Cutting IssuePossible Solutions Thumbs always turning down Song: Keep your thumbs up... Place small sticker on thumbnail and use verbal cue, “make sure you can see your sticker” Cut up towards the sky Cannot get the paper between the blades Practice cutting small strips of thicker paper Cut playdoh, other materials

19. Discussion Questions Sharing Ideas