1. School Readiness Skill Building from an OT perspective Paola Azzuolo OT Reg(Ont.) All Kids Can Fly www.allkidscanfly.ca Paola.azzuolo@allkidscanfly.ca

2. What skills are required to be school ready? Good Hand Skills Upper Extremity Control Grasp Patterns Bilateral Hand Skills Visual Motor Control Activities of Daily living. Self-Regulation www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

3. Hand Developmental Milestones Development of arches in the hand Development of wrist extension. Development of an awareness of the skilled side of the hand.. Development of an open web space. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

4. Upper Extremity Control This control comes from the ability to move your arm with precision as well as the ability to vary the strength or force of movement. Factors that contribute to upper extremity control are shoulder, forearm, wrist strength, and good body in space awareness. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

5. Grasp Pattern Development Fisted grasp: The pencil is held in a fisted hand with the point of the pencil on the fifth finger side of the hand. Child’s wrist is slightly flexed and forearm supinated. This is typical of children ages 1-1.5 years. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

6. Pronated grasp: The pencil is held with the all fingers and thumb with tip in thumb and index. This is typical of children ages 2 to 3 years. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

7. Static Tripod Grasp : Grasp with tip of pencil in the thumb, index and middle fingers, movement comes from arm and shoulder. This is typical of children ages 3-4 years. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

8. Dynamic Tripod Grasp: Grasp with tip of pencil in the thumb, index and middle fingers, movement comes from fingers while pinky side of hand rests on table. This is typical of children ages 4.5-6 years. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

9. Inefficient Grasp Patterns Five finger grasp: The pencil is held with the tips of all five fingers. The movement when writing is primarily on the fifth finger side of the hand. Thumb tuck grasp: The pencil is held in a tripod or Quadripod grasp but with the thumb tucked under the index finger.. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

10. Inefficient Grasp Patterns Thumb wrap grasp: The pencil is held in a tripod or Quadripod grasp but with the thumb wrapped over the index finger. Tripod grasp with closed web space: The pencil is held with the tip of the thumb and index finger and rests against the side of the third finger. The thumb is rotated toward the pencil, closing the web space. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

11. Inefficient Grasp Patterns Finger wrap: The index and third fingers wrap around the pencil. The thumb web space is completely closed. Flexed wrist or hooked wrist: The pencil can be held in a variety of grasps with the wrist flexed or bent. This is more typically seen with left-hand writers but is also present in some right-hand writers. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

12. Examples of Pencil Grasp www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

13. Bilateral Hand Skills Refers to the ability to use your hands together to accomplish a task. For example, when drawing, the pencil is held in the dominant hand & the non- dominant hand is preventing the paper from moving. Another example is when using scissors, the lead hand is operating the scissors & the assist hand is holding & turning the paper when cutting around a corner. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

14. Age Expectations for Scissor Skills 2-3 years: often holds scissors with two hands to open and close Begins to open and close the scissors with a mature grasp Learns to snip paper; there is no forward movement of the scissors May be able to use “helping hand” to hold paper and bring into scissors www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

15. Age Expectations for Scissor skills 3-4 years: Cuts on straight lines with some accuracy Cuts on curved lines and around corners, but without accuracy Begins to turn the paper with “helping hand” 4-5 years: Can cut fairly accurately along curved lines and around shapes Turns the paper fairly effectively with “helping hand” to stay on the line www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

16. Visual Motor Control Refers to the ability to coordinate eyes, arms & hands. Contributes to one’s ability to learn new shapes, cutting, drawing and writing www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

17. Age Expectations for Visual Motor Skill Development One year old: scribbles Two year old: imitates vertical lines, horizontal lines, paints Three year old: copies circles, imitates oblique lines Four year old: Draws a person with 3 body parts, copies a cross Five year old: Copies a triangle, draws a person www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

18. Activities to improve Visual Motor Integration Salt tray Clay tray: use gold tees to draw Shaving cream Popsicle sticks Pegboard or Lite Brite String colored beads with a pattern Sidewalk chalk Lacing Coloring Origami Flashlight tag Play catch with various balls www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

19. Activities to Promote Hand Skill Development Squirt bottles, turkey basters, eye dropper activities Bead stringing/lacing Pouring Practice opening different lids Spin tops or play with wind-up toys Various small writing tools (chalk, pastel) Pop Bubble Wrap Play dough/Silly putty Use of various tongs Tearing paper or crumpling paper into balls Handful of pennies into slots www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

20. Activities to Promote Handwriting Development Painting, chalk, coloring, Drawing people or homes or animals Building letters with straws or popsicle sticks Learn upper case letter formation before learning lower case. Use small writing tools Encourage top to bottom formation for vertical lines; left to right formation for horizontal lines (unless left-handed); and counterclockwise rotation for O, C, Q, G (unless left- handed). Recommend Handwriting Without Tears (www.hwtears.com) program for learning letter formation.www.hwtears.com www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

21. Correct Seating/Posture Look Out For: 1.Tables that are too high/too low 2.The students legs dangling from the chair without support under their feet What Can You Do: 1.Place the child’s feet on a couple of phone directories or a small stool 2.Raise the height of the chair or the table 3.90-90-90 rule www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

22. Dressing Skills One year old: Removes socks Puts on and takes off hat Assists with dressing Two years old: Removes shoes Pulls down pants Assists with undressing and dressing www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

23. Dressing skills (continued) Three Years: Can button large front buttons and zip and unzip a jacket if the shank is already connected. Four years: Able to insert the shank together to zip up a jacket with practice Five years: Able to dress independently depending on how much practice he has had www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

24. How to promote dressing skills Use backward chaining approach https://www.canchild.ca/en/canchildresour ces/resources/chaining.pdfhttps://www.canchild.ca/en/canchildresour ces/resources/chaining.pdf Visual schedules can be useful for some Best to encourage parents to work on such skills at bath time (for undressing) or during weekends as it needs not to be rushed. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

25. Self-Regulation Is a critical competency that underlies the mindful, intentional, and thoughtful behaviors of younger and older children alike. Self-regulation or Executive function refers to the capacity to control one’s impulses whether it be to stop a behavior or to start, if needed. Self-Regulation is not obedience or compliance www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

26. Development of Self-regulation skills Self-regulated children can delay gratification, suppress impulses long enough to think ahead to the consequences of their actions and to consider alternatives actions Not limited to the social-emotional domain Also applies to the cognitive behaviors such as remembering or paying attention. Self-regulation is ranked as the most important competency for school readiness www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

27. How to promote it? Eliminate waiting in line with nothing to do, wandering around the classroom during center time, being unclear about what to do during an activity, and not being able to get help. Rather, create a consistent classroom in which expectations are clear and fairly enforced and where children are engaged in meaningful activities at all times. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

28. Make-believe Play Mature, intentional make-believe play is foundational for self-regulation development in preschool All play is NOT created equal Make-believe play provides the three types of interactions which lead to self- regulation: 1.Regulation by others 2.Regulation of others 3.Self-regulation www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

29. Do you have any questions? www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

30. References American Occupational Therapy Association (2002). Occupational therapy practice framework: Domain & process. American Journal of Occupational Therapy, 56, 609-639. Bridgeman, M. (2002).The Finer Motor Olympics. Maine: Therapro, Inc Case-Smith, J. (2005). Occupational Therapy for Children. Missouri: Elsevier. Erhardt, R. (2009). Erhardt Developmental Products Hand Poster. Texas: Pro-Ed. Frick, S.M & Kawar, M.J. (2004). Core concepts in Action. Wisconsin: Vital Links. Henry, D. (2004). Sensory Integration Tool Chest: For Teachers, Parents and students. Arizona: Henry Occupational Therapy Services. Sena, L. (2004). Fingermania: Program for hand skill development. Maine: Therapro.Inc. www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca

31. Links http://www.choc.org/wp/wp- content/uploads/2014/11/Rehab-Developmental- dressing-skills.pdfhttp://www.choc.org/wp/wp- content/uploads/2014/11/Rehab-Developmental- dressing-skills.pdf http://dcd.canchild.ca/en/EducationalMaterials/r esources/dcd_scissor_skills_2013.pdfhttp://dcd.canchild.ca/en/EducationalMaterials/r esources/dcd_scissor_skills_2013.pdf https://www.naeyc.org/files/yc/file/201107/Self -Regulation_Florez_OnlineJuly2011.pdfhttps://www.naeyc.org/files/yc/file/201107/Self -Regulation_Florez_OnlineJuly2011.pdf http://illinoisearlylearning.org/tipsheets/self.pdf http://www.toolsofthemind.org/philosophy/self- regulation/http://www.toolsofthemind.org/philosophy/self- regulation/ http://developingchild.harvard.edu/resources/too ls_and_guides/enhancing_and_practicing_executi ve_function_skills_with_children/http://developingchild.harvard.edu/resources/too ls_and_guides/enhancing_and_practicing_executi ve_function_skills_with_children/ www.allkidscanfly.ca paola.azzuolo@allkidscanfly.ca