Dyspraxia

Dyspraxia is a neurological disorder that affects physical coordination and movement. It is also known as the Clumsy-child Syndrome, Developmental Coordination disorder (DCD) and Motor Dysfunction. 

Under Dyspraxia the problem with coordination is caused by a disconnect between the brain and the body. The brain of a dyspraxic child is unable to get the body to do what it wants. 

Dyspraxia can have a range of effects such as inability to plan, coordinate, organize, move or perform actions. It has nothing to do with intellectual or physical deficits but is linked to immature neurological development. 

What causes Dyspraxia?

There are no known obvious causes of Dyspraxia. Most professionals attribute the condition to immature neural development. Nerve cells in the brain may not develop properly as a result of premature birth or brain damage during gestation. Low birth weight and other pregnancy related issues can also result in DCD. 

Like most other disorders Dyspraxia can also be hereditary i.e. children with a family member similarly affected are at a greater risk than other children. 

What are the signs of Dyspraxia?

Signs of Dyspraxia are present from very early on but a definite diagnosis cannot be made until a child is 5 years old or more since each child varies in their developmental stages. 

Symptoms tend to vary depending on the age of the person however the condition causes difficulty in following key areas:

  • Fine and Gross motor skills
  • Motor planning
  • Coordination

The most common signs of dyspraxia are:

  • Delayed developmental milestones (such as crawling, walking, potty training etc.)
  • Unusual body positions
  • Poor balance, posture and hand-eye coordination
  • Poor spatial awareness
  • Body coordination problems (problems with running, writing, playing)
  • Accident prone 
  • Feeding and sleeping problems
  • Fatigue and clumsiness
  • Frequent temper tantrums 
  • Restlessness, irritability and fidgeting  

What can help kids improve?

Dyspraxia is not completely curable but can get better with therapeutic intervention. Some symptoms of dyspraxia may even resolve with age. The earlier the intervention starts the better are the results. 

Usually treatment entails therapy which allows a child to better manage the symptoms and enhances their abilities. Specialists such as occupational therapists, Speech-language therapists, psychologists, behavior-analysts and pediatricians most commonly treat children with dyspraxia. Treatment plan is generally tailored to your child and depends on the severity of condition, age of the child and presence of any coexisting conditions.

How can I support my child at home?

  • Provide praise and encouragement to your child.
  • Use simple instructions.
  • Provide breaks and an opportunity to pause what they’re doing. 
  • Break large tasks into smaller ones.
  • Alter materials of use e.g. using a pen grip or a lined paper to facilitate writing. 
  • Introduce alternatives to writing e.g. matching, typing or coloring can replace writing since writing can be frustrating for a dyspraxic child.
  • Always be prepared to help with tasks that involve fine motor skills e.g. cutting or folding.
  • Use visual aids as much as possible. 
  • Set realistic goals for all tasks to be performed.
  • When teaching a new skill, start with small and less difficult steps and build on them.
  • Recognize their strengths and provide opportunities to succeed.

If you think your child is struggling with physical coordination and movement, talk to our professional therapists to find out how you can help your child cope with these motor difficulties. 

Dysphagia (Feeding and Swallowing Difficulties)

Dysphagia means difficulty in swallowing. Swallowing happens in three phases. A child with Dysphagia can have a problem in either of these stages:

  1. Oral stage 
    Transporting food or liquid to the mouth and into the throat. (e.g. chewing, sucking)
  1. Pharyngeal stage
    Swallowing begins and the food is squeezed down the pharynx (throat). The epiglottis closes off the passage to the windpipe so food doesn’t go into the lungs.
  1. Esophageal stage
    The esophagus (tube that goes from the mouth to the stomach) squeezes food down to the stomach.

Dysphagia can cause inability of food and liquids to pass from a child’s mouth to the throat and through the sophagus to the stomach. 

Causes

Dysphagia is caused by structural problems and weak or damaged muscles/nerves in the mouth, throat, or esophagus. Dysphagia is most commonly associated with:

  • Brain damage and defects
  • Nervous system disorders e.g. Meningitis
  • Neuromuscular disease 
  • Premature birth or low birth weight
  • Prenatal malformations
  • Heart or lung diseases
  • Head or neck problems
  • Gastroesophageal disorders (reflux or other stomach problems)
  • Cleft palate or lip
  • Autism
  • Foreign bodies in the esophagus
  • Large tongue or tonsils
  • Tumors or masses in the throat

Signs and symptoms

Symptoms may present differently in every child. Some common symptoms of dysphagia are as follows:

In infants:

  • Difficulty in sucking and swallowing
  • Gagging during feeding
  • Drooling
  • Food or liquid coming out of the nose during or after feeding
  • Frequent spitting up or vomiting
  • Irritability while feeding

In children:

  • Trying to swallow a mouthful of food several times
  • Eating slowly
  • Feeling like food or drink gets stuck in the throat or feeling like there’s a lump in the throat
  • Coughing or choking while eating or drinking
  • Chest congestion after eating or drinking
  • Feeling like food or liquids are sticking in the throat or esophagus or feeling like there’s a lump in the throat
  • Prone to respiratory infections 
  • Voice changes (Wet or raspy sounding voice) during or after eating during or after eating
  • Frequent respiratory infections
  • Weight loss

Treatment:

The treatment plan usually depends on a child’s age and severity of the symptoms. Specialists such as Speech-language therapists, occupational therapists, gastroenterologists, pulmonologist and pediatricians most commonly treat children with dysphagia.

An SLP or feeding team may suggest:

  • Medical treatment
  • Feeding therapy
  • Changing feeding/eating position
  • Changing texture, temperature or type of food intake
  • Changing feeding equipment or utensils 
  • To get your child to try new foods 
  • Seeing another professional, like a psychologist 

What role can you play:

  • Ask questions from an SLP/OT in order to understand the problems your child has.
  • Accompany your child during treatment.
  • Follow the suggestions your therapist makes .
  • Discuss your child’s situation at their school and with family members.
  • Discuss your child’s progress with the therapist.

If you child suffers from Feeding and swallowing difficulties and you want to learn more about how you can support them please do get in touch with our skilled occupational therapists and speech-language pathologists.

Sensory Integration

Sensory integration is a process whereby the brain organizes and interprets sensory experiences. Sensory experiences include touch, taste, smell, sight, movement and body awareness.

Those who suffer from sensory processing issues have trouble organizing or processing information coming in through their senses. Sensory processing issues are also known as sensory integration disorders or sensory integration dysfunction. 

People with sensory integration disorder can be over-sensitive, under-sensitive or both towards sensory inputs. For over-sensitive individuals’ sensory input can be too overwhelming due to which they might try to avoid any sort of sensory stimulation. On the other hand, individuals who are under-sensitive to sensory input might be more seeking of sensory stimulations. 

What factors affect the sensory integration of a child? 

There are no absolute known causes or risk factors of sensory processing issues. However, family history of similar disorders and birth complications might make it more likely for a child to develop sensory processing issues. 

Sensory integration issues are most commonly associated with OCD, ADHD, ASD and other developmental delays. These conditions are not a cause of Sensory processing issues but have been seen as co-occurring with it. 

What do difficulties with sensory integration most commonly look like?

People with sensory processing issues might be sensory avoiding or sensory seeking.

Sensory Avoiding:

If a child is over-sensitive to sensory inputs and gets easily overwhelmed by sensory stimuli, they are more likely to be sensory avoiding. In this case they are more likely to react in the following ways when exposed to any type of sensory input:

  • Easily overwhelmed by people
  • Seeks out less noisy or crowded places
  • Easily bothered by bright lights and loud/sudden noises 
  • Refuses to wear clothes that are slightly uncomfortable
  • Avoid touching other people  
  • Have trouble trying new things (foods, places)
  • Have a strong reaction to the texture or smell of certain foods
  • Minute changes to their environment might upset them to large extent

Sensory Seeking:

Kids who are under sensitive to sensory input seek sensory stimulation. Here are some signs you might see in a child who is under-sensitive to sensory inputs: 

  • Constantly touches things
  • Takes physical risks while playing
  • Have a higher pain threshold
  • Is constantly squirming and fidgeting
  • Are more likely to invade other people’s personal space
  • Gets easily distracted
  • Are more accident prone
  • Are more clumsy 

Signs and symptoms of sensory processing issues are not limited to the five major senses of sight, smell, taste, touch and hearing. It also includes lesser-known senses such as Interoception (helps you understand and feel what’s going on in your body), proprioception (body awareness or a sense that tell us where our body parts are) and the vestibular sense (helps keep you stable and upright)

Treatment for sensory processing issues?

sensory processing issues are usually treated through therapy. Therapy sessions led by a trained therapist can help children manage the challenges they are facing. There are different types of therapy currently being used to treat sensory processing issues:

  1. Sensory integration therapy: This type of therapy teaches a child to experience stimuli without feeling overwhelmed through different types of activities. A therapist can help a child deal with different sensory stimuli and help them formulate regular, everyday responses towards sensory inputs. 
  2. Sensory diet: A sensory diet is not a typical food diet but consists of sensory activities for children. Sensory diet is mostly customized based on a child’s needs and might include activities such as allocate time for walking every other hour or listening to music while working.
  3. Occupational therapy: A child might also need occupational therapy to help with symptoms related to sensory processing issues. OT can help with fine motor skills, gross motor skills and teach everyday skills to children with sensory processing issues. 


Sensory-friendly games and activities for home

  • Scratch-and-Sniff Painting
    Scratch-and-sniff painting appeals to children’s tactile and olfactory senses. Have the children mix a few drops of extracts such as peppermint or orange etc. to paint. Let your child paint on cardboard or heavy paper. Once the painting is complete and dry, one can rub their fingertip over it to reactivate the smell.
  • Play-Doh
    Using clay or play doh strengthens fine motor skills. Try hiding small objects in a ball of dough for your child to find or ask them to roll it or make things out of the dough. 
  • Twister
    This classic game is a great way for kids to improve proprioceptive and vestibular senses. 
  • Music and Dance Party
    For kids who are sensory seeking a simple dance party can prove to be helpful. Put together a child-friendly playlist and let them dance to it. 
    In addition to that they can make their own music at home as well to seek auditory and tactile stimulation. By using things at home such as string and shoeboxes, or pots and pans with a spoon etc. different sounds can be produced by a child. 
  • Cook or bake food
    This is most likely to appeal to a child’s tactile and olfactory senses. Kneading dough or rolling it to form round cookies will allow them to work with their own hands.  

If your child is showing sign of sensory processing disorder and you want to learn more about how you can support them please do get in touch with our skilled occupational therapists.

Genetic Syndromes

There are a large number and variety of genetic disorders and syndromes diagnosed in children that require occupational therapy to alleviate symptoms. Syndromes may present characteristic symptom patterns such as  orofacial anomalies, limb length, organ anomalies, abnormal muscle tone and hyper-mobile joints. Examples of these syndromes include: Down syndrome, Edwards’ syndrome, Patau’s syndrome, Turner’s syndrome, Carpal tunnel syndrome, Asperger’s syndrome and Rett’s syndrome

Genetic syndromes often have associated various health problems with them such as cardiovascular abnormalities, obesity, respiratory infections, thyroid deficiencies, visual or hearing impairments, sensory processing issues etc.

An Occupational therapist with a team of specialists such as SLP, pediatricians implement various strategies to help these children achieve their optimal level of functioning.  

 

1.     Down’s Syndrome

Down syndrome is a condition in which a person has an extra chromosome. This extra chromosome causes problems as the brain and physical features develop. It can result in following difficulties:

  • Reduced muscle tone
  • Muscle weakness
  • Poor grip
  • Coordination difficulties 
  • Poor fine and gross motor skills 

A professional occupational therapist is able to provide effective treatment and assessment of the types and severity of symptoms of Down’s Syndrome. After initial assessments a detailed treatment program is designed for a child in collaboration with the parents.

An occupational therapist helps children learn skills to make them more independent and less reliant on their caregivers. Goals of the treatment could be:

  • Fine motor improvement 
  • Gross motor improvement 
  • Improved grip (e.g. handwriting or carrying objects)
  • Improved social skills
  • Increased independence in daily life skills such as getting dressed

2.     Asperger’s Syndrome

Asperger’s syndrome is technically no longer a diagnosis on its own; it is a part of Autism spectrum Disorder (ASD).  ASD is a spectrum of related conditions with shared symptoms. Asperger’s syndrome is a “high-functioning” type of ASD i.e. its symptoms are less severe than other kinds of autism spectrum disorders.

Asperger Syndrome affects each individual and family differently so an occupational therapist collaborates with parents to design a treatment plan best suited for a child. 

An Occupational therapist helps children improve their motor, social and sensory integration skills to minimize the impact of Asperger’s syndrome. For Asperger’s syndrome an Occupational therapist aims to: 

  • Help teach the child how to act in certain social situations
  • Support children in transitions – such as starting school
  • identifies the difficulties and how they impact daily life in order to provide adequate treatment 
  • Developing routines and structure to help manage daily life 
  • Builds physical skills (strength and coordination)

 

3.     Carpal Tunnel Syndrome 

Carpal tunnel syndrome is a common condition that is characterized by pain and numbness in the hand and arm. It occurs when the median nerve is compressed as it travels through the wrist. Early diagnosis and treatment of Carpal tunnel syndrome is very important since if the pressure on the median nerve continues it can lead to nerve damage.

An occupational therapist usually puts splints on the affected area, suggests exercises, and massages to alleviate pain. Occupational therapists aim to reduce the impact of Carpal tunnel syndrome on a patient’s life. An occupational therapist can treat a client with Carpal Tunnel Syndrome in the following ways:

  • Splinting 
  • Introduce minor aids and useful gadgets for use around the house 
  • Suggest exercises to strengthen the hand, wrist, and shoulder
  • Advice on routine structure and incorporating rest.

4. Retts syndrome

Rett syndrome is a rare genetic neurological disorder. It is characterized by severe impairments impacting a child’s ability to speak, walk, eat, and breathe easily. Complications of Rett syndrome can include seizures, scoliosis, and sleeping problems. Severity of symptoms of Rett’s syndrome varies from person to person 

Occupational Therapy can support a child with Rett’s Syndrome in the following ways:

  • Teaching and expanding in different life skills 
  • Help teach the child how to act in certain social situations        
  • Support children in transitions – such as starting school
  • Fine motor improvement 
  • Gross motor improvement 
  • Developing routines and structure to help manage daily life.
  • Increasing independence in daily life skills 
  • Builds physical skills (strength and coordination)
  • Set functional and achievable goals for a child
  • Educating parents/caregivers and teachers about Rett Syndrome and the skills a child should be demonstrating
  • Introducing minor aids and useful gadgets for use around the house to assist the child to participate in daily activities

Daily life skills

Life Skills include all necessary and meaningful activities carried out in our daily lives. Activities of daily life include grooming, dressing, feeding, toilet-use, bathing etc. These important life skills allow us to deal effectively with daily-life challenges.

Daily life skills for children and adolescents are divided into cognitive, emotional and interpersonal/social skills.

Cognitive skillsDecision-making
Problem solving
Critical thinking
Learning abilities
Creative thinking
Emotional SkillsSelf-awareness
Self-management
Interpersonal/social skillsCommunication skills
Social awareness
Relationship maintenance

Some people might be unable to carry out these tasks of daily lives with ease and might need the help of a professional.

Occupational therapy for daily life skills

An occupational therapist identifies limitations with functioning and designs a treatment plan aimed at maximizing independence and responsibility for daily activities. An occupational therapist aims to develop psycho-social competence in a client by teaching them constructive behaviour about well-being.

In case of temporary deficits an Occupational therapist identifies a patient’s limitations and teaches them skills necessary to return to independence. However in case of permanent deficits or limitations a therapist teaches the client new methods and skills to cope with these limitations or introduces the use of adaptive equipment.

An occupational therapist might be able to support your child’s developing life skills in the following ways:

  1. Breaking the task down: Occupational therapists break activities down into teachable steps and then show children what is expected of them in different tasks of daily lives. 
  2. Involve in fun play: If your child is into trains, planes, rockets, Lego or dolls an occupational therapist uses these things in your child’s sessions as a teaching tool to build essential life skills.
  3. Understanding the environment:Therapist understands the impact of the environment on children and develops strategies that can help a child cope better in the environments they have a difficulty in or they find challenging.

A professional occupational therapists who specialises in supporting children in gaining independence and responsibility in daily life skills can be a fantastic ally for any child or family who needs support with life skills. If you are worried about your child’s life skills progress  and want to learn more about your role in the process please do get in touch with our skilled occupational therapists.

Emotional Regulation

Emotional regulation is one’s ability to recognize, process and act upon emotions that one feels. Emotional regulation or managing emotions is a skill people acquire over time. Some people might be unable to regulate or manage their emotions effectively.

Emotional regulation allows individuals to respond to social situations with adequate emotions i.e., it enables a person is able to initiate, inhibit or modulate behavior in order to garner social acceptance.  

What do difficulties with emotional regulation most commonly look like?

Children who face a difficulty recognizing and managing their emotions might commonly display the following signs:

  • Frequent outburst and tantrums when things don’t go according to plan.
  • Might get overly excited.
  • Have difficulty recovering from disappointment.
  • Get easily anxious in social settings.
  • Have difficulty focusing or paying attention.
  • Inadequate social skills.
  • Reduced interest in playing with other children.
  • Might get easily upset, frustrated or worried when minor changes occur around them.

Emotional Regulation Training 

An occupational therapist can use structured programs including a variety of cognitive and sensory strategies to support emotional regulation for a child. A professional occupational therapist equips children and their families with the skill set required to regain control of their actions and emotions.

In collaboration with the parents an occupational therapist might teach children the social skills needed to survive social situations adequately. An OT might introduce different exercises to practice in order to manage and control emotions. They might do this by introducing a range of emotions and categorizing them into different zones, followed by teaching the child about adequate behavior for every zone of emotions. 

What can I do at home?

Here are some strategies for promoting emotional regulation at home: 

  • Increase emotional literacy: In order to develop awareness of emotions use emotional based language in your house, express emotions and physical sensations associated with every emotion in day-to-day discussions. 
  • Work together to develop strategies: Empower your child with skills to self-regulate emotions. Teach them tips and strategies for recognizing, expressing and managing emotions. For example, teaching breathing exercises for situations that call for calming oneself. 
  • Be patient: Emotional regulation strategies vary from person to person and there is no there is no ‘one size fits all’ solution to it. Constant trial and error with patience will determine which strategies work best for your child. 
  • Validate your child’s feelings: Teach them that everyone feels different emotions at different points in time and it’s okay for people to feel all sorts of emotions.  
  • Praise your child’s efforts: Whenever your child tries to regulate their emotions reinforce their behaviours by praising and encouraging them.

Activities and games that can help Improve emotional regulation

  • Use fidget toys, stress balls, play-doh, bubble wrap or kinetic sand for discharging anger from the body or releasing tension.
  • Deep-breathing exercises.
  • Role play, acting out different situations with different emotions and discuss what the consequences may be for each sort of response.
  • Practice short exercise or physical activities to burn any excess energy.
  • Create a mood chart to help your child label and identify whatever they are feeling.

If you are worried about your child’s emotional regulation skills and want to learn more about your role in the process please do get in touch with our skilled occupational therapists.

Feeding therapy

Feeding therapy generally benefits people who have trouble chewing, swallowing, controlling/coordinating food from their mouths to the throat and helps children who are picky eaters or refuse to eat specific foods.

People with feeding and swallowing difficulties or dysphasia might need feeding therapy from a professional occupational or speech-language therapist.

What to expect?

Feeding therapy does not just include teaching a child to eat but a detailed assessment and evaluation of underlying sensory or motor issues is carried out before a treatment plan is designed by a professional occupational therapist. After determining the source of feeding and swallowing difficulties therapists usually develop a therapy plan to make the process of eating easier for children.

How feeding therapy works?

With feeding therapy, therapists work with children to provide them with the skills they need to make eating more enjoyable and nutritious. Feeding therapy usually aims to improve:  

  1. Oral skills: Oral strengthening leads to Improvement in controlling and coordinating chewing, swallowing, sucking, sipping while eating and drinking.
  2. Food orientation: Feeding therapy assists children in broadening the types and amounts of foods they eat by introducing a balanced and a healthy diet. Therapists aim to increase the range of accepted foods for a child and reduce sensitivity to certain types of food.
  3. Eating experience: Due to illnesses, allergies, sensory aversion to food or reduced oral skills a child might develop negative feelings toward the whole eating process. A therapist thus introduces strategies aimed at improving the overall meal-time experience for children.  
  4. Self-feeding: Improving self-feeding skills by using strategies such as introducing special utensils or other equipment to make the eating process easier.

What can I do at home to aid a child’s feeding process?

Following fun feeding therapy related activities might encourage the children to try new foods:

  • Different colors and shapes:

Use cookie cutters to cut sandwiches, fruits/vegetables, etc. into your child’s favourite shapes. You can also add food colouring to make food look more appealing and exciting for children.

  • Fun Plates and Utensils:

Use colourful and fun plates and utensils during mealtimes e.g. paper plates shaped as different animals or plates with children’s favourite fictional characters.

  • Food Preparation Games: 

Involve your children in meal planning, grocery shopping and food preparation. Show them pictures of foods that they can choose from and let them decide the menu for any mealtime. Try gathering ingredients and cooking these meals with the child.

  • Food play: 

Use food during play time to decrease aversion to certain foods for example make play-dough out of marshmallows or paint with pasta and edible paint.

If you are worried about your child’s feeding and swallowing difficulties and want to learn more about how you can support your child please do get in touch with our skilled occupational therapists.

Sleep Support

Good sleep is important for improved health, attention span, mental and physical health and a better quality of life. Getting adequate rest enables the body to repair and be ready for another day. Typical sleep development patterns of children are as follows:

Newborns11-18 hours of sleep during any time of the day
4-12 months9-12 hours of sleep with short naps during the day
Children 1-2 years11-14 hours of sleep at night
Children 3-5 years10-13 hours of sleep at night
Children 6-12 years9-12 hours of sleep at night

Sleep deprivation can lead to various health issues. According to studies losing sleep can make a person more prone to accident, obesity, diabetes, depression and ADHD. Even if an hour of sleep is lost it can have negative effects on emotions and behaviors of an individual. 

Sleeping problems or sleep deprivation can be a result of stress, hectic schedule or other external factors. However, they may also indicate a sleeping disorder such as Sleep apnea, Insomnia, Parasomnia, Restless leg syndrome or Narcolepsy. 

What sleep deprivation looks like?

If your child is sleep deprived they might display the following signs and symptoms:

  • Difficulty falling or staying asleep.
  • Tired and fatigued.
  • Unusual breathing patterns.
  • Restlessness while trying to sleep. 
  • Irritability or anxiety.
  • Impaired performance at school.
  • Lack of concentration.
  • Weight gain.

Treatment for sleep deprivation

Sleep deprivation is often treated by an occupational therapist. An occupational therapist assesses issues related to sleep preparation, latency, duration and daytime sleep patterns. After assessing and evaluating the impact of sleep on school or work and sensory systems an occupational therapist addresses factors that are reducing the quality of sleep of a person.

An occupational therapist usually aims to establish a sleeping routine by eliminating all the sleep related issues. They might suggest modifying the sleeping environment, lights, noise, temperature, bedding to ensure good quality sleep. An occupational therapist might also teach a child self-regulation and relaxing techniques so they can put themselves to sleep. 

What can be done at home to improve the quality of sleep?

  • Keep a diary with sleeping and waking up times for your child.
  • Fix sleeping routine. 
  • Keep lights in the bedroom dimmed in the evening to prepare your child for sleep at night.
  • Give your child a warm bath before bedtime. 
  • Practice calming exercises before bedtime.
  • Make bedding comfortable.
  • Reduce naps during the day. 
  • Reduce sugar intake before bed.
  • Avoid drinking fluids before bed.
  • Don’t let your child have heavy meals right before bed.
  • Don’t let your child have screen time right before bed.

If you are worried about the quality of sleep your child gets and want to learn more about how you can help them get a better quality sleep please do get in touch with our skilled occupational therapists.

Handwriting

Handwriting is a complex skill that is essential for achieving academic success at school. It is a skill that requires maintaining a proper pencil grip, letter formation, and an upright body posture along with coordination of eyes, arms and hands

Since handwriting is the means by which children’s academic performance is assessed, a child struggling with handwriting may soon become frustrated and lose motivation in academics. 

What are handwriting problems?

If a child has difficulties with handwriting performance they might:

  •  Have difficulty in holding a pencil and producing written work.
  •  Have a messy and illegible writing.
  •  Write letters outside of the line or that are of incorrect size.
  •  Be slow to complete written tasks.
  •  Easily get tired of writing or typing.
  •  Experience Inability to express ideas through writing.
  •  Avoid writing. Prefer verbally explaining things.
  •  Be unable to apply appropriate pressure required to write. 
  •  Use both arms together poorly.
  •  Have poorly graded movements (control of the speed of movement).
  •  Face challenges with visual-motor coordination (using eyes and hands together). 

What factors affect the handwriting of a child? 

Handwriting problems can be caused by several external factors and internal factors. External factors such as improper adjustment of desk-chair height, inconsistent handwriting instruction etc. can contribute to problems with handwriting of a child. 

In addition to that internal factors such as vision problems, poor hand-eye coordination, poor pencil grip, developmental delays in fine motor skills, and poor shoulder and wrist stability can also result in handwriting issues.

How to improve your Child’s Handwriting Development?

Occupational therapy can help with your child’s handwriting problems and equip them with the skills they need to succeed. An occupational therapist generally works with the specific issues that a child has due to which they are struggling with producing appropriate written work. An OT supports your child in developing proper posture, strengthening their muscles, and learning to form letters correctly after conducting detailed handwriting evaluations and assessments. These evaluations help them determine why your child is struggling with handwriting and what strategies can they employ to support their handwriting development. 

What can I do at home?

  • Encourage your child to participate in different activities and sports so that their visual, motor, and coordination skills may improve.
  • Praise when they are learning new things that may be difficult for them to master.
  • Require children to use utensils while eating to improve grip. 
  • Practice activities that involve a lot of hand movement e.g. using scissors. 
  • Encourage writing e.g. by asking them to write letters to friends and family or write grocery lists for you.
  • Practice letter formation. 
  • Discuss your child’s condition with their teachers at school in order to work together on your child’s improvement. 
  • Practice pencil fluency by using patterns designed to enhance fluid pencil movement.
  • Practice different pencil grips e.g. change the size and shape of the pencil or the paper/board they are writing on.

Materials that can Help Improve Children’s Handwriting 

  • Silly Putty (can increase the strength of hands).
  • Play doh tool kit (kneading and pulling it strengthens the small muscles of their hands.
  • Art easel (writing or drawing on the vertical surface of an easel requires maintaining an upright posture and improves arm and shoulder movements).
  • Operation board game (using tweezers improves pencil grip).
  • Pegs (use pegs to make an animal face on a paper plate to build finger strength).
  • Colouring books (improves pencil grip).

If you want to improve your child’s handwriting skills and want to learn more about your role in the process please do get in touch with our skilled occupational therapists.

Gross Motor Skills

Gross motor skills involve movements of the whole body and of the large muscles of the arms, legs, and torso. Kids rely on gross motor skills to perform everyday functions, such as walking, running, jumping etc. at school and at home. Gross motor skills are related to:

  • Ability to balance
  • Coordination of movements 
  • Body awareness
  • Physical strength
  • Reaction time

What do difficulties with gross motor skill commonly look like?

Children who struggle with gross motor skills have trouble doing whole-body movements and commonly display:

  • Developmental delays e.g. unable to crawl or sit up independently.
  • Avoidance of  physical tasks.
  • Rushed performance of  tasks to mask difficulty or fatigue.
  • Poor posture.
  • Difficulty in performing physical activities especially those involving sequences.
  • Clumsy movements (makes them more accident prone).
  • Low endurance (Participate in physical activity for only short periods).
  • Inability to follow multiple instructions to complete a physical task.
  • Inability to transfer a skill (use the same skill in different settings).

Factors That Affect Gross Motor Development 

There are many factors that can affect the development of gross motor skills:

  • A sedentary lifestyle, accompanied by too much rich food, means that adults are less likely to engage in physical games with their children. 
  • Underlying physical difficulties with coordination, balance, motor planning, and concentration 
  • These difficulties may also stem from other underlying conditions such as: 
    •  Dyspraxia
    •  Cerebral Palsy
    •  Stroke
    •  Brain injury or trauma
    •  Muscular Dystrophy
    •  Premature birth
    •  Neurological impairment
    •  Developmental delays
    •  Developmental coordination disorder
    •  Abnormal muscle tone

Gross Motor Activity Training

If a child has difficulties with gross motor skills it is recommended that they consult an Occupational Therapistand a physiotherapist if need be. An appropriate assessment process allows an occupational therapist to identify the nature of a child’s difficulties with gross motor skills. Once identified, a treatment plan is drafted according to the child’s needs. 

One of the major types of treatment used by OTs is Gross motor activity training. It aims to improve gross motor functioning e.g. balance or hand-eye coordination. Gross motor activity training can:

  • Improve balance.
  • Improve coordination.
  • Improve perception skills.
  • Improve confidence.
  • Promote independence and ability.
  • Strengthens muscles.
  • Improved ability to understand instructions. 
  • improve performance in physical exercises and sports.
  • Improve motor planning.

What can I do at home to improve a child’s gross motor skills?

  • Use exercises to strengthen core muscles and improve stability.
  • Work on endurance and strength, coordination and balance, attention, awareness of body and space through different activities and games.
  • Break physical tasks down into easy steps.
  • In order to develop stamina, use a graded approach to intensity and duration of tasks.
  • Try to improve the child’s ability to plan tasks (e.g. asking the child to verbally state a required task and steps to achieve it before performing it).

 Activities that can help improve gross motor skills: 

  • Play HopScotch.
  • Play Simon Says for improving movement planning.
  • Practice balancing e.g. Walking/climbing over unstable surfaces (e.g. large pillows) as it increases overall body strength.
  • Play catch (Start with large sized balls and eventually move on to smaller ones).
  • Obstacle races, to combine lots of gross motor skills together into one practice.
  • Spend time at the playground e.g. climbing and running.
  • Swimming (improves coordination).

If you are worried about your child’s gross motor skills development and want to learn more about your role in the process please do get in touch with our skilled occupational therapists.