School OT- Michele Dunham Tells Us How to Use the Adaptive Products

Parents are often the first ones to suggest items to me after hours of research. There are so many different devices and tools out there to help children with special needs on a daily basis. As we start to think about and prepare for the upcoming school year, you may be thinking about ways to make the new year more successful for your child or students. You may be stressed about your child entering a new school building or having a new teacher. Your child may be getting a new therapist or aide. Maybe as you think back to last school year, you remember being stressed or felt unprepared by your morning routine and had so much to do. We understand those concerns and hopefully have some items to help you navigate this next school year more easily. The following items may be the items you are looking for or could be a great addition to your routine to help make things a little easier for you and your child.

 

As an Occupational Therapist, I deal with sensory tools on a daily basis. So many of the students I see have sensory processing difficulties and benefit from a sensory diet, sensory tools, and adjustments to their school environment to help them be successful with regulation throughout the school day. These are not just students on the Autism Spectrum, there are many children who struggle with self-regulation and sensory overload. The use of compression clothing has been used for years to provide input to the body. Increasing proprioceptive input with compression garments helps to calm the central nervous system and increases focus. The input received from deep pressure is like a big hug and feels like the calming effect a baby gets from being swaddled. The great thing about compression versus weighted materials, is that compression garments can be worn all day long and do not require a set wearing schedule like weighted materials do. The Cor the Calming Heart, compression day backpack is a compression vest and day pack/backpack all in one. The compression material of the vest provides input throughout the day and students can easily wear it to school and simply remove the day pack portion that contains their materials.

In addition to school and home use, this all- in-one product is great for field trips, days at the park, or other outings in which children would benefit from the use of a compression vest but also need to have personal supplies available. The design of the vest has compression material in the front panel and the criss-cross design on the back helps to provide the compression. The criss-cross design also adds some relief from the compression on the back. The Cor the Calming Heart compression vest has open sides, allowing it to be more comfortable for all day wear. If you child or loved one benefits from deep pressure and proprioceptive input, the versatility of The Cor the Calming Heart compression day pack/backpack may be just the item you have been looking for. As an Occupational Therapist, I would suggest having a discussion with your child’s Occupational Therapist at school to discuss the utility and need for an item like this and how it can best be incorporated into your child’s school day.

 

Does your child have a medical diagnosis or information you need to portray to others, including emergency personnel in the event of an emergency?

Whether your child is diabetic or non-verbal, portraying vital information is your top priority as a parent. First and foremost, compliance is a huge factor to consider when purchasing a medical ID bracelet. If there is important and vital information contained on the bracelet, then we need to find a way to make wearing compliance as high as possible. While we can all agree that having this information accessible to others is important, we also need to consider several things about your child when considering which medical ID bracelet to choose.

As an Occupational Therapist, I would encourage you to consider the following:

1. What are your child’s interests? Is there a favorite character, game, or tv show that would make wearing a bracelet more fun?

2.Does your child have sensory issues that may interfere with wearing a bracelet? Do you know how annoying an ill-fitting bracelet is when it slides up and down the arm all day long? The fit of the bracelet is very important and needs to be considered.

3.Does your child fuss or fidget with things on their arm, around their neck, or do things like tags bother your child to the point of it becoming a distraction? Does the clanging noise of a metal bracelet on the desk every time they write cause your child frustration? The material and feel of the bracelet is an important considerations to make when choosing a bracelet. Consider your child’s sensory needs and aversions when choosing a medical ID bracelet.

The great thing about Sticky J Medical ID bracelets is that many factors that influence compliance have been considered, and their line of medical ID bracelets are stylish, comfortable, and made with your child in mind. You can choose from a variety of fun Minecraft-themed designs (with more themes coming soon) that your child will actually enjoy wearing. My favorite part as an OT, considering the sensory aspects of a medical ID bracelet, is that the band is soft and adjustable like a watch band. There will be no slipping of the bracelet up and down the arm, and it can easily be adjusted to the child’s desired fit. The design of the bracelet looks less “medical” and does not draw attention to it from peers like other medical ID bracelets do.

Orientation of clothing can be a real struggle for those who have coordination or motor planning difficulties. For many people, getting dressed is easy and children typically learn it quickly and easily by trial and error. Sure, there are the usual “inside out” and “backwards” clothing days, but for the most part it comes pretty easily unless your child has difficulties with orientation, motor planning, balance, fine motor skills, or coordination. Let’s consider the steps and complexity of putting on socks. To put on socks, you must first orient the direction of the socks, by looking for the toe and heel parts. Next, understanding and manipulating the socks by inserting your thumbs and opening the sock to be able to insert the foot can be difficult to coordinate. Once the hands are positioned to open the sock, balance, coordination, fine motor skills, and motor planning are skills needed to be able to put the socks on successfully. Additional manipulation to the sock to adjust and align toes/heel is often needed after the sock is on the foot. With the Beedlebug socks, many of these steps are simplified and they can eliminate the need for the coordinated efforts described in these steps.

The Beedlebug socks, which come in a variety of colors and prints, contain holes in the side of the sock for easy orientation. The holes are outlined with different colored threads to make finding the thumb holes a breeze. Also, colored toes/heels make the orientation of the socks easier.

Steps for teaching your child to put on the Beedlebug Socks:

1. Pick up the sock and look for the toe and heel parts of the sock.
2. With the toe part facing away, slip thumbs into the opening at the top of the sock and through the thumb holes located on the side of the sock.
3. Gently stretch the sides of the sock open using an outward pulling motion to reveal the sock opening.
4. Insert the foot into the sock opening and pull upward to get socks on.
5. Adjust the socks as needed to ensure the toe/heel portions are aligned.

Tips to Consider, depending on your child’s needs:

1. Consider where your child is sitting to put socks on. A bench may not provide the support and balance needed to support the trunk/body when putting socks on. A more supportive chair may be more beneficial and eliminate the “balance” part needed while learning this new skill.
2. If sitting on the floor, some children may cross their leg to reach their foot, which may change the orientation of the sock. Encourage your child to sit up against a wall when sitting on the floor and to bend the knee up to put on the sock. For children with the tone, tight muscles, or decreased range of motion – sitting on the floor to put on socks may be too difficult, and therefore a chair or other seated option may allow the child to be more successful.
3. When teaching this skill, children will likely have a difficult time seeing it demonstrated from a different angle. I encourage you to sit behind your child, them sitting between your straddled legs. Reach around your child and put the socks onto their feet using hand over hand assistance. This will help them orient the sock from their perspective and point of view.

The Wright Stuff, EaZy Hold is a package of 5 easy hold grip straps that can be secured to most cylindrical objects that a child needs to grasp and manipulate. Children with poor or decreased grasping skills may drop items or lack the force/pressure needed to hold items in their hand and be able to motor plan and manipulate items functionally to use them efficiently or successfully.

Ways I have used The Wright Stuff – EaZy Holds with my students as an Occupational Therapist:

A. Writing tools (markers, crayons, paint brushes) can be used with the EaZy Hold to increase participation in school and leisure activities. Simply stretch the bands around the writing tools and then slip the strap onto the hand. The versatility of the strap allows for both a pronated (palm down/thumbs down grasp) or a supinated grasp (palm up/thumbs up grasp) depending on your child’s age and available range of motion.

B. Using the EaZy Hold on items such as eating utensils is a game changer. The Wright Stuff EaZy Holder is great to use with individuals who have weak grasps and also those children who may be prone to throwing/dropping their utensils. Throwing utensils is frequently seen with children on the Autism Spectrum who may have food aversions and may prefer to finger feed versus using utensils at meals. Mealtime may be stressful for these children and therefore throwing/dropping utensils may be a sign of frustration or a way to escape the task. In addition, children who have increased/decreased tone, like those with cerebral palsy, may be able to use a gross grasp on utensils using a holder such as the EaZy Hold. Children with cerebral palsy may have tone that is activated when they complete motor activities, such as feeding. With the use of the EaZy Hold, children can securely hold utensils without dropping them when tone kicks in. Use of the EaZy Hold requires less assistance from others to help those with decreased grasps, tone, or other physical impairments.

C. EaZy Hold can be used with personal hygiene tools such as a toothbrush or hairbrush to allow increased independence with daily activities. Simply use the strap on these items, and independence is increased. Again, the strap allows for various grasp patterns, therefore, children who have various grasps can still be successful.

D. Certain toys such as action figures and Barbies can also be used in the EaZy Hold, allowing a child to hold and manipulate toys for leisure and play. Play is the primary occupation and role of children. Research shows that children learn much quicker through play than through any other means; therefore finding ways to allow children to play successfully with peers is an amazing use for EaZy Hold.

As an Occupational Therapist, I really value the numerous applications that the EaZy Holder provides. These straps can easily be removed and put onto other items/tools easily, are easy to wash and transport, and can be put on so many different items, which allows a child to access so much more within their environment. As it was earlier discussed, children learn and grasp skills when it is presented to them from the same perspective that they are seeing it; therefore, it is recommended that you get behind your child and demo using hand-over-hand assistance and then fade or reduce the amount of assistance until your child can move/manipulate objects as intended.

As a school-based Occupational Therapist, I have spent countless hours working with students on those pesky combination locks. Let’s be honest, most students have difficulties when first faced with using a combination lock on their locker. When students are unsuccessful with using their combination locks, most end up jamming something into the lock mechanism so it doesn’t fully close or lock. I also see students who will try to carry everything with them for the entire day to avoid the need to use their locker except for at the beginning or end of the school day. To make matters worse, let’s now add a time limit on how fast a student must get from one side of the school building to the other, stop at their locker to switch out supplies, and quickly open their combination lock. What are the consequences if your locker combination is limiting your access? Start to sweat and become anxious because you either go to the next class without your supplies or you fumble with your lock until you are able to open it and risk being late.

Now imagine this scenario being more stressful… because you have fine motor and motor planning deficits. Now you must use a 3-finger grasp on the inside part of the lock dial, spin it in the correct direction Right – Left- Right, make sure you pass the zero, stop exactly on the tiny notch for numbers 3 -14-27. You mess up and have to start all over again…. Some students also have vision difficulties that make seeing and aligning the small notches more difficult to pinpoint. It is so stressful!

The Masterlock Easy Combination makes using a combination lock easier with its color-coded design and easy combination numbers. Now stopping at numbers 5-10-15, on color-coded numbers, makes using this lock easier for students with dexterity, coordination, and fine motor delays. The increased visual cues with color-coded numbers and the use of notches/numbers that are shown on the lock allow those with decreased vision to align the lock for more success successfully.

As an Occupational Therapist, I would do the following to help students access their lockers and combination locks:

1. Teach the directional sequence that students will need to use, which is Right – Left- Right. . Using an unattached combination lock, have the student hold the lock and give them a number on the lock that they need to turn the dial to as practice. Practice numbers that are written on the lock (0, 5, 10, 15, etc…) In addition, practice rotating the dial in the same sequence of Right – Left – Right when practicing.
2. Work on accessing their locker during non-timed and non-stressful times. Between classes, when few people are in the hallway, will allow the student the time to practice and become comfortable with their locker combination, allowing as much time as needed for them to be successful.
3. The design and easy combination of The Masterlock Easy Combination will help to make manipulating and accessing the locker easier for those who struggle with standard locks with difficult combination numbers, decreased fine motor coordination, and poor vision.

 

I absolutely love these laces and have used them several times with my students. While “bungee” shoelaces have been the craze for the past 10 years or so for younger children, there is a limit to shoe options once a child’s shoe size or age makes shoes with bungee laces less age appropriate in look and style. I don’t know about you, but I have tried on several shoes with built-in laces, and they are often too tight on my feet and very uncomfortable to wear for long periods of time. Lock Laces are so versatile and can be used with most pairs of shoes/boots, which makes them even more appealing. These laces are not just for children or those with limited dexterity, others like these shoelaces because they “lock,” and you no longer need to fuss with those laces that are always coming untied. What is so great about Lock Laces?

You simply purchase the Lock Laces, which come in a pack of 2 stretchy laces, a lock, and an end piece. You can turn almost any shoe into a “slip on” shoe, eliminating the need to tie them. What is great about Lock Laces is that if your child or loved one can put on other slip-on style shoes, then they will be able to put on a shoe that has Lock Laces in them.
This is such a great way to not only add versatility to the type/style of shoes your child or loved one wears… but the independence that comes along with being able to put on shoes independently is amazing. Children feel a sense of accomplishment when they can dress themselves, and they also want to fit in by wearing the shoes their classmates are wearing, and Lock Laces make that a reality.

How do Lock Laces work?

1. First, get a set of Lock Laces and a pair of shoes you want to use the laces in.
2. Remove the shoelaces that came in the shoes and then lace up the shoes with the stretchy Lock Laces.
3. It is advised that the shoe should be tried on your child and laces adjusted to ensure the laces are not too tight or too loose.
4. With the laces near the tongue of the shoe, insert the left and right sides of the laces into the holes on the lock. There is an area on
   the top of the lock that you must push down for the laces to be able to go through the holes. Release when the laces are pulled snugly.
5. There will likely be excess lace length, especially in children’s shoes. Lock Laces advises you to keep 2-3” of extra lace and then cut off the excess. The laces are then fed through the end piece and clamped down to secure the excess lace pieces in the event you need to adjust the laces later.

6.Lock Laces are removable by opening the clamp using a screwdriver and holding open the lock to release the laces.

The beauty of these laces is that after set up, there is nothing else that needs done to make the shoes accessible for your child or loved one. Lock Laces are a great option for children who may struggle with the dexterity, fine motor skills, motor planning, sequencing of shoe tying steps, or lack of range of motion. Think of those older students who may need to change their shoes for gym class and really want to wear those name brand sneakers, however, have not yet mastered the skill of shoe tying – Lock Laces will help make that a possibility.

 

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This post originally appeared on our July/August 2023 Magazine