<b>Tools for Early Identification and Intervention for 0- to 5-year-olds</b>
Sensory Modulation Training
Another form of sensory modulation is "Deep Pressure" or "Heavy work" activities. These are wonderful for providing children with the input they crave including deep proprioception and joint compression.
Heavy Work Activities for Teachers
1. Scooter board to and from a designated location (sit or lie on stomach and propel with arms).
2. Place chairs on desks at end of day or take down at beginning of day.
3. Erase or wash the chalkboard.
4. Carry beanbags on shoulders or head and walk across the room. Wear weighted vests, belts or wrist weights.
5. Help rearrange desks in the classroom.
6. Push the teacher around on a wheeled chair or scooter board.
7. Pull someone while they sit on a scooter board holding onto a hula hoop.
8. Child can pull himself/herself up a ramp while on a scooter board.
9. Help out the janitor with emptying wastebaskets, mop the floor, etc.
10. Fill egg crates (small ones that kids can carry) with books to take to other classrooms. Teachers could ask kids to move these crates back and forth as needed.
11. Help the gym teacher move mats, hang them up, etc.
12. Chewy candy breaks (this addresses the janitor's "no gum rule"). There are lots of chewy candy that take awhile to chomp and don't get stuck on furniture.
13. Sharpen pencils with a manual sharpener.
14. Cut out items for display with oak tag.
15. Have students carry heavy notebooks to the office or from class to class.
16. Wear a weighted backpack when walking from class to class. Parents can put a notebook, book or books (depending on the size of the child) into their backpack each day for the ride or walk to school. One therapist suggested that "you might want to be careful about adding weight to backpacks as it could result in low back pain." It might also be contraindicated with diagnoses such as Spina Bifida. Maybe weight could be added elsewhere such as in fanny packs.
17. Carry books with both hands hugging the book to yourself.
18. Tie a Theraband around the front legs of a chair that a child can kick his/her legs into.
19. Propel scooter board across carpeted floor.
20. Have child pass out papers/objects to class members.
21. Wash desks or chalkboard/dry erase board.
22. Push the lunch cart or carry lunch bin to the cafeteria.
23. Staple paper onto bulletin boards.
24. If there is a garden project at the school, have child dig the dirt.
25. Play with medicine balls (get from gym teacher).
26. Run around the track at school.
27. Bounce up a ramp on a Hippity Hop ball. Put two ramps fastened together at right angles and let the kids hop up one, cross to the platform of the second ramp and hop down. After about 10 to 15 trips, it takes out "aggressiveness."
28. Push a large therapy ball across/around the room (can purchase weighted therapy balls).
29. Push square plastic nesting boxes (the largest one was 18 to 20 inches) from the classroom to the OT room and back. The next child would do the same thing. This particular school had a carpeted hallway which provided extra resistance. One or two of the nested boxes can be removed to decrease the weight or small balls and/or bean bags could be added to the box to increase the weight. I also found that turning the smallest box upside down over the balls and bean bags helped easily distracted students complete the task at hand.
30. Use beanbag chairs in classrooms, allowing kids to use them during silent reading time or to lay over or under them during independent work tasks to get a change in position and the benefit of consistent pressure input. More of a passive mechanism, but definitely helpful for students.
31. Push a wheeled therapy stool while someone is seated on it. If necessary, person on stool can assist by "walking" with their feet.
32. Have kids pull themselves by a long jump rope tied by one end to a doorknob while they are seated on a scooter board with their legs crossed and off the floor. Can also have one child hold the jump rope while the other child is pulling him/herself on the scooter board up to the child holding the rope. A variation is to play "army jungle maneuvers" where the child on the scooter board can deliver secret messages to the other child, and that child (who is holding the rope) has to write a secret answer back to the commander (teacher). This could be incorporated into academics in lots of ways. How about the first child taking a math problem to the second, the second solves the math problem and sends it to the commander (teacher).
33. Bouncing on a large therapy ball while counting down from 100.
34. Prior to seat work, have child pinch, roll, pull theraputty; use hand exercisers, balloons filled with flour. Give the child firm pressure on the shoulders. Play on playground equipment, hanging from a bar, running up steps, etc. Wrap the forearms with ace bandage.
35. Use bubblepack as part of an obstacle course. Children can jump onto it or run across it. They love the noise it makes!
36. In the classroom, use heavy duty tape to fasten a large phone book to the bottom of students chairs then teacher arranges the student's schedules so that the students move to a new area of the room (taking their chair) between subjects. Teach the use of wall push-ups or the idea of "the room feels small this morning, can everyone help me push the walls out" for younger students.
37. Have student move several packs at a time of Xerox paper from the storage area to the school copy center.
38. Use the Ellison cut-out machine. Students can collect orders from teachers (who provide the paper and use these cut-outs for bulletin boards, etc.) and then presses out the number of pieces required under the supervision of an adult. This very heavy work is a great strategy for organizing behavior.
39. Pull therapist's suitcase on wheels or therapy cart.
40. Climbing activities (such as playground equipment).
41. Swing from the trapeze bar.
42. Push against a wall.
43. Fill up big toy trucks with heavy blocks, push with both hands to knock things down.
44. Sports activities involving running and jumping.
45. Two adults can swing child in a sheet. Watch child's face carefully to note when child has had enough.
46. Have the child color a "rainbow" with large paper on the floor in a quadruped position.
47. Play "cars" under the kitchen table (or table in classroom) where the child pushes the car with one hand while creeping and weight bearing on the other hand.
48. "Hot dog" game where child lies across end of a blanket and is rolled (ends up inside the rolled up blanket with head outside)
49. Walk up a ramp or incline
50. Use theraband or tubing attached to a door and pull it then let it snap. Supervision necessary.
51. Wood projects requiring sanding and hammering.
52. Play wrestling: pushing game where two people lock hands facing each other and try to see who can push and make the other person step back first. Use other body parts also, but be sure to have rules (no hitting, no biting, no scratching, one person says stop then both stop).
53. Open doors for people.
54. Quiet squeeze toys such as the cow, fondly named by everyone as "Moo" (squeaky squeeze toys are frowned on by our teachers). Kids can be taught to squeeze Moo or the likes of him on their laps under their desks so as not to disturb the class.
55. Chew on fish tank (aquarium) tubing, Theratubing or refrigerator tubing, if appropriate. One therapist stated that "refrigeration tubing (the kind the water runs through to the ice maker in your freezer) is FDA-approved while aquarium tubing is not. Cut the tubing into 2- to 3-inch strips and put it on the end of the elementary school age child's pencil to be an appropriate "chewy" when food is not allowed."
56. Chair push-ups.
57. Fall into a beanbag chair.
58. Jumping and rolling games.
59. Slowly roll a ball or bolster over the child, applying pressure.
60. Bounce on a Hippity Hop ball.
61. Sandwich games (child is place between beanbags, sofa cushions, mattresses and light pressure is applied to top layer).
62. Play catch with a heavy ball. Bounce and roll a heavy ball.
63. Push weighted carts or boxes across carpeted floor.
64. Animal walks (crab walk, bear walk, army crawl).
65. Play "row, row, row your boat" both sitting on the floor, pushing and pulling each other.
66. Rice play, koosh balls, water play, jello play, theraputty.
67. Mini trampoline.
68. Stack chairs.
69. Two children can play "tug of war" with jump rope or heavy Theraband. (If you use the Theraband, children need supervision so they don't purposely let go of Theraband and "snap" the other child.)
70. Isometric exercise breaks.
71. Push on large therapy ball with someone else giving resistance from the other side.
72. Have child hold therapy ball with arms and legs while lying on his/her back. Try to take the ball away and tell the child to hold on to the ball as hard as he can.
<b>Tools for Early Identification and Intervention for 0- to 5-year-olds</b>