Category Archives: Uncategorized

Do Pencil Grips Help with Writing?

Was your child offered a pencil grip to help their writing at school? 

Usually, parents tell me that school already tried a pencil grip to help with writing? 

When I ask if it helped, most say their child finds them uncomfortable or won’t use it. 

So, should or shouldn’t we use a pencil grip? 

I find pencil grips to rarely be helpful from the get-go. And it’s not just because the child has to get used to the grip. 

Using a pencil grasp requires strength and coordination on the child’s part and is ultimately, an exercise in itself.  

Kids first need to develop sensory processing, core strength and fine motor skills for pencil control or to more comfortably use the grip.  

Once kids have had some OT support, some OT’s may then use a pencil grip as a way to further strengthen or support the fingers.  It all depends on the child.  

However, I have found most kids don’t find them to be comfortable and so we work on the skills they need for better fine motor skills and pencil control. 

There’s my two cents on pencil grips.  Hmmm…… how does that translate to London English? There’s my two pennies? Doesn’t sound the same, and I may be humouring myself now. 🙂

Munira

P.S. I am a fan of shorter, thicker, or triangular shaped pencils, Stabilos, or smoother gliding lead pencils. And if kids are ready, I love Crayon Rocks. 

How do you improve an incorrect pencil grasp?

Earlier, I shared how stability leads to mobility (i.e. pencil control in this case).  So, what happens to pencil grasp when we don’t have stability? 

In this video I’ll show you why your child may have an awkward pencil grasp, the skills they need to develop, and  some top tips to help get you started. 

Munira 

P.S. I’m confident that this mini-series will help improve your child’s pencil control.  https://ot4kids.thinkific.com

How to build stability for better handwriting?

Stability leads to mobility! 

Have you heard this before?  

When I refer to stability, I consider three types:

  1. sensory processing (their body and spatial awareness, balance and coordination, sensory needs to ground themselves)
  2. core stability and strength
  3. emotional readiness and confidence

At each age, children develop stability in their core and / or shoulders  to support development of fine motor skills for each stage of development.  

For example, a baby will first be able to lay on their back and lift their arms to grasp objects with their whole hand.  Then as they get older, they’ll be able to push up into sitting or quadruped positions, and grasp smaller objects in their fingers.  

This loop of gaining stability for more refined grasp continues to occur throughout children’s development.  

Have a look at the diagram below created by my 8-year old who really wants to ‘help’ me with work. 🙂 You can also hear me talk more about this subject here.  

PENCIL GRASP Stability for Mobility

Help Me Improve My Child's Writing

Why is my child holding their pencil wrong?

What are inefficient pencil grasps? 

My child struggles to hold their pencil.

My child says their hands are sore or are tired when writing. 

My child refuses to write. 

Parents often say the above when their child has an inefficient pencil grasp.  Oftentimes, children who have decreased sensory processing and strength (the skills we need for STABILITY in our body), will find other ways to be stable in their body, leading to inefficient pencil grasps. 

See below for some common inefficient pencil grasps, and why kids may be using them? 

INEFFICIENT PENCIL GRASPS

Help Me Improve My Child's Writing

When should a child hold their pencil correctly?

What is the correct way to hold a pencil? 

These are common questions that parents ask me so I have created this visual to show typical grasping development and its connection to the whole body.

Afterall, ‘it’s all connected.’

Have a look below to see how STABILITY leads to MOBILITY for typical pencil grasp development. Immature pencil grasp development refers to when your child acquires these ‘typical’ grasps at a later age. PENCIL GRIP MILESTONES Typical

To improve your child’s pencil control for writing, buy the mini-course here: 

Help Me Improve My Child's Writing

Tips for Left-Handers

How to Help Left-Handers with Writing and Fine Motor Tasks? 

I just learned that 13th August is Lefties Day.  I never knew this till now. 🙂 

So, in celebration of Lefties, I thought I’d share some of my top tips: 

  1. While sitting at a table or in a classroom, it is best when Lefties sit on the left side of the table or even the room as they tend to turn their body a bit to the right.  This way if seated on the left side, they can more easily turn toward others and the teacher to see what’s going on. 
  2. If you’re a rightie and want to teach your leftie an activity, have them sit in front of you and mirror you. 
  3. The top of their paper will be tilted about 20-30 ish degrees to the right.  You can put a piece of tape on their desk to show where to place the top of the paper.
  4. Make sure to have access to left-handed tools such as pencils (esp if using Stabilo etc), scissors, tools with handles, potato peelers, and sports equipment such as gloves and rackets.  If using pencil grips, just check if there’s a leftie version needed (some do and some don’t). **See note below. 
  5. Explore which pens and markers to use as there’s likely some ‘smudging’ due to the way the left hand will rub over the writing as it goes across the lines.  Explore felt tip markers versus fountain pens for instance. 
  6. Check out www.anythinglefthanded.co.uk for more information and to see their ‘store’ where everything is easily accessible in one place
  7. Note that lefties will sometimes cross their letters from right-to-left
  8.  Lefties will naturally hook their wrist a bit while writing, some more than others.
  9. Consider notebooks used when writing as any rubbing of binder edges will be uncomfortable on the left hand.  Perhaps flip-top ones may be better or turning the spiral bound so you write towards it instead.  

If children are able to figure out how to use ‘regular’ utensils, this may be ideal because then they can use whatever is available wherever they go.  E.g. Scissors.  However, for some children who struggle with strength and coordination, it may be easier for them to use special left-handed items.  For those who want to be very skilled in certain sports, they may also look for a specifically left-handed tool as this may allow them to be even more dexterous in that sport.  

There are lots of things to consider really while writing and manipulating objects based on the child’s strengths, needs, and interests.  

As always, there’s never just one way, and we must take into consideration the child’s individual needs. 

Hope this is useful. Do share if you have any other tips.  If you’d like to receive some free tips on fine motor and hand strengthening activities, do sign up here for my free tips and news. 

Free Resources & News

 

 

Writing Mini-Series till 9th August, ’20

Hi Everybody.

I’m offering a writing mini-series only for PARENTS and TEACHERS to help you learn how to identify the sensory and motor skills your child needs to develop to improve their pencil control for writing through the power of fun and connection.  

I have too often seen children being given pencil grips and writing worksheets to improve their writing, which ultimately causes stress and pain in their hands. 

I want to show a better way where we can work from the child’s foundational sensory and motor skills to improve their pencil control for writing in a way that will have a bigger impact and last longer, and most importantly, whilst preserving their self-esteem and confidence.  All this in a way that is fun for your child. 

I’d love to see as many teachers as possible sign-up for this mini-series so that we can better understand why kids are struggling.  

I hugely believe that children are not lazy or not interested in writing, and we need to dive deeper to learn why they are struggling with these skills.  

This mini-series will help you figure that out. It’s only available till 9th August.  

Sign-up above! 

Munira

How Do Paediatric Occupational Therapists Partner With Parents?

Usually, when people think about paediatric Occupational Therapy, the first thing that comes to mind is dropping your child off to see an OT who will do 1:1 treatment with them.  Sometimes parents aren’t present which means that they may not fully understand what the OT is working on with their child, and more importantly, don’t know how to support their child in their daily lives.  

How do OT’s help parents support their kids? 

At ot4kids, we have always valued working closely with parents in these ways:

  • Parents or caregivers are present throughout our sessions
  • We have regular parent-ONLY coaching sessions (similar to a teacher-parent conference but not rushed and more often) to review how things are going at home, identify areas of continued concern, understand rationale behind certain ‘behaviours’ and why certain sensory tools are effective and how to use them.  
  • Some parents do only parent consultations where they learn about sensory processing and motor skills, learn simple strategies to do with their child, and review in their OT consultations
  • Sometimes even grandparents and nannies have joined coaching and / or treatment sessions which has been so fantastic

What do parents think of 1:1 coaching sessions with their OT? 

Parents often find these consultation meetings to be the most helpful to them in understanding their child’s needs, and parenting their kids in a way that supports them developmentally and emotionally versus using traditional parenting techniques.  

How do parent coaching sessions / consultations help us (OT’s) help you? 

As an OT, I find the parent consultations really effective as:

1) parents know their child best so their input and feedback are great clues into figuring out effective ways to help their child

2) it’s important to know how the child fares in their daily lives as we want them to develop skills beyond the clinic and into their ‘real’ environments for the best impact

The aim of parent consultations / coaching

Our aim is to help reduce the overwhelm that parents can feel, and to help you find simple and effective ways in helping nurture your kids.  

My message to parents is that you know your child best, follow your gut instinct, and know that we can help you to be confident in helping your child to be coordinated, calm, and connected.  

Sign up here to learn more about parent coaching / consultation sessions. http://www.ot4kids.co.uk/occupational-therapy/parent-group-coaching-sessions

Subscribe to Blog

How is Teletherapy and Working Closely with Parents Helping Kids? 

Subscribe to Blog

Can you believe we have been doing Teletherapy and parent consultations for three months now?

Oftentimes, people think that OT has to be done 1:1 with an OT to help their child (and don’t get me wrong, direct treatment is really important and helpful).  Thanks to COVID-19, it has been absolutely amazing to see both parents and kids thriving.  Kids are calmer and building relationships, developing their motor skills, and problem-solving during play.   Parents are understanding their child’s ‘signs’ and needs, and as a result, figuring out what to do coming up with great strategies to support their kids.  

It has been a highlight building relationships, joining forces with parents, and having an impact in the kids’ natural environments. 

How do Occupational Therapists do Teletherapy?

Teletherapy sessions have taken a combination of two forms: 

  1. Directly working with the child via the parent 
  2. Indirectly by meeting only the parent and reviewing videos of child between sessions

What lessons have we learned (i.e. benefits gained) from teletherapy during COVID-19? 

Less is more

Kids have made great progress with what they have at home.  

Parents have been nicely surprised how much we are able to do with what they have at home, and as a result, they are more able to incorporate sensory strategies or motor activities into their days.  In many ways, I have found that children have made even more progress during their intensive blocks as we are so much more focused on certain areas and we use what they have.  

Empowering parents

For me, I have loved building relationships with the parents, and tag teaming with them to support their families and kids.  I feel that this has also been key to the progress we have made in sessions, and the support the parents feel that they are receiving.  Parents are empowered knowing that they can help their kids using their own hands and ideas.  

Learn by doing

I learn by doing things myself. 

These parent consultations and virtual sessions have enabled parents to ‘do’ with their kids themselves, and become confident in their own abilities to support their child.  Being mum to my 8-year old, I know how important this is.  

New future plans? YES!

So far, many families want to continue in this way to some capacity, and I’m fore-seeing positive changes going forwards in how we provide OT via supporting parents, whether it be directly, indirectly, through trainings and coaching, or a combination.  

Get in touch to discuss how tele-therapy can help your child.   

Schedule A Call

 

Sensory Chalk Walk Obstacle Courses

Lockdown has finally given us the impetus to create some Chalk Walk Obstacle Courses for our neighbourhood.  (See video examples below.)  I’ve always wanted to make these, and now that we have started, my son loves making them too.  

People often think these chalk walks are difficult to make, however they’re so fun and you can involve your kids in making them too.  We have now made a bunch of these during the past couple of months, including for younger and older children.  

We have done very simple ones by going down our street drawing designated areas for ‘dancing,’ being ‘goofy,’  doing ‘silly walks,’ and drawing Hop Scotch grids which even the older people on our street have loved doing.  

How chalk obstacle courses develop sensory processing and motor skills: 

  • FUN while social distancing!
  • gross motor skills
  • body and spatial awareness
  • balance and coordination
  • motor planning skills to create, plan and execute 
  • fine and visual motor control 
  • organisational skills
  • emotional regulation 

TOP TIP:  Check the weather before you draw out your chalk course.  We learned the hard way as it sadly rained the day after we made ours a couple of times. 

How to create and arrange a chalk walk obstacle course, keeping your child in mind: 

  1. Start with a more intense, heavy work component such as jumping or doing press-ups
  2. Next, do a balance and / or challenge task such as walking along a wavy line or jumping and turning
  3. Have a high energy component (running on the spot for a minute, running for the home stretch)
  4. a mindful calming section (e.g. blow out the candles, sniff the flowers, sing a song, or unscramble letters to words, or say affirmations).   

Although do just have fun, follow your child’s lead and get them involved in creating these.    

Subscribe to Blog

Chalk Walk Obstacle Course Examples: 

Here are several examples that my son and I have done for our neighbourhood.  Do share your ideas.  We’d love to see them. 

 

Shop Local – Occupational Therapists in Southfields

 

Subscribe to Blog

The Southfields Grid Association has put out this list of local businesses to particularly support during these times.  I’m so grateful to them for including ot4kids on there, and for living where we do. 

My husband and I moved to Southfields 9 years ago when I was pregnant with my son.  I needed a work balance shift as I developed Hyperemesis and couldn’t travel anymore so my husband had this great idea of building a ‘house practice’ with a clinic where families could come to me in a cozy environment.  At the same time I wanted more time with the baby as he’d grow up.

 This was the beginning stages of two babies, my clinic and my child. 

We passed by Southfields when Riverford, our local veg box scheme, had offered a free dinner nearby.  It was soooo delicious.  We were immediately drawn to the ‘village’ because of its quaint family feel, small independent shops, and ease of reaching the city centre.  I never heard of Southfields before this.  For those who know me, you know my heart is in my stomach so this sequence of events is not at all surprising.  🙂

As we have our own independent practices, we have always tried to support local businesses which in return means supporting local families, our community, and more jobs.

I always recommend local cafes and shops to families who come to see me.  We have so many great places nearby including:  Chanteroy, the french deli for amazing sandwiches on freshly baked baguettes, Salt and Pepper for super friendly company and local grown homey food (we love their tapas), our local fruit and veg shop, Chalk for cards and stationary, Drop Shot for coffee, De Rosier for hot chocolate and deserts, Thai restaurants, optometrists, a physiotherapist, an osteopath, and so much more.  

To support locally, check out their listing here

Click here to follow ot4kids’ blog. 

 

ot4kids Job Opportunities

When I moved to London 5 years ago, few people knew about occupational therapy especially for children.  There was even less awareness about early intervention (EI) and sensory integration therapies.  I had gone from having a caseload full of babies and toddlers whilst in New York City to only one baby here in London.  It was so sad to hear others say ‘wait and see’ and ‘your child will grow out of it’ especially when I had firsthand seen the difference early intervention makes for the entire family.

During my first several years in London, I spent a lot of time raising awareness and advocating for children who have special needs and developmental delays by developing my website as a resource, and writing articles for National Childbirth Trust (NCT), Families and special needs magazines.  I also held baby ‘Move and Groove’ groups with many local NCT mums groups to advocate for early intervention, encourage and show parents how to help their baby move in and out of different positions. Many parents were nervous to put their babies on their tummies.  It was great fun and a fantastic opportunity to advocate for EI.

Five years on……I now treat lots of babies and toddlers.  Although parents come to me by word of mouth, many want to start early as a means of prevention and so their child will be more ready for school and require less support.  I still treat children up to 7 years as its important to see how kids grow and what they face in their future.

I would now love to have a team join me so we can provide the best and most effective services for kids to progress and thrive in London.  I am looking for experienced and passionate therapists.  Below are some requirements:

QUALIFICATIONS:

Bachelors and / or Masters in OT
8-10 years pediatric experience
SI education and experience a MUST
Bobath / NDT knowledge (preferred)
Ongoing CPD and courses
HPC qualified
Liability insurance

SKILLS:

Evaluate and treat children with disabilities
(Cases offered based on your experience and expertise)

Must be self-motivated to keep up with continuing education, professional development, peer networks, and staying up-to-date with new information

Creative and resourceful with therapy supplies – must be able to use what’s available in homes, schools and your own therapy bag

Good communication skills with parents, schools, diverse health professionals, and the kids

Team player required to work with diverse team

Eclectic treatment approach, modern and up-to-date, SI, NDT / Bobath knowledge critical

Holiday – 5th to 25th August, ’13

Hello.

Please note that I will be away from 5th to 25th of August, ’13.  I will not have access to voicemail or text messages.  If you would like to reach me, please email me at munira@ot4kids.co.uk and I will respond within 1-3 days.

Thank you and hope all of you enjoy the rest of summer.

Munira

Write On!

I commonly get referrals for children with handwriting difficulties between 5-7 years old.

There are so many factors to consider when assessing a child who struggles with handwriting. Here are just a few:
1.  Core strength – Can the child sit upright long enough to do writing in class? Do they tire easily? How do they manage with gross motor and physical activities at recess or P.E.?
A child must have a strong core to sit in their seat and to support their arms for writing.

2.  Shoulder stability and arm strength – Imagine the shoulder to be like a hinge to hold a frame. It must be strong to support what hangs off it (i.e. the hand). Chances are if the shoulders are weak or unstable, it can’t support the hands.  This causes the child to tire easily and have poor grasp on their writing utensil.

3.  Visual motor and perceptual skills – Does the child use the muscles of their eyes to visually track objects? Do both eyes work well together? Does the child spatially organise parts to draw a picture such as a house or a person? This is necessary on a finer level to form letters.

4.  Fine motor skills – Are the child’s thumb and fingers strong enough to grasp and coordinate the pencil? Do they have isolated control of fingers or use their whole hand to manipulate their writing utensil?

5.  Body and spatial awareness – Is the child aware of front/back, right/left, top/bottom on their own bodies, when given directions, or to draw and write?  These skills are first developed with gross motor skills, on the playground, when building forts from sofa cushions and dining room chairs, playing with blocks and then forming letters.

6.  Balance, midline crossing and bilateral integration – Can the child balance in their chair or when sitting on the floor at circle time? Oftentimes a child may slump over the table or have difficulty sitting still at circle time due to core weakness and poor balance.  Have they developed a hand dominance? To do this the child must comfortably be able to turn their body and cross midline without losing their balance? And lastly, do they use both hands to play, get dressed, open / close bags, cut, or hold the paper while writing.

7.  Motor planning and sequencing – Can the child follow a sequence, problem-solve, do a multi-step task?
http://www.apraxia-kids.org/site/apps/nlnet/content3.aspx?c=chKMI0PIIsE&b=788449&ct=464199

8.  Attention, auditory processing, and more.

Could we help these kids earlier before starting school? ABSOLUTELY!
Here are some difficulties children who struggle with handwriting often have when younger:

-Disliked tummy time
-Short or no crawling period
-Described as ‘lazy’ and lacking desire to move
-Delayed infant milestones
-Cautious with movement and climbing activities

-Avoided manipulative or constructive play (blocks, Legos)

-Difficulty with hand actions to nursery rhymes

Handwriting is very complicated.  There are early red flags and children do benefit most from receiving therapy input early.  It’s never too early or too late, however earlier the better.  If children have the chance for early intervention, they can focus their energies at school on attention, learning, and playing with friends.

ot4kids has an office!

I’m so excited to tell you that ot4kids now has its own office space in Southfields, southwest London.

Funnily when I first moved to London a few years ago, somebody mentioned that they worked in Southfields. I think I probably scrunched my nose as I had no idea where or what Southfields was. And now I’m working here. 🙂

At first I wasn’t sure what to call this practice.  When I was in California, we’d use the term ‘Sensory Integration Clinic’  and in New York City, ‘sensory gym’.  Either way, I’ve always wanted a practice that is in a home so that it’s comfortable, a natural environment, and parents can replicate what we do in a treatment session using what they have at home.  I will have specialized therapy equipment however I will also use what’s naturally available in one’s home. I hope this will be a cozy practice where kids can have fun, grow and reach their best potential.

I’m also looking forward to start some BABY groups for parents and babies who are:

  • at-risk due to having prematurity or a traumatic birth
  • have medical diagnoses such as Down’s syndrome
  • have developmental delay or aren’t reaching their developmental milestones
Groups will be hands-on, targeted to a child’s needs, and kept very small so parents and babies can get the most benefit.   Feel free to contact me at munira@ot4kids.co.uk to sign-up or for further details.
I will put up photos as soon as settled in. Stay tuned. 🙂
All the Best! Munira

Sensory Processing – Early Warning Signs for Babies

In my practice I work with many children with sensory processing difficulties that are identified during their school years.  These children may struggle with concentrating in class, coping with transitions or changes, or playing with peers.  They can be clumsy, have difficulty holding a pencil or writing, awkward with their movements, or be either withdrawn or aggressive.  Oftentimes, they are very bright and as a result, their sensory processing difficulties are misunderstood.  Usually, warning signs were present as babies however parents were told to ‘wait and see,’ ‘your child will grow out of it’ or that their child is misbehaving.

Early signs of sensory processing difficulties I have seen amongst babies include:

  • Hates tummy time, prefers to sit or stand
  • Plays while sitting still versus moving around and exploring their environment
  • Tend to get ‘stuck’ with their movements, delayed milestones (e.g. rolling, crawling, clapping hands, waving)
  • Cautious with movement, dislike being laid down or moved
  • Fussy or irritable babies, cry easily sometimes for no known reason
  • Not a ‘cuddly’ baby, resists being held
  • Struggle to settle down or going to sleep
  • Difficulty with nursing, transitioning to other textures
  • Startles easily to loud sounds, distracted, avoids eye contact
  • Very easy going, described as a ‘lazy baby’, don’t know they’re in the room

These difficulties indicate that a child’s central nervous system is struggling to process sensory information.  It is a neurological problem that can impact on their movements and development, learning, and social-emotional skills.

Here’s a nice article that discusses the early warning signs of Sensory Processing Disorder amongst infants.

Due to the plasticity of a young child’s brain, there is hope and good potential for progress and improvement with Early Intervention.  If you are concerned about these early warning signs, seek advice from an Occupational Therapist who specializes in working with infants and younger children, particularly those with sensory processing difficulties.  It is never too early or never too late to get help.

Look here for links and books about sensory processing.

April is Occupational Therapy Month- Hug your OT! :)

I’m so happy there’s a month to celebrate and raise awareness about topics related to Occupational Therapy (OT).  But for me, everyday is OT day. I’m fortunate to have one of the best jobs and love working with the kids and their families.

OT is gaining much recognition and awareness over the past few years, primarily for working with adults.  However, people still do often ask me why a child would need an OT or what’s a child’s job?  My response is:  A child’s job is to move, play, learn, socialize and be happy.  As an OT, we work on the foundational skills they need to do these jobs such as their gross and fine motor skills, sensory processing, eye-hand coordination, or emotional regulation.  Parents, teachers, and siblings are a key part of this process AND it’s NEVER TOO EARLY to start.  The earlier a problem is detected, the earlier we can help.

Many of you know I lived in NYC for a number of years.  Oftentimes, I’d walk along Broadway and look down to see Times Square and its famous big screen.

The American Occupational Therapy Association has an ad playing on the big Times Square screen throughout this month.

Also, check out the AOTA’s Top 10 Reasons to Care about OT Month.

Until next time, Happy OT Month!

Seating for Children at Home and School

Infants and children must have good posture while laying down, sitting or standing so they have a good foundational base from which to move their arms and manipulate objects as well as attend and learn at school.  If a child has to concentrate on holding up their body, this will take away from their ability to grasp and manipulate objects and concentrate and learn at school.

Therefore, it is critical for babies and children to be well supported at their chairs and tables at home, daycares and schools during feeding, reading, writing and learning tasks.

If a child is unable to maintain good posture while sitting in their chairs at home or school, it’s important to consider whether these difficulties are contributed to by poor balance, body awareness, trunk and upper body strength, or sensory processing difficulties.

Here is a great article which describes how a child should be sitting in their chair, alternate sitting positions, and ideas for movement breaks.  Do share with teachers, family and friends.

October is National Sensory Awareness Month in the US

October is National Sensory Awareness Month created by Kathleen Morris from Sensory Integration Focus.

You can download a free poster of 10 signs and symptoms of SPD from SensoryStreet to raise awareness, thanks to Ida Zelaya.

Do share with doctors, teachers, nursery schools, family and health professionals.  The more people are aware about Sensory Processing, the earlier children can get help they need.

Sensory Processing Disorder (SPD) is a real neurological problem affecting 5 to 13% of children entering school.  With help from an Occupational Therapist trained in Sensory Integration, children with SPD show improvements in attention, learning, movement, socialization, coping and self-esteem.