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Occupational Therapy in the Home

The Occupational Therapy teams within The Autism Spectrum Disorder Assessment Team (ASDAT) and Child Adolescent Mental Health Service (CAHMS) learning disabilities has put together a list of resources to help parents/carers with OT activities in the home. Please navigate these below.

Getting through the day with sensory play

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Sensory Activities

Staying calm and regulated

Calm and Alert activity ideas and basic template

Please see below to download a template for delivering activities to help keep your child calm and alert. move to top

Download Calm and Alert template

  • Create a calm and alert poster 
Identify calming and alerting activities. We all have internal levels of arousal (otherwise known as levels of alertness). You can think of these as a scale of 0-10, with 0 being very sleepy or even asleep (perhaps how you feel last thing at night or first thing in the morning) and 10 would be really hyperactive, having lots of energy and being unable to sit down and concentrate. We all vary along this scale throughout the day but the ‘just right’ ideal level of arousal is 5, when we are alert and able to attend and concentrate to the things around us.
Creating an individual poster for a child or young person can help them and you to gain greater awareness of levels of alertness and what they ‘look like’ when they are feeling calm, alert and over-alert. There is a basic template with some activity ideas at the end of this advice sheet but there are lots of creative ideas online. Some people have used specific characters or animals to illustrate their poster to make it more personal.

Sensorimotor activities

Encourage your child to engage in a variety of sensorimotor activities throughout the day, these types of activities involve the following three sensory systems in particular: Proprioception, tactile and vestibular

You may start to identify which types of activities are stimulating for your child and which activities help them to become calm and regulated.

Proprioception

This is known as the ‘modulator’ of our nervous system and can help to calm and regulate the nervous system Carrying out any heavy work or activity that activates the muscles and joints, provides proprioceptive input including:

  • Jumping
  • Animal walks
  • Weight lifting
  • Yoga
  • Running, shuttle runs are a good idea in small spaces this can be done in the living room, hallway, garden or on the drive.
  • Crawling (through objects in an obstacle course for example)
  • Push-ups or planks
  • Pulling activities
  • Gardening
  • Baking
  • Bouncing on or playing catch with a large therapy/ exercise ball
  • Hoovering (if noise is tolerated)
  • Sweeping, washing the car/ windows etc.

Oral Motor Activities

This relates to activities which develop muscle tone around the mouth. These activities can also be calming for the child who has difficulty regulating their behavioural responses. Some children may chew items and objects when they are seeking proprioceptive input. These activities can also be useful prior to eating a meal if a child has difficulty tolerating textures for example.

Blowing Activities

  • Using whistles of varying shapes to make sounds
  • Blowing through party blowers that unwind as the child blows them up
  • Playing on hands and knees, or kneeling by a table top, blow balloons back and forth with a partner
  • Blowing cotton reels across the floor to a finishing point
  • Blowing shell boats across a table top ‘pond’
  • Blowing ping pong balls around an obstacle course or tray
  • With a straw blowing blobs of paint across paper to form patterns
  • With a straw blowing into water with a small quantity of washing up liquid in, to froth the water into bubbles. N.B. Watch that blowing does not become sucking by mistake
  • Use a straw and a rolled up piece of paper to play ‘blow football’ across the table
  • Any small games which involve blowing that can be purchased commercially

Sucking Activities

  • Using straws to drink with. Thinner straws are harder as are thicker drinks like milkshakes
  • Using a straw transfer large dried peas or chocolate buttons from one plate to another in a given time. Decrease the time. Use heavier items.
  • Using a straw, lift paper fish from a ‘pool’ into a ‘net’. Start with thin paper.
  • Upgrade by: Increasing the number of fish in a given time
  • Make the fishes from thicker paper
  • Use two different colours and ask for only one colour to be caught
  • Mix the ‘weight’ of fish to be caught

Other Games

  • Rhymes and stories which involve mouth movements to pucker the lips or blow as in blowing a candle out, etc.
  • Chewing and sucking on food and sweets. Crunchy foods e.g. carrots and apples provide the child with proprioceptive input which is calming and helps them develop awareness of movement and body position.
  • Making faces in the mirror – copying or playing ‘Simon says'.

Tactile play

Incorporate some tactile activities into your daily routine. You can also use some of them to encourage writing (shapes and letter formation) or spelling practice. If the child finds any of these experiences uncomfortable, stop and try something else:

Guidelines for providing tactile experiences

  • A quiet and enclosed area is most beneficial
  • Where possible the child should play with arms and legs bare to increase the tactile experience, but only if tolerated
  • Children often find touch much more acceptable when applied to their arms and legs rather than their faces or other body areas.
  • Deep touch pressure applied by the parent is more beneficial than light pressure.
  • Sand play - dry sand then add water to wet the sand. Draw pictures / write words in the sand
  • Water play (in a bowl or padding pool - use different sized containers to pour / measure / play). Add bubbles!
  • Paint on a plate or a smooth, flat surface - use your finger to make shapes / letters or pictures. Press paper onto the wet paint to make a picture
  • Use shaving foam, yoghurt or 'squirty' cream on a smooth surface to form shapes and letters (ensure child does not lick hands or put in their mouth if using shaving foam)
  • Use large paintbrushes and plain water to paint on outside walls or patios
  • Use chalk to draw on paths, drives, patios or walls
  • Use cooked pasta / spaghetti to hide objects in - encourage the child to feel for them without looking and guess what they have found.
  • Use dried beans, rice or lentils in a bowl or box to hide objects in
  • Mix cornflour and water and place small plastic toys into it for your child to play with
  • Use cooked spaghetti to make letters and spell out words
  • Use clay, Plasticine or play dough to make models. You can even make your own playdough with flour, salt, vegetable oil and food colouring (N.B.food colouring may stain) - Playdough recipe
  • Use your finger to 'draw' letters on your child's back or arm and see if they can guess what letter you are drawing
  • Pop or walk on jiffy bag liners or bubble wrap.
  • Draw on textured surfaces, e.g. tree bark, coin rubbing, corrugated card.
  • Pretend to 'make pizza' on your child's back by getting them to lie on the floor, then pretending to knead and roll out the dough by pressing and rubbing their back, then adding different toppings (spread on tomato sauce, sprinkle on cheese etc.). Ask the child what toppings to add and pretend to put them on to. Use different pressure and touch for each topping. If the child is uncomfortable with any of them, do not continue but try something else. For children who are sensitive to touch, firm touch tends to be more comfortable than light touch.
  • Apply a variety of materials e.g. talcum powder, shaving foam, baby lotion etc. to the child's arms and legs. Get them to rub it off of their skin using different textures e.g. shower buff, furry material, plastic spatula, nail brush, cotton wool, towel.

Vestibular system

Vestibular activities include any activity that moves the head in different planes e.g. head positioned forward, downwards, tipped back, turning from side to side, head tilted forward etc. Vestibular input improves the muscles ability to work and improves balance/ coordination. Vestibular activities can be stimulating for the under-responsive child and particularly when combined with proprioceptive activities can be calming for the over-responsive or sensory seeking child. Some vestibular activities include:

  • Wheelbarrow walking
  • Working over an exercise ball in prone (on tummy) and rocking back and forth slowly (your child could complete a puzzle or jigsaw in this position)
  • Gentle rocking in a rocking chair
  • Riding on a rocking horse
  • Forward/backward rolls
  • Bouncing on a space hopper etc.
  • Playing games/songs that have a vestibular element e.g. row, row, row your boat, I’m a dingle dangle scarecrow (lying down and jumping up), head, shoulders, knees and toes etc.
  • Hanging upside down on a climbing frame in the garden
  • Running in and out of cones or in a figure of 8 shape, change direction – make into an obstacle course
  • Balance activities – balance beams, stand on half inflated beach ball, balance items on head whilst walking
  • ‘Simon says’ games with actions that change position e.g., touching the floor, leaning back to see what is behind etc.
  • Log rolling – lie on the floor and roll across the room – repeat in opposite direction
  • Encouraging marching, stomping and walking on uneven surfaces to improve balance and coordination (this can be included in an obstacle course).

You should always follow vestibular work with proprioceptive activities (see section above) to minimise any adverse reactions. Stop the activity if your child looks pale, complains of a headache or is nauseous. The activities above also involve the proprioceptive system so should not cause any adverse reactions.

Other sensorimotor activity ideas

  • Create a ‘sensory path’ in the garden or house using chalk or tape to map out your course, this could include sections of the sensory path to hop, skip, jump up/down, spin, hopscotch, do animal walks. There are lots of ideas online and parents have been sharing their creations (Sensory Stuck at Home on Facebook has some ideas).
  • Build an obstacle course in the garden or house, include everyday objects and furniture to climb over, under, around and through, low balance beams, trampoline, bouncing and hopping, objects to squeeze through. You don’t need to have specialist equipment, just use what items you have in your home or garden, you could even use items with different textures to add a tactile element.
  • Gardening: this provides lots of proprioceptive input digging into the soil, weight bearing on hands and knees. The smell and feel of the soil (gardening gloves should be worn or wash your hands really well when finished), fresh air and sunshine, listening to the birds and sounds around you can help us to feel grounded and connected.

Quiet time

Encourage your child to have some quiet and relaxation time throughout the day. A change of routine can increase anxieties and worries as well as the current situation. Try to limit the amount of time your child access the news throughout the day and try to avoid them listening to the news last thing at night as this can raise levels of anxiety.

Ideas for quiet activities

  • Make a den with sheets in the corner of a room or bedroom and use large cushions, beanbags or pillows to create an area that the child or young person can squeeze into and use this as a quiet safe space
  • Listen to calming or relaxation music
  • Lie in the garden on a blanket if the weather is good and listen to all the sounds around you
  • Mindfulness colouring
  • Play board games as a family
  • Use playdough, Fimo, plasticine or moulding clay
  • Do some baking or make some bread
  • Complete the daily Lego challenge

Wellbeing and Autism Wheel

There may be other difficulties that your child may be are experiencing at the moment such as poor sleep, eating and other sensory issues. Please refer to the Wellbeing and Autism Wheel.

In the ‘ways to help my child’ section there are useful resources on:

  • Sleep
  • Eating
  • Sensory, which explains all the different sensory systems and possible explanations, activities and ideas
  • Daily Living Skills such as bathing, dressing, tooth brushing and toileting

Helpful websites with ideas to keep children and young people entertained 

 

Resources to help explain about Covid-19/ Coronavirus