school readiness skill building from an ot perspective paola azzuolo ot reg(ont.) all kids can fly ...

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School Readiness Skill Building from an OT perspective Paola Azzuolo OT Reg(Ont.) All Kids Can Fly www.allkidscanfly.ca [email protected]

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School Readiness Skill Building

from an OT perspective

Paola Azzuolo OT Reg(Ont.)All Kids Can Fly

[email protected]

www.allkidscanfly.ca [email protected]

What skills are required to be school ready?

• Good Hand Skills• Upper Extremity Control • Grasp Patterns • Bilateral Hand Skills • Visual Motor Control • Activities of Daily living.• Self-Regulation

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Hand Developmental Milestones

• Development of arches in the hand

• Development of wrist extension.• Development of an awareness of

the skilled side of the hand.. • Development of an open web

space.

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Upper Extremity Control

• This control comes from the ability to move your arm with precision as well as the ability to vary the strength or force of movement.

• Factors that contribute to upper extremity control are shoulder, forearm, wrist strength, and good body in space awareness.

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Grasp Pattern Development

• Fisted grasp: The pencil is held in a fisted hand with the point of the pencil on the fifth finger side of the hand. Child’s wrist is slightly flexed and forearm supinated. This is typical of children ages 1-1.5 years.

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Pronated grasp: • The pencil is held with the all

fingers and thumb with tip in thumb and index. This is typical of children ages 2 to 3 years.

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Static Tripod Grasp : • Grasp with tip of pencil in the

thumb, index and middle fingers, movement comes from arm and shoulder. This is typical of children ages 3-4 years.

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Dynamic Tripod Grasp:

• Grasp with tip of pencil in the thumb, index and middle fingers, movement comes from fingers while pinky side of hand rests on table. This is typical of children ages 4.5-6 years.

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Inefficient Grasp Patterns

• Five finger grasp: The pencil is held with the tips of all five fingers. The movement when writing is primarily on the fifth finger side of the hand.

• Thumb tuck grasp: The pencil is held in a tripod or Quadripod grasp but with the thumb tucked under the index finger.

• .

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Inefficient Grasp Patterns

• Thumb wrap grasp: The pencil is held in a tripod or Quadripod grasp but with the thumb wrapped over the index finger.

• Tripod grasp with closed web space: The pencil is held with the tip of the thumb and index finger and rests against the side of the third finger. The thumb is rotated toward the pencil, closing the web space.

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Inefficient Grasp Patterns

• Finger wrap: The index and third fingers wrap around the pencil. The thumb web space is completely closed.

• Flexed wrist or hooked wrist: The pencil can be held in a variety of grasps with the wrist flexed or bent. This is more typically seen with left-hand writers but is also present in some right-hand writers.

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Examples of Pencil Grasp

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Bilateral Hand Skills

• Refers to the ability to use your hands together to accomplish a task.

• For example, when drawing, the pencil is held in the dominant hand & the non-dominant hand is preventing the paper from moving.

• Another example is when using scissors, the lead hand is operating the scissors & the assist hand is holding & turning the paper when cutting around a corner.

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Age Expectations for Scissor Skills

2-3 years: • often holds scissors with two hands to

open and close• Begins to open and close the scissors

with a mature grasp• Learns to snip paper; there is no

forward movement of the scissors• May be able to use “helping hand” to

hold paper and bring into scissors

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Age Expectations for Scissor skills

3-4 years:• Cuts on straight lines with some accuracy• Cuts on curved lines and around corners, but

without accuracy• Begins to turn the paper with “helping hand”

4-5 years:• Can cut fairly accurately along curved lines

and around shapes• Turns the paper fairly effectively with “helping

hand” to stay on the line

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Visual Motor Control

• Refers to the ability to coordinate eyes, arms & hands.

• Contributes to one’s ability to learn new shapes, cutting, drawing and writing

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Age Expectations for Visual Motor Skill Development

• One year old: scribbles• Two year old: imitates vertical lines,

horizontal lines, paints• Three year old: copies circles, imitates

oblique lines• Four year old: Draws a person with 3

body parts, copies a cross• Five year old: Copies a triangle, draws a

person

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Activities to improve Visual Motor Integration

• Salt tray• Clay tray: use gold tees to draw • Shaving cream• Popsicle sticks• Pegboard or Lite Brite• String colored beads with a pattern• Sidewalk chalk• Lacing• Coloring• Origami• Flashlight tag• Play catch with various balls

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Activities to Promote Hand Skill Development

• Squirt bottles, turkey basters, eye dropper activities • Bead stringing/lacing• Pouring • Practice opening different lids • Spin tops or play with wind-up toys• Various small writing tools (chalk, pastel)• Pop Bubble Wrap • Play dough/Silly putty• Use of various tongs• Tearing paper or crumpling paper into balls• Handful of pennies into slots

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Activities to Promote Handwriting Development

• Painting, chalk, coloring,• Drawing people or homes or animals• Building letters with straws or popsicle sticks• Learn upper case letter formation before learning lower

case. • Use small writing tools• Encourage top to bottom formation for vertical lines;

left to right formation for horizontal lines (unless left-handed); and counterclockwise rotation for O, C, Q, G (unless left-handed).

• Recommend Handwriting Without Tears (www.hwtears.com) program for learning letter formation.

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Correct Seating/Posture • Look Out For: 1. Tables that are too high/too low2. The students legs dangling from the

chair without support under their feet • What Can You Do: 1. Place the child’s feet on a couple of

phone directories or a small stool2. Raise the height of the chair or the

table 3. 90-90-90 rule

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Dressing Skills

One year old:• Removes socks• Puts on and takes off hat• Assists with dressing

Two years old:• Removes shoes• Pulls down pants• Assists with undressing and dressing

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Dressing skills (continued)

Three Years:• Can button large front buttons and zip and

unzip a jacket if the shank is already connected.

Four years:• Able to insert the shank together to zip up a

jacket with practiceFive years:• Able to dress independently depending on

how much practice he has had

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How to promote dressing skills

• Use backward chaining approach• https://www.canchild.ca/en/canchildreso

urces/resources/chaining.pdf

• Visual schedules can be useful for some• Best to encourage parents to work on

such skills at bath time (for undressing) or during weekends as it needs not to be rushed.

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Self-Regulation• Is a critical competency that underlies

the mindful, intentional, and thoughtful behaviors of younger and older children alike.

• Self-regulation or Executive function refers to the capacity to control one’s impulses whether it be to stop a behavior or to start, if needed.

• Self-Regulation is not obedience or compliance

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Development of Self-regulation skills

• Self-regulated children can delay gratification, suppress impulses long enough to think ahead to the consequences of their actions and to consider alternatives actions

• Not limited to the social-emotional domain• Also applies to the cognitive behaviors such

as remembering or paying attention.• Self-regulation is ranked as the most

important competency for school readiness

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How to promote it?

• Eliminate waiting in line with nothing to do, wandering around the classroom during center time, being unclear about what to do during an activity, and not being able to get help.

• Rather, create a consistent classroom in which expectations are clear and fairly enforced and where children are engaged in meaningful activities at all times.

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Make-believe Play

• Mature, intentional make-believe play is foundational for self-regulation development in preschool

• All play is NOT created equal• Make-believe play provides the three

types of interactions which lead to self-regulation:

1. Regulation by others2. Regulation of others

3. Self-regulation

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Do you have any questions?

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References• American Occupational Therapy Association (2002).

Occupational therapy practice framework: Domain & process. American Journal of Occupational Therapy, 56, 609-639.

• Bridgeman, M. (2002).The Finer Motor Olympics. Maine: Therapro, Inc

• Case-Smith, J. (2005). Occupational Therapy for Children. Missouri: Elsevier.

• Erhardt , R. (2009). Erhardt Developmental Products Hand Poster. Texas: Pro-Ed.

• Frick, S.M & Kawar, M.J. (2004). Core concepts in Action. Wisconsin: Vital Links.

• Henry, D. (2004). Sensory Integration Tool Chest: For Teachers, Parents and students. Arizona: Henry Occupational Therapy Services.

• Sena, L. (2004). Fingermania: Program for hand skill development. Maine: Therapro.Inc.

www.allkidscanfly.ca [email protected]

Links• http://www.choc.org/wp/wp-content/uploads/2

014/11/Rehab-Developmental-dressing-skills.pdf

• http://dcd.canchild.ca/en/EducationalMaterials/resources/dcd_scissor_skills_2013.pdf

• https://www.naeyc.org/files/yc/file/201107/Self-Regulation_Florez_OnlineJuly2011.pdf

• http://illinoisearlylearning.org/tipsheets/self.pdf

• http://www.toolsofthemind.org/philosophy/self-regulation/

• http://developingchild.harvard.edu/resources/tools_and_guides/enhancing_and_practicing_executive_function_skills_with_children/