Therapists love nothing more than finding ways to solve problems. For me, it’s one of the best parts of my job. So, today I thought I would go over some of the best ways I have found to solve the problem of access. By access, I mean the ability to play with, hold, use, and interact with things in the environment like toys, games, school materials, etc. Children with developmental delays and movement impairments often are not able to play with and explore these items independently. However, adapting items to meet their specific skill level can allow them to do just that.
As a therapist my goal is always to teach kids how to perform tasks on their own, or as we say independently. However, before a child completely masters a skill, they need to be able to explore and experience their environment as much as possible with whatever movement, strength, and control they have right now. The ability to independently explore and experience gives them a motivation to work on skill acquisition and is essential to learning.
The list of ideas I have on this topic is really long, so since we are headed back to school, I am going to focus my ideas on access to school type items. But, I promise I will revisit this topic at a later day with more ideas.
Things to consider first…
When trying to adapt a specific tool, toy, or game, I first consider these three ares:
- Physical Movement: Does a child have a condition or disorder that affects how their muscles function or how much control they have over their muscles? For example, children with cerebral palsy can have increased muscle tone, or tightness in their muscles. This tightness might impact the strength, control, and coordination in the muscles of their arms and hands. Due to the mobility limitations in their arm and hand they may not be able to independently turn the pages of a book. So, I would need to make adaptations to the book that would allow them to turn the pages independently.
- Vision: Does a child have difficulty seeing, perceiving, or processing the materials? I am by no means a vision specialist, but I am lucky enough to work with some amazing OTs and vision teachers in my school district that are very specialized in this area. These amazing ladies have taught me some simple tips and tricks to adapt activities for kids with both acuity and perception deficits. And, in order to increase my understanding in this area, the told me about a great website: www.eyecanlearn.com. This website really helped me understand the basics of visual perception and processing deficits.3
- Sensation: Is there a specific sensory component to this item that is making the child resistant to using it, overstimulated by it, etc.
Favorite Materials…
Ok, now that we know what areas we need to consider when adapting, let’s talk about some of my favorite materials. Purchasing pre-adapted items can get pretty pricey. But, I have found that adapting things on your own can be pretty inexpensive if you have the right tools. Some of the basic tools I always have on hand are:
- Pool Noodles: Great for padding surfaces and creating things.
- Duct Tape: It fixes everything!
- Velcro: Great for securing items and making items moveable.
- Dycem: This is the most expensive item on the list, but it is worth the cost. I have tried to use shelf liner in place of Dycem, but it’s never quite as good.
- Laminator: An inexpensive laminator can protect all of the materials you have worked so hard to create.
Adapted Ideas…
Books: Board book pages can be really difficult to get your fingers between to turn. Creating a little space in between the pages can really help a child with diminished fine motor control access the book. To create this space, try hot gluing pom poms between the pages. These soft little spacers are usually just enough to allow fingers to slide in. I have also seen books adapted with craft sticks. Pom Poms and craft sticks also provide a textural prompt to where the pages separate for kids with visual impairment.
Board Games: Games like Candy Land and Shoots and Ladders can be a lot of fun and a great way to practice skills like counting and color identification, but if a child has difficulty control their hand/arm when reaching they can often knock the pieces off the board, This can be very frustrating for the child and often leads to an adult just moving the piece for them. So, try using small velcro dots on the bottom of the playing pieces and each square on the game board. With this technique, even if the child over shoots their piece and bumps the other pieces with their hands, everything will stay in place. The velcro also creates a more stable target for them to grab their own piece. Put the game on a large lazy Susan so you can move it closer and get the best angle. For games like monopoly with cards to draw, try putting them vertically in a small plastic container. Tip the next card to draw forward and velcro the container to the board. This will allow the child to easily grasp one card and not knock the container over in the process.
Playing Cards: There are a lot of great commercial card holders out there to assist a child with card games. Here are some of my favorites. As I have learned from some of my SLP friends, these card holders are not only great for playing cards, but also great for holding communication pictures. However, I do find that these holders can easily topple over if bumped by a child during a reach, so try velcroing them to the surface, or using a piece of dycem under the holder to improve stability. If you don’t want to purchase a card holder, you can make an inexpensive one out of a pool noodle. Simply cut the noodle in half with a serrated knife, then cut an opening in the top to allow cards to slide in. This slit can be hard to find once you cut it, so try using a marker to trace around the opening. This pool noodle card holder can be velcroed to the surface. Or, you can create a handle for it with another small piece of pool noodle taped or velcroed to top piece.
Ars and Crafts: I want to preface this section with a reminder that I am a PT not an OT. So, I am definitely not qualified to teach you about grasping and a child’s ability to hold a pencil, crayon, or pair of scissors. Instead, I want to use this section to give you a few ideas on how to allow children with movement limitations to access small items like crayons and paint brushes if they have limited control and grasping abilities. First, try building up the circumference of the grasping area. Larger items are usually easier to hold and control. This can be done by cutting a hole in a foam ball and slipping a crayon in or using a foam dart and pulling the elastic mechanism out. If you would rather purchase an item, try this universal cuff. One of my favorite OT friends uses this item often with many of the students we work with. Making crayons in silicone molds that have a larger grasping area can be a fun activity and a great use for broken old crayons. The large size of these crayons make them much easier to hold and control. There are also tons of adaptive products you can buy. I will link my favorites at the end of this post and in the toolbox section.
Paper Activities: When helping kids access paper, worksheets, and communication boards I usually follow two rules. 1. Keep the item still. Paper loves to slip and slide all over the surface. So, keeping it still can be definitely improve access. The easiest way to do this is a with a clip board and dycem. 2. Change the angle of the item. Angling an item up and closer to the child can bring it into the child’s visual field and provide a support surface for upper extremities that are accessing the item. My go to for paper items are slant boards and dycem. Slant boards can purchased online. Here are a few my OT friends like: More often than not, we usually make them. There are several easy ways to make a slant board. First, grab a 3 ring binder. These come in multiple sizes allowing you to change the angle. Binders can slide around so of course I usually put dycem under them. If you need the paper to adhere to the slant boar, try hot gluing binder clips or clothes pins to the top. I also made a slant board from an upside down spice rack I found at the Dollar Tree. The small legs at the bottom allow you to put tablets, dry erase board, clip board, etc on the surface and hold them in place. Not surprising, I would put dycem under it to hold it in place.
Videos: Did you know that you can slow down YouTube videos to allow your child to keep up with the dance or exercises? Simply click on the cog wheel icon at the bottom right of the video screen. Select playback speed and choose your speed. Slowing down a dance video may give a child time to safely perform the activity and decrease frustration as they start learning.
Free Online Adapted Resources: tarheelreader.org Tarheel Reader is an amazing website full of books that can be read aloud to your child. If your child can use a mouse they can turn pages using a laptop. You can also access this website on a tablet allowing kids to simply touch the icon to turn the page. Many of the SLPs I work with connect switches to computers to allow kids to turn the pages that way. When you choose a book you can determine what kind of voice a child hears and what colors work best for the text and background.
There are so many simple and inexpensive ways to adapt tools and materials for special needs kiddos. I hope these ideas were helpful. If you have any ideas or questions, please comment below. I would love to hear from you. Thanks for stopping by!
– Heather
Products used/mentioned in the video:
Pom Pom: https://amzn.to/309bkAh
Candy Land and Chutes and Ladders: https://amzn.to/2CXMhY4
Playing Card Holder: https://amzn.to/3hKlQ6W
Playing Card Holder: https://amzn.to/3jN7BjA
Universal Cuff: https://amzn.to/2P7QomY
Palm Grip Crayons: https://amzn.to/3f9ukmy
Large Grip Paint Brush: https://amzn.to/3f9ukmy
Loop Scissors: https://amzn.to/3f9ukmy
Mounted Table Top Scissors: https://amzn.to/3f7VKcs
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