When receiving therapy services in a pediatric clinic, it is important for therapists to remember that the older children who come in require a slightly different approach to their intervention plan. This is just as important when working with these older kiddos in the home. Some activities that are fun and intriguing to the younger kids just may not be “cool” for the older kids! When working with middle school and high school aged kids, we need to be a bit more creative to find fun, yet effective ways to address OT goals. We need to make sure that the activities provide just the right challenge but are not patronizing to these older kiddos.
OT goals may look completely different if you compare a three year old to a 15 year old’s goals. When kids are younger, the goals may often reflect skills such as simple cutting tasks, pre-writing skills, eating or feeding, or self-dressing. When kids are older, their goals may reflect skills such as writing, typing, strengthening, or pre-vocational skills. For example, a high school aged individual and their family may be looking at life after school which comes with a new skill set. This certain kiddo may want to get a job or move out of their parents’ home. In this case, it is important for OT to focus on the skills that this individual will need to be independent on their own. After all, that is all an OT wants, for their clients to be as independent as possible!
The following are just a few activities that can be done at home for those older kiddos to increase their skill set.
- Crumple Paper: Have your child crumple a sheet of newspaper or scrap paper in both hands until it is a tight ball. If you need a challenge, only let them use one hand at a time. Make it fun and toss it in a basket- 2 points!!
- Walk a Ball: Have your child use their fingers to walk a small ball up and down the legs. If you need a challenge, only let them use their tripod fingers (thumb, index finger, middle finger).
- Theraputty Search: Hide small manipulatives into a strong theraputty and have your child search for each piece with their fingers. Have them stretch the theraputty and use their pincer grasp (thumb and index finger) to remove each piece that is found. For a challenge, use a stronger theraputty.
- Coin Slot: Make multiple small slits in the top of a shoe box, both vertically and horizontally. Have your child pick up coins using a pincer grasp (thumb and index finger) and insert the coins into the slots.
Upper Body Strengthening/Coordination
- Hand Grip Squeezes: Using a hand gripper, have your child squeeze the gripper for 3 sets of 10 repetitions with each hand.
- Tennis Ball Toss: Toss a tennis back and forth with your child. You can toss and catch the ball with both hands and then with only one hand. Add a challenge by distancing yourselves or adding in additional moves to the activity (put the ball around your back, bounce the ball to each other, hop three times, etc.)
- Resistance Band Exercises: There are a variety of exercises that can be used with a resistance band. Securely step on one end of the theraband. Bicep curls: Bend elbow up toward shoulder, hold for 1 second and slowly return to starting position. Tricep pull down: Elbow is bent with palm downward. Hold band at waist level, then straighten elbow and hold for 1 second. Slowly return to starting position. Band pull apart: Loop band around each palm and put arms in front of body with elbows slightly bent. Pull band outwards, across your chest, hold for 1 second and slowly return to starting position.
- Typing: Complete typing classes with your child using typingclub.com. This program promotes the use of the home row keys and makes your child comfortable with the keyboard. There are also games on the program to improve typing speed.
- Handwriting: Have your child copy sentences from their favorite book. Ensure that their letters are placed properly on the baseline, and have appropriate spacing and sizing of letters.
- Home Management: Have your child sort laundry into similar colors. Have them complete the washing and drying cycles and then fold them properly with visual or verbal prompts.
- Retail/Grocery: Give your child a budget and let them make a list. Label clothing items or groceries around the house with prices and have them complete a simulated shopping trip.
- Cooking: Have your child find a simple recipe of a yummy treat and have them make a list of the items that are needed for ingredients. Have them follow the recipe with visual or verbal prompting as needed to keep them safe.
- Filing Paperwork: Provide your child with a list of names and simulate filing information in alphabetical order. Provide a challenge by giving a longer list of names with last names using the same first letter.
Always keep in mind that it is important to grade these activities to the appropriate skill level. We do not want frustrations to arise and a child to no longer want to participate because the activities are too difficult. Some older kids just need to put in some extra work sometimes, and that is just fine, as long as we have the right approach!
-Rachel Guiser, OTR/L