Checkup Newsroom

Fun Summer Activities To Improve Your Child's Handwriting

Thu, 15 Jun 2017 11:21:34 -0500

The school bell has rung for the last time of the 2016-2017 school year! Are you finding yourself wondering what to do to make sure your child will have the same quality of handwriting when he/she returns to school? Or better yet, have you thought about what you can do to improve your child’s handwriting? Handwriting can be a challenge anytime of the year and finding ways to practice during the summer can take a little bit of creativity.

You may not have really ever sat down to think about it, but good handwriting requires many things working together at the same time. Each of these things play an important role in the quality of handwriting your child puts on paper: strength of hands, arms, and core, bilateral coordination (both hands working together), visual perception (how your brain interprets what you see), visual motor (eye-hand) coordination, and fine motor precision (how fine-tuned fingers move together).

Here are some summer activities that DON’T involve pencil and paper that you can do as a family to improve or maintain your child’s handwriting skills:

Go to the park and use the monkey bars and climbing walls -increases hand, arm, and core strength.

Paint the side of the house with a bucket of water and a paint brush – increases strength of hands, arms, core and bilateral coordination and visual motor coordination.

Water play with squirt bottles or water guns using index and middle fingers to squeeze handle – strengthens hands and fine motor precision.

Soak a sponge full of water and then wring it out in another bucket or an older child could help wash the car – strengthens hands and bilateral coordination.

Use side walk chalk on the driveway to make pictures, shapes, and/or letters – fine motor precision and feedback to where your hand is in space.

Pop bubbles with one finger or two hands together– increases fine motor precision and bilateral coordination.

Play the game “Hot Potato” with a balloon filled with air. See how long you can pass the balloon back and forth without the it falling on the ground. Add more balloons when one balloon is too easy. – Improves visual motor coordination.

Create with playdough – Increases strength of fingers and fine motor precision.

Swim freestyle, back stroke, breast stroke or butterfly (with adult supervision, of course!)– increases core, arm, and hand strength, and bilateral coordination.

Water play in the shallow end with splash balls or a beach ball (again, with adult supervision) - increases visual motor coordination, strength, and fine motor precision.

Go fishing at a lake, pond, create a pond using a tub, or Bass Pro Shop has a free fishing event Saturday mornings (check your local store): increases bilateral coordination, core strength and visual motor coordination

Take Karate lessons– increases core and arm strength and bilateral coordination.

Learn to play a musical instrument – increases visual motor coordination, bilateral coordination, and fine motor precision.

Woodworking or gardening with an adult either at home or workshops for kids. Some Home Depots offer free workshops for kids on the first Saturday of the month (check your local store)– increases strength, visual motor coordination, bilateral coordination and fine motor precision.

Take advantage of the good summer weather and let your child learn while enjoying the outside!

About the Author

Marybeth Oliva is an occupational therapist at Cook Children's. Occupational therapy focuses on fine motor and functional skills to enhance development, restore function and to prevent disablility from pediatric conditions, illness and injury. At Cook Children's, we understand that no two children are alike. That's why we offer four types of therapy plans, tailored specifically for your child and his or her needs. We want to make every appointment unique for each family.

‘Much More Than His Diagnosis’

Thu, 25 May 2017 09:46:54 -0500

Forget that Nathaniel Adams has a rare genetic diagnosis called Opitz G/BBB syndrome. That’s not who he is.

His mom, Crystal, will be the first to tell you her little boy is just "a really cool kid."

“He is very smart. He loves dinosaurs and wants to be a paleontologist when he grows up,” Crystal said. “Nathaniel is more typical boy than not. He likes to run, jump, climb, be gross and tell silly jokes. He likes to have fun.”

So with his love of dinosaurs and all things that comes with being a boy, it makes sense that Dinotrux, swimming and an assortment of popcorn salts have helped with his treatment in speech therapy.

Nathaniel was born on April 22, 2010, via C-Section following his mother's water breaking and labor not progressing at 36 weeks. He stayed in the Neonatal Intensive Care Unit (NICU) for 3 weeks.

Nathaniel was nasogastric fed (a tube is placed through your nose into the stomach) for a while in the NICU due to being a "sleepy" eater. He also has a history of gastrointestinal reflux. In addition, he has low muscle tone which requires more energy to use his oral motor skills for saying sounds.

Nathaniel received early childhood intervention services until he was about 15 months old. His gross and fine motor skill development were delayed as well as speech. He also struggled with chewing certain foods and would either gag or vomit to get the food out. Crystal said, “Those skills along with every other milestone have developed at his own pace and in his own time. He can't be rushed.”

In addition to seeing Mary Kukolich, M.D., in Genetics, Nathaniel receives speech therapy and occupational therapy at Cook Children’s. Nathaniel’s pediatrician and gastroenterologist (Carrie Jones, M.D., and Jane Keng, M.D., respectively) are also with Cook Children’s.

Along with his stint at the NICU, Nathaniel received eye muscle surgery and hypospadias repair at the medical center.

“Our experiences with Cook Children's have always been positive! The doctors and staff not only do their jobs with the highest of quality but they also care about our baby, and that means the world to us,” said Crystal.

Nathaniel has been coming to speech and feeding therapy at Cook Children’s Rehab in Hurst since August 2016 to improve sound production and add foods to his diet as he was a very picky eater.

Before coming to therapy, Nathaniel was extremely anxious especially in social situations with his peers. Nathaniel's family did not feel that public school was the best fit for him so they chose to homeschool him.

When Nathaniel was asked what new things he learned in therapy, he stated he learned how “to do sounds,” to chew foods and how to eat new foods. He also said he learned to use arrow eyes.

“You have to look at the person when you are talking to them.” Nathaniel said that he didn’t look at people because he was afraid. He was afraid like Click Clack (a character in the show Dinotrux). “He is always afraid. But now I am like Revvit. He’s not afraid and I’m not afraid anymore.”

Nathaniel’s mom, Crystal, reported that he made coming to speech and feeding therapy sound so fun that his cousin wanted to come too.

“Nathaniel loves to go to therapy,” Crystal said. “His cousin asked him what he does at therapy. He said he plays fun games with his friend Mrs. DeeDee and they "do sounds" and that he eats fun foods with his "friend" Mrs. Kathy. Since starting therapy he has grown so much. His sounds have improved greatly. His confidence has increased, and with the help of those handy popcorn salts he will eat almost any vegetable, except green beans. He says nothing can make those taste better. “

So what do popcorn salts have to do with therapy? When Nathaniel first started feeding therapy, he typically looked at a new food and stated it’s “yucky.” One way he began tasting new foods especially vegetables was to season them with a variety of popcorn salts. Nathaniel was discharged from feeding therapy in March.

Crystal reported that meal times are so easy and enjoyable now that Nathaniel is willing to eat a wider variety of foods. Nathaniel said he likes to “make new recipes” with his mom. Tears come to his mom’s eyes when he asks for seconds of a food he has just tried.

One day while driving in the car, Nathaniel asked his parents if they would help him make friends. His parents decided to enroll him in swimming lessons which would not only be a good way to make friends but also a good activity to build muscle strength and endurance. Now when he comes to speech therapy, he tells his therapist all about his friends. His mother reported that he has so much more confidence now to talk to people and they understand him. As a mother, it’s nice to go somewhere and watch your child be excited to go play. This is something that Nathaniel never would have done before participating in therapy.

According to Nathaniel’s mother, coming to speech and feeding therapy has built his confidence, decreased his anxiety and made mealtimes more fun. However, the most important result of coming to speech therapy is Nathaniel’s increased confidence and desire to make friends.

“Nathaniel enjoys eating now! And he has so much to say, thanks to his speech therapists he is able to say what's on his mind and be heard and understood as well as have the confidence to talk to other kids and make friends,” Crystal said.

About the Author

Kathy Soland is a speech pathologist at Cook Children's Rehabilitation Clinic in Hurst. Speech and language pathologists evaluate, treat and develop programs and activities to help children with feeding and swallowing, articulation, voice and hearing loss, to name a few. If you child's condition affects hearing, speech and/or language, you may be referred to one or a combination of these therapists. Learn more about audiology and our rehabilitation services. To learn more about making an appointment, click here.

Warm up to stretching

Mon, 29 Dec 2014 14:20:15 -0600

Although dynamic stretching is important for everyone, it may have an even greater importance for young, growing athletes. Bones typically grow at a faster rate than muscles so it’s important to improve the muscles flexibility to allow pain-free motion.

The role of warming up and its impact on performance is debated regularly. Sometimes the coaches of our kids’ sports teams do not find the time to have the athletes perform an appropriate warm up prior to practice. They may not see enough benefit to use precious practice time for warming up. However, participating in sporting activities, practice or competition, without an appropriate warm up can not only decrease performance, but also place the athletes at risk for injury.

Much of the recently published evidence shows that static stretching (i.e. holding positions for set amounts of time) can decrease the muscles ability to respond to the stresses it experiences during activity. Static stretching may be of more benefit post workout or when only focused on increasing muscular length for improved flexibility.

A dynamic warm up or dynamic stretching is a method of warming up in which the athlete moves throughout available range of motion with stretches in a controlled manner. It has many benefits that are not seen with static stretching such as increasing blood flow to the muscles, increasing internal temperature, and preparing muscles for the sport specific movements they will need for the activity. This sort of warm up increases blood flow to the muscles and stretches them through specific motions that will be used while participating in their sport. In addition, most dynamic stretches target large muscle groups or multiple muscle groups together.

To successfully complete a dynamic warm up, athletes should follow some important steps. An appropriate warm up usually takes approximately 15 minutes.

1. Perform light aerobic activity to increase cardiac output and blood flow.

2. Follow with dynamic stretches to stretch muscles that will be needed for participation.

3. Optionally follow up with agility drills as desired. Examples include: butt kicks, high knees, skips, etc.

When performing dynamic stretches, it is important to monitor form and control. If dynamic stretches are performed without appropriate control, muscles can be stretched too far too quickly and pose a threat to injury. If you have an injury or need further guidance, please see a medical professional, such as your primary care physician or pediatrician.

Related articles

About the author

Amanda Stukey, PT, DPT, is a physical therapist for the SPORTS program at Cook Children's. Our physicians, therapists, nurses and technologists work exclusively with kids and understand the unique needs of a growing athlete's bones, muscles, body and mind.

Is it right for my child to be left-handed?

Fri, 26 Dec 2014 09:04:00 -0600

Recently, after a post from Justin Smith, M.D., on handwriting, a reader wrote in to ask:

“Do you have any information on a little older child who has dysgraphia? He is 11 ½ years old, he is also a left-handed writer and eater, but does most sports right handed. To add confusion, his right foot, left foot dominance is somewhat equal. I would appreciate any information you can share.”

Kim Greenberg, M.O.T., O.T.R., an occupational therapist for Cook Children’s and works in the specialty clinics in Arlington and Mansfield, gave us some insight into dysgraphia.

Development of grasp

The growing curiosity of toddlers’ hands happens before we know it. They begin by watching their hands open and close, then playing with their hands in front of their eyes, eventually reaching for different rattles and toys, and soon pulling on mommy’s hair.

Crawling is also an essential developmental skill that builds upper body strength; especially building the hand muscles of the thumb, pointer, and middle fingers, as these are the fingers that will ultimately hold writing tool.

As children’s eye-hand coordination continue to progress, they will become increasingly curious and independent with holding their own bottle, cup, spoon and fork. Eventually, children will show interest in holding crayons and scribbling on paper. At first, a child may show a full fisted grasp pattern, and not show a preference to use either hand. I often recommend that parents do not force hand dominance. Therapists often recommend that a utensil or writing tool be placed in a neutral midline position in front of their child.

Hand dominance

Whichever hand children initiate using will typically become their dominant hand. Once children show their hand preference, parents may encourage their child to then develop their feeding and pre-writing skills. When children turn 6 years of age or begin kindergarten, they will have established their hand dominance of being either right-handed or left-handed.

Dysgraphia

Then there is the subject of dysgraphia, or “difficulty with handwriting.” Handwriting is a complex process. It involves a combination of many systems to include visual-motor, eye-hand coordination, motor planning, learning and memorizing the shapes and forms of letters and numbers. To complicate matters, there are also many types of handwriting curriculums. When a child has a diagnosis of dysgraphia, I often ask their parents to attempt to write using their non-dominant hand, as this is how it feels to our children as they begin to write. Now more then ever, there are more pressures on our children to be enrolled in pre-school and pre-kindergarten programs that force them to write when they’re simply not developmentally ready.

Sports

I have also worked with children who demonstrate a hand dominance for feeding and writing, and a different hand dominance for playing sports or a musical instrument. The fact remains that we live in a right-sided dominant world. I often educate my parents to support their child no matter what their natural hand dominance.

As a child begins playing sports or a musical instrument, a qualified coach or teacher will understand how hand and foot dominance affect the skills of the child. A “switch hitter” is often the most valuable position in baseball. A parent should feel empowered to tell their child’s coach and teachers of their child’s natural dominance, and that a child should be taught in a positive manner that develops his skill and confidence.

Conclusion

Most importantly, I would like to stress that even with the most proficient grasp pattern, a child may still demonstrate dysgraphia, or poor handwriting legibility.

In this instance, a child should be evaluated by an occupational therapist, either from a reputable outpatient clinic, such as the Rehab facilities at Cook Children’s or from an occupational therapist through his or her school district.

Kim Greenberg, M.O.T., O.T.R.

About the author

Kim Greenberg, M.O.T., O.T.R., an occupational therapist for Cook Children’s and works in the specialty clinics in Arlington and Mansfield. Cook Children's Healthcare System provides a full spectrum of occupational therapy including inpatient,outpatient, and home health.