Monday, February 8, 2016

Autism versus ADHD - Comparing Motor Impairments

Comparing Motor Impairments Autism versus ADHDThe Journal of Autism and Developmental Disorders published research to examine the evidence regarding motor impairment specificity in autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD).   It is difficult to determine if there is evidence for specificity of motor impairment within different clinical groups.  For example, are certain motor impairments associated with specific diagnoses?  Previous research indicates the following:
  1. Seventy nine percent of children with ASD demonstrated movement impairments in comparison to only 36 % of children with ADHD.
  2. Children with Asperger’s syndrome have been shown to demonstrate greater impairments in throwing and catching.
  3. Children with developmental coordination disorder (DCD) demonstrate greater impairments in balance and dexterity.
  4. Children with ASD showed deficits in: catching a ball, balance, manual dexterity and visual motor feedback.
  5. Children with ADHD have a more general impairment in basic motor abilities.
  6. Children with ASD exhibit great motor impairment than children with ADHD.
This recent study compared motor impairments in 200 children, ages 8-13 years old (56 with ASD, 63 with ADHD and 61 typical developing-TD).  Each child was evaluated with the Movement Assessment Battery for Children: Second Edition (MABC-2).  The following results were recorded:
  1. all three MABC subscale scores (Manual Dexterity, Aiming and Catching, and Balance) were significantly negatively associated with having a developmental disability.
  2. when comparing children with ADHD and children with ASD, the Aiming and Catching and Balance subscale scores were significantly associated with having ASD as the primary diagnosis.
  3. children in the ASD group demonstrated greater overall motor impairment compared to children with ADHD.
  4. deficits in tasks involving visual feedback and static balance are most aligned with having an ASD.
  5. performance on manual dexterity tasks appeared more strongly related to ADHD.
The researchers concluded that “impairments in motor skills requiring the coupling of visual and temporal feedback to guide and adjust movement appear specifically deficient in ASD.”
Reference:  Ament K, Mejia A, Buhlman R, Erklin S, Caffo B, Mostofsky S, Wodka E. Evidence for specificity of motor impairments in catching and balance in children with autism. J Autism Dev Disord. 2015 Mar;45(3):742-51. doi: 10.1007/s10803-014-2229-0.
Teaching Catching, Throwing and Kicking Skills from
Summary: Help children learn how to catch, throw and kick with this packet full of 
information of age progression of skills, visual picture cards, tips, letter to parents and more!

Create Your Future

Part of our job as pediatric therapists, teachers and parents is to encourage children to succeed. Whether it be a small accomplishment, a big dream or a lofty goal children need our support and help through motivating words.  This is especially true during therapy sessions when children are faced with many challenges.  You can print this motivational poster "The Best Way To Predict the Future is to Create It" here.  Check out the complete download of Motivational Posters and Cards here.    

Sunday, January 31, 2016

Tablet Use Results in Less Muscle Activity, Repetitive Movements and Poor Posture than Toy Play

Young Children At Risk For Skeletal Problems Due to Tablet UseA small study examined five children (ages 3-5 years old) participating in three conditions (15 minutes each) in randomized order:
1) playing with traditional age appropriate toys to simulate free play environment (e.g. drawing/crafts, trains, toy cars).
2) playing with iPad2 with a range of age appropriate apps.
3) viewing television with a range of age appropriate programs.
During the different conditions mentioned above three variables were measured: mean and variation in dominant arm hand movement using an ActiGraph GT3X+, wrist, thorax and head posture  with Vicon motion analysis and upper trapezius muscle activity with an EMG system.
The results indicated the following:
  1.  the most hand movement occurred during traditional play followed by tablet use with television viewing being the least
  2. greatest mean and variation in upper trapezius muscle activity during playing with traditional toys followed by tablet play and than television viewing.
  3. mean neck flexion during tablet play was greater than the other conditions.
  4. the thorax was also more flexed during tablet play than when playing with toys or watching television.
In summary, tablet computer use by young children results in less movement, muscle activity, repetitive wrist movement and poor spinal posture than toy play.  All of these issues may put children at risk of musculoskeletal symptom development.
Remember to offer children ample time for typical play time to avoid overuse issues from excessive tablet use.  Need ideas?  Check out Play Move Develop.
Play Move Develop from
Play Move Develop includes 100 reproducible games and activity ideas to encourage motor skill development and learning in children. Great resource for fun, home exercise program activities. FIND OUT MORE.
Reference:  Straker, L et al. Movement, posture and muscle activity in young children using tablet computers. Retrieved from the web on 1/31/16 at

Wednesday, January 27, 2016

Colored Caps - Fine Motor and Visual Spatial Activity

Colored capsI happen to love colored dots and index cards so this activity is a win-win for me!  Plus it is super simple to set up, lightweight and small to toss into the therapy bag and can be modified in so many different ways.  
So all you need to do is start off with some blank index cards and draw a grid.  You can do a 2×2 grid to keep it simple or make the grid larger to make it more challenging.  
Take some recycled water bottle caps and place some colored stickers on the inside to make the colored caps.  Now put some stickers on one side on the grid.  
Give an index card to the child and he/she needs to match the colored cap on the other side of the grid.  You can turn the index card so sometimes the student is matching the dots from side to side and sometimes from top to bottom.
To modify this activity you could have the child use dot markers to match the colored sticker dots, peel and stick more colored dot stickers or draw colored circles.
You could change it up entirely with other more complex shapes or stickers.  If you want to use larger stickers use full size paper and recycled milk jug tops.  
Dot Phonics Mazes
Dot Phonics Mazes – Follow the dot path from the letter to the correct word that starts with that letter. There are 26 mazes each on half a page. There are also 8 different examples of how to differentiate the lesson such as using stickers, using dot markers coloring in the larger versus the smaller circles, pushing golf tees through the circles and more. This is a great activity for 
push in therapy ideas or for centers.  FIND OUT MORE.

5 Things to Do BEFORE You Write an IEP Goal

It is that time of year again when annual reviews will slowly start to begin.  Here are 5 things to do before you write an IEP goal:

1.  Check present levels of performance - Perform a new evaluation if it is necessary.  Determine the student's strengths and weaknesses.  When you formulate a goal try to build on strengths to offset weaknesses.

2.  Review data and notes.  Check the student's progress towards the current IEP goals.  Does it seem likely that the goals will be reached by the end of the year?  Are you able to think about the next step for independence in a certain domain?

3.  Analyze deficits.  What is the impact of those deficits on academic success or accessing the educational environment?  If the deficits do not hinder educational success you do not need an IEP goal for them.

4.  Discuss with the multi - disciplinary team including parents on how your services can help the student.

5.  Discuss goals with student.  Make sure the student is on board - internal motivation is a key to success.

IEP Goals Related to the Common Core for OT/PT
Grades K-2 - this download is a large goal bank for school based occupational and physical therapy that is aligned with the English Language Arts (ELA) and Mathematics common core standards for grades K-2.  It is meant to provide guidance and suggestions on relating occupational and physical therapy goals to the common core curriculum in order to establish educationally relevant goals for a student's individualized education program (IEP).  FIND OUT MORE.

Monday, January 25, 2016

Visual Discrimination with Physical Activity

Visual Discrimination Freebies from www.YourTherapySource.comHere is a unique way to practice visual discrimination skills while adding in some physical activity.  You can download the freebies from Your Therapy Source.
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