December 16, 2015
Too often the therapist arrives at a patient’s home and the child is slow to engage in therapy activities or even separate from the parent or caregiver. NOW, the question is what to do to help the child separate more easily and prepare the child to engage in therapy activities. It is always easier to engage a child if you have a variety of tool techniques in your TOOL BOX. These are just a few tools that may be helpful to the therapist and the parent.
Infant massage techniques provide non-threatening touch in an easy delivery approach which can be done with the child still in the parent’s lap/arms or with the child lying on the floor. Simply giving a moderate stroking pressure to the back from the shoulders to the waist/diaper line can be very calming. Also the “Cross My Heart” pattern in the back massage strokes incorporates strokes from the LEFT shoulder to the RIGHT side of the waist/hip and the RIGHT shoulder to the LEFT waist/hip by crossing the midline using a firm pressure with the fingertips. These two massages help provide a non-threatening touch through deep pressure even for those children with tactile defensive behaviors as well as facilitating organization around the midline. Both of these techniques segway well into use of the components of the Wilbarger brushing protocol, joint compressions alone, and/or Brain Gym activities.
If the child is not on the Wilbarger brushing protocol as part of his intervention plan, joint compressions can be done alone. This can be very effective even while the child is sitting in the parent’s lap for additional calming and trust development. The addition of music through a song such as the ABC Song or a counting song makes the activity even more effective.
Another activity involves incorporation of a Brain Gym cross body activity. One activity that been quite successful is “Head, Shoulders, Knees and Toes” while engaging the child in imitation of the Cross Body pattern using the RIGHT hand to touch the LEFT side of the head and the LEFT hand to touch the RIGHT side of the head. Continue to repeat the pattern with the shoulders, knees and toes. This activity is successful with SLPs, OTs/PTs alike in helping to meet goals for bilateral coordination and language development. This is also a FUN FAMILY activity that is good for all of the children, parents TOO.
Another engagement strategy is rolling a 6-8” ball down the child’s back then outline each of his extremities(arms/legs) with the ball using a firm pressure. This activity also has a calming effect and increases the body awareness through the tactile system in the skin.
One last activity recommendation involves using musical instruments such as rhythm sticks (drum sticks or dowels), bells, or tambourines. Children seem to engage more easily with the vibration and silly songs that are included when introducing the instruments. This activity works well as part of developing posture by reaching to “drum” on varied surfaces to the front and each side. Children love hearing the different sounds made by different surfaces; this usually brings smiles to their faces. Try arranging a variety of surfaces around the child or ask the child to arrange different surfaces and create a pattern with sounds or colors.
These activities used to engage children in therapy sessions can easily be taught to parents/caregivers for Home Exercise Programs (HEP) and have been “kid-tested” for non-threatening activities in a varied pediatric population.