Simple Low-Cost Games and Activities

for Sensorimotor Learning

by the same author

Understanding Motor Skills in Children with Dyspraxia, ADHD,

Autism, and Other Learning Disabilities
A Guide to Improving Coordination
Part of the JKP Essentials series
ISBN 978 1 84310 865 8
eISBN 978 1 84642 672 8

Visual Perception Problems in Children with AD/HD, Autism, and

Other Learning Disabilities
A Guide for Parents and Professionals
Part of the JKP Essentials series
ISBN 978 1 84310 826 9
eISBN 978 1 84642 505 9

How to Help a Clumsy Child

Strategies for Young Children with Developmental Motor Concerns
ISBN 978 1 84310 754 5
eISBN 978 1 84642 413 7

of related interest

Playing, Laughing and Learning with Children on the Autism

Spectrum
A Practical Resource of Play Ideas for Parents and Carers
2nd edition
Julia Moor
ISBN 978 1 84310 608 1
eISBN 978 1 84642 824 1

Motivate to Communicate!
300 Games and Activities for Your Child with Autism
Simone Griffin and Dianne Sandler
ISBN 978 1 84905 041 8
eISBN 978 0 85700 215 0
Can’t Play Won’t Play
Simply Sizzling Ideas to get the Ball Rolling for Children with
Dyspraxia
Sharon Drew and Elizabeth Atter
ISBN 978 1 84310 601 2
eISBN 978 1 84642 758 9

The Pocket Occupational Therapist for Families of Children With

Special Needs
Cara Koscinski
ISBN 978 1 84905 932 9
eISBN 978 0 85700 721 6

Fun with Messy Play

Ideas and Activities for Children with Special Needs
Tracey Beckerleg
ISBN 978 1 84310 641 8
eISBN 978 1 84642 854 8
Simple Low-Cost
Games and Activities for
SENSORIMOTOR
LEARNING
A Sourcebook of Ideas for Young
Children Including Those with Autism,
ADHD, Sensory Processing Disorder,
and Other Learning Differences

Lisa A. Kurtz

Jessica Kingsley Publishers

London and Philadelphia
First published in 2014
by Jessica Kingsley Publishers
73 Collier Street
London N1 9BE, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA

www.jkp.com

Copyright © Lisa A. Kurtz 2014

Front cover image source: iStockphoto®. The cover image is for illustrative
purposes only, and any person featuring is a model.

All rights reserved. No part of this publication may be reproduced in any

material form (including photocopying or storing it in any medium by
electronic means and whether or not transiently or incidentally to some
other use of this publication) without the written permission of the
copyright owner except in accordance with the provisions of the Copyright,
Designs and Patents Act 1988 or under the terms of a licence issued by the
Copyright Licensing Agency Ltd, Saffron House, 6–10 Kirby Street,
London EC1N 8TS. Applications for the copyright owner’s written
permission to reproduce any part of this publication should be addressed to
the publisher.

Warning: The doing of an unauthorized act in relation to a copyright work

may result in both a civil claim for damages and criminal prosecution.

Library of Congress Cataloging in Publication Data

Kurtz, Lisa A.
A sourcebook for sensorimotor learning : simple low-cost games and
activities for young children
including those with autism, ADHD, sensory processing disorder, and other
learning differences / Lisa A.
Kurtz.
pages cm
Includes bibliographical references and index.
ISBN 978-1-84905-977-0 (alk. paper)
1. Children with disabilities--Education. 2. Educational games. 3. Children
with disabilities--Recreation.
4. Perceptual-motor learning. 5. Sensory stimulation. I. Title.
LC4026.K87 2014
371.9--dc23
12013035783

British Library Cataloguing in Publication Data

A CIP catalogue record for this book is available from the British Library

ISBN 978 1 84905 977 0

eISBN 978 0 85700 879 4
 CONTENTS

PREFACE

1 Introduction: The Importance of Play

2 Promoting Gross Motor Skills

Strength and Endurance, Body Awareness, Motor Planning,
Balance, Bilateral Integration

3 Promoting Fine Motor Skills

Hand and Upper Body Strength, Manual Speed and Dexterity,
Eye-Hand Coordination

4 Promoting visual skills

Visual Attention and Tracking, Visual Perception, Visual-Motor
Integration

5 Promoting Sensory Skills

Sensory Modulation, Tactile Discrimination and Awareness,
Auditory Discrimination and Awareness

Appendix A: Reference Guide For Selection of Activities

Appendix B: Instructions For Homemade Supplies

Equipment
Non-edible recipes
Edible recipes
 Favorite fidgets
Weighted tools

Appendix C: Further Resources

Recommended organizations and websites for information and
guidance about children with disabilities
Other recommended activity guides
Free online resources for sensorimotor learning
Books that introduce young children to concepts related to
disabilities and Sensory Processing Disorder

GLOSSARY
LIST OF ACTIVITIES
 PREFACE

Since the early 1970s, I have enjoyed the privilege of working

professionally with young children who have a wide range of
abilities and challenges in home, school, community, and hospital
settings. Although I have had exposure to just about any kind of
disability a child might experience, I have always held a special
interest for those children with developmental differences that
impact learning, behavior, and social adjustment, such as autism,
attention deficit disorders, sensory processing disorder, and specific
learning disabilities. The activities described in this book are
developed with those populations in mind, although most activities
are also appropriate for children with typical development, and
many can be easily adapted for children with other types of
disabilities, including motor impairments (such as cerebral palsy),
or sensory impairments (such as a vision or hearing impairment).
As an occupational therapist, I have been trained to carefully
analyze the ways in which a child’s unique abilities, interests, and
environmental influences impact his behavior and development.
With this information at hand, I am able to create an individualized
intervention program that motivates a child to engage in
meaningful activities that have been designed to overcome
obstacles to his development, and to have lots of fun in the process.
(For ease of reading, the gender pronoun has been alternated by
chapter.) There is no specific formula for helping children to learn.
Therapy looks different for each child, and often includes a wide
range of components, such as specific exercises, seating and
positioning devices, adapted tools and equipment, environmental
modifications, parent and caregiver training and instruction,
behavioral shaping strategies, and many more techniques than I
could possibly describe in a brief description of my profession. The
unifying theme in my therapy, however, is that whatever
interventions I choose, they are always embedded in a playful
activity that is enjoyable to the child as well as to myself. Without
question, that is the best way to ensure motivation, enthusiasm, and
effort on the part of the child. How lucky I am to get to play with
children every single day that I go to work!
Parents, teachers, social workers, coaches, or other adults often
approach me with questions about how they might help a child to
follow through with their therapy goals. Of course, there are many
official ways in which I am able to share my recommendations
through parent conferences, in-service presentations, or informal
hallway chats. Sadly, though, there never seems to be enough time
for this kind of dialogue as the current economy drives greater and
greater demands for cost-saving productivity and accountability.
This book was developed as a resource to supplement the
recommendations and guidelines that might occur as part of a
therapy or special education process. Although my focus is on
young children in preschool through elementary school years, some
of the activities can be easily adapted to younger or older children.
Please understand that the ideas and suggestions included in this
book are not intended to replace professional recommendations that
may be specific to a child with a disability. Ultimately, a
pediatrician or other appropriate health professional should be
consulted to determine what types of activities are safe or unsafe
for an individual child. Likewise, only a professional who knows
and has worked with a child can determine whether certain
activities are going to be therapeutically appropriate and beneficial.
 If you are the parent of a child who has not been identified as
having special needs, but are concerned about his development or
behavior, start by discussing your concerns with the child’s
pediatrician. Be as specific as possible, and don’t be afraid that the
pediatrician will think you are being over reactive. In my
experience, parents are notoriously excellent observers of their
children, and all questions that parents might ask are good
questions. Because of their many daily interactions with the child,
parents have the opportunity to observe subtle differences in the
way their child behaves that a doctor cannot possibly be aware of,
given a short office visit every now and then. Pediatricians are well
trained to perform a screening evaluation of a child’s development.
If a screening evaluation suggests delays, the pediatrician can then
make referrals to the appropriate specialists for a more in-depth
evaluation as indicated.
How therapies and special education services are funded and
provided varies across countries. In the United States, children with
disabilities are protected by the Individuals with Disabilities
Education Act, initially passed in 1990 and revised in 2004 as the
Individuals with Disabilities Education Improvement Act. This is
federal legislation that governs how states and public agencies
provide early intervention, special education, and related services
to eligible children from birth through age 18 or 21 (depending
upon the disability). Children from birth to age two may be eligible
for early intervention services under Part C of this legislation,
while children ages three to twenty-one may be eligible for special
education and related services under Part B. For children who have
not yet entered school, the pediatrician can inform parents how to
go about requesting an evaluation through the appropriate state
agency to determine what, if any, early intervention services the
child may be eligible to receive. Once in school, the child may be
eligible to receive special education and related services (which can
include occupational or physical therapy) if they meet both federal
and state standards for disability eligibility. Keep in mind, though,
that not all children with disabilities are eligible to receive services
through school. In order to qualify under the special education
umbrella, the child must meet the criteria for having a disability,
and must also be determined to require special education services
in order to benefit from the educational program. In some cases,
children with disabilities are able to learn adequately and are
therefore not eligible for special education services, but require
other supports and accommodations due to a disability or health-
related problem. Section 504 of the Rehabilitation Act of 1973 is
federal civil rights legislation designed to prevent discrimination to
persons with disabilities. In schools, this legislation may be
appropriate for providing these children with the supports they
need to access a public education. If your child is struggling in
school and is not responding to efforts by the regular education
staff to improve his performance, ask to sit down with a special
education teacher to discuss the process for considering a referral
for a special education evaluation, or for other options to receive
school support.
In the United Kingdom (UK), students with disabilities or
special learning needs are protected under the Education Act of
1996. Under this act, each of the countries in the United Kingdom
has separate systems under separate governments for providing for
students with Special Education Needs, or SEN. The services
provided are widely variable throughout the UK, with a preference
for maintaining students with disabilities in mainstream state
schools, but with access to specialist schools in some
circumstances. All publicly funded schools in the UK are required
to maintain an SEN Coordinator position, and SEN services must
follow an SEN Code of Practice which provides non-binding
guidance on how educational supports are shaped and maintained.
 Remember that publicly funded early intervention services and
special education programs are not the only places to find help for
a child with a disability. Parents need to understand that the
mandate for public schools is to provide a free and appropriate
education to all children, including those with disabilities or
learning differences. The evaluations and services provided by
schools are designed to support the educational, not medical, needs
of the child. Many parents find the need to access services and
supports in addition to those offered by the schools, especially
when the diagnosis is serious, complicated, or requires medical
supervision. When a significant disability exists, schools may not
be equipped to offer specific recommendations about a child’s
prognosis, how to plan for the child’s future, or when it may be
appropriate to consider various medically based interventions.
Many parents opt to obtain medical or therapy evaluations outside
of the publicly funded sources, often accessing private insurance to
pay for those services. Again, this is a good topic of discussion for
the pediatrician.
My intention in writing this book was not to replace any
recommendations made as part of an individualized therapy
program developed for a specific child, but to help parents,
teachers, and others involved in the lives of children with and
without special needs to think creatively about how to play with the
child in ways that support his development, using materials that are
readily available in most households, or that can be purchased or
homemade at a very low cost. In today’s economy, there are few
parents (or professionals, for that matter) who can afford to
purchase very many of the commercially available toys and tools to
support development. My own practice has always been to
purchase a select few items that are harder to make or substitute,
and then to make do with whatever I have on hand. I have been
able to augment my therapy supplies substantially through creative
stockpiling, for example:
• frequenting flea markets or yard sales, where sellers are often
willing to give me an extra discount when they hear why I
need a particular item
• making my own toys, or enlisting the help from willing
volunteers when I lack the construction skill needed
• soliciting donations from parents whose children have
outgrown the usefulness of their toys
• accessing online resources for children’s crafts, worksheets
and other activity suggestions.

Above all, this book is intended to open your eyes to the many
possibilities for supporting a child’s development through playful
interactions. It doesn’t need to take a lot of money, or even a very
sophisticated knowledge of how children learn and grow. Almost
any playful activity has the potential to teach. Let this book help to
inspire you to think outside of the box when you have time to play
with your children. As you experiment with the recommendations
in this book, please strive to have as much fun, or maybe even
more, than those special children in your lives!

Note: All emboldened terms in the main text are explained in the
glossary at the end of the book.
Chapter 1

INTRODUCTION
The Importance of Play

Play is the universal passion of all children. All children play, although children
(like their adult counterparts) have varying interests and abilities that impact their
choice of playthings and play activities. Play is the means by which children
explore, interact with, and master their environments, and is a critically important
part of how children learn to develop physically, cognitively, and socially. Play
allows children to find respite from the adult-directed structure of everyday life,
and to feel successful while engaging in an activity that they truly enjoy. Child-
initiated play is pursued voluntarily, is always self motivated, and is thoroughly
engaging and enjoyable.
When an adult is hoping to entice a child to participate in play with the purpose
of supporting development, the adult needs to ensure that the activity is enjoyable
in the child’s eyes, and also that she has sufficient skill to ensure success with the
activity. One common-sense way to ensure that activities are enjoyable in the
child’s eyes is to design them around the child’s unique interests. For example, a
simple beanbag toss game can take many different forms:
• placing several cooking pots on the floor and throwing ingredients into the
pot (for the food aficionado)
• lining up opened shoeboxes and pretending they are a train, then aiming for
the engine or the caboose (for the child with a passion for trains)
• cutting out pictures of bugs and pasting them onto cardboard targets to
squash (for the child who has more aggressive tendencies or who enjoys
nature).

Children also need to feel in control in at least some aspects of the selected play
activity in order to feel self directed. If you, as the adult, have suggested a game
that is agreeable to the child, allow as much choice as feasible. For example, if
the activity involves coloring, allow a choice of using crayons, markers, or chalk,
and whether to color on white paper, recycled shopping bags, or construction
paper. If the child tends to prefer more sedentary make-believe activities and you
wish to introduce more physically challenging play, encourage the child to invite
a favorite doll or stuffed animal to watch, or better yet, to join in on the game.
Offer choices as to when to play a game (before lunch, or after lunch), in which
environment (inside or outside), and with which participants (should a friend or
sibling be invited to play?). Allow the child to let you know when she has had
enough of a game. Children will let you know whether they are having fun or not.
Avoid the temptation to push a child to continue playing if they are clearly tired,
bored, or frustrated. You may succeed in getting the child to cooperate for your
request, but learning requires effort on the part of the child, and if she is not
having fun, it is unlikely that significant learning will occur.
It is also important to find as many opportunities as possible for providing
immediate, positive reinforcement for a child’s participation in a learning activity.
Reinforcement can take many forms. Many children are reinforced through such
simple measures as a high five, hug, or verbal compliment. Remember to
reinforce the effort more than the actual end product. For example, let’s say the
child is working on a coloring page but really cannot do more than scribble. Try
giving some concrete suggestion (for example, “Let’s try holding the crayon this
way,” or “Let’s see what happens when you slow down”), and then reinforce the
child’s response to your suggestion with statements like, “Look how well your
fingers are holding that crayon!” or “Great job slowing down!” Many children
also respond well to visual tools to reinforce their participation in learning
activities. This can take many forms, and at school or in formal therapy programs
may include a visual chart or schedule of activities the child is expected to do. As
each activity is completed, the child might move a token to a “finished” column,
or might receive a star or checkmark for each task completed. After a
predetermined number of successes, the child then earns a small prize or “choice”
time. An easy way to do this at home is to have a supply of index cards at hand,
and tell the child that she must earn a certain number of stars, happy faces, or
another symbol, in order to earn a preferred reward. Using a marker or self-inking
stamper, you can give an immediate visual reward each time the child shows
effort. This can be a very open-ended way of providing reinforcement, as the
adult can control when a symbol has been earned. For example, the older child
who generally shows good effort might earn a symbol for every completed
activity. The younger or more easily frustrated child might earn more incremental
rewards, such as one symbol for sitting at the table, another for choosing between
markers or crayons, another for writing one letter in their name, and so forth. This
can be a very promising way to gradually build tolerance for sustaining effort in
non-preferred tasks!
When thinking about selecting which activities to choose, it is equally
important to ensure that the child has the cognitive maturity and skill level to be
successful. There are many factors that contribute to a child’s rate and quality of
development of sensorimotor skills. Genetic or inherited traits can impact overall
strength, agility, and general talent for physical challenges. Culture and lifestyle
preferences also play a role, as many children in today’s society tend to be less
interested in physical activities, and more and more entranced by the latest and
most compelling technology developments. Developmental differences—
common among children with autism, ADHD, and other learning differences—
vary widely from child to child. Most children will acquire skills following fairly
predictable stages known as developmental milestones. Because all children
develop according to their own timeline, and children with disabilities may be
delayed in acquiring certain milestones, it is important to select play activities
that fit with the child’s developmental level of skill, as opposed to their
chronological age. If your child receives special education or therapy, you may be
able to receive some guidance as to the child’s developmental level by your
child’s teacher or therapist. Table 1.1 presents some of the more common
developmental milestones that are expected of young children with typical
development.
Table 1.1 Typical developmental milestones

Age Fine Gross motor Speech/language Cognitive/perceptual Play

motor
6 Transfers Plays with Pays attention to Shakes rattle on No interest in
mos toy from feet when music or singing purpose peers
hand to lying on back Understands “hi” Follows moving Simple give-
hand Rolls in both and “bye-bye” objects with eyes and-take play
Rakes at directions Imitates simple with family
toy with all Sits with sounds like “ba- like tickling
fingers hands ba” or “wa-wa”
propped
forward
Bounces on
feet with
hands held
9 Grasps Head still lags Stops activity Holds toys in each Plays “peek-a-
mos block with when pulled when name is hand and brings boo” and “pat-
 fingers to sit from called together at midline a-cake”
Holds wrist lying on back Understands “no”
in “bent Creeps or Uses simple
back” crawls gestures, like
position Sits pointing to
when independently desired object
holding with hands
objects free for play
Pulls to stand
at low table or
bench
12 Stacks two Stands alone Responds to Imitates scribbling Initiates
mos blocks without simple with crayon familiar
Grasps tiny support commands games, like
object Takes first without gestures “peek-a-boo”
using pinch steps holding Knows one body Simple
Holds hand part imitation, like
crayon Beginning to use bringing
using fisted single words empty spoon
grasp meaningfully to mouth
Helps to
turn pages
in book
15 Stacks Walks Points to named Enjoys fill-and-dump Starting to
mos three independently object activities show interest
blocks Crawling is Points to several Scribbles with crayon in other’s play
Can place discarded, body parts without (watching)
small pegs except on demonstration Likes books,
in holes stairs points to or
Uses spoon Plays while pats pictures
to scoop squatting
with Gets to
spilling standing
position
without
holding
anything
18 Stacks four Seats self in Refers to self by Inserts simple shapes Talks to self,
mos blocks small chair name into formboard often using
Turns book Climbs stairs Puts together sing-song
pages holding rail two-word rhythm
sentences
 alone, 2–3 Seldom falls Experiments
at a time when walking with
movement
24 Stacks Kicks a ball Produces 25–200 Matches three colors Enjoys
mos seven forward words Imitates simple listening to
blocks Jumps with Jargon has strokes (circular simple stories
Strings both feet disappeared scribble, vertical and nursery
small beads leaving floor lines) rhymes
Climbs stairs May hold out
with two feet toys, but
on each step reluctant to
share
Stubborn (the
“terrible
twos”)
30 Stacks nine Climbs stairs Using more Imitates horizontal Can play
mos blocks with one foot words to strokes quietly for 10–
Turns book to each step communicate Names own drawing, 15 minutes
pages Stands briefly ideas even if Still very
singly on one foot Fills in words or unrecognizable possessive
Prefers one Rides tricycle phrases to with toys
hand for familiar stories
crayon
36 Stacks 10 Runs on toes Vocabulary of Imitates cross with Parallel play,
mos blocks Runs, turning about 1000 words crayon but interested
Holds sharp corners 2 to 4 words in Names and sorts in playing
crayon with without sentence objects by color alongside
fingers like falling Who, what, Counts three objects others
adult Can broad when, where, correctly Imaginative
Cuts jump why questions play with dolls
“fringe” approximately Carries on and stuffed
with 30cm (12") purposeful animals
scissors Can jump off conversation More attentive
low step No longer repeats to rules with
or echoes others fewer
tantrums
4 Can place Hops on one Can recall four Names some letters, Attends to
yrs 10 raisins foot digits in correct numbers play for 30
in small Catches sequence Copies square with minutes
pill bottle beanbag with 4 to 5 word crayon Some turn
the hands (not sentences taking and
 within 20 against the Speech is 90% sharing with
seconds body) understandable peers
Shifts Can broad Likes to tell Likes to make
crayon jump stories to dolls or things and is
up/down approximately stuffed animals interested in
using 60cm (24") product
fingers Throws ball
only to overhead with
adjust control
Puts
shoes/socks
on
correctly
Washes and
dries hands
correctly
Cuts a
2.5cm (1")
line to
within
0.16cm
(¹⁄₁₆")
5 Can place Runs through Capable of long Counts 10 objects Communicates
yrs 10 raisins obstacle narratives correctly with peers to
in small course Questions Prints first name organize
pill bottle avoiding persistently Draws recognizable activities
within 18 obstacles person with body, Plays simple
seconds Skips with stick limbs, facial board games,
Cuts out alternating features but with little
square feet understanding
within Stands on one of strategy
0.6cm (¼") foot for 10 Starting to
Dresses seconds understand
with that people
minimal have different
assistance thoughts and
Ties the feelings about
half-knot things
on shoes
6 Can move Performs one Likes silly stories Copies triangle and Likes
yrs coin from each of sit-up and riddles crude diamond construction
palm of with attention
 hand to and knee 6 to 8 word Prints all letters and to small
fingers to push-up sentences numbers 1–9 without details
place in Rides two- Starting to enjoy a model Cooperates
soda wheeler stories without Performs simple with peers
machine illustrations addition and with more
Uses subtraction social give-
knife/fork Discriminates left and-take
to cut from right More rivalry
Ties bow in competitive
Writes games
name
legibly and
on line
Able to
carry
fragile
items
safely

It is also important to understand that children go through different stages of play

interests and themes. For children aged 0–2 years, playtime tends to be very
physical as children learn about themselves and the objects that occupy their
world. Children at this age enjoy exploring their ever-expanding world by riding,
pushing toys back and forth, pulling on things, placing objects in and out of
containers, and in general, seeing how things work. From the age of two to four
years, children like to learn by imitating what they see others doing, either by
using actual objects or through make-believe. They are beginning to learn
concepts such as shape, color, and number through play. They are also interested
in putting objects, actions, and sounds together in simple constructions. This is
the period when many children are introduced to simple art activities and learn to
enjoy being creative. At this stage, children will play alongside each other, but do
not typically engage reciprocally in play or willingly share toys. As children
continue to mature at the ages of approximately four to seven, they become more
interested in playing with other children, build more constructively, and engage in
games that allow them to dramatize the things they are seeing out in the real
world. This allows them to develop more mature social interactions with peers.
As they play typical games like tag or board games, they learn many important
social rules such as waiting for one’s turn, following the rules, and learning how
to win or lose graciously. Children at this age are often bossy or impatient with
peers as they learn to negotiate the social expectations of play. Between 7 and 11
years of age, most children enjoy more complex games with rules, organized
sports, and other activities that encourage a competitive spirit. This is also the
time when many children become interested in specific hobbies such as crafts,
collecting things, or joining clubs along with peers who have similar interests.
To begin using this book, start thinking about what skills you think your child
needs to improve. Each section begins with a description of why that particular
skill area is important to learning, and what might be the signs and symptoms that
a child is struggling in that area. A therapist or teacher who works with your child
may be helpful in steering you towards the most important areas to stress. Next,
skim the book to find activities that you think your child might enjoy playing
with you. Activities are grouped according to the primary skill area addressed,
but most activities offer learning challenges in multiple areas. A quick reference
guide for selecting activities is included in Appendix A (see p.122). For example,
you might be focusing on improving balance, but want to find balance activities
that also offer opportunities for working on visual attention and tracking, or
perceptual skills. Appendix A offers an easy way for you to consider your
options. Remember to use your own creativity to expand or modify the activities
in any way that suits your child’s interests, developmental level, or your available
resources. Some of my most successful therapy sessions have occurred when I
am challenged to think on the spot and just have fun!
Please remember that this book is designed as a general guide and not as a
formal occupational therapy program for your child. I have attempted to provide
a general overview of some of the most important concepts involved in
sensorimotor learning, but I wanted to focus more on the creative use of activities
than on the rationale behind sensorimotor learning approaches. The resource
section, located in Appendix C, offers a comprehensive list of books and other
resources for the reader who wishes to delve deeper into understanding the nature
of sensorimotor learning differences in children with disabilities. Remember, too,
that some of the activities described may not be appropriate for every child. For
example, children with certain medical problems may be limited in the amount of
physical activity they can safely undergo, and some parents will want to avoid
activities that might expose their child to latex, dyes, or other materials that might
trigger sensitivities. Check with your child’s pediatrician or therapist if you have
any concerns. Some activities require materials that could be unsafe for certain
children, for example because they involve small parts that could become a
choking hazard, or because they use materials that could cause allergic reactions
to sensitive children. Always use common sense and closely supervise any
activity that could potentially cause risk to a young child. I’ve learned to expect
the unexpected when I am working with children, and am extra careful especially
with gross motor activities, or when working with materials that might be thrown,
or that might find their way into a child’s mouth!
One final note—think carefully about how you engage the child in
conversation about why you are asking her to participate in these activities. Many
very young children are happy to play just for the sake of having fun, but others
have an emerging understanding of their differences, or require more
encouragement to put effort into tasks that are challenging. This is the perfect
opportunity to talk about how every person has unique differences, and to
introduce some basic information about the child’s disability. Many children
actually feel empowered when they learn that there is a reason why they have a
hard time doing certain things that other children can do easily. Playing
therapeutically with a child provides the perfect opportunity to offer your
observations as to what things are hard or easy for a particular child, to offer
positive feedback for effort (not just success) with the activities, and to engage in
collaborative problem-solving for making things easier. I use my sessions with
children to offer simple explanations about why various games or activities are
important for helping them in ways that are meaningful to them. Some examples
of simple explanations I might use include:
• “When we play ‘treasure hunt’ it helps your eyes to get better at noticing
small details. That should make it much easier for you at school when you
are learning how to read.”
• “I notice that you are getting stronger every time that we practice these
balancing games. That’s great, because children who have strong bodies find
it easier to sit still and pay attention to learning when they are at school.”
• “Look how strong your fingers are getting! I’ll bet that means your hand
won’t get so tired when you have to write a lot of words!”
• “I notice that your body looks calmer when we play this game.”
• “Let’s find out if it’s easier for you to cut on the line when you hold your
scissors like this.”

Appendix C also includes a list of recommended child-friendly storybooks that

can be used to help children develop a beginning understanding of disabilities.
Many of these are especially useful in helping friends or siblings understand why
some children learn or behave differently, and how they can be of help.
Chapter 2

PROMOTING GROSS MOTOR

SKILLS

RELATIONSHIP TO LEARNING
Gross motor skills refer to those body movements that involve
large muscle groups and total body movements. Examples of these
include crawling, walking, running, balancing, throwing and
catching a ball, or climbing on playground equipment. Newborn
infants have very little voluntary control over their gross motor
movements, but quickly start to develop control of the head and
neck muscles within the first few weeks of life. As the young child
grows and matures, most typical young children exhibit high levels
of energy as they are intuitively driven to explore their environment
in a very active manner. Just think of how much energy most
toddlers exhibit when they play! This is nature’s way of making
sure that children regularly exercise their muscles in order to
develop control of their posture, balance, strength, and
coordination.
Physical exploration of the environment also results in exposure
to many different perceptual experiences through all of the body
senses. These include the familiar sensations of vision, touch,
hearing, taste and smell, but also certain sensations specific to
gross motor control, including vestibular awareness (sense of
gravity and motion originating from receptors in the inner ear), and
proprioceptive awareness (sense of body motion and position
originating from receptors in the joints and muscles). As the child
experiences sensory input during movement activities, the brain
processes that information, decides how the body should respond,
and then sends signals to the appropriate muscles so the body can
take action. In this way, the sensory feedback that occurs during
gross motor activities is an important factor in the motor learning
process. Gross motor skills require considerable practice and
repetition in order to develop. Children who do not enjoy physical
challenges, or who have sensory processing differences that result
in confusing or unpleasant sensory experiences during movement,
may be less willing than other children to independently explore
their environment, and consequently receive less practice in
developing their motor skills.
Although gross motor skills are most rapidly developed during
the first two years of life, they continue to improve and become
increasingly automatic well into the adult years. Gross motor skills
are considered the foundation for many higher-level learning and
behavioral skills. For example, the ability to maintain an upright
posture during desk work at school is needed in order to stay alert
and pay attention, to provide a stable base of support so that the
hands can engage in controlled fine motor activities, and for
keeping the head in a steady position so that the eyes can move and
track smoothly without head movement during reading or other
activities requiring visual attention.

STRENGTH AND ENDURANCE

Strength and endurance are critical to the development of gross
motor skills. Strength is defined as the amount of force produced
during a muscle contraction. Endurance is the ability to sustain
physical effort over time. Most healthy and active children will
naturally gain in their overall strength and endurance as they
mature, but several common factors can contribute to decreased
strength and endurance. Muscle tone refers to the length of
muscles at rest, before a contraction, and is very variable among
individuals. Children with significant neurological disabilities, such
as cerebral palsy or traumatic brain injury, often experience high
muscle tone, or hypertonia. Hypertonic muscles are shorter than
average when at rest, which makes joints seem rigid and inflexible.
In contrast, many children with milder learning differences such as
autism, attention deficit disorders, or learning disabilities have low
muscle tone, or hypotonia. Hypotonic muscles are longer than
average when at rest, which causes increased flexibility and
decreased stability of joints. Some people use the term double-
jointedness to describe this condition. Children with hypotonia
tend to have decreased strength, endurance, and postural stability.
Some people believe that they may also experience less sensory
feedback from movement experiences, making it harder for them to
learn new or unfamiliar motor skills. Children who prefer a more
sedentary lifestyle are also at risk of developing decreased strength
and endurance because they spend less time in active play. The
development of strength and endurance is critically important for
maintaining an overall healthy lifestyle, for preventing obesity and
related health concerns, and for helping to prevent childhood
injuries.

BODY AWARENESS
Body awareness, also called proprioception, is the unconscious
sense of body position and movement that comes from sensory
receptors located in the joints and muscles of the body. This is the
sense that allows us to accurately perform familiar movements such
as wiping our nose or buttoning a shirt even if our eyes are closed.
It allows us to make automatic, continual, unconscious adjustments
to our body positions according to the particular demands of a task.
For example, when a child attempts to catch a ball, he must reach
in the direction of the ball, position the hands appropriately,
maintain balance, and judge both the speed and direction of the ball
as a moving target. The eyes inform the child whether he is likely
to be successful, so body movements can be adjusted accordingly.
In the process of catching a ball, the child gives very little
conscious thought as to how the body feels when performing these
adjustments. Children with poor body awareness need to pay
conscious attention to movements that should otherwise occur
automatically. For example, if asked to imitate arm and hand
movements rapidly, the child with poor body awareness may have
to look back and forth at the adult’s arm, then his own arm, to make
sure the movement is performed correctly. In general, children with
decreased body awareness lack fluency and speed in performing
motor movements that should be automatic. They often appear
clumsy or disorganized when compared to other children their age.

MOTOR PLANNING
Motor planning is the ability to conceptualize, plan, and execute
non-automatic movements and motor sequences. It is sometimes
referred to as praxis, and children who have decreased skill in this
area are considered dyspraxic. In normal motor planning, the child
must possess a clear mental picture of what should occur, precise
vestibular and proprioceptive feedback during movement, and the
ability to make rapid, automatic adjustments to movement in time
and space. Children with motor planning difficulties typically
appear awkward when moving, have difficulty learning motor
skills at a rate comparable to that of their peers, and have difficulty
generalizing a learned motor skill to a new situation. For example,
children typically first learn to tie a bow when they are learning to
tie their shoelaces. Once learned, most children can easily transfer
this skill to tying a bow on a package, or a ribbon in their hair, but
children with motor planning difficulties struggle with the transfer
of this skill to new or unfamiliar situations. Often, children with
motor planning difficulties are easily frustrated and avoid
challenging motor activities, and tend to be disorganized in their
use of time and materials. Motor planning is not the same thing as
motor coordination. A child with motor planning difficulties may,
in fact, have very good coordination for challenging motor skills
once those skills have been learned and committed to memory.

BALANCE
Balance refers to the ability to maintain a stable body position, and
comes in two types. Static balance is the ability to maintain a
position while the body is stationary, such as when standing on one
foot. Dynamic balance is the ability to maintain position and
manage postural changes while the body is moving, such as when
running on an uneven surface. Balance requires the integration of
multiple sensory inputs. Vestibular sensory input from the inner ear
informs the brain about the effects of motion and gravity on
postural control. Proprioceptive sensory input from the joints and
muscles informs the brain about where the body is in relation to the
world. Visual sensory input aids in estimating how close or far
away an object is from our body (called depth perception), and in
its orientation in relation to our body (called spatial awareness).
Children with learning differences may have problems with one or
more of these sensory processing skills affecting balance.

BILATERAL INTEGRATION
Bilateral integration refers to the ability of the two sides of the
body to cooperate with each other during execution of motor
activities. It develops gradually over time, leads to the development
of a dominant hand for performing skilled motor activities, is a
factor in automaticity of motor planning, and contributes to the
cognitive awareness of certain spatial concepts, such as left and
right orientation. Most children begin to show a preference for
using one hand at about two and a half years of age, and by the
start of kindergarten will consistently use the dominant hand when
manipulating crayons, pencils, or scissors. Children who do not
have a clear hand preference by the time they enter school are at a
disadvantage because a large portion of the school day is spent in
performing fine motor activities. Certain fine motor activities are
performed slightly differently when using the right versus the left
hand. For example, writing paper is positioned differently for right
and left-handed children, so that left-handed children can see what
they write as they place letters from left to right across the page.
Children who switch hands during writing can become confused
about how to hold and position the pencil and paper, so these
movements do not become automatic and habitual. Switching
hands when manipulating objects that require less skill, such as
blocks or beads, is not necessarily considered to be a problem, and
may continue throughout childhood. Some people believe that a
tendency to switch hands and to fail to develop a dominant side
may be related to a problem with vestibular processing. Often,
children switch hands because they are uncomfortable reaching
across the midline of their body, so they choose to use the hand that
is closest to the object being manipulated. Other children switch
hands because of decreased hand strength. As they use one hand
and start to become fatigued, they switch to the other hand to allow
their tired hand to rest.
Common signs of difficulty with gross motor skills include:
• slow to achieve gross motor milestones (see Table 1.1)
• trips or falls more frequently than other children
• avoids playground, sports or other physically challenging
activities
• reacts with strong emotion (positive or negative) to common
movement experiences, such as swings or riding an elevator
• appears stiff or clumsy when walking or running
• frequently bumps into furniture or other people
• manipulates objects roughly or with too much force, often
dropping or breaking items
• gets tired more easily than other children
• has a difficult time learning new skills, such as riding a bike or
tying shoes
• fails to show a clear hand preference by age five
• has difficulty using the two sides of the body together (for
example, skipping, performing jumping jacks, or holding
paper down during drawing or coloring).

GROSS MOTOR ACTIVITIES

1 WHEELBARROW WALK
Primary learning focus
• Strength, body awareness, motor planning, bilateral
integration.
• Tends to be a calming and organizing activity.

Materials needed
• None.
Description
The child assumes a crawling position on the floor with arms out
straight and the palms of the hand flat on the floor. The adult then
grasps the child by the ankles (or the knees for a child with poorer
strength and control) and lifts so that the child can walk on his
arms assisted by the adult. Encourage the child to keep his back
and neck straight. This activity generates a lot of heavy work and
proprioceptive input, and can be used for transitions from one
room to another, or can be turned into a game, such as walking
around obstacles.

Variations
• Spread beanbags or wads of newspaper around the room for
the child to pick up with one hand and throw at a target. This
requires shifting weight to one side in order to throw, which
encourages more strength, bilateral integration, and eye-hand
coordination.
• Build in practice for cognitive skills by asking the child to count
how many steps they can take without falling, or by instructing
them to walk around a room and see how many things they
can find that are red, or square, or soft.
• Encourage memory skills by asking the child to recall a series
of targets to walk towards (for example, “Let’s take three
steps towards the couch, then five steps towards the door”).
• Use wheelbarrow walking as a calming transition activity, for
example, walking to the bedroom for a nap, or to the closet to
get outerwear for a trip outdoors.

2 ANGELS IN THE SNOW

Primary learning focus
• Body awareness, motor planning, bilateral integration.

Materials needed
 • None.

Description
The child lies on his back on the rug or floor. The adult asks the
child to make “angels” by opening and closing arms and legs in a
synchronized manner. Try different patterns of movement, such as
moving only the arms or legs, moving only the arm and leg on the
right side, moving only the left arm and right leg, or moving
everything except the left leg.

Variations
• Tie red ribbons on the right arm and leg (“red” is for “right”) if
the child is confused about these terms.
• Ask the child to close his eyes, then gently touch the parts to
be moved to enhance body awareness.
• Ask the child to recall a two-step pattern, for example move
only the arms five times, then only the legs five times, and
continue the sequence.
• Tie a jingle bell around the limbs that should not move—if a
bell rings, the child knows he has made a mistake.

3 MAGIC CARPET
Primary learning focus
• Strength, balance, motor planning, bilateral integration.
• Tends to be a calming activity.

Materials needed
• Carpet sample square, fuzzy side up.
• A slippery floor, such as tile or linoleum.

Description
The child assumes different postures on the magic carpet (sitting,
kneeling, tummy lying, back lying) and propels himself (forwards or
backwards) using arms and legs. Try to encourage the child to be
as creative as possible in trying different ways to move the magic
carpet.

Variations
• Create a simple obstacle course using pillows or cardboard
boxes, and draw a “map” of the course to show where to go.
• Hide a specified number of small toys (for example, 10 toy
cars, or 25 Lego pieces) for the child to find and place on the
carpet; when all have been found and counted, the child gets
to play with them.
• Let the child sit cross legged on the carpet, holding a rope or
hula hoop while an adult pulls the child around a room.
• Substitute two lids from shoeboxes, have the child step into
the lids and practice “skating” around the room.

4 BALANCE BEAM
Primary learning focus
• Balance, body awareness, motor planning, strength.

Materials needed
• An area of grass or rug that is soft and safe to fall on (move
potential dangerous obstacles away from the balance beam).
• Improvised balance beam—consider a 5cm × 10cm (2" × 4")
wooden beam, garden hose, or large wooden building blocks
placed end on end.

Description
Ask the child to practice walking the beam using a variety of
approaches, including forward, backwards, sideways, heel-to-toe.
Be sure that the child is barefoot, or wearing sensible shoes for
this activity (for example, no flip-flops or Crocs). If the child feels
very insecure, providing gentle support at the hips is better than
holding the child’s hand, since that might cause the child to lean
towards the adult’s hand, losing his balance.

Variations
• If the child is fearful of the balance beam, start by using a
non-raised line made of masking tape, or use chalk to draw a
line on the sidewalk.
• Place small objects on either side of the beam, so the child
must squat to pick them up without falling; or give the child a
handful of small objects like buttons or beads, place a row of
empty soda bottles next to the beam, and have him bend to
put one object in each bottle (increase the challenge by
placing the objects in the child’s dominant hand, and the
bottles on the opposite side of the beam, so he must cross the
midline to perform the task).
• Walk the beam while balancing something on the head.
• Walk the beam while holding a spoon in each hand, and
balancing a ball or plastic Easter egg in each spoon.
• With very close adult supervision, try walking the beam with
eyes closed.

5 MAKING STATUES
Primary learning focus
• Trunk strength, balance, body awareness.

Materials needed
• None.

Description
Ask the child to assume various positions, for example on hands
and knees with one hand on a hip, or standing while bracing
hands against knees. Challenge the child to be “stiff like a statue—
don’t let me knock you down.” Next, apply firm but gentle pressure
to hips, shoulder, etc. in a gentle effort to break the pose. This
requires the child to contract and stabilize the weight-bearing
muscles in order to maintain balance.

Variations
• Have the child watch you as you assume a posture, then try
to imitate the posture, requiring motor planning skills.
• Try this activity with eyes closed to increase body awareness.

6 T-STOOL GAMES (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Balance, body awareness, bilateral integration, eye-hand co-
ordination.

Materials needed
• Homemade T-stool.
• Various items to roll, throw, catch (beanbags, koosh balls,
marbles to put in empty coffee can with hole in plastic top).

Description
A T-stool (one-legged stool) is a versatile piece of equipment that
challenges a child to balance while sitting with an unstable base of
support. T-stools can be used at a desk or table during any fine
motor activity, but there are also many simple games that can take
place while sitting on the stool. Teach the child to place feet well in
front of the body, and to lean slightly forward to maintain a center
of gravity. Once balanced on the stool, try engaging the child in
various action songs (like itsy-bitsy spider, or head-shoulder-knees
and toes) while balancing on the stool. Or play simple games of
catch with a soft ball.

Variations
 • Using an empty coffee can with a hole punched in the plastic
lid, roll marbles towards the child, who must catch them and
push them through the hole.
• Aim marbles or balls purposely in a direction that requires the
child to cross his midline in order to catch.
• For the child who has difficulty with eye-hand coordination,
use bubbles or balloons to hit, as these items move more
slowly than heavier objects.

7 OBSTACLE COURSE
Primary learning focus
• Strength, motor planning, balance, sequential memory, spatial
awareness.

Materials needed
• An assortment of objects to move in, under, on, or around,
such as non-fragile pieces of furniture, large pillows, or
cardboard boxes.

Description
Set up an obstacle course using whatever materials are at hand,
but be sure to vary the challenges by including things to go over,
under, or around. Ask the child to maneuver the obstacle course
using different modes of locomotion, and following a sequence of
directions (for example, “crawl under the table, then hop around
the sofa two times, then crab-walk to the big cushion and let
yourself crash”).

Variations
• Try it with eyes closed, making sure the child will be safe, to
increase body awareness.
• Use one mode of locomotion (for example, walking or
crawling) but increase the number of steps the child needs to
 recall.
• Draw a simple picture of the obstacle course, and then place
it in a clear plastic sheet protector. Using a wipe-off marker or
crayon, draw a simple “map” for the child to follow.
Alternatively, have the child “read” the map out loud, while you
maneuver the obstacle course — this requires the child to
practice using the vocabulary that describes spatial concepts.

8 LOG ROLL
Primary learning focus
• Motor planning, bilateral coordination.
• Tends to be an energizing activity.

Materials needed
• Beanbags, koosh ball, or small stuffed animals.

Description
Teach the child to lie down on a soft surface and practice rolling in
a perfectly straight line. This is harder than it looks, and requires
considerable motor planning. If needed, use something to use as a
visual guide for rolling straight (for example, rolling on a large foam
mat, or creating boundaries by using masking tape or cushions).
Have the child place a beanbag or other small, soft object in a
particular location on their body (for example, between the wrists
with hands held above head, between the knees, under the chin,
or in the armpit) and then roll to a specified location without
dropping the beanbag.

Variations
• Try it with eyes closed to increase body awareness.
• Try rolling faster or slower to see what difference it makes in
rolling straight.
 • Have the child lie down at one end of a large sheet or blanket,
hold onto the edge, and roll so that he gets wrapped up in the
blanket to make a “hot dog”.

9 MAKE-A-KITE
Primary learning focus
• Strength, motor planning, bilateral integration.
• Tends to be an energizing activity.

Materials needed
• Plastic grocery bag without holes.
• String.
• Ribbons, crepe paper strips.

Description
Tie the two handles of the bag together at the very top, so that the
bag looks like it has two “U’s” at the top. Tape or staple ribbons or
strips of paper at the bottom of the bag (to make streamers) and
decorate the bag using permanent markers if desired. Tie a length
of string to the U-shaped handles. Encourage the child to hold the
string and run as fast as he can, so that wind will enter the kite to
help keep it flying.

Variations
• Try making two kites, one for each hand.
• Have the child run to different targets according to a
sequence (for example, “run to the back door, then to the red
bush, then to the swings”) to encourage memory and
sequencing skills.
• Jump off a step or low obstacle, pretending that the bag is a
parachute.
10 BELLY TIME
Primary learning focus
• Core trunk strength, body awareness, motor planning.
• Tends to be a calming activity.

Materials needed
• Miscellaneous fine motor games (coloring sheets, dot-to-dot,
mazes, building blocks, etc.).
• Simple board games, such as Candyland or Chutes and
Ladders.
• Book to read or pictures to look at.
• i-pad games.

Description
Spending time while lying on one’s belly and propping upper body
weight on the elbows helps to build strength in the shoulder, trunk,
and neck muscles, and also provides powerful proprioceptive
input. Encourage the child to play various games while in this
position, aiming to increase the amount of time he can tolerate the
position.

Variations
• Incorporate belly time as part of an obstacle course.
• Adapt a favorite board game by creating a set on index cards
with the name of a physical exercise or activity written on
each card (for example, “hop five times on each foot,” or
“tightrope walk to the sink and back”). Then, choose a color
for each player. When a player lands on his selected color, he
must take a card from the top of the pile and perform that
activity a specified number of times. For children who do not
enjoy physical activities, include some cards with fun
consequences, like “Get a hug from Mom,” or “Give me a high
five” or “Eat an M&M of the specified color.”
 • If needed, you can roll up a towel or small blanket to place
under the child’s chest, making it a little easier to prop on the
arms.
• Some children have an easier time keeping their head up if
the activity is placed on a slanted surface, for example a large
three-ring binder.

11 THE SUPERMARKET GAME

Primary learning focus
• Strength, proprioceptive input, bilateral integration.
• Tends to be a calming activity.

Materials needed
• Sturdy plastic laundry basket.
• An assortment of objects to go “shopping” for, preferably
including some heavier items like telephone books, canned
goods, boxes of rice, etc.

Description
Place items around the room or house, and then ask the child to
push the laundry basket (the “shopping cart”) to collect items.
Older children can read an actual shopping list; younger children
can get one item at a time, and then check in with the adult to find
out what is next on the list. Pushing the heavy cart is a great
heavy work activity that builds strength and proprioceptive
awareness.

Variations
• Count how many items are in the basket, guessing what letter
each item begins with, or identifying the first letter sound for
each item (for example, “T” for telephone book, “C” for can,
etc.).
 • Play this game outdoors, substituting a wagon or other
wheeled toy for collecting items.
• Have the child search for items to collect by category, for
example, “find something you cannot eat,” “find something
brown,” “find a vegetable,” etc.

12 BALLOON TWISTER
Primary learning focus
• Balance, motor planning.

Materials needed
• Balloon.

Description
Have the child practice tapping a balloon to see how long he can
keep it in the air. Count the number of taps to practice counting (or
count by two’s, or recite the alphabet to see how far he can go).

Variations
• Try batting the balloon with different body parts (elbow, knee,
head), or according to a sequence or pattern (right knee, left
knee).
• Tie different color ribbons on the right and left wrist, if the child
is too young to understand the concepts “right” and “left”.
• Try it while standing on a slightly unstable surface, such as a
sofa cushion, to improve balance.
• Play “pass” with a partner, and have each partner call out
what body part is next.

13 EGG RACES
Primary learning focus
• Balance, body awareness, motor planning.
Materials needed
• Plastic Easter eggs.
• Spoons, scoops, or measuring cups.
• Box, basket, or large unbreakable mixing bowl.
• Miscellaneous materials for filling eggs, for example, sand,
rice, dry beans.
• Tape.

Description
Establish a starting point and an ending point for a race, with the
box or bowl at the end of the race. Give the child a spoon to pick
up eggs and carry to the finish line without dropping. Filling the
eggs with something makes them heavier and easier to balance
on the spoon—just be sure to tape them closed so that they will
not open accidentally and make a mess! This is a great game to
play alone (try timing the child’s speed) or with one or more
partners.

Variations
• Place a balance beam, pillows, or rope to balance on when
carrying eggs to the finish line.
• Try carrying one egg in each hand.
• Have the child balance a beanbag or small stuffed animal on
his or head and try to get to the finish line without dropping
either the egg or the beanbag.
• Discard the spoon, and have the child crawl to the finish line
pushing the egg with his nose, or crab walk and push the egg
with a foot.
• Have two children stand side by side holding hands, with each
partner holding one spoon in their free hand—the partners
must work together to reach the finish line without dropping an
egg.
14 MONKEY TOES
Primary learning focus
• Balance, motor planning, crossing the midline.

Materials needed
• Unbreakable bowl, bucket, or tote bag.
• Cotton balls, pompoms, or other small, soft objects.

Description
Scatter the cotton balls or other objects around a small area, and
then have the child remove shoes and socks and collect the
objects to place in the container using only his feet. If a cotton ball
is too far away, have the child retrieve it and then hop on one foot
to get to the container.

Variations
• Use different size or color pompoms, and have the child
collect items according to size, color, or a pattern.
• Have the child sit on his bottom, and use two feet together to
pick up objects.
• Have the child trap a beanbag between both feet, then jump
on two feet to get to the container without losing the beanbag.
• Challenge balance skills by doing this activity with arms held
over the head, hands in pockets or behind the back, or on a
slightly unstable surface (for example, sofa cushion or air
mattress).

15 CRAB-WALK SOCCER
Primary learning focus
• Strength, balance, motor planning.

Materials needed
 • Beach ball or playground ball.
• Something to use as a goal (for example, laundry basket or
large cardboard box placed on one side).

Description
Have the child assume a crab-walk position (on hands and legs
with belly facing the ceiling, holding bottom off the floor), while he
attempts to kick the ball into the goal, or defends the goal while
you try to get the ball into the goal. This takes a great deal of
heavy work involving the core trunk muscles, and provides a
tremendous amount of proprioceptive and vestibular input.

Variations
• Play with a partner, each defending his own goal.
• Turn it into a relay, where the child picks up one ball, balances
it on his belly while crab-walking to the goal, then sits down to
throw the ball into the goal.
• Try playing soccer using different animal walks, such as “duck
walking” (child squats and holds ankles, then tries to kick the
ball with feet into the goal), or “elephant walking” (child bends
over and holds hands together like an elephant’s “trunk,”
using the trunk to maneuver the ball into the goal).

16 YOGA BALLS
Primary learning focus
• Balance, strength, motor planning.
• Tends to be a calming activity.

Materials needed
• Inflatable yoga ball (these can be found inexpensively at
discount stores, but I have found them at yard sales costing
almost nothing).
 • A soft, safe surface with no nearby obstacles (outdoors on the
lawn, or indoors on a mat or soft rug, well away from
furniture).

Description
The child sits on the ball with an adult holding the child’s hips. Tilt
the ball in various directions, asking the child to maintain his
balance. Experiment with different positions, such as lying back on
the ball then trying to sit up, or belly lying over the ball and bearing
weight on the arms.

Variations
• Place beanbags or other objects for the child to pick up and
throw at a target or container without losing balance.
• Have the child hold one side of a hula hoop while you hold the
other side, and let the child experiment with controlling his
balance on the ball.
• Sit on the ball while sitting at a desk or table and playing a
game.
• Use the ball to play pass, or for practicing how to dribble—the
large size and weight of the ball makes it move more slowly
than other balls, so it is easier to control.
• Sit on the ball and bounce up and down to the rhythm of
favorite music—this is very calming for some children.

17 THE POPCORN GAME

Primary learning focus
• Strength, bilateral integration.
• Tends to be an energizing activity.

Materials needed
• Bed sheet or blanket (smaller size works better).
 • Balloons, small stuffed animals, lightweight balls or other
objects to serve as the “popcorn.”

Description
Two people stand at each side of the sheet holding on to the edge
(or better yet, this game is even more fun with more people
holding onto different sides of the sheet). Place the soft objects in
the center of the sheet, then shake up and down as hard as you
can until all of the objects have been “popped” and have spilled
from the sheet.

Variations
• Practice counting or saying the alphabet with each shake.
• Use a marker to draw shapes, numbers, or letters on
balloons, or use pieces of paper with symbols that have been
wadded into balls—see which one is the first to leave the
sheet and which is the last.
• Try it with eyes closed to see if the child can tell by feel when
everything has left the sheet.

18 ZOOM TUBE (SEE APPENDIX B FOR DIRECTIONS)

Primary learning focus
• Strength, bilateral integration, motor planning.

Materials needed
• Homemade zoom tube.

Description
A zoom tube is a cardboard tube, outfitted with two long strings
inserted through the middle, and loops tied at each end of the two
strings to form “handles.” The child holds two handles, one in each
hand, with a partner holding the other two handles. Each partner
stands just far enough away that the two strings are kept taut (this
is really hard for young children, and requires considerable body
awareness and motor planning). One partner opens arms wide
while the other partner simultaneously brings arms together,
causing the zoom tube to fly towards the partner whose arms are
held together. It will require a good deal of shoulder and arm
strength, as well as teamwork, to keep the zoom tube moving back
and forth.

Variations
• Try zooming with arms held overhead, or facing away from
the partner with arms held behind the back.
• Zoom to the beat of music, while counting or skip counting, or
for the older child, while spelling out words.
• Vary the length of the strings—longer strings require more
control than shorter ones.

19 SCOOPING CUPS (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Strength, balance, motor planning, bilateral integration.

Materials needed
• Homemade scooping cups.
• Beanbag, koosh ball, or wadded tissue paper ball.

Description
Scooping cups are a little bit like jai-alai, but the scoops are much
bigger and easier for children to use. Teach the child to hold one
scoop with the opening facing towards the ceiling. Place a
beanbag or other soft projectile in the cup, and teach the child to
toss it in the air and catch it again with the scoop. Once the child
has learned to be successful with one scoop, provide another
scoop for the other hand and practice tossing with one hand and
catching with the other.

Variations
• Use scoops to play catch with a partner, each holding one
scoop.
• Use two scoops to catch according to a pattern, for example,
left, left, right.
• Substitute large plastic drinking cups and ping-pong balls;
place a ball into one cup, tip it over to bounce on the floor or
table, and catch it with the other cup.
• Play catch while sitting on a yoga ball or T-stool, or while
standing in a confined space, such as on a sofa cushion.

20 THE DRESS-UP RACE

Primary learning focus
• Strength, motor planning, body awareness, fine motor
dexterity.

Materials needed
• Assorted clothes, preferably a little too large for the child (use
a parent or sibling’s clothes, or collect from a thrift shop).
• Something to mark the start and end of the race.
• Index cards and marker.
• Egg timer or watch.

Description
Place clothes at one end of the race, and position the child (or
children) at the start. Each child should have an index card with
his name on. When the adult says, “go,” the child must run to the
clothes and don one item, then return to the start. If the piece of
clothing is on correctly, the child gets a star or happy face on his
card, and runs to don another piece of clothing. This game can be
played solo (use the timer or watch to see how long it takes to don
a designated number of items), or as a race with another player
(see who correctly dons all items first).

Variations
• For the child who is having trouble with a particular skill, such
as managing zippers or buttons, have several items that
challenge only that skill—the child must don the item, then
take it off before donning the next item.
• To increase the motor planning challenge, try donning clothing
(omitting the fasteners) while wearing mittens.
• Increase the listening challenge by providing a verbal clue
indicating the next clothing item (“Put on something striped” or
“Put on something for a rainy day”).

21 SHADOW MAKER
Primary learning focus
• Body awareness, motor planning, bilateral integration.
• Tends to be a calming activity.

Materials needed
• Empty wall.
• Darkened room with a strong lamp or lantern.

Description
Have the child stand in front of the adult, facing the wall, with the
light shining behind both so that their shadows are projected
against the wall. Instruct the child to keep his shadow “inside” of
the adult’s shadow. The adult assumes various body postures,
while the child tries to imitate the posture (without looking at the
adult). If done correctly, the child’s shadow will remain invisible
inside of the larger adult’s shadow.
Variations
• Practice animal walks to see what their shadows look like.
• Practice hand shadows patterns.
• Let the adult sit next to the child and use his finger to make a
shape or a letter of the alphabet, while the child tries to
imitate.
• Learn the sign language alphabet—great for fine motor
planning—and practice these during shadow play.

22 CHARADES
Primary learning focus
• Motor planning, body awareness, bilateral integration.

Materials needed
• Index cards, old magazines.
• Egg timer.

Description
Search through magazines to find pictures of things that can fit
different categories, such as “animals,” “sports,” or “things that
parents do,” being careful to choose categories that will require
moving the whole body to act out the picture. Glue the pictures
onto one side of each card, and mark the other side to indicate the
category (for example, red = animal, blue = sports). The child
takes turns selecting a card, looking at the picture, and then acting
it out for another player (or players) to guess before the timer runs
out. Set the timer for about 15 seconds per turn, or longer for a
child who really struggles with this activity.

Variations
• Play the game silently, without making any noises, to increase
the challenge.
 • For older children, choose categories that require more
abstract concepts, for example preparing different foods, or
acting out a particular TV program or star.

23 RHYTHM STICKS
Primary learning focus
• Bilateral integration, motor planning.

Materials needed
• Sticks for tapping, two per child (you can use paper towel
tubes, drumsticks, unsharpened pencils, knitting needles—
whatever you have).

Description
Start by using rhythm sticks to keep time to familiar tunes. Once
this is mastered, try teaching the child to imitate different patterns
that the adult demonstrates (for example, a two-step pattern would
be right, left, right, left, while a more difficult pattern might be right,
right, both, left, left, both). Many children can do this while facing
the adult who demonstrates the pattern, but others find it easier if
the adult sits behind them. If the child is getting confused about
which stick to use, provide a visual cue by having both the adult
and the child wear different colored ribbons on each wrist (for
example, red for right wrist and blue for left wrist), or by holding
different colored sticks in each hand.

Variations
• Vary the qualities of the pattern by hitting harder or softer,
faster or slower.
• Instead of demonstrating a pattern, use verbal directions to
indicate the pattern (for example, tap two times with the left
stick, then one time with the right stick).
• Tie ribbons or strips of crepe paper to the end of the sticks,
and have the child follow motions with the sticks without an
 auditory cue.
• Use two sticks that produce different sounds when tapping the
floor or table—the child closes his eyes to hear the pattern
then attempts to copy the pattern.

24 I WENT TO THE GYM…

Primary learning focus
• Strength, body awareness, motor planning, memory.
• Tends to be a calming activity.

Materials needed
• Nothing—just a safe area for exercising.

Description
This is a variation of the classic memory game “I went on a
shopping trip and bought a… ,” where each player must add an
item until someone forgets the correct order of the shopping list. In
this variation, players say, “I went to the gym and I did… ” adding
exercises (for example, hopping, skipping, jumping jacks, etc.).
The child acts out the exercises in the sequence, instead of using
words. This is a good way to build strength and endurance while
burning off excess energy!

Variations
Choose other themes that can be acted out, for example “I went to
the zoo and I saw a monkey eating a banana… ,” or “I went to
school and I read a book and colored a picture…” while acting out
each motion.

OTHER IDEAS FOR SUPPORTING GROSS

MOTOR DEVELOPMENT
• Use playground equipment for climbing, swinging, sliding.
• Play twister.
• Use tin can stilts.
• Practice animal walks.
• Play Simon says.
• Play follow the leader.
• Play tug of war.
• Set up relay races.
• Jump on a trampoline.
• Jump on a pogo stick or hoppity-hop.
• Ride an exercise bike.
• Ride a sit-n-spin toy.
• Swim.
• Play sports.
• Learn karate or other martial arts.
• Learn to jump rope.
• Play hopscotch.
Chapter 3

PROMOTING FINE MOTOR

SKILLS

RELATIONSHIP TO LEARNING
The development of fine motor skills is a critical need for young
children in order to establish success and independence in their
performance of common daily activities. Fine motor skills are those
that require using the small muscles located in the hands, mouth,
and eyes, and they develop most rapidly in early childhood. Fine
motor skills are continually refined into the adult years as an
individual gains repeated practice both in performing familiar daily
activities, such as using a keyboard or using a knife in the kitchen,
and also in learning new skills that may be required of an
individual’s personal situation, job requirements, or recreational
interests.
When children first enter kindergarten, they are already expected
to have mastered controlled use of a pencil, scissors, or crayon, and
in fact they spend surprisingly large portions of their day engaged
in activities that require these skills. Children who struggle with
fine motor skills are at a distinct disadvantage for experiencing
success in their early school years. They may be slow to complete
assignments, avoid challenging work, especially those involving
paper and pencil, and become easily frustrated. Teachers may
consider them to be less competent learners than they really are,
because they may have a hard time showing what they know using
paper and pencil. Commonly, children who struggle with fine
motor skills also experience a poor self-image because they are
well aware that they are having difficulty performing certain
activities as well as other children.
Besides the typical school-related fine motor activities, many
other daily functions are also impacted by fine motor skills. Self-
care independence relies on the child’s ability to manipulate
buttons, zippers, or snaps during dressing; to open food containers
and use utensils without spilling when eating; and to learn to brush
teeth and wash one’s face and hands to maintain hygiene. Learning
to read requires coordinated use of the small muscles surrounding
the eyes in order to scan from left to right without losing one’s
place, to maintain visual focus on an object despite changes in head
position, and to shift the eye’s focus from near to far when looking
from the teacher or board back to work at one’s desk. Learning to
speak clearly and with good coordination requires precise use of
the small muscles that control the jaw, tongue, and lips. The
smaller muscles involved in performing fine motor skills are often
referred to as the distal muscles, because they are farthest away
(distal) from the trunk.

HAND AND UPPER BODY STRENGTH

Developmentally, children first develop strength and control in
their proximal muscles, which are the larger muscles located in the
shoulders, trunk, and hips that underlie core strength and good
posture. Strength in these muscles is necessary in order to have a
stable base of support for developing refined fine motor
movements. Children with low muscle tone—commonly those with
autism, ADHD, or other learning differences—are especially
susceptible to difficulties developing strength and stability of the
proximal muscles. Surprisingly, at first glance they may appear to
demonstrate good overall hand strength, as for example when
asked to squeeze your finger, play tug of war, or lift a heavy tote
bag using the handles. However, children with low tone and poor
postural stability may be compensating for poor muscle strength in
the complex muscular structures of the hand by substituting force
using their shoulder and forearm muscles. They have difficulty
isolating smaller hand movements from larger body movements. A
close look at how they grasp and manipulate small objects reveals
problems with moving small objects within the hand using only
finger motion, a set of skills referred to as in-hand manipulation.
They may commonly hold their pencil without the thumb tip
touching the pencil, use scissors awkwardly, and may appear
clumsy when handling small items like beads or Lego blocks.
Because of this need for precision when manipulating small
objects, there are more distal muscles than proximal muscles
involved in fine motor control. For example, nine muscles are
responsible just for controlling movements of the thumb, and six
muscles (called extraocular muscles) control the movements of
each eye.
Fine motor movements are best executed when the child has an
upright posture, with feet firmly planted on the floor. The child
needs sufficient strength in the shoulder and elbow to keep the arm
in a stable position tucked into the side of the body, as this allows
control when using the smaller muscles of the forearm and wrist.
This stability is best demonstrated by the child’s ability to color,
cut, or manipulate small objects without a lot of observable
movement in the shoulder or elbow. For best control, the wrist is
held straight or in a slightly extended (tipped back) position, and
with a supinated forearm (thumb facing towards ceiling and pinky
finger pointed towards the table), which creates the anatomical
balance necessary for opposing the thumb to the fingers with
precision. With the wrist held in the proper position, the two sides
of the hand are able to work cooperatively to efficiently manipulate
small objects. The ring and pinky finger form the ulnar side of the
hand, and typically curl into the palm of the hand to provide
strength and stability during fine motor manipulations. The thumb
and forefinger (the radial side of the hand) are then free to
manipulate objects with control. To experience how this works, try
performing a fine motor activity such as stringing small beads or
putting paper clips on paper, first with poor posture and the elbow
held high and the wrist bent downward (a position of poor
stability), then with good posture and the elbow held in towards
your side and your wrist held straight (the position of stability).
You should be able to feel the difference in muscles used and ease
of performance, which may help you to understand the importance
of stability in developing control of motor movements.

MANUAL SPEED AND DEXTERITY

Once children develop the ability to apply a stable base of support
for using their fine motor skills, they benefit from opportunities to
practice and develop these skills in order to develop their manual
dexterity, or skill and ease in using the hands. Consider what it
feels like when you are learning any new skill that requires fine
motor coordination, like learning to knit or to crochet. At first, you
will need to consciously focus on how to perform the task, but as
you practice over time, the movements become more automatic,
and as a result, much faster. Children with poor motor planning
ability struggle to learn how to perform movements automatically,
or to apply learned skills to new situations (for example, tying
bows on packages after learning how to tie their shoes), and are
often slower than other children in completing fine motor activities.
For this reason, many tests of fine motor skill use speed as an
overall measure of fine motor skill. Most children are competitive
by nature, and their natural drive to compete and win can be an
effective tool for motivating them to practice fine motor skills.
Children love to see if they can “beat” a parent or other child in
simple activities like stringing a selected number of small beads, or
flipping pennies from heads to tails. This is a great way to
encourage practice of fine motor skills.

EYE-HAND COORDINATION
Eye-hand coordination refers to the use of visual and
proprioceptive information to guide and direct the hands when
performing fine motor activities. In order to successfully
manipulate an object with the hands, the eyes must first locate the
object to be manipulated, and provide basic information about its
shape, size, texture, and weight in order for the person to know
where to grasp the object, and with what amount of force or
strength to grasp without breaking or dropping the object. This is
sometimes referred to as feedforward, referring to the sensory
information that will predict precisely what movements will lead to
success in performing the desired fine motor activity. Once the
hand has made contact with the object, visual feedback combined
with tactile and proprioceptive feedback allows the individual to
adjust their grasp or manipulation of the object in order to
accomplish the intended task. Often, fine motor activities that
require eye-hand coordination also require an element of
perceptual reasoning (as, for example, when using a pencil to
solve a maze or to copy pictures from a model), or timing (as when
bouncing and catching a ball).
Common signs of difficulty with fine motor skills include:
• slow to achieve fine motor milestones (see Table 1.1)
• fails to demonstrate a consistent hand preference for skilled
tools (pencil, scissors) before starting kindergarten
• shows limited interest in, exhibits frustration with, or avoids
age-appropriate fine motor activities such as drawing,
coloring, cutting
• uses unusual patterns of grasping a pencil or scissors
• drops small items frequently
• overly depends on adult assistance for common daily living
activities, such as opening food containers or managing
clothing fasteners
• has poor speech articulation
• seems unusually messy when eating
• drools or has difficulty chewing or swallowing without
spilling food from mouth
• demonstrates poor handwriting compared to same aged peers.

FINE MOTOR ACTIVITIES

1 RAINBOW WRITING
Primary learning focus
• Eye-hand coordination, perception, auditory processing.
• Tends to be a calming and organizing activity.

Materials needed
• Writing surface, preferably large.
• Writing utensils of different colors (crayons, markers, sidewalk
chalk).

Description
This is a fun activity for teaching young children to recognize
differences between the various strokes used when forming
letters. Draw a long line across the top and bottom of the paper (or
use a chalkboard or whiteboard), to represent the lines on
handwriting paper. Teach the child to make a row of strokes from
left to right across the page while saying the name of the stroke
(for example, “down, down, down” or “slide up, slide up, slide up”).
Then trace the same strokes using a different color each time. The
common strokes include: down, up, slide down (left to right
diagonal), slide up (left to right diagonal), under (“U” shape), over
(inverted “U” shape), and across (horizontal stroke). Larger paper
and larger strokes provide more movement and sensory feedback
than working in a smaller space, and may better reinforce learning.
Once the child has mastered basic strokes, increase the challenge
by creating multi-step patterns to follow, for example: “slide up,
slide down, go across.” After the child has learned the basic
strokes, transfer this skill to regular, lined writing paper, and use
the words to reinforce how to make the correct strokes for forming
letters of the alphabet.

Variations
• For the younger child who may be confused about where to
start, use colored lines or dots to provide a cue (green means
“go” and red means “stop”).
• Create a middle horizontal line with dots or dashes to teach
the child size concepts (for example, “big down, little down”).
• Perform while belly lying to increase strength and body
awareness. a Have the child close eyes or wear a blindfold
while the adult holds the child’s hand to draw the pattern; the
child must use words to describe the strokes.

2 BEAT THE CLOCK

Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.
Materials needed
• Stopwatch or watch/clock with second hand.
• Assorted fine motor challenges that can be timed, for
example:
Flipping ten pennies from head to tail.
Stringing ten beads on a shoelace.
Putting five paper clips on an index card.
Using tweezers to put ten buttons into an empty pill bottle.
Using a hole puncher to make ten holes in an index card.

Description
This is a very motivating way to help children to track their own
progress as they develop and refine their fine motor skills. Create
a “kit” of activities (aim for at least eight to ten) that are suitable for
the particular challenges of the child. Then, provide directions for
each activity, say “ready, set, go,” and begin timing each activity.
At the end, add up the total amount of time used for each activity
to create the child’s “score.” Repeat this game periodically to see if
the child can “beat” her record. Many children enjoy keeping a
chart or record of their speed so that they can track their
improvement over time.

Variations
• Infinite variations are possible depending on what skills are
challenging for the child—try to include some skills that are
very easy and fun, along with several that are more
challenging.

3 SUNCATCHERS
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.

Materials needed
 • Thin cardboard (a file folder works well).
• Clear contact paper.
• Tissue paper in different colors.
• Permanent marker.
• Scissors.

Description
Help the child to decide what shape they would like for their
suncatcher, such as a flower or balloon shape. Draw a 10cm to
15cm (4" to 6") shape on the cardboard, and cut it out to make a
template of the shape the child has selected. Next, help the child
to cut or tear tissue paper into very small pieces, just over 1cm
(about ½") in size, and place these in a bowl. Cut out two squares
of contact paper a little bit larger than the template. On the plastic
side of one piece of contact paper, help the child to trace the
shape template using a marker. Peel off the paper backing, and
place the contact paper on the table, sticky side up (the shape will
be visible through the clear contact paper). Instruct the child to
place tissue paper pieces, one at a time, onto the sticky paper until
the entire shape is filled in (it’s OK if paper pieces overlap one
another or go outside of the line—this actually creates a really
interesting contrast when the finished suncatcher is held up to a
window). When the shape is completely filled with tissue paper
bits, peel off the paper backing on the other piece of contact
paper, and place it sticky side down over the child’s creation,
making a “sandwich.” The child then cuts out the shape on the
marker line. When placed in a sunny window, the suncatcher will
glow like a stained window.

Variations
• Holiday themes are especially suitable for this activity, like an
egg for Easter, a shamrock for St Patrick’s Day, or a pumpkin
for Halloween. Children can often be motivated to make
multiple suncatchers to make as gifts for friends or relatives,
 giving themselves more opportunity for practice with
developing their fine motor skills.
• If desired, you can use pieces of construction paper to add
details for the picture, for example facial features on a
pumpkin in order to make a jack-o-lantern. These pieces
should be placed on the contact paper first, before the tissue
paper, so that they stand out in the finished product.
• Give directions for the child to follow a color pattern when
placing tissue pieces to challenge auditory memory.

4 PAPER SNOWBALLS
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.

Materials needed
• Old magazines or catalogues ready for recycling.

Description
The child and a partner each have one magazine to work from.
Rip out a designated number of pages (maybe ten). Then, each
partner must place one hand in a pocket or behind her back, and
using only one hand must crunch up the paper to make a dense
ball. This requires considerable motor planning, hand strength,
and dexterity. When all of the balls are completed, say, “ready, set,
go” and have a snowball fight (or throw balls at a designated
target).

Variations
• Practice making balls with both the dominant and the non-
dominant hand.
• Vary the weight and texture of the paper—for example, tissue
paper may be more acceptable for the child who has weak
hand strength or who dislikes the feel of sturdier paper.
 • Throw balls at targets (for example, empty shoe boxes) that
are placed around the room to provide practice in throwing
near versus far, or aiming at targets across the midline of the
body.
• Use a set of non-breakable mixing bowls, and assign different
point values for each bowl, so the child can practice adding up
her score.

5 WINDMAKERS (SEE APPENDIX B FOR DIRECTIONS)

Primary learning focus
• Fine motor strength, eye-hand coordination, visual attention,
and tracking.

Materials needed
• Assorted, empty squeeze bottles (for example, ketchup or
mustard squeeze bottles, an infant nasal aspirator, or empty
nasal spray bottles).
• Permanent markers for decorating bottles (optional).
• Cotton balls, small pompoms, or small pieces of tissue paper.

Description
Clean and dry bottles well before using. Then decorate as desired,
for example, making the bottle into an animal or creature, using
the spout as the animal’s “nose.” Next, the child and a partner sit
across a table from each other, and use the bottle to “blow” a
lightweight ball across the table. The child must try to score a goal
by blowing the ball off the table before her opponent can blow it
back.

Variations
• Play this game while belly lying on the floor to build strength
and body awareness in the trunk and upper body.
 • Make a simple obstacle course, and provide verbal directions
to get to the end point.
• Set up two goals at the far side of the table, and have the
child hold two windmakers (one in each hand), to see which
hand can more accurately reach the goal.
• For a tactile experience, put small pompoms or confetti on the
child’s arms or legs and use the windmaker to blow them
away.

6 GO FISHING
Primary learning focus
• Eye-hand coordination.
• Easily adaptable to challenge gross motor or perceptual skills.

Materials needed
• Stick or dowel approximately 60cm (2 feet) long.
• String or twine approximately 60cm (2 feet) long.
• Small magnet.
• Index cards.
• Paper clips.

Description
Secure the string to one end of the stick, with the magnet attached
to the other end of the string. Have the child draw fish or other
simple figures on the index cards, and then attach a paper clip to
each index card. The child then uses the fishing rod to pick up the
index cards.

Variations
• Create cards that include concepts the child is learning, such
as colors, letters of the alphabet, or sight word vocabulary.
 • Have the child practice fishing while on an unstable surface,
such as a sofa cushion, T-stool, or yoga ball.
• Start by holding the rod with both hands together, then try it
with the dominant hand alone, then the non-dominant hand to
challenge bilateral integration and motor planning skills.
• Make a smaller version of the fishing rod, substituting a paper
clip hook for the magnet, and small plastic fish (cut from thin
plastic or Styrofoam) with holes cut near the head. Float the
fish in water and attempt to catch with the hook.

7 THE MARSHMALLOW FACTORY

Primary learning focus
• Dexterity, eye-hand coordination, perception.

Materials needed
• Mini marshmallows.
• Toothpicks.

Description
Connect marshmallows with toothpicks to create all sorts of
buildings or other structures.

Variations
• Instruct the child to copy a design modeled by the adult, with
the model in sight, then hidden to improve memory skills.
• Use the toothpicks to make letters of the alphabet.

8 SECRET ENVELOPES (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.
Materials needed
• Assorted envelopes (it is fine to use recycled envelopes—just
use tape to close them up as needed)—see Appendix B for
directions.
• Wide-lined markers or masking tape.
• Stickers, small treats, or index cards.
• Computer mousepad, washcloth, or sponge (optional).

Description
This is a great way to practice cutting for the child who is
challenged by using scissors. Prepare the game by placing one
sticker or small treat inside each envelope, then taping it closed.
Make sure the sticker or treat is at one end of the envelope. On
the other end of the envelope, draw a line (straight, waving,
angled) for the child to cut open to obtain the reward.

Variations
• For the child who cuts while holding their scissors upside
down, use a computer mousepad, a coaster, or a folded
washcloth as a “launchpad” for resting the pinky side of the
hand so the thumb remains facing the ceiling.
• Use strips of masking tape instead of a marker to increase
tactile feedback during cutting.
• Instead of treats, insert exercise “messages” written on index
cards inside the envelopes, for example, “hop five times.”

9 TAP THE BALL (SEE APPENDIX B FOR DIRECTIONS)

Primary learning focus
• Eye-hand coordination, strength, bilateral integration, motor
planning, perception.

Materials needed
 • Lightweight plastic ball (such as a whiffle ball) attached to a
string approximately 60cm (2 feet) long.
• Rod or stick approximately 60cm (2 feet) long (empty
wrapping paper tubes work well).
• Markers or different colored plastic tape.

Description
Prepare the rod by using markers or tape to create three different
colored lines, one around the center of the rod, and one
approximately 15cm (6") from each end of the rod. Next, suspend
the ball from a tree branch or door sill so that it hangs
approximately at the child’s eye level. Instruct the child to hold
both ends of the rod, and gently tap the ball on the middle line so
that the ball does not bounce or bobble. When the child can do
this well using the center line, try tapping with one of the end lines.
This requires considerable attention as well as motor planning skill
and bilateral integration.

Variations
• Instruct the child to tap out a pattern using the colored lines,
such as red, blue, red, blue, without losing control of the ball.
• Tap out a pattern while skip counting or reciting the alphabet.

10 BUBBLE BLASTER
Primary learning focus
• Fine motor strength, eye-hand coordination.

Materials needed
• Empty spray bottle with trigger handle.
• Bubbles (see Appendix B for a homemade recipe).
• Bubble wand (you can make your own with wire or a coat
hanger).
Description
This is a great outdoor activity for a warm summer day! Fill the
bottle with clear water, and then let the child try to pop bubbles by
squeezing the trigger.

Variations
• Use shaving cream on a beach ball to make shapes or
pictures, then use the spray bottle to clean off the beach ball.
• Use the spray bottle to try to propel a ping-pong ball to a
target.
• Help spray plants with water.
• Add a few drops of food coloring and use the sprayer to make
pictures in the snow.

11 PUTTY GAMES
Primary learning focus
• Hand strength, dexterity, tactile discrimination.
• Tends to be a calming activity.

Materials needed
• Clay, therapy putty, play-doh, etc. (see Appendix B for
homemade recipes).
• Rolling pin, plastic knives, cookie cutters.
• Small objects (coins, beads, buttons, pegs).

Description
Playing games with clay or putty provides the resistance needed
to develop hand strength, and also provides the tactile input that
many children crave (but some dislike). Teach the child to use a
rolling pin to flatten the clay, then use cookie cutters or a plastic
knife to make shapes. Reshape into a ball, and hide small objects
inside the clay and have the child go on a “treasure hunt” to find all
the hidden bits. Roll the putty into shapes for a head and body,
then add toothpicks, buttons, dry macaroni or other small objects
to make an alien or animal.

Variations
• Try to find hidden bits with eyes closed.
• Roll out thin snakes to place onto pictures of shapes or
letters.
• If the child strongly dislikes the feel of clay or putty, try having
the child wear non-latex medical gloves at first.

12 THE TURKEY BASTER GAME

Primary learning focus
• Fine motor strength, eye-hand coordination.
• Tends to be a calming activity.

Materials needed
• Turkey baster (can substitute an infant bulb syringe).
• Bucket of water.
• Empty plastic soda bottle.

Description
This is another great outdoor activity for a warm day. Have the
child dip the baster into the bucket of water to see how fast she
can use the baster to fill up the soda bottle.

Variations
• Use two basters to create a relay race with a partner.
• Set up multiple soda bottles in different locations, and have
the child follow verbal directions (for example, “do one squirt
in the bottle next to the back door, then two squirts in the
bottle under the picnic table”).
 • Instead of a turkey baster, use a sponge to soak up the water
and then squeeze into the bottle to build even greater hand
strength.

13 THE MUNCHER MAN (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Hand strength, eye-hand coordination.

Materials needed
• Tennis ball.
• Sharp razor knife.
• Permanent markers.
• Small objects (beads, buttons, pompoms, plastic letters).

Description
Prepare a muncher man by slicing a 6cm to 8cm (2½" to 3") line
along the rubber seam that separates the fuzzy parts of the ball.
This becomes the muncher’s “mouth.” Use a red marker to draw
lips around this cut, then adding eyes, nose, and any other desired
facial details. The child holds the tennis ball in her palm with the
thumb next to one side of the mouth, and the other fingers next to
the other side of the mouth. By squeezing hard, the muncher’s
mouth will open so that the child can “feed” it small objects.

Variations
• Create relays, where the muncher “eats” something, then the
child performs an exercise (for example hopping or skipping
across a room to allow the muncher to “spit out” the food into
a bowl (children love making gagging noises when they do
this).
• Use magnetic letters or alphabet beads to have the muncher
eat letters to form simple words.
 • Instruct the muncher to eat a sequence of objects (for
example, if using colored pompoms, “eat a red strawberry,
then a blueberry, then a yellow lemon”).

14 GRABBER GAMES
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.

Materials needed
• An assortment of tools requiring a pinch to pick up small
objects (such as tweezers, strawberry hullers, squeeze-type
hair clips, squeeze-style clothespins, or one-piece practice
chopsticks).
• Small objects (such as beads, plastic bugs or spiders, small
pompoms.

Description
Spread out objects on a table and have the child select a grabber.
Use the grabber to pick up items and place them in a container.
Combine different objects into a messy pile, and then have the
child sort different objects into different containers, which can also
challenge visual figure-ground perception. This can easily be
made into a relay race type of challenge.

Variations
• Use alphabet cereal to identify (then eat) letters or short
words.
• Use grabbers instead of fingers to move game pieces around
a playing board.
• Use clothespins or hair clips to pinch onto objects around the
room, then go on a treasure hunt to collect the items.
• Hang a string across a room and use clothespins to clip
artwork for display.
 • Use grabbers for a special snack using food cut into tiny bites.

15 AIR TRAFFIC CONTROLLER

Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.

Materials needed
• Blank computer or drawing paper.
• Crayons.
• Target (wastepaper basket, laundry basket, or large
cardboard box with a hole cut in one side).

Description
Each player chooses a designated number of pieces of paper, and
decorates the paper in a way that will identify who it belongs to—
this might mean that one player decorates using blue and green,
while another player uses red and yellow, or possibly one player
draws fish and another player draws dinosaurs. Teach the child
how to fold paper to make airplanes (younger children will need
help with this). Then, players stand 2.5m to 3m (8 to 10 feet) away
from the target and throw their airplanes, attempting to hit the
target.

Variations
• Try making airplanes with smaller pieces of paper—these will
take more dexterity to fold, and will also fly faster.
• Place multiple targets at different distances to require
adjusting how hard or softly to throw the airplane.

16 BOTTLE BOWLING
Primary learning focus
• Fine motor strength, eye-hand coordination, motor planning.
Materials needed
• Ten empty large plastic soda bottles.
• Water or sand.
• Masking tape or sidewalk chalk.
• Medium-sized playground ball.

Description
Use small bits of masking tape or sidewalk chalk to mark out
where the bowling pins will be placed, and to make a starting line
about 3m (10 feet) away from the pins. Fill each bottle with an inch
or so of water or sand, and replace the tops so the bottles will not
leak. Then have the child stand on the line and try to roll the ball to
knock down the pins.

Variations
• Fill bottles with more sand or water to require more force to
knock down the pins and to make them heavier to set up (this
will increase the amount of proprioceptive input involved in the
game).
• Mark the bottles in some way (draw shapes or letters on each
bottle, or fill with water colored with food coloring) and create
a “code” for tallying points (for example, red pins get one
point, green pins get two points, etc.).

17 BUBBLE WRAP
Primary learning focus
• Fine motor strength, eye-hand coordination, bilateral
integration.

Materials needed
• Bubble wrap.

Description
Children absolutely love to pop the bubbles in bubble wrap! Give
the child small pieces of bubble wrap to pop as a warm-up before
other fine motor activities, or cut out two squares of similar size,
and have a race to see who can pop their bubbles first. Remember
that larger bubbles are easier to feel and pop than smaller
bubbles.

Variations
• Use a permanent marker to place small colored dots on the
bubbles to make a shape or letter, then have the child pop
only those bubbles that form the shape.
• Try to pop all of the bubbles while eyes are closed.
• Incorporate larger bubble wrap into obstacle courses so
children can hear the pops as they maneuver the course.
• Use large packing bubbles to practice jumping skills—have
the child stand on a bottom step or sofa cushion, then jump
down to pop the bubble.

18 RUBBER BAND BALL

Primary learning focus
• Fine motor strength, dexterity, motor planning, eye-hand co-
ordination.
• Making the ball tends to be calming (but playing with it tends
to be energizing).

Materials needed
• Page from a newspaper.
• Large number of rubber bands (elastics).

Description
Teach the child to start by crumpling the newspaper into the
tightest ball possible. Then, start wrapping the rubber bands
around the ball as tightly as possible, maintaining the round
shape. Stop when the ball reaches about 4cm to 5cm (1½" to 2")
in diameter. The child will be surprised by how high this type of ball
can bounce!

Variations
• Play various throw, bounce, or catch games using the ball.
• This can make a good fidget toy, as the child can remove and
replace bands while listening to a story or riding in the car.
• Place a series of tall targets, such as wastepaper baskets, at
different distances from the child, and practice seeing how
hard the ball needs to be bounced to reach different targets.

19 TISSUE ART
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.

Materials needed
• Index cards with a simple outline (for example, ice cream
cone, flower, dinosaur).
• Colored tissue paper cut into about 1cm (½") squares.
• Non-toxic glue.

Description
For this challenging art activity, the child must spread glue inside
the outline, then take one piece of tissue paper at a time, and roll it
into a tight ball using the thumb and forefinger. Use these balls to
fill in the outline to make a three-dimensional art design.

Variations
• Instead of tissue paper, use small pieces of sponge or cotton
swabs to dip into paint and fill in the outline.
• Use tweezers or other “grabbers” to pick up the tissue balls
and place them in the outline.
20 CUTTING SANDWICHES
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination, bilateral
integration.

Materials needed
• Two pieces of heavy duty cardboard cut in the same size and
shape—these can be shaped like a piece of bread, or like any
other shape that appeals to the child.
• Paper (computer, construction, anything you have).
• Scissors.
• Metal binder clip.

Description
Place a piece of paper between the two cardboard shapes (this is
the “filling” for the sandwich), making sure that the shapes match
up. Secure firmly with a binder clip. Have the child cut around the
shape using scissors, cutting off any of the filling that spills out of
the shape. For many children who avoid using scissors, this is a
motivating activity that really draws their attention.

Variations
• Place a computer mouse mat or a folded washcloth for the
hand holding the scissors to rest on—this can help keep the
forearm in the correct position during cutting.
• Add extra pieces of paper (pretend they are lettuce or
tomatoes)—cutting through multiple layers requires greater
strength and motor planning.
• Once the child gets the hang of it, try removing the binder clip
so the child has to hold the pieces together without any help.

21 HAUNTED HOUSE
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination, motor
planning.

Materials needed
• A large cardboard box.
• Razor cutter or razor knife.
• Markers or crayons to decorate the house.
• Paper (newspaper or magazine pages work well).
• Paper towels or tissues.
• String.

Description
First, use the knife to cut windows and doors in the haunted
house. Then let the child decorate the house. Encourage creativity
—and demonstrate how to make cobwebs or bats for the child to
copy. Assemble materials to make “ghosts,” including the
newspaper, towels or tissues, and 15cm (6") lengths of string.
Take the pieces of newspaper or magazine paper and crumple
them into tight balls. Place each ball in the center of the towel or
tissue, and teach the child how to tie a simple overhand knot
tightly around the ball to make a ghost. This is a good way to
introduce tying for the child who cannot yet tie shoelaces. Play
games throwing the ghosts into the windows and doors of the
haunted house.

Variations
• Experiment with different materials to make ghosts smaller,
larger, heavier or lighter.
• Place the haunted house farther away, or up on a table, to
make it harder to play.

22 PUSH-INS
Primary learning focus
• Fine motor strength, dexterity, eye-hand coordination.

Materials needed
• Assorted empty containers with plastic lids (for example,
coffee cans, Pringles containers, or empty film cans).
• Razor knife.
• Assorted small objects (coins, marbles, toothpicks), choosing
a different type of object for each can.

Description
Place objects in containers according to size (for example,
marbles would fit well in a coffee can, coins in a small Pringles
container, toothpicks in a film canister.) Use the knife to cut an
opening in the lid just large enough to insert the objects (small X
for the marbles, a slit for the coins, small hole(s) for the
toothpicks). Empty the contents of one container into a small bowl,
and instruct the child to pick up items one at a time and transfer to
the palm of their hand. See how many objects the child can hold
before she starts to drop the items—this takes a great deal of skill
with in-hand manipulation skills. Then, let the child practice
inserting the items one at a time into the container.

Variations
• Create matching containers, and try using both hands
simultaneously.
• Try it with eyes closed to increase sensory feedback.
• Have the child sit on a T-stool or yoga ball, then roll marbles
for the child to catch and insert into the can.

23 BUTTON SNAKE (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
 • Fine motor strength, dexterity, eye-hand coordination, motor
planning, bilateral integration.

Materials needed
• 8cm (3") pieces of felt or fleece cut in rectangles or ovals
(different colors).
• Scissors.
• Buttons (all the same size), needle, and thread.

Description
Sew a button on the end of each felt or fleece piece, and cut a slit
(the buttonhole) at the other end. Let the child practice buttoning
pieces together to make a pet snake.

Variations
• Use snaps instead of buttons.
• Sequence the size of buttons and pieces of felt or fleece from
larger to smaller.
• Instruct the child to assemble the snake according to a color
pattern.
• Use pieces of thin cardboard (for example, from a file folder),
punch a hole in each end using a hole puncher, and assemble
with copper paper fasteners (brads)—children love to color or
decorate these snakes.

24 HOMEMADE RING TOSS

Primary learning focus
• Eye-hand coordination, motor planning.

Materials needed
• Lid from a large cardboard box.
• Markers or crayons for decoration.
 • Empty spools of thread.
• Hot glue gun.
• Chenille pipe cleaners to form rings.

Description
Glue empty spools onto the inside of the cardboard box lid. Write
numbers under each spool to indicate the point value. Decorate as
desired (for example, make it a space game by drawing stars,
moons, or planets around each spool). Form rings by twisting the
pipe cleaners together. Start by trying to toss rings while the ring
toss is placed flat on the floor. A more difficult challenge is to throw
rings onto the spools while the ring toss is propped up on its side.

Variations
• Place the ring toss at one end of a balance beam or taped
line, with rings placed at the other end — instruct the child to
pick up one ring at a time, walk the beam, then throw at the
target.
• Glue more than one empty spool on top of each other to make
a longer “stick” to catch the rings.
• Practice with smaller and larger rings.

25 TREAT BOXES (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Fine motor strength, dexterity, motor planning, bilateral in-
tegration.

Materials needed
• An empty cardboard box, such as a shoebox.
• Two shoelaces, each colored differently (thicker laces, or
textured sport laces work best).
 • Small candies, stickers, or other reward.

Description
This is a great activity for motivating children to practice tying their
shoes. Start by punching two holes in the bottom of the box. Next,
cut the shoelaces in half and tie two halves together so that you
have a lace with different colors at each end. Poke the ends of the
shoelace through the holes from the inside of the box (so they
project outwards through the bottom of the box). Put the lid on the
box, and wrap the laces around so that you can teach the child
how to tie. The two different colors make it easier to learn where
each lace must go, and thicker laces are easier to control than
thinner ones.

Variations
• Vary the length and texture of the laces to require more motor
planning skill.
• Use several boxes of different sizes so that they can nest
inside one another.
• I like to place a reward inside the smallest of a nesting set of
boxes, and practice tying until all of the boxes are inside of
one another. Then, I engage the child in a more challenging or
non-preferred learning activity, and if she is successful, they
can untie all of the boxes to get their treat.

OTHER IDEAS FOR SUPPORTING FINE

MOTOR SKILLS DEVELOPMENT
• Using pop beads.
• Using pegboards.
• Playing with building or construction toys, the smaller the
better.
• Using spinning tops.
• Playing with wind-up toys.
• Using finger puppets for make-believe.
• Assembling crafts.
• Playing games with small parts, like Cootie or Mr Potato
Head.
• Helping in the kitchen (for example, snapping beans, husking
corn).
• Using stencils for tracing.
• Having a box of old clothes and accessories for dress-up.
• Dressing up dolls or stuffed animals.
• Using craft punches to make confetti or for art projects.
• Singing songs with fingerplays.
• Learning the sign language alphabet.
Chapter 4

PROMOTING VISUAL SKILLS

RELATIONSHIP TO LEARNING
Vision is commonly thought of as our “window to the world,” and
is critically important in all aspects of learning. Obviously, one
needs to see clearly in order to learn shapes, colors, letters and
numbers; to safely negotiate one’s environment; to take care of
daily needs like buttoning a shirt or pouring milk into a glass
without spilling; or to understand whether someone’s body
language and facial expression means “That’s a great idea!” or
“Don’t bother me now!” Most of the time, significant issues with
visual acuity (seeing things clearly whether they are near or far
away) or eye muscle control are identified early in childhood and
managed using medical interventions or the use of glasses.
However, vision plays a much more complex and dynamic role in
daily life than just being able to see clearly. Using vision
effectively involves paying attention to multiple simultaneous
stimuli that are constantly changing in time and space, then
applying meaning to those stimuli. The eyes must have sufficient
muscle control to be able to work together to move and adjust
focus on stationary targets as well as those that move around so that
the orientation, lighting and background are constantly changing.
Problems with eye muscle control, sometimes called visual
efficiency disorders, can be very subtle and hard to detect, and can
fluctuate over time. If mild or intermittent, they may not be
identified during routine eye exams, because they do not affect the
child’s acuity, or ability to see clearly. However, such problems can
cause the child to tire easily or to feel discomfort when using his
eyes, especially for close-up viewing. Young children often fail to
complain about symptoms of visual efficiency disorders, which
may include blurring, headaches, or double vision. This is because
they may not recognize these symptoms as problematic. If their
eyes have always worked in the same way, they will not even
consider the possibility that other children might actually see things
differently.
Once the eyes transmit images to the brain, the brain must
interpret the meaning and importance of those images, a process
referred to as visual perception, or perceptual reasoning.
Problems with visual perception involve difficulty recognizing,
remembering, and organizing the visual images transmitted by the
eyes to the brain. Problems with visual efficiency and visual
perception are common among children with developmental
differences, including those with autism, ADHD, and specific
learning disabilities. Although they can vary widely among
children, certain visual difficulties are predictably more associated
with certain disabilities. For example, children with autism
commonly avoid eye contact with others, seek intense visual
stimulation such as spinning objects while ignoring stimuli
peripheral to the object they are looking at, and avoid looking at
their hands when manipulating objects. Some children with ADHD
are believed to have difficulty maintaining close visual focus on
near objects, a problem with visual efficiency, which may be why
they are so easily distracted by things they see. Children with
specific learning disabilities including dyslexia often have poor
visual memory skills, or show reversals in their reading and
writing. It is important to understand that activities designed to
improve visual efficiency or visual perception cannot actually
change the way that the brain processes information. However,
activities to improve visual efficiency can make visual learning
more comfortable and automatic, and can increase a child’s
motivation to learn. Activities to promote visual perception skills
can help children to better attend to relevant visual details, to
develop coping strategies for better understanding of visual
information, and to experience less frustration during learning
challenges.

VISUAL ATTENTION AND TRACKING

Visual efficiency skills play an important role in how easily a
person can focus on various visual targets. Accommodation refers
to the ability of the muscles surrounding the eyes to change the
shape of the lens at the front of the eye as objects move closer or
farther away from the eyes. When accommodation occurs correctly,
the visual image remains clear, regardless of the distance from the
eyes. Accommodative disorders result in unfocused vision, and
exist when accommodation is less than normal, slower than normal,
or cannot be sustained for the normal length of time. Typically,
most young children have better accommodation ability than many
adults, since adults tend to gradually lose the muscular elasticity
needed for this skill. That is why many older adults need to use
glasses for reading or other close work, even when they never wore
glasses as a child. Problems with accommodation can make it hard
to catch or throw a ball, since the eyes need to remain focused as
the ball comes closer or moves farther away. Similarly, children
with accommodative disorders often have difficulty shifting their
vision from the teacher or board back to their desk.
Binocular vision refers to the ability of the visual system to
convert the separate images received from each eye into a single
visual image for the brain to process. Children who have a different
level of visual acuity in each eye may struggle with binocular
vision unless they wear glasses to correct their vision. Other
children have problems with alignment of the eyes, also called
strabismus. Strabismus is a common childhood problem, and can
be caused by a number of factors, including abnormal focusing
ability, a weakness in the eye muscles, or a disorder of the nerves
controlling eye movement or in the part of the brain that controls
eye movements. Strabismus causes one eye to turn in or out or
upwards and can be constant or intermittent. When the eyes are
misaligned, each eye sends a different message to the brain, which
the brain then processes as double vision. Because the brain has
trouble interpreting this double image, one of two mechanisms may
occur. Sometimes, the child may be able to exert extra muscular
effort to realign the eyes, at least for some period of time, a strategy
that can lead to eyestrain. Alternatively, the brain can elect to
ignore one of the two images, a mechanism known as suppression.
When young children suppress vision in one eye, that eye no longer
receives visual stimulation, which can halt the development of that
eye. This is called amblyopia, or lazy eye, which is a serious
condition that can lead to permanent vision loss if left untreated.
Significant problems with strabismus are generally identified
during routine vision exams, but milder problems or those that
occur intermittently may go unnoticed. Problems with eye muscle
control can also affect the child’s ability to rapidly scan or track
visual stimuli along a horizontal plane, a skill that is extremely
important during reading. Children with eye tracking difficulty
frequently lose their place during reading, or use excessive head
movement to follow the print. If your child has had normal vision
examinations, but shows any signs of visual efficiency difficulties,
you may wish to seek a second opinion from an optometrist who
specializes in the vision problems associated with learning
differences, called a developmental optometrist. Several websites
are described in Appendix C to learn more about what these
specialists have to offer.

VISUAL PERCEPTION
Visual perception simply means understanding what is seen, and
plays a critical role in all aspects of cognition and learning. These
skills are part of how the brain processes information for learning,
and as such, contribute to an individual’s overall intelligence.
Visual perception problems may co-exist with visual efficiency
problems, but also commonly occur in children with normal vision.
There are many different types of visual perceptual weaknesses,
and different specialists may use different terminology to describe
the problems. However, certain common problems are generally
well understood among professionals.
Visual attention relates to a child’s alertness and readiness for
learning when visuals are involved. It requires conscious effort to
concentrate and persist with looking. It also requires the child to
notice which visual stimuli are unimportant to the task at hand, and
to make a choice as to which stimuli to focus on, and which to
ignore. Children with problems affecting visual attention may fail
to notice relevant details in a learning task, or alternatively, may
become easily overwhelmed by visual details that are better
ignored. Visual discrimination skills are those that allow the child
to recognize the basic features of an object such as color, shape, or
size through sight alone. Visual closure refers to the ability to
recognize forms or objects that are incomplete, based on relating a
visual stimulus to previously learned information. This is the skill
that allows a baby to recognize his bottle, even if it is partially
hidden under a blanket, or for an older child to recognize that there
is a good chance that the next letter after “C” and “A” will
probably be “T” when reading a story about pets. Problems with
visual closure often underlie poor spelling or reading abilities.
Visual form constancy is the skill that allows the child to
understand that objects and visual stimuli do not have to look
exactly alike in order to mean the same thing. It is what allows the
child to recognize that a two-dimensional picture of a ball means
that round thing that is so much fun to throw and catch; that a fire
engine seen from far away is really larger than it seems; and that a
printed letter means “A” whether it is upper case or lower case,
manuscript or cursive, or presented in different fonts or forms.
Visual figure-ground discrimination helps the child to separate
foreground from background visual stimuli in order to attend to
relevant details. It allows the child to focus quickly on the most
relevant details of an image, while retaining an awareness of the
relationships of parts to the whole image. Children with poor
figure-ground skills often lose their place when doing visual
activities, and may benefit from books or worksheets that have
fewer images per page, or that visually highlight the most relevant
aspects of the materials. Visual memory is the ability to recall
visually presented information. There are different types of visual
memory, including the ability to immediately recall something right
after it was seen (also called working memory); long-term recall
of information (such as what different punctuation marks are
supposed to look like); and the ability to remember the exact order
of a series of stimuli, such as a telephone number (also called
visual sequential memory). Many children with learning disabilities
have problems with visual memory, especially working memory.
Visual-spatial perception is the ability to recognize the orientation
and position of objects to other objects or to oneself. It allows the
child to recognize such basic concepts as left from right, up from
down, top from bottom, and to learn the vocabulary associated with
these concepts. Children with problems in this area often reverse
letters, numbers or words beyond the age when it is
developmentally appropriate to do so (up to second grade or so).
They commonly have difficulty with drawing and handwriting, or
with organizational skills, and may exhibit problems with higher-
level math skills.

VISUAL-MOTOR INTEGRATION
Visual-motor integration is a broad term used to describe how
visual perceptual information coordinates with fine motor or gross
motor skills to produce an accurate and well-executed motor
response to an environmental demand. It requires the child to
continually adjust his movements based upon the visual
information that keeps changing as the movement is executed.
Visual-motor integration skills are what allow a child to connect his
foot with a moving ball during soccer, to anticipate how wide to
open the mouth to accept a bite of food without spilling, or to move
the hand in a precise manner in order to cut on a line or color
within boundaries. Children with visual-motor integration problems
may appear generally clumsy, and often have trouble with many
school activities requiring the manipulation of pencils, scissors or
other classroom tools and materials.
Common signs of difficulty with visual efficiency or perceptual
skills include:
• frequently squints, rubs eyes (especially one more than the
other), or gets watery eyes unrelated to a cold or allergies
• complains of aching or burning eyes, headaches, blurred or
double vision, or nausea and dizziness during or immediately
after close visual activities
• dislikes or avoids activities that require close visual attention
• shows difficulty concentrating or attending to activities
requiring visual attention
• shows unusual sensitivity to sunlight, glare, or fluorescent
lights
• has unusual difficulty throwing at a target or bouncing and
catching a ball
• demonstrates poor reading comprehension despite good
vocabulary and spoken language skills
• frequently loses place during reading (skips words or whole
lines)
• reverses letters, numbers, or words after first grade
• poor handwriting, especially size and spacing consistency, and
use of margins
• shows difficulty with math concepts such as time, money,
carrying, or use of graphs
• tilts head, or closes one eye during reading
• moves whole head to follow a line of print, instead of moving
the eyes independently of the head
• persistently holds books or worksheets in an unusual position
• demonstrates excessive fatigue at the end of a typical school
day.

VISUAL LEARNING ACTIVITIES

1 GEL BAGS (SEE APPENDIX B FOR DIRECTIONS)
Primary learning focus
• Visual attention/tracking, visual-motor integration.
• Tends to be a calming activity.

Materials needed
 • Large, freezer zip-lock bag.
• Colored hair gel.
• Duct tape.
• Small bead or button.

Description
Squirt a good amount of gel in the bag (enough to fill the bag to
approximately 0.6cm (¼") thickness all around). Insert the bead or
button, and carefully squeeze to remove all excess air. Close the
zipper and seal with duct tape to prevent leaking. This bag can be
placed on top of shapes or letters to trace, dot-to-dot pages, or
mazes. The child uses his index finger to push the bead in the
desired path.

Variations
• Add glitter or sequins for visual contrast.
• Chill the bag in the refrigerator to create a different tactile
sensation.

2 POMPOM MAGNETS
Primary learning focus
• Visual attention/tracking, eye-hand coordination, visual-motor
integration, fine motor strength and dexterity.

Materials needed
• Assorted colored pompoms, one size only.
• Magnets or magnet tape.
• Hot glue gun.
• Aluminum cookie tray.

Description
Use the hot glue gun to attach magnets to the pompoms. Then,
use the pompoms as an art medium to create various pictures and
designs on the cookie tray.

Variations
• Practice making letters and shapes with the pompoms.
• Use pompoms to reinforce number concepts, for example
“how many red pompoms did you use?” or “did you use more
blue pompoms or more yellow pompoms?” or “How many
pompoms do you think we will need to write your name?”.
• Tape a coloring shape or maze to the cookie tray, and use
pompoms to color in an area, or follow a path.
• Prop the tray so it is in a vertical plane at eye level to
encourage arm strength and a good hand position for
maintaining a pincer grasp, or use the pompoms on a
refrigerator or metal file cabinet.
• This is a good activity to perform while sitting on a T-stool or
yoga ball.

3 MARBLE ROLLER (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Visual attention/tracking, visual-motor integration, motor
planning, bilateral integration.

Materials needed
• Marble.
• One half of a small plastic Easter egg, or a bottle cap just
large enough to fit completely over the marble. This is the
“roller.”
• Tray (lightweight plastic works best, but a small cookie tray or
empty cardboard box top would also work well).
 • Paper and markers.

Description
This activity requires using the two hands together while focusing
visually on a moving target. Considerable timing and motor
planning are required to control the marble. Draw simple paths or
mazes on paper (or find free printables from the internet), and then
place the paper on the tray. Next, place the roller over the marble
and place it on the tray so it can roll around. If desired, the child
can decorate the bottle cap to make it look like an alien or animal.
The child must grip the sides of the tray, and try to control the
marble as it moves along the path.

Variations
• Make a paper that has numbers or letters of the alphabet
scattered around; the child must count, recite the alphabet, or
spell simple words while rolling the marble to the correct
location.
• Try this with a partner, having each partner hold one side of
the tray and work together to control the marble.
• Call out verbal directions (one at a time, or a sequence of
several directions) for the child to follow as quickly as
possible.
• Use masking tape on a linoleum floor to mark out a basic
shuffleboard course, and use the marble roller to slide to
designated areas in order to earn points—this is a good way
to learn how to control the force of movement, which helps to
develop proprioceptive awareness.

4 MY COLOR BOOK
Primary learning focus
• Perceptual, eye-hand coordination, dexterity.

Materials needed
 • Construction paper in different colors.
• Stapler or other method for assembling a book.
• Old magazines or catalogues.
• Glue stick, scissors.

Description
This is a great rainy day activity! Assemble a book with different
colors for each page. Allow the child to decorate a cover for their
book. Then, allow the child to search through magazines to find
objects of different colors, cutting and pasting them on the correct
page. This is an activity that can be done in one day, or work on it
a little at a time over several days.

Variations
• Create other category books, for example shapes, types of
animals (pets, zoo, forest, farm), or food categories (meats,
vegetables, grain, dairy, desserts). Put one example of the
category at the top of each page.

5 PADDLE BALL (SEE APPENDIX B FOR DIRECTIONS)

Primary learning focus
• Visual attention/tracking, eye-hand coordination, motor
planning.

Materials needed
• One or more paddles.
• Balloons, ping-pong balls.

Description
Use a paddle (such as those used for ping-pong) or make your
own by bending a metal coat hanger into an oval with a handle,
stretch a used leg from pantyhose over the oval, wrap the handle
with foam or cloth, then cover the handle with duct tape to hold it
all together. Teach the child to hold the paddle flat and to practice
tapping a ball, making sure that he keeps their eyes on the ball.
Start with something that moves slowly and is easy to hit (like
bubbles), next try it with balloons, and finally try it with a fast-
moving ping-pong ball. Children love to keep track of how many
times they can hit the ball without letting it fall to the ground.

Variations
• Use paddles to hit a balloon back and forth with a partner.
• Let the child hold one paddle in each hand and tap back and
forth with one hand, and then the other.
• With a partner, paddle a ball back and forth on the floor while
standing, kneeling, or sitting on a T-stool or yoga ball.

6 HIDE AND SEEK FOR THE EYES

Primary learning focus
• Visual attention/tracking, figure-ground perception.

Materials needed
• A collection of small objects, for example, 10 beads, or 15
paper clips—anything you happen to have around the house.
• A paper bag or small bowl for “collecting” the items.

Description
Have the child start by counting the number of objects so he
knows how many things to find for a treasure hunt. Next, teach the
child that this will be a treasure hunt for the eyes alone—nothing
will hide inside of or underneath anything else, and nothing will be
too high for the child to reach without climbing on anything. This is
also a time to teach about any areas that might be “off limits” (for
example, when I play this game at school my students know that
nothing will be hidden on my teacher’s desk). Then, have the child
cover his eyes while you hide the objects. When ready, give the
child a small bag or bowl and let them find the items, giving clues
as needed (such as “you are getting warmer!”).

Variations
• I always hide one item on my person, which is especially
useful for encouraging children with autism to make eye
contact and really connect with another person.
• Have the child remain seated and find the objects with eyes
only, telling you where each item is so that they have to
practice using expressive vocabulary.
• Children love doing this activity on holidays, using theme-
based materials, such as stickers, or small Easter eggs. At
Easter time, I hide a small carrot or two and make a big fuss
about the Easter bunny being nearby; at Christmas I hide one
or two small pieces of doll clothing that I have made out of
felt, or a scarf that I have knitted using fine wool and
toothpicks (obviously misplaced by one of Santa’s elves).
• Use pinch-style clothespins or hairclips clipped onto curtains
or other likely places, so that children have to use their fine
motor skills when searching.
• Make it an auditory perceptual game by asking “Where am I
now?” as you move about the room to hide objects.

7 FLASHLIGHT TAG
Primary learning focus
• Visual attention/tracking, visual-motor integration.

Materials needed
• Two narrow-beam flashlights.

Description
Sit behind the child in a darkened room, facing a blank wall. Draw
lines, trails or paths for the child to follow with his flashlight,
starting with slow movements in a small area, and gradually
moving faster and over a wider area.

Variations
• Take turns drawing shapes or letters while the other person
guesses.
• Use a laser pointer instead of a flashlight to make shapes or
letters that the child must guess—the laser pointer makes a
clearer image, but be very careful not to shine it near the
child’s eyes, as this could be harmful.

8 TOOTHPICK TUNNEL
Primary learning focus
• Visual attention/tracking, eye-hand coordination, perception.

Materials needed
• Cylinder of various sizes (toilet paper tube, empty towel roll,
fat drinking straw).
• Two toothpicks.

Description
Give the child two toothpicks, one to hold in each hand. Hold the
cylinder horizontally in front of the child, and see if he can insert
both toothpicks simultaneously in and out of the cylinder while you
move it closer or farther away. This requires a great deal of
coordination and depth perception.

Variations
• Try it while sitting or standing on an unstable surface.
• Tilt the cylinder at various angles to increase the challenge
and require greater depth perception.

9 PUFF BALL
Primary learning focus
• Visual attention/tracking, motor planning.
• Tends to be a calming activity.

Materials needed
• Drinking straw.
• Cotton ball, pompom, or small pieces of tissue paper.

Description
Sit across a table from the child, placing the cotton or tissue in the
middle of the table. Both the adult and child use a straw to try to
blow the cotton off the opponent’s side of the table, scoring a
point. Keeping the mouth closed around the straw and blowing
with control requires a great deal of oral motor input that is calming
to many children.

Variations
• Have the child get on the floor on hands and knees, and use
the straw to blow a ball through a maze or an obstacle course.
• Have the child suck through the straw to pick up a small piece
of tissue paper and carry it to a designated area so that he
can deposit it in a bowl—this can be set up as a relay race
with a partner.

10 THE DETECTIVE GAME

Primary learning focus
• Visual attention/tracking, perception.

Materials needed
• Recycled magazines or catalogues.
• Pencil or marker.

Description
This activity is great for helping children to learn how to sustain
visual attention and to develop the tracking skills needed for fluent
reading and writing. Take a page from a magazine (number of
lines and size of print depend on the child’s maturity). Teach the
child to track each line with the eyes and to look for specified
items, and then cross off each item using the pencil or marker. For
example, have the child look for all of the letter “t’s” or all of the
words starting with the letter “b,” without skipping any lines or
letters.

Variations
• If you have access to a computer and printer, you can make
your own pages and customize the task to the child. For
example, type out a sheet of random letters, and have the
child find each letter in their name in sequence, or type out
random words with a targeted spelling word inserted
periodically.
• Using a computer, make random rows of commonly reversed
letters or words for the child who struggles with this (for
example, make random lines or “b’s” and “d’s,” or “mom” and
“wow”).
• Attach the paper to a clipboard so it will not slip around, then
make a small “spyglass” out of cardboard for the child to hold
with the non-dominant hand, checking off items with the
dominant hand (this is a very challenging bilateral integration
task).
• Lay the paper on a pillow or piece of Styrofoam, and let the
child poke out the targeted letter or word using a toothpick.
• Using larger print pages, tape the page to a wall and have the
child stand a few feet away. Using a pointer, the adult slowly
tracks the lines, and the child must call out “stop” each time
the targeted letter or word occurs.

11 BASIC VISUAL MEMORY GAMES

Primary learning focus
• Visual attention, perception.

Materials needed
• Cookie pan or small tray.
• Assorted small objects.
• Something to cover the tray (empty pillowcase, or large empty
box).

Description
Assemble several objects on the tray (start with four or five and
gradually increase the number). Have the child study the objects
for a few seconds, then cover the tray and ask how many objects
the child can recall.

Variations
• Have the child study the objects on the tray, then place a
cover over the tray and remove one item to see if the child
can remember which item is missing.
• Have the child study the objects on the tray, then place a
cover over the tray and add one item to see if the child can
identify what was added.
• Have the child study the objects on the tray, then place a
cover over the tray, move the objects around, then see if the
child can replace objects to their original position.
• Line up the objects from left to right on a strip of masking
tape, cover them and change the order, and see if the child
can return objects to their original order.

12 PATTERN MEMORY GAMES

Primary learning focus
• Visual attention/tracking, perception, eye-hand coordination,
visual-motor integration.
Materials needed
• Assorted drawing materials (paper and pencil, crayons or
markers).
• Assorted materials for three-dimensional construction (for
example, building blocks or Lego bricks).
• File folder or other visual barrier.

Description
The adult and child are each provided with a set of the same
materials. Sit across a table from the child and draw or build
something to copy. Place the file folder so that it hides the adult’s
model, and see if the child is able to copy the model from memory.

Variations
To work on auditory skills, the adult can leave the barrier in place
while building the model, and provide verbal clues, for example,
“I’m starting with a red block, then putting a blue block on top of
the red block, and a green block in front of the red block”—the
child copies the model by listening to the clues.

13 SPOON RELAY
Primary learning focus
• Visual attention/tracking, perception, balance, body
awareness, motor planning.
• Tends to be a calming activity.

Materials needed
• Plastic spoon.
• Cotton ball, pompom, or ping-pong ball.
• Balance beam or simple obstacle course.

Description
Ask the child to balance the ball on the spoon while holding the
spoon in his mouth. Then see if the child can negotiate a balance
beam or obstacle course without dropping the ball. To do this, the
child must frequently shift visual focus from near point (the ball) to
far point (feet) in order to balance, which requires a great deal of
visual focus and coordination.

Variations
• Substitute a small edible (raisin or M&M) and allow the child
to eat any that make it to the end without falling on the floor.
• Have the child follow verbal directions to get to an end point
(for example, take two sideways steps, then two backwards
steps).

14 THE DOT MAP

Primary learning focus
• Visual attention, spatial perception, motor planning, bilateral
integration.

Materials needed
• Sidewalk chalk.
• Paper and marker.
• Clipboard with clear sheet protector and wipe-off crayon or
marker.
• Red and blue ribbons (optional).

Description
Draw a grid that has 25 large dots, five across and five down (or,
create larger grids for older children). This will be the map (you
may wish to use a computer for this, so that the dots are evenly
spaced and you can print out more than one copy). Insert the map
into the sheet protector and secure with the clipboard. Using the
sidewalk chalk, find a large area of asphalt or sidewalk, and create
a similar grid with 25 dots. Find a landmark at one end of the grid
(such as a tree or swing set) and teach the child that his feet must
always be pointing towards that landmark (this will avoid spatial
confusion as the child attempts to follow the map). Use the marker
to draw a path on the map, and then let the child carry the map as
he tries to follow the path. If needed, put a red ribbon around the
child’s right ankle (“r-r-red means right”) and a blue ribbon around
the left ankle to help the child to remember which side is which.

Variations
• Have the child hop or jump to the dots to encourage gross
motor skills.
• Have the child look at the map and then try to follow the path
from memory.
• Give verbal directions for the child to follow (for example,
“take two steps forward, then one step backwards”) and then
have the child carry a blank map and try to draw lines
representing the steps taken.

15 BUTTON BOX
Primary learning focus
• Visual attention/tracking, visual-motor integration, motor
planning, bilateral integration.

Materials needed
• One or more empty egg cartons with the top removed.
• Markers.
• A button or other small, lightweight object.

Description
Mark each section of the egg carton with a different color or
symbol (letters, numbers, shapes) leaving one section unmarked.
Place the button in the unmarked section. Instruct the child to hold
the egg carton with two hands and then try to flip the button to a
designated location.

Variations
• Have the child try to follow a sequence, such as spelling out
the letters of his name, counting to ten, or recalling a
sequence of shapes or colors.

16 PUZZLING
Primary learning focus
• Visual attention, perception, bilateral integration, dexterity,
eye-hand coordination.

Materials needed
• Recyclable magazines with “busy” pictures.
• Ruler and marker.
• Scissors.
• Clear tape.

Description
Choose a picture for the child to study for a few moments, then
turn the picture over and ask how many things they can
remember. Turn back to the picture and give the child some
categories of things to find, for example “blue” things, or “skinny
things,” or “things that are on top of something.” Next, turn the
picture over, and help the child to use the ruler and marker to
make lines at various angles across the back of the picture.
Finally, have the child cut along the lines, mix up the pieces, and
tape them back together to reconfigure the picture.

Variations
• Make puzzles using artwork that has been created by the
child.
 • Make puzzles using mazes to see if the child can line up the
paths correctly.

17 WHAT’S NEXT?
Primary learning focus
• Visual attention, perception.

Materials needed
• Empty cardboard tube.
• Different colored square building blocks (or large Lego bricks).

Description
Sit facing the child, and slowly insert blocks into one side of the
tube (start with only two, and build up to a longer sequence). Hold
your hands over the ends of the tube, and tip it to one side, asking
the child to predict the order that the blocks will come out in that
side. As the child gains practice, try rotating one or more times so
that they have to mentally manipulate the spatial order of items.

Variations
• Substitute toy cars, colored ping-pong balls, or other items—
just make sure they are large enough that they will remain in
the same order inside the tube.
• Let the child be the one to hide blocks in the tube for a good
opportunity to practice bilateral motor integration.

18 STRING ART
Primary learning focus
• Visual attention/tracking, perception, eye-hand coordination,
visual-motor integration, dexterity.

Materials needed
 • A block of wood, with small nails hammered in to make a grid
(25 is a good number to start with)—or use a piece of
Styrofoam with golf tees hammered in.
• Yarn, string, or ribbon of different colors.

Description
Demonstrate how to wrap the string around the nails to form
different patterns. Use more than one color to make overlapping
designs. Encourage the child to copy patterns you have made.

Variations
• Vary the texture of string used to increase tactile input.
• Use grids with more nails, or with nails placed closer together
to increase the dexterity needed.
• Practice making letters or numbers on the grid.
• Substitute colored rubber bands (elastics) for the string or
ribbon.

19 HOMEMADE LABYRINTH GAME (SEE APPENDIX B

FOR DIRECTIONS)
Primary learning focus
• Visual attention/tracking, eye-hand coordination, perception,
motor planning, bilateral integration.

Materials needed
• Rectangular piece of cardboard, empty cardboard box lid, or
cardboard tray.
• Pre-printed large-scale maze (make your own using markers,
or refer to Appendix C for ideas about where to find free
printables).
• Drinking straws.
• Scissors.
 • Hot glue gun or tacky glue.
• Marble.

Description
Glue the maze onto the cardboard (or draw your own). Then, use
scissors to cut different lengths of straw to glue onto the sides of
the paths, leaving gaps here and there to make a labyrinth. Be
sure to glue straws along the edges of the cardboard as well, or
place the cardboard in a tray with sides. The child holds the
cardboard using two hands, and maneuvers the marble through
the labyrinth.

Variations
• Use a textured surface (such as sandpaper, non-slip shelf
liner, or a piece of felt) to glue the straw pieces onto—this will
slow down the marble for the child who has difficulty with this
activity.
• Place the labyrinth on a table or on the floor, substitute a
small pompom, and have the child try to use a straw to blow
the pompom through the labyrinth—this can be a very calming
activity for some children.

20 HOMEMADE LACING CARDS

Primary learning focus
• Visual attention/tracking, eye-hand coordination, motor
planning, dexterity, bilateral integration.
• Tends to be a calming activity.

Materials needed
• Simple shapes of familiar or favorite items (for example, fruits,
dinosaurs, flowers) drawn on thin cardboard (or find printable
shapes on the web and glue onto cardboard).
• Clear contact paper.
 • Hole puncher.
• Long shoelace.

Description
Cover the desired shape on both sides with clear contact paper to
make a sturdier lacing card. Then, use the hole puncher to make
equally spaced holes around the edge of the shape (about 1cm
(½") from the edge). Tie a knot at one end of the shoelace, and
teach the child to “sew” around the edge using either an over-
under pattern, or a whip-stitch (always going in from the top or out
from the bottom of each hole).

Variations
• Many children find this a calming activity that they enjoy
practicing over and over—smaller lacing cards can also make
a great fidget toy!
• Punch holes in shapes made out of different textured fabrics
for tactile input.
• Make lacing wheels with holes for remembering the order of
the alphabet, or to use for skip counting (label or number each
hole).

21 MEMORY CARDS
Primary learning focus
• Visual attention, perception, dexterity.

Materials needed
• A deck of cards or
• Homemade memory cards (see description).

Description
This is a fresh take on the commercial memory card games that
are readily available. Cards are placed face down on the table in
rows, and each player turns over two cards to see if there is a
match. If the cards match, that player gets to keep the cards and
turn over two more, until he fails to find a match. Children love to
make their own memory cards according to favorite topics or
themes. I often download pictures from the web (snowflakes for
winter, dinosaurs, autumn leaves) and paste them to one side of
index cards to make special memory cards.

Variations
• Cut letters out of thin sandpaper and paste to index cards for
a memory game; the child can trace the letters with his finger
to get a tactile cue that might help to trigger the memory.
• Collect bottle caps from soda or milk bottles or water bottles,
and glue tiny pictures inside the cap to make a different type
of memory game requiring manipulation of small objects.

22 MAKING HIDDEN PICTURES

Primary learning focus
• Visual attention, perception, visual-motor integration, bilateral
integration, motor planning.

Materials needed
• Paper and pencil.
• Colored markers or crayons.
• Simple shapes to trace around (a simple puzzle with large,
non-interlocking pieces, nesting cups or mixing bowls, or even
common household objects could work).

Description
Help the child to hold down an object with the non-dominant hand,
then trace around that object using a pencil held in the dominant
hand. Repeat with the remaining objects, making sure that the
shapes overlap one another to make a confusing sort of design.
Then ask the child to find and trace each shape using a different
color crayon or marker, using the object as needed to check for
correctness. The end product will be a colorful abstract design that
most children love.

Variations
• Tracing the objects on a vertical surface increases the motor
planning challenge, and is also a good way to increase
shoulder and arm strength.
• Try this with smaller objects, such as different sized buttons.
• Free-draw large letters, numbers or shapes that overlap for
the child to trace.

23 FINGER PALS
Primary learning focus
• Visual attention/tracking, eye-hand coordination.

Materials needed
• Two finger puppets, one for the adult and one for the child,
placed on the index finger (if you don’t have any finger
puppets, you can draw a face on each person’s index finger
pad, and make a little paper hat for the finger).

Description
The adult sits facing the child, and slowly moves his puppet while
the child attempts to follow, keeping approximately 15cm (6")
between the puppets. Every now and then the adult says, “Give
me a kiss (or hug, or high five),” signaling that the child should
touch his puppet to the adult’s puppet. This requires the child to
rapidly shift his visual focus.

Variations
 • Move the puppet in such a way as to draw a letter or shape in
the air so the child has to guess what it is and copy the shape.

24 FIND-IT BAG (SEE APPENDIX B FOR DIRECTIONS)

Primary learning focus
• Visual attention, perception.
• Tends to be a calming activity.

Materials needed
• Large, sturdy plastic bag with a zipper-style closure (can
substitute a clear plastic tube or empty soda bottle); if the bag
has writing on it, you may be able to use lighter fluid to erase
the writing.
• Two each of assorted small objects (elastic bands, beads,
magnetic letters, buttons, etc.—just be sure there are no
sharp points to puncture the bag)—you will need at least 25–
30 sets of objects.
• Filler for hiding the small objects (for example, sand,
uncooked rice, seed beads, poly beads).
• Duct tape.

Description
Fill the container or bag about half full with the filler. Then add one
of each small object, reserving the matching object to keep in a
separate small bag or box. Close the zipper and seal the closure
with duct tape. Pull out one of the reserved objects, show it to the
child, and see how quickly he can find it in the bag. This is harder
than it appears, because the filler tends to cover parts of the object
so that an understanding of part to whole awareness is
challenged.

Variations
 • To challenge auditory skills, the adult can select an object and
hide it in his hand, then provide auditory clues to see if the
child can find something that matches the clue. For example,
the clue for a paper clip might be, “You use this to hold things
together.”
• Give the child a designated period of time to see how many
different things he can find and write down on a piece of
paper.

25 THE HOLE-IN-ONE GAME (SEE APPENDIX B FOR

DIRECTIONS)
Primary learning focus
• Visual attention/tracking, eye-hand coordination, motor
planning.

Materials needed
• Empty cardboard tube, such as one used for toilet tissue.
• Length of string, about 45cm (18").
• Ping-pong ball.
• Hot glue gun.

Description
Poke a tiny hole in the ping-pong ball and attach the string using
the hot glue. Then, poke a small hole in one end of the cardboard
tube and attach the other end of the string. The child holds the
cardboard tube and tries to flip the ball up in such a way that he
can catch it with the open end of the tube.

Variations
• Make two tubes, and hold one in each hand.
• Lengthen the string for increased challenge.
 • Stand up three or four tubes so that they are touching, and
hold them together using tape. Color the inside rim of each
tube a different color. Use only one string and ball, but have
the child try to get the ball into a particular color or sequence
of colors. As an added challenge, the child may need to use
both hands to hold on when multiple tubes are used.

OTHER IDEAS FOR SUPPORTING VISUAL

SKILLS DEVELOPMENT
• Color or paint by number.
• Where’s Waldo or other hidden picture games.
• Mazes or dot-to-dot games (see Appendix C to find websites
that offer free printables).
• Parquetry or pattern blocks.
• Lite-Brite.
• Etch-a-sketch.
• Puzzles.
• Perfection game.
• Construction toys, or building toy models.
• Video games that require fast action to a visual stimulus.
• Dartboards or other target games.
• Bowling.
• Miniature golf.
• Lining up dominos and then watching them fall down in a row.
• Nesting cups or dolls.
• Bingo or lotto games.
• Lite Brite toy.
Chapter 5

PROMOTING SENSORY SKILLS

RELATIONSHIP TO LEARNING
Humans are endowed with multiple sensory systems that serve to
process information from the body and from the external
environment in order to influence our physical activity, learning
style, and emotional regulation. When most people think of the
senses, they think of sight, sound, touch, taste, and smell, and have
at least a general appreciation of how these sensory systems
support learning. Earlier sections of this book have introduced
other less well-understood sensory systems including the
proprioceptive system (sensory information derived from joints and
muscles that contribute to body awareness and an unconscious
sense of body movement) and the vestibular system (information
derived from the inner ear that contributes to balance and a sense of
head position in relation to the environment or the body).
Each of the sensory systems relies on one or more organs that
function as receptors for that sense. For example, the eyes are the
receptor organs for sight, ears are the receptor organ for sound, and
skin is the receptor organ for touch. Each of the sensory receptors
are the organs responsible for transmitting sensory information to
the brain, where it will be interpreted, a process known as sensory
perception. Someone who has a disorder in one of the receptor
organs, as in the case with a child who is blind or hard-of-hearing,
will obviously have a difference in the way that she learns based on
the disability. However, even among people who have normal
sensory reception, there is wide variability in how an individual
responds to that sensation. For example, people with well-
developed sound perception might find it easier to appreciate music
or to learn to recognize birdsongs than those with less developed
sound perception. People with strong perceptual skills relating to
vestibular and proprioceptive information might gravitate towards
sports or other activities requiring balance and coordination, while
those with less well-developed skills may prefer more sedentary
activities.
It is rare that we need to use any one sensory system by itself.
Instead, each of the sensory systems work in concert with each
other to provide us with a very complex and comprehensive picture
of the environment in a process called sensory integration.
Consider this example of sensory integration at work. You are
walking to a coffee shop talking to a friend, when you come to a
street you need to cross. You use vision and sound to determine
whether the traffic light permits crossing, and whether the traffic
conditions look and sound safe. Once you determine it is safe to
cross, you step off the curb leading with your right foot. Your
vision and proprioception senses tell you whether your foot is
aimed in the right direction so that it will land safely in the street.
To maintain balance, your body will shift weight to your left leg
and tilt your trunk slightly to the left to help you to maintain an
upright posture. Without any conscious effort on your part,
proprioceptive input from your leg and trunk inform the brain how
much adjustment is not too much or too little, but just right. At the
same time, you are able to remain alert to the potential dangers in
the street. The sudden sound of a siren alerts you to stop walking
until you determine whether you are in danger from a fire engine
moving in your direction. During the whole time, you have been
able to continue your conversation with your friend without
distraction, maintaining eye contact while she speaks, yet scanning
the environment with your eyes to make sure it is still safe to cross.
You have also noticed that clouds are gathering and it looks like it
might rain, and you try to recall whether you remembered to put an
umbrella in your bag. For most people, those with good sensory
integration skills, this process occurs naturally and without
conscious thought. For others, the process works less well. Sensory
messages sent to the brain are misinterpreted, and the individual
finds that they must concentrate more closely on each discrete
aspect of the situation, which can be very overwhelming. Problems
in this area are referred to as sensory processing disorder or
sensory integration disorder. Fortunately, we know that sensory
integration tends to improve as a child matures, and that there are
many strategies that can help a child to integrate sensory
information more efficiently.

SENSORY MODULATION
Sensory experiences play an important role in shaping an
individual’s behavior and emotional tone. As we are continually
bombarded with sensory information from our bodies and from our
environment, we need to be able to attend to those sensations that
are relevant to guiding our response to a situation, and tune out or
ignore those that are not. This process of selectively attending to
sensory experiences is referred to as sensory modulation.
Everyone’s ability to modulate sensory information varies
according to different situations. For example, when you first
awake in the morning, or are feeling tired or sick, you may seem
lethargic and be less alert to sensory experiences. Alternatively,
when you are highly excited or stressed, you may be startled or
overreact to simple sensory inputs, such as someone loudly calling
your name from behind your back. Consider this example. You are
invited to a neighborhood party and arrive with your spouse. It is a
very busy party, with loud music, children chasing each other, and
neighbors calling out greetings to one other. When you first arrive,
you may feel a little overwhelmed by the noise level, but after a
while, your nervous system adjusts so that you can tune out some
of the noise, allowing you to focus more on the congeniality of
food and friendship. If you are new to the neighborhood and don’t
know very many people, and you arrived at the party a little late,
after a very stressful day at work, and you are worried because you
left your children with a new babysitter, your nervous system may
take longer to adjust. If you feel more relaxed because the party is
on a vacation day, and you have a close and friendly relationship
with many of the neighbors, and you brought a favorite dish that
you know will draw compliments, your nervous system is likely to
adjust much more rapidly.
Many children with sensory integration dysfunction have
problems with sensory modulation that can affect their overall
arousal level and alertness to various sensations. Some children are
hyporesponsive and need higher levels of sensory input to take
notice, some children are hyperresponsive and over attend or
become overwhelmed by normal levels of sensory input, and others
show arousal levels that fluctuate from low to high. Children also
show different behavioral reactions to sensory modulation
difficulties. Some hyporesponsive children may appear overly
passive, tired, or lethargic because they are not noticing sensory
inputs that might trigger a drive to act on an environmental
demand. Others may appear overly active, because they choose to
seek out the sensory experiences their nervous system craves.
Similarly, some hyperresponsive children appear passive because
they have taught themselves to avoid situations that might expose
them to potentially overwhelming sensory input. Others with
hyperresponsivity are very active and lack impulse control. Their
nervous system has trouble filtering sensory input, and they may
incorrectly perceive some sensory experiences as threatening. To
complicate things, a child may be hyperresponsive to certain
sensory experiences (for example sound) but hyporesponsive to
others (for example pain or temperature).
As adults, most of us have developed a number of strategies for
maintaining an optimal level of sensory arousal. For example,
when you find yourself falling asleep during a long car drive, you
may choose to chew gum, turn on some loud music with a strong
rhythm, and open the window to allow cool air to help wake you
up. Alternatively, if you just finished a heated argument with your
teenaged son, you may retreat to a quiet room with a warm cup of
tea, and read a book while sitting in a rocker to calm your nerves.
Children with sensory modulation difficulties can be taught to
recognize how their body reacts to different sensory experiences,
and to apply similar strategies to get their body to a calm,
comfortable, and alert state. It’s important to understand that
everyone responds differently to a sensory experience. For
example, some people are energized by loud music while others
find it calming. However, we can generally predict that certain
types of sensory inputs are likely to be either energizing or calming
to most individuals. Table 5.1 presents examples of these. By
experimenting with different sensory modifications to activities,
you should be able to identify the particular sensory style of each
child.

Table 5.1 Typical sensory responses

Sensory Energizing input Calming input

input
Touch Gentle, light touch Firm touch or holding
Tickling Hugging
 Soft textures Firm strokes in direction of hair
Unexpected touch growth
Movement Fast movement Slow movement
Bouncing, jumping Rocking or swaying
Spinning or rolling Moving against resistance (push,
pull, carry heavy objects)
Gravity Head upright without Head supported by headrest, hands
support
Sound Loud or exciting Soft or gentle music
music Quiet, rhythmic sounds
Loud or sudden noise “White” noise
Unexpected changes
in pitch or tone
Vision Bright lights or colors Indirect, low-intensity light
Objects in motion Reduced visual distractions
Complicated design
Taste Crunchy textures Sweet or bland foods
Salty, spicy, or sour Chewy textures
foods Sucking through a straw
Temperature Very hot or very cold Warm, moderate temperature
Smell Strong or unfamiliar Familiar odors
odors Lavender, vanilla
Peppermint, cinnamon

TACTILE DISCRIMINATION AND AWARENESS

The tactile system is very large, including not only sensory
receptors located in the skin, but in others throughout the body
tissues located inside the body such as the lungs and digestive
system. Combined with visual input, this system transmits
information to the brain about size, shape, and texture. It also
transmits such sensations as pain, temperature, pressure, and
vibration; a feeling of emptiness meaning hunger; or a feeling of
fullness indicating the need to use the bathroom. There are two
different types of tactile sensations, and each type travels along a
different nerve pathway to the brain. Discriminative tactile
sensations allow an individual to precisely locate where a tactile
sensation occurs. They also inform whether something feels
textured like a peach or smooth like an apple, cool like a metal
writing pen or neutral like a pencil, or shaped like a sphere or a
cube. Protective tactile sensations are those that alert an
individual to potential danger, as when touching something
unexpectedly hot or sharp. When the brain receives this type of
information, it causes the individual to rapidly move away from the
potentially dangerous object.
Children who have poor tactile discrimination skills often have
coordination difficulties because they are not getting enough
information from the objects they touch. Getting shoes on the
correct foot may be hard if they cannot feel where the arch is
supposed to be, and learning to do buttons may be hard if they
cannot feel the button slipping through the hole. Children with
sensory modulation differences often show problems with the way
that they modulate tactile information. A child who is
hyporesponsive to tactile input may seem to tolerate pain or
dramatic changes in temperature better than other children. She
may not notice that her hands are sticky with jelly, or that her shirt
is on backwards with the tag in front. Children who are
hyperresponsive to tactile (often referred to as tactile
defensiveness) overreact to typical sensory experiences. Their
brain interprets common tactile experiences as very unpleasant or
dangerous, even when they are not. They typically avoid situations
involving tactile input, such as messy play or playing in the sand,
and can become behaviorally explosive if exposed to offending
inputs. To some extent, this can happen to all of us once in a while.
Imagine that you are lounging at the beach, engrossed in a good
novel. You feel something very light move quickly across your
bare foot, and immediately jump up, thinking it is a bug or a crab,
only to find that it was only a dead leaf blowing in the wind. That
unexpected touch sensation had the power to trigger a strong, if
brief, emotional response. Imagine the stress and discomfort when
children with tactile defensiveness experience that kind of
emotional reaction all day long.

AUDITORY DISCRIMINATION AND AWARENESS

Hearing is another sensory system that plays an important role in a
child’s learning style as well as her ability to self-regulate behavior.
Many children with learning differences including autism, ADHD,
or learning disabilities have auditory processing disorders, even
though their actual hearing acuity is normal. Auditory processing
disorders occur when the sounds transmitted to the brain are heard,
but misinterpreted. The brain may misunderstand the specific
attributes of the sound, such as the loudness of the sound, the pitch,
the duration of the sensation, or the location of the sound. Many
children with sensory integration dysfunction have trouble
integrating all of the qualities of sounds to adequately understand
what they are hearing. This can contribute to delays in learning
language, and to understanding the sounds involved in forming
words used in reading and writing. Children with sensory
modulation difficulties may also over-or-under respond to sounds
within their environment. Hyperresponsive children may appear to
be easily distracted, or excessively fearful of unexpected noises.
Hyporesponsive children may appear to daydream or to ignore
directions offered by parents or teachers.
Common signs of difficulty with sensory processing skills
include the following:
Hyporesponsivity to sensory input
• shows decreased reactions to pain or extreme temperatures
• messy during eating, unaware of spills or food on face
• shows a constant need to touch other people or objects
• fails to react when name is called
• enjoys chewing on non-edible objects, like shirt or pencil
• constantly picks or scratches at skin
• craves intense physical activity, like running, jumping,
crashing—often with disregard for safety considerations
• demonstrates poor balance or body awareness
• tends to overstuff mouth, may gag or choke easily
• seems unaware of need to evacuate bowel or bladder, or fails
to notice toileting accidents
• smells everything before eating or manipulating.

Hyperresponsivity to sensory input

• avoids or dislikes being hugged or kissed by familiar adults
• dislikes having face or hair washed
• seems unusually sensitive to clothing seams or tags
• avoids messy play, like glue or fingerpaints
• seems unusually picky about food odors, tastes, or textures
• over reacts to unexpected noises, like lawn mowers or fire
alarms
 • is intolerant of movement, dislikes being upside down, may
experience motion sickness
• hesitates to take risks during play, prefers sedentary activities.

Poor tactile discrimination

• uses an unusual way of grasping pencil, scissors, fork, or other
tools
• appears clumsy when manipulating small objects
• looks away from hands when engaged in skilled fine motor
activities
• drops small items easily
• unable to identify the location of a gentle touch when eyes are
closed
• unable to guess basic shape or texture with eyes closed.

Poor auditory discrimination

• demonstrates unclear speech, with poor articulation of sounds
• has difficulty learning to rhyme
• has difficulty hearing differences between similar-sounding
words, like “duck” and “dock”
• frequently says “what” or asks for repetition when spoken to
• is easily distracted by common background noises, like a fan
or water faucet
• shows delays in learning to read and write.
SENSORY ACTIVITIES
1 SENSORY SEARCH
Primary learning focus
• Tactile awareness and perception, dexterity.
• Tends to be a calming activity.

Materials needed
• Deep, plastic storage container with lid.
• Sheet or cloth to place under container.
• Dry beans or uncooked rice.
• Small toys or other objects to bury in rice or beans.

Description
Many children love the sensation of placing their hands in rice or
beans, and find this to be a very calming type of sensory input.
Hide the toys in the container and let the child dig, explore, and
play at will (placing a sheet underneath will greatly help clean-up!).

Variations
• Use kitchen tools like measuring cups, funnels, and spoons to
play with—this requires that the child uses the two hands
together, and can also make pleasing sounds as the rice or
beans are poured from container to container.
• Hide magnetic letters of the alphabet to find which spell out
the child’s name or simple words.
• Try digging in the container with eyes closed and guessing
what is found by feeling it.
• Play at a table while sitting on a T-stool or yoga ball.

2 GOOP ON A TRAY
Primary learning focus
 • Tactile awareness, visual-motor integration.
• Tends to be an energizing activity.

Materials needed
• Plastic or metal tray (cookie sheet with sides works well).
• Unscented shaving cream, hand lotion, pudding (or see
Appendix B for recipes for other types of goop).

Description
This is a messy activity best done outdoors, or place a sheet or
tablecloth under the tray to contain the mess. Put some goop on
the tray, and let the child use it for finger-painting, or for practice in
drawing shapes or letters.

Variations
• This activity offers a good opportunity for teaching the child
how to isolate their index finger while curling the other fingers
into the palm. If the child has difficulty doing this, try placing a
pompom or small eraser in the pinky side of their palm and
see if they can keep it there while they draw with their index
finger.
• Add a small amount of sand or glitter to add texture.
• Sit at a table using a T-stool or yoga ball.
• Use a blender or food processor to whip up a small amount of
dishwashing detergent to make “snow,” then put the snow on
a tray and use toy cars or plastic figures to play in the snow.

3 SPAGHETTI SHAPES
Primary learning focus
• Tactile awareness, dexterity, visual-motor integration.

Materials needed
• Cold, cooked spaghetti (thicker noodles work better).
 • Tray or plastic placemat.

Description
Cold spaghetti noodles make a wonderful tactile medium for
making shapes, letters, or designs. Allow the child to experiment
on her own, or make a model for the child to copy.

Variations
• Do this while belly lying on the floor to build upper body
strength and body awareness.
• Shapes can be allowed to dry, then paint and glue to make
collages or secret messages.

4 RECIPE FOR A SQUEEZE

Primary learning focus
• Tactile and proprioceptive processing, body awareness.
• Tends to be a calming activity.

Materials needed
• Assorted pillows, beanbag chairs, air mattresses, yoga ball—
be creative!

Description
Choose a food that the child enjoys eating, for example pizza, a
sandwich, or burrito. Tell the child that you have a recipe for
making that food item. Have the child lie on something soft (thick
rug, mat, sleeping bag, folded blanket, or comforter) while you
construct the food item by layering different ingredients on top of
the child. With each ingredient, give the child a few squeezes,
focusing especially on the weight bearing joints (shoulders and
hips)—this provides lots of proprioceptive (deep pressure) input
that many children crave and find to be calming. You may want to
add condiments like ketchup or mayonnaise by massaging these
on the child’s arms, legs, or back, but always stroke in the
direction of hair growth (stroking against the direction of hair
growth can be very disregulating).

Variations
• Challenge auditory memory and sequencing by providing a
verbal sequence of ingredients to layer, and then see if the
child can remember the “recipe” by repeating the sequence in
the correct order.

5 EDIBLE CHEW NECKLACE

Primary learning focus
• Eye-hand coordination, dexterity.
• Tends to be a calming activity.

Materials needed
• Licorice laces.
• Cheerios or other loop-type cereal pieces.

Description
Allow the child to string cereal pieces onto the licorice lace to
make a necklace. Assist the child in tying a knot so the necklace
can be worn. Putting something in their mouth calms many
children, and chewy or crunchy textures seem to be especially
calming. The child can wear the necklace when working on an
activity that requires concentration, and periodically bite off one or
more cereal pieces to help with focus, eating the licorice after all of
the cereal has been chewed off.

Variations
• Teach the child to put cereal pieces on according to a color
pattern.
 • Teach the child to tie a simple half-knot on the licorice lace,
and alternate knots with cereal pieces.

6 DEEP-SEA DIVING FOR TREASURE

Primary learning focus
• Tactile, perceptual.

Materials needed
• Deep washbasin or other container to hold water.
• Quarters, nickels, dimes, pennies (five of each).
• Non-latex medical gloves or rubber dishwashing gloves.
• Blindfold.

Description
This is another messy activity, so play it outdoors, in the tub, or
with something underneath the container to soak up the mess.
Place the coins in the bottom of the container, blindfold the child,
and see if she can find all five of a specified coin while wearing the
gloves.

Variations
• Place both hands in the water to compare sizes of different
coins and to encourage bilateral integration.
• Play with a partner—each partner gets to pull out five coins,
then adds up the points to see who got the most money.
• Challenge the older child to collect coins totaling a specified
monetary amount, for example $.36.
• Substitute other small objects, such as magnetic letters of the
alphabet to find.

7 FIND THAT FINGER

Primary learning focus
 • Tactile, body awareness.

Materials needed
• Paper and markers.
• Blank file folder.
• Feather, cotton swab, or pencil with eraser (optional).
• Tape.

Description
Tape the paper to the table. Next, have the child place her hands
on the paper with fingers spread wide, and trace around the
fingers to make a picture of the child’s hands. Practice counting
the number of fingers, and talk about which hand is right versus
left. Next, ask the child to place hands on top of the picture while
you hold the file folder under her face to block vision. Use your
finger (or a feather, cotton swab, or pencil eraser) to provide a
quick, light touch to one of the child’s fingers. Remove the file
folder, and see if the child can identify where she was touched. If
correct, draw a star on the picture of that finger. See how many
stars the child can collect on each finger.

Variations
• Try using two simultaneous touches, either to the same finger,
or to two different fingers.
• Wearing shorts and a short sleeve shirt, blindfold the child
and place a mini-sticker on different body parts, and then see
if the child can feel where you placed the sticker and peel it off
without looking. This is a great way to help children to stretch
and reach different areas of their bodies—something very
important for developing the coordination and body
awareness needed to learn to dress oneself!

8 DON’T SHAKE THE TABLE GAMES

Primary learning focus
• Body awareness, dexterity, eye-hand coordination, motor
planning.
• Tends to be a calming activity.

Materials needed
• Extremely variable—any game or toy that requires a high
level of fine motor skill.

Description
This is one of my favorite methods for teaching wiggly children to
become more aware of their bodies and to learn the importance of
knowing how to sit still. There are many, many commercial games
that challenge fine motor skills, such as pick-up sticks, blockhead,
or Jenga. These can be purchased at minimal cost, or in many
cases, you can make your own (for example, use short wooden
skewers to replace pick-up sticks, or pieces of Lego or any other
construction toy to use as blockhead blocks). Teach the child that
this is a “don’t shake the table” game, and demonstrate what might
happen if the table shakes (the pick-up sticks might roll, the blocks
might fall). Talk about ways to avoid shaking the table (keep feet
flat on the floor and hands and body away from the table unless
it’s your turn). Then, take turns playing the game, periodically
making a mistake that shakes the table causing you to lose your
turn. Teach the child that any body movement that causes the
table to shake, including things like sneezes, could cause a
mistake.

Variations
• Play the game while seated or standing on an unstable
surface to increase the challenge.
• Play the game using the non-dominant hand, with the
dominant hand held behind the back or in a pocket.
• Substitute tweezers for manipulating the game pieces.
 • Use the same language for teaching body awareness and
self-control during daily living activities, for example during
dinner one might caution, “Be careful not to shake the table or
you might spill your milk.”

9 POP GOES THE FEELING

Primary learning focus
• Calming, strength, body awareness.

Materials needed
• Small paper bags, such as lunch bags.
• Stapler or tape to seal the bags.
• Paper and crayons or markers (optional).

Description
This is a good activity for helping a child to take responsibility for
calming down when she is feeling angry or frustrated. When
something happens to cause emotions to escalate, talk to the child
about what is bothering her, then teach the child to blow that
feeling into the bag and seal it up. The child can then jump on the
bag to “pop” the feeling and make it go away.

Variations
• Older children can draw a picture depicting the situation that
upset them and place the picture in the bag before popping it
—or crush the picture into a ball and throw it into the trash
can.
• Use large plastic packing bubbles instead of paper bags. Use
a permanent marker to draw a face depicting the mood, then
jump on the bubble to make it pop.
• For older children, substitute balloons—have the child blow up
the balloon (this takes a lot of energy, and helps to calm), then
 let go of the balloon and watch those feelings go flying around
the room as the air is released.

10 FEEL-IT BAG
Primary learning focus
• Tactile, dexterity, perception.

Materials needed
• Cloth bag or pillowcase.
• Objects to sort by touch (for example, magnetic alphabet
letters, pieces from non-interlocking puzzles or shape sorters,
scraps of different textured materials, common household
objects such as a paperclip, spool of thread, or button).
• Bowl, tray, or empty box top.

Description
Spread the objects on a tray or other container so the child can
look at what she must find. Allow the child to manipulate the
various objects to get an idea of how they feel. Then, without the
child looking, select one of the objects to hide in the bag. The child
reaches inside the bag (no peeking — you might have to hold the
opening of the bag around the child’s wrist) so that she can feel it
and identify what it is. This requires not only tactile perception, but
also good in-hand manipulation skills to feel all surfaces of the
object and move it within the hand. The ability to identify shapes
by feel is closely linked to visual perception skills.

Variations
• Gradually increase the number of items in the bag, and
instruct the child which one she must find—the added tactile
input from multiple objects makes it more confusing to identify
the specific features of an item.
 • With multiple objects in the bag, see if the child can find one
object and squirrel it into the palm of their hand, then find a
second object without dropping the first object.
• Try finding objects with the non-dominant hand.

11 EGG TIMER ERRANDS

Primary learning focus
• Auditory, strength, motor planning, balance.
• Tends to be an energizing activity, but may calm some
children who have the need to burn off energy.

Materials needed
• Egg timer.
• Stickers.

Description
This is a great way to “wake up” a child who has low energy or
arousal levels. Create several fast-paced gross motor “errands” for
the child to perform (for example, “Run upstairs and bring me your
teddy bear,” or “Here are five pieces of trash—pick up one at a
time, hop to the trashcan and then throw it away”). Set the timer
for an appropriate amount of time to complete the task. If the child
beats the timer, she earns a high-five or a sticker.

Variations
• For the child who is slow to complete daily routines such as
getting dressed in the morning, create a chart for each
morning task the child must complete (for example, brush
teeth, comb hair, get dressed), and let the child earn stickers
or tokens to be traded for a reward when she has earned an
agreed-upon number of tokens.
• Use illogical directions to encourage good listening skills, for
example, “Go to Daddy’s bureau, find a clean white sock, turn
 it inside out and put it in the freezer.”

12 DIZZY DISCS
Primary learning focus
• Energizing, motor planning, balance, eye-hand coordination.

Materials needed
• Plastic lids (for example, from coffee cans or Pringles
containers) to use as makeshift frisbees.
• Empty box or basket to use as a target.
• A method for spinning (sit-and-spin, swing, or swivel chair).

Description
Rotary movement (spinning) is energizing to most children, but
must be used with great caution. Children who crave spinning and
never seem to get dizzy can suddenly become over-stimulated, so
it is very important to monitor their reactions. Never allow
prolonged, unsupervised spinning, and stop immediately if the
child reacts by becoming nauseated, disregulated, or sleepy. Have
the child sit on the spinner, and spin moderately fast about ten
times in one direction. Stop the spin, and have the child throw
several discs towards a target. Then spin in the opposite direction,
stop and throw. Do not prolong this game for more than five
minutes or so.

Variations
• Substitute other actions for the disc throwing, for example a
fine motor activity (like assembling five pop beads) or a motor
sequence (clap five times, then skip to the door).

13 MY BOUNCING BALL
Primary learning focus
 • Energizing, balance, strength, auditory perception.
• Can be calming for some children who need to burn off
energy.

Materials needed
• Yoga ball.
• Music with a fast, well-defined beat or rhythm.
• Musical instruments (purchased or homemade).

Description
Both bouncing on a ball and listening to fast music with a beat
tend to be very energizing for most children. Play music while the
child sits on the ball and bounces to the rhythm (if you don’t have
a ball, you can substitute marching or jumping on an unstable
surface). Allow the child to make movements in time to the music,
or to play various musical instruments in time with the beat. Many
instruments can be easily homemade. For example, fill cardboard
tubes with uncooked rice or beads and seal to make shakers; use
an empty oatmeal container for a homemade bongo drum; or glue
two paper plates together with a few jingle bells inside to make a
tambourine.

Variations
• Sing familiar songs, and experiment with speeding up or
slowing down the song to see if the child can adjust her
rhythm.
• Periodically stop the music unexpectedly and see how quickly
the child can “freeze” her motion.

14 WALL PUSH-UPS
Primary learning focus
• Strength, body awareness.
• Tends to be a calming activity.
Materials needed
• A wall (if desired, cut out a pair of handprints using contact
paper and stick to the wall).

Description
Heavy work activities that provide proprioceptive input are very
calming for most children. Sometimes, children just need a quick
little boost to help them get ready to work on a non-preferred
activity, or to get ready for a transition. This activity can be done
virtually anywhere, and is a favorite of many children. If you want,
place contact paper handprints on a wall or other location suitable
for performing the activity (in schools, we often place a set of
handprints outside of each classroom). Teach the child to stand
away from the wall and place her palms against the wall (or on the
handprints) with elbows extended so that the arms are straight.
One foot should be slightly in front of the other, with the knee
slightly bent. Keeping feet flat on the floor, slowly push in towards
the wall until the nose touches the wall, then push out again and
repeat ten times. Switch foot position, and repeat ten more times.

Variations
• Instead of calling them push-ups, make a game out of
pretending that a wall is falling down, and the child must push
against the wall to keep it from falling.
• Chair push-ups can be performed by sitting in a chair, placing
palms on the chair seat under the buttocks and pushing with
the arms until the buttocks slightly rise from the seat.
• Wall sit-ups can be performed by standing with the back flat
against the wall, bending the knees until both hips and knees
are at a 90 degree angle (with the back still against the wall),
then pushing with the legs until back in a standing position.

15 DRESSING IN THE DARK

Primary learning focus
 • Tactile, body awareness, motor planning, dexterity, strength.

Materials needed
• Assorted clothes (clothes that are a little too large are easier).
• Paper bags or cardboard boxes.
• Blindfold (optional).

Description
Hide a different piece of clothing in each bag or box. Line up the
bags or boxes so that they are easy for the child to find. Turn out
the lights, pull down the shades, and see how quickly the child can
put on each piece of clothing. Turn on the lights and let the child
peek in a mirror to see how well she did.

Variations
• Vary the level of demand according to the child’s maturity. For
example, do not expect younger children to be able to
manage fasteners as easily as older children.
• Have the child try it while wearing a mitten or non-latex
medical glove on one or both hands, or while wearing a
blindfold.
• Make it silly—instruct the child to put clothes on backwards or
inside out.

16 NAME THAT LETTER

Primary learning focus
• Tactile, perception.
• Tends to be a calming activity.

Materials needed
• Printed alphabet, or shapes drawn on paper.

Description
Sit behind the child, who is facing the alphabet or shapes. Tell the
child that your finger is a “magic pencil” for drawing letters or
shapes on the child’s back, which the child must then guess. Pull
down the child’s shirt so there are no wrinkles, and use your finger
to slowly draw the shape. If the child has difficulty guessing, use
verbal cues to describe the letter strokes (for example, to make a
letter “T” you would say “start at the top, go down, jump up, and go
across”). Use the palm of your hand to erase each letter before
drawing the next one (always erase by rubbing firmly downwards
in the direction of hair growth, as this tends to have a calming and
organizing effect).

Variations
• Let the child use chalk to draw the letter on a carpet sample
instead of guessing out loud—she must then erase the letter
using a different body part.
• Have the child lie down on the floor and use her body to make
the letter for another person to guess.
• Have one or more partners work together to make a letter or
short word for someone to guess—a great teamwork activity!

17 IF I HAD A HAMMER
Primary learning focus
• Strength, eye-hand coordination, visual attention, bilateral
integration.
• Tends to be a calming activity.

Materials needed
• Age-appropriate materials for hammering (toy hammer and
pegboard for toddler, golf tees and Styrofoam for older
children, wooden board or tree stump and real nails for the
child who can safely do this under supervision).

Description
Children (especially boys) love to use a hammer, and can amuse
themselves for a long time given the opportunity! Hammering
provides an excellent opportunity to practice eye-hand
coordination, and provides a lot of strong proprioceptive input as
well, which can be calming for some children. This is, of course,
an activity that needs close supervision according to the maturity
of the child.

Variations
• Use a marker to draw a picture or shape on the wood or
Styrofoam, and tap in nails or golf tees staying on the line.
• Hammer according to the rhythm of a song.
• Use different colored golf tees to create a sequenced pattern.
• Hammer ice in a zipper type bag, then use the ice chips to
cool down a drink.

18 BLOWING IN THE WIND

Primary learning focus
• Strength, visual attention/tracking.
• Tends to be a calming activity.

Materials needed
• Small empty milk or cream containers (clean and cut off about
4cm (1 ½") from the bottom, creating an open box).
• Craft sticks.
• Paper cut to approximately 8cm (3") square.
• Scissors.
• Tape.
• Bathtub, wading pool, or other large container of water.

Description
Tape the paper to one end of the craft stick, and tape the other
end of the craft stick inside of the milk carton bottom. This creates
a small sailboat that can float in water without sinking because of
the waxy covering on the milk carton. Use these boats to have
races, propelling the boats by blowing into the sails. Sustained
blowing takes a great deal of effort, and provides calming
proprioceptive input to the mouth and lungs. Experiment with how
the boat moves differently if you blow soft or hard, or if you place
small objects inside the boat.

Variations
• Partners can make secret messages to blow back and forth to
each other, with instructions to perform a specified activity,
such as acting out something, or performing an exercise.
• Experiment with other games that require sustained blowing,
like bubble pipes, making and blowing into pinwheels, or
using blower party favors to push a ping-pong ball around a
path.

19 NAME THAT TUNE

Primary learning focus
• Auditory perception.

Materials needed
• None.

Description
This is a quick and easy auditory perception game that can be
done anywhere with virtually no equipment. Using your hands on
your lap, tap out the rhythm of a common song, such as “Happy
Birthday.” You could also clap out the rhythm, or use a pencil
against a hard surface. See if the child can recognize the tune.

Variations
 • After the child guesses the tune, sing it together and act out
the rhythm by marching, clapping hands, or snapping fingers.
• Take turns being the tapper and the listener.

20 MIRROR DRAWING
Primary learning focus
• Auditory perception, visual-motor integration.

Materials needed
• Paper and markers or crayons.
• File folder or other object to use as a visual barrier.

Description
In this game, the child attempts to draw a picture that looks the
same as the adult’s picture, given only auditory clues. The adult
and child each have paper and drawing materials. Place the file
folder or other barrier in between the child and the adult, so that
they cannot see each other’s paper. The adult then draws one
item at a time, giving a verbal direction for the child to do the same
thing. For example, the adult might say, “Draw a large square in
the center of the paper, with a small circle inside the square. Next,
make a smiley face in the top left hand corner of the paper.” After
several directions, remove the barrier and compare the two
pictures, discussing how they are different or similar. Let the child
take turns being the one to give directions to the adult.

Variations
• Use lined paper, and give directions to copy sequences to
encourage memory skills (for example, “Let’s draw circles to
make this pattern: red, blue, green, red, blue, green”).
• While shapes and colors are easier to describe, this game is
also fun when you make it more creative. For example, give
 directions for drawing the family pet, but add silly directions,
like making a green tongue, or a dog wearing mittens.
• Draw while lying on your belly, or at a vertical surface to
strengthen upper body skills.

21 MY LISTENING GAME
Primary learning focus
• Auditory perception.

Materials needed
• Child-friendly books, stories, or songs.

Description
Select a word that is included multiple times in a particular story or
song, and then read or sing to the child, instructing her to listen for
that word. Each time the child hears the targeted word, she must
perform a designated action, such as clapping hands, acting like
an animal, or jumping up and down. You can make the action
relevant to the story or song (for example, if the story is about
dinosaurs and the target word is dinosaur, the child must stomp
her feet like a dinosaur).

Variations
• Some children may find it easier to listen if they close their
eyes.
• Experiment with speeding up or slowing down while you read
the story.
• Have the child hide under a blanket and jump out every time
the target word is heard.
• For older children who can read, substitute listening for words
that start with a targeted sound, or listening for words that fall
into a particular category, like foods or animals.
22 COLOR ON COMMAND
Primary learning focus
• Auditory perception.

Materials needed
• Paper and markers or crayons.

Description
Draw a row of simple pictures, for example flowers, beach balls,
Easter eggs, or a string of Christmas lights. Vary the number of
items in the row according to how well the child can count and
demonstrate one-to-one correspondence. Next, provide directions
that require the child to process information, for example, “Color
the first ball red and the sixth ball yellow.”

Variations
• Do this with a partner, and have each partner take turns giving
directions.
• Do this while lying on the belly, or at a vertical surface so that
one hand has to hold the paper while the other hand colors.

23 DO YOU HEAR WHAT I HEAR?

Primary learning focus
• Auditory perception.

Materials needed
• Anything that makes a noise.
• Blindfold.

Description
Blindfold the child, and then activate common environmental
sounds to see if the child can guess what you are doing (for
example, turn on water, use a stapler, open the refrigerator door,
pull down a window shade, tear a piece of paper, etc.)

Variations
• Turn on a fan or low volume music to create background
noise, which increases the listening challenge.
• Make the sound more than once so the child has to count how
many times the sound occurred as well as identifying what
caused the sound.
• Create a sequence of different sounds for the child to guess.

24 COPY THE SOUND

Primary learning focus
• Auditory perception, motor planning, visual-motor integration,
perception.
• Tends to be an energizing activity.

Materials needed
• Various noisemakers (commercial or homemade rhythm
sticks, shakers, drums, etc.).

Description
Have the child sit facing away from you while you make a series of
sounds using the instruments. See if the child can copy your
sounds. Practice with loud/soft volume, and vary the speed from
slow to fast.

Variations
• Have the child sit on a T-stool or yoga ball while doing this
activity.
• Create some background noise to compete with the sounds to
copy.
• Try doing this behind a closed door.
 25 MATCH THAT SOUND
Primary learning focus
• Auditory, fine motor strength and dexterity.

Materials needed
• A collection of same-sized containers (for example, paper
lunch bags, empty film canisters, or opaque pill bottles).
• Assorted materials to place inside containers (for example,
rice, beans, cheerios, paper clips, marbles, etc.).

Description
Create two sets of sound-makers, trying to use the same amount
of fillers so that they sound exactly alike. Give the child one set,
and stand across the room with the other. Choose one of the
containers, shake it, and see if the child can find the one that
sounds the same. Ask if he can guess what is inside (then open
up and peek).

Variations
• Create background noise (for example music or a fan) to
increase the listening challenge.
• Have two adults stand away from each other, shaking
different containers, and ask the child “Who is shaking the …
(marbles, rice)?”
• Have the child identify two different sound-makers, then copy
sound sequences by holding one sound-maker in each hand
and shaking according to a pattern.

OTHER IDEAS FOR SUPPORTING SENSORY

SKILLS DEVELOPMENT
• Sitting in beanbags or rocking chairs for calming.
• Gentle roughhousing.
• Sit or lie on a blanket while two adults hold each end and
provide a swing.
• Create a quiet area for self-calming, such as a table covered
with a blanket and pillows on the floor.
• Use playground equipment for vestibular input (for example,
swings and slides).
• Perform yoga poses.
• Use scented markers or dough.
• Use fidget toys (see Appendix B for ideas).
• Using weighted blankets, vests, or pencils for calming (see
Appendix B for directions on how to make these items).
• Towel dry and apply scented lotion after a bath.
• Play in a sand box or at a water table.
• Play with Silly String.
• Use a vibrating toothbrush, toys, or pens.
• Wear tight fitting clothing such as leotards or neoprene shorts
for calming.
• Blow whistles, flutes, pinwheels.
• Play games involving different head motions (like somersaults
or cartwheels).
• Ride in elevators or on escalators.
• Guess different tastes or smells while blindfolded.
• Make a nature collage using different textured natural
materials.
• Be thoughtful about choosing clothes for the child to wear to
school. Avoid dressing in a way that might cause distractions
(hair falling in the eyes, loose jewelry or tassels that create
light touch sensations, ill-fitting shoes, pants that are too loose
and tend to fall down, etc.).
Appendix A

REFERENCE GUIDE FOR

SELECTION OF ACTIVITIES

Use this guide to identify which activities might be especially

helpful for a particular child. Identify one or more areas of
weakness for the child, then scroll down each column to select
appropriate activities.

P = Primary focus of activity

S = Secondary focus of activity

A = Adaptations possible to address this skill

? = Typically addresses this skill, but each child reacts differently

Appendix B

INSTRUCTIONS FOR
HOMEMADE SUPPLIES

EQUIPMENT
T-STOOL
Materials
• 20cm (8") square of plywood, 2cm (¾") thick.
• 8cm (3") plywood square, 2cm (¾") thick.
• Wooden dowel, 2.5cm (1") diameter by 20cm (8") long.
• Eight 2.5cm (1") nails.
• One 3.8cm (1½") screw.
• One rubber crutch tip (available at pharmacies or medical
supply stores).

Directions
• Sand the edges of the two wood squares to prevent splinters.
• Insert screw through the middle of the 8cm (3") plywood
square into the dowel.
• Place the larger plywood square over the center of the smaller
square and secure using nails.
 • Place the rubber crutch tip over the bottom of the dowel.

FIGURE B.1

ZOOM TUBE
Materials
• Empty toilet tissue roll.
• Contact paper.
• Markers, colored tape, stickers as desired.
• Two lengths of cord (slippery is better), each approximately
2.7m to 3m (9 to 10 feet) long.

Directions
• Tie loops onto both ends of the two cords to form handles.
 • Cover the toilet tissue roll with contact paper, folding excess
length over the ends of the tube (this makes the tube stronger
and more slippery).
• Decorate the tube as desired.
• Insert one end of each cord into the tube.
• To use, two partners face each other, each holding one set of
the handles with the zoom tube in the middle of the cords.
Each partner steps back until the cords are taut. One partner
brings her arms together, while the other partner brings her
arms apart. This makes the tube “zoom” to the partner whose
arms are together. By keeping the cords taut and carefully
timing the opening and closing of arms, the tube will race
back and forth between partners.

FIGURE B.2
SCOOPING CUPS
Materials
• Two large, clean, empty plastic bottles (such as those used to
hold bleach, milk, or laundry detergent).
• Colored tape (plastic or duct tape).
• Lightweight object for throwing and catching (small beanbag,
koosh ball, or crumpled wad of paper).

Directions
• Cut off the bottoms of both bottles.
• Cover the cut edges with tape to make sure they are smooth.
• To use, place a beanbag or other object inside one bottle to use
for toss and catch games.

FIGURE B.3

WINDMAKERS
Materials
 • Assorted, empty squeeze bottles (for example, ketchup or
mustard squeeze bottles, infant nasal aspirator, or empty nasal
spray bottle).
• Permanent markers for decorating bottles.
• Cotton balls, small pompoms, or small pieces of tissue paper.

Directions
• Remove any labels from the bottles, then clean and dry well.
• Use markers to make faces on the bottles, with the nozzle
serving as the nose.
• To use, squeeze the bottle so that the cotton ball or tissue
moves.

FIGURE B.4
SECRET ENVELOPES
Materials
• Assorted empty envelopes (used ones are fine).
• Wide-tip markers, or masking tape.
• Small prizes for the envelopes (stickers, secret messages, or a
small edible treat).
• Scissors.
• Something to use as a tactile “launch pad” (for example,
computer mouse pad, folded washcloth, sponge, or drink
coaster).

Directions
• Place the prize inside the envelope at one end.
• Seal the envelope (use tape if recycling a used envelope).
• At the end of the envelope opposite to where the prize is
hidden, create a path for the child to cut, using either the
marker or tape (for more tactile input).
• Use the “launch pad” for the child to rest her hand on during
cutting, teaching that the pinky side of the hand stays down
towards the table, and the thumb side of the hand points to the
ceiling.
FIGURE B.5

TAP THE BALL

Materials
• Lightweight plastic ball with holes (for example, Wiffle ball).
• String.
• Wooden dowel or empty cardboard tube, approximately 45cm
to 60cm (18" to 24") long.
• Colored tape or markers.

Directions
• Tie the string to the ball, and suspend from a tree branch or
door still so that it is at the child’s eye level.
• Use the tape or markers to create three lines around the dowel
or tube, with one color forming a ring around the center, and
two other colors forming rings approximately 15cm (6") from
the ends of the dowel or tube.
 • Holding the dowel at each end, the child faces the hanging
ball and practices various tapping patterns while keeping the
ball’s movement steady and well controlled.

FIGURE B.6

MUNCHER MAN
Materials
• Tennis ball.
• Sharp razor knife.
• Permanent markers.
• Small objects to “feed” the muncher man.

Directions
 • Carefully slice a 6cm to 8cm (2½" to 3") line along the seam
that separates the fuzzy parts of the ball—this becomes the
muncher’s mouth.
• Use a red marker to color in lips around the cut, and other
markers to add other facial features.
• The child holds the muncher man in her palm, positioned so
that the thumb is at one end of the cut and the other fingers are
at the other end of the cut. By squeezing at these points, the
muncher man’s mouth will open and close.

FIGURE B.7

BUTTON SNAKE
Materials
• Felt or fleece fabric cut into rectangles or ovals approximately
8cm (3") in size (these fabrics work best because they will not
fray).
 • Scissors.
• Buttons.
• Thread and needle.

Directions
• For the body pieces, sew a button onto one end of each piece,
and cut a buttonhole at the other end.
• Make a head with only a buttonhole at one end, and a tail with
only a button at one end.
• Use the pieces to practice buttoning and unbuttoning.
• Alternatively, use cardboard pieces, hole puncher, and brass
paper fasteners (brads) to make a toy snake to play with.

FIGURE B.8
TREAT BOXES
Materials
• Empty cardboard boxes.
• Long, thick shoelaces, with different colors and textures.
• Something to punch holes in the cardboard boxes
(screwdriver, awl, knitting needle).
• Small treats or stickers.

Directions
• Cut shoelaces in half, and then tie two different shoelace
halves together. This will create a shoelace that has different
colors and textures on each side.
• Punch two holes in the bottom of the box.
• Thread the two ends of the shoelace into the bottom of the box
from the inside.
• Place the lid back on the box, and wrap the shoelace around
the outside of the box.
• Teach the child to tie a bow around the box, using the two
different colored laces to help the child to learn the steps of
tying.
• If desired, find several boxes of different sizes that can nest
together.
• If desired, use a treat or sticker to place in the box as a reward
for good effort.
FIGURE B.9

GEL BAGS
Materials
• Large, freezer storage bag with zipper-style closure.
• Colored hair gel.
• Lighter fluid (optional).
• Duct tape.
• Small bead or button.
• Glitter or sequins.

Directions
• Try to find a clear bag without any writing on it. For some
brands of bag, the white writing is easily removed using
 lighter fluid and a paper towel.
• Squirt enough gel into the bag to create a thickness of
approximately 0.6cm (¼") when the bag is placed on its side.
• Place the bead or button, plus some glitter or sequins, into the
bag.
• Close the zipper, squeezing out as much air as possible.
• Seal the closure with duct tape to prevent spilling.

FIGURE B.10

MARBLE ROLLER
Materials
• Marble.
• Bottle cap just large enough to cover the marble, or half of the
smallest sized plastic Easter egg.
 • Small wiggle eyes or other decorations for the marble roller.
• Lightweight plastic tray, empty box top, or cookie sheet.
• Paper and markers.

Directions
• Using paper and markers, make a variety of worksheets to use
for rolling the marble (this could be mazes, simple dot-to-dots,
letters of the alphabet or numbers). Place one paper on the
tray.
• Decorate the bottle cap or Easter egg half as desired to make it
into a creature or robot.
• Place the cap over the marble, then place it on one of the
papers on the tray.
• Instruct the child to use both hands to hold the tray and
maneuver the roller along a desired route.

FIGURE B.11
PADDLE BALL
Materials
• Bendable coat hanger.
• Nylon hosiery.
• Foam for padding.
• Duct tape.
• Balloons.

Directions
• Bend the coat hanger to form an oval shape with a handle.
• Cut off one leg of hosiery (or use a knee-high) and slip it over
the metal loop, securing it with tape around the handle.
• Use tape to secure the hosiery to the handle.
• Wrap the handle with foam to make a soft, padded handle, and
cover with more duct tape.
• Blow up one or more balloons and use with the paddle.

FIGURE B.12
LABYRINTH GAME
Materials
• Rectangular piece of cardboard, cardboard tray, or empty
cardboard box lid.
• Mazes (make your own, or refer to Appendix C for advice as
to where to find free printable mazes online).
• Drinking straws.
• Scissors.
• Hot glue gun or tacky glue.
• Marble.

Directions
• Draw or print mazes large enough that the paths will fit the
marble.
• Cut straw lengths to fit the lines of the maze and glue in place.
• Allow to dry.
• Place the maze inside a tray or empty box lid (if using a
cardboard rectangle, add straw pieces to the sides of the
rectangle to prevent the marble from rolling off the edges).
• To use, the child holds the labyrinth with both hands and
attempts to maneuver the marble through the maze.
FIGURE B.13

FIND-IT BAG
Materials
• Large, sturdy freezer storage bag with zipper-style closure
(can also use an empty 2 liter soda bottle or other type of clear
plastic tube).
• Lighter fluid (optional).
• Identical pairs of assorted small objects (elastic bands, beads,
buttons, avoiding sharp points or edges that might puncture
the bag).
• Filler, such as sand, uncooked rice, poly beads (found in craft
stores), or colored seed bead.
• Duct tape.

Directions
• Separate each pair of objects, placing one of each inside the
bag or bottle, and reserving the other in a separate container.
 • If using a zipper bag, try to find a clear bag without any
writing on it. For some brands of bag, the white writing is
easily removed using lighter fluid and a paper towel.
• Place enough filler to fill the bag or bottle to about three-
quarters full.
• Close and seal the container with duct tape (if using a bag, try
to remove some of the excess air so the filler and objects are
easy to move around in the bag).
• To use, show the child one of the reserved objects, and see
how quickly the child can find it in the bag or bottle.

FIGURE B.14

HOLE-IN-ONE
Materials
• One or more empty cardboard tubes (from toilet tissue or
paper towels).
• Length(s) of string approximately 45cm (18").
 • Ping-pong ball.
• Hot glue gun.
• Colored tape.

Directions
• To make a single hole-in-one, glue one end of the string to the
ping-pong ball, and tie or glue the other end of the string to
the cardboard tube.
• To make a multiple hole-in-one, place additional cardboard
tubes adjacent to the single hole-in-one, tape together, and use
different colors of tape around the edges of each tube.

FIGURE B.15

NON-EDIBLE RECIPES
KNEADING DOUGH WITH FLOUR
Ingredients
1 cup flour
½ cup salt
1 tsp cream of tartar
1 cup water
1 tbsp cooking oil
Food coloring

Directions
Place all ingredients except food coloring in a saucepan and cook
over medium heat until the mixture begins to pull away from the
sides of the pan to form a ball. Remove from heat and cool, then
add food coloring and knead until smooth. Store in an airtight
container or plastic zipper bag. This makes a very soft dough
similar to Play-doh.

FLOURLESS KNEADING DOUGH

Ingredients
1 cup baking soda
½ cup cornstarch
⅔ cup lukewarm water
Food coloring (optional)
Clear nail polish or shellac (optional)

Directions
Mix the baking soda and cornstarch in a pot, then add water and
stir until smooth. Cook over medium heat until it comes to a boil
and assumes a texture like mashed potatoes. Pour onto a board to
cool, and knead, adding food coloring if desired. This dough will
stay pliable for several weeks in an airtight container, but hardens
quickly when exposed to air. Use it to make sculptures, leave to
harden, and paint or shellac when dry.

SCENTED KNEADING DOUGH

Ingredients
85g (3 oz) sugar-free gelatin, any flavor or color
2 cups flour
1 cup salt
4 tbsps cream of tartar
2 cups boiling water
2 tbsps cooking oil

Directions
Mix all of the dry ingredients in a pot, and then add the boiling
water and cooking oil. Stir over medium heat until the mixture
forms a ball. Allow to cool. Store in an airtight container and
refrigerate when not in use.

HOMEMADE FINGERPAINTS
Ingredients
1 cup flour
2 tsp salt
3 cups cold water
3 cups boiling water
Food coloring

Directions
Mix the flour and salt together in a pot. Add the cold water, stirring
until smooth. Add the boiling water, and cook over medium heat,
bringing to a boil and stirring continuously until clear. Then add the
desired food coloring and cool before use.

PUFFY PAINT
Ingredients
1 cup flour
1 cup salt
1 cup water
Tempera paint to add color

Directions
Mix the first three ingredients, and then add tempera paint as
desired to color the paint. Put the paint into squeeze bottles for
painting. This paint puffs up and hardens when dry, creating a fun
texture.

HOMEMADE SILLY PUTTY (WARNING — DO NOT

INGEST!)
Ingredients
1 cup white Elmer’s glue (do not substitute another brand)
1 cup liquid starch
Small amount of food coloring, if desired

Directions
Put glue and food coloring (if desired) into a plastic container. Add
starch, a little at a time, stirring constantly until the mixture holds
together like putty. Keep checking the texture and add very small
amounts of starch until the putty feels smooth and rubbery. This is
great putty for stretching, bouncing, transferring comic pictures, or
burying small objects to find. Store in an airtight container. Can be
refrigerated if the child enjoys a cold temperature.

SOAP CRAYONS
Ingredients
1¾ cups powdered Ivory Snow soap flakes
¼ cup water
Food coloring
Directions
Mix soap flakes and water together. Add food coloring and pour
into ice trays or other molds. Allow to harden, and then remove
from the molds. These are especially fun to play with in the
bathtub!

EDIBLE RECIPES
IRISH POTATOES
Ingredients
½ cup warm mashed potatoes (no milk, salt or butter)
907g (2 lbs) confectioner’s sugar (approximate)
½ tsp vanilla extract
Cinnamon

Directions
Add the vanilla to the warm mashed potatoes, and then add
confectioner’s sugar, a little at a time until the mixture forms a
dough. Form into small balls and roll in cinnamon. These should be
kept in the refrigerator and eaten the same day.

NUTTY PUTTY
Ingredients
1 cup peanut butter
½ cup honey
2 cups confectioner’s sugar
Chocolate chips, raisins, etc. for decorating (optional)

Directions
Mix the peanut butter, honey, and confectioner’s sugar, kneading
until the mixture forms a dough. This can be shaped into small
shapes or figures and decorated as desired. Store in the refrigerator
in an airtight container. CAUTION: not appropriate for children
with peanut allergies.

CANDY CLAY
Ingredients
½ cup light corn syrup
113g (¼ lb) softened margarine or butter (not melted)
½ tsp salt
1 tsp vanilla extract
4 cups confectioner’s sugar

Directions
Blend the corn syrup and softened butter in a bowl. Add salt,
vanilla extract, and confectioner’s sugar. Knead with the hands
until smooth. Store in an airtight container in the refrigerator.

BUGS IN DIRT
This recipe is a great motivator for children who dislike mixing the
textures of food.

Ingredients (individual portion)

Snack size container of chocolate pudding
2 chocolate sandwich cookies
Gummi worms or bugs

Directions
Scrape the frosting off the cookies, and then let the child crush
them with her hands into a bowl. In a plastic drinking cup or other
tall container, alternate layers of pudding, cookie crumbs (the dirt!)
and worms.

ANTS ON A LOG
This is another good recipe for mixing food textures.

Ingredients
Celery sticks
Peanut butter
Raisins

Directions
Spread peanut butter on the celery sticks, and then line up raisins
(ants) on the log. CAUTION: not appropriate for the child who has
a peanut allergy, but you can substitute cream cheese.

SLURPEES
Sucking food through a straw is calming and organizing for many
children. The following are just some suggestions for foods
appropriate for slurping. Experiment with crazy straws and thinner
cocktail straws, which tend to require a stronger suck.

Slurpee foods
Milkshakes
Fruit smoothies
Apple sauce
Pudding, thinned with milk
Yogurt drinks

TOOTHPICK TREATS
This makes a fun snack, and encourages children to taste different
textures and to practice their fine motor skills at the same time. Cut
an assortment of foods into small cubes (think raw fruits and
vegetables, cheese, chunks of meat, salad croutons, or goldfish
crackers). Provide the child with a toothpick, and let her stab the
food with the toothpick to eat!

BREAD PAINT
Ingredients
1 tbsp milk
4 drops food coloring
Light colored bread

Directions
Mix the milk and food coloring in a small bowl (make as many
colors as desired). Use a small paintbrush to paint designs or secret
messages on the bread, and then use the bread to make toast,
sandwiches, or French toast (the colors will remain true even if the
bread is cooked or toasted).

HEALTHY ALERTING SNACKS

In general, foods that are cold, crunchy, or have a strong, sour taste
are alerting for the child who under-registers sensory information.
The following are suggestions for snacks to help these children:
• crunchy raw fruits and vegetables
• crunchy granola or granola bars
• pretzels
• rice cakes
• air popped popcorn
 • whole grain dry cereal
• sugar-free sour candy or gum
• fruit juice or sugar-free koolaid, frozen in ice cube trays
• graham crackers spread with yogurt and put in the freezer.

HEALTHY CALMING SNACKS

Foods that require a lot of chewing, along with those that are sticky
and need “mouth work” to swallow tend to be more calming for
children with high energy levels. Examples include:
• nut butters (be cautious about potential allergies)
• cream cheese or other spreadable cheeses
• raisins or other dehydrated fruits
• fruit leathers without added sugar
• nitrate-free meat jerky
• dense breads (such as bagels).

FAVORITE FIDGETS
Many children enjoy having a small toy or tactile object to keep in
their hands when they need to be quiet or to concentrate in school.
Occupational therapists refer to these as “fidget toys.” The trick is
to teach the child that a fidget is something to use quietly (not to
play with), and is a tool to help them to maintain a calm body. If a
fidget becomes distracting, it is taken away. Some children enjoy
having a shoebox or other small container where they can keep a
supply of several fidgets and choose one as needed. Others like to
keep one in their pocket, or a few in a fanny-pack to carry around
during the day. A few commercial fidgets have clips that can be
attached to a belt loop or backpack strap so it is readily available.
Use common sense when choosing fidgets, for example avoiding
small objects that could cause a choking hazard if the child is prone
to putting things in her mouth.
In my experience, teachers are very variable in their tolerance for
children using fidgets at school. Some are happy to accommodate
the child; others are concerned about the potential for distraction to
the child as well as to her peers. Some of my favorite, quieter
fidgets include:
• squeeze balls—these are readily available, or you can make
your own using latex balloons and cornstarch. Use a funnel
and chopstick to force cornstarch into a balloon until it is a
little larger than a golf ball, tie it off, stuff it into a second
balloon, and tie off again. This makes a fascinating texture to
quietly squish
• a large nut and bolt to twist on and off
• worry beads (string a few onto a string or chenille pipe stem
fastened into a circle)
• wrist coil key ring (with the metal key ring removed)
• a small bendable toy (like a Gumby doll or a bendable pencil)
• small koosh ball (some are made into key rings that can attach
to a belt loop).
• small, smooth pebble for the pocket (if desired, use a
permanent marker to write a secret reminder, like “Stay
cool!”)
• rubber band ball
• braided, knitted or crocheted necklace or bracelet using fancy
yarns that have interesting textures.
WEIGHTED TOOLS
Children who have sensory processing differences often crave deep
pressure and proprioceptive inputs. Using weighted garments or
tools can be very calming and organizing to some children, and are
often included as part of a therapy program. Commercial products
are readily available, but unfortunately can be prohibitively
expensive. The following sections provide directions for making
some simple weighted tools at a much lower cost than purchasing
commercially. If you choose to try these, remember that they
should be used under supervision (especially if there is risk of the
weighted filling leaking). Do not use items made with poly pellets
or other small weighted materials if the child is prone to chewing
on clothing or blankets. In the event a seam should break, the small
pellets could cause a serious choking hazard. There is no absolute
standard for how much weight to use, but my recommendation for
home use would be to use approximately 5 percent of the child’s
body weight, unless directed otherwise by a professional. Weighted
garments should never be worn for long periods of time, because
the child acclimatizes to the sensation after about 20 minutes,
making it no longer helpful. As a general rule, weights should be
used for about 20 minutes, with at least a 20 minute “break” before
they are used again.

LAP BLANKET
Materials
• Approximately 90cm (one yard) of flannel in a child-friendly
pattern (or use a flannel pillowcase).
• Sewing machine with polyester thread.
• Approximately 1.4kg (3 lb) of poly pellets (these can be found
in craft stores or online).
 • Funnel.

Directions
• Fold the flannel in half, printed sides together, and sew the
two long sides and one short side to make an open-ended
rectangle (or use a purchased pillowcase).
• Turn the rectangle so the printed side is on the outside.
• Sew eight straight seams along the length of the rectangle,
forming eight channels.
• Using the funnel, pour one and a half cups of poly beads into
each channel.
• Sew the open seam at the end of the rectangle closed.
• Lay the rectangle flat, and using your hands, push the beads so
that half are on each side of each channel.
• Sew a seam down the middle, forming two sets of eight
channels with an equal distribution of poly beads in each
channel.
• Repeat this process, until you have a rectangle divided into
eight by eight channels.
• The lap blanket can be hand washed and air dried (do not use
a washer or drier in case a seam fails and spills the poly
pellets).
FIGURE B.16

VEST
Materials
• Child sized fisherman’s vest with lots of pockets.
• Cloth for making beanbags.
• Sewing machine with polyester thread.
• Poly pellets.

Directions
• Use cloth to make beanbags approximately 9cm to 10cm (3½"
to 4") in size, filling each beanbag with half a cup of poly
pellets.
• Place finished beanbags in the pockets of the vest, making
sure that weight is evenly distributed.
• Remove beanbags before washing the vest.
SENSORY SNAKE
Materials
• One men’s extra-long white tube sock.
• Poly pellets.
• Fiberfill padding.
• Sewing machine.
• Large wiggle eyes.
• Hot glue gun.

Directions
• Fill the sock with alternating layers of fiberfill padding and
poly pellets, using approximately 450g (1 lb) of the poly
pellets.
• Sew the open end closed.
• Glue wiggle eyes onto the toe end of the sock.
• Use as a soft weight around the neck and shoulders, or as a lap
weight.
FIGURE B.17

WEIGHTED PENCIL
Materials
• Pencil.
• Metal nuts to fit the diameter of the pencil.
• Hot glue gun.

Directions
• Glue two or three nuts around the pencil shaft (above the area
where the child will hold the pencil).
Appendix C

FURTHER RESOURCES

RECOMMENDED ORGANIZATIONS AND

WEBSITES FOR INFORMATION AND
GUIDANCE ABOUT CHILDREN WITH
DISABILITIES
American Association on Intellectual and Developmental Disabilities
501 3rd Street NW, Suite 200
Washington, DC 20001, USA
Telephone: +1 (202) 387-1968
Website: www.aaidd.org

This organization promotes progressive policies, sound research,

effective practices, and universal human rights for people with
intellectual and developmental disabilities.

American Occupational Therapy Association

4720 Montgomery Lane, PO Box 31220
Bethesda, MD 20824–1220, USA
Telephone: +1 (301) 652-2682
Website: www.aota.org

This is the professional membership organization of occupational

therapists in the United States. It offers consumer information including
how to find an occupational therapist.

American Physical Therapy Association

 1111 North Fairfax Street
Alexandria, VA 22314–1488, USA
Telephone: +1 (800) 999-2782
Website: www.apta.org

This is the professional membership organization of physical therapists

in the United States, and offers a variety of consumer resources.

American Speech-Language Hearing Association

2200 Research Boulevard
Rockville, MD 20850–3289, USA
Telephone: +1 (800) 638-8255
Website: www.asha.org

This is the professional membership organization of speech therapists

and audiologists in the United States. It has a section dedicated to
providing information and resources for consumer audiences.

Association of University Centers on Disabilities

1100 Wayne Avenue, Suite 1000
Silver Springs, MD 20910, USA
Telephone: +1 (301) 588-8252
Website: www.aucd.org

This is the home organization for University Centers for Excellence in

Developmental Disabilities, which are supported by federal funding and
legislation in the United States. These centers serve as the bridge
between the academic arena, and public policy and services. They focus
on the training of advanced level practitioners, dissemination of state-
of-the-art knowledge, and in some cases, direct service for individuals
with developmental disabilities.

Autism Independent UK
199–203 Blandford Avenue
Kettering, Northants NN1 9AT, UK
Telephone: +44 (0) 1536 523274
Website: www.autismuk.com
 This useful website offers many information resources for parents and
professionals, including an extensive listing of links to worldwide
resources pertaining to autism.

Autism Society of America

4340 East-West Highway, Suite 350
Bethesda, MD 20814, USA
Telephone: +1 (800) 328-8476
Website: www.autism-society.org

This organization provides information and referral services for children

with autism.

Center for Disability Information and Referral: Kids Corner

Website: www.iidc.indiana.edu/cedir/kidsweb

This is a wonderful website for children to access information about

what it is like to have a disability. It includes links to games, books,
celebrities who have disabilities, movies and television shows featuring
persons with disabilities, and more!

CHADD National
8181 Professional Place, Suite 150
Landover, MD 20785, USA
Telephone: +1 (800) 233-4050
Website: www.chadd.org

This organization sponsors continuing education programs for parents

and professionals, as well as parent support groups for children with
ADHD.

Children’s Defense Fund

25 E. Street NW
Washington, DC 20001, USA
Telephone: +1 (800) 233-1200
Website: www.childrensdefense.org
 This agency provides information about United States federal
legislation pertaining to child health, welfare, and education. It
publishes a consumer guide describing parent rights under the
Individuals with Disabilities Education Act.

College of Optometrists in Vision Development

215 W. Garfield Road, Suite 200
Aurora, OH 44202
Telephone: +1 (330) 995-0718 or +1 (888) 268-3770
Website: www.covd.org

This website offers extensive resource information on the role of vision

in autism, ADHD, and learning disabilities, as well as a directory of
qualified developmental optometrists.

Council for Exceptional Children

2900 Crystal Drive, Suite 1000
Arlington, VA 22202–3557, USA
Telephone: +1 (888) 232-7733
Website: www.cec.sped.org

This is an association for parents and professionals with an interest in

children with developmental differences. It provides literature reviews,
referrals, and computer searches on topics related to developmental
disabilities.

Educational Resources Information Center (ERIC)

Website: www.eric.ed.gov

Sponsored by the United States Department of Education, this website

produces the world’s premiere database of journal and non-journal
education literature, with many full-text articles offered to consumers at
no charge.

Future Horizons
721 West Abram Street
Arlington, TX 76013, USA
 Telephone: +1 (800) 489-0727
Website: www.fhautism.com

This organization offers extensive listings of publications and

continuing education opportunities pertaining to autism. It also offers
links to other autism-related websites.

Learning Disabilities Association of America

4156 Library Road
Pittsburgh, PA 15234–1349, USA
Telephone: +1 (412) 341-1515
Website: www.ldaamerica.org

This organization disseminates information, provides advocacy, and

seeks to improve education opportunities for individuals with learning
disabilities.

National Autistic Society

393 City Road
London EC1V 1NG, UK
Telephone: +44 (0)20 7833 2299
Website: www.nas.org.uk

This organization offers resources and services for children with autism
and their families residing in the United Kingdom.

National Center for Learning Disabilities

381 Park Avenue South, Suite 1401
New York, NY 10016, USA
Telephone: +1 (888) 575-7373
Website: www.ncld.org

This agency provides public awareness of learning disabilities by

publishing a magazine for parents and professionals, and by providing
site-based information and referral services.

National Dissemination Center for Children with Disabilities (NICHCY)

 PO Box 1492
Washington, DC 20013, USA
Telephone: +1 (800) 695-0285
Website: www.nichcy.org

This serves as the central source of information on children with

disabilities in the United States. It includes easy to read information on
the federal regulations governing early intervention and special
education services, and provides state resource sheets for accessing
these resources.

Optometric Extension Program

1921 E. Carnegie Avenue, Suite 3–L
Santa Ana, CA 92705–5510
Telephone: +1 (949) 250-8070
Website: www.oepf.org

This website offers extensive articles and resources on the topic of

vision and disabilities.

Optometrists Network
58 Mohonk Road
High Falls, NY 12440
Website: www.optometrists.org

This website offers a directory of participating optometrists, as well as

useful articles, and links to other websites relating to learning
disabilities. It also contains child-friendly pages that discuss vision
difficulties, games and screening tests for older children, and a link to
anecdotal reports from parents whose children have shown success
following vision therapy.

Pacer Center, Inc.

8161 Normandale Boulevard
Bloomington, MN 55437, USA
Telephone: +1 (800) 537-2237
Website: www.pacer.org
 This is a parent information and training center for families of children
and youth with all types of disabilities. It offers publications,
workshops, and other resources including a national bullying prevention
center.

Sensory Processing Disorder Foundation

5420 S. Quebec Street, Suite 135
Greenwood Village, CO 80111, USA
Telephone: +1 (303) 794-1182
Website: www.sinetwork.org

This website offers a wealth of information pertaining to sensory

processing disorder, including research, treatment options, and tips and
strategies for children and families.

Sensory Smarts
Website: www.sensorysmarts.com

This website provides great information about sensory processing,

including how to find an occupational therapist, suggestions for sensory
diet activities, practical suggestions for common problems at home and
school, and where to find specialty toys and products addressing
sensory needs.

Special Needs UK
Website: www.specialneedsuk.org

This website offers comprehensive information about schools and

parent support groups for children of all ages within the United
Kingdom.

United Kingdom Government

Website: www.gov.uk/children-with-special-educational-
needs/overview

This government sponsored link outlines the process for obtaining

assessment and special education services for children with special
 needs in the United Kingdom.

United States Department of Education

Website: http://idea.ed.gov

This governmental link provides a description of the federal Individuals

with Disabilities Education Act, which provides for early intervention,
special education, and related services to children ages 0 through 21
residing in the United States.

Zero to Three: National Center for Infants, Toddlers, and Families

1255 23rd Street
Washington, DC 20037, USA
Telephone: +1 (202) 638-1144
Website: www.zerotothree.org

This is a non-profit, multidisciplinary organization that serves to inform,

educate, and support adults who influence the lives of infants and
toddlers.

OTHER RECOMMENDED ACTIVITY GUIDES

Angermeier, P., Krzyanowski, J. and Moir, K.K. (2009) Learning in
Motion: 101+ Sensory Activities for the Classroom, 2nd edition.
Arlington, TX: Future Horizons.
Arwine, B. (2011) Starting Sensory Therapy: Fun Activities for the Home
and Classroom. Arlington, TX: Future Horizons.
Beckerleg, T. (2008) Fun with Messy Play: Ideas and Activities for
Children with Special Needs. London: Jessica Kingsley Publishers.
Biel, L. and Peske, N. (2005) Raising a Sensory Smart Child: The
Definitive Handbook for Helping Your Child with Sensory Integration
Issues. New York: Penguin Books.
Brack, J.C. (2009) Learn To Move, Moving Up! Sensorimotor Elementary-
School Activity Themes. Shawnee Mission, KS: Autism Asperger
Publishing Co.
Brack, J.C. (2004) Learn To Move, Move To Learn. Shawnee Mission, KS:
Autism Asperger Publishing Co.
Brady, L.J., Gonzalez, A.X., Zawadzki, A. and Presley, C. (2011) Speak,
Move, Play and Learn With Children on the Autism Spectrum. London:
Jessica Kingsley Publishers.
Bruni, M. (2006) Fine Motor Skills for Children with Down Syndrome: A
Guide for Parents and Professionals. Bethesda, MD: Woodbine House.
Delaney, T. (2009) 101 Games and Activities for Children with Autism,
Asperger’s, and Sensory Processing Disorder. New York: McGraw-Hill.
Drew, S. and Atter, E. (2008) Can’t Play Won’t Play: Simply Sizzling Ideas
to get the Ball Rolling for Children with Dyspraxia. London: Jessica
Kingsley Publishers.
Griffin, S. and Sandler, D. (2009) Motivate to Communicate! 300 Games
and Activities for Your Child with Autism. London: Jessica Kingsley
Publishers.
Haldy, M. and Haack, L. (1999) Making It Easy: Sensorimotor Activities at
Home and School. San Antonio, TX: Psychological Corporation.
Hickman, L. and Hutchins, R.E. (2010) Eyegames: Easy and Fun Visual
Exercises: An OT and Optometrist Offer Activities to Enhance Vision,
2nd edition. Arlington, TX: Sensory World.
Jacobs, D.S. (2012) Everyday Activities to Help Your Child With Autism:
Simple Exercises to Boost Functional Skills, Sensory Processing and
Coordination. London: Jessica Kingsley Publishers.
Jereb, D. and Jereb, K. (2010) Move About Activity Cards. Arlington, TX:
Sensory World.
Koscinski, C. (2012) The Pocket Occupational Therapist for Families of
Children With Special Needs. London: Jessica Kingsley Publishers.
Kranowitz, C. (2006) The Out-Of-Sync Child Has Fun: Activities For Kids
With Sensory Disorder, revised edn. New York: Perigee Trade.
Kurtz, L.A. (2008) Understanding Motor Skills in Children with Dyspraxia,
ADHD, Autism, and Other Learning Disabilities. London: Jessica
Kingsley Publishers.
Kurtz, L.A. (2006) Visual Perception Problems in Children with ADHD,
Autism, and Other Learning Disabilities. London: Jessica Kingsley
 Publishers.
Moor, J. (2008) Playing, Laughing and Learning with Children on the
Autism Spectrum: A Practical Resource of Play Ideas for Parents and
Carers, 2nd edition. London: Jessica Kingsley Publishers.
Sher, B. (2009) Early Intervention Games: Fun, Joyful Ways to Develop
Social and Motor Skills in Children With Autism Or Sensory Processing
Disorders. Hoboken, NJ: Jossey-Bass.
Smith, B.A. (2011) From Rattles to Writing: A Parent’s Guide to Hand
Skills. Framingham, MA: Therapro, Inc.
Smith, B.A. (1998) The Recycling Occupational Therapist: Hundreds of
Simple Therapy Materials You Can Make. Tucson, AZ:Therapy Skill
Builders.
Tilley, K. (2011) Active Imagination Activity Book: 50 Sensorimotor
Activities for Children to Improve Focus, Attention, Strength, and
Coordination. Arlington, TX: Sensory World.
Winders, P.C. (1997) Gross Motor Skills in Children With Down Syndrome:
A Guide For Parents and Professionals. Bethesda, MD: Woodbine
House.
Zysk, V. and Notbohm, E. (2010) 1001 Great Ideas for Teaching and
Raising Children with Autism or Asperger’s, 2nd edition. New York:
McGraw-Hill.

FREE ONLINE RESOURCES FOR

SENSORIMOTOR LEARNING
Activity Village (www.activityvillage.co.uk)

This website is an extensive resource offering free learning games and

activities for children.

All Kids Network (www.allkidsnetwork.com)

This website offers a wealth of craft ideas, worksheets, games, and

puzzles.
Artists Helping Children (www.artistshelpingchildren.org)

This site includes an extensive list of homemade toys and crafts for
children of all ages, with very clear, easy to follow directions and many
free printables.

Blue Bonnet Village (www.bluebonnetvillage.com/recipes.htm)

This website has a great list of simple recipes for homemade clay, craft
dough (including several that are edible), and paints.

Brain Connection (www.brainconnection.positscience.com)

This website has a section offering online brainteasers and memory

games, generally more difficult and geared towards teenager or young
adult audiences.

Childhood101 (www.childhood101.com/playopedia)

This website offers a comprehensive reference network of unique play

ideas organized by different categories of play.

Dance Mat Typing (www.bbc.co.uk/schools/typing/flash/stage1.shtml)

Free, on-line, typing games and activities for all levels of keyboarding
skill.
DLTK (www.dltk-kids.com)

This popular website has links to a wide range of craft ideas,

worksheets, and printables. It features especially helpful ideas for
holidays and educational themes.

Eye Can Learn (www.eyecanlearn.com)

This website offers free activities and exercises designed to improve

visual tracking scanning skills, eye teaming, and visual perception
skills.
Free Preschool Crafts (www.freepreschoolcrafts.com)

This website includes a wonderful collection of craft ideas using

inexpensive and recycled materials.

Free Typing Games (www.freetypinggame.net)

This website offers free, theme-based games for learning keyboarding

skills.

Handwriting Worksheets (www.handwritingworksheets.com)

This website offers custom-made handwriting practice sheets.

OT Mom Learning Activities (www.ot-mom-learning-activities.com)

Developed by an occupational therapist, this website suggests a wide

range of activities to support sensorimotor learning with clear
photographs of children participating in each activity.

PapaJan (www.activitypad.com)

This website offers many printable games and activities suitable for
preschoolers, as well as a variety of online games to help develop visual
attention and perception.

Printable Mazes (www.printablemazes.net)

This website offers free downloadable mazes, mostly suitable for older
children.

School Sparks (www.schoolsparks.com)

This website offers a wide variety of free worksheets for developing

school readiness skills, with particular emphasis on improving auditory
perceptual skills, visual discrimination, and fine motor skills.

Small School OT (https://sites.google.com/site/smallschoolot)

 Developed by an occupational therapist, this website offers extensive
activity resources and internet links for parents, teachers, and students.

Therapy Fun Zone (www.therapyfunzone.com)

This website features activities recommended by occupational therapists

and physical therapists, including free printables (activities, cutting
templates, pencil fun templates, paper folding templates). Therapy toys
and materials are also sold at this site.

Therapy Street (www.therapystreetforkids.com)

A website offering activities and printables, as well as fun recipes for

putty, fingerpaints, and various tactile games.

Your Therapy Source (www.yourtherapysource.com/freestuff.html)

This website offers a wide range of activities suitable for therapy or

special education needs.

BOOKS THAT INTRODUCE YOUNG

CHILDREN TO CONCEPTS RELATED TO
DISABILITIES AND SENSORY PROCESSING
DISORDER
Band, E.B. and Hecht, E. (2001) Autism Through a Sister’s Eyes. Arlington,
TX: Future Horizons.
(Asperger’s and high-functioning autism, ages 8 and older)
Betancourt, J. (1995) My Name is Brain Brian. Danbury, CT: Scholastic
Paperbacks.
(Learning disabilities, ages 8 and older)
Birdseye, T. (1996) Just Call Me Stupid. New York: Puffin Books.
(Dyslexia, ages 8 and older)
Edwards, B. and Armitage, D. (2012) My Brother Sammy is Special. New
York: Sky Pony Press.
(Autism, ages 5 and older)
Fenner, C. (1997) Yolanda’s Genius. New York: Aladdin Publishers.
(Learning disabilities, ages 8 and older)
Filing, V. (1997) Be Good To Eddie Lee. New York: Philomel Books.
(Down syndrome, ages 4–10)
Gainer, C. (1998) I’m Like You, You’re Like Me: A Child’s Book About
Understanding and Celebrating Each Other. Minneapolis, MN: Free
Spirit Publishing Inc.
(General disability, ages 5–9)
Harding, J. (2011) Ellie Bean The Drama Queen: A Children’s Book About
Sensory Processing Disorder. Arlington, TX: Sensory World.
(Sensory processing disorder, ages 5–9)
Hoopman, K. (2012) Inside Asperger’s Looking Out. London: Jessica
Kingsley Publishers.
(Asperger’s, ages 5 and older)
Hoopman, K. (2008) All Dogs Have ADHD. London: Jessica Kingsley
Publishers.
(ADHD, ages 5 and older)
Hoopman, K. (2006) All Cats Have Asperger Syndrome. London: Jessica
Kingsley Publishers.
(Asperger’s, ages 5 and older)
Hoopman, K. (2001) Of Mice and Aliens. London: Jessica Kingsley
Publishers.
(Asperger’s, ages 6 and older)
Janover, C. (2000) How Many Days Until Tomorrow? Waldoboro, ME:
Goose River Press.
(Dyslexia, ages 8 and older)
Kraus, J. (2004) Cory Stories: A Kid’s Book About Living With ADHD.
Washington, DC: Magination Press.
 (ADHD, ages 5–10)
Lears, L. (1998) Ian’s Walk: A Story About Autism. Morton Grove, Il:
Albert Whitman & Company.
(Autism, ages 5 and older)
Lewis, B. (2007) In Jesse’s Shoes: Appreciating Kids With Special Needs.
Grand Rapids, MI: Bethany House Publishers.
(Sibling issues, ages 4–9)
Lowell, J. and Tuchel, T. (2005) My Best Friend Will. Shawnee Mission,
KS: Autism Asperger Publishing Co.
(Autism, ages 5 and older)
Moss, D. (2006) Shelley, the Hyperactive Turtle. Bethesda, MD: Woodbine
House.
(ADHD, ages 4–9)
Nadeau, K.G. and Dixon, E.B. (2004) Learning To Slow Down and Pay
Attention, 3rd edition. Washington, DC: Magination Press.
(ADHD, ages 6 and older)
Ogaz, N. (2008) Buster and the Amazing Daisy. London: Jessica Kingsley
Publishers.
(Asperger’s, ages 10 and older)
Peralta, S. (2002) All About My Brother: An Eight-Year-Old Sister’s
Introduction to Her Brother Who Has Autism. Shawnee Mission, KS:
Autism Asperger Publishing Co.
(Autism, ages 4 and older)
Polacco, P. (2012) Thank You, Mr. Falker. New York: Philomel.
(Learning disabilities, ages 5–8)
Renna, D.M. (2007) Meghan’s World: The Story of One Girl’s Triumph
Over Sensory Processing Disorder. Center Moriches, NY: Indigo
Impressions.
(Sensory processing disorder, ages 5 and older)
Robb, D.B. (2004) The Alphabet War: A Story About Dyslexia. Morton
Grove, IL: Albert Whitman & Co.
 (Dyslexia, ages 7–10)
Rothe-Fisch, M. (2009) Sensitive Sam: Sam’s Sensory Adventure Has a
Happy Ending. Arlington, TX: Future Horizons.
(Sensory processing disorder, ages 6 and older)
Schnurr, R.G. (1999) Asperger’s Huh? A Child’s Perspective. Ottowa, Ont.:
Anisor Publishers.
(Asperger’s, ages 6–12)
Shriver, M. (2001) What’s Wrong With Timmy? New York: Little Brown
Books for Young Readers.
(Mental retardation, ages 2–6)
Smith, M. (1997) Pay Attention, Slosh! Grove, IL: Albert Whitman &
Company.
(ADHD, ages 8 and older)
Steiner, H. (2012) This Is Gabriel, Making Sense of School: A Book About
Sensory Processing Disorder, 2nd edn. Arlington, TX: Sensory World.
(Sensory processing disorder, ages 7 and older)
Thompson, M. (1992) My Brother, Matthew. Rockville, MD: Woodbine
House.
(Mental retardation, ages 4–10)
Tourville, A.D. (2010) My Friend Has Autism. Mankato, MN: Picture
Window Books.
(Autism, ages 5 and older)
Tourville, A.D. (2010) My Friend Has ADHD. Mankato, MN: Picture
Window Books.
(ADHD, ages 5 and older)
Tourville, A.D. (2010) My Friend Has Down Syndrome. Mankato, MN:
Picture Window Books.
(Down syndrome, ages 5 and older)
Tourville, A.D. (2010) My Friend Has Dyslexia. Mankato, MN: Picture
Window Books.
(Dyslexia, ages 5 and older)
Veenendall, J. (2009) Why Does Izzy Cover Her Ears? Dealing With
Sensory Overload. Shawnee Mission, KS: Autism Asperger Publishing
Co.
(Sensory processing disorder, ages 6 and older)
Veenendall, J. (2008) Arnie and His School Tools: Simple Sensory Solutions
That Build Success. Shawnee Mission, KS: Autism Asperger Publishing
Co.
(Sensory processing disorder, ages 6 and older)
Welton, J. (2008) Adam’s Alternative Sports Day: An Asperger Story.
London: Jessica Kingsley Publishers.
(Asperger’s, ages 8 and older)
Wilson, L.F. (2009) Squirmy Wormy: How I Learned To Help Myself.
Arlington, TX: Sensory World.
(Autism and sensory processing disorder, ages 6 and older)
Wine, A. (2005) What It Is To Be Me! An Asperger Kid Book. Fairdale, KY:
Fairdale Publishing.
(Asperger’s, ages 4 and older)
Zimmett, D. (2001) Eddie Enough! Rockville, MD: Woodbine House.
(ADHD, ages 4 and older)
 GLOSSARY

Accommodation: the ability to use the eye muscles to focus as objects

move closer or farther away from the eyes.
Ambyopia: the loss of visual acuity due to disuse of vision as opposed to
acuity impacted by a refractive error or eye disease. Also referred to as
“lazy eye.”
Auditory processing disorder: difficulty understanding and responding to
sounds or language.
Bilateral integration: The neurologic process of organizing sensations
from both sides of the body to allow smooth, coordinated, and reciprocal
movement between the two body sides.
Binocular vision: the ability of the visual system to convert the images
from each eye into a single image for the brain to interpret.
Body awareness: (see proprioception).
Depth perception: using the visual feedback from both eyes to judge the
distance of an object.
Developmental milestones: skills that most children can be expected to
achieve at a predictable age, for example, taking a first step at 11 to 13
months of age.
Developmental optometrist: an eye care professional with advanced
training vision problems related to childhood development and learning.
Discriminative tactile sensations: perception of tactile input leading to an
awareness of the size, shape, temperature or texture of an object, or of
body sensations like hunger or thirst.
Distal: pertaining to parts of the body that are far away from the midline or
the trunk.
Double-jointedness: having an increased range of motion in a joint
compared to others.
Dynamic balance: maintaining balance while the body is in motion, for
example when walking across a balance beam or climbing stairs.
Dyslexia: a specific learning disability characterized by difficulty learning
to read fluently and with good comprehension despite normal
intelligence.
Dyspraxia: limited ability to plan and carry out unfamiliar motor activities
with skill. Also referred to as poor motor planning.
Education Act of 1996: this is the legislation that governs access to a broad
and balanced National Curriculum for students with physical or learning
disabilities residing in the United Kingdom.
Endurance: the ability to sustain physical effort over time.
Extraocular muscles: also called the extrinsic eye muscles—the six
muscles that surround and control the movement of each eye.
Feedforward: sensory information that helps to predict what is needed to
perform an action successfully; for example, when catching a ball, vision
informs the speed and size of the ball to be caught, and proprioception
informs whether the hands are positioned correctly.
Fine motor: referring to the smaller muscles of the hands, mouth, and eyes
that are involved in precision movements.
Gross motor: referring to the larger, weight bearing muscles that control
posture, balance, and large movements such as those involved in
walking, running, or climbing stairs.
Hyperresponsive: unusually alert to a sensory experience.
Hypertonia: (see muscle tone).
Hyporesponsive: unaware of a sensory experience that others would
typically notice.
Hypotonia: (see muscle tone).
Individuals with Disabilities Education Act (1996): Along with the
Individuals with Disabilities Improvement Act of 2004, this United
 States legislation provides for a free and appropriate education for all
eligible students with disabilities ages birth through 21.
In-hand manipulation: moving objects within the hand using only the
small muscles of the hand.
Manual dexterity: skill and ease with which one can use the hands to
perform rapid, automatic fine motor movements.
Motor planning: (see praxis).
Muscle tone: The degree of tension present in muscles when at rest or
when passively moved, which may range from low to high; children with
low tone (hypotonia) typically have poor posture and increased joint
mobility, while children with high tone may have stiff movements and
limited flexibility.
Perceptual reasoning: the ability to understand and find relationships
between visually presented, non-verbal stimuli, such as pictures or
objects; a set of skills related to overall intelligence that are typically a
good indicator of problem solving and organizational skills.
Postural stability: the ability to control the center of mass in relation to the
base of support in order to feel steady, to move with control, and to
prevent falling.
Praxis: Also called motor planning—the ability to plan, organize,
sequence, time, and execute unfamiliar motor activities in a skillful
manner.
Proprioception: the unconscious sensation of body position and movement
that stems from sensory receptors in the joints, muscles, and tendons.
Proximal: pertaining to parts of the body that are close to the midline or the
trunk.
Protective tactile sensations: tactile sensory experiences that alert the
person to potential danger and trigger a reflexive need to move away
from that danger.
Radial: pertaining to the side of the hand closest to the thumb.
Section 504 of the Rehabilitation Act of 1973: This is a United States
civil rights law that prevents discrimination to citizens with disabilities
 when they access publicly funded resources. In certain situations,
children with disabilities or health-related concerns may be eligible for
accommodations to their public school program under this act.
Sensory reception: the process that occurs when an organ of reception
(such as the eyes or the ears) is stimulated by an event (such as a visual
image or a sound), so that that information can be transmitted to the brain
for interpretation.
Sensory integration: the brain’s way of organizing sensory inputs to allow
for an adaptive response.
Sensory integration disorder: problems with filtering or interpreting
sensory inputs needed for learning or behavioral self-regulation—
sometimes referred to as sensory processing disorder.
Sensory modulation: The ability to appropriately filter sensory input in
order to maintain an appropriate level of alertness and behavioral self-
regulation.
Sensory perception: the brain’s interpretation of sensory experiences.
Sensory processing disorder: (see sensory integration disorder).
Spatial awareness: an awareness of one’s body in space, and the
relationship of one’s body to other objects in space.
Special Education Needs (SEN): this is the umbrella term used in the
United Kingdom to describe those aspects of public school education
focusing on students with physical or learning disabilities.
Static balance: maintaining balance while the body is still, for example
standing on one foot without falling.
Strabismus: poor alignment of the eyes.
Strength: the amount of force produced during a muscle contraction.
Tactile defensiveness: problems with perception of certain tactile
experiences often leading to strong emotional reactions, hyperactivity, or
other behavioral difficulties.
Ulnar: pertaining to the side of the hand closest to the pinky finger.
Vestibular: pertaining to the sensory system, located within the inner ear,
that provides information about gravity, body movement within space,
and head position. This sense plays an important role in balance, motor
planning, and coordinated eye movements.
Visual acuity: the ability to see clearly. Problems seeing things that are far
away is called nearsightedness, and problems seeing things up close is
called farsightedness.
Visual attention: the ability to apply conscious effort to focus and persist
with viewing a visual stimulus.
Visual closure: the ability to recognize pictures or forms that are
incomplete.
Visual form constancy: an understanding that visual stimuli can look
different, yet mean the same thing, such as a word presented in different
fonts or styles of writing.
Visual discrimination: the ability to use vision to recognize the basic
attributes of an object, such as size, shape or color.
Visual efficiency disorders: problems with eye muscle control that make it
hard to maintain visual focus or to visually track a moving target.
Visual figure-ground discrimination: the ability to separate foreground
from background visual stimuli in order to focus on the most important
details.
Visual memory: The ability to recall visually presented information.
Visual-motor integration: the ability to coordinate visual information with
fine or gross motor skills to produce a well-executed response to an
environmental demand requiring motion.
Visual perception: an assortment of information processing skills that
allow a person to understand what is seen.
Visual sequential memory: the ability to recall a series of visual stimuli in
the correct order.
Visual-spatial perception: the ability to recognize the orientation and
position of an object relative to other objects or to oneself.
Working memory: immediate recall of information that has been recently
presented.
 LIST OF ACTIVITIES

Air traffic controller 61

Angels in the snow 28
Balance beam 29
Balloon twister 35
Basic visual memory games 83
Beat the clock 51
Belly time 34
Blowing in the wind 115
Bottle bowling 61
Bubble blaster 57
Bubble wrap 62
Button box 86
Button snake 67
Charades 43
Color on command 118
Copy the sound 119
Crab-walk soccer 38
Cutting sandwiches 64
Deep-sea diving for treasure 106
Dizzy discs 111
Do you hear what I hear? 119
Don’t shake the table games 107
Dressing in the dark 113
Edible chew necklace 105
Egg races 36
Egg timer errands 110
Feel-it bag 109
Find that finger 107
Find-it bag 92
Finger pals 92
Flashlight tag 80
Gel bags 76
Go fishing 54
Goop on a tray 103
Grabber games 60
Haunted house 65
Hide and seek for the eyes 79
Homemade labyrinth game 89
Homemade lacing cards 89
Homemade ring toss 67
I went to the gym… 44
If I had a hammer 114
Log roll 32
Magic carpet 28
Make-a-kite 33
Making hidden pictures 91
Making statues 30
Marble roller 77
Match that sound 120
Memory cards 90
Mirror drawing 117
Monkey toes 37
My bouncing ball 111
My color book 78
My listening game 117
Name that letter 114
Name that tune 116
Obstacle course 31
Paddle ball 79
Paper snowballs 53
Pattern memory games 84
Pompom magnets 76
Pop goes the feeling 108
Puff ball 81
Push-ins 66
Putty games 58
Puzzling 87
Rainbow writing 50
Recipe for a squeeze 105
Rhythm sticks 43
Rubber band ball 63
Scooping cups 40
Secret envelopes 56
Sensory search 103
Shadow maker 42
Spaghetti shapes 104
Spoon relay 85
String art 88
Suncatchers 52
Tap the ball 57
The detective game 82
The dot map 85
The dress-up race 41
The hole-in-one game 93
The marshmallow factory 55
The muncher man 59
The popcorn game 39
The supermarket game 35
The turkey baster game 59
Tissue art 64
Toothpick tunnel 81
Treat boxes 68
T-stool games 31
Wall push-ups 112
What’s next? 87
Wheelbarrow walk 27
Windmakers 54
Yoga balls 38
Zoom tube 40
Also available

Understanding Motor Skills in Children with

Dyspraxia, ADHD, Autism, and Other Learning
Disabilities
A Guide to Improving Coordination
Lisa A. Kurtz
Part of the JKP Essentials series
ISBN 978 1 84310 865 8
eISBN 978 1 84642 672 8

‘The book is user-friendly and includes clear diagrams in each section,

along with tables to outline key points. I found these very useful and they
are an easy reference/ reminder, for example, they include a normal
development chart, what assessments are available and their main aims.’
– National Association of Paediatric Occupational Therapists

Coordination problems often make everyday activities a challenge for

children with learning disabilities. This accessible manual offers practical
strategies and advice for helping children with coordination difficulties.
The author explains how to recognize normal and abnormal motor
development, when and how to seek help, and includes specific teaching
strategies to help children with coordination difficulties succeed in the
classroom, playground, and home. She describes a wide range of
therapeutic methods and provides a comprehensive list of resources.
Full of practical help, this is essential reading for anyone caring for, or
working with, children with developmental motor concerns.