What’s Wrong with W-Sitting?

Thursday, December 18th, 2014

Lots of children without any diagnosis W-sit. So do many children with low muscle tone, developmental delays, cognitive disabilities and motor delays.

While many children W-sit some of the time, they can easily transition out of it with a simple “friendly feet” kind of reminder. It is of concern when W-sitting is the child’s primary way of sitting on the floor to play. It can inhibit trunk mobility, balance reactions in the trunk, crossing the midline, and prevent children from reaching all around them and behind them to grab toys. For children who have motor delays, it feeds into patterns that can ultimately be harmful to the muscles and joints, and interfere with the development of higher level motor skills.

With patience and perseverance you can make a big change. At first you might have to unfurl your child’s legs and place them in side sitting or criss-cross-applesauce, but eventually you will just need to give them a cute cue, like “friendly feet.”


This entry was posted on Thursday, December 18th, 2014 and is filed under Boost Gross Motor Coordination & Rhythmicity.

Reap the Benefits of OT in the Pool at POTS

Wednesday, May 28th, 2014


Strengthening: Negotiating the water requires your child to use all of his/her muscles. Your child’s core, arms and legs, will become stronger while playing against the resistance naturally provided by the water.

Coordination: Swimming requires a lot of coordination! While each stroke is different, they all require simultaneous movement from your child’s arms and legs in many different combinations: symmetrical, asymmetrical, in-phase, out-of-phase, contralateral and ipsilateral. As your child moves through the water using arms and/or legs with various fun floatation devices, he/she will learn how to coordinate multiple movements in multiple body parts at the same time, which is fundamental to coordination and motor planning.

Sensory input: Swimming is a great way to get a lot of powerful sensory input in a short amount of time. The water itself provides deep pressure input to the whole body at once. The constant sensation of the water can help to decrease the tactile hypersensitivity that your child may experience out of the water. The water also provides proprioceptive input, which boosts body awareness and the sense of body position in space. Changing the position of your child’s head when swimming on the back, front, side, vertically and under water provides vestibular input, which also contributes to the sense of body position in space. Touch, proprioception and vestibular input are the building blocks of motor planning.

Social skills and communication: Eye contact and vocalization are often enhanced because of the sensory properties of the water and the natural boundaries of the pool.

Contact us at chaye@potsot.com or call our office at 201-837 9993 to explore whether pool-based occupational therapy is appropriate for your child.

This entry was posted on Wednesday, May 28th, 2014 and is filed under Boost Gross Motor Coordination & Rhythmicity, Gross Motor Activities, Seasonal Tips, Uncategorized.

What’s App Wednesday: MetroTimer

Thursday, June 27th, 2013

What is it?

MetroTimer (iPhone/iPad app; Free) is a digital metronome. A metronome is used to keep a steady beat and typically used by musicians to help improve rhythm, timing and speed. This metronome can be set to a speed ranging from 40 bpm (beats-per-minute) to 208 bpm. There are eight options of metronome sounds and a flashing light (optional) accompanies the sound of the beat.

What can a metronome help my child achieve?

What are some metronome activities to try?

Pick a specific speed between 40 and 60 bpm. Check with your occupational therapist first to determine what speed is the most appropriate for your child.

Try doing the following activities “to the beat”:

  • Clap both hands
  • Tap your shoulders or knees
  • March in place
  • Hit a target on the wall with one or both hands
  • Hit a target on the floor with one or both feet

To increase the challenge, choose activities that require crossing the midline of the body:

  • “Cross Crawl”: Alternate touching your right hand to your left knee and your left hand to your right knee
  • Hand games such as “Miss Mary Mac.”
  • Sit back to back and pass a ball to each other by rotating from side to side

Get as silly as possible to keep your child engaged and encourage creativity:

  • Stick your tongue out to the beat
  • Make animal noises to the beat
  • Move like different animals
  • Lie on your back and move your feet in the air


For more information on digital metronome check out http://www.potsot.com/stick-to-the-beat.html


Submitted by:  Ariela Warburg Harcsztark, OTR/L

This entry was posted on Thursday, June 27th, 2013 and is filed under Boost Gross Motor Coordination & Rhythmicity, What's App Wednesday.

What’s App Wednesday: FitQuest Lite

Wednesday, June 19th, 2013

How to Play:

In “FitQuest Lite” (iPhone/iPad app; Free) jogging, jumping and ducking, takes the squirrel on an adventure down paths, over snakes and under eagles. The squirrel’s actions are generated by the child’s movements.

What are the benefits?

  • Endurance and strength: Jogging promotes endurance. Jumping and squatting builds lower body strength. For a child with poor endurance, start with a few seconds of jogging and slowly increase time spent using the app.
  • Sensory modulation: Jumping provides proprioceptive input and the up and down of jumping and ducking provides vestibular input. The child must modulate responses by jogging, jumping and ducking in a goal directed and organized manner.
  • Timing & projected action sequencing: Jumping over and ducking under obstacles encourages anticipation and timing of movements according to what is happening in the environment.

Who is it for?

This app is appropriate for preschool aged children through adults!

Why we love it!

Children who lack a refined sense of body in space often rely on vision to navigate the environment. This app provides visual feedback (the squirrel) while providing proprioceptive and vestibular input (jumping and ducking) that will enhance body in space and gradually reduce over-reliance on visual cues.

Submitted by:  Ariela Warburg Harcsztark, OTR/L

This entry was posted on Wednesday, June 19th, 2013 and is filed under Boost Gross Motor Coordination & Rhythmicity, What's App Wednesday.

Teaching Right versus Left

Thursday, June 13th, 2013

Teaching right versus left is not an easy process. Studies report that children learn right and left best when it is compared to their own bodies. Using your child’s hand dominance is a great starting point. If you don’t know your child’s dominant hand, observe which side is used most frequently for daily activities such as eating and brushing teeth. To detect leg dominance, try rolling a ball on the ground in a straight line and see which leg is used most frequently to kick the ball.

Some activities that can help your child develop an understanding of right and left are:

  • Singing the Hokey Pokey (ex. Put your right leg in and shake it all about).
  • Tickling or squeezing the child’s dominant side. For example, if your child is right side dominant, say “raise your right hand” and tickle them underneath!
  • Try implementing right and left during daily activities. For example, say: “we are crossing the street and I want to hold your right hand.” Make sure to squeeze their hand so they get that gentle input. Another example is during dressing. Say to your child, “put your right hand in” etc.

Helpful Hints:

  • Learning right and left is challenging, so be patient!
  • Activities that target right/left concepts should follow or coincide with intense movement activity and “heavy work” such as wheel barrow walking (to heighten body awareness).
  • Use your own body to demonstrate right and left, but make sure to stand next to the child (and not opposite).

Adapted from http://www.kidspot.com.au/schoolzone/Learning-games-Best-teaching-practices-for-left-vs-right+4249+316+article.htm

Submitted by: Sarah Small, Occupational Therapy Student

This entry was posted on Thursday, June 13th, 2013 and is filed under Boost Gross Motor Coordination & Rhythmicity.

Balloon Bop Benefits

Thursday, January 10th, 2013

“Balloon Bop” is a fun gamwe often play at POTS. It involves using a balloon, and hitting (or bopping) it to keep it from dropping to the ground. Not only is it an enjoyable game, but it can be used to address a number of therapeutic objectives.

Eye-hand coordination: In general, using a balloon is an excellent way to work on eye-hand coordination because it moves much more slowly than a ball, and allows for additional time to visually track it and prepare to hit it.

Right/left discrimination: Balloon Pop is a great game for learning or reinforcing right versus left. Begin by having your child bop the balloon back to you by alternating hands (right, left, right, left). Next, call out which hand your child should use to bop the balloon. Keep your child on his/her toes by using an irregular pattern so that he/she cannot predict what you will say. If your child benefits from proprioceptive input, play the same game with a light beach ball or a heavier 7-9 inch rubber ball.
Body awareness: Once your child has gotten the hang of the game, call out a body part with which he/should bop the balloon back to you, such as an elbow, knee, shoulder, or foot. You can facilitate right/left discrimination and body awareness together by giving instruction such as, “bop the balloon with your right elbow.”

Balance: Challenge your child’s balance by having him/her stand on an unstable surface, such as a BOSU while bopping the balloon, which will require him/her to make dynamic postural adjustments. To begin, bop the balloon directly to your child. Once this has been mastered, challenge him/her to reach out of his/her base of support (further away from where he/she is standing) in order to make contact with the balloon by bopping it just short of your child or to either side.

Blog written by: Aviva Goldwasser, MS, OTR/L & Chaye Lamm Warburg, DPS, Director of POTS

Follow our blog on www.potsot.com, on Facebook and Twitter.

This entry was posted on Thursday, January 10th, 2013 and is filed under Boost Gross Motor Coordination & Rhythmicity, Parenting.

Gross Motor Dice Roll

Monday, January 7th, 2013

The cold winter weather poses a challenge to playing outdoors, and not many parents are keen about having their children use the house as an indoor gym. This DIY game gets your children moving in an organized manner and lets them practice building their gross motor skills in a fun way. It is simple to create, and offers portability, so you can take it with you when your family is on the go.

To make your own dice, you will need two over-sized plush or inflated dice. On each of the 6 sides of one die, assign a different gross motor activity such as: jumping, hopping, skipping, galloping, stride jumps, jumping jacks, crab walking and frog jumping. When the die is rolled, whichever activity is facing up needs to be done. Feel free to use any gross motor activity or movement that you feel would benefit your child or that your therapist has suggested for your child’s home program. For children who do not yet read, use a picture to depict each activity.

Roll the second die to determine how many repetitions of each activity should be done. One way to make the activity more challenging is by adjusting the repetitions. For instance, you may begin by having your child do their activity one time for each dot on the dice (i.e. if a 6 is rolled, your child will jump 6 times). Then, to increase the challenge, each dot on the dice can represent 2,3,4 or 5 times that the motor activity should be done (i.e. if a 6 is rolled, your child will jump 30 times).

Be sure to take turns! If you are part of the process the game will be fun, rather than “homework.”

Blog written by: Aviva Goldwasser, MS, OTR/L & Chaye Lamm Warburg, DPS,    Director of POTS
Follow our blog on www.potsot.comhttp://www.facebook.com/potskids, and http://www.twitter.com/pots3

This entry was posted on Monday, January 7th, 2013 and is filed under Boost Gross Motor Coordination & Rhythmicity, Gross Motor Activities, Parenting, Seasonal Tips.

Chinese Jump Rope

Thursday, July 19th, 2012

I have fond memories of playing Chinese jump rope as a child. Now that I am an occupational therapist, I appreciate this pastime for its therapeutic benefits and convenience as well as fun. Chinese jump rope can be tapped to improve gross motor coordination, motor planning and sequencing, and directionality:

  •  Because there are so many different ways to play Chinese jump rope, it is easy to make the activity more or less challenging based on your child’s ability. For example, begin with the rope at the level of the ankles, and as your child progress, raise the rope incrementally to increase the challenge
  • This is a good activity to help children learn directional terms, such as “in”, “out”, “on top of”, “to the side of”, “over”, “under”, etc.
  • If your child has difficulty understanding the aforementioned terms and/or has difficulty with motor planning, demonstrate the moves for your child so he/she can watch before his/her turn
  • Pair the visual cues (demonstration) with auditory cues by saying the words out loud as you jump
  • Along with demonstration, you can also offer visual cues/aides by creating a drawing of the movement or sequence of moves.  See our moves below!

Here are a few of the features of Chinese jump rope that make it a pragmatic choice:

  •  Chinese jump rope offers versatility in that it can be played individually (simply use legs of a chair to serve as enders in place of additional people), in pairs, or in teams of 4+ players
  • It is highly portable and can travel wherever you go
  • It can be played both indoors and outdoors

See the diagrams below to add more moves to your repertoire.

Blog written by: Aviva Goldwasser, OTR/L

                         Dr. Chaye Lamm Warburg, OTR/L, Director of POTS


 chinese jump rope 1

This entry was posted on Thursday, July 19th, 2012 and is filed under Boost Gross Motor Coordination & Rhythmicity.

Toy Review: Balloon pump

Friday, June 22nd, 2012

Now that the weather is warm, I find that I am spending as many afternoons as possible outdoors with my children. One of their favorite past-times is to make water balloons. Listed below are some of the therapeutic benefits to this fun activity suited for all ages.

To challenge your child’s fine motor coordination place the balloon on the tip of the pump, using the “pinch fingers” (thumbs and index fingers). To fill the balloon once it is in place, be sure that your child is using a thumbs-up position to squeeze down on the lever. (This is the same position that your child uses to hold scissors). Practice good “helping hand” habits, by encouraging your child to stabilize/hold the pump with his/her non-dominant hand while pumping and squeezing with the preferred hand. 

If your child is working on following a series of multi-step directions, place him/her in charge of sequencing the steps of this task. For example, (1) place the balloon on the tip, (2) pump 5 times, (3) and squeeze to the count of 10.

In order to facilitate eye-hand coordination, make a target out of chalk, spray foam soap, or a tree and have your child aim for the target when throwing the water balloon. At first, make the target larger.  Gradually decrease the size to up the ante. Your child can also stand closer or farther from the target, depending on his/her ability.

Don’t waste the water! Once you get to the bottom of the pump, you can squeeze the water out to water a plant. Keep in mind that the heavier the bottle, the greater the challenge to strength.

Blog written by: Aviva Goldwasser, MS, OTR

                         Chaye Lamm Warburg, Director of POTS, DPS

This entry was posted on Friday, June 22nd, 2012 and is filed under Boost Gross Motor Coordination & Rhythmicity, Seasonal Tips.

Using the Nintendo Wii in Occupational Therapy

Thursday, October 7th, 2010

Here we are in the beginning of Fall and some kids are in full sports mode playing soccer or baseball. While the weather is still nice we encourage our kids to get outside and play. But, soon Fall turns into Winter and the kids are inside looking for some ways to play and entertain themselves and they may ask “Mom\Dad, can we go on the Wii?”

Initially we may say “no” because we don’t want to encourage “screen time”, however with a little ingenuity and creativity the Nintendo Wii can be turned into a powerful therapeutic tool. The Wii and Wii Fit games come packaged with numerous activities for strengthening and aerobic activity such as yoga and running. They were designed to be played as you would naturally play any sport. This may become trite over time, so let’s change it up to be more innovative, dynamic and even therapeutic.

To work on shoulder or neck strengthening, try the Wii Fit board.  For the soccer game (in the balance game section) for instance, you can get on your hands and knees, place and push your weight over your hands and try to play the game that way. This encourages neck extension and shoulder strengthening. Still too easy?  Then put your feet\knees on a low chair or low stool and your hands on the board to maintain your full body weight on your hands for a harder challenge.

Looking to gain endurance, try the running game. Instead of running on the floor try standing on a mini trampoline and jump\bounce, or do jumping jacks for the duration of the game. Try sitting on a therapy ball and bounce for extra sensory input. Bouncing on a large ball works with many children who can’t run. You can even put the Wii in front of your treadmill and exercise while playing the game. You can really simulate those hills!

Can’t stand for long periods of time? Then place the Wii board on a chair and sit on the Wii board. Shift your weight from side to side to make the characters move.

If you are playing the Sports games such as baseball, boxing, bowling, you can increase the challenge by putting on wrist weights. Try to improve balance to play the games while standing on a Bosu ball or other unstable challenging surface. This way you are activating your core muscles as well as your shoulder and hand muscles.

There have been studies that indicate that exercising while using virtual reality systems, such as the Wii, tend to be more engaging, interactive, absorbing and FUN! Therefore, people are willing to spend more time and work harder at home exercise programs that include interactive games compared to those exercises that do not include such activities. Your child’s therapist can always recommend specific games and adaptations to meet your child’s individual needs.

So now when the kids ask “Can I play on the Wii?” you can safely respond yes knowing that with a little creativity and ingenuity they are getting a good therapeutic work out.

Gershon Kravetz MS\OTR\L

This entry was posted on Thursday, October 7th, 2010 and is filed under Boost Gross Motor Coordination & Rhythmicity.