Occupational Therapy

Sensory Strategies to Calm and Engage Children with Autism Spectrum Disorder - Estrategias sensoriales para calmar e involucrar a niños con trastorno del espectro autista

Though there is great variability in ASD-related behaviors, occasionally clinicians encounter behaviors so challenging that they interfere with treatment. Some research indicates a relationship between several characteristics—lower nonverbal IQ, lower levels of expressive language, more severe social deficits and more repetitive behaviors—and the incidence of aggression, self-injurious behaviors and tantrums in children with ASD. When confronting such behaviors, clinicians may struggle to keep children on task. They may spend more time managing and addressing behaviors and less time providing treatment, thus limiting progress. OTs frequently work with children with ASD to address their sensory-processing differences. They use a variety of interventions, including sensory integration and sensory-based strategies, to help children organize environmental input and perform daily activities. Such strategies may include jumping, swinging and weight-bearing activities. SLPs are among the other professionals OTs commonly work with—in addition to teachers and parents—in providing sensory strategies to help children attend, participate and communicate.
Si bien existe una gran variabilidad en los comportamientos relacionados con la TEA, en ocasiones los médicos encuentran comportamientos tan desafiantes que interfieren con el tratamiento. Algunas investigaciones indican una relación entre varias características (menor coeficiente intelectual no verbal, niveles más bajos de lenguaje expresivo, déficits sociales más graves y conductas más repetitivas) y la incidencia de agresión, conductas autolesivas y berrinches en niños con TEA. Al confrontar tales comportamientos, los clínicos pueden tener dificultades para mantener a los niños en la tarea. Pueden pasar más tiempo administrando y abordando los comportamientos y menos tiempo brindando tratamiento, lo que limita el progreso. Los OT con frecuencia trabajan con niños con TEA para abordar sus diferencias en el procesamiento sensorial. Usan una variedad de intervenciones, que incluyen integración sensorial y estrategias basadas en la información sensorial, para ayudar a los niños a organizar información ambiental y realizar actividades diarias. Tales estrategias pueden incluir saltos, balanceos y actividades de carga de peso. Los SLP se encuentran entre los otros profesionales con los que los OT suelen trabajar, además de los maestros y los padres, para proporcionar estrategias sensoriales que ayuden a los niños a asistir, participar y comunicarse.
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Activities to improve hand skills

Some activities can be used to help fine motor development and promote and improve hand grasp skills for writing. Nothing is more motivating to a student than toys, games, and play. The activities chosen should be experienced as purposeful. The student should focus on the activities rather than on consciously "working" to improve a skill. Be sure that these activities incorporate both hands and allow for some success as well as a challenge.
Silly Putty - Rolling pieces into words or sculptures
Rolling Coins - Placing coins into coin wrappers by holding a handful of coins in the palm and working them up to the fingers one at a time
Board Games - Play games that involve lots of pieces (such as Pick-Up-Sticks, Jenga, Connect 4, Operation etc.). Use tweezers to pick up/move objects when possible.
Hand Exerciser - Can be purchased from a bargain store or dollar-type store or can use rubber bands to stretch open and closed
Tug of War - Play tug of war with different width materials (a foam pool noodle, a beach towel, or rope).
Longer Holder - Have a competition to see who can hold various sized sports balls (tennis ball, baseball, or softball) the longest with one hand, before dropping it to the ground. Try to beat best self-time
Clothespin Study - Write one letter on each clothespin and spell vocabulary words by clipping pins onto a vertical surface, such as an upright binder
Cooking/Baking - Making/baking a pie- child can inch the edges of a shell crust or make his/her own "turnover" with crimped edges; Hand stirring of cookie dough at increments as dough becomes stiffer or making Rice Crispy treats
Clay Sculpting - Many varieties available from craft/hobby shops including hardening modeling clay, sculpt, (a low temperature, kitchen oven fried clay).
a. Grade difficulty of working the clay with temperature or level of dryness.
b. Grade size of pieces worked with moving from large "sculptures" to smaller forms.
Instruments Lessons - Try piano/keyboard, guitar, bass guitar
Snap fingers - Snap out rhythms to songs or syllables in words
Spin a top - Have a competition to see who can spin the top longer
Use a squirt gun or spray bottle - Have child "clean" windows with water or cleanser, water plants with squirt bottles
Stringing items - Beads, popcorn, cereal, or macaroni onto regular string or shoestring licorice
Use single-hole punchers for art projects - Practice lacing with holes made
Opening containers of all sizes - May need to be loosened first by adult
Using scissors - Cut multiple sheets at once or use cardstock to increase resistance (ensure child is holding them correctly) to make flash cards for math facts, science vocabulary, etc
Working in vertical position - Tape word searches, crosswords, homework, any paper activity to the wall or an easel at eye level
Typing - Using proper keyboarding techniques works on finger isolation skills

Occupational Therapy:

By Sari Ockner, OTR/LSpecial Education Articles

There are many muscles that are responsible for the movements in the hand. To be exact, there are a total of 34 muscles that move the palm, fingers, and thumb. Our fingers actually do not have any muscles inside; their movement comes from the tendons of all the muscles in the palm and forearm. Nine individual muscles control the thumb alone! Many children naturally develop adequate strength in all of these muscles to learn the fine motor skills needed to manipulate toys, dress themselves, and use a pencil and scissors. There are some children however, that do not acquire this strength as easily and need extra attention to gain that necessary strength.

Here are some activities designed to help children with weak hand muscles and poor fine motor skills. 


Play-doh is a great tool. Have your child knead it, roll into logs or small balls with their finger tips, squash it with open palms and use their fingers to mold it into a larger ball. Use cookie cutters too!

You can even make your own:

1/4 cup salt

1 cup flour

1/4 cup water

Have your child mix the flour and salt in a bowl then add water. Knead and squeeze the dough to make a clay consistency. You may need to add more water.

Theraputty is more resistive than Play-doh; it comes in a variety of resistances ranging from soft to extra firm. Hide small items (buttons, coins, beads, etc) inside and have the child pull it apart with their hands and fingers to locate the items. Roll the theraputty into a log and have your child snip it with scissors. This activity can be graded by changing the thickness of the log or using varied levels of resistive putty; adapt according to your children's abilities.


Tongs, tweezers, chopsticks, and clothespin activities use muscles for pinch strength in the hands and subsequently for the muscles used in holding writing tools properly. Always make sure a neutral wrist position and proper pinch grasp are used to maximize strengthening of hand and finger muscles. There are a variety of toys with tongs that can be purchased such as Wok and Roll and the Hungry Dog Motor Skills Game. There are also creative ways to come up with home-made activities such as the two described below.

Label clothespins A to Z and work on spelling words. Clip them onto fabric or a “clothes line” hung slightly above shoulder height of child to incorporate wrist and shoulder muscles in this activity.


Use metal tongs or strawberry pickers to transfer marbles placed on the suction cups of upside down bathtub treads into a narrow mouthed bottle or container.




When children crawl as infants the arches within the palm of the hand develop and strengthen. These are the muscles that allow us to cup a dice and shake it within our hand. Great activities to try with your child to develop and strengthen these arches are crawling on all fours through a tunnel or over uneven surfaces like couch cushions, propelling themselves in a prone position (laying on stomach) on a scooter board, and wheelbarrow walking.


Squeezing activities may include use of a stress balls, large chip bag clips, crumbling large pieces of paper to make snowballs and have a friendly snowball fight! Incorporate spray bottles and water squirt bottles to create chores for your child to clean the table after a meal and water plants. There are a few hand grasp toys (see image below) that children love that can be used to pick up trash or toys during clean up time!

Remember, stronger hands will lead to more independence in self-help tasks like opening food wrappers and manipulating clothing fasteners. Strong hands and fingers will allow your child to play with a variety of toys and fun games that require the use of good fine motor skills. Lastly, good strength in hands and fingers will give your child the foundation to correctly hold a pencil and manipulate scissors with precision.

Sari Ockner, OTR/L received her degree in Occupational Therapy from the University of Wisconsin – Madison in 1998, in their extended Occupational Therapy program with an emphasis in her fieldwork studies in the scope of pediatrics. Sari began her practice in New York City and is currently living and practicing in the Los Angeles area. She has over 13 years of experience working with children with a variety of special needs in school, clinic, and home-based settings. Sari is certified in Sensory Integration Theory and Practice (SIPT) and specializes in handwriting and child development.

Follow Sari on Facebook at Kidz Occupational Therapy or on Twitter at Sari_KidzOT for on-going information to support children in school, at home, and in the community. For further information visit : www.KidzOccupationalTherapy.com

Occupational Therapy

A nice video from the American Occupational Therapy Association on what OT's do.