What's my program going to look like?
Updated: Sep 22, 2019
Every single program is different. As I have received training in so many different areas of development and increased my knowledge base, I have added many more methods. At each appointment with each individual, I often create an activity just for them and their situation.
Working on proprioception - Where the body is in space - high or low tone, issues with gross or fine motor skills. Call also be used for calming and when there is trauma and the brain no longer recognizes the body part.
Realizing every child is different, the following is an activity from my own son's program after he was hurt.
This patient was in a near-fatal car accident ten days before this photo was taken. Doctors and nurses insisted he had significant brain damage and paralysis. They rated his function on the Glasgow coma scale at a 6 or 7 (very low as he was not able to follow simple directions. “open your eyes”, “thumbs up”)….until deep pressure was given to his hand, arm and thumb several times a day for four days.
Thumbs up Glasgow Coma Scale. We did it!!
Feet, legs, hands, & arms should be bare for this exercise. (It is used to increase deep tactile awareness & perception, which is very important for the development of fine & gross motor function; muscle tone, & proprioception.)
Begin w/ the little toe on the right foot. Firmly grasp the end of her little toe w/ your thumb & index finger, & slowly begin to squeeze the end of the toe by applying more & more pressure until a response is elicited. Often resistance is seen by slight flinching or pulling away. Be sensitive to her resistance & hold for a few seconds.
Slow and steady, not fast and intense. The goal of this activity is to raise the pain threshold- therefore, the pressure is applied to the point that she experiences some discomfort & resists any further pressure. Don't stop before you get close to the pain threshold- if you're applying pressure equal to that of a deep massage, then you're probably not squeezing hard enough.
After you've elicited a response, from the end of the little toe, move up the toe & apply pressure to the areas between the joints of the toes, squeezing until you meet resistance. Proceed in like manner w/ each of the toes on the right foot.
Following the toes, apply pressure to the foot. The size of the foot will determine how many spots need to be pressed. (With a small child, one should be sufficient; w/ an adult, you should apply pressure simultaneously to the top & the soles of the foot, hitting two or three areas until the heel is reached.)
From the foot, proceed up the leg to the thigh, making sure that pressure is applied to the point of resistance. (Generally, sensitivity increases as you move from the distal toes to the proximal thigh, & it takes less pressure to elicit a response as you move up the limb to the trunk.)
Repeat the process w/ the left foot & leg next, then
Proceed to the fingers, hand & arm of the right side, & then the left side (after completing both legs)
Don't push to the point of pain! The goal of this activity is to raise the pain threshold-
When applying pressure to the fingers, apply pressure to the ends of each finger & between the joints- do NOT apply pressure directly to the joints! Move from the fingers up to the hands, & then up through the arms to the shoulders.
When applying deep pressure, apply slowly & increase pressure until you hit the point of resistance, giving time to react (& avoiding causing pain).
If he seems to be reacting more than expected, or if he is anticipating the pressure, it's helpful to distract him during the process (i.e.: watching TV or engaging in conversation)
In general, the areas that are the most hypo-sensitive (the areas w/ the least response) are the areas that need the most attention.
It's not unusual to see inconsistencies between the left & right sides of the body; it's also normal to see significant variations from day to day.
Reading- Can be started with a very young child. Once they are able to recognize and identify 100 or so pictures receptively and/or expressively is a good time to start.
High-Interest Word Cards w/ 5-10 New each Week (number will depend on each child's ability)
Start off w/ the most interesting words in his vocabulary
Don't be concerned about the length of the words (longer words w/ more interesting configurations are easier to learn than are 3-4 letter words).
Mix initial letters & word length when introducing new words.
Print the words on white, unlined 3" x 5" index cards in black marker.
The word on each card must be uniform in size & writing style.
Hold the cards facing yourself upside down, & flash the cards by flipping them over so that they face the child (This way he sees only one card at a time & isn't looking at one card while another word is said).
Flash the cards quickly & intensely, at a rate of one card per half-second.
Play games to get his intensity level up (i.e. ·” Say it before I do", etc.) Do what works; always reinforce when he is a happy, active participant!
Periodically ask him for output during a teaching session. This helps increase his participation & determines the learning of new words. Often, hesitating momentarily while flashing provides the opportunity to say the word first.
He should be able to name the word on a card that is shown that hasn't been seen for a couple of days; picking a card from a field of 2 or 3 does not insure that he really knows the word (verbal ID is always preferred), but in non verbal children it is an easy way to see they know the word. I would recommend a field of 6 to ten cards at a time for this sort of testing.
If enough new words are presented each week, he should be able to identify about 70-80% of them by the end of the week. (If he can identify them all, accelerate the rate at which new words are added. If he is learning less than 60%, make sure you are presenting them with enough intensity and frequency or decrease the number of new added weekly.)
High-Interest Word Cards-Review Old
Place the words learned every week into a review file box at the end of each week.
Select the last cards from the review box to begin each review session.
The number of word cards used in a review session can vary from 10 to 15; review cards should be adjusted based on his responses. (Some children get bored if there aren't a lot of cards in each review session, & others do better w/ just a few.)
Review a new set of words in each review session of the day, so that in four review sessions a day, 40-100 word cards will be reviewed.
Constantly rotate & review all of his sight words.
Have fun in order to turn him on to reading! As w/any, academic subject, the primary goal in every session is to teach him to love whatever it is that he is being taught.
If he isn't responding or isn't retaining the majority of review words, there is a likely a problem with the way the cards are being shown, perhaps they all look too similar? Maybe the intensity is not high enough? Maybe there are too many cards in the pile? Maybe you are not doing them with a high enough frequency?
A good place to start is to do this activity 4 times each day for 1 minute each time
Here is a good example of how words look different. It is important to keep in mind the child takes a picture of the word card so it needs to be very different. Words like mom, dad and car are too similar.
It is important to read to your child regularly. New books, new material, not ones they have heard over and over, as they tend to memorize them and kiddos can tune out easily. You reading to your child can help them learn cadence, prosody, expression, and flow.
Read to Your Child
Find a quiet, cozy spot & encourage him, to get comfy.
Attempt to choose a book that is a small step above his present receptive language, as well as fun & interesting.
The books you are reading should teach him some new vocabulary &/ or information, yet be at a level he can understand. During the day, to try to excite w/ new books. (Reserve his favorite books that he wants to read repeatedly for bedtime.)
Try to finish his story time with him wanting more, to make every reading time fun & positive.
Begin to use reading to turn him onto information. Moving from storybooks to informational books should begin ASAP. You will want him to love reading both as food for the imagination & as a great way to learn. Try to make reading a daily part of every child's life, regardless of their age. Have fun!
Read to him (at least) once daily for 10 minutes.
(To turn him onto independent reading, try cliffhangers. Find adventure books that are written at a grade level or so below his word recognition level. Read these books to him & try to create as much excitement about them as possible. Build up to anticipation & then stop reading at a really critical point in the story. Hopefully, at the “to be continued" point, he may start picking up the book himself to read further.)
**Please note, I no longer use sequential processing activities as the core of what I do. I have found this process much less effective than others I have developed. You will see simple activities on this blog related to processing, though if used, I do them only for a very short period of time. Kids and parents get burned out on them fast.
The Auditory Hunt (auditory, because the objects are covered and cannot be seen when you ask for them.)
Hide more than the 2 objects that he is to sequence under a towel, behind a lid, or in a box.
(Start w/ current auditory sequencing level & work up.)
In a monotone voice at one-second intervals, name a random sequence of objects to be retrieved from the room or house. (DON'T allow him to look at the objects as they are named, & hide more than number to be retrieved.)
He should select the 2 objects in the same order that they were named after the listening to the entire object sequence.
Intensity is vital- do everything possible to increase the intensity! (On a scale of 1 to 10, if his intensity is below a '5', he'd be better off taking a nap; if the intensity. level is a 6 or a 7, real progress will be seen.)
Provide praise & reinforcement EACH time he completes a sequence correctly, even if assistance was given. (Outside reinforcement may also be needed.)
Example: Say first, “give them to me in the right order, ok? Here we go!" & name 2 (or more) objects.
If he picks out objects in the wrong order or picks out incorrect objects, repeat the sequence & help him complete the sequence hand over hand.
By varying the objects & sequences creatively, this activity becomes fun, playful, interesting, & part of his day. (i.e., use grocery objects, collect things for an art project, or select books from a bookshelf, etc.) Have fun, & think big!
Alternative Sequence Activity
In a monotone voice at one second intervals, ask to touch a sequence of body parts or objects. (Be sure that he can physically touch objects)
Give random (unrelated & different) verbal directions w/out any visual cues, such as looking at or pointing to objects. (The sequence should be random & different each time, unrelated to any context & to each other.)
He needs to listen to the entire sequence before starting to respond- it may be helpful to hold his hands while giving the sequence. Example: Say, “put your hands on your head, & then touch my nose.” (While holding his hands for the two step sequence}
Help him hand over hand to follow the directions if he does it incorrectly. (If he doesn't perform the sequence in the correct order or omits part of the sequence, then say the sequence again & help him complete the sequence hand over hand.)
Give praise & reinforcement after each sequence he performs correctly, even if assistance was given. (Outside reinforcement may be needed, since doing something frequently tends to decrease the intensity.)
Work toward longer sequences once he can do this level 70-80% of the time.
Use high intensity responses, especially when he achieves the next desired level. Intensity is vital w/ this activity- do whatever is necessary to get his intensity level as high as possible (preferably a '6' or 7 on a scale of 1-10. If intensity level is below a '5', he would be better off taking a nap!)
Do this activity 2 times each day for 2 minutes each time