Children with articulation delay often have fine motor delay.  At times, a consultation with an occupational therapist (OT) is necessary.  Other times children may simply need to be exposed to the types of activities listed below to encourage development of the hand muscles.  

Encourage the writing fingers (see picture above) to do the work during precise fine motor activities.  While holding a marker or crayon, encourage a proper grip (see picture at right).   


During writing and many other fine motor tasks, the writing fingers (thumb, pointer and middle fingers) are active, while the pinky and ring fingers stay tucked in, secure against the palm.


Proper use of the fingers lays the foundation for higher level fine motor skills like writing letters and tying shoes.

By Lauren Stern OTR/L

Sensory integration is the automatic process in which our brain registers sensory information from our five senses, as well as our internal senses of body position and movement. The brain reacts to this information with an appropriate adaptive response. For example, when we go outside on a sunny day, we either squint or put on sunglasses. The stimuli in this example, is the sun and our eyes are the “sense” which detects the stimulus. Our brain processes this information by organizing and planning a response. This is the way typical sensory integration operates.

Most of the time, we do not think about our responses to various stimuli because our brains produce quick responses. Think about your commute to work. For those of us who take the subway in the morning, our bodies already have an “internal map” of where to go once underground; therefore it’s familiar and automatic.

Think about a trip to an amusement park. Typically, we know the amount and intensity of movement our bodies can handle before we may get motion sickness. Our brain registers this information and tells our body that we have had enough movement from roller coasters or that we can and want to go on more rides.

Imagine you are sitting in a boring lecture. Some of us can coast through this without a problem. Others need stimulation to keep our attention on task and will use compensatory strategies such as chewing gum, drinking water or biting a pen to help us do so.

A child with Sensory Processing Disorder (SPD) has sensory systems that are not functioning optimally. These children do not have the ability to make the types of connections such as the ones discussed above. They have difficulty interpreting one or more of their senses. The senses we are referring to include our basic five senses; vision, hearing, touch, taste, and smell. There are two more senses that may be unfamiliar to you. These senses include our vestibular sense (our sense of gravity and movement which is stimulated by change in head position) and our proprioceptive sense (tells us where our body position is in space). The vestibular and proprioceptive senses coupled with the tactile sense (sense of touch) are often referred to as the power systems, as these three systems are the most essential in early development.

Does my child need Sensory Integration Therapy?

Here are some signs of Sensory Processing Disorder (SPD):

1. Afraid of movement or constantly moving too much
2. Overly sensitive or under-reactive to touch, smells, tastes, textures, temperatures in food, sights or sounds
3. Easily distracted
4. Poor eye contact
5. An activity level that is too high or too low
6. Impulsive; lacking in self control, poor safety awareness
7. Inability to unwind or self calm
8. Social and/or emotional problems, frequent tantrums
9. Physical clumsiness, poor balance
10. Difficulty making transitions from one situation to another
11. Delays in speech and language development
12. Delays in motor skills and difficulty planning new movements

If your child presents with a few or more of these behaviors, contact an Occupational Therapist to schedule an OT evaluation. A comprehensive evaluation will determine if your child will benefit from Sensory Integration treatment. Click here to locate a therapist who is certified in Sensory Integration.

Lauren Stern, OTR/L is a Pediatric Occupational Therapist specializing in Sensory Integration and Handwriting. She currently shares her time between working at the YAI/New York League for Early Learning’s Gramercy School, and treating children privately in their Manhattan homes. Lauren has almost 10 years experience as an Occupational Therapist and is SIPT (Sensory Integrative Praxis Test) certified. She has developed individual sensory diets including: equipment suggestions for homes, weekly activity assignments and therapeutic exercises. Lauren strongly believes homework and parent/family involvement optimizes therapeutic intervention. She also specializes in handwriting. Lauren uses a sensory-based and hands-on program called Handwriting Without Tears, providing children with a fun and motivating way to learn writing skills. Lauren has supervised level one and level two graduate students and is continuously expanding her knowledge by attending continuing education seminars. She has received YAI’s annual Therapist of Excellence Award twice, exemplifying her dedication and passion for occupational therapy.

Contact Info:
Lauren Stern
laurendstern@gmail.com
(516) 298-4084

By Lauren Stern, OTR/L

Occupational Therapy is a health profession focused on maximizing an individual’s ability to function in his/her daily life. An Occupational Therapist addresses difficulties arising from cognitive impairment, physical injury, psychosocial dysfunction, developmental or learning disabilities. Many people associate the word occupation with “work”. Therefore, it is usually surprising to hear that Occupational Therapists often treat children. A child’s “work” is comprised of play, self-care skills, learning, school performance and social interactions. Most of these skills fall within the following areas:

Fine motor skills (ex: stringing beads, grasp on a crayon/eating utensils, manipulation of clothing fasteners)

Visual motor skills (ex: tracing lines, completing puzzles, imitating shapes via drawing, copying block designs)

Sensory processing skills

Self help skills (grooming and dressing)

Handwriting

Environmental adaptations (organizing and adapting home/classroom to meet each child’s specific needs)

Play and socialization

Neuromuscular development (muscle strength and endurance)

As therapists, we tap into a child’s interests to provide challenging therapeutic activities aimed at improving areas of weakness. We specialize in creating opportunities for children to master developmental tasks and achieve independence in home, school and within their communities. Therapy sessions look like “play”, which is exactly what the children who are participating think they are doing. Occupational Therapists are trained extensively in psychology, human physiology and development. Therapists often continue training beyond college to become certified in specific areas of treatment including, but not limited to, Sensory Integration (SIPT certified), Handwriting and Listening Therapy.

Lauren Stern, OTR/L is a Pediatric Occupational Therapist specializing in Sensory Integration and Handwriting. She currently shares her time between working at the YAI/New York League for Early Learning’s Gramercy School, and treating children privately in their Manhattan homes. Lauren has almost 10 years experience as an Occupational Therapist and is SIPT (Sensory Integrative Praxis Test) certified. She has developed individual sensory diets including: equipment suggestions for homes, weekly activity assignments and therapeutic exercises. Lauren strongly believes homework and parent/family involvement optimizes therapeutic intervention. She also specializes in handwriting. Lauren uses a sensory-based and hands-on program called Handwriting Without Tears, providing children with a fun and motivating way to learn writing skills. Lauren has supervised level one and level two graduate students and is continuously expanding her knowledge by attending continuing education seminars. She has received YAI’s annual Therapist of Excellence Award twice, exemplifying her dedication and passion for occupational therapy.

My child’s teacher told me that I should discourage my daughter from sitting in a “W” position.  Why?

From a speech perspective, a W sitting position does not allow for good respiration, phonation and articulation. A child needs a strong and stable trunk to support the muscles of the jaw, lips and tongue.

From a physical and occupational therapists point of view, excessive W sitting during the growing years can lead to future orthopedic problems (e.g., hip dislocation and muscle tightness at the: hamstrings, internal rotators, and heel cords). A child is planted in place or “fixed” through the trunk in this position. The trunk can not rotate and the child can not use lateral weight shift which reflects on overall balance.

W sitting discourages crossing over midline because a child is fixed playing with toys right in front of him or her. A child who sits in this fashion may have difficulty determining hand preference because he or she may do everything unilaterally in this fixed position.

Please encourage your child to sit in a “criss-cross applesauce” position (also known as a Tailor Sit, as seen below) while seated on the floor.