Gross Motor Breaks During Homework

Gross Motor Breaks During Homework

Homework is something the majority of kids struggle with. After sitting in class all day the last thing anyone wants to do is to come home and sit down and do more work. Incorporating small gross motor breaks can help your child stay focused longer. A study done in 2011 showed that kids concentrate better after some form of physical activity. “Specifically, our preliminary work suggests that sustained involvement in structured physical activity may offer benefits to motor, cognitive, social, and behavioral functioning in young people exhibiting ADHD symptoms” (Smith et al., 2011). When sitting down to do homework, give your child a specific number of problems to complete, and then after they hit the target number have them get up and step away. Have them complete a quick gross motor activity before continuing the homework.


An article on stated that the best exercises were ones that stimulate the vestibular system.  This means that the exercises you do need to get the body and the head moving. For example, singing and moving along to the “Head, Shoulders, Knees, and Toes” song is a great gross motor break. It gets your child up and away from the desk/table, and allows them to move and stimulate the vestibular system. Another idea would be to place items on the ground and have your child pick them up one at a time. Have them bend at the waist instead of the knees. This makes the head go up and down giving the vestibular system some stimulation. Swings and trampolines are great tools to stimulate the vestibular system. Have your child jump and spin, and make sure you spin both to the right and the left. These are just a couple of ideas to help give your child a homework break and help increase their attention and focus while doing homework. Below is the link to the 2011 research article and to the OT-moms web page.


To view the article, please copy and paste into your web browser:

-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist



 Smith, A. L., Hoza, B., Linnea, K., McQuade, J. D., Tomb, M., Vaughn, A. J., … Hook, H. (2011). Pilot physical activity intervention reduces severity of ADHD symptoms in young children. Journal of Attention Disorders, 17(1), 70–82. doi:10.1177/1087054711417395





Executive Functioning Skills, Part 2: Homework!

Executive Functioning Skills, Part 2: Homework!                                Author: Krista Flack, MS OTR/L


Last week I talked about how executive functioning skills impact a child’s ability to fully participate in school.  This week I’m going to talk about how some of those same skill-sets can impact a child’s ability to complete their homework.  With children with well-developed executive functioning skills, the process of homework goes something like this:

  • receiving the information to know what your homework is (meaning that attention was given during class, or that assignment rubrics were properly filed in an organized manner)
  • remembering the assignment, requirements, and due date (requiring working memory or organizational skills to properly fill out a planner/assignment book)
  • giving yourself enough time to complete the assignment or project (requiring planning and time management)
  • starting and completing assignments in an appropriate order (requiring initiation, sequencing, and prioritization)
  • completing all parts of assignments, without errors or omissions (this requires frustration tolerance, impulse control/inhibition, and problem-solving to work through problems, and self-monitoring to double check work for thoroughness and accuracy)
  • tolerating interruptions and distractions during work (requiring sustained and divided attention and mental flexibility)
  • bringing homework back to school and turning it in to the right teacher at the right time (organization, initiation, and time management)

As you can see, “doing your homework” requires so many more steps and skills than simply knowing the information.  When children have deficits in executive functioning, any one of these steps could be interrupted, resulting in homework not being completed or turned in.  When you add in the extra challenges some children have with academics, language, handwriting, etc., this entire process can become overwhelming, frustrating, and discouraging. 

There are many ways we can help our kids be successful despite some of these executive functioning deficits.  Of course, our favorite goal is to improve overall executive functioning skills so that the child is independent in these areas.  Sometimes, though, accommodations and modifications can be very helpful to reduce frustration and negativity associated with these difficulties.  Here are some accommodations and modifications that can be used for each step mentioned above:

  • receiving the information to know what your homework is
    • use sensory strategies to help improve attention in class, so your child gets the information correctly the first time (ie fidgets)
    • ask about preferential seating, to minimize distraction in the classroom
    • ask your child’s teacher to double check his or her assignment book
  • remembering the assignment, requirements, and due date
    • request that assignment sheets and important due dates be sent home
    • help your child get organized at the beginning of each day/week/month (as often as your child needs it), using color-coded materials for different subjects, do/done folders, or other organizational supplies; staying organized can be easier than initiating the organization
  • giving yourself enough time to complete the assignment or project
    • TimeTimers or other visual timers can help a child manage their time better
    • visual or written schedules can help children stay on task and know what is coming next
  • starting and completing assignments in an appropriate order
    • again, use a written or visual schedule, designed by you or in collaboration with your child, to list what needs to get done and in what order
  • completing all parts of assignments, without errors or omissions
    • offer breaks at specific intervals or as needed (see Matt’s blog this week for ideas!)
    • help work through example problems for the child to refer back to
    • sit down and complete homework together, offering help as needed or as requested
    • double check your child’s work prior to it being turned in, so there is time to correct errors and complete missed parts
  • tolerating interruptions and distractions during work
    • sensory strategies can be great to reduce distraction
    • find a quiet place to work to minimize distraction
  • bringing homework back to school and turning it in to the right teacher at the right time
    • again, help your child get organized, and teach them to use the organizational system properly to stay organized
    • place reminders on commonly used items, like a pencil box or lunch box, to make sure assignments get turned in
    • ask for collaboration with teachers to offer verbal reminders during class time to submit assignments

These are just a few examples of what can be done to compensate for executive functioning deficits related to completing homework.  Talk to your child’s therapist or teacher for more ideas that might work better in your routine or use your child’s individual strengths more effectively.  And as always, if you have concerns about your child’s executive functioning skills, talk to your doctor or a Lowcountry Therapy Center therapist about a  FREE screening or evaluation.  We can help!

Executive Functioning Skills

Executive Functioning Skills               

There are many areas of executive functioning that impact a child ability to fully participate in school, at home, and in the community.  For example, study-skills and test-taking skills require time management, the ability to organize and prioritize, and working memory.  Many of these same skills are required to complete and turn in assignments, remember lessons and homework, and make it to school and between classes on time.  Here is some more information about a few areas of executive functioning, how they impact our day-to-day lives, and how to improve or accommodate when there are deficits.

Impulse Control: Poor impulse control can lead to behavior problems in class, but can also be reflected by academic success.  If you give the first answer you think of, rather than taking the time to double check and think through answers, you are more likely to make, and fail to notice, small errors.  Games that require strategy are great for learning impulse control.  I love the card game Jungle Speed, where you need to find matches quickly, but are penalized for calling a match incorrectly.   If your child is motivated by technology, apps like Rush Hour and Mind Resolve include challenges in which you are not timed, but rather are encouraged to take your time to complete the level in the least number of moves. 

Time Management: Being able to manage your time includes estimating how long a task will take and being able to judge if you need to move quickly or not.  Giving yourself enough time to complete an assignment, or get between classes, can be difficult if you don’t have good time management skills.  Time Timers and visual schedules (see Matt’s blog this week for more info!) are great ways to encourage independent time management!

Sustained and Divided Attention: Whether you’re at home or at school, there are times when you have to focus in on one thing and ignore other input (sustained attention), and there are times when you have to divide your attention (for example, when the phone rings while cooking, and neither can be completely ignored).   Refer back to this blog for ideas about sensory strategies to improve self-regulation and attention. 

Organization: Getting, and staying, organized can be big challenges for some people.  Organization is a skill that must be learned, but once it is figured out, it can be applied to so many areas of life to improve efficiency!  This blog listed some school supplies, like a planner and color-coded folders, notebooks, and book covers, that can help encourage organization and get you off to the right start this school year.

While the above areas of executive functioning are perhaps the most obviously relatable to the school day, executive functioning also includes initiation, flexibility, problem-solving, emotional control, and self-monitoring, all of which are important skills to have for success in the classroom and the community.  If you have concerns about your child’s executive functioning skills, talk to your doctor or a Lowcountry Therapy Center therapist about a screening or evaluation.  We can help!

Author: Krista Flack, MS OTR/L

Visual Schedules

Visual Schedules

Now that school has begun it is hard to keep track of all the after school activities, homework assignments, meal times, bed times, and everything else that goes on when your child gets home. Visual schedules are a great way to keep your child organized and on task. Some children are able to stay on task and know what needs to be done with verbal instructions. But for children with anxiety, poor attention, auditory processing difficulties, or other challenges, this verbal information is not enough. A visual schedule is a way to provide structure to a child’s life. It gives them information about what activities will be happening, and in what sequence they will occur.


Visual schedules can be used in many different ways. You can use it to show your child an overview of their entire day or evening activities when they come home. You can also use them to show all the steps in a multi-step task such as brushing your teeth. Visual schedules help to reduce anxiety in children by showing them what is coming next. They can also improve communication and help your child understand what is expected of them.


So where can I get a visual schedule for my child?

We can make visual schedules here at LOWCOUNTRY THERAPY CENTER for $15!


What does it come with?

The visual schedules include 35 pre-set pictures such as bed, school, shopping, play, etc. They also include 35 customizable picture cards that apply to you and your family, and can include specific pictures of toys, people, or places. The visual schedule also comes with 4 storage sheets, 1 schedule sheet, and 1 first/then sheet.


If you are unsure if a visual schedule is right for your child ask your therapist to trial one while they are in therapy. If you would like order a visual schedule just ask your therapist for an order form.


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Vision Screens and Exams: What You Need to Know!

Vision Screens and Exams: What You Need to Know!


For many local families, school begins next week!  While you prepare to head back to school, you have probably made an appointment for your child’s annual physical, or well-child visit.  It is important to remember that your children’s eyes and vision should also be evaluated regularly. 

  • The American Optometric Association (AOA) recommends that infants have their first comprehensive eye exam at 6 months of age.  InfantSEE is a program that offers FREE eye exams to children ages 6-12 months.  Check out their website to find a local optometrist that participates.  I took my son to an InfantSEE examination when he was 9 months old and it was a great experience!
  • Children should have additional eye exams at age 3, and just before they enter the first grade — at about age 5 or 6. 
  • For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually, or as recommended by their optometrist or ophthalmologist.

Early eye examinations are crucial to make sure children have normal, healthy vision so they can perform better at school and play!  Children need the following basic skills related to good eyesight for learning:

  • Near vision
  • Distance vision
  • Binocular (two eyes) coordination
  • Eye movement skills
  • Focusing skills
  • Peripheral awareness
  • Hand-eye coordination

While school vision screenings are a helpful tool that can detect some vision problems, there are limitations to these screenings.  An in-school vision screen should not replace comprehensive eye exams at regular intervals as outlined above.  And as always, talk to your doctor or make an eye exam sooner if you have concerns! 

If a vision screening detects problems, or if you have concerns, you may be referred to an optometrist or an ophthalmologist, depending on the concerns you have.  Your sight depends on seeing the right eye doctor at the right time.  Ophthalmologists and optometrists each play an important role in providing eye care, but the levels of training and expertise can vary significantly for each type of provider:

  • An ophthalmologist — Eye M.D. — is a medical or osteopathic doctor who specializes in eye and vision care.  As a medical doctor, an ophthalmologist is licensed to practice medicine and surgery.  An ophthalmologist diagnoses and treats all eye diseases, performs eye surgery and prescribes and fits eyeglasses and contact lenses to correct vision problems.
  • Optometrists are healthcare professionals who provide primary vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes.  An optometrist is not a medical doctor, but rather receives a doctor of optometry (OD) degree.  They are licensed to practice optometry, which primarily involves performing eye exams and vision tests, prescribing and dispensing corrective lenses, detecting certain eye abnormalities, and prescribing medications for certain eye diseases. 

If your eyes are healthy and don't require specialized medical or surgical treatment, the type of eye doctor you choose for a routine eye exam is a matter of personal preference.  Optometrists and ophthalmologists both perform routine eye exams and both types of eye doctors are trained to detect, diagnose and manage eye diseases that require medical and non-medical treatment, and can refer you to the appropriate professional if other needs arise.  To read about what to expect at your child’s eye exam, check out this website.

For more information on children’s vision development, signs of problems, and ideas to support and improve vision development, check out the American Optometric Association’s website and the College of Optometrists in Vision Development’s website.

One last area I want to cover briefly today is vision therapy.  Vision therapy is another area of vision care that may benefit your child.  Vision therapy is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities.  Some optometrists, and even some ophthalmologists, are trained in vision therapy.  Sometimes these professionals are called developmental or behavioral optometrists or ophthalmologists.  While your child’s occupational therapist may be helping to address deficits in visual perception, eye-hand coordination, ocular motor skills, and visual motor integration, occupational therapists do not receive near the depth of training in vision nor are they trained in the use of lenses, prism and filters.  Seeing a professional trained in vision therapy can provide more options to treat vision problems.  For more information on vision therapy, check out this website.

Author: Krista Flack, MS OTR/L

1st Annual LTC Olympic Games!!!

1st Annual LTC Olympic Games!


Starting August 15th we will be hosting the first annual LTC Olympic Games! The games will last from August 15th to August 19th. It will be a decathlon with different activities that focus on physical, occupational, and speech therapy activities. Upon completion of each activity the child will get a gold piece of paper to write their name on and add to the paper chain in the lobby. They will also be awarded a gold medal sticker on the tracking sheet next to each activity they complete. Each activity is able to be adjusted to be easier or harder to allow all age groups to participate. Below are the list of the ten different activities and a little description about each one.


1. Dressing

This event will challenge how quickly you can get dressed. You will be timed while you complete a dressing activity such as buttoning a shirt, tying your shoes, putting your socks on, etc.

2. High Jump

This event will challenge your leg strength. You will have to jump over pool noodles stacked on top of each other.

3. Alphabet Game

In this game you will be timed on how fast you can name each letter of the alphabet and something that starts with that letter.

4. Scissor Cutting

This event will look at how accurately you can cut out shapes and cut on a line, but don’t take too long because this is a timed event.

5. 100 Meter Scooter board

How quickly can you go around the clinic on a scooter board using either your hands or your feet?

6. Categories

In this event you will be given a category and asked to name 10 items that fall under that category as quickly as you can.

7. Marble Grasp

You will have to pick marbles out of one bin and transfer them to another using either your fingers or some tongs.

8. Shuttle Run

This event will challenge your speed and agility. You will need to run down the hall and pick up a bean bag and then bring it back to the starting line.

9. Tongue Twister

How quickly and correctly can you repeat a tongue twister?

10. Long Jump

In this event you will have 3 tries to jump as far as you can.


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Being Prepared In Case of an Emergency

Being Prepared In Case of an Emergency


As much as we hate to imagine all of the worst-case scenarios that could play out, doing so can help you prepare for emergencies, which can result in less stress and better outcomes in the moment.  There are many services, products, and programs available that can help you and your family be more prepared in case of an emergency, many of which have features that can specifically help families of children with special needs.

One such resource is a program called Smart 911.  By creating a free profile that is linked to your phone number and/or address, the emergency dispatchers at Beaufort County Sheriff’s Office can access important information instantly when you call.  For example, you can list medical conditions and precautions, such as autism, behavioral difficulties, communication deficits, allergies, and/or physical impairments.  This information can help dispatchers, paramedics, fire fighters, and police officers help you and your family more effectively if an emergency arises. 

If your child has autism, you may qualify for a Big Red Safety Box, a free-of-charge safety toolkit for families in need of wandering-prevention tools.  These kits include:

  • Educational materials and tools, including NAA’s Be REDy Booklet
  • Two (2) GE Door/Window Alarms including batteries
  • One (1) RoadID Personalized, Engraved Shoe ID Tag
  • Five (5) Adhesive Stop Sign Visual Prompts for doors and windows
  • Two (2) Safety Alert Window Clings for car or home windows
  • One (1) Red Safety Alert Wristband
  • One (1) Child ID Kit from the National Center for Missing & Exploited Children


Autism Speaks has a great list of numerous other resources available for families of children, and adults, with special needs, including social stories to promote safety, and equipment to increase safety in the home and the community. 

AWAARE has additional resources and items available for families to download and purchase, as well as free  Social Stories  you can personalize to educate your child on how to handle emergency situations.

The Red Cross has a booklet on preparing for disasters for people with special needs, which gives practical tips and guidelines for emergency and natural disaster preparedness.

It is important to think about the unique characteristics and needs of your family and child, in order to plan accordingly and be as prepared as possible for an emergency.  Having a kit and supplies ready and having practiced escape routes and evacuation plans provides a little extra peace of mind that, when an emergency happens, you’re prepared.  


Author: Krista Flack, MS OTR/L

Olympic-Themed Therapy!

Olympic-Themed Therapy!


Friday August 5th marks the opening ceremony for the 2016 summer Olympics in Rio. The Olympics are where the best athletes of each country come together and compete against one another in different events, but you do not have to travel to Rio to compete. Hosting your own Olympic games are a great way to get your kids outside and playing. Below are some different ideas for Olympic style games that also help work on gross motor activities. If your remember from one of my previous blogs, gross motor skills are body movements such as walking, running, jumping, throwing, etc. You can also work on social interaction skills by inviting other kids in the neighborhood over to compete.


Event: Gymnastics

Gymnastic events are a great way for kids to work on balance and stability. One idea is to spray paint a line in the grass using field paint. This will act as a balance beam, and you can create different events such as walking forward, walking backward, standing on 1 foot, and even hopping on 1 foot all while staying on the balance beam.


Event: Track and Field

Track and field events are great ways to build strength and endurance. You can create your own decathlon in the backyard. You can do some individual races such as sack races or crab walking races, or create an obstacle course and have a team relay race. Field events such as throwing and jumping are also great ways to improve strength. Use bocce balls for shot put, and stack pool noodles on top of each other to create a high jump. Pool noodles are also great to lay down throughout the yard and create a hurdle track.


These are just a few ideas to turn your backyard into an Olympic arena. Below are some great links for other event ideas along with different craft ideas to create team costumes and medals.



-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist


Sensory Strategies for a Successful School Year

Sensory Strategies for a Successful School Year


When it comes to having a successful school year, paying attention is a key part of learning the material being taught.  There are many sensory strategies that can help children pay better attention.  Many of these strategies can be beneficial for numerous kids (not just those with more significant special needs), and some are even used on a daily basis by adults without realizing it!  Do you squeeze a stress ball, turn the music on or off, chew gum, or take a walk to help you refocus and get your work done?  These are all strategies that target your body’s various sensory systems, which include tactile (touch), gustatory (taste), visual (seeing), auditory (hearing), olfactory (smell), proprioceptive (body awareness), and vestibular (balance and movement).  For a detailed explanation of each sensory system, check out this blog.  Below are some strategies that can easily be implemented before, during, or after school to help improve your child’s attention and arousal level.

Fidgets – Fidgets are small manipulatives that can help keep fingers and hands busy so that the rest of your body can focus on listening and engaging in the task being completed.  This can stimulate the child that needs a pick-me-up to stay engaged (“daydreamer”), or calm the child that would otherwise be out of his chair or picking at his notebook numerous times.  There are many fidgets on the market, and finding the right one can mean some trial-and-error.  Some fidgets can be too distracting.  Others get lost easily, or can become messy!  Here are a few of my favorite fidgets for during the school day:

·       Finger Spring: these rubber springs are quiet and easily manipulated.  But when your child needs to write, it can twist right around a finger or pencil, leaving hands free to get work done.

·       Kneadable Eraser: I love fidgets that double as a functional tool!  This eraser can be squeezed and manipulated like putty, but still serves a purpose and draws less attention to itself.  Some companies make scented kneadable erasers, which provide olfactory input as well!

·       Velcro – Adhesive-backed hook-and-loop can be stuck onto many surfaces to give your child an opportunity to seek out some tactile input to refocus.  Place a piece on your child’s pencil box, agenda, or another item easily accessible throughout the day.  Talk to your child’s teacher about placing it on the underside of his or her desk!

More movement – For kids that need more movement, there are some good tools out there that provide just the input your child’s body is craving:

·       Wiggle Cushion – placing a wiggle cushion on your child’s chair allows him to rock, wiggle, and move just enough to provide the vestibular input he needs, without risking falling out of his chair or distracting other students.  Not only do these come in different sizes, but most have a smooth and a textured side (and different cushions even have different textures) to further customize it.  Altering the amount of air inflated into the cushion can also change how much movement is allowed. 

·       Theraband – Tying a piece of Theraband around the front two legs of a chair allows your child to get proprioceptive input from the resistance, which can minimize the constant swinging of legs under the chair! 

Heavy Work – Tasks that require actively using your muscles can help regulate arousal levels:

·       Classroom chores – talk to your child’s teacher about your child being assigned a role that provided him with heavy work opportunities throughout the day.  Perhaps that is carrying a book or stack of papers to the office, watering the plants, or sweeping the floor. 

·       Heavy work in your seat – some exercises can be taught to your child that provide heavy work without leaving their seat.  Chair pushups and isometric exercises (pushing your hands together or pulling them apart with hands held) are easy to learn and are not too distracting to other students nearby.  A small picture of the exercises taped to your child’s desk can help remind her to use them!

·       Sensory breaks – Allowing your child to stand up and complete a heavy work activity for a few moments can sometimes pay off.  The temporary disruption from their work can mean they return to the task and get several minutes of good work done!  Wall pushups or crab walking are a few examples of breaks that can get your child to refocus.  Some teachers even find that these kind of strategies work for the whole class!

Snacks – Along with providing nutrients your body needs, the right snacks can provide sensory input to change your child’s arousal level:

·       Gum – while chewing gum can be distracting for some students, for others, it provides proprioceptive input through chewing, swallowing (saliva)and breathing,  which can be calming and organizing.

·       Crunchy foods – crunchy snacks are alerting.  If you child needs a pick me up during the day to regain or maintain focus, consider snacks that have a crunchy feel: carrots, celery, crackers, or pretzels are great options.

·       Chewy foods – chewy foods, like licorice, a bagel, or beef jerky, on the other hand, are great heavy work activities for your mouth! 

One thing to remember is that, while some of these strategies can be fun, fun is not their purpose.  It is important that these strategies are considered “tools” and not “toys.”  Talk to your child and your child’s teacher about the benefits that these tools have.  Rather than using these as a reward or punishment, these tools should be available as needed.  If one is too distracting or is not having the desired effect, it may not be a good fit, and there are plenty of other tools to try! 

Ask an OT at Lowcountry Therapy Center for more suggestions of individualized sensory strategies that may help your child based on his or her specific needs and sensory system.

Author: Krista Flack, MS OTR/L

Back-To-School Tips

Summer is winding down and the first day of school will be here before you know it. This week I am going to share some tips to help you and your family get back into the school routine. The hardest part for me as a kid was always getting on a proper sleeping schedule. Make sure to have set times for going to bed and waking up in the morning for once school is back into session. Take 2 weeks before school actually starts and slowly push back your child’s bedtime and start waking them up earlier. Do this over the last two weeks of summer and by the first day of school they should have no problem going to bed on time and waking up on time.


South Carolina and Georgia’s tax free weekends are a great time to begin back to school shopping. With hundreds of deals you can get everything you need at a good price, but before you begin your shopping create an inventory first. Have your child try on all of their old school clothes. Find out what fits and what doesn’t. Also find out what school supplies you already have at home and create a list of clothing and school supplies that you will need to purchase.


My last tip is to stay organized. The first week of school you are going to be flooded with papers to sign, lunch menus, upcoming events, upcoming projects, etc. Have a designated spot to store all of this paperwork and in this spot have a calendar. Use the calendar to mark important school dates such as project due dates or field trip dates. This is also a good place to keep track of after school activities such as school meetings and even therapy times. This is also a good place to store visual schedules. Visual schedules are a great way to keep a busy house on task and off to school on time. If you have multiple kids make each one a different visual schedule with a different order to help prevent people waiting for things such as the sink to brush their teeth.


Here are some more resources below with other tips and tricks! (Has printable checklists for back to school shopping, after school activities, and lunch menus)


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist


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