Hand and foot play is an important part of a child’s development. So is bringing the feet to their mouth (unfortunately I didn’t get a good picture of that!). So what are some of the reasons it is so important?
- Hamstring stretches – They just spent 9 months cramped up in the ‘fetal’ position. This means their knees were flexed and in close to the body. By reaching for their feet they are beginning to perform hamstring stretches that will help to lengthen the muscle.
- Core strength – By lifting their feet up and reaching with their hands, they are working their abdominal muscles which will help to develop their core strength. You try lifting both your feet up and reaching with your hands. Its not easy work on those abs!
- Midline – You can see in the pictures that they can bring their hands and/or feet to midline which helps to increase their awareness of where midline is.
- Body awareness – Hand and foot play allows your baby to explore their body and the various parts of their body. They begin to realize that their feet are attached to them and that their hands and feet can work together.
- Exploration – Once they are participating in hand and foot play, you will probably see them putting their feet in their mouth. This is how babies explore. They put everything in their mouth, including their own toes!
- Movement – As you can also see in the photos lots of movement is happening. He isn’t just lying flat on his back holding his feet. He is rocking back and forth, dropping one foot, picking it back up again, etc. This helps to create building blocks for movement and cause and effect. If they end up on their side, what do they have to do next?
- Self-soothing – When they are engaged in play with their feet, or putting their toes in their mouth, they are also able to self-soothe. This can help with sensory regulation.
If your child isn’t doing this, you can help to encourage them. Gently bring their feet up towards their hands. Maybe help them to put their hands on their feet and try to grasp them. You can make a game out of it by playing peek-a-boo behind their feet so that their feet are in midline when you are ‘hiding’. You could also do ‘This little piggy’ while you have their feet up in the air and count each toe. You can play ‘patty-cake’ while holding their hand and feet together and bringing them to midline for each ‘clap’.
What are other ways you have encouraged hand and foot play?
Wikki Stick People
Pipe Cleaner Person
Kids can have fun creating people out of a ton of different materials. Two of the materials we use are pipe cleaners and wikki sticks.
Areas it works on:
Fine Motor Dexterity: This activity incorporates a lot of pincer grasping and finger isolation in order to push the wikki sticks onto the white board and to twist the pipe cleaners together. Kids also needs bilateral hand use in order to twist the pipe cleaners together and stick the wikki sticks together. In addition, they can work on snipping with scissors to cut the wikki sticks and pipe cleaners to the appropriate length.
- Alternative Ideas: If the kids are having a lot of difficulty in placing the pipe cleaners or wikki sticks, you can still work on finger isolation by placing them for them and then having them trace them with their index finger, so they are still attending to placement and shapes and working on pointing their finger.
Body Awareness: Some kids are still working on learning where their body parts are and how they relate to the space around them. Working on visuals of the body can be a way to work on this and to have them be aware of things such as arms and legs come out of the body and not the head!
- Alternative Ideas: You can play directional and movement games when placing the body part to make it more interactive. The kids have to place the arms and then raise their arms in the air, or they have to make a head and then turn their head side to side, to name a few options.
Visual Copying: You as the therapist, parent, etc. can build the person and see if the child can duplicate what you created allowing them to working on visual processing skills and eye-hand coordination.
- Alternative Ideas: You can grade this activity to make it easier or harder for them. This can be done by: complete the person one step at a time in order to make sequencing easier for them or complete multiple steps and judge from their motor planning/sequencing skills whether the task needs to be graded up or down.
How have you worked on these concepts? What other items have you used for creating people?
I love having students in our practice. Not only do they challenge us as therapists to be deliberate and think about why we do what we do, but they also bring an influx of ideas in and add to our overall toolbox. Our most recent OT student shared this idea with us that she did a paper on in grad school.
Her paper focused on a child with Developmental Coordination Disorder (DCD) and handwriting. The resources (Benbow, 2006; Ziviani & Wallenberg, 2006) suggest that a child’s slow performance in writing is a result of compensation strategies of decreased visual motor control with greater reliance on visual monitoring. Some of the sources suggest that helping a child to develop kinesthetic memory and kinesthetic feedback can be beneficial. Activities that develop kinesthetic memory will increase internal sensitivity to when a letter movement is correct. Kinesthetic feedback can be developed while minimizing visual motor control (i.e. taking vision out of the equation).
An example of an activity includes having the child place an object on the desk surface within their reach. Then have the child place their hands on their lap and reach for the object with their eyes shut. They tried this strategy with one of their kiddos who was able to reach for the object, but miscalculated and placed their hand directly to the side of the object on the first try.
The resources suggest this can be applied to handwriting by blindfolding the child while they write a couple of letters of the alphabet. Or, for those kiddos that would not do well with blindfolding, stick a pen through a paper plate and have them write a few letters. If this is continuously practiced, the movement patterns will be part of the child’s kinesthetic memory. Eventually, handwriting will progress in speed and ease with less visual monitoring.
Benbow, M. (2006). Principles and practices of teaching handwriting. In A. Henderson & C. Pehoski (Eds.) Hand function in the child: Foundations for remediation (pp. 319-342). St. Louis, MO: Mosby Elsevier.
Ziviani, J. & Wallenberg, M. (2006). The development of graphomotor skills. In A. Henderson & C. Pehoski (Eds.) Hand function in the child: Foundations for remediation (pp. 217-236). St. Louis, MO: Mosby Elsevier.
So after 3 weeks of keeping my left hip from turning out I am finally allowed to. Since my legs tend to turn out on their own I was being extra careful over these last 3 weeks by either actively holding it straight or making it turn in (since it was allowed to turn in as much as it wanted). Well today when I let it turn out for the first time I was still lying in bed and couldn’t see my feet. I was actually excited because I felt like it had turned out almost as far as my other foot had. This was good because it meant the pain and soreness I was expecting that would go along with stretching wasn’t going to be there. Well imagine my surprise when I finally looked at my feet and they were nowhere even close to being the same.
What does this mean? Well besides it meaning that I will actually have to do stretching it also means that because of 3 weeks of keeping my foot turned in, my body’s sense of where it is and where midline is became skewed. To my brain (when not looking) my feet felt the same. It wasn’t until I added the visual input that I could see that wasn’t correct. I was amazed at this because it gave me a whole new insight into the kids I work with.
I have always intellectually understood that a kiddo may not have a good idea of where their body was in space, or not realize where midline was because they were so used to being in a position that wasn’t midline. However, this was the first time that I experienced it. Now granted, mine is small compared to some of the kids but it is just one more insight into some of the challenges they have to overcome for movement.
As I retrain my brain and body the proprioceptive input in my hip joint will realign so that they send a message to my brain that matches what I am seeing. I’m sure it won’t happen overnight but it should happen relatively quickly since its only been 3 weeks. What about those kiddos that have torticollis and have held their heads turned towards one side for months, or the kiddos that are always lying down or in a reclined position. They are going to need a lot more assist with learning where midline is and where their body is in relation to the world around them.
I hope this helps to give a slight glimpse into what some of our kiddos are trying to figure out.
Stacking cups can be a great activity for many skills including motivation for gross motor skills!
- Visual motor skills – you can vary the size of the cups, the color of the cups or even the weight of the cups to provide different input and make it easier or more challenging
- grading of movements – if the child puts the cup down too hard the whole tower may fall over so they get to practice regulating their force
- accuracy of movement and body awareness – when reaching to place the cup the child can work on accuracy. They get immediate feedback if they aren’t accurate because they can knock the whole tower down or the single cup they are placing could fall off! In addition, if they walk right into the tower they will receive immediate feedback as well.
- squatting – you can have the cups on the floor so the child has to squat down to pick up the next one and then stand to place it on the tower.
Once the tower is built you can practice rolling balls, throwing balls, riding on a scooter to crash into the tower and then start all over again!
Crashing can be used as an activity to increase arousal or to work on self regulation.
What other ideas do you have?
I have to admit, I’ve been waiting to try this idea, that I saw in not one but two places on pinterest, out for a while and I had the perfect kiddo that I wanted to be the one to test it. This kiddo has developmental coordination disorder and so I really wanted to see how she was able to navigate the through the tape blocking the hallway. I made it simple because I wanted her to have some success with the task, allowing her to have fun while doing it, and ultimately working to improve her mobility skills. I only had two levels of tape, one a few inches off the ground and one about 2 feet above that. I kept them at varying distances from each other (and a few going diagonally) as they made their way down the short 3-5 feet of hall that we were going to traverse.
It was a great activity for her to practice and for me to observe and assist. It also helped that we were getting through it to get to the Wii at the end of the hallway. I let her get through the first time on her own. Then of course I had to go through it as well. She knew exactly what she needed to do although being able to do it was a different story. I will say, we never once made it through without getting tangled up in the tape somehow. I think I would try to figure out a different tool to use to create the maze as the tape falls down quickly and all of a sudden you are caught in a cocoon of tape rather than working your way through the spiderweb!
The problem was that as long as she could see where she was placing her hand or foot she was able to clear the tape successfully. However, as soon as she moved an extremity that she wasn’t watching she couldn’t judge where to place her foot or hand, or how high to lift it to clear the obstacle. And when she was focusing on her extremities she forgot about the rest of her body causing her head or shoulder or back to bump into the tape. This was true even as I provided verbal cues and then added in assist at a leg or a hand.
This activity has great potential for helping kids with body awareness, motor planning, coordination, and problem solving. I think if I could use a heavier barrier such as poles it would help to provide limits for body placement and provide more cues as to body awareness. (I’m not sure how I would rig this up but I will give it some thought). Pool noodles would also be a great way to create the maze. If you make it into a game and make a buzzer sound whenever they hit the barriers it could provide an auditory cue as well. As they improve you can make it more challenging or change the maze materials and eventually bring it back to tape. It’s a 3-D way of playing a version of limbo!
Who else has tried this activity and what have you learned from it?
I have frequently used picking up marbles with your toes as a tool to strengthen a kiddo’s intrinsic foot muscles to help with their arches however, when I was using this activity with a kiddo recently I realized some other areas it can help in.
- Coordination/Motor Planning – As the kiddos are trying to pick up one or more marbles they need to coordinate keeping their toes closed around the marble as well as moving their leg and foot over the bucket to drop the marble in. Multiple times the kiddo would have a marble in their toes and then they would focus on moving their leg and foot and the marble would drop because they couldn’t focus on both activities at once. It became even more challenging when two marbles were introduced, if they were even able to pick up both marbles at the same time.
- Foot-Eye Coordination – When attempting to drop the marble in the bucket the kiddo needs to be able to focus on the target while aligning their foot and holding onto the marble. Many times the marble didn’t quite make it into the bucket because of miscalculation as to where the bucket was in relation to their foot.
- Body Awareness/Sensory Input – Having to use their feet to pick up the marbles increases the tactile input to their feet as well as encourages them to use their feet to feel for the marble and make sure it is lined up correctly. In addition they will have to know where their foot is in space in order to accurately drop the marble into the bucket.
- Strengthening – Picking up marbles with your toes is a great way to work on the strength of foot intrinsic muscles that assist with foot stability and foot arches. It becomes more challenging the more marbles you add. See how many marbles the kiddos can get at one time!
It can be a great game and you can alter it by seeing how many marbles they can get in a certain amount of time, how many marbles they can pick up at a time, which foot is faster at picking up all the marbles, which foot gets more marbles into the bucket on the first attempt, or any other combination of fun!
What else do you use picking up marbles for?