Tools for Early Identification and Intervention - 0-5 years
Sensory
Modulation Training
Deep Pressure and Heavy Activities for School Age Children
Another form of sensory modulation is "Deep Pressure" or
"Heavy work" activities. These are wonderful for providing children
with the input they crave including deep proprioception and joint compression.
Heavy Work Activities for Teachers
1. Scooter board to and from a designated location (sit or lie on stomach and
propel with arms)
2. Place chairs on desks at end of day or take down at beginning of day
3. Erase or wash the chalkboard
4. Carry beanbags on shoulders or head and walk across the room. Wear
weighted vests, belts, or wrist weights
5. Help rearrange desks in the classroom
6. Push the teacher around on a wheeled chair or scooter board
7. Pull someone while they sit on a scooter board holding onto a hula hoop
8. Child can pull himself/herself up a ramp while on a scooter board
9. Help out the janitor with emptying wastebaskets, mop the floor, etc.
10. Fill egg crates (small ones that kids can carry) with books to take to
other classrooms. Teachers could ask kids to move these crates back and forth as
needed
11. Help the gym teacher move mats, hang them up, etc.
12. Chewy candy breaks (this addresses the janitor's "no gum
rule"). There are lots of chewy candy that take awhile to chomp and don't
get stuck on furniture
13. Sharpen pencils with a manual sharpener
14. Cut out items for display with oak tag
15. Have students carry heavy notebooks to the office or from class to class
16. Wear a weighted backpack when walking from class to class. Parents can
put a notebook, book, or books (depending on the size of the child) into their
backpack each day for the ride or walk to school. One therapist suggested that
"you might want to be careful about adding weight to backpacks as it could
result in low back pain." It might also be contraindicated with diagnoses
such as Spina Bifida. Maybe weight could be added elsewhere such as in fanny
packs.
17. Carry books with both hands hugging the book to yourself
18. Tie theraband around the front legs of a chair that a child can kick
his/her legs into
19. Propel scooter board across carpeted floor
20. Have child pass out papers/objects to class members
21. Wash desks or chalkboard/dry erase board
22. Push the lunch cart or carry lunch bin to the cafeteria
23. Staple paper onto bulletin boards
24. If there is a garden project at the school, have child dig the dirt
25. Play with medicine balls (get from gym teacher)
26. Run around the track at school
27. Bounce up a ramp on a Hippity Hop ball. Put two ramps fastened
together at right angles and let the kids hop up one, cross to the platform of
the second ramp and hop down. After about 10-15 trips it takes out
"aggressiveness."
28. Push a large therapy ball across/around the room (can purchase weighted
therapy balls)
29. Push square plastic nesting boxes (the largest one was 18 to 20 inches)
from the classroom to the OT room and back. The next child would do the same
thing. This particular school had a carpeted hallway which provided extra
resistance. One or two of the nested boxes can be removed to decrease the weight
or small balls and/or bean bags could be added to the box to increase the
weight. I also found that turning the smallest box upside down over the balls
and bean bags helped easily distracted students complete the task at hand
30. Use beanbag chairs in classrooms, allowing kids to use them during silent
reading time or to lay over or under them during independent work tasks to get a
change in position and the benefit of consistent pressure input. More of a
passive mechanism, but definitely helpful for students
31. Push a wheeled therapy stool while someone is seated on it. If necessary,
person on stool can assist by "walking" with their feet
32. Have kids pull themselves by a long jump rope tied by one end to a
doorknob while they are seated on a scooter board with their legs crossed and
off the floor. Can also have one child hold the jump rope while the other child
is pulling him/herself on the scooter board up to the child holding the rope. A
variation is to play "army jungle maneuvers" where the child on the
scooter board can deliver secret messages to the other child, and that child
(who is holding the rope) has to write a secret answer back to the commander
(teacher). This could be incorporated into academics in lots of ways. How about
the first child taking a math problem to the second, the second solves the math
problem and sends it to the commander (teacher)
33. Bouncing on a large therapy ball while counting down from one hundred
34. Prior to seat work, have child pinch, roll, pull theraputty; use hand
exercisers, balloons filled with flour. Give child firm pressure on shoulders.
Playground play, on equipment, hanging from a bar, running up steps, etc. Wrap
the forearms with ace bandage. Wear a watch tightly
35. Use bubblepack as part of an obstacle course. Child can jump onto it or
run across it. They love the noise it makes!
36. In the classroom, use heavy duty tape to fasten a large phone book to the
bottom of students chairs then teacher arranges the student's schedules so that
the students move to a new area of the room (taking their chair) between
subjects. Teach the use of wall pushups or the idea of "the room feels
small this morning, can everyone help me push the walls out" for younger
students
37. Have student move several packs at a time of Xerox paper from the storage
area to the school copy center
38. Use the Ellison cut-out machine. Students can collect orders from
teachers (who provide the paper and use these cut-outs for bulletin boards,
etc.) and then presses out the number of pieces required under the supervision
of an adult. This very heavy work is a great strategy for organizing behavior
39. Pull therapist's suitcase on wheels or therapy cart
40. Climbing activities (such as playground equipment)
41. Swing from the trapeze bar
42. Push against a wall
43. Fill up big toy trucks with heavy blocks, push with both hands to
knock things down
44. Sports activities involving running and jumping
45. Two adults can swing child in a sheet. Watch child's face carefully to
note when child has had enough
46. Have the child color a "rainbow" with large paper on the floor
in a quadruped position
47. Play "cars" under the kitchen table (or table in classroom)
where the child pushes the car with one hand while creeping and weight bearing
on the other hand
48. Hot dog" game where child lies across end of a blanket and is rolled
(ends up inside the rolled up blanket with head outside)
49. Walk up a ramp or incline
50. Use theraband or tubing attached to a door and pull it then let it snap.
Supervision necessary.
51. Wood projects requiring sanding and hammering
52. Play wrestling: pushing game where two people lock hands facing each
other and try to see who can push and make the other person step back first. Use
other body parts also, but be sure to have rules (no hitting, no biting, no
scratching, one person says stop then both stop)
53. Open doors for people
54. Quiet squeeze toys such as the cow, fondly named by everyone as
"Moo" (squeaky squeeze toys are frowned on by our teachers). Kids can
be taught to squeeze Moo or the likes of him on their laps under their desks so
as not to disturb the class
55. Chew on fish tank (aquarium) tubing, theratubing, or refrigerator tubing,
if appropriate. One therapist stated that "refrigeration tubing (the kind
the water runs through to the ice maker in your freezer) is (FDA?) approved
while aquarium tubing is not. Cut the tubing into 2-3 inch strips and put it on
the end of the elementary school age child's pencil to be an appropriate 'chewy'
when food is not allowed"
56. Chair push ups
57. Fall into a beanbag chair
58. Jumping and rolling games
59. Slowly roll a ball or bolster over the child, applying pressure
60. Bounce on a Hippity Hop ball
61. Sandwich games (child is place between beanbags, sofa cushions,
mattresses and light pressure is applied to top layer)
62. Play catch with a heavy ball. Bounce and roll a heavy ball
63. Push weighted carts or boxes across carpeted floor
64. Animal walks (crab walk, bear walk, army crawl)
65. Play "row, row, row your boat" both sitting on the floor,
pushing and pulling each other
66. Rice play, koosh balls, water play, jello play, theraputty
67. Mini trampoline
68. Stack chairs
69. Two children can play "tug of war" with jump rope or heavy
theraband. (If you use the theraband, children need supervision so they don't
purposely let go of theraband and "snap" the other child)
70. Isometric exercise breaks
71. Push on large therapy ball with someone else giving resistance from the
other side
72. Have child hold therapy ball with arms and legs while lying on his/her
back. Try to take the ball away and tell the child to hold on to the ball as
hard as he/she can
Heavy Work Activities for Parents
1. Carry heavy items (baskets with cardboard blocks, groceries for Mom, etc.)
2. Mop the floors
3. Allow child to chew gum, eat chewy or crunchy foods, or sip water from a
water bottle with a straw while doing homework
4. Push or pull boxes with toys or a few books in it
5. Pillow cases with a few stuffed animals in it for weight, pushing or
pulling up a ramp, incline or stairs
6. Take the cushions off the sofas, vacuum under them, then put them back.
Can also climb on them, hide under them, jump and "crash" into them,
play sandwich games with them
7. Pull other kids around on a sheet or blanket
8. Roller skate uphill
9. Pull a heavy trash can
10. Yard work, including mowing the lawn, raking grass/leaves, pushing
wheelbarrow
11. Housework including vacuuming and mopping, carrying buckets of water to
clean with or to water flowers/plants/trees
12. Shovel sand into a wheelbarrow, wheel the wheelbarrow to a spot, dump out
sand and use a rake to level it out. (functional for filling in low spots in
backyard)
13. Pull a friend or heavy items in a wagon
14. Push a friend in a wheelbarrow
15. Milkshake rewards sipped through a narrow straw
16. Suck applesauce through a straw
17. Scrub rough surfaces with a brush
18. Carrying heavy cushions
19. Pillow fights
20. Playing in sandbox with damp heavy sand
21. Have the child "help" by pushing in chairs to a table or push
chairs into table after a meal
22. Push a child's cart filled with cans and then put the cans away on a low
shelf where the child needs to be in a weight bearing quadruped (on hands and
knees) position
23. After a bath, parents can squeeze child and rub him/her briskly with a
towel
24. Use heavy quilts at night and tight flannel pajamas
25. Swimming. Also, have child dive after weighted sticks thrown in pool
26. Dancing
27. Activities such as gymnastics, horseback riding, wrestling, karate
28. Bathe the dog
29. Wash the car
30. Carry the laundry basket
31. Sweep, mop, vacuum the floors
32. Jump or climb in inner tubes
33. Fill up a child's suitcase with heavy items (such as books) and push/pull
the suitcase across the room
34. When travelling, let child pull own small suitcase on wheels
35. Go "shopping" with a child's shopping cart filled with items
36. Child can help change the sheets on the bed, then toss the linens down
the stairs
Heavy Work Activities for Parents
37. Go "camping" with a heavy blanket pulled across a few chairs.
Child can help set up and take down the blanket
38. Child can help rearrange his/her bedroom furniture
39. Have child put large toys and equipment away
40. Wipe off the table after dinner
41. Help dust the furniture
42. Climbing activities (such as playground equipment)
43. Swing from the trapeze bar
44. Push against a wall
45. Fill up big toy trucks with heavy blocks, push with both hands to knock
things down
46. Sports activities involving running and jumping
47. Two adults can swing child in a sheet. Watch child's face carefully to
note when child has had enough
48. Have the child color a "rainbow" with large paper on the floor
or with sidewalk chalk outside while child is on his/her hands and knees
49. Play "cars" under the kitchen table (or table in classroom)
where the child pushes the car with one hand while creeping and weight bearing
on the other hand
50. Hot dog" game where child lies across end of a blanket and is rolled
(ends up inside the rolled up blanket with head outside)
51. Walk up a ramp or incline
52. Use theraband or tubing attached to a door and pull it then let it snap.
Supervision necessary.
53. Wood projects requiring sanding and hammering
54. Play wrestling: pushing game where two people lock hands facing each
other and try to see who can push and make the other person step back first. Use
other body parts also, but be sure to have rules (no hitting, no biting, no
scratching, one person says stop then both stop)
55. Open doors for people
56. Quiet squeeze toys such as the cow, fondly named by everyone as
"Moo" . Kids can be taught to squeeze Moo or the likes of him on their
laps under their desks so as not to disturb the class
57. Chew on fish tank (aquarium) tubing, theratubing, or refrigerator tubing,
if appropriate. One therapist stated that "refrigeration tubing (the kind
the water runs through to the ice maker in your freezer) is (FDA?) approved
while aquarium tubing is not. I cut the tubing into 2-3 inch strips and put it
on the end of the elementary school age child's pencil to be an appropriate
'chewy' when food is not allowed"
58. Chair push ups
59. Fall into a beanbag chair
60. Jumping and rolling games
61. Slowly roll a ball or bolster over the child, applying pressure
62. Bounce on a Hippity Hop ball
63. Sandwich games (child is place between beanbags, sofa cushions,
mattresses and light pressure is applied to top layer)
64. Play catch with a heavy ball. Bounce and roll a heavy ball
65. Push weighted carts or boxes across carpeted floor
66. Animal walks (crab walk, bear walk, army crawl)
Heavy Work Activities for Parents
67. Play "row, row, row your boat" both sitting on the floor,
pushing and pulling each other
68. Rice play, koosh balls, water play, jello play, theraputty
69. Mini trampoline
70. Stack chairs
71. Two children can play "tug of war" with jump rope or heavy
theraband. (If you use the theraband, children need supervision so they don't
purposely let go of theraband and "snap" the other child)
72. Isometric exercise breaks
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