Kinesthetic
Kinesthetic
Copyright © 2020
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ISBN: 978-81-946509-0-4
Any resemblance to actual person, living or dead, or actual events is purely coincidental
First Impression, 2020:
R&D Team
Dr. Himangshu Das, Director, NIEPMD, Chennai
Dr.A.Amarnath, HoD, Social Work & Research In charge, Dr.B.Amutha, Senior Consultant (R&D), NIEPMD, Chennai
NIEPMD, Chennai.
Dr.R.Karthikeyan, M.B.B.S., M.D., Department of Physical Shri.Pankaj Kumar Occupational Therapist, Head of Therapeutics
Medicine and Rehabilitation, Sree Balaji Medical College & Services & Research, Reviviscence Rehab Institute Pvt Ltd, Chennai
Hospital, Chromepet, Chennai,
Consultant at Kauvery Hospital, Chennai.
Hamsa Brain and Spine Rehab, Chennai
Shri.S. Samuel Dinakaran, Asst Professor, Occupational Shri.Sugumar Paulraj, Occupational Therapist, Managing Director,
Therapy, Department of Therapeutics, NIEPMD, Chennai. Srimathi Karthikeyani School for Special Children, Dindigul.
Advisory Team
Shri.S.Sankara Narayanan, Deputy Registrar, NIEPMD, Dr.K.Balabaskar, HoD, AIL, NIEPMD, Chennai
Chennai
Shri. Rajesh Ramachandran, R&O, Social Work, NIEPMD, V.Vaijayanthi, Research Assistant, NIEPMD, Chennai
Chennai
Credits
Ministry of Social Justice& Empowerment, GoI.
Department of Empowerment of Persons with Disabilities (DIVYANGJAN), GoI.
NIEPMD for aiding us with data collection
i
KINESTHETIC AND VESTIBULAR ACTIVITIES FOR
DEVELOPMENTAL DISABILITIES
ii
Preface
In everyday life, a child engaging in play & other activities of daily living require integration of
inputs from various senses which includes visual kinesthetic, and vestibular information to
compute child’s relative position in the environment. Children rely on their senses to
successfully interact with the surrounding environment.
Specialized senses enable perception of self or extrinsically induced movement of our bodies
(vision, vestibular and kinesthesia).Problems associated with vestibular & processing can make
many aspects of everyday life very challenging. Children may appear to be fearful of movement
because they feel insecure and unbalanced. This often leads to children preferring sedentary
activities, avoiding swings or climbing, or other activities where their feet leave the ground. They
also may have difficulty moving through the environment at home or in the playground, often
moving cautiously or slow.
Studies have found engagement of children in kinesthetic & vestibular activities have shown
improvement in the above senses to certain extent.
The following book has been written with the intention of providing added information to
parents & caregivers & other professionals about various activities that can be given to child to
improve their kinesthetic & vestibular sense. The chapters explain about kinesthetic & vestibular
sense & the dysfunctions caused by the impairment of the two senses. Empirical evidence review
has also been done about the effectiveness of the activities. The book contains 50 simple activities
to improve kinesthetic & vestibular sense, information about play, developmental consideration
& precautions have also been elaborated.
iii
Table of Contents Page No
4. Evidence Review 16
Glossary 79
iv
CHAPTER- 1
PLAY, DEVELOPMENTAL CONSIDERATION AND PRECAUTIONS
All children play and it is through play they learn about themselves and
environment. According to the American Occupational Therapy Association (AOTA)
Practice Framework, Play is one of important occupations in which children engage.
Play is considered as internally motivating activities that help in amusement, relaxation,
enjoyment& also for self-expression.
Children learn through play. When selecting play activity for child, the things to be
taken into consideration are whether the child likes those activity and whether the
selected play activity are age appropriate for that child.
1
stronger which is quintessential for learning. Play experiences foster multiple
developmental benefits and enhance the child's quality of life.
Children’s play preferences were found to be impacted by their sensory
preferences (Mische Lawson & Dunn, 2008; Welters-Davis &Mische Lawson,
2011), for example a child who seeks sensation prefers to play with toys that
met his/her sensory needs.
When a child with developmental disabilities is made to engage in play, how
each child’s play behavior varies, need to be considered. Play activity
designed should help in addressing & improving the difficulties child might
have.
b) Developmental consideration:
Developmentally sensation is important in emergence of play skills. During
play development, behavior of child is dominated by influence of basic
sensory functions. According to Nancy Takata, the first and important phase
in development of play is sensor motor phase or epoch.
Sensor motor play (0-2 years) children during this stage of play development
engage in activities through utilizing body or other objects so they can
explore the various sensory characteristics (e.g. mouthing a toy, shaking a
sound producing object, banging a toy drum).This explains the importance of
sensation in development of play skills.
Sensory play especially involving tactile, vestibular& kinesthetic sense have
been found beneficial in various studies. Researchers have found that sensory
play facilitates and builds nerve connections in brain’s pathways, which in
turn are helpful in child’s ability to accomplish learning tasks which are
complex. Sensory play aids in cognitive and language development, mastery
in fine and gross motor skills, also helps in achievement of problem solving
skills, and to a greater extent to improve social interaction. This type of play
helps in developing memory. Sensory play has been found to be helpful to
calm an anxious child or a child who is frustrated .This type of play also does
help the child to learn different sensory attributes like hot & cold.
Children who have sensory processing issues were found to have a delay in
the achievement of at appropriate play skills, especially in social play, and it
was also found that they have a decreased duration engaging with toys and
objects, these children preferred toys that would satisfy their sensory needs.
Most important sensory development is believed to occur in infancy from
birth to one year. During this time infants learn about surrounding which
means they learn world through their various senses, they look at their
surroundings, faces of parents and also begin to respond to smiling face. As
and when the sensory processing skills mature, important pathways in
2
nervous system are redefined and it also becomes strengthened .The problem
solving skills of the children also becomes better and they are able to deal
with challenges in life. Life is considered as a sequence of continual sensory
experiences.
Play is viewed as child’s work and it fosters chances to make sensory
integration to occur. For child to develop sensory integration & to develop
good organization skills, the play experience should be diverse comprise an
at same time he child should engage in pay frequently.
The benefits of sensory play for children with developmental disabilities needs include:
We will briefly view how adaptations can be done for a child with over
responsivity & sensory seeking A child with sensory over responsivity (sensory
defensiveness)respond to sensation much faster ,also with more vigor, or for longer
duration than a child with typical sensory responsivity. For such children changes can
be made to decrease litter near child’s desk , make the worksheets much simpler by
removing additional pictures and using font which is bigger ,place the child’s desk in a
cubicle so distractions can be minimized (visual adaptations).Auditory adaptations
include seating the child away from the loud sounds, allowing child to use headphones
which help in noise reduction and also preparing child beforehand for unanticipated
3
noises. Tactile adaptations like modifying messy play, positioning the child away from
crowded place can also be done.
A child who is a sensory seeker desires more amounts or the type of sensory
input and seems to have an unappeasable desire for various sensations. For a child who
is tactile seeker children adapting the environment which includes encouraging the
teachers to permit the child to use a toys like stress ball during quiet work or tests, or
make the child hold a weighted ball or stuffed animal during group time and also
making the child sit on an inflatable cushion when they’re seated can really help great
deal.
The adaptations that can be done for child who is a oral seekers include
providing a chewy snack for about twice or thrice in a day, providing hard candy that
provides intense oral input, and child can be made to drink using straw to provide
powerful oral input.
In a group set up like a classroom, the child can be given activities which provide
kinesthetic & vestibular sense to establish safe & supportive surroundings, offer rich,
stimulating atmosphere and creating opportunities for group learning.
Planning sensory activities for children group can help sensitive students
increase their tolerance while providing appropriate stimulation to those who crave it,
thereby helping to reduce inappropriate sensory-seeking behaviors
Repetitive & rhythmic vestibular input activities like rocking, swaying, or gentle
swinging has been found to be very useful for most children with sensory issues. These
sensory inputs can be a beneficial ways to help a child calm down when children are
over stimulated or when dealing with the child’s tantrums. Adding rocking chair in a
class room and having therapy ball can come in handy to provide calming movement
when the children need it. Small changes to the environment can significantly
contribute to improving sensory regulation of the child. Movement Breaks can be given
at regular intervals for children in a group. This is nothing but scheduling activities to
get up and move around the room. Playing in a balance beam, obstacle course activities
can also be included during this time to incorporate kinesthetic & vestibular sense. Also
some brief stretches, playing in a swing during break or rocking to &fro in a rocking
chair can help child to calm while in a group.
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d) Do’s & Don’ts for parents:
Do’s:
Do let your child direct their sensory play, provide assistance only when
needed
Do play with your child in variety of ways, which helps the child to
understand the difference between them
Do encourage playing with other similar age grouped children
Do allow frequent breaks
Do be cautious if child has seizure disorder or other medical condition e.g.
vestibular stimulation has to be minimal & controlled for a child with seizure
disorder
Do take safety precaution like covering flooring & walls with protective
material needs to done, children with balance issues should be closely
monitored while vestibular & kinesthetic stimulation
Don’ts:
Don’t excessively direct child’s sensory play , it’s crucial for child to
participate in play with their own concepts
Don’t pressure play activities on the child , play should be stimulating and
fun
Don’t over stimulate ,child can receive too much sensory stimulation, which
results in reactions which could be disruptive, must closely monitor a child’s
reactions to counteract those reactions
Don’t under stimulate
Don’t make the child sit next to distracting sources of noise, visual stimulus
Don’t compare the child’s progress as duration to elicit an adaptive behavior
varies for each child
5
References:
1. Arnwine, B., & McCoy, O. (2006). Starting sensory integration therapy: Fun activities
that won't destroy your home or classroom!
2. Future Horizons Aquilla, Paula, Ellen Yack, and Shirley Sutton, OT. Building Bridges
Through Sensory Integration . 2nd ed. Las Vegas, NV: Sensory Resources, 2009.
3. Ayres, Jean, Sensory Integration and the Child . Los Angeles: Western Psychological
Service, 2005.
4. Biel, Linsey, and Nancy Peske. Raising a Sensory Smart Child . New York: Penguin,
2005. Cohen, David. (2018). The Development of Play.
5. Coleman, Mary, and Laura Krueger. Play and Learn . Roseville, MN: AbleNet, 1999.
Dennison, Paul, Ph.D. and Gail E. Dennison. Brain Gym . Binghamton, NY: Edu -
6. Kinesthetics, 1992. Diamantis, A.. (2010). Sensory integration. The British Journal of
Occupational Therapy Dunn, Winifred. 1997.
7. The impact of sensory processing abilities on the daily lives of young children and their
families: A conceptual model.
8. Infants and Young Children Fisher, Anne G., Elizabeth A. Murray, and Anita C.
Bundy. 1991. Sensory Integration Theory and Practice. Philadelphia, PA: Davis Frick,
S., and Hacker, C. (2000) Listening with the Whole Body, Madison, WI: Vital Links.
9. Kranowitz, Carol. The Out - Of - Sync Child Has Fun . New York: Perigee Trade, 2003.
10. Kranowitz, Carol, and Lucy Miller. The Out- of- Sync Child . New York: Perigee Trade,
1998.
11. Kranowitz, Carol, and Joyce Newman. The Out - of - Sync Child: Recognizing and
Coping with Sensory Integration Dysfunction.
12. New York: Perigee Trade, 2009 Lawton-Shirley, N., and Oetter, P., Sensory Integration
& Beyond: Power Tools for Treating Children, Seminar 2005.
13. Mailloux, Z. (2007) Play and the Sensory Integrative Approach, in Parham, L.D., and
Fazio, L., Play in Occupational Therapy for Children, Boston: Mosby.
14. May-Benson, T.Sc.D. (2007) A Theoretical Model of Ideation in Praxis, in Roley, S.,
Banche, E., and Schaaf, R., Understanding the Nature of Sensory Integration with
Diverse Populations, Austin, TX: Pro-Ed.
15. Miller, L. J. (2006) Sensational Kids”Hope and Help for Children with Sensory
Processing Disorder (SPD), New York: Perigee Books.
16. Ottenbacher, K. J., &Degraft, M. A. (2013). Vestibular processing dysfunction in
children. Routledge. Preedy, Pat. (2019). Enhancing physical development through play.
17. Sher, B., n.d. Everyday Games For Sensory Processing Disorder.
Trott, Maryann Colby, Marci K. Laurel, and Susan L. Windeck.
18. SenseAbilities: Understanding Sensory Integration . San Antonio, TX: Therapy Skill
Builders,
6
19. Welters-Davis, Melissa. (2011). The Relationship Between Sensory Processing and
Parent–Child Play Preferences.
20. Journal of Occupational Therapy, Schools, and Early Intervention. 4.
10.1080/19411243.2011.595300.
21. Wilbarger, P., and Wilbarger, J. (1991) Sensory Defensiveness in Children; Intervention
Guide for Parents & Other Caretakers, Santa Barbara, CA: Avanti Educational
Programs.
22. Yack, E. 1989. Sensory integration: A survey of its use in the clinical setting. Canadian
Journal of Occupational Therapy 56, no. 5:229–235.993.
7
CHAPTER- 2
-Dr.R.Karthikeyan
Posture
The term Posture means “the relative position of the parts of the human body, either
static or dynamic”. In static posture, the body and its segments are immobile,
maintained with alignment in certain positions. Examples - standing, sitting, lying.
Dynamic posture refers to mobile postures in which the body or its segments keeps
moving— Examples - walking, jogging and swimming.
In order to maintain a stable and functional posture – both static and dynamic, the
following senses / structures are essential:
8
In a dark cinema hall - we are able to walk, pass between the rows of seats to reach
ours. And while watching the movie, we do eat pastries with our hand precisely
putting into our mouth – all these without seeing in the dark. This is where the
proprioception and kinesthetic sense works – which makes you to know where your
body parts are and how they are moving, through sensory receptors in your muscles
and joints.
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Bodily - Kinesthetic intelligence
Bodily - kinesthetic intelligence is defined as “the ability of the individual to use his
body to solve problems, express ideas and emotions and manipulate objects”. Thereby
acquiring the ability to employ the human body in various activities requiring skill to
fulfill a need and achieve a goal. For Example – Gardening, Dancing, Drawing.
Kinesthetic intelligence helps to improve gross and fine motor skills, flexibility and
agility of the body, dexterity of hands.
Vestibular Sense
When you are in Elevator / Lift, you can sense whether it is moving up or down –
even when the Lift / Elevator is closed. Your Vestibular sense acts at this time, with
its sensory receptors present in the inner ear
Ear is divided into three parts – Outer ear, Middle ear and Inner ear.
Conduction of
Outer and
Sound for hearing
Middle Ear
For Hearing
Cochlear Duct
Inner Ear
For balance and
equilibrium.
Semicircular
Canals
Otolithic Organs -
Utricle and Saccule
Sources: www.neurones.co.uk
The Vestibular system functions based on our head movements to control body
balance, eye movement and spatial orientation. It consists of specialized organs as
follows
Semicircular Canals – are three in number (anterior, posterior and lateral) within
the inner ear, receives sensory information of angular movements of the head and its
velocity.
10
Otolithic Organs – Saccule and Utricle – receives sensory information of linear
motion and static tilt of the head.
Vestibule Cochlear Nerve is the nerve present in the ear – which is for the
function of Equilibrium (Vestibular part) and Hearing (Cochlear part)
11
References:
1. Textbook of Human Anatomy - 6th Edition - 3rd volume ( Head - Neck & Brain) -
B.D.Chaurasia
2. Textbook of Human Physiology - 10th Edition - Guyton & Hall
3. Vestibular Rehabilitation - 3rd Edition - Susan J. Herdman.
4. Online Image Courtesy - www.neurones.co.uk
12
CHAPTER- 3
-S.Samuel Dinakaran
Kinesthetic Sense
It is the ability to identify active and passive movement of a body part. The
kinesthetic system is vital part of the human physiology that provides each individual
with sensory awareness about the position and movements of the body. This kinesthetic
system is the one which makes individuals aware of our posture and motor actions,
from the raising of an arm, to walking, even swallowing. For example, when a person
comes eyes and raises an arm and moves it around above head, it is the kinesthetic
system that makes us aware of where the arm is positioned and it is in motion.
Kinesthetic sense plays a very vital role in the learning and performance of hand
movements that are skilled including handwriting. Fine motor skills and hand function
need kinesthetic awareness. If the kinesthetic sense is impaired it has impact on the
functional use of hand.
Dysfunction
Kinesthetic sense is primary component of muscle memory and eye - hand co-
ordination. Position sense is disrupted when person has problems in processing
information related to kinesthetic sensory information. If child has kinesthetic
dysfunction, the child might have difficulty in accurately sensing information about
whether certain muscles are relaxed or tensed and also has will face difficulty in sensing
13
how much effort the muscles are making. As a consequence of this, tensed muscles will
continue to remain tensed, and sooner or later the tension leads to pain. Till the time
kinesthetic awareness is dysfunctional, child cannot progress the way he/she carries
and use the body. Training can improve kinesthetic sense.
Vestibular sense
The vestibular sensory system acts to changes in position of head movement and
it coordinates eye, head, and body movements, and also maintains the posture and
good stable visual field. Vestibular receptors are located within inner ear. The ability to
maintain balance and body posture is made possible by vestibular sense. The sensory
organs of this system are in inner ear, very next to the cochlea.
14
References:
1. Parham LD, Ecker C, Miller H, Henry DA, Glennon TJ. Sensory Processing Measure.
Los Angeles: WPS; (2007). [Google Scholar]
2. Dunn W. Sensory Profile 2: User’s Manual. USA: Pearson, Inc; (2014). [Google
Scholar]
3. Dunn W. Supporting children to participate successfully in everyday life by using
sensory processing knowledge. Infant Young Child (2007) 20(2):84–
101.10.1097/01.IYC.0000264477.05076.5d [CrossRef] [Google Scholar]
4. Ayres J. Sensory Integration and Praxis Tests (SPIT). Los Angeles: Western
Psychological Services; (1989). [Google Scholar]
5. Parham LD, Mailloux Z. Sensory integration. 4th ed In: Case-Smith J, editor. , editor.
Occupational Therapy for Children. St. Louis: Mosby; (2001). p. 329–81. [Google
Scholar]
6. Lucy Jane Miller Sensational Kids: Hope and Help for Children With Sensory Processing
Disorder (New York: Perigee, 2014, 2nd edition).
7. Biel L, PeskeN, GrandinT, Raising a Sensory Smart Child: The Definitive Handbook for
Helping Your Child with Sensory Processing Issues, Revised and Updated Edition
Paperback – 25 Aug 2009
8. Lane SJ, Bundy AC. Kids Can Be Kids a childhoods Occupations Approach. Philadelphia:
F.A Davis Company; (2012). p. 437–59. [Google Scholar]
15
CHAPTER- 4
EVIDENCE REVIEW
-Pankaj Kumar
Joe Tranquillo (2008) depicted sensation learning in the study hall as a lot of
data exists with respect to the various methods by which understudies learn new ideas.
Albeit visual, sound-related and sensation learning are the most generally recorded
learning styles, little consideration has been given to sensation learning. This is
particularly obvious in address based courses at the school level where the organization
favors verbal and visual students. Here we make a speculative contention for the
benefit of remembering sensation learning exercises for address based classes as a
vehicle for educating ideas. To start, it is critical to clarify how our functioning meaning
of sensation taking in might be not quite the same as past work. To begin with, the
expression "dynamic learning" as of now implies something to the training network and
may incorporate teacher exhibitions, conceptualizing, reflections and moment papers.
The variant of sensation learning considered here is a sub-set of dynamic realizing
where understudies will be out of their seats and actually dynamic. Second, the
expression "sensation learning" is in like manner use in some training circles. Inside
those circles, the attention is commonly on learning a manual ability or refining muscle
coordination. Architects must figure out how to construct physical structures,
frequently utilizing their hands to perform complex undertakings. While a lot of
learning happens in getting able at wire wrapping and binding a circuit board,
interfacing and fixing tubes in a stream circle or penetrating an exact gap in an area of
sheet metal, the learning is to a great extent a tweaking of muscle memory. In most
educational plans, these aptitudes are polished and aced in a lab setting. The rendition
of sensation learning considered here will occur in the study hall with the target of
presenting and reinforcing ideas just as interfacing thoughts together. Along these lines,
when the expressions, "dynamic" or "action" show up beneath, they truly mean some
sort of physical movement that is proposed to invigorate profound thinking.1
Matthew Lai, Danny Luong, and G. Youthful (2015) depict about Kinesthetic
Learning Activities and its Effectiveness Teaching Computer Algorithms inside an
Academic Term. Sensation learning is an instructing strategy that includes
understudies' physical cooperation among one another and the earth. The regular
technique for educating, a study hall with a teacher talking and understudies tuning in
and taking notes, has been the standard for a considerable length of time. This
exploration endeavors to show that the sensation learning activities(KLA) approach can
be a reasonable other option. In this examination, the exhibition of understudies from
16
an undergrad level software engineering course, Parallel Processing, is thought of. In
the spring 2014 quarter, the class was separated into two gatherings. Each gathering
was then again showed utilizing KLA and customary techniques, permitting us to
check the adequacy of the KLA approach in one quarter. By playing out this test
through the span of a solitary quarter, we want to all the more completely show the
adequacy of a KLA way to deal with educating understudies. The understudies' picked
up information was estimated through pre/ posttests. We estimated that the KLA
approach would be as proficient as the customary talks if not progressively productive.
The information that was gathered from these tests favour our hypothesis.2
19
Helen Cohen, Laura V. Mill operator, Maureen Kane Wineland, Catherine L.
Hatfield (1989) portrayed restoration program about Vestibular Rehabilitation With
Graded Occupations Patients with vestibular issues may have vertigo the dream of self-
movement generally depicted as spinning or fizzling disequilibrium, bewilderment,
obscured visiondue to ;In debilitated vestibulocular reflex (VOR), and expired
autonomy in exercises of (Iail" living (ADL) (Cohen, 1992; Cohen &Keshner, 1989:
Farber, 1989; Mmris, 1991). Finding of vestibular issues usualincludes target trial of
equalization and trial of the VOR,during which eve developments are recorded.
Generally withelectrooculography (EOG). The EOG battery normally remembers caloric
tests for which warm or cool water or air isput in the outer vehicle while the patient is
lying prostrate just as tests in which tile understanding sits upstanding in a PC
controlled seat and is wavered in an assortment of visual conditions (Zane. Rauhut, and
Jenkins, 1991). The three patients portrayed in this article were tried with part or all of
such a battery. The offices of the analytic research centers in which these patients were
tried contrasted in the sort of hardware accessible and spoke to the scope of offices
commonly utilized by otolaryngologists and nervous system specialists who treat
patients with vestibular issues. In contrast to the average clinical Situation, nonetheless,
in this investigation all alluding otolaryngologists were associated with clinical schools
and educating medical clinics. AJI subjects got fortnightly 40-min treatment meetings at
outpatient centers for about a month and a half; every one of them needed to drive their
vehicles to the treatment Facilities 01" were driven by others; no subjects had the option
to take open transportation, The specialists utilized a standard assessment in-hint drove
walk, moves, scope of movement, and Functional muscle quality, Additionally, the
force, term, recurrence of vertigo were surveyed, Vertigo power with the accompanying
five-point subjective scale: 1. ordinary, no vertigo: 2. just notice < l vertigo loss of
balance; 3. gentle, slight loss of equalization, no sickness; 4. serious, loss of parity,
potentially with nausea; 5. extraordinary, complete loss of parity, with queasiness,
retching, ADL freedom was assessed with a scale shortened from Cohen (1992). This
instrument utilizes a five point subjective scale, from free to subordinate, and
incorporates bed versatility, dressing, washing, prepping, home administration, and
general mobility tasks, Static standing offset was surveyed with the Clinical Test of
Sensor\' Interaction on B81ance (CTSIB), which has six distinctive test conditions (sec
Table J) (Cohen, Blatchlv, & Gombash, 1993; Shumw8v-Cook & Horak, 1986), Each
patient's reactions to a variet)' of mixes of head developments and positions were
methodically assessed to figure out which movements ought to be focused on curing
treatment exercises, AJI subjects were given a straightforward home program of tedious
head developments in yaw (revolution of the head looking from side to side), pitch
(neck flexion and hyperextension), and move (Iareral flexion to eithel' side), Subjects
were told to rehearse the activities when they didn't go to treatment, None of the
20
subjects on meds to control vertigo while taking part in this treatment program, albeit
two of them has been dealt with ineffectively preceding for treatment with drugs that
smother the vestibular system9.
Results: Both members showed critical upgrades in the zones of social cooperation, way
to deal with new exercises, reaction to holding or embracing, and reaction to
21
development. Diminishes were noted in the recurrence and length of problematic
practices (e.g., high action levels, aggressive practices), with an expansion in utilitarian
practices, for example, unconstrained discourse, intentional play, and consideration
regarding exercises and discussion. Simultaneous intercessions that were not part of
this investigation (e.g., commencement of language training, preschool, nutrients) may
have perplexed these outcomes. End: These discoveries bolster the use of tangible
integrative-based word related treatment as a piece of the administrations gave to
certain kids PDD. Further exploration is expected to repeat these discoveries and to
disengage the impacts of tangible integrative-based word related treatment on the
grounds that the two members were getting different intercessions at the hour of this
study11.
Lynne Welham ( 2013 ) has done their examinations on Multiple Sclerosis and he
portrays about mediation of Occupational Therapy for Fatigue in Patients with MS.
Weariness influences a high extent of patients with different sclerosis (MS), with
different examinations demonstrating that somewhere in the range of 78% and 90% of
MS patients might be influenced. Exhaustion can cause numerous issues for the
individual with MS. The compounding of physical manifestations can prompt
challenges in doing the standard every day exercises and to the requirement for
acclimations to schedules. Mental issues, for example, uneasiness and sorrow may
likewise happen, just as family and social troubles including false impressions or being
viewed as a malingerer. The point of this exploration was to examine the quantities of
word related treatment divisions, inside an example bunch who do mediate for
weariness in MS patients, the sorts of intercession they use and any remarks they
wished to make about this territory of word related treatment. A survey was created for
consummation by word related specialists working with MS patients all in all nervous
system science and in neuro rehabilitation. The points of the poll were to evoke the
most well-known mediation systems utilized, and how successful these were felt to be
by the specialists in question. (The subtleties of the poll are appeared in Appendix 1.) A
pilot study was not viewed as fundamental since the survey was just planned to
accumulate essential data and general remarks. Surveys were sent to a sum of 20 word
related treatment offices. Of these, 13 were sent to general emergency clinics with
nervous system science offices in the North West Thames Region as an example bunch
inside the neighborhood 7 were sent to arbitrarily chosen recovery units the nation
over, since there was just a single restoration unit inside the North West Thames Region
around then. The poll was sent to recovery units just as general medical clinics on the
supposition that weakness is bound to be tended to in a restoration unit than a general
hospital12.
22
Jean Ayres Linda S. Tickle (2011) has accomplished their work on mentally
unbalanced kid and introduced about hyper responsively to Vestibular Stimuli, Touch
or Sensory Integration Procedures in chemical imbalance Sensory handling aggravation
in medically introverted kids as an indicator reaction to tactile integrative methodology
was researched. Ten mentally unbalanced kids, ages 3-15 to 1) years (mean, 7.4 years),
uteri at first assessed in respect to their hypo-, hyper-, or typical responsively to
common, auditory, tactile, vestibular, proprioceptive, rhetoric, and gustatory stimuli.
After assessment, every youngster got treatment that gave soma to sensory and
vestibular incitement and evoked adaptive responses to these upgrades. Toward the
finish of one year of treatment, each child's advancement That has made a decision
about in relationship to that of the others, and the gathering was partitioned into the six
best and the four poorest respondents. Stepwise discriminate investigation recognized
which initial test factors predicted good or helpless reactions to treatment. The good
respondents demonstrated material protectiveness, shirking of landmark, gravitational
uncertainty, and a situating reaction to an air purl. Results propose that children who
enlisted sensory input yet neglected to tweak it responded better to treatment than
those who were hypo-responsive or neglected to arrange to tangible input13.
Helen Cohen (2014) has total their exploration in Vestibular restoration and
clarified in the examination that how Vestibular rehabilitation reduces functional
inability. Vertigo brought about by vestibular turmoil might be effectively rewarded
with a physical therapy program of evaluated activities to adjust the patient to the
vertiginous improvement and to build the scope of movement through which the
patient can endure moving. Performance on day by day self-care entrusting significant
pointer of the patient's tolerance for head development and the accomplishment of
treatment. In this examination, salt-center ability in subjects with complex and
brainstem injuries when accepting vestibular restoration was inspected. Subjects
improved essentially after non-intrusive treatment, showing more prominent freedom
in their capacities to think about themselves. These data provide further help for the
estimation of vestibular restoration procedures14.
Helen Cohen (2011) depict about how Vestibular Rehabilitation Improves Daily
Life Function This article surveys ongoing research that addresses the utilitarian results
mediation for vesicular issues. Vestibular hindrances cause disequilibrium, blurred
vision, confusion, and vertigo. These tangible unsettling influences and engine
hindrances in turn cause brokenness in numerous exercises of every day and in social
connections that customary clinical medicines don't address. The molar sequelae some
vestibular issues can be dealt with fruitful with projects of reviewed 8yercises and
exercises. These national ramifications which are depicted here in. The enthusiastic
hindrances brought about by other testicular issues, which can't be treated with graded
23
activities, are additionally portrayed These issues include bilateral vestibular
misfortune brought about by connective tissue disorders or by the utilization of ototoxic
drugs, clocks 0/the maze or vestibular nerve, and Jeanpierre '.'I infection. Word related
therapy intervention for these conditions may involve policing versatile hardware,
showing elective methodologies for performing exercises of everyday living, and
mental sick, were lion for sadness and anxiety15.
Targets: To create and approve another self-report out-come measure named the
Vestibular Activities and Participation (VAP) for individuals with vestibular issues to
look at their exercises and support as indicated by the International Classification of
Functioning Disability and Health. Plan: Delphi iterative study for the improvement of
the VAP and approval study. Setting: Tertiary parity facility. Members: A board of
overall specialists (n17) in vestibular brokenness partook in the advancement of the
VAP, and patients (N58) with vestibular issues were taken on the approval of the VAP.
Mediation: Not pertinent Main Outcome Measures: For the improvement of the VAP,
an Internet-based study of 55 exercises and cooperation things was introduced to the
board of specialists and the rate understanding per thing was determined. For the
approval of the VAP, the VAP was finished twice to look at the test-retest
dependability, the World Health Organization Disability Assessment Schedule II
(WHO-DAS II) was utilized to inspect the simultaneous legitimacy with the VAP, and
the Dizziness Handicap Inventory (DHI) was utilized to analyze the focalized
legitimacy of the VAP. Results: After 2 rounds of the Delphi strategy, the VAP was
created. The VAP complete score had amazing test-retest reliability (intra class
relationship coefficient.95; certainty interval.91–.97) and great to phenomenal
understanding per thing demonstrated by the un weighted kappa (.41–.80) and the
weighted kappa (.58 – .94). The base perceivable change at 95%confidence degree of the
VAP score was .58. The VAP had solid relationship (.70; P.05) with the WHODAS II and
moderate to solid connections (.54 – .74) with the DHI subscale and complete scores.
After modification for age, we saw sex and self-revealed awkwardness as free logical
factors of the changed VAP all out score. Ends: The VAP measure was created to
analyze the incapacitating impact of vestibular issues on individuals' exercises and
investment dependent on a normalized structure (the International Classification of
Functioning Disability and Health). The VAP exhibited phenomenal unwavering
quality and was approved with outer instruments in individuals with vestibular issues
16.
24
ParthChholak, GuiomarNiso, VladimirA. Maksimenko, SemenA.
Kurkin,Nikita S. Frolov, Elena N. Pitsik , Alexander E. Hramov, Alexander N.
Pisarchik (2018) has had their exploration take a shot at kinaesthetic and visual modes
influence engine symbolism to take subjects who are undeveloped. The comprehension
of neuro physiological systems liable for engine symbolism (MI)is fundamental for the
advancement of cerebrum PC interfaces (BCI) and bio prosthetic. Our magneto
encephalographic (MEG) tries different things with deliberate members affirm the
presence of two kinds of engine symbolism, kinaesthetic symbolism (KI) and visual
symbolism (VI), recognized by initiation and restraint of various mind regions in engine
related α-and β-recurrence districts. In spite of the fact that the mind action relating to
MI is typically seen in exceptionally prepared subjects or competitors, we show that it is
additionally conceivable to distinguish specific highlights of MI in undeveloped
subjects. Like genuine development, KI infers solid sensation when playing out a
nonexistent moving activity that prompts occasion related desynchronization (ERD) of
engine related mind rhythms. On the other hand, VI alludes to perception of the
comparing activity that outcomes in occasion related synchronization (ERS) of α-and β-
wave movement. A prominent contrast among KI and VI bunches happens in the
frontal cerebrum territory. Specifically, the investigation of evoked reactions shows that
in all KI subjects the action in the frontal cortex is smothered during MI, while in the VI
subjects the frontal cortex is consistently dynamic. The precision in grouping of left-arm
and right-arm MI utilizing man-made reasoning is comparable for KI and VI. Since
undeveloped subjects for the most part exhibit the VI symbolism mode, the likelihood
to build the precision for VI is sought after for BCIs. The use of counterfeit neural
systems permits us to characterize MI in raising both ways arms with normal exactness
of 70% for both KI and VI utilizing fitting filtration of information signals. A similar
normal precision is accomplished by upgrading MEG channels and diminishing their
number to just 13.17.
Elliot Mylott, Justin Dunlap, Lester Lampert, and Ralf Widenhorn (2014) has
introduced Kinesthetic Activities for the Classroom Educators have discovered that
sensation association in an analysis or exhibit can draw in students in an incredible
way.1-3 With that as our objective, we created three exercises that permit understudies
to interface with and quantitatively investigate key material science standards from
mechanics with three fun physical difficulties. By introducing these activities as
rivalries, we can provoke understudies to use what they think about the pertinent
material science to improve their performance and beat their own score or those of
different understudies. Every movement utilizes a unique, ongoing information
collecting program that offers understudies and instructors a basic, clear method to
show different material science ideas including :( 1) motivation force, (2) focal point of
mass (COM), and (3)kinematics. The UI, written in Lab VIEW, is instinctive to work and
25
just requires Vernier Force Plates Vernier Lab Quest, 5 a webcam, and a PC. In this
article, we will portray every one of these exercises, which are all well suited and
promptly accessible for other effort occasions or homeroom demonstrations18.
Joan Snyder Lydic, Mary Margaret Windsor, Margaret Anne Short &Terry Ann
Ellis (2009) contemplated Effects of Controlled Rotary Vestibular Stimulation on the
Motor Performance of Infants with Down Syndrome where she considered Eighteen
newborn children, extending in age from four to ten months at the beginning of the
investigation, were partitioned into control and treatment bunches utilizing a defined
irregular testing method. Youngsters were chosen based on age, explicit kind of Down
syndrome, and investment in an ordinary sensor motor mediation program from
outside the investigation. Youngsters in the treatment bunch got, in their home,
revolving vestibular incitement multiple times week after week for twelve weeks
notwithstanding their customary program. Kids in the benchmark group got just their
customary program. All kids were assessed at first, toward the finish of about a month
and a half, and toward the finish of twelve weeks by a similar inspector, who was
guileless to aggregate task. Assessments incorporated the Movement Assessment of
Infants (MAI) and the Gross Motor segment of the updated Peabody Developmental
Motor Scales (PDMS). Investigations of fluctuation demonstrated huge preliminaries
yet non-noteworthy gatherings or communication impacts with both engine
instruments. The speculated differential treatment impact of vestibular incitement was
not validated, yet significant clinical data was gotten. This examination showed that,
26
over a 12-week time span, down disorder newborn children are fit for rolling out huge
improvements in engine capacities, to which both the Movement Assessment of Infants
and the Peabody Developmental Motor Scales are touchy. Treatment and control
bunches rolled out proportionate improvements. Regardless of whether those
progressions are the consequence of maturational factors normal for down condition
babies at that age, family factors, or investment in early mediation programs isn't
known however worth is proceeded with assessment.
Pablo Mleziva, Lillian Janette Mleziva and Eric Glenn Johnson (2018)
examined Sensory handling issue and vestibular recovery a pediatric Case Report and
she discovered Sensory incorporation has been depicted as a system for how the body
forms tactile contribution from the earth. Streamlining of "fit" among patient and
condition may help control task requests to improve nature of activities. Ayres
hypothesized that debilitated tactile preparing may influence work and built up the
term tangible coordination brokenness. Tangible preparing issue (SPD) "influences the
manner in which the mind deciphers approaching data and the reaction that follows,
causing enthusiastic, engine, and different responses that are improper and
extraordinary.”SPD influences roughly 16% of school-matured kids including
interruption in their exercises of day by day living with commonness evaluations of
tactile handling issues dependent on clinical experience going from 5%-10% for kids
without handicaps. Kids with SPD have been portrayed as being "just wired in an
unexpected way. “Parental figure report quantifies and normalized evaluations, for
example, the Sensory Profile, are utilized to order and portray quiet tactile practices and
shortfalls. One of the primary SPD classes is tactile based engine issues with proposed
subtypes including postural confusion, which can be portrayed by helpless equalization
and postural security. Postural strength gives a steady base to refined developments by
means of mix of vestibular, proprioceptive and visual data. Tangible incorporation
treatment (SIT) was initially intended for youngsters with learning inabilities with SPD
or tactile reconciliation brokenness. SIT is viewed as a questionable mediation and
exploration has not unmistakably shown that SIT is more successful than different
intercessions. Tangible based treatments, medicines and mediations (SBIs) utilize tactile
modalities (e.g., vestibular, contact, sound-related) with latent exercises (e.g., weighted
vest) to progressively powerful exercises (e.g., divider climbing) and are viewed as a
segment of a complete treatment plan. Since numerous youngsters with SPD present
with tactile based engine issues, the vestibular framework and postural steadiness are
frequently influenced. The reason for this case report was to portray the impact of VRT
on postural solidness in a patient with SPD.
Case introduction: The patient was an 8-year-old male whose guardians, both of
who horse physical specialists and contributing creators of this case report, saw that age
27
proper achievements were not being reached. At around 5 months old enough, the
patient gave indications of low tone and diminished trunk control and trouble lifting
his head while keeping up an inclined position. The patient didn't have any co-
morbidities or significant ailments. The patient could express single words at age 2 yet
couldn't talk full sentences by age 4. Moreover, the patient experienced issues managing
diverse natural tangible data sources including boisterous sounds, food surfaces, tight
apparel, failure seeing agonizing boosts true to form, powerlessness to concentrate on
assignments so as to finish them, and trouble concentrating outwardly on an errand.
Offered these hints and side effects, the patient's folks looked for clinical counsel.
Eventually, through the span of 4 years, the patient got language training, tactile
coordination treatments for engine control, visual, smell and sound-related incitement,
right side of the equator incitement works out (counting breathing activities, smell
incitement, crude reflexes works out), and intellectual treatment; with moderate
enhancements in psychological, discourse and engine control practices. The patient was
in the long run determined to have SPD at 8 years of age. The SPD conclusion depended
on psychoeducational evaluations including intellectual, social/passionate, memory
and working identified with scholastics, language, perusing, spelling, composing, math
and visual working. Engine evaluations uncovered tactile handling wasteful aspects in
body mindfulness, two-sided coordination, postural security, visual-engine
incorporation, engine planning and penmanship. Handling of vestibular and visual
data was beneath age level on two-sided coordination and equalization tests. Given this
data, the guardians booked a counsel with a physical advisor that had some expertise in
vestibular recovery.
Each condition included three 20-second preliminaries and the normal was
determined. CDP can distinguish vague vestibular framework deficiencies and give
data about an individual's capacity to appropriately incorporate vestibular framework
data with data from other tangible frameworks. The Bertec CDP figures postural
solidness and produces a balance score. Signs from the member's endeavors to look
after his/her parity are tested and broke down at 1,000 Hz, and the influence way is
registered. The testing convention computes the influence way from the harmony
scores, evaluating how well the member's influence stays inside the normal precise
restrictions of strength under each testing condition. The accompanying recipe was
utilized to ascertain the harmony score (ES): 12.5°−(taMAX − taMIN)]/12.5°)×100. ES
utilizes 12.5° as the typical furthest reaches of the front back influence edge go; taMAX
is the theta most extreme and taming is the theta least. The influence edge was
determined with the accompanying recipe: influence edge =arcsine (COGy/ [0.55 × h]),
where y=anterior–back influence hub and h=participant's stature in centimeters or
inches. The opposite side of the focal point of gravity (COG) was separated by 55% of
every individual's stature. Members indicating little influence will have harmony scores
almost 100, while subjects whose influence moves toward their restrictions of steadiness
will have scores close to zero.
Results: The exercise based recuperation follow-up visit was directed 3 months after the
fact. The consequences of the CDP showed checked improvement in vestibular
29
framework uprightness and improved postural strength. The CDP reconsideration
exhibited changes in generally harmony scores. The CDP condition 5 best speaks to
vestibular framework uprightness as eyes are shut and stage is shaky. The composite
score speaks to the general harmony score over all testing conditions. The pre-treatment
composite balance score was 51 (Figure 1) and the posttreatment was 68 (Figure 2),
speaking to a 25% expansion in postural solidness. The pre-treatment normal for 3
preliminaries of CDP condition 5 (C-5) was 19 (Figure 1) and the post-treatment normal
was 53.3 (Figure 2), speaking to a 64% expansion in vestibular framework work.
Discussion: This case report depicts the effect of VRT on postural strength and
vestibular framework respectability in a youngster with SPD. There is no all-inclusive
system for diagnosing SPD and tactile related practices; tangible deficiencies depend on
guardians or parental figures' reports and appraisals. The patient for this situation
report was determined to have SPD following quite a long while of accepting medicines
for tactile incorporation challenges. Since vestibular framework disabilities were
recognized, the patient was assessed by a physical advisor that had practical experience
in vestibular recovery. Since SPD regularly incorporates consideration shortfalls, the
HEP was changed to improve task consideration and guarantee right execution by
giving a wide range of optotypes that the patient read so anyone can hear during the
activity. The patient was surveyed and reevaluated over a time of 3 months and CDP
uncovered stamped enhancements in vestibular framework trustworthiness and
postural solidness.
In spite of the fact that the viability of tangible combination medicines have been
addressed in the writing; the patient for this situation report improved his postural
security after a HEP of explicit VRT dynamic look soundness practices were
recommended . Early intercession is significant once SPD has been analyzed so as to
give the "on the money challenge" in light of the youngster's aptitude level. Giving
chances to preparing tangible data is significant for versatile reactions to happen and
regularly requires changing the kid's condition. Tactile incorporation treatment utilizes
multisensory conditions that include exercises including vestibular tangible info.
Reiteration can enable the youngster's cerebrum to process tangible incitement all the
more ordinarily and start to interface viably inside tactile situations. It has been
speculated that reiteration of ordinary reactions to tactile upgrades makes new neural
pathways and gives a steady surface to taking an interest in true conditions. A HEP of
look solidness practices with explicit changes to keep up task consideration were
utilized to give monotonous vestibular incitement. The outcomes propose improved
tactile incitement preparing and postural security.
Conclusion: This case report depicts the postural solidness and vestibular framework
honesty upgrades, as estimated by CDP, in a patient with SPD following a multi month
30
VRT program. Vestibular activities can be effectively performed at home with parental
or guardian direction. In light of our discoveries, further exploration is justified here of
clinical examination.
31
References:
32
13. Jean Ayres Linda S. Tickle (2011) The American Journal of Occupational Therapy,
Hyper-responsivity to touch and Vestibular Stimuli as a Predictor of Positive Response
to Sensory Integration Procedures by Autistic Children. 13
14. Helen Cohen (2014)Vestibular rehabilitation reduces functional disability volume 107,
Vestibular rehabilitation reduces functional disability. 14
15. Helen Cohen (2011)The American journal of Occupational Therapy Vestibular
Rehabilitation Improves Daily Life Function. 15
16. Susan L. Whitney, Joseph M. Furman ,Carol E. Baker, Alia A. Alghwiri ,Gregory F.
Marchetti, Joan C. Rogers, Joseph M. Furman and Patrick J. Sparto (2012) American
Congress of RehabilitationMedicine, The Development and Validation of the Vestibular
Activitiesand Participation Measure . 16
17. VladimirA. Maksimenko, GuiomarNiso ,SemenA. Kurkin,Elena N. Pitsik ,,
ParthChholak ,Alexander E. Hramov, Alexander N. Pisarchik, Nikita S. Frolov
(2018)Visual and kinaesthetic modes affect motor imagery classification in untrained
subjects. 17
18. Ralf Widenhorn, Justin Dunlap, Lester Lampert, and Elliot Mylott(2014)The Physics
Teacher Vol. 52,Kinesthetic Activities for the Classroom. 18
19. Warren K Yunker 1, Scott G Walen, Elizabeth J Lange (2009), Feb;30(1):66-8. doi:
10.1097/DBP.0b013e3181976a6c, Journal of Developmental and behavioural Pediatrics,
Vestibular Pathology Presenting as Behavioral Problems in a Child With Down
Syndrome: A Case Report
20. Joan Snyder Lydic,Mary Margaret Windsor,Margaret Anne Short &Terry Ann Ellis
(2009) Effects of Controlled Rotary Vestibular Stimulation on the Motor Performance of
Infants with Down Syndrome, Pages 93-118 | Published online: 29 Jul 2009
21. Pablo Mleziva, Lillian Janette Mleziva and Eric Glenn Johnson (2018) Physical Therapy
and Rehabilitation, Sensory Processing disorder and vestibular rehabilitation : A
pediatric Case Report.
33
CHAPTER- 5
Vestibular activities can be very beneficial to children to help get their bodies and
brains ready to learn. Let’s take a closer look at why vestibular activities are helpful
throughout the school day for some students. Vestibular activities can be extremely
calming and soothing, often times perfect to help get kids ready for bed or winding
down after school. They can give the body a chance to re-charge and relax. At the same
time, other vestibular activities may be very stimulating and arousing. This may be
good thing if your child is lethargic or difficult to get energized. As always, how your
child responds to these activities will be unique, and to make them successful you’ll
want to watch for that response. Seeking vestibular input isn’t necessarily a bad thing,
some kids simply like it and enjoy the sensation. However, if your child is constantly,
almost obsessively looking for ways to get vestibular input, it can start to interfere with
life. This fixation on movement happens because their brain is under processing the
vestibular input. Basically, that means that the signal isn’t getting through that they’ve
gotten vestibular input, so they keep trying to get it. That’s where vestibular activities
come in, because they can help the brain start to process the input it’s getting better!
Avoiding, or over processing, vestibular input is a whole other can of worms. Instead of
the signal not getting through in the brain, for kids that are sensitive to movement, the
brain is getting too many signals! It’s on overdrive and even the little movements can
seem much bigger. In more extreme cases, when kids are incredibly fearful of any type
of movement, it’s called gravitational insecurity because they’re literally afraid to leave
the ground in any capacity.
The term kinaesthetic refers to touching, doing, experiencing, or being physically
active, and it’s one of the three main pathways to the brain.
When children are taught using all three pathways to the brain, they learn even
more than when they are taught only through just one pathway (Farkas, 2003)1. The
more senses we involve, the more learning occurs. So even if your child is an auditory
34
or visual learner, it is still important to teach through kinaesthetic activities as well. By
doing so, not only will you be sure to teach to your child’s strongest pathway, but you
will also maximize long-term retention of the information.
Target population:
Steps: children are made to stand around the cardboard box on the floor .Each child
takes turn to throw in the box
Duration /frequency: This activity can be given for about 5 – 10 minutes depending on
child’s physical ability. For group with more children time can be increased.
Adaptation/accommodation: if child has difficulty holding ball in one hand, the ball
can be made bigger, so he/she can hold with two hands and throw.
Impact expected: Eye-hand co-ordination, waiting for turns& attention span of the child
improves
Outcome indicator: The child is able to throw the ball with precision inside the box
35
Contraindication: Fatigue should be avoided, try to vary the activity when the child
shows boredom
Target population:
Steps: The children stand in a circle. It is told to the children, we will make sandwich.
Two of them will be the bread. Others will be ingredients. After the children stand
closer to each other with two breads & ingredients, they are gently brought together by
hug by caregiver/parent.
Duration /frequency: The activity continues till 4- 5 children who constitute the group
get turns standing in the middle as ingredients.
Impact expected: Awareness about others, helps develop pretend play, improvements
seen in following directions, able to tolerate physical closeness& touch.
36
3) ACTIVITY: WRAP &WALK
Target population:
Steps: Have one child stand at the back of other child with parent/caregiver wrapping
the scarf around the both child’s body. Instruct both the child to walk in unison.
Duration /frequency: Till all children in the group get the chance.
Impact expected: The pressure of scarf provide children with proprioceptive input. This
also helps in improving their balance.
Contraindication: An adult has to do the squeezing within tolerable limit for the child
37
4) ACTIVITY: HIT THEBALLOON
Target population:
Steps: A balloon is thrown towards the child, encouraging child to hit the balloon,
when child succeeds in hitting balloon, the other children made to try and catch the
balloon
Impact expected: Motor planning, spatial awareness, balance and spatial awareness
improve. This activity provides much vestibular stimulation.
Outcome indicator: Child able to hit balloons most of the time with precision, once
learning occurs.
38
5) ACTIVITY: RIDE ON A BLANKET
Target population:
Steps: The child is made to sit on a blanket and the parent/caregiver pulls the blanket
Adaptation/accommodation: A big pull along toy on which a child can sit can also be
used but need to be more careful and monitored by the adult.
Outcome indicator: Child is able to balance self when direction of the pull is changed,
over time.
Contraindication: look out for signs of sensory overload like distractibility or confusion
and also check to see if child is breathing rapidly during activity .Stop the activity if the
above signs occur.
39
6) ACTIVITY: THE TUNNEL
Target population:
Steps: The parents stand in a straight line behind each other with their legs spread apart
.The children are made to go through the tunnel made on all fours and crawl through
the legs of the parents.
Impact expected: Children become aware of the differences in space .Ability to plan
motor movement improves
Outcome indicator: child is able to crawl inside tunnel with less difficulty & assistance
when coordination improves.
Contraindication: Parents need to observe the children to prevent the children from
getting distracted.
40
7) ACTIVITY: WHERE ARE THE COLOURS
Target population:
Steps: paste sheets of colored paper on the floor by alternating the colors. The child
starts the activity by jumping from one color to the next .If the child knows the color
he/she encouraged to call out the color name while jumping on the sheet.
Duration /frequency: child made to play till they finish jumping on all the colored
sheets placed on floor.
Outcome indicator: the child is able to jump from one color/shape to next with
minimal mistakes& duration taken to complete the activity decreases over time.
Contraindication: child with balance issues need to be provided assistance from adult.
41
8) ACTIVITY: OBSTACLE COURSE
Steps: The objects are arranged so that the child moves from one obstacle to another.
Once all the obstacles are finished hey start over again
Duration /frequency: opportunity given to all children to complete the entire course
Outcome indicator: the child completes the course with very minimal verbal & physical
cues form caregiver/parent.
Contraindication: Other children waiting for their turn need to be engage so they won’t
be bored.
42
9) ACTIVITY: BLANKET WRAP
Target population:
Steps: The child lies on one end of the cloth. The adult rolls the child from one end of
the blanket to the other, child is wrapped in the blanket
Outcome indicator: Child becomes calm, wrapping acts as neutral warmth which is an
inhibitory technique.
Contraindication: Avoid this activity for children who show excessive fear or cry when
being wrapped.
43
10) ACTIVITY: CATCH IT
Target population:
Steps: The parent/caregiver tosses the scarf up and instructs child to catch it.
Duration /frequency: Allow the child to catch the scarf for about 5- 6 times (distraction
to be avoided).
Outcome indicator: Child is able to catch the scarf most of the time, once the co-
ordination improves.
44
11) ACTIVITY: STACK THE CANS
Target population:
Steps: The child is made to make a tower with the cans ,with one can over top of
another. Child has to knock the tower down by throwing the ball.
Duration / Frequency: Give more time for child who had difficulty in co-ordination.
Provide assistance when needed.
Impact expected: waiting for turns, eye hand & bilateral co-ordination improves.
Contraindication: avoid using a heavier ball, make sure bottles used are safe.
Target population:
Steps: Children and parents stand holding each other’s hand. One parent says the word
start and everyone walks forward and when same parent says stop, all stop walking
Duration / Frequency: Within permissible attention span of the children in the group
Contraindication: Care should be taken to avoid children pushing each other & getting
hurt.
Target population:
Steps: Children form two groups on either side .When the activity starts the children
start pulling the scarf.
Impact expected: Vestibular & proprioceptive sense improves, child’s upper limb
strength develops.
46
Outcome indicator: The child is able to independently pull the scarf on command.
Contraindication: Care should be taken for the scarf not to hurt the child’s hand when
pulling.
Target population:
Steps: The parent stand at the back of their child and hold them by their hip and trunk
,The child is then slowly rocked to give the sensation of being off center during the side
to side and back and forth movement
Impact expected: Stimulates the vestibular system, child understands concepts like fast
and slow
47
15) ACTIVITY: IT’S ME
Target population:
Steps: children are made to sit in front of mirror, cover mirror with the scarf .One child
will remove the scarf & other children have to say child’s whose image appears in
mirror.
Duration /Frequency: Till all children get their turn.
Adaptation/accommodation: Place a scarf over a child’s head instead, and the scarf is
removed to reveal the child. Then other children say his/her name.
Outcome indicator: Children will be able to learn name of other children in group.
Contraindication: None
Target population:
48
Attention deficit disorder
Specific learning difficulty
Developmental coordination disorder (DCD)
Sensory processing disorder
Target population:
Steps: Parent/caregiver blows a feather and has the child catch it, and then the child is
made to blow the feather.
Adaptation/accommodation: Reduce distance between child & parent for children who
find it difficult to catch. Reinforce child every time he/she catches the feather.
49
Impact expected: Children learn to modulate their breath .Attention and eye contact
improves
Outcome indicator: The child’s co-ordination improves & is able to blow/catch feather
accurately.
Contraindication: None
Material required: Rice, medium- sized container, small toys, Ping - Pong balls.
Target population:
Steps: Hide the items in the rice & have the child to pick up objects only by touch,
without seeing the objects.
Duration /frequency: Activity done till the child finds all the hidden object
Adaptation/accommodation: Use bigger toys for children who find it difficult to find
small toys.
Contraindication: care should be taken to avoid the child putting objects in mouth.
50
19) ACTIVITY: CLAY PLAY
Material required: Clay/Sand, Aprons.
Target population:
Adaptation/accommodation: Use dry materials if the child is not able to tolerate clay
Impact expected: Decreases the tactile defensiveness. Improves tactile awareness and
fine motor functions
Target population:
Steps: Put al the objects in the bag ,then ask the child to pick one object for the bag.
After the child takes an object out help the child in naming the object.
Adaptation/accommodation: initially start with only one object in bag ,once child starts
to name the object then add another one. Put the objects in open box for child who has
tactile defensiveness and refuses to put hand inside bag.
Contraindication: none
Steps:
1. Place peanut ball and safe area and ensure clutter free environment
2. Place child in leg kept sideways to the ball.
3. Give sideways shaking movement to facilitate vestibular sense in rhythmic slow
motion.
Outcome Indicators: child will initiate feet placement for seeking balance
Contraindications: In case seizure episodes stop activity and provide necessary support
to child.
52
Material Required: Peanut Ball
Steps:
1. Place peanut ball and safe area and ensure clutter free environment
2. Place child in leg kept sideways to the ball.
3. Give sideways shaking movement to facilitate vestibular sense in fast irregular
motion.
Outcome Indicators: child will initiate feet placement for seeking balance
Contraindications: In case seizure episodes stop activity and provide necessary support
to child.
Steps:
1. Place any markers on white board like A, B, 1, 2
2. Ask child to Hold strapper with both hands
3. Give instruction to touch desired item on board with strapper
Duration: 15 Min
Impact Expected: Child with be able to understand praxia, eye hand coordination and
kinesthetic and vestibular integration while performing activities
53
Outcome Indicators: Child will actively touch instructed items without assistance or
will gradually reduce seeking assistance
Material Required: Color box, Bubbles rapper, piece of white cloth/ chart paper, baby
chair
Steps:
1. Ask child to mix colors in tray and keep it in the starting point
2. Ask child to spread the cloth.
3. Ask child to put both palms in the tray and cross the cloth by crawling to the end
point
4. Ask child stand in color tray and cross the cloth by walking to the end
Outcome Indicators: seeks minimum assistance for completing activity and walk
steady in straight line
Contraindications: sever contracture of hand and foot shall not be given, lack head and
neck
Material Required: Different color cloth pieces, Different size of cloth pieces,
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Target Population: Children with multiple physical/ Intellectual disabilities/
ASD/ADHD from 5 years to 15 years
Steps:
1. Instruct the child to tie the knot at the end of the clothes
2. Put knotted clothes in bath tub
3. Ask child to take out specific color out of tub.
4. Praise the child for completion.
Impact Expected: Child will develop bilateral hand coordination, Kinesthetic &
Vestibular sense awareness, Bilateral Integration.
Outcome Indicators: Child exhibits better eye hand coordination and body awareness
and Upper Limb use in bath tub. Child manages to search and locate ball and get it
without assistance.
Material Required: Plastic Basket, Bucket with lid, Variety of Toys, Tape
Steps:
1. Draw figure 8 on the floor with tape
2. Place toys at one end of figure 8.
3. Place basket at another end of figure 8
4. Ask child to walk on tape with same instructed direction.
5. Ask child to carry one toy at a time and place in basket till all toys are collected
Impact Expected: Child will exhibit improved Kinesthetic & Vestibular sense
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Outcome Indicators: Child will initiate feet placement for seeking balance on curvy and
zig zag way, Grabs and places toy without dropping
Steps:
1. Ask child to keep vegetable filled tray in the end corner of house as starting
point.
2. Ask the child to keep an empty tray at another end as finishing point.
3. Ask child to take vegetable and transfer to another tray by frog jumping ;( Knee
flexed, Hand At knee and Jump without standing)
Impact Expected: Child will develop dynamic balance with eye hand coordination,
proprioceptive sense, vestibular and kinesthetic sense integration.
Outcome Indicators: Improved frog jump and finishing distance at shorter time.
Material Required: Different colors & Size of balloons, Double sided tape
Steps:
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3. Cut tapes into small pieces
4. Place tape at balloon at one side
5. Place balloon on the wall above shoulder level
Impact Expected: Helps to perform and improve Range of Motion and coordination,
Praxia, Kinesthetic and vestibular sense integration
Outcome Indicators: Child will be able to place balloons on wall with reduced number
of burst balloons due to hand pressure.
Steps:
Duration: 10-20 minutes (Time frame can be extended based on child interest and
completion of activity)
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Impact Expected: Child will develop praxia, balance, coordination, instruction
understanding
Material Required: Rope, Inside Room/Hallway, 5 small items which can be carried in
hand eg. Beads, clips etc .
Steps:
Duration: 10-20 minutes ( Time can be extended as per child interest and completion of
the activity)
Outcome Indicators: Child will take less time to complete activity with less puzzled
between ropes
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Steps:
Impact Expected: Vestibular and kinesthetic sense integration with fine motor
development and visual memory
Outcome Indicators: Child will be able to copy design and not leaning on the floor,
maintains balance while squat sitting
Steps:
1. Arrange less distracted and non clutter place.
2. Keep hurdles and 1 feet distant from each other.
3. Demonstrate child to jump over it with both feet off the ground.
4. Ask child to do same and cross all hurdles
Impact Expected: Child will develop balancing, Bilateral Integration, Praxia, Kinesthetic
and vestibular Sense Integration
Outcome Indicators: Child will cross the obstacle with minimum or zero assistance
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Contraindications: If any seizures episode is reported or any muscle disease it should
be avoided, Spina Bifida
Steps:
1. Place beam on flat surface
2. Place bucket 5 feet distant in front of beam
3. Ask child to stand on beam.
4. Keep Balls just below nearby beam
5. Ask child to carry a ball and throw in bucket and repeat till ball finishes.
Outcome Indicators: Child will have decreased fall tendency and improved balance
while carrying and throwing ball in bucket
Steps:
1. Place Ball in the corner of house
2. Give child to hold peg board tray
3. Ask child to sit on Gym Ball keeping leg touched with ground.
4. Place Peg Board beads on raised tray in front nearby child.
5. Guide child to arrange peg board beads while sitting and bouncing on ball.
6. Caregiver shall present and assist to hold gym ball.
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Duration: 10-20 minutes
Impact Expected: Child will have improved vestibular and kinesthetic sense integration
along with hand function and cognitive skills development
Steps:
1. Keep cardboard box in the room
2. Keep room clutter free and ensure safety
3. Keep 2 stools at each end of cardboard box
4. Ask child to stand on a stool and jump in cardboard box.
5. Once child jumps into cardboard box guide child to climb on another stool kept
at another end of box.
6. Repeat 10 times
Outcome Indicators: Child will Jump and Climb readily without assistance
Impact Expected: child will develop equilibrium reaction and balance, Vestibular and
kinesthetic integration
Outcome Indicators: child will initiate feet placement maintaining balance on one leg.
Steps:
1. Place inclined ramp in the house or place a wooden platform diagonally with
one end at height.
2. Keep 5 toys at one end
3. Ask child to crawl and transfer toys from one end to another end.
Outcome Indicators: child will crawl in straight line without leaning on floor
Contraindications: Poor Head & Neck Control with Muscle strength on neck less then 2
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38) ACTIVITY: WEIGHT BEARING
Steps:
1. Place plastic coated metal ball at one end in hall
2. Ask child to stand at another end of Hall.
3. Keep a ribbon market at another end of hall
4. Ask child to transfer mass weight ball with both hands form one end to ribbon
marked place.
Impact Expected: child will develop equilibrium reaction, balance, endurance, muscle
strength.
Outcome Indicators: child will be able to perform activities with maximal or average
muscle strength
Steps:
1. Place water paint in a tray
2. Pour some water and prepare color to be ready for activity nearby balance board
on the floor
3. Keep balance board in non clutter room
4. Ensure safety and fall hazards.
5. Place paper in paper clip in front on the wall.
6. Ask child to stand on balance board and take color in hand.
7. Ask child to paint paper while standing on balance board
8. Guide child to take color again from tray by bending down on the balance board.
9. Repeat the same as per child interest
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Duration: 10-20 minutes (Can be increased as per need)
Contraindications: sever contracture of hand and foot shall not be given, lack head and
neck control kids shall avoid such activities
Steps:
1. Ask the child to stand on the trampoline.
2. Ask him to start jumping slowly
3. Give Basket ball to the child while jumping on trampoline
4. Guide child to play catch and throw with basket ball while jumping on
trampoline.
Outcome Indicators: child will initiate feet placement at one place after jumping for
seeking balance
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Target Population: children with
Autism
Attention deficit hyperactive disorder (ADHD)
Specific learning difficulty (DYSLEXIA)
Developmental coordination disorder (DCD)
Sensory processing disorder (SPD)
• Adaptation/Accommodation
• Impact Expected: vestibular sense processing will modulate properly by this activity
•Outcome Indicator: the attention and concentration of the child will increase,
Balance& coordination
• Do’s and Don’ts: After intense spinning, it is important to have your child ground
their bodies again. This can be done by jumping up and down in place with the hands
placed on top of their head and pushing down on their head while jumping.
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42) ACTIVITY : HANGING
Hanging can also be great for proprioceptive input (input through the muscles
and joints for body awareness). Children who are vestibular seekers can benefit from
hanging upside down.
• Materials Required: You can do this on monkey bars, laying on the couch and
hanging upside down, rope climbing, etc.
Autism
Attention deficit hyperactive disorder (ADHD)
Specific learning difficulty (DYSLEXIA)
Developmental coordination disorder (DCD)
Sensory processing disorder (SPD)
• Steps: Make the child hand upside down on a monkey bar or a rope ladder
• Adaptation/Accommodation
• Outcome Indicator: The child will be more organized distraction will reduce and
attention & concentration will increase.
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• Do’s and Don’ts: Do not the child hand for longer periods watch for redness or
blushing in eyes and cheeks
• Caution Indications: Avoid over stimulation and reduce the risk of fall or injury child
may feel dizzy or blushing and redness during overstimulation.
Children who crave vestibular input will love scooter boards. Seekers may need
something a little more daring with their scooter boards to get the input they need. You
can have them ride down a small hill on them or crash into a crash pad with them.One
rule we always have is that you have to be on your stomach or sitting on your bottom.
Depending on the activity, you may need a helmet. Get creative and come up with your
own obstacle course or have a scooter board race. For an avoider, just sitting or lying on
the scooter board while it moves slowly may be enough input. You can also include it
with some other fine motor activities as we do with this obstacle course set up
• Steps: Make the child sit or lye down on their stomach and ask them to move on their
own or you can also push them and make them enjoy it,
• Duration/Frequency: no limitation in time the child can be allowed to enjoy the ride
as much as possible.
• Adaptation/Accommodation
• Impact Expected: The balance and coordination will improve, reduces vestibular
seeking behaviour
• Do’s and Don’ts: make sure the child is safe during maneuvering the scooter board.
• Caution Indications: The child should be seated properly to avoid injury during the
activity. Avoid over stimulation.
Rock climbing, rope courses, monkey bars, tree climbing, are all great options for
vestibular seekers.
Materials Required: wall ladder, rope ladder, monkey bars rope courses etc
Target Population: children with
Autism
Attention deficit hyperactive disorder (ADHD)
Specific learning difficulty (DYSLEXIA)
Developmental coordination disorder (DCD)
Sensory processing disorder (SPD)
• Steps: Make the child climb in any of the climbing equipment available.
• Adaptation/Accommodation
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Equipment: safety slings
Instructions: make the child wear the safety sling before
climbing to prevent fall or injury, use more cushions on
the ground to prevent injury.
• Impact Expected: core muscle strength hip and shoulder stability will improve the
child’s hand function skills will also improve
• Do’s and Don’ts: Do not push or force the child to do the activity, ensure safety of the
child to avoid injury, always keep the activity more fun.
• Caution Indications:
Always consult your occupational therapist before starting any sensory diet
never force a child to participate in a sensory activity, especially vestibular.
Choose simple activities initially and slowly grade them according to the level of
the child
Your child’s sensory need may change from day to day and even hourly manner
so be watchful always choose the activities which the child likes the most.
If you've ever watched America Ninja Warrior, these types of obstacle courses
are perfect for children who are vestibular input seekers. use a homemade balance
beam or a ninja rope course.
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Specific learning difficulty (DYSLEXIA)
Developmental coordination disorder (DCD)
Sensory processing disorder (SPD)
• Steps: Ask the child to cross over all obstacles one by one independently
• Do’s and Don’ts: Do not push or force the child to do the activity, ensure safety of the
child to avoid injury, always keep the activity more fun.
• Caution Indications: Always consult your occupational therapist before starting any
sensory diet never force a child to participate in a sensory activity, especially vestibular.
Choose simple activities initially and slowly grade them according to the level of the
child
Your child’s sensory need may change from day to day and even hourly manner so be
watchful always choose the activities which the child likes the most.
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46) ACTIVITY : BALANCE BEAM
• Steps: Make the child balance and walk over balance beam or stepping stones
without touching the ground
• Adaptation/Accommodation
• Outcome Indicator: Attention, concentration, memory and vocal skills will improve.
• Do’s and Don’ts: Do not push or force the child to do the activity, ensure safety of the
child to avoid injury, always keep the activity more fun.
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• Caution Indications: Always consult your occupational therapist before starting any
sensory diet never force a child to participate in a sensory activity, especially vestibular.
Choose simple activities initially and slowly grade them according to the level of the
child
Your child’s sensory need may change from day to day and even hourly manner so be
watchful always choose the activities which the child likes the most.
Children who are sensory avoiders may avoid swinging and spinning. Never
force a child to do these activities, but you can gently introduce them so their sensory
system begins to tolerate movements like it.
Gently push a child on a platform swing or a swing that is low to the ground so
that their feet can touch the ground. You can also have them sit on your lap as you
gently swing back and forth with your feet on the ground. Platform swings are a great
option for vestibular avoiders as it gives them a greater base of support and they can
feel more secure on them. Hammocks would also be a great, cost-effective version of a
platform swing.
For spinning, you can purchase a sit and spin or have them lay on a scooter
board on the floor so they have more control over the pace of the spinning. Remember
to have them spin in both directions. Even one rotation can be a huge benefit.
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Sensory processing disorder (SPD)
• Steps: Make the child sit on the swing assist him to swing slowly in linear then
circular and grade slowly
• Outcome Indicator: The attention & concentration of the child will improve
hyperactivity reduces over all motor planning abilities will improve, expressive
language skills will improve.
• Do’s and Don’ts: Do not push or force the child to do the activity, ensure safety of the
child to avoid injury, always keep the activity more fun.
• Caution Indications: Always consult your occupational therapist before starting any
sensory diet never force a child to participate in a sensory activity, especially vestibular.
Choose simple activities initially and slowly grade them according to the level of the
child
Your child’s sensory need may change from day to day and even hourly manner so be
watchful always choose the activities which the child likes the most.
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48) ACTIVITY : WHEELBARROW WALKING
Another great option for vestibular avoiders. Have the child put their hands on
the ground and gently lift their legs behind them so their weight in on their hands. An
avoider may not like their feet up off the ground, so you could have a pillow or step
stool nearby to place under their feet. This will give them the effect of their weight
being at the front but still supported from behind.
This activity is a great way to gradually get a vestibular avoider to put their head
in a different position than just being upright. And it doubles as amazing
proprioceptive input through the joints and muscles. Gradually work up to the child
taking a few “steps” on their hands while you support their legs.
• Steps: Make the child walk on his hands with maximal assistance initially slowly
reduce the support.
• Duration/Frequency: Ask the child to move for 2-3 times initially and slowly grade
the duration.
• Impact Expected: Shoulder hip and paraspinal muscles will strengthen during this
activity on a long run and its one of a strong proprioceptive and vestibular sensory
input.
• Outcome Indicator: joint stability and upper and lower back muscles will strengthen.
• Do’s and Don’ts: watch for fatigue and exertion while doing this activity.
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• Caution Indications: Always consult your occupational therapist before starting any
sensory diet never forces a child to participate in a sensory activity, especially
vestibular.
Choose simple activities initially and slowly grade them according to the level of the
child
Your child’s sensory need may change from day to day and even hourly manner so be
watchful always choose the activities which the child likes the most.
This is fun activity where the child learns to ride a bike or a cycle with good
balance and maintaining proper posture. Either the occupational therapist or the care
taker can teach the activity. It’s an important play skill were the child’s motivation will
be high it will work as a vestibular and kinesthetic stimulation for the child. The child’s
motivation and self-interest will also develop during this fun filled play skill.
• Steps: Make the child sit on the cycle/ bike assist him to pedal slowly, then increase
the speed distance and time of cycling day by day
Steps: The child can have side safety wheels to prevent from
fall; the child will wear helmet, knee cap, Elbow pad etc. to
prevent injury during fall.
Equipment: Side wheel accessories, Helmet, knee cap, elbow
pad etc.
Instructions: Use the safety equipment’s properly according
to the need of the child
• Outcome Indicator: The attention & concentration of the child will improve
hyperactivity reduces over all motor planning abilities will improve, expressive
language skills will improve.
• Do’s and Don’ts: Do not push or force the child to do the activity, ensure safety of the
child to avoid injury, always keep the activity more fun.
• Caution Indications: Always consult your occupational therapist before starting any
sensory diet never forces a child to participate in a sensory activity, especially
vestibular.
Choose simple activities initially and slowly grade them according to the level of the
child
Your child’s sensory need may change from day to day and even hourly manner so be
watchful always choose the activities which the child likes the most.
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Attention deficit hyperactive disorder (ADHD)
Specific learning difficulty (DYSLEXIA)
Developmental coordination disorder (DCD)
Sensory processing disorder (SPD)
• Steps: Teach the child to jump over the rope repeatedly, and then increase the speed
day by day
• Duration/Frequency: Initially ask the child to do 10-20 jumps per day and slowly
grade the number of e times look for child’s reaction and decide accordingly, It a
physically exhausting outdoor play so initially start of for minimal timing then slowly
grade according to the child’s stamina and interest level.
• Impact Expected: The child’s bilateral coordination and balance will improve
• Outcome Indicator: The attention & concentration of the child will improve
hyperactivity reduces over all motor planning abilities will improve, expressive
language skills will improve.
• Do’s and Don’ts: Do not push or force the child to do the activity, ensure safety of the
child to avoid injury, always keep the activity more fun.
• Caution Indications: Always consult your occupational therapist before starting any
sensory diet never forces a child to participate in a sensory activity, especially
vestibular.
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Choose simple activities initially and slowly grade them according to the level of the
child
Your child’s sensory need may change from day to day and even hourly manner so be
watchful always choose the activities which the child likes the most.
yoga poses (especially great for avoiders!), dancing, jumping rope, rolling down
a hill (a great way to start with avoiders), somersaults, cartwheels, gymnastics, walking
the line (use painters’ tape on the floor in a straight or zig-zag line), play Twister,
climbing and sliding at the playground, do a handstand, riding a bike, swimming,
using a ball chair or wiggle cushion for seated activities, running, obstacle courses,
skipping, leap frog, tug of war, wheelbarrow walking, various animal walks (walking
like a crab, hopping like a kangaroo, etc.), row, row, row your boat with a partner,
Vibration (is alerting versus calming when used in short bursts), handheld massagers,
vibrating cushions/pillows, teethers and chewable toys, Chewing, crunchy foods, gum,
salty or spicy foods, chewy jewellery, chewable pencil tops, chewable safe toys, carrying
groceries, pushing empty Garbage cans inside, raking leaves, pulling weeds, shovelling
snow/sand, vacuuming , pushing grocery , Cart, carrying a laundry basket, a rope tied
to a door knob or heavy object, Riding, scooter board, bikes, scooters, skateboard, roller
blades, sleds, any of the above over bumps or down hills, seesaw, outdoor swings,
indoor swings, porch swings, swinging child in a blanket, Jumping, Jumping on the
bed,couch, trampoline, Climbing, rock walls. jungle gyms, monkey bars, ropes, slides,
through a tunnel, Obstacle course.
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GLOSSARY
79
18. Visual: information that is received through the eyes, processed in the brain, and
then coordinated with other sensory systems for a person to understand the
information appropriately.
List of abbreviations
80
Publications of NIEPMD
Title Cost
81
Kinesthetic and Vestibular Activities for Developmental Disabilities
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