0% found this document useful (0 votes)
42 views87 pages

Kinesthetic

Uploaded by

shubham gupta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
42 views87 pages

Kinesthetic

Uploaded by

shubham gupta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 87

Indian Edition Published by NIEPMD.

Copyright © 2020

All rights reserved. No part of this publication may be reproduced, distributed or


transmitted in any form or by any means, including photocopying , recording or other electronic
and mechanical methods, without prior written permission of the publisher, except in the case of
brief quotations embodied in critical reviews and certain other non-commercial uses permitted by
copyright law. For permission requests, write to the publisher, addressed “Attention :
Permissions Coordinator “to the address below

NIEPMD, East Coast Road, Muttukadu, Kovalam Post Chennai – 603112,Tamil Nadu, India.
Ph: 044- 27472113, 27472046
Email: [email protected]
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.

Chief Investigator Investigator


Shri.B.S.Santhosh kanna, HoD, Therapeutics, NIEPMD, Shri.S. Kurinji Selvan, Lecturer, Occupational Therapy, Department
Chennai of Therapeutics, NIEPMD, Chennai.
Shri.Pankaj Kumar, Occupational Therapist Head of Therapeutics
Services & Research, Reviviscence Rehab Institute Pvt Ltd, Chennai
Shri.S. Samuel Dinakaran, Asst Professor(OT), NIEPMD, Chennai
Chapter Contributors

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

Developed & Published by

NATIONAL INSTITUTE FOR EMPOWERMENT OF PERSONS


WITH MULTIPLE DISABILITIES (Divyangjan), (NIEPMD)
(Dept. of Empowerment of Persons with Disabilities (Divyangjan),
Ministry of Social Justice & Empowerment, Govt. of India)

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

1. Play, Developmental Consideration and Precaution 1

2. Understanding kinesthetic and vestibular sense and


8
skills

3. Challenging behaviors / consequences of kinesthetic


13
& vestibular sensation dysfunction

4. Evidence Review 16

5. Activities to improve kinesthetic and vestibular


34
sense and skills

Glossary 79

iv
CHAPTER- 1
PLAY, DEVELOPMENTAL CONSIDERATION AND PRECAUTIONS

-S. Samuel Dinakaran

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.

a) Play for children with developmental disabilities:


 Play is incredibly valuable for children of all age group. If possible play
should be chosen by the child as play is personal and internally motivated.
This implies that a child with special needs may need little support in
selecting the play activity, but they need to be given freedom to choose what
they can play and how to go about.
 If a child has a hearing or visual impairment, play is crucial in strengthening
other senses to them in navigating and exploring the world around them. If
they have mobility impairment, play provides exercise to muscles and also
improves coordination. When a child with autistic spectrum disorder (ASD)
engages in play, the child might have impaired social interaction with others
or may be less imaginative during play. These children may be interested in
non-toy objects and enjoys by engaging in play like counting or sorting
objects, this still qualifies as play.
 A child with attention deficit hyperactivity disorder (ADHD) might have
difficulty in social play, because of symptoms like difficulty in them waiting
for their turn and this could result in other children not interested in playing
with them .For a child with ADHD, play constitutes an important role in
giving them a chance to express self and aids in exerting some energy and
also with minimal guidance from parents play can help build association with
other children. Exploring and finding new things are vital for play, and when
child explores with various senses, it could be a source of enjoyment for that
child. Stimulating these senses helps in making connections in the brain much

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:

 Cognitive development: children understand how various things around


them work, and they get to compare the different attributes of various
materials during sensory play
 Social skills: children observe how others children are playing and get an
opportunity to copy ,share ideas
 Self-awareness: children get an insight to what they like and don’t like ,this in
turn helps to gain an understanding of self
 Physical development: Sensory activities are particularly good for muscles in
both hands & fingers
 Emotional development: Play aids in release for both energy or stress, which
helps children to convey positive feelings
 Communication skills: children express their responses to different materials,
e.g. showing excitement while playing in water, or astonish when they
experience new things.
c) Adaptations:

Generally adaptations /modifications are usually done to environment so that


child with developmental disability can be engage in age appropriate activities.

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.

Incorporating kinesthetic, vestibular senses in group activities:

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.

4
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

UNDERSTANDING KINESTHETIC AND VESTIBULAR

SENSE AND SKILLS

-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:

 Proprioception / Kinesthetic sense (receptors in Muscles, tendons and Joints),


 Vestibular sense (receptors in Inner ear)
 Visual sense (Eye)
 Cerebellum
 Cerebral Cortex & Spinal Cord

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.

Proprioception and Kinesthetic sense

Proprioception is a “specialized variation of


touch including the sensations of both joint movement
and joint position (Lephart and Fu, 1995)”.
Proprioception includes as Balance sense
(associated with vestibular and visual systems)
and the kinesthetic sense as related to
movements of the body and its parts.

To assess the position and movement of the


muscles, the muscles has the following sensory
receptors (also called as Proprioceptors) Sources: www.neurones.co.uk

Muscle Spindle Receptors Senses the


(present within the muscle) - Length of the muscle fibres
- Rate of change of muscle fibres length

Golgi - Tendon Organ Senses the


( present along Muscle tendon junction) - Tension along the muscle fibres
- Rate of change of muscle tension
Muscle Spindle Receptors along with Golgi Tendon Organs are responsible for
the transmission of the sensory information regarding the position and movements of
the limbs, through the Spinal Cord to the Cerebellum and Cerebral cortex. With this
information, motor planning is done to maintain joint position sense, muscle tone,
balance and co-ordination.

9
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

Ears has two important functions – Hearing and Equilibrium.

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)

Vestibular function is important for

 Balance and equilibrium of the body, in relation to movements of the head


 Visual tracking
 Muscle tone
 Language development, with auditory function.
 Hand / fine motor skills
 Self-care and Independence

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

CHALLENGING BEHAVIORS / CONSEQUENCES OF KINESTHETIC &


VESTIBULAR SENSATION DYSFUNCTION

-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.

The ability to assess the weight of an object is another function of kinesthetic


sense. Many activities we do without thinking, such as walking, whether we do it
correctly or not is a kinesthetic experience.

Dysfunction

Without this kinesthetic system it is impossible to walk without watching one’s


feet or to walk in the dark without losing one’s balance. It would also be impossible to
learn how to drive cycle as one could not handle the cycle handle or use foot pedals
while looking at road ahead.

Everyday physical skill learning involves stimulating, enhancing kinesthetic


system to improve balance, co-ordination, alignment, spatial awareness & efficiency of
action. Lack of this learning leads to difficulty in catching ball, & finely tuned sense of
position of joints & limbs.

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.

The vestibular system plays crucial part in establishing postural equilibrium by


appropriate adjustments during movements which are self-generated as well as those
movements which are by the external disturbance. Its importance is clear cut when a
person experience motion sickness or experience any other infections to the inner ear.

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

Y Hendra Yana (2017) examined investigation of Role of Kinesthetic Perception


in Supporting the Acquisition of Skills in Sports Games Success in sports execution
relies upon how viably the entertainers distinguish, find and utilize applicable tactile
data. Regularly, the champ of a game is the most quickly distinguish an example of
activity on your rival. The wellsprings of tangible data are eksteroceptive and
proprioceptive. The organs of eksteroceptive data source is eksteroceptor which
established in two things: vision and hearing. While Resources is proprioceptor
incorporate proprioceptive tactile receptor explicitly in muscles, ligaments, joints and
vestibular mechanical assembly (which is a piece of the focal sound-related/labyrinth).
Proprioceptor called sensation recognition or sensation detects, which implies the tactile
info that happens in the body that fills in as feeling answerable for the accuracy of a
development. This investigation plans to decide the job of sensation discernment in
supporting the obtaining of aptitude in sport game. The examination strategy utilized
was overview with connection procedure. Populace and Sample are players early ages
12 to 13 Years of 40 individuals. In view of the consequences of information handling
connection coefficient of 0.77 and a coefficient of assurance (R) of 0.60. It tends to be
presumed that there is a commitment of 60% sensation recognition towards sporting
event3.

Ted Richards (2012) led concentrate on Ptolemaic and Copernican Retrograde


Motion by utilizing Kinesthetic Activities. This paper portrays a strategy for showing
planetary retrograde movement, and the Ptolemaic and Copernican records of
retrograde movement, by methods for an arrangement sensation learning exercises
(KLAs). In the KLAs portrayed, the understudies actually stroll through the movements
of the planets in the two frameworks. A review factual investigation shows that
understudies who took part in these exercises performed better on assessment
questions relating to retrograde movement than understudies who didn't. Expected
clarifications for this outcome, including the breaking of study hall schedule, the impact
of body development on reasonable memory, and egocentric spatial proprioception, are
considered.4
17
Rowan Cheney ,Dr. Robert Hautala , Dr. Gavin Keulks (2017) portrayed
Lecture Setting for grown-ups dependent on Kinesthetic Teaching Strategies;
Kinesthetic educating is a gainful route for grown-ups to learn and hold new data, yet
isn't regularly utilized by educators. The motivation behind this undertaking was to
compile and talk about a rundown of sensation methodologies to assist educators with
encouraging learners' ability to draw in and center around the learning material during
introductions. The rundown of strategies was part into three segments: procedures that
can be instituted by the learner, strategies utilized by the moderator with no particular
learning results, and methodologies that are utilized by the moderator with explicit
learning outcomes.5

Marian H. Williams (2012) Collaborative sensation three-dimensional Mind


Mapping has transcendently been utilized by people or cooperatively in bunches as a
paper-based or PC produced learning methodology. With an end goal to make Mind
Mapping sensation, cooperative, and three-dimensional, a creative instructive system,
named Physical Webbing, was conceived. In the Physical Web movement, bunches
cooperatively assemble concrete (physical) portrayals of substance utilizing sensation or
participatory manipulative. The hypothetical underpinnings of the Physical Web
remember the logical discoveries for the genuineness of learning and Papers
constructionist hypothesis. A contextual analysis case of the usage of the Physical
Webbing process portrays a particular application and gives methods to replication and
extension of the technique. Subjective investigation of the attitudinal overviews
following the movement gave information in regards to understudies' inclination to the
Physical Webbing action over the conventional talk, acknowledgment of participatory
manipulative, saw learning and mentalities towards community sensation three-
dimensional Mind Mapping.6

The American Journal of Occupational Therapy (2004) Intervention for Adult


Vestibular Rehabilitation in Occupational Therapy People with hindrances of the
vestibular framework frequently have inconspicuous issues that have significant
consequences for their capacity to take part in day by day life assignments and exercises
at home and to take an interest in the public arena outside the home. Vestibular
debilitation frequently limits a person's capacity to take an interest in ordinary
occupations, influencing that person as well as noteworthy others, including relatives,
companions, colleagues, and parental figures. Word related treatment encourages
expanded autonomy in everyday life undertakings and interest in work and social
occupations. Therefore, word related treatment is a suitable intercession for customers
requiring vestibular restoration to diminish indications and increment autonomy in all
parts of their lives. Accordingly, vestibular restoration is within the extent of training
for word related advisors and word related treatment assistants1 who have specific
18
information and aptitudes around there. This archive gives a comprehension of the
fundamental information and abilities required by specialists working with people with
vestibular disabilities and will hold any importance with payers, professionals, or
shoppers who wish to find out about word related treatment work on utilizing
vestibular restoration procedures. Individuals with vestibular issues may give
manifestations including vertigo, oscillopsia, sickness, disequilibrium, and spatial
confusion, visual movement affectability, diminished powerful visual sharpness,
diminished focus, and diminished ability in double errand execution. Spatial direction
shortages and disequilibrium might be showed as head and body tilt while sitting or
standing, view of tilt while sitting or standing, veering or floating aside while strolling
or controlling a vehicle, or a feeling of not realizing what direction is up. These issues
may bring about dread of falling. These manifestations may influence word related
execution and can bring about social withdrawal and discouragement. For instance,
visual movement affectability may cause disequilibrium, vertigo, sickness and
confusion, prompting more slow or progressively abnormal execution of self-care
aptitudes, diminished investment in social exercises, and diminished capacity to
perform home administration undertakings outside of the home, for example, shopping
for food. Vertigo, disequilibrium, and different manifestations may meddle with work
aptitudes as they cause trouble standing, coming to, strolling, turning the head to
examine the earth, or making social signals with the head, for example, nodding7.

Sun-Joung Leigh A (2014) has accomplished their work on vestibular incitement


impact on a kid with hypotonic cerebral paralysis. The reason for this case report is to
introduce the impacts of vestibular incitement on a kid with hypotonic cerebral
paralysis using swings. [Case Description] The subject was a 19-month-old kid with a
finding of hypotonic cerebral paralysis (CP) and swaying nystagmus. The subject had
gotten both non-intrusive treatment and word related treatment two times each week
since he was 5 months old however demonstrated practically zero improvement.
[Methods] Pre and post-mediation tests were finished by the specialist utilizing the
Bayley Scales of Infant and Toddler Development II. The subject was given vestibular
incitement 3 times each week for 10 weeks in 1 hour meetings led by his mom as trained
by the analyst. During this exploration every other treatment were halted to decide the
impacts of the vestibular incitement and to reject the impacts of different treatments.
[Results] The subject exhibited improvement of 4 months in engine aptitudes and of 3
months in mental abilities as appeared by the Bayley Scales of Infant and Toddler
Development II. [Conclusion] Vestibular incitement was viable in improving postural
control, development, enthusiastic prosperity, and social interest of a kid with
hypotonic cerebral palsy8.

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.

Helen Cohen, Maureen Kane-, Laura V. Mill operator, and Catherine L.


Hatfield (2014) has accomplished their work on vestibular or visual and word related
association in vestibular restoration Otolaryngologists frequently recommend head
development practice programs for patients with vestibular issues, in spite of the fact
that the viability of these projects and the basic highlights of the activities are
inadequately comprehended. Since numerous patients who aversion practicing don't
finish their activities, options in contrast to the conventional redundant activities would
be helpful. Subjects determined to have vestibular issues were treated for about a
month and a half with an outpatient practice program that fused intriguing, deliberate
exercises or a straightforward home genius gram of head developments, tantamount
with the activities otolaryngologists regularly give their patients when they don't allude
to recovery. The two medicines joined redundant head developments in all planes in
space, graduated in size and speed. Subjects were completely tried when treatment with
standard proportions of vestibule ocular reflex and parity, level of vertigo, net engine
abilities, and self-care freedom. Subjects in the two gatherings improved altogether on
the utilitarian measures, with somewhat more noteworthy upgrades in the word related
treatment gathering. The outcomes were kept up 3 months after the end of mediation.
These information recommend that evaluated intentional exercises territory helpful
option for rewarding this patient populace and that the basic factor in any activity
program is the utilization of redundant head movements10.

Tami M. Linderman, Katherine B. Stewart (2012) depicted Occupational


Therapy based tactile reconciliation and Functional Outcomes in Young Children with
Pervasive Developmental Disorders. This single-subject examination investigated the
impacts of tangible integrative-based word related treatment gave in an outpatient
facility on the utilitarian practices of two little youngsters with inescapable formative
issue (PDD) at home. Strategy. The members were two 3-year-old young men with
PDD. Prior to the examination, the members had not gotten a predictable program of
tactile integrative-based word related treatment Before the gauge stage, three objective
practices were recognized for every kid, utilizing an adjusted adaptation of Cook's
modified Functional Behavior Assessment for Children with Sensory Integrative
Dysfunction. These objective practices were operationalized and utilized as rehashed
estimates taken in the home during both the 2-week benchmark and treatment stages.
The treatment stage was 11 weeks for Participant 1 and 7 weeks for Participant 2.

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.

Alia A. Alghwiri, Susan L. Whitney, Carol E. Bread cook, Patrick J. Sparto,


Gregory F. Marchetti, Joan C. Rogers, Joseph M. Furman (2012) portrayed about The
Development and Validation of the Vestibular Activities and Participation Measure

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.

Warren K Yunker 1, Scott G Walen, Elizabeth J Lange (2009) introduced an


instance of predominant crescent trench dehiscence (SSCD) in a non-verbal 17-year-old
male patient with trisomy 21 that gave conduct issues, rather than the more average
side effects of rambling clamor actuated vertigo. SSCD condition is described by sound-
, or pressure-actuated vertigo. Patients regularly gripe of vertigo or oscillopsia evoked
by boisterous commotions, which might be either outer sounds or those inspired by the
patients themselves when they are talking. In instances of SSCD, sound-related testing
will commonly uncover a conductive hearing misfortune on the influenced side while
high-goal transient bone processed tomography will show hard dehiscence overlying
the ipsilateral prevalent half circle trench. Here we present a report of SSCD in a patient
with Down syndrome who was without discourse and responded to commotion
incitement with social upheavals. For this situation, straightforward adjustments, for
example, clamor evasion and hearing assurance had the option to impact positive
changes in conduct and improve social collaborations. This case underscores the
significance of a wide differential finding, and the need to think about exchange
introductions, in youngsters with Down syndrome or any kid who is in any case
incapable to communicate himself19.

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.

Vestibular restoration: One of the principle tangible frameworks influenced by


SPD is the vestibular framework. SBIs principally mean to give incitement to these
frameworks where vestibular-based mediations can be furnished with treatment balls,
treatment pads, remedial horseback riding, and swings. Since the vestibular and visual
frameworks are firmly related, a portion of the essential objectives of VRT incorporate
improving look and postural strength. SPD incorporates moves identified with sensory
based handling and frequently influences engine arranging and additionally postural
dependability. During the underlying exercise based recuperation meeting, tangible
association testing was performed utilizing the Bertec Balance Advantage TM Dynamic
Computerized Dynamic Post autography (CDP) under six conditions (in the
accompanying request):

Condition 1: Stable platform with stable visual scene

Condition 2: Stable platform with eyes closed

Condition 3: Stable platform with unstable visual scene


28
Condition 4: Unstable platform with stable visual scene

Condition 5: Unstable platform with eyes closed

Condition 6: Unstable platform with unstable visual scene

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.

Aftereffects of the CDP testing recommended vestibular framework disabilities


and postural flimsiness (Figure 1). In light of the discoveries, a particular kind of VRT
called look steadiness practices were endorsed as a home exercise program (HEP) to
legitimately invigorate the vestibular framework. The HEP was performed with the
patient sitting upstanding and parent holding an optotypic at eye level around 3 feet
away. The HEP was changed so as to improve task consideration by including16
diverse 48-textual style capital letters on streak cards as optotypes. The patient at that
point turned his head easily from side to side for 30 seconds. The HEP adjustment
included changing the letter each couple of seconds and having tolerant recited the
letter for all to hear to keep him centered for the 30-second span. The patient performed
3 arrangements of the activities with rests of 30 seconds between sets 1 time for every
day. The patient was consistent with the HEP playing out a normal of 4-5 times each
week.

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:

1. Joe Tranquillo (2008) American Society for Engineering Education, KINESTHETIC


LEARNING IN THE CLASSROOM. 3
2. Danny Luong, Matthew Lai, and G. Young (2015) Int'l Conf. Frontiers in Education:
CS and CE , A Study of Kinesthetic Learning Activities Effectiveness in Teaching
Computer Algorithms Within an Academic Term .
3. Y Hendrayana ,IOP Conference Series: Materials Science and Engineering The Role of
Kinaesthetic Perception in Supporting the Acquisition of Skills in Sports Games. 2
4. Ted Richards (2012) Department of Philosophy, University of Tennessee, Knoxville
Using Kinesthetic Activities to Teach Ptolemaic and Copernican Retrograde Motion. 4
5. Rowan Cheney, Dr. Gavin Keulksand, Dr. Robert Hautala (2017) Kinesthetic Teaching
Strategies for Adults in a Lecture Setting. 5
6. Marian H. Williams (2012) Physical Webbing: Collaborative kinesthetic three-
dimensional Mind Maps®. 6
7. The American journal of occupational therapy (2004) specialised knowledge and skills in
adult vestibular rehabilitation for occupational therapy practices.
8. Sun-Joung Leigh an (2014) J. Phys. Ther. Sci., The effects of vestibular stimulation on a
child with hypotonic cerebral palsy. 8
9. Helen Cohen, Laura V. Miller,Catherine L. Hatfield Maureen Kane Wineland, Catherine
L. Hatfield Maureen Kane Wineland, Vestibular Rehabilitation With Graded
Occupations. 9
10. Maureen Kane wlneland,Helen Cohen ,Catherine and l. Laura v. Miller (2014)
hatfieldotolaryngol head neck surgery occupation and visual/vestibular interaction in
vestibular rehabilitation. 10
11. Tami M. Linderman, Katherine B. Stewart (2102) The american journal of occupational
therapy , Sensory Integrative- Based Occupational Therapy and Functional Outcomes in
Young Children With Pervasive Developmental Disorders: A Single-Subject Study. 11
12. .Lynne Welham (2013) British Journal of Occupational Therapy, Occupational Therapy
for Fatigue in Patients with Multiple Sclerosis. 12

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

ACTIVITIES TO IMPROVE KINESTHETIC AND VESTIBULAR INTEGRATION

-S.Samuel Dinakaran, Pankaj Kumar, SugumarPaulraj

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.

Kinaesthetic activities help ingrain learning into long-term memory by turning a


lesson into a physical experience. When a child is engaged in a kinaesthetic activity, he
is moving and touching and interacting with his lessons. And a great side benefit is that
kinaesthetic learning activities are usually lots of fun.

1) ACTIVITY:AIM & THROW


Material required: Ball ,cardboard box

Target population:

Child with Autism spectrum disorder

Attention deficit hyperactive disorder

Attention deficit disorder

Specific learning difficulty

Developmental coordination disorder (DCD)

Sensory processing disorder

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

2) ACTIVITY : MAKE A SANDWICH

Material required: None

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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.

Adaptation/accommodation: Increase the number of children if they are able to tolerate


the group

Impact expected: Awareness about others, helps develop pretend play, improvements
seen in following directions, able to tolerate physical closeness& touch.

Outcome indicator: Child begins to tolerate various movements as well as touch

Contraindication: Avoid excessive physical exertion for the child, parent/caregiver


have to closely watch for discomfort to children while hugging.

36
3) ACTIVITY: WRAP &WALK

Material required: A long scarf or therapy bands

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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.

Adaptation/accommodation: if the child is cooperative then whole boy is wrapped but


if child starts throwing temper tantrums and doesn’t like this activity then it is started
with just wrapping one body part

Impact expected: The pressure of scarf provide children with proprioceptive input. This
also helps in improving their balance.

Outcome indicator: Child is able to tolerate varying amount of pressure

Contraindication: An adult has to do the squeezing within tolerable limit for the child

37
4) ACTIVITY: HIT THEBALLOON

Material required: Balloons

Target population:

Child with Autism spectrum disorder

Attention deficit hyperactive disorder

Attention deficit disorder

Specific learning difficulty

Developmental coordination disorder


(DCD)

Sensory processing disorder

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

Duration /frequency: For about 5 – 10 minutes

Adaptation/accommodation: Physical prompts might be needed for children who have


difficulty with eye hand coordination and judgment

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.

Contraindication: Avoid excessive stimulation, observe the child while he/she


performs the activity (e.g. excessive sweating, tiredness).

38
5) ACTIVITY: RIDE ON A BLANKET

Material required: Small blanket

Target population:

Child with Autism spectrum disorder

Attention deficit hyperactive disorder

Attention deficit disorder

Specific learning difficulty.

Developmental coordination disorder (DCD)

Sensory processing disorder

Steps: The child is made to sit on a blanket and the parent/caregiver pulls the blanket

Duration /frequency: A child completes a circle by ride followed by other child

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.

Impact expected: Balance improves, waiting for turn improves.

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

Material required: Three or more adults

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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.

Duration /frequency: 5 – 10 minutes

Adaptation/accommodation: once the children learn to do this activity the parents


bring the legs a bit closer so the tunnel space becomes narrower and makes the activity
even more interesting.

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

Material required: Two different colored


papers

Target population:

Child with Autism spectrum disorder

Attention deficit hyperactive disorder

Attention deficit disorder

Specific learning difficulty

Developmental coordination disorder (DCD)

Sensory processing disorder

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.

Adaptation/accommodation: for a child who has difficulty identifying colors, common


shapes which child knows can be pasted on floor

Impact expected: motor co-ordination improves .This activity provides vestibular


stimulation. Child is able to wait for turns and spatial awareness of the child improves.

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

Materials required: A short balance


beam, objects to climb over(chair), to
crawl under(table), to crawl
through(cloth tunnel)&to jump
on(trampoline) can be used.
Target population:

 Child with Autism spectrum


disorder
 Attention deficit hyperactive
disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination
disorder (DCD)
 Sensory processing disorder

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

Adaptation/accommodation: the obstacles can be rearranged if the child finds it


difficult

Impact expected: Motor planning, understanding prepositions, balance improves. Child


learns to wait for turns.

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

Material required: Blanket

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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

Duration /frequency:5 – 10 minutes depending on child ability to tolerate being


wrapped.

Adaptation/accommodation: Do the game standing up if child doesn’t like being rolled


in lying down position

Impact expected: Vestibular, proprioceptive, tactile stimulation, body awareness


improves,

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

Material required: Scarf

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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).

Adaptation/accommodation: The instructions are kept to minimum, ask child to throw


scarf if they have difficulty catching it.

Impact expected: eye - hand coordination, visual& proprioceptive input improves


along with vestibular & kinesthetic sense.

Outcome indicator: Child is able to catch the scarf most of the time, once the co-
ordination improves.

Contraindication: Avoid over stimulation& physical exhaustion for the child.

44
11) ACTIVITY: STACK THE CANS

Material required: Ten clean, empty aluminum


cans, ball

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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.

Adaptation/accommodation: Use bottles which can be easily stacked

Impact expected: waiting for turns, eye hand & bilateral co-ordination improves.

Outcome indicator: child is able to stack cans with minimal assistance.

Contraindication: avoid using a heavier ball, make sure bottles used are safe.

12) ACTIVITY: FOLLOW THE SOUND

Material required: stop sign, green , red color cloth , bell

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
45
 Sensory processing disorder

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

Adaptation/accommodation: for children who have difficulty comprehending, actions


can be used.

Impact expected: Attention span, ability to follow commands improves.

Outcome indicator: Child is able to follow commands independently.

Contraindication: Care should be taken to avoid children pushing each other & getting
hurt.

13) ACTIVITY: TUG - OF – WAR

Material required: a long scarf.

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

Steps: Children form two groups on either side .When the activity starts the children
start pulling the scarf.

Duration /frequency:5 – 10 minutes (exertion to be avoided)

Adaptation/accommodation: Parent can assist child in holding if child has difficulty in


the grasp.

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.

14) ACTIVITY: LET’S GO ROCKING

Material required: None

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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

Duration /frequency:5 – 10 minutes (avoid over stimulation)

Adaptation/accommodation: Movements done slower for child who cannot tolerate


excessive movements

Impact expected: Stimulates the vestibular system, child understands concepts like fast
and slow

Outcome indicator: Vestibular seeking behavior decreases

Contraindication: Avoid over stimulation, look for sweating, nausea. Activity is


stopped immediately if the above are seen in a child.

47
15) ACTIVITY: IT’S ME

Material required: Mirror ,Scarf

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder
(DCD)
 Sensory processing disorder

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.

Impact expected: eye contact, attention span improves

Outcome indicator: Children will be able to learn name of other children in group.

Contraindication: None

16) ACTIVITY: STEP ON THE ROPE

Material required: Small piece of rope or ribbon

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder

48
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

Steps: The rope is place on the ground and one


end held by the parent. Ask the child to step on
he rope. When the child is doing this, move it
quickly
Duration /frequency: 2-3 minutes

Adaptation/accommodation: For children who


have difficulty moving fast, move the rope slowly
so it gives them a chance to step on it.

Impact expected: improves Attention, motor coordination, visual and spatial


awareness.
Outcome indicator: Child is able to step on rope when he engages in the activity.

Contraindication: Adult to stand at the back of the child to avoid falls

17) ACTIVITY: FEATHER BLOWING

Material required: Small feathers

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

Steps: Parent/caregiver blows a feather and has the child catch it, and then the child is
made to blow the feather.

Duration /frequency: 3 – 4 minutes depending on child’s attention span

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

18) ACTIVITY: LOST IN RICE

Material required: Rice, medium- sized container, small toys, Ping - Pong balls.

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

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.

Impact expected: object permanence develops, attention span improves.

Outcome indicator: Child is able to pick up all objects through touch.

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:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
 Sensory processing disorder

Steps: Clay is placed in front of the child &child


is asked to spread the clay & write/draw circles
in it with fingers.

Duration /frequency: 5 – 10 minutes

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

Outcome indicator: Child starts to touch sticky substance

Contraindication: Adult should supervise to avoid child putting object in mouth

20) ACTIVITY: WHAT’S IN THE BAG?

Material required: One small bag ,different


common household objects, such as a key ,spoon
etc

Target population:

 Child with Autism spectrum disorder


 Attention deficit hyperactive disorder
 Attention deficit disorder
 Specific learning difficulty
 Developmental coordination disorder (DCD)
51
 Sensory processing disorder

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.

Duration /frequency: Till the child names all objects

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.

Impact expected: Increasing tactile awareness, building vocabulary

Outcome indicator: child starts naming familiar objects

Contraindication: none

21) ACTIVITY: RHYTHMIC PEANUT BALL BALANCING

Material Required: Peanut Ball

Target Population: Children with multiple physical/ Intellectual disabilities from 5


years to 15 years

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.

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices may be used for better foot placement.


Spinal Orthoses or any hand splint recommended shall be worn

Impact Expected: child will develop equilibrium reaction and balance.

Outcome Indicators: child will initiate feet placement for seeking balance

Contraindications: In case seizure episodes stop activity and provide necessary support
to child.

22) ACTIVITY: NON-RHYTHMIC PEANUT BALL BALANCING

52
Material Required: Peanut Ball

Target Population: Children with multiple physical/ Intellectual disabilities from 5


years to 15 years

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.

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices may be used for better foot placement.


Spinal Orthoses or any hand splint recommended shall be worn

Impact Expected: child will develop equilibrium reaction and balance.

Outcome Indicators: child will initiate feet placement for seeking balance

Contraindications: In case seizure episodes stop activity and provide necessary support
to child.

23) ACTIVITY: FLY STRAPPER HITTING

Material Required: 2 Flying strapper , whiteboard

Target Population: Children with Multiple Disabilities

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

Adaptation/Accommodation: Hand splint and standing assistive devices can be used to


compensate physical barrier. A thick grab handle can be used in strapper to facilitate
good grasp.

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

Contraindications: Absent Head Control and


Muscle grade 1 for Head & Neck and Trunk children
Muscular Dystrophy with severe muscle weakness

24) ACTIVITY: HAND AND FOOT PAINTING

Material Required: Color box, Bubbles rapper, piece of white cloth/ chart paper, baby
chair

Target Population: Children with multiple physical/ Intellectual disabilities /


ASD/ADHD from 5 years to 15 years

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

Duration: 20 minutes (Sufficient time shall be given for completion of activity if


required time can be increased)

Adaptation/Accommodation: Crawler can be given in case child cannot crawl.

Impact Expected: Kinesthetic development, praxia development, vestibular sense ,


Gross motor coordination development

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

25) ACTIVITY: RAINBOW FUR GAME

Material Required: Different color cloth pieces, Different size of cloth pieces,

54
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.

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices can be provided if child is having poor


pinches and ROM

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.

Contraindications: Muscle Dystrophy and sever weakness

26) ACTIVITY: WALKING ON SLEEPING EIGHT

Material Required: Plastic Basket, Bucket with lid, Variety of Toys, Tape

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices may be used for balance or body


anatomy correction as indicate by therapist.

Impact Expected: Child will exhibit improved Kinesthetic & Vestibular sense

55
Outcome Indicators: Child will initiate feet placement for seeking balance on curvy and
zig zag way, Grabs and places toy without dropping

Contraindications: seizure episodes, Severe Locomotive Disability.

27) ACTIVITY: FROG JUMPING ACTIVITY

Material required: 2 trays, some vegetables

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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)

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices can be given for the kid if


recommended by therapist, Hand splints can also be used if needed

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.

Contraindications: Severe locomotive Disability

28) ACTIVITY: TOUCH THE TARGET

Material Required: Different colors & Size of balloons, Double sided tape

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

Steps:

1. Ask the child to blow the balloons.


2. Tie filled balloon

56
3. Cut tapes into small pieces
4. Place tape at balloon at one side
5. Place balloon on the wall above shoulder level

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices can be used as per requirement consult


therapist for need of assistive device

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.

Contraindications: Should be given under proper supervision and should be avoided if


any muscle or joint complication or pain is there in performing

29) ACTIVITY: KICK THE CUP

Material Required: Disposal cups, A football

Target Population Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

Steps:

1. Place cups in line in front of the child.


2. Put numberings on cup
3. Ask child to stand 10 feet distance in front of the target balloons
4. Give a football to child
5. Ask child to target desired numbered cup with football

Duration: 10-20 minutes (Time frame can be extended based on child interest and
completion of activity)

Adaptation/Accommodation: Distance can be manipulated based on successful


completion form near to far gradually

57
Impact Expected: Child will develop praxia, balance, coordination, instruction
understanding

Outcome Indicators: Improved target hits without assistance

Contraindications: Severe Muscular Dystrophy

30) ACTIVITY: OBSTACLE MAZE

Material Required: Rope, Inside Room/Hallway, 5 small items which can be carried in
hand eg. Beads, clips etc .

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

Steps:

1. Fix rope in zigzag pattern in hallway


2. Child will walk through zigzag arranged rope pattern.
3. Place 5 Objects at one end and ask child to take and shift each item at a time.
4. Appraise child for completing each segment of completion and overall activity
completion.

Duration: 10-20 minutes ( Time can be extended as per child interest and completion of
the activity)

Adaptation/Accommodation: Supportive devices and visual cues can be given to plan

Impact Expected: Improved Motor Planning, Body awareness, kinesthetic and


vestibular integration, coordination

Outcome Indicators: Child will take less time to complete activity with less puzzled
between ropes

Contraindications: Epilepsy, Severe Locomotive Disability

31) ACTIVITY: MATCH STICK STACKING PLAY

Material Required: Match sticks, even surface floor

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

58
Steps:

1. Place match sticks freely on floor


2. Ask child to copy designs in squat sitting like rectangle, square, triangle, etc
made by you
3. Make interesting by using story narration
4. Praise child on completion of segment and overall completion of activity
5. Ask child to keep all matchsticks in proper place as guided by you

Duration: 10-20 minutes

Adaptation/Accommodation: Hand function splint if needed

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

Contraindications: Severe Ankle Joint contracture

32) ACTIVITY: OBSTACLE JUMPING

Material Required: Wooden \ plastic hurdle

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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

Duration: 10-20 minutes

Adaptation/Accommodation: Splints or other adaptive devices can be given, Physical


support

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

59
Contraindications: If any seizures episode is reported or any muscle disease it should
be avoided, Spina Bifida

33) ACTIVITY : THROW BALL ON BEAM

Material Required: Balls, one bucket, Beam

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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.

Duration: 10-20 minutes

Adaptation/Accommodation: A raised stool can be used if beam not available.

Impact Expected: Bilateral coordination improvement, Kinesthetic and Vestibular Sense


Inputs, Body Schema & Awareness, Body Balance and Equilibrium reaction

Outcome Indicators: Child will have decreased fall tendency and improved balance
while carrying and throwing ball in bucket

Contraindications: Seizure, Severe Multiple Disability, Ataxic CP

34) ACTIVITY : BOUNCE & PEG

Material Required: Peg board, 65B CM Gym Ball, raised Tray

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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.

60
Duration: 10-20 minutes

Adaptation/Accommodation: Safety Harness can be given for improved safety and


sever balancing kids

Impact Expected: Child will have improved vestibular and kinesthetic sense integration
along with hand function and cognitive skills development

Outcome Indicators: Child will be completing activity without falls

Contraindications: Neuro-Muscular degenerative or progressive disease

35) ACTIVITY: HOPPING FROM STOOL TO BOX

Material Required: 2 Stools, and cardboard Box

Target Population: Children with multiple physical/ Intellectual disabilities /


ASD/ADHD from 5 years to 15 years

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

Duration: 10-20 minutes

Adaptation/Accommodation: Hanging rope can be given for support

Impact Expected: Improved Kinesthetic and vestibular sense integration, balance,


Coordination

Outcome Indicators: Child will Jump and Climb readily without assistance

Contraindications: Severe Multiple Disabilities, Muscular Dystrophy

36) ACTIVITY: HOP UP SIDEWALK WORD LADDER

Material Required: Chalk

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years
61
Steps:
1. Draw a ladder with chalk on the floor
2. Write basic letters such as A, B etc..in the ladder spaces.
3. Ask child to Jump on One leg from one letter to another.
4. Ask the child to take step on by one and repeat for 3 times.

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices may be used for better foot placement.

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.

Contraindications: Severe locomotive disability.

37) ACTIVITY: CRAWL ON INCLINED RAMP

Material Required: Inclined ramp, small toys

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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.

Duration: 10-20 minutes

Adaptation/Accommodation: Adaptive devices if needed, Dupatta can be used to give


support to raise belly above from floor

Impact Expected: Improved Kinesthetic, vestibular, Gross motor Coordination, Joint


stability.

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

62
38) ACTIVITY: WEIGHT BEARING

Material Required: Plastic coated metal or heavy ball, ribbon

Target Population: Children with multiple physical/ Intellectual disabilities/


ASD/ADHD from 5 years to 15 years

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.

Duration: 10-20 minutes

Adaptation/Accommodation: Hand splint if needed, Heavy Vegetable packs of Potato


or tomato can be used in place of mass weight ball

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

Contraindications: ASD, VSD and other cardio-respiratory conditions

39) ACTIVITY: FINGER PAINTING WHILE STADNIG ON BLANCE BOARD

Material Required: Water paint , water , tray ,paper, Balance Board

Target Population: Children with multiple physical/ Intellectual disabilities /


ASD/ADHD from 5 years to 15 years

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
63
Duration: 10-20 minutes (Can be increased as per need)

Adaptation/Accommodation: Wall Support can be given initially but gradually should


be removed .

Impact Expected: Kinesthetic development, praxia development, vestibular sense

Outcome Indicators: seeks minimum assistance for completing activity

Contraindications: sever contracture of hand and foot shall not be given, lack head and
neck control kids shall avoid such activities

40) ACTIVITY: JUMPING ON TRAMPOLINE & BASKET

Material Required: Trampoline, Basket Ball

Target Population: Children with multiple physical/ Intellectual disabilities /


ASD/ADHD from 5 years to 15 years

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.

Duration: 15-20 minutes (Can be increased based on interest of child)

Adaptation/Accommodation: Wall Support can be given initially for fall prevention.

Impact Expected: child will develop equilibrium reaction, Coordination, Bilateral


Integration and balance

Outcome Indicators: child will initiate feet placement at one place after jumping for
seeking balance

Contraindications: Sever Locomotive Disability, Muscular dystrophy.

41) ACTIVITY : SPINNING

Spinning is the fastest and strongest way to get vestibular input.

 Materials Required: we don’t need any materials during this activity

64
 Target Population: children with
 Autism
 Attention deficit hyperactive disorder (ADHD)
 Specific learning difficulty (DYSLEXIA)
 Developmental coordination disorder (DCD)
 Sensory processing disorder (SPD)

• Steps: Ask the child to spin by verbal instruction or modelling

• Duration/Frequency: Children must spin in both directions (clockwise and counter-


clockwise) and no more than 10 rotations at a time.

• Adaptation/Accommodation

 Steps: for children who have difficulty in spinning we


can use swings and make them spin with support.
 Equipment: Spinning can be done with swings
 Instructions: Make the child sit on a Disc swing and spin
slowly

• 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.

• Caution Indications: Remember if a child becomes over stimulated with spinning


and shows signs such as red cheeks, feeling sick to their stomach, faint or dizzy, etc.

65
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.

• 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 hand upside down on a monkey bar or a rope ladder

• Duration/Frequency: 1minute or less than a minute and repeat for 3- to 6 times in a


session.

• Adaptation/Accommodation

 Steps: The child can hang in rope ladder/trapeze bar


 Equipment: rope ladder, trapeze bar can be used
 Instructions: hold the child upside down carefully in any of
the equipment and make them hang for few seconds to a
minute

• Impact Expected: sensory seeking behaviour will be reduced

• Outcome Indicator: The child will be more organized distraction will reduce and
attention & concentration will increase.

66
• 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.

43 ) ACTIVITY: SCOOTER BOARDS

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

 Materials Required: scooter board, helmet, knee pad, cushions 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 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

 Steps: scooter board with side rails can be used for


protection of the child.
67
 Equipment: Ropes, side rail scooters cushions and crash bins
 Instructions: ask the child to hold the rails and push the
scooter board in any direction.

• Impact Expected: The balance and coordination will improve, reduces vestibular
seeking behaviour

• Outcome Indicator: child’s attention and concentration will increase, motor,


coordination balance and motor planning abilities will improve,

• 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.

43) ACTIVITY : CLIMBING

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.

• Duration/Frequency: child can be allowed to repeat as many times as possible till


they feel tired or bored

• Adaptation/Accommodation

 Steps: safety slings can be attached to prevent fall.

68
 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

• Outcome Indicator: motor planning skills attention concentration and problem-


solving 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.

45) ACTIVITY : OBSTACLE COURSES

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.

 Materials Required: make an obstacle course with available materials


in your play area or therapy area like a maze.
 Target Population: children with
 Autism
 Attention deficit hyperactive disorder (ADHD)

69
 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

• Duration/Frequency: child can be allowed to repeat as many times as possible till


they feel tired or bored

• Adaptation/Accommodation: adapt the obstacle course according to the level of the


child

 Steps: Plan the obstacle course according to the level of


the child and slowly grade the level.
 Equipment: Use the available equipment’s in the play
area or therapy area
 Instructions: give clear instructions to child to move
from one obstacle to another and complete the course

• Impact Expected: child’s confidence and independent functioning will improve.

• Outcome Indicator: attention, concentration, motor planning and problem-solving


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.

70
46) ACTIVITY : BALANCE BEAM

Steppingstones at varying heights are a great option, or balancing on playground


equipment is also great. An avoider may not like their feet off the ground. You can
begin with walking a line using painters’ tape or a rope on the ground.

 Materials Required: balance beam


 Target Population: children with
 Attention deficit hyperactive disorder (ADHD)
 Specific learning difficulty (DYSLEXIA)
 Developmental coordination disorder (DCD)
 Sensory processing disorder (SPD)

• Steps: Make the child balance and walk over balance beam or stepping stones
without touching the ground

• Duration/Frequency: child can be allowed to repeat as many times as possible till


they feel tired or bored

• Adaptation/Accommodation

 Steps: according to the level of the child the activity can be


modified to ensure the independent performance.
 Equipment: The available materials in the ground or
therapy area can be used
 Instructions: the child has to be instructed to walk over and
balance in the equipment.

• Impact Expected: The child’s balance and coordination will improve

• 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.

71
• 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.

47) ACTIVITY : SWINGING AND SPINNING

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.

 Materials Required: platform swing, bolster swing, disc swing,


hammock swing etc
 Target Population: children with
 Autism
 Attention deficit hyperactive disorder (ADHD)
 Specific learning difficulty (DYSLEXIA)
 Developmental coordination disorder (DCD)

72
 Sensory processing disorder (SPD)

• Steps: Make the child sit on the swing assist him to swing slowly in linear then
circular and grade slowly

• Duration/Frequency: look for any child’s reaction and decide accordingly.

• Adaptation/Accommodation: we can add safety slings to the swings to ensure the


safety of the child.

 Steps: decide whether the sling is needed or add cushions to


the floor to prevent Impact on the floor when fall occurs
 Equipment: cushions and slings
 Instructions: Use the safety equipment’s properly according
to the need of the child

• Impact Expected: The child’s 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 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.

73
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.

 Materials Required: no materials needed


 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 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.
74
• 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.

49) ACTIVITY : RIDING A BIKE/ CYCLE:-

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.

 Materials Required: bike/cycle, Helmet, knee guard, elbow pad 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 sit on the cycle/ bike assist him to pedal slowly, then increase
the speed distance and time of cycling day by day

• Duration/Frequency: look for any child’s reaction and decide accordingly, It a


physically exhausting outdoor sport so initially start of for minimal timing then slowly
grade according to the child’s stamina and interest level.

• Adaptation/Accommodation: Therapist or caretaker should definitely assist or hold


the cycle/ bike to ensure safety of the child. Using of helmet knee cap and elbow pads
75
will prevent injury if the child falls from the cycle/bike. The child should learn to ride
or drive the bike/ cycle in a ground or Park Lane not in normal roads.

 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

• Impact Expected: The child’s 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.

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.

50) ACTIVITY : SKIPPING:

 Materials Required: Skipping Rope


 Target Population: Children with
 Autism

76
 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.

• Adaptation/Accommodation: Therapist or caretaker should definitely ensure safety


of the child. Make the child to jump on a plinth or cushion to prevent injury. The child
should learn to jump on a ground later.

 Steps: The child should jump on a plinth or cushion


 Equipment: skipping rope, plinth or cushion
 Instructions: Use the safety equipment’s properly according
to the need of the child

• 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.

77
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.

List of Activities For Vestibular Input

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.

78
GLOSSARY

1. ADD (Attention Deficit Disorder): attention problems


2. ADHD (Attention Deficit Hyperactivity Disorder) :ADD with hyperactivity or
excessive movement
3. Arousal: the condition of the nervous system that determines at which rate a person
is ready to receive information so he or she can pay attention in an appropriate
manner
4. Auditory: pertaining to hearing
5. Auditory discrimination: The ability to recognize small differences in sounds
6. Autism: A developmental disability that is marked by impairments in normal
communication, social interaction, and behavior and usually manifests before the
age of two or adaptive response. the appropriate response—in movement or
language—to a stimulus
7. Communication: The exchange of thoughts and information through body language,
speech, or writing.
8. Dysfunction :abnormality or impairment in the operation of a specified bodily organ
or system
9. Expressive language: Using tone of voice, gestures, words, and rate of speech; the
language used to convey thoughts, feelings, or events.
10. eye movement: how the eyes move; for example, in order to follow an object
11. eye-hand coordination. the combination of eye-hand movements fine motor skills.
finer movements of the body, such as writing, coloring, fastening buttons, and tying
shoelaces
12. kinesthetic :relating to a person's awareness of the position and movement of the
parts of the body by means of sensory organs in the muscles and joints
13. Play :Engage in activity for enjoyment and recreation rather than a serious or
practical purpose
14. Sensory play :Sensory play includes any activity that stimulates your young child's
senses namely touch, smell, taste, movement, balance, sight and hearing
15. Senses. functions of the body that are involved in receiving stimuli from the body
and the immediate environment
16. Sensory integration. the ability to take in information about the immediate
environment through the body, select information, and combine it to choose an
appropriate reaction
17. Vestibular: equilibrium sensory system that helps with balance, reaction to gravity,
and ability to keep eyes on a target while the person is moving

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

SPD: Sensory processing disorder

VRT: Vestibular rehabilitation therapy

CDP: Computerized dynamic post autography

HEP: Home exercise program

SIT: Sensory integration therapy

SBI’s: Sensory-based therapies treatments and interventions

taMAX: Theta maximum

taMIN: Theta minimum

ES: Equilibrium score

COG: Center of gravity

80
Publications of NIEPMD

Title Cost

1. Resilience Headway Youth with Intellectual Disability: A Manual………..Rs.400/-


2. Resilience Headway Siblings of Children with Special Needs:A Manual...Rs.400/-
3. Resilience Headway Youth with Multiple Disabilities: A Manual………...Rs.400/-
4. Acceptance &Coping : Families of Persons with Multiple Disabilities…...Rs 300/-
5. Empowering Caregiving Staff: Disability Care…………………………..….Rs 300/-
6. Capacity Building of NGOs in Disability Management……………………Rs 400/-
7. High Support : Parental Needs…………………………………………..…....Rs 300/-
8. Parental Wellbeing in Raising a child with Special Needs………...…….…Rs 400/-
9. Individuals with deaf blindness: Perception Analysis ……………...….…..Rs.350/-
10. Specific Learning Disabilities: An Introduction…………………….…….…Rs.500/-

81
Kinesthetic and Vestibular Activities for Developmental Disabilities

About this book

It is indeed a requirement to understand at present that the most commonly faced


difficulty among population at risk is vestibular and kinesthetic perceptual difficult. It
presents in various form in wide variety of conditions such as Autism, ASD, Multiple
Disabilities, Cerebral Palsy, Learning Difficultly, Developmental Delay, etc. It is usually
found in form of Apraxia, hypokinesia, hyperkinesis, coordination difficultly etc. This
book is a resource for parent of population at risk and for professionals who are dealing
with these conditions to develop vestibular and kinesthetic perceptual skills which not
only include sensory motor performance but also various components of sensory
development from grass root level. Itgives basic understanding on these senses, and
various home based activities to develop those skills. This book will explain procedures
to plan activity under supervision to target individual components or multiple
components of vestibular and kinesthetic perceptual skills.

Chapter Contributors

Dr.R.Karthikeyan, M.B.B.S., M.D., Department of Physical Medicine and Rehabilitation,


Sree Balaji Medical College & Hospital, Chromepet, Chennai, Consultant at Kauvery
Hospital, Chennai. Hamsa Brain and Spine Rehab, Chennai.

Shri.Pankaj Kumar, Occupational Therapist Head of Therapeutics Services & Research,


Reviviscence Rehab Institute Pvt Ltd, Chennai

Shri.S.Samuel Dinakaran, Asst Professor(OT), Occupational Therapy Unit, Department


of Therapeutics, NIEPMD

Shri.SugumarPaulraj, Occupational Therapist, Managing Director, Srimathi


Karthikeyani School for Special Children, Dindigul.

Contact Us

East Coast Road, Muttukadu,


Kovalam Post Chennai - 603112,
Tamil Nadu,India.
Phone: 044- 27472113, 27472046
Email: [email protected]

Cost of this book Rs 300/-


82

You might also like