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OT Tips and Suggestions


Fine Motor, Visual Motor, and Perceptual Skills


Cutting Tips

  • Bold the outline of what needs to be cut with a highlighter or a marker.
  • There is a sequence to teaching cutting skills.  We start with cutting plastic straws and progress to cardboard and card stock and eventually to cutting paper.
  • We start out with snipping the paper (making fringe around the edge of paper and progress to cutting across the paper and then progress to cutting lines and straight edge shapes (squares) before circular lines and zig zag shapes.   
  • Hold scissors and paper with “thumbs on top.” You can place a sticker on your child’s thumb nail as a reminder.
  • Always remind the student to “turn the paper”
  • As said before- Begin first with cutting straight lines, then basic shapes, then complex shapes.
  • Use hand-over-hand assistance as needed.

Gluing Tips

  • When gluing, put the glue on the object being glued and NOT the paper.
  • Make a mark/draw a line as a visual of where the glue should go.
  • Try glue sticks for children with decreased strength.
  • Squeezing out the glue is helpful for students who need to increase hand strength

Pencil Grasp Tips

  • Use broken crayons and short pencils to encourage an efficient grasp.  We use golf pencils with most preK and Kgn. students.
  • Have your child hold a small coin or cotton ball with their pinky and ring fingers leaving only their pointer (index finger) , middle finger and thumb available to hold the pencil.
  • Work on tripod grasp activities that encourage use of 3 fingers (thumb, index, and middle finger) such as squeezing tiny sponges (3 fingers only), clothespins, pinching clay/putty, using an eyedropper


Hand Strengthening Activities

  • Anything resistive – where there is push/ pull using the muscles is a way to strengthen the hand and the fingers.
  • Push and Squeeze hands together (against each other- in a  praying position)
  • To developmentally increase strength – Do weight bearing activities - Hand weight bearing activities include wheelbarrow walks; crab walks, push-ups, push the wall or push the table, and crawling. Lay over a ball and walk out with your hands. Lay on the couch and put your hands on the floor to lean on.

          Clay and Playdoh play: roll into balls (mini-meatballs), make a        snake, press with stamps, hide and find pegs or beads, etc. Squeeze     the playdoh balls between fingertips

  • Push and pull toys apart (mega blocks, lego’s, bristle blocks, pop beads
  • Pinch clothespins, paint with eyedroppers, & pick up items with tweezers.
  • Crafts, such as beading, lacing, ripping paper to make a collage, Use a hole punch
  • Use a spray bottle to play in the bath, help with cleaning, water the plants etc.
  • For in-hand manipulation, place coins in a piggy bank or make your own with a coffee can with a slot in the top. Hold several coins in one hand at a time and the bank with the other hand. Place them one at a time from palm to fingertips (This should be done within their one hand. Other hand cannot help)


Visual Skills Activities

  • When reading use an index card or ruler or to help isolate one line or word at a time.
  • Activities such as mazes, cryptograms, Do-A-Dot markers, word finds,  puzzles, ball or balloon toss, following an object with eyes only (not moving head)
  • Hidden pictures (where’s waldo and ISpy)
  • To view more visual perceptual activities, visit the free wonderful website: 
  •  Writing Skills

Proper Posture When Writing on a Table Top

  • Feet flat on the floor (A footstool or thick book can be placed under the feet to assist if feet do not reach the floor.) Sit upright in chair.
  • Wrist supported on table. Paper stabilized by non-writing hand.
  • For many children, it is helpful to have the paper on a vertical surface (taped to the wall at eye level) or use a slant board (you can use a binder on its side or position a pizza box with a 45 degree angle. It helps with vision and eye-hand coordination to put materials on a slant.  

Letter Formation

  • When printing, prompt your child to use a top down formation: “Start at the top!” All capital letters start at the top.
  • Try this routine: You write the letter…Your child writes the letter…You write the letter…Your child writes the letter.
  • Lots and lots of tracing then write the same thing (helps with motor memory)
  • Give the student ‘starting dots’ of where to start the letter or number they are writing.





  • Have child use their finger or a Popsicle stick after each word to create an appropriate space before beginning the next word.
  • For older students- Use graph paper to give a visual cue for spacing out words and letters. Take loose leaf paper and turn it sideways (vertical lines instead of horizontal) to help them make columns for lining up math problems.
  • There are many types of writing paper. Be sure to check with your child’s therapist on the best type of paper or strategy for your child.
  • Stress using the lines of the paper and getting the size of the letter correctly.  Tall letters and capital letters must touch the top and bottom lines. Most lower case letters must touch the middle line and the bottom line and below the line letters must touch the middle line and go below the line.   


Letter and word placement

  • Draw a green line along the left margin of the paper and a red line on the right to signal where to “start” and “stop.” Have them attend to the margin when writing
  • If your child has difficulty writing on the line, darken the baseline with a marker.
  • Use a highlighter to indicate where to write between lines.


Practice Writing Skills

  • Schedule a 10 minute interval daily to practice writing.
  • Encourage your child to write about a preferred topic of choice.
  • Help your child make greeting cards for family and friends.
  • Write a grocery list together.
  • Make lists: favorite TV programs, movies, things to pack before a trip.  Copy what is written on a cereal box or a recipe


Self-Regulation and Sensory Processing

Self-regulation is the ability to control one’s thoughts, emotional responses, actions and level of alertness/attention. It can be influenced by several different factors including sensory processing. Sensory processing is how we process information from the world around us as well as what is going on inside of us to produce an appropriate behavioral response.



Calming Activities – Calm Down Activities

  • Play games that reinforce structure and require waiting/ turn-taking: such as red light green light, freeze dance, Simon says.
  • Yoga, meditation and belly breathing will help child develop better control of their physical body, thoughts, and emotional states. You can start by sitting still with eyes closed with a slow count of 5.  There are many videos for children on YouTube and many books on YouTube about mindfulness and breathing. More to come on this.
  • Routines, structure and clear expectations will help your child with self-control. Review any changes to normal routine before it happens.  Prepare for transitions before they happen.
  • Provide a quiet personal space for your child to calm.
  • Relaxing music and background music is very helpful for students that need to calm down. Studies have shown classical music playing softly in the background helps to calm.
  • A bean bag chair or soft pillows to burrow into or under may be helpful. Some kids like weight on them and like to go under the couch cushions.
  • Encourage a variety of work positions such as standing, lying on the floor, kneeling.
  • Offer your child a chewy snack to provide organizing sensory input (i.e. Twizzlers, dried fruits, bagels, etc.).
  • “Heavy work” activities help the student to be more grounded (carrying heavy items, push/pull activities, pushing or pulling something heavy like a bin of books from one area to another

Energizing Activities – Wake up Activities

  • Have your child jump on a mini-trampoline, perform jumping jacks or play hopscotch.
  • Do Push-ups on the floor or push-ups against the wall.
  • Organized sports activities- running, yoga, karate, gymnastics, bike -riding.
  • Climbing on or hanging from playground equipment.
  • Eating crunchy foods (i.e. popcorn, pretzels- esp sourdough pretzels, carrots, apples, etc.).
  • Play and dance to loud, fast-paced music.
  • Use toys that make noise or light up.


Tips for Children with Tactile Sensitivities

  • Gradually expose your child to different textures going from the least to most messy. (for example- Play-doh is less messy than shaving cream or finger paints.)
  • Provide firm pressure rather than light touch always when holding hands or giving hugs. Give bear hugs
  • When they come out of the bath – use firm pressure when drying with the towel if they dislike light touch
  • Make sure that blankets, pajamas and clothes are comfortable for the child as this may disrupt their sleep and other daily activities. (I.e. Cut out clothing tags if causing discomfort, wear socks inside out if irritating, etc.)
  • When I have a student that will not touch things – I have them put things into that substance that they dislike (for example- if they don’t like to touch model magic clay – we put golf tees or pegs into it – we do the same putting characters into the bath with shaving cream)
  • Use unscented – non-toxic laundry detergent.  


Attention and Focus.

  • Choose a location in the home with minimal distractions when completing structured activities such as homework or studying.
  • Break down instructions into simple 1-2 step directions.
  • Have child repeat directions back to you to reinforce understanding.
  • Use a visual timer to gradually increase attention to a non-preferred activity.
  • Allow your child to take short, intermittent movement breaks. Go on YouTube and find a kids dance or movement or exercise video to break up the work sessions
  • Use a reward chart with stickers or check-marks to reinforce positive behaviors.


Toilet Training

  • Look for signs for readiness, like discomfort when wet or soiled or staying dry for several hours at a time.
  • Have your child wear easy to manage clothing (i.e. sweatpants).
  • Establish a schedule according to wetness pattern.
  • Toileting symbol may be helpful for requests.
  • Use charts for positive reinforcement and celebrate each success.


Shoe Tying

  • Children typically require demonstration, explanation, and lots of practice to master tying their shoes.
  • Remember there are two common methods for tying laces and recently a newer way to try; the bunny ear approach using two loops, or the wrap-around technique, making one single loop then wrapping the other string around and tucking through. Try either and see what works best for your child. There is also a new shoe tying technique where you make an open knot and put the laces through and pull. There are many videos on YouTube for this
  • Be sure laces are long enough (but not too long) so that your child can make large loops if needed.
  • Reinforce that the child must hold the loop down low to the base
  • Practicing knots on a jump rope or pipe cleaner can also make it easier and more fun.


  • Practice dressing skills through pretend play with dress-up clothes / dolls/ or a dress up board.  
  • Help your child up until the very last step to allow him/her to successfully complete the dressing task. Do less and less as your child can do more and more. For example:
    • Assist with fastening the zipper but allow the child to pull it up.
    • Help your child put each leg into his/her pants but have your child pull his/her pants up and down independently.  
    • Insert a button halfway into the hole, but let your child pull it fully through.
  • Teach your child to locate the tag first to identify the front when putting on shirts or jackets.  




Hand Washing Schedule – you can use a social story and a visual schedule with pictures

  1. Use Soap
  2. Scrub palm to palm
  3. Scrub back of hands
  4. Wash between fingers
  5. Wash thumbs
  6. Scrub fingernails
  7. Wash wrists
  8. Rinse hands
  9. Dry Hands