All Things Sensory by Harkla

#143 - Teach The Skill, Not The Goal

March 10, 2021 Rachel Harrington, COTA/L, AC & Jessica Hill, COTA/L
All Things Sensory by Harkla
#143 - Teach The Skill, Not The Goal
Show Notes Transcript

As parents, therapists, and teachers, we have specific goals we want our kids to be able to achieve, whether it’s something like brushing their teeth at home, drinking water from an open cup, or working on their handwriting. 

What we don’t always think about are those underlying skills that we need them to establish before they can actually work on and achieve those specific goals. 

Today, on All Things Sensory, we are going to talk about how to address those underlying skills for specific goals. Some of these underlying skills include bilateral integration, primal stability, coordination, strength, visual perception, and attention, and these are just a few! 

Be sure to check out the show notes on our blog at  Harkla.Co/Podcast.

Brought To You By Harkla

This podcast is brought to you by Harkla.  Our mission at Harkla is to help those with special needs live happy and healthy lives. We accomplish this through high-quality sensory products and child development courses.

Make sure to check out Harkla's Primitive Reflex Integration Training.

Podcast listeners get 10% off their first order at Harkla with the discount code "sensory". Head to Harkla.co/sensory to start shopping now.


Key Points From This Episode:

  • How we decide on the goals we want to achieve and how they drive our sessions.
  • Why it is important for your child to master underlying skills related to the specific task you are working on.
  • Some underlying skills as it relates to a “buttoning” example, such as bilateral integration, coordination, strength, and fine motor skills.
  • How empathy plays into these sessions; why you need to know what the child is dealing with.
  • Defining the underlying skills and what they entail.
  • The ones we often forget: postural control and proximal stability.
  • What it means when we say “proximal stability before distal control.”
  • Primitive reflex integration; without integration, you’ll have trouble using your arms and hands. 
  • Practicing buttoning: the child needs confidence in their ability to button in all environments.
  • Other examples of how you can address different skills that are required for different tasks.
  • Cup drinking: bilateral integration (Zoom ball), catching and throwing, mid-range control (Jenga), and convergence (Zoom ball).
  • Sequencing letters in handwriting: visual perception and spatial relations (draw a person, Where is Waldo), sensory using different tactile mediums, and memory.
  • Brushing your teeth: proximal stability, grasp (rope pulling/ monkey bars), sequencing (visual schedules), and oral motor skills (blowing, sucking, spitting).  

Links Mentioned in Today’s Episode:


Rachel:

Hey, guys, I'm Rachel.

Jessica:

And I'm Jessica. And this is All Things Sensory by Harkla.

Rachel:

Together, we're on a mission to help children, families, therapists and educators live happy, healthy lives.

Jessica:

We dive into all things sensory, special needs, occupational therapy, parenting, self care, and so much more. In each episode, we share raw, honest, fun ideas and strategies for everyone to implement into daily life.

Rachel:

Thank you so much for joining us. Hey, friends, welcome to All Things Sensory by Harkla. You are listening to Rachel and Jessica, and this is episode 143.

Jessica:

I can't quite match your energy. Sorry. Okay. So today we are going to talk about how to address underlying skills for specific goals. So this is a great episode, if you're a therapist. However, this is also really great for parents, educators, and whoever else is listening. So that you can kind of get an idea of how to just teach your kid how to do everything.

Rachel:

But going along with that, as parents, we have goals for our children. So we're gonna stick with the goal of doing buttons throughout this podcast. So you have these goals for your kiddo to learn to do buttons. Instead of just teaching them how to do buttons, we are going to teach you how to work on all of the underlying skills that go into buttoning in order to improve buttoning, but without actually working on buttoning if that makes sense. It's a lot of words. But yeah, so this podcast is for everyone. That's what we're trying to do.

Jessica:

There you go. We made it, we made it. So okay, specifically for us as occupational therapy assistants, we have specific goals for our clients. And these goals are based on age level deficits identified using standardized testing, as well as these goals are based on family goals. And these goals that we have drive our treatment and what we do in our sessions.

Rachel:

Yeah, they basically create a treatment plan for us. So these are the activities that we're setting up with a focus on meeting those goals or helping the child meet those goals.

Jessica:

And oftentimes, we have very specific goals related to daily activities like dressing, self feeding, handwriting, those types of things. And it can be really easy to do just one specific goal during your session. So for example we're using the buttoning, and if the goal is the travel button, and unbutton, three buttons within one minute, it's really easy to just sit there and put your timer on and see how fast your child can button or unbutton. Right?

Rachel:

It's easy for therapists to do this. But raise your hand how often you do this, hopefully none of you raise your hand.

Jessica:

If you are raising your hand. That's fine, just stop.

Rachel:

But we're glad that you were listening to this episode

Jessica:

and stop. And just stop.

Rachel:

So yeah, like Jessica was saying, instead of just turning your phone on and starting your timer and seeing how fast they can button, the buttons, turn it into an entire treatment session working on an obstacle course with incorporating buttons as one of those steps. So that way, you're working on the gross motor skills, proximal stability, strength, fine motor skills, dexterity, all the things. We're going to talk about that later.

Jessica:

Exactly. And so you know, if you have a buttoning goal, it's probably because your child wasn't able to do a buttoning task on the standardized test, as well as the family probably wants the child to be able to dress themselves. So it makes sense, right. And in order for your child or your client to actually be successful in this area, they have to be able to do buttoning in a variety of settings, not just one with different types of buttons, not just on a button board. And they need to master those underlying skills as well.

Rachel:

Absolutely. So when we talk about the underlying skills required for buttoning there's a lot that goes into it. So things like bilateral coordination using both hands.

Jessica:

You've got a lot of finger dexterity going on. So we've got that fine motor piece, but also strength and the ability to move your fingers in a coordinated way.

Rachel:

Yeah, it does take a lot more strength than you initially think about like and think about buttoning your pants, and actually, like, stop. And while you're buttoning your pants, think about how much strength is required to actually pull the button through and stabilize the material. There's a lot

Jessica:

For sure. And then we're also looking at some somatosensory processing and stereognosis. And that's being able to do something by the feel of it. You're not always going to be able to see the buttons that you're doing depending on what you're buttoning.

Rachel:

Yeah, so yeah, exactly. Think about, I mean, do you have to look at your pants to button them now? Or can you just button without looking? That should be the goal? I've got that in your head about it.

Jessica:

Should I do my button really quick?

Rachel:

Or if you're like most of us nowadays, you just wear yoga pants all day.

Jessica:

That's fair.

Rachel:

You don't even have to worry about it. That's so true. Okay, so instead of just teaching the goal of buttoning, let's develop those underlying skills, and let's talk specifically about those underlying skills right now. Right? So bilateral integration, being able to use both hands, one hand to stabilize, and one hand to do the fine motor work.

Jessica:

Yeah, and just a quick note, you guys, we talked about empathy, so much, you should be practicing these skills with your kiddos or making sure that you know exactly what is required, don't just throw a button in front of them and say, Here you go. You should be going through the motions and feeling it. So you know, what they're dealing with, and you can identify what they're struggling with. After you complete it yourself. You're like, oh, man, no wonder they can't do it. They can't hold both sides of the button together.

Rachel:

Yeah, I think that's such a good point. Because if you can watch your child and how they're struggling with this task, and you can identify specifically, yes, it's a strength or Yes, it's the bilateral or it's the attention or the visual perception, then you're going to be able to develop that specific skill versus trying to do all of it.

Jessica:

Yes. Okay. So the next skill that we wanted to address was the visual perception side of it. So this is specifically spatial relations, to be able to understand how the button and hole relate to each other, as well as how to hold each piece with the button and figure out which part of the button actually goes through the hole and which part you have to stabilize and pull back around the button.

Rachel:

Yeah, that's a lot.

Jessica:

Sure is.

Rachel:

All right, we already talked a little bit about the fine motor strength and the dexterity, you have to be able to hold that material for a specific amount of time to be able to do the fine motor component. And that's going to require a lot of pinch of strength

Jessica:

This is one that we kind of forget about. So

Rachel:

all the time for sure.

Jessica:

I'm talking about the next one. Yeah, I know.

Rachel:

Okay.

Jessica:

I know exactly where we're at. And I know you always forget about this.

Rachel:

Do you guys know what it is? Can you pick up on what we're putting down here?

Jessica:

It's the postural control and proximal stability.

Rachel:

Did anybody get that?

Jessica:

So what this means is, can the child even sit up? Can they have the adequate core strength? Can they hold their bodies up against gravity? Do they have the right amount of shoulder strength and stability to even complete this fine motor development. And what's important to remember is this quote that we learned in school, it says, proximal stability before distal control. So what that means is you have to have strength and stability in those muscles closer to the body, like your shoulders before, you'll have control of those distal muscles, which is like your fingers. So you have to be able to have those strong shoulders in order to be able to work your fingers efficiently.

Rachel:

For sure. And then you've also got a lot of visual motor going on here. And that's basically your hand eye coordination. So that goes right into the visual perception and the fine motor as well. And then I think I mentioned this earlier, but attention, right? Does the child have enough sustained attention to not get distracted by other things in their environment?

Jessica:

Yeah, it's a big one. I struggle with it sometimes

Rachel:

all the time.

Jessica:

The last thing that we want to touch on is primitive reflex integration. And if you listen to our podcast, you know that the last one here is primitive reflex integration. Because, holy cow, if you have reflexes that you are holding on to specifically that palmar reflex, then you're not gonna be able to do anything that you want to with your hands.

Rachel:

I was even just thinking, when I'm buttoning my pants, you gave me that example already. If I'm looking down, and I'm getting that neck flexion what are my arms gonna be doing if my primitive reflexes aren't integrated?

Jessica:

So true? Yeah. All right. So if your client has a buttoning goal, you're going to want to address all of these underlying skills into your treatment session, as well as practicing buttons.

Rachel:

Right? And I think, you know, maybe there was some confusion earlier in the session when we said don't practice buttoning, I mean, you still gotta practice button. Yes. But you want to incorporate those skills into every treatment session.

Jessica:

Absolutely. We want the child to feel confident in their ability to button across all environments, which means school, home, OT, grandma's house, everywhere,

Rachel:

friend's houses, and so they're embarrassed at their friend's house when they're trying to get dressed.

Jessica:

Yeah. It's crazy.

Rachel:

We just want to take a minute and talk to you about our company Harkla. Our mission at Harkla is to help those with special needs live happy, healthy lives. Not only do we accomplish this through the podcast, but we also have therapy products, easy to follow digital courses, and the Harkla sensory club to try to bring holistic care to you and your family. Listeners of the All Things sensory podcast get 10% off their first purchase at Harkla. With the discount code sensory, we'd recommend checking out some of our best sellers like the compression sensory swing, weighted blankets, or our course on sensory diets.

Jessica:

And here's the best part 1% of each sale gets donated to the University of Washington Autism Center to support autism research and fun scholarships to families in need to receive in clinic therapy for their child.

Rachel:

Learn more about Harkla and all we have to offer@harkla.co That's h a r k L A dot C O. And don't forget to use the discount code sensory to get 10% off your first purchase. That's s e n s o r y for 10% off.

Jessica:

And the best part is all Harkla orders come with a lifetime guarantee and free shipping. You really can't beat that.

Rachel:

No, you can't.

Jessica:

Okay, let's get back to the show. So we wanted to give you guys a couple of other examples. I hope all of this is making sense.

Rachel:

It is yeah,

Jessica:

you think so?

Rachel:

I hope so.

Jessica:

If not just ask yes, no, that's fast on Instagram.

Rachel:

That's fair. So we've got a couple of other examples for you guys here. And how you can address different skills that are required for different tasks.

Jessica:

This is why you're all here.

Rachel:

You want the specific examples, we've got them for you. So the first one would be cup drinking, we do get a lot of questions from people on how to help their child drink from an open cup. And there's a lot of skills that go into it.

Jessica:

We actually just put a handout in the club on this because we had someone asked about it. So if you guys need more specific resources than what we're giving in here, just join the Club.

Rachel:

Yep. And there's links in the show notes that you can find that super easy.

Jessica:

Yeah, so one of the first skills that we need to have for cup drinking is going to be bilateral integration. Now, I think most of us probably use one hand to drink from a cup. But when a child is learning how to drink from an open cup, they're going to use both hands to bring it up. So they need to be able to coordinate both hands, both arms in order to do this.

Rachel:

So one of our favorite activities to work on bilateral integration is zoom ball.

Jessica:

If you don't know what a zoom ball is, it's super fun. And we can use it for a ton of different skills, which you'll learn soon. Another way that you can work on cup drinking, and specifically the bilateral integration is catching and throwing. So catching a beanbag, a ball, a rock, a pom pom, whatever.

Rachel:

A rock?

Jessica:

You know, whatever you have in your environment. Work on catching and throwing.

Rachel:

Yep, totally. Another skill that you're going to need for cup drinking is mid-range control. And this is basically the ability to have good control of your arms and your hands to do a task smoothly and fluidly.

Jessica:

Yeah, so one of our favorite activities for promoting mid range control is Jenga or just stacking blocks because you have to lift those muscles up against gravity and gently place the block or pull the Jenga block. So it's a good one.

Rachel:

And another one. Yeah, super fun. And then the other one is suspend. And I forgot about this game. But this game is so cool,

Jessica:

awesome game. We also like to attach like exercises or activities on to each piece, you can incorporate that into the activity as well. There you go, another treatment activity for you. And one other skill that we want to work on for cup drinking is convergence. So being able to bring your eyes together almost like you're going cross eyed, and guess what the activity is to work on that Zoom ball. Alright, so get zoom ball. It's like $10 on Amazon. We'll link it in the show notes.

Rachel:

And you're gonna use it all the time.

Jessica:

Yes.

Rachel:

All right, let's talk about another goal that many clients have and that is going to be handwriting, specifically sequencing the letters. So the idea here is that we want our kiddos to have easy fluid handwriting skills. So it doesn't, we don't want it to be hard. And so in order to do that, they need to be able to sequence their letters in a specific way. And if you guys are familiar with Handwriting Without Tears, they have some great activities to use to help sequence those letters. But a lot of these underlying skills are going to be visual. So specifically visual perception and spatial relations. And I like spatial relations the most because it's just so important. Understanding where the top is, where the middle is, where the bottom is, left versus right. So those are some really specific skills that you need for hand. Right?

Jessica:

Yeah. I mean, if you don't know which way is up, and which way is down, which was left to right, how are you going to be able to write efficiently?

Rachel:

you're not.

Jessica:

No. So think about that. I mean, address these underlying skills before you even start working on handwriting, or before you even put a pencil in your child's hand.

Rachel:

Yeah, some ways that you can work on that would be to do a draw person activity and identify where the head is, where the body is, where the legs are, and then do it with yourself in the mirror, so that the child is physically looking and touching and feeling their different body parts and where they are top, middle, bottom, left versus right.

Jessica:

Yeah. And another way that you can work on some of those visual perceptual skills are search and find games like Where's Waldo.

Rachel:

Yes, that's a fun one.

Jessica:

Or like those I Spy games. They have those like board games and card games for I spy.

Rachel:

I just gotten a book for a Tripp that's like, where's the dinosaur, its the same thing.

Jessica:

That's perfect.

Rachel:

Yeah. Anyways, another aspect that you want to address with handwriting is sensory. So just think about like different ways to draw letters, different tactile mediums, like sand or jello, or applesauce or rocks.

Jessica:

Well, and this is a big one. Like a lot of times we get questions on how to help kids with spelling, and learning their spelling words. And I always say use a different tactile medium to practice writing those letters because it's really going to just reinforce that memory component.

Rachel:

Definitely.

Jessica:

So one last skill that you need to focus on with handwriting is going to be memory, you need good visual memory, you need good working memory, you need good memory overall, in order to remember how to sequence those letters. So anytime you can play like, what's the one game where you put the cards face down? The game memory? Oh my gosh,

Rachel:

There are so many different versions now!

Jessica:

Yes.

Rachel:

cars and dinosaurs and mermaids and stuff. Yes. So that would be a great game to use.

Jessica:

Okay, so let's move on to the last goal, which is brushing your teeth.

Rachel:

Okay. First underlying skill is proximal stability. So any type of weight bearing activity would be fantastic. So things like bear crawls, push ups, wall push ups, wheelbarrow walks,

Jessica:

I was even thinking like, some hanging activities, like get out to the playground and get like, just hang from a bar,

Rachel:

grab on, straight arm hang

Jessica:

straight arm hand and challenge your kiddo to see how long they can do it and then do it every day and have them try to be their time every day.

Rachel:

I love that.

Jessica:

Yeah, so easy.

Rachel:

Yeah,

Jessica:

Except when it's cold. Because then those metal bars are cold.

Rachel:

They are cold. But yeah, you make it work.

Jessica:

How many people have home gyms now?

Rachel:

That's true.

Jessica:

Just put a pull up bar, put one of those in the doorway.

Rachel:

A pull up bar in the doorway, that's perfect.

Jessica:

And then make it into a family competition.

Rachel:

I need to do that

Jessica:

me too.

Rachel:

The next underlying skill that we want to work on is your grasp. So one thing that we can work on to address your grasp is pulling a rope while you're on a scooter board. If you don't have a scooter board, then you can pop your kid up at the top of the slide and attach something onto a rope at the bottom of the slide and have them pull an item up the slide with the rope. Oh yeah! work on like the reciprocal, one hand in front of the other. That's like it's a challenging thing to coordinate. And you also want to make sure when they're doing this, that they've got like a full grasp with their thumb going across, because oftentimes kiddos with, you know who struggle with grasp skills, so compensate and have their thumb, like, up by their finger, or by their fingers in their hand versus like, coming and grabbing all the way around. I hope you guys can see that as I'm doing it.

Jessica:

It's almost like the. letter S with sign language, instead of the letter A

Rachel:

Oh, yeah, yeah, there you go.

Jessica:

There's your visual.

Rachel:

There it is. Thank you.

Jessica:

Now you know what to Google if you can't picture it.

Rachel:

Another really great one to promote grasp strength and skills are monkey bars or like we were even just saying like a straight arm hang and making sure that thumb is wrapped all the way around the bar.

Jessica:

Yep. Okay, the next underlying skill is sequencing.

Rachel:

Ooh, yes, this is really, really hard for a lot of kids. And going along with the sequencing, it's just like organizing the materials and planning, and that working memory piece to know what comes next.

Jessica:

Here's what I want you all to do try to brush your teeth and put the toothpaste on your toothbrush with your opposite hand. And that will put you in the shoes of either your kiddo or the kids that you work with. And that's empathy. You guys you'll realize how awkward it is. And you'll take a step back and really work on these underlying skills once you know what that feels like.

Rachel:

I was just thinking I don't even want to try brushing my teeth with my left hand.

Jessica:

Yeah,

Rachel:

that was just I'm not going to be able to do it very well.

Jessica:

Oh, So there you go.

Rachel:

Okay, but also use a visual schedule. Visual Schedule, super simple and easy. Just have the pictures of each step, including cleanup, and have that in the bathroom.

Jessica:

Yep. Okay. The last underlying skill, like we were kind of saying is oral motor skills. So can your child spit the toothpaste out? Can they keep their mouth closed around the toothbrush? Can they move their tongue where it needs to be?

Rachel:

Can they tolerate that input? Whether it's from the taste of the toothpaste or the feeling of the toothbrush? Does it cause them to gag? Do they have a immature gag reflex?

Jessica:

They might Yeah,

Rachel:

It happens a lot.

Jessica:

So what we want to do is play games working on blowing and sucking, do some de sensitization with vibration, or just like a different tactile input inside their mouth. Practice gargling and spinning and it's challenging to teach a kid how to spit.

Rachel:

It really is.

Jessica:

So good luck with that. I don't think we can we can like verbally teach someone how to teach another person to spit on a podcast.

Rachel:

Just try it though.

Jessica:

Sorry, guys.

Rachel:

All right. So hopefully, this gives you a good idea of kind of what we're talking about. We have these specific goals, parents, therapists, we all do. And let's focus on those underlying skills, break the task down and see what needs to be worked on and focus on that.

Jessica:

Yeah. And if you tried any of these, like, empathy activities, let us know because we want to hear how you empathize with your kiddo. Put those sensory goggles on and you're just ready to rock and roll.

Rachel:

There you go. If you have a minute, you could leave us a review on iTunes. It really helps us to get out there and reach more people. You could also screenshot this episode and share it on Instagram.

Jessica:

Yeah, tag us! We'd love to share that. Let us know your thoughts. Y'all are great. We love that you spend time here with us whether you're listening in your car or cleaning your house or driving.

Rachel:

Yeah, whatever.

Jessica:

Yeah. Okay, I'll see you next week.

Rachel:

Okay, bye. Thank you so much for listening to all things sensory by Harkla. If you want more information on anything we mentioned in the show, head over to harkla.co/podcast. To get all of the shownotes.

Jessica:

We always have the show notes and links plus full transcripts to make following along as easy as possible for everyone. If you have follow up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at Harkla_family. If you just search Harkla you'll find us.

Rachel:

Like we mentioned before our podcast listeners get 10% off their first order at Harkla. Whether it's for one of our digital courses, one of our sensory swings, that discount code sensory will save you 10%. That code is SENSORY. Head over to harkla.co/sensory to use that code right now. So you don't forget.

Jessica:

We're so excited to work together to help create competent kids all over the world and work towards a happier, healthier life.

Rachel:

All right, we'll talk to you guys next week. We are so excited to work together to help create confident kids all over the world and work towards a happier, healthier life. Just a friendly reminder, this is general information related to occupational therapy, pediatrics, and sensory integration. We do not know you or your child therefore, we do not know any specific needs. Therefore you should always refer back to your pediatrician and occupational therapists for more information.