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You do not need a referral or a formal diagnosis of autism to get help. A Specialist Autism Navigator is on duty Monday-Friday 9am-5pm.

They can arrange to meet with you on weekday evenings and Saturday mornings if you are not available during the day.

Navigators support parents/carers and autistic adults. They operate across Lincolnshire.’ Parents can call directly for support.

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The Virtual Autism Hub is an innovative source of all age autism support to empower autistic people and their parents/carers. We work closely with community groups and organisations to strengthen support for autistic adults, children and young people and parent/carers, increasing the range, breadth and reach of these groups.

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Developing vocabulary in the Early Years

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Developing vocabulary in the Early Years

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Development of speech sounds by age

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Communication development for 5-11 years

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Speech and Language UK: Changing young lives

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Skip to content

We give families the confidence and skills to help their children. If you're concerned about your child's speech and language development, we can help.

We know that it can be hard to know where to start if you are worried about your child's development. If you think your child is having challenges with talking and understanding words, we are here to help you.

Our free resources and services can help with understanding what to look out for, how to get support and even some simple ways you can help your child at home.

Our progress checker will provide short questions you can answer to see how your baby or child is getting on with their talking and understanding of words.

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Help for families - Speech and Language UK: Changing young lives

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We give families the confidence and skills to help their children. Access our free resources and learn more about ways to encourage children's speech and language development.

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Support for learning difficulties may be required when children and young people learn at a slower pace than their peers, even with differentiation. Learning difficulties cover a wide range of needs, including moderate learning difficulties (MLD), severe learning difficulties (SLD) through to profound and multiple learning difficulties (PMLD) where children are likely to have severe and complex learning difficulties, as well as a physical disability or sensory impairment. Specific learning difficulties (SpLD) affect one or more specific aspects of learning.

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Cognition and learning – Professional resources

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Definition & Diagnosis

The relied on definition is set out by the Diagnostic and Statistical Manual of Mental Disorders. These criteria are presented in shortened form and are for information only. Diagnosis can only be done by a medical professional.

Inattention

Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:

Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

Often has trouble holding attention on tasks or play activities.

Often does not seem to listen when spoken to directly.

Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).

Often has trouble organising tasks and activities.

Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

Is often easily distracted

Is often forgetful in daily activities.

Hyperactivity and Impulsivity

Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person's developmental level:

Often fidgets with or taps hands or feet, or squirms in seat.

Often leaves seat in situations when remaining seated is expected.

Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).

Often unable to play or take part in leisure activities quietly.

Is often "on the go" acting as if "driven by a motor".

Often talks excessively.

Often blurts out an answer before a question has been completed.

Often has trouble waiting their turn.

Often interrupts or intrudes on others (e.g. butts into conversations or game)

In addition, the following conditions must be met:

Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.

Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).

There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Diagnosing ADHD in Adults

ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17 years or older, only 5 symptoms are needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity. If you are an adult looking for indications that you might have ADHD you can take the WHO screener survey here.

Presentation:

There is a persistent thought from some parts of the general population that ADHD requires some form of hyper-activity. This is not the case. Based on the above criteria there are three kinds (presentations) of ADHD that can occur. Because symptoms can change over time, the presentation may change over time as well

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What is ADHD? It is a disorder that is defined through analysis of behaviour. People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with day-to-day functioning and/or development.

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How can I explain about Dyslexia to my child?
You can view and share our booklet 'Understanding Dyslexia', which was written by a parent and child, specifically for parents and children. The booklet is available in two versions, one for primary age and one for secondary aged children.Click here

Helpful information is also available via the CBBC Newsround website here
How can I support my child's reading, spelling or writing?
You can also view the parent area on the websites of some of the Trust Member organisations.

What about other Specific Learning Difficulties?

Other useful links for support of those with Specific Learning Difficulties are:

Other Resources

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How can I explain about Dyslexia to my child? You can view and share our booklet 'Understanding Dyslexia', which was written by a parent and child, specifically for parents and children.

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This website places cookies on your computer to improve your experience. By continuing to browse the site, you are agreeing to our use of cookies. For more details, see our privacy policy. I agree

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The British Dyslexia Association is the voice for the 10% of the population that are dyslexic

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This app is free to families in Lincolnshire and aims to support with key areas in SEMH

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Lumi Nova - Free for families in Lincolnshire — Lumi Nova: Tales of Courage

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Child and Adolescent Mental Health Services (CAMHS)

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Child and Adolescent Mental Health Services (CAMHS)

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Providing support and treatment for children, young people and their families who are experiencing mental health difficulties. We support children and young people aged up to 18 years (25 years if they have been a child in care and it is agreed that we are the best service to meet their needs) who are experiencing

psychological distress and need support with their mental health.

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The children who need love the most will always ask for it in the most unloving ways Welcome to SEMH.co.uk, a site designed in 2016 to bring education staff together on the topic of SEMH and explore the best methods to support children and young people with social, emotional and mental health needs.

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The workshops and groups we deliver are easy to access virtually.

It can be quite scary attending a group or a workshop when you don't know anyone else in the group. If you are worried about coming to a group or workshop there are lots of things we can do to support you.

Here is some feedback from other young people:

It is really good! Everyone is friendly and you learn some really helpful things which you can keep practicing.

I would say that I was worried before I started a group but once you get in to it it's completely fine and you forget about being nervous. From my experience once the session had started I felt more confident in myself

Although the groups and workshops are to support your emotional wellbeing, they are not like attending a lesson in school. They have been proven to have a positive effect on your emotional wellbeing and are there to help you with life's problems before they get too much to handle.

Top three benefits of groups and workshops:

You're not alone and they help you to realise that we all have similar experiences, but cope with them differently

Making new friends and building positive relationships

Groups and workshops include lots of interactive activities, games, quizzes, alongside learning some new skills to manage your emotional wellbeing.

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The workshops and groups we deliver are easy to access virtually. It can be quite scary attending a group or a workshop when you don't know anyone else in the group. If you are worried about coming to a group or workshop there are lots of things we can do to support you.

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Parent questionnaire for a positive sensory profile

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Parent questionnaire for a positive sensory profile

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How to complete a positive sensory profile

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First Move for gross and fine motor support

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First Move for gross and fine motor support

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Helpful information and resources

First move

Introduction

By looking at this resource, it is likely that you have a child who you think may have a movement and/or skill development need.

Remember that factors influencing a child's movement skills may include:

The child's general development

The child's level of experience and practice

The child's vision and hearing

The child's understanding, attention and listening skills

Any genetic or medical issues or conditions

To use 1st Move, look at the units of motor skills and follow the key principles of the resource.

The Motor (movement) skills supported by 1st Move are divided into eight units, as shown in the contents. Each unit is in its own section for ease of use.

Where a skill area outlines a range of 'Component Skills', these can be found in the 'Core Skills' and 'Fine Motor Skills' units.

Key principles of First Move

Balance

Foot Strengthening

Foot strength is an important aspect in developing balance. The activities are fun and can be worked on individually, in pairs, small groups and practised in

P.E sessions. Many of these could be incorporated into the warm up during P.E to allow even more practice. Remember, make it interesting!

Static balance

Stand on one leg

Child stands between two chairs holding back of each chair with one hand, child lifts one leg off the floor and assumes a 'stork' position with heel to opposite knee, but not touching. Encourage the child to hold a still posture for five seconds. Now, alternate legs (at this initial stage it may be necessary to help the child achieve this balance)

Hold the stork position with a still posture for five seconds. Remember to practice with both legs. Use a chair either side for support.

Progression

Balance on various parts of the body

Instruct the child to balance on specific parts of the body eg.

Progression

Reduce number of contact points

Statues

Statues are a great static activity to promote balance, as well as body awareness, strength and working with a partner. These can be worked on individually, in pairs, small groups and practised as part of PE lessons.

REMEMBER: clean floor/mat! Also, balance activities are more effective with bare feet.

Child assumes 4-point kneel position whilst partner gently pushes him at shoulders or hips to the right or to the left, forwards or backwards. Child tries to remain stationary. More pressure can be exerted once child understands the concept.

Progression

As the child becomes proficient at each shape, move on to the next shape. Don't forget - these would complement the gymnastics/ PE curriculum too!

As with the 4-point kneel position but now in a cross legged position. The partner needs to be careful. The aim isn't to push the child over but to allow them to resist the push.

Dynamic balance

Stepping

Child steps into hoops placed touching on the floor in different patterns (see diagram 1)

Child steps onto bean bag (positioned like the hoops - not on smooth floor)

Strength

PLEASE NOTE: Some children find it difficult to hold postures against gravity. If the major extensor muscle groups are strengthened, the child can assume a more extended posture allowing the limbs to work from a more secure base. Remember the principle of quality movements.

Adequate muscle strength, joint stability around the hips is required for standing on one leg, hopping and kicking a ball

Equipment

Activities

PLEASE NOTE: All exercises should initially be held for a count of five seconds unless instructed otherwise and repeated five times, as strength improves increase both the length of time the exercises are held for (aiming for up to 20 seconds) and the number of repetitions (aiming for ten) to further develop muscle strength.

Press ups

Use the 4-point kneeling position (see statues exercises in the section on balance). Make a press up from this position. This exercise should use the arms to push up - ensure the effort comes through the arms

Banana

Bridging

Lying on the back, arms by sides, knees bent and feet flat on the floor (legs symmetrical but not touching) in a sit up type position. Keep head firmly on the floor. Lift hips directly up keeping knees apart and hold for a count of five seconds and slowly lower back down. Repeat

Sit ups

(Follow PE safety guidelines) Lying on back, knees bent up, feet on floor, tuck chin in towards chest, arms down by sides. Slide both hands up legs (symmetrically) towards knees. Hold for a count of three seconds and slowly slide back to the floor (keep chin tucked in until the end of the movement and avoid rapid or bouncing actions)

Reversed sit ups

(Follow PE safety guidelines) Adopt the sit up position (knees bent, arms by sides). Lift legs (knees bent at all times) up towards chest. The action is made slowly, up and down.

The task can be progressed by putting a bean bag between ankles and encourage child to place or 'throw' bean bag into a hoop above his/her head

Step ups

Step up onto a bench. With the leading foot, step down. Repeat x 10. Alternate feet (encourage rhythm and upright posture)

Progress, stand on bench facing lengthways (child may need support to maintain his/her balance), lower one leg to touch the floor with toes and then stand back up (upright posture). Alternate legs. (This activity is a bit like dipping a toe into the water at the swimming pool!)

Star jumps

Stand straight, arms by sides. Jump into a star position, arms and legs wide. Jump back straight position. Repeat x 10.

Progress: stand straight, feet apart, crouch and touch floor and then jump into a standing star position

Shoulder girdle stability activities

Below are some specific activities to promote shoulder stability.

Pulling own weight eg. along a bench, with progression to an inclined bench

Games and activities that involve taking weight through arms eg. hanging on rope, climbing up a rope and hand walking along an overhead ladder

Push ups against a wall or on the desk as preparation for fine motor activities or handwriting

Drawing vertical lines on a chalk board (one or both hands). Keeping arms out straight draw by bending and straightening at the knees. The child has to keep the chalk against the board as he/she moves. If this is too difficult, ask the child to draw parallel vertical lines with straight arms working from top to bottom and then reverse. Progression is to draw diagonal lines on the chalkboard

Draw shapes on chalk board with arms out straight. Circles and figures of eight are most effective (remember, arms outstretched)

Paint on the wall with a roller or pasting brush (water can be used on outside walls in warm weather). The weight of the paint and brush/roller adds to the effectiveness of this activity

Encourage games that require some shoulder strength eg. badminton, tennis and racquet ball (ball attached to a cord). Volleyball and basketball would be progressions in the area of strength

Other activities which promote strength

Hop scotch

Crab football (a game of 'football' but the players move on hands and feet, face up, bottoms lifted off the floor)

Body awareness

POINTS OF NOTE: Children with low muscle tone (floppy muscles and/or excessive joint ranges) often have poor body awareness. Messages from muscles and joints (proprioceptors) let them know the position their body is in; the awareness of the position of body parts

in relation to each other and their environment and the force of the movement the body makes. This is important as it helps the child organise and plan activities and make automatic adjustments to the movement eg. judging how to manoeuvre through a classroom with speed and not bump into things.

To improve proprioception, children need lots of activities against resistance or with pressure to enable them to become more aware of their body positions, such as push and pull activities.

Equipment

Activities

Child is instructed to clap hands hard, stamp feet and clap named parts of the body. The child is then asked to stop and feel the body parts 'tingling'

Log rolling: lie at one end of a line of three gym mats and roll to the other end with arms raised

As above, but hold a ball

Lie on stomach on a bench and pull forwards along the bench, once at the end push backwards move in the opposite direction

Statues: (see balance) hold 'high kneeling' position whilst partner tries to push you over

Tug of war

Bunny hops: encourage the child to have weight through their arms

Star jumps

Chinese tug of war: stand back to back, bend forward and grasp right hands between legs, pull partner to opposite wall (ensure safety guidelines are followed)

Desk push ups: in standing place hands on desk and lower nose to surface and push up

Sitting push ups: sitting at desk place hands on either side on seat and push down lifting bottom off the seat

Sitting pull ups: place hands either side of seat and pull up

Knowledge of left and right

POINTS OF NOTE: Many children are confused about the right and left sides of their own bodies creating difficulties for them in everyday life. Children need to be able to internalise the knowledge of right and left so responses become automatic and instantaneous.

Equipment

Preparation

Stamp or stick red sticker on back of right hand

Use reminder - "This is the right hand and this is the one that's left"

Activities

Physical and verbal cueing

Adult touches the right arm of the child and instructs the child to take two steps sideways to the right. Repeat, but this time on the left

The child holds a bean bag in each hand. The adult cues the child to throw by touching the right arm with a verbal cue 'throw with your right hand'. Repeat but with the left hand

Verbal cueing only

Movement from left to right

POINTS OF NOTE: Gross motor movements from left to right will help reinforce the movement patterns required for writing. These exercises should be carried out using the child's writing hand.

Equipment

Activities

Move quoits

The child is placed behind a line 1m away from a bench and the child lifts each quoit with a hockey stick and puts it over the bench. The child starts at the left and works down the line to the right

Progress:

Move along children

A line of children side by side passes objects along the line starting at the left and passing to the right. The one at the end runs to the beginning of the line and starts again

Bilateral motor coordination

Equipment

Activities

Pivoting

The child sits on the floor and lifts feet up. He/she then propel themselves around in a circle using their arms. He/she turns three times in one direction and then three times in the other

Progress

Pick a beanbag up with feet and turn 180° to put the beanbag in a hoop placed behind them

Same activity but lying on their front, pivoting on their front

Walk the line

Walk sideways along a line, crossing one leg in front of the other, change direction (ensure the child does not twist their trunk)

Progress

As above but walk along a beam

Sideways jump - jump sideways in one direction and then the other

Bean bag walk

Progress

Step with right foot on the bean bags placed on the left and vice versa

Progress

Stand astride a beam and walk the length of the beam crossing legs over it. Encourages knees to be lifted high

Bat and ball

Throw the ball into the air with the non-dominant hand and hit the ball with the bat held in the dominant hand

The child should be able to move both arms and hands in the same movement pattern in a smooth coordinated manner before working on these activities (as prepared in the bilateral coordination activities). Bilateral integration activities are intended to improve ability to use either hand for different functions.

One hand leads the activity and the other hand assists.

Position

Be sure the child is positioned the same on both sides of the body (symmetrically) for any bilateral (two-handed) activities, with both shoulders and both hips the same distance from the desk/table.

Position objects in front of the child in the midline of their body.

Activities

This skill will develop with the practice of a range of activities that require different movements from each hand.

Jars and containers with lids

Have the child open and close a variety of twist-top or flip-top containers. Materials and toys can be stored in closed containers. The child gets materials out and puts them away. A box full of jars filled with attractive small objects such as stars, stickers and other interesting items can be used as part of the task and as a reward

Cutting with scissors

Encourage child to use one hand to hold and manipulate paper while the other hand operates the scissors

Paper and crayons

Colouring or drawing in pieces of paper encourages stabilisation/fixing as the paper moves unless held steady (however, remember that colouring should start with big movements before moving to precise colouring)

Templates

Tracing around plastic shape templates, or making rubbings with a crayon encourages stabilisation/fixing with the non-preferred hand so that the tracing or design will be clear. These activities provide visual feedback about how well the paper or template was stabilised and progress can be seen clearly. Adults can provide verbal feedback if the child needs further information

Spatial awareness

POINTS OF NOTE: For a child to plan and organise his/her movement he/she must have good understanding of his/her body in space.

Equipment

Activities

Distance practice

Dodge the hoops

Place six hoops around the gym/hall. Have the child run in and out of the hoops, putting red beanbags into red hoops, yellow into yellow etc.

Lay a path of hoops in a line and have the child jump (or step) from one to another without touching them (the greater distance being the child's height)

Roll along the wall

The child stands facing a wall with a ball between the wall and child's stomach. Child rolls self along the wall, keeping the ball between body and wall

Knowledge of shape

Equipment

Activities

Making shapes

Visual skills

Recognition and visualisation skills

Sometimes children need support to improve their ability to recognise and recall shape, letter and number formations. Multi-sensory approaches can be used when presenting material. It is helpful to consider all sensory modalities (including touch, sight and sound). If visual information is confusing for the child, or he/she has strengths in kinaesthetic perception, they may benefit from emphasising movement and touch when teaching shape, number and letter forms.

Examples of activities that emphasise touch and movement include:

Practising writing big letters and shapes on white board/black board

Lots of repetition of motor patterns for letters, with eyes closed

Use of tactile alphabet

Writing in damp sand with a finger

Writing spelling words in paint

Writing with crayon on paper over a textured surface

'Air writing'

The use of letter strips fastened across the top of the desk/table may assist with writing when letter and numerals can be recognised but cannot be recalled quickly

Using joined writing to recall spellings (as appropriate)

Multi-sensory approaches also reinforce letter learning through linking sound with visual and motor patterns (see First Call for materials focusing on auditory perception and recall)

Visual perception

This is, put simply, interpreting what is seen. It is a complex and very important activity which allows us to make sense of what we see. There are a number of areas that are important to develop and need to work together for good visual perception.

Visual discrimination

This is the ability to recognise the main features of different objects eg. colour, shape, position and letters and numbers. This is important in all visual perceptual skills. It is important to help the child to spot things that are the same or different about objects (start with two objects as the child develops his/her skills).

Activities

Visual figure ground

This is the ability to see an object as distinct from its background or surrounding objects.

Activities

Pick out items from a box (eg. all the red objects)

Find a shape in a box of other shapes eg.

a cube in a box of beads (make it obvious to start with and gradually build in difficulty)

Picture books where the child has to look for something that is 'hidden' eg. 'Where's Wally' or Richard Scarry's Cars and Trucks and Things that Go' where he/she has to search

for 'Goldbug'

Looking for objects in the environment eg. asking questions 'Can you point to the blackbird?' (This would be a great way to involve home)

Visual form constancy

This is the ability to recognise an object or shape when it is seen from different angles.

Activities

Reinforce the idea that shapes are the same, even when other variables change eg. colour, size or orientation

Look for shapes in the environment eg. 'how many circles/squares/triangles can you find in the classroom?'

Visual spatial relationships

This is the ability to recognise how objects are positioned in relation to your own body and other objects.

Activities

Use construction toys eg. Lego

Copy simple 2d block design and patterns (progress to 3d design)

Visual closure

This is the ability to recognise a whole object when only a small part can be seen.

Activities

'Can you guess what it is?' games - reveal a small amount of a shape/object and encourage the child to work out what is hidden object

Complete the shapes games - the child completes a shape from being given part of it

Visual recall

Visual recall is the ability to remember things which have been seen. Sometimes children may benefit from opportunities to develop their visual recall skills. This may be particularly relevant for children who:

Cannot remember non-verbal experiences

Have language difficulties and are heavily reliant on visual recall

Can reproduce a given symbol from a model, but cannot reproduce it when model is removed

Misspells a word several different ways on the same paper

May be able to remember all letters in a word, but gets them in the wrong sequence

Has difficulty in L ➔ R progression

Jumping, hopping, skipping

Once the basic Core Skills are in place children will begin to develop more complex movement requiring greater levels of strength, balance and

understanding of body in space. The development of these extension skills will only be possible if the Core Skills are in place.

Jumping, hopping, skipping depend on the ability to alternate between static (stationary) balance and dynamic (moving) balance. They are often best learnt by breaking the skill down into smaller more manageable components. It is also useful to introduce rhythm with repetition into the movements.

When developing jumping, hopping and skipping skills, remember, focus on:

Allowing for the child's level of development

Using it in real situations

Giving sufficient time (it always takes longer than adults expect!)

Jumping

POINTS OF NOTE: On jumping, emphasise how the knees should bend, the bottom should lower on landing and the landing should be on the toes.

Equipment

Activities

Swing up, swing down

Child stands with knees slightly apart and bent knees. Arms are positioned behind. He/she is then instructed to raise his/her arms forwards and upwards and stand on his toes. Repeat until fluent, "Swing up, swing down"

"Swing up" and jump to reach a bean bag

Jump off step

As above but jump off small step eg. two-three gym mats (may need to hold hands initially)

As above, jump off into a hoop placed in front of step (encourage knees bend and feet together)

Jump forward

Hopping

POINTS OF NOTE: A child must have established one leg stand before attempting hopping, and 'warm up' with jumping, emphasising bent knees and landing on toes.

Equipment

Activities

Child, supported by partner or chair, stands on dominant (preferred) leg and bends other behind as in 'one leg stand'. He/she then raises himself on to toes and down again onto bent knee. Once carried out fluently progress.

Progress:

Practice hands held on a trampette

Holding onto chair and attempt hop

Activity as above but not supported (or supported with object such as skipping rope so you are in control of support given)

Bends knee and encouraged to hop forwards over a line

Alternate legs

Activities as above but not supported on preferred side

Once established on dominant leg practise on non-dominant leg

Skipping

POINTS OF NOTE: Skipping can only be developed once the child can hop on either leg.

Equipment

Activity

Step, hop

Activities to use jumping, hopping and skipping

PE activities

Playtime games

PE activities

Depending on the child's age and development, many PE sessions will require jumping, hopping, skipping and movement. During these lessons, it is important to remind the class of good technique and this may allow the child to apply what they have practised

Playtime games

Fine motor skills

It is important to appreciate that the development of fine motor skills is likely to be more successful if the child has established sound gross motor skills.

In typical development, babies establish basic gross motor skills by playing and exploring their environment. They develop strength and balance skills allowing them to achieve upright postures, learn about their bodies and their relationship to their environment. Soon they are in a position to begin refining their movements to accomplish fine motor skills.

Sometimes this pattern of development does not happen and there are 'holes' in children's basic skills. This may be due to due to a genetic factor such a low muscle tone or from a lack of opportunity to experience, practice and consolidate skills.

Should a child be experiencing difficulties in writing, scissor activities or other apparently fine motor skills, it would be worth investigating whether there are difficulties in his/her gross motor skills.

Developmental areas important in fine motor skills

Associated 1st Move programmes

Physical

Good proximal stability (trunk) giving the child a secure base to move his/her distal body parts

(hands and feet). Good proximal stability can be achieved by practising the associated activities.

Strength

Body awareness Balance Hopping Jumping

Body awareness Knowledge of right and left Spatial awareness

Bilateral motor coordination Ball skills

Perceptuo-motor

These are the skills that give the child an understanding of his/her body in space. These include the knowledge of right and left and the ability to cross the body's midline as well as the relationship between objects, distance and direction.

Body awareness Balance Hopping Jumping

Body awareness Knowledge of right and left Spatial awareness

Bilateral motor coordination Ball skill

Checklist

What to do next

Also:

Normal development of pincer grasp

Fine motor activities

These activities are helpful in the development of fine motor skills in general and will be beneficial in developing thumb/ finger opposition to improve pencil grasp.

A stopwatch, egg timer or kitchen timer will be useful in providing a motivational challenge eg. giving children a target to beat the clock. Results may also be recorded on a table or graph as part of the activity.

Threading pasta

The child threads as many pieces of straight pasta onto the string or shoelace as he/she can in one minute. The pasta is picked up between the thumb and index finger, or thumb, index finger and middle finger. The task can be varied in difficulty by the size of the pasta and the stiffness of the string (a piece of sellotape on the end provides a suitable stiffener). The task can also be varied by which hand is used to hold the string.

Equipment

A piece of string or a shoelace

Pieces of straight pasta

Posting peas through a narrow neck bottle

The child holds a bottle firmly on a table with non-writing hand. He/she picks up the peas one at a time and posts through the top of the bottle. He/she picks up the peas between thumb and index finger. Progression is using thumb and middle finger and then (and this is hard for adults too!) thumb and ring finger and then thumb and little finger (this is really hard for adults too!).

Equipment

Plastic bottle and dried peas (follow the school health and safety guidelines).

Making paper footballs for table football

The child places his/her 'handwriting' hand flat and stretched out on the piece of paper and the other hand behind his/her back. The child has to scrunch the paper into a ball by turning it in his/ her hand to make it round. Both hands can then be used to make a really tight ball. Progression is using alternate hands. The task can be varied in difficulty by the thickness of the paper. Thin paper eg. tissue paper will be easier and thicker grade paper will increase difficulty.

Equipment

Flicking the paper balls

The child lines up the balls on the table and flicks the balls with each finger in turn to shoot at a target (this can be an ice-cream tub, washing up bowl, target on the wall). The child keeps his/her wrist flat on the table. Progression is alternating hands, then both hands at once and flicking with each finger in quick succession.

Equipment

Use the paper footballs made in the previous activity

Flicking marbles

As above but with marbles.

Equipment

Marbles (follow the school health and safety guidelines regarding the use of marbles)

Flicking rice

The activity involves the child picking up the grains of rice by placing his/her wet hand palm down onto the rice. The child then turns his/her palm over and using each finger and the thumb, tries to flick off the rice until none remains (adults enjoy this activity too!)

Equipment

Rice on a tray or in a container

Clipping pegs around a box

The child has to see how many pegs he/she can clip onto the box in one minute. The child uses thumb and index finger and progresses to each finger in turn on each hand. The child can reverse the process as part of the activity (the box may need a weight in the bottom to stop it falling over if all the pegs are removed from one side).

Equipment

Springy clothes pegs and a cereal box (with the bottom cut off and squeezed at one end to make it pointy and boat shaped).

Posting coins through a slot in a box lid or money box

The coins are posted one at a time through the slot making sure the child uses thumb and one finger.

Equipment

A box lid with a slot or a money box and coins

Picking up pebbles

The activity involves the child picking up as many pebbles in one hand as he/she can and then tries to let go of them, one at a time, into a container. Jacks could also be used in this activity.

Equipment

Putting pegs in pegboards

The activity involves the child picking up pegs, one at a time, and places them in rows into the pegboard. The child can try placing the pegs vertically, horizontally or diagonally.

Equipment

Squeezing sponges

The activity requires the child to empty the tub with the sponge by soaking it and squeezing the sponge with either or both hands.

Clearly, the task can be varied by the volume of water in the tub and/or by setting a time challenge.

Equipment

Water, an ice-cream tub (or similar) and sponge

Roll and pinch pots

Make coil pots by rolling the dough/clay into strips. Make pinch pots by making a ball of dough, pushing the thumbs into the centre and pinching round in a circle to form a pot.

Equipment

Building a tower

The child, using thumb and index finger or middle finger, builds a tower as tall as he/she can before it falls down.

Equipment

This progression activity requires the child to build a tower as tall as possible in one minute using one hand. Ensure the child gets to practice with both hands.

Equipment

Shuffling cards

As part of any card game - but it may take a little bit of practice.

Handwriting

Lots of perfectly functioning adults exhibit far from model tripod grips, therefore apply this model sensitively, we want to empower children to mark make effectively and not be frightened because their grip isn't 'just so'. It is important to know the typical stages of pencil grip development. The decision about this should relate to what age and stage the child is at. Do they have other recognised difficulties that need to be considered?

Normal development of drawing skills

Teaching handwriting

Imitation precedes copying prepared examples. Model it!

Pencil/pen grasp

It is a good idea to teach how to grip the pencil, as this will avoid the need for remedial action later on. It is important to show the child how to hold the pencil - model it! If you are teaching a left handed grip, use your left hand and for a right handed grip, use your right hand.

Development of pencil control

As children develop pencil control, the movement changes from large shoulder movements to controlled finger movement with the forearm resting on the writing surface. This is only achieved effectively when shoulder stability is established.

Principles underlying good handwriting

Good sitting

Good sitting forms the basis of good handwriting.

Ensure the table and chair is the correct height. Taller or shorter children may need additional furniture or adaptation to existing furniture.

The principles of good sitting:

Paper position

Many children will place their paper in such a way it prompts them to work in awkward positions. It helps to teach a good way to of writing.

'Left-handedness'

Left handed people make up approximately 10% - 15% of the population. They are generally

confronted by techniques and equipment designed by and for right-handed people. This can make life unnecessarily complicated for left-handed children.

Activities and tools to promote good writing

Do:

Do:

Do:

Handwriting practice

Remember:

Structuring the handwriting session

A handwriting session could consist of:

Starting position

Getting ready or preparation activities

If a child finds handwriting difficult, it is a good idea to do some preparation activities to help with body awareness and posture before starting the handwriting.

Clap hands to rhythms (with increasing complexity)

Fine motor activity

Pencil activity

Benefits of using an angled writing board

The 20-degree angle of a writing board is considered to be the optimum position for writing and also assists with improved reading.

Resources and suppliers

Equipment suppliers:

Scissor skills

Using scissors is yet another complex perceptuo - motor skill, requiring the child to simultaneously use a range of component skills. Clearly, most children will increase their skills with scissors if they have opportunity to practise using them regularly.

Scissor skills can be supported through scissor specific activities but there are a number of component parts to help develop scissor skills. If any of these skills are absent or poorly integrated, a difficulty may occur in tryingto use scissors correctly.

Checklist

What to do next

When developing scissor skills, remember focus on:

Also:

Preparation

Ensure that the child is in a good position. Table and chair at the right height and the child is well positioned with their feet on the floor.

Ensure that the scissors are sharp enough to cut

Teach a good grasp. To hold the scissors well the child needs to isolate the middle finger and thumb to go into the scissor loops. The index finger should be used as a guide finger stabilising the lower loop.

Games to promote scissor skills

Games using a variety of tongs and squeeze operated toys help develop the opening and closing hand action needed for cutting. Whatever equipment is used, check it mimics the scissor action. Some activity ideas are shown below at the end of this section.

Starting

Get the child to make short snips on card or firm paper. The finer the paper the harder it is to cut. Progress to cutting on a thick dark line and stop where the line stops. Use creative ideas eg. lanterns for Halloween are excellent for scissor

Direction

Pick-up games

Purpose

To practice opening and closing tools like scissors

Materials

- be creative!)

The activity

Have the objects in one of the buckets/ containers. Have the child pick up an object and transfer it to the other container using the tongs. Make it stimulating and fun!

Variations

Place the objects in sand or (if you're brave) soapy water! Do consider environment, it could be messy!

Paper punch games

Purpose

To practice directing a tool in a forward motion

Materials

Three activities

Have the child use the paper punch to make random holes in the stiff paper. The child can then lace the card or connect the holes with crayon lines.

Draw coloured dots or small circles on the paper or card. Have the child punch out the coloured pattern.

Draw a path on a piece of stiff paper and put a house, star, sweet shop or appropriate target of interest at the top of the paper. The child punches holes along the path to the destination (Caution - adults enjoy these activities too!)

Resources, equipment and suppliers

Resources

Pre-Scissor Skills - Skill Starters for Motor Development by Marsha Dunn Klein, M.Ed , O.T.R. Therapy Skill Builders a Division of the Psychological Corporation

Equipment

Suppliers

Ball skills

The development of ball skills depends on the child's sound foundation of the core skills. To throw or kick a ball, the child must have developed some ability in the understanding of his/her body in space, the strength to carry out the action and the balance to maintain the posture. They must also have begun to develop visual perception to appreciate distance and direction, timing and the emphasis required in throwing, catching or kicking.

Checklist

What to do next

When developing ball skills, remember focus on:

Also:

Typical progression of development

Developmental sequence of underarm throwing

Rudimentary

Throwing ball underarm with feet stationary

Stands with feet shoulder width apart

Swing throwing arm downward and forward without follow through

Functional

Throwing ball underarm while stepping forward on the same side

Swings throwing arm down and forward on the same side

Releases ball and follows through with throwing arm

Mature

Throwing ball underarm while stepping forward with opposite foot

Developmental sequence of overarm throwing

Rudimentary

Throwing ball overarm with feet stationary

Functional

Throwing ball overarm while stepping forward on the same side

Mature

Throwing ball overarm while stepping forward with opposite foot

Developmental sequence of catching

Rudimentary

Trapping ball against chest with both hands

Functional

Catching ball with both hands with feet stationary

Mature

Catching ball in both hands while moving

Development sequence of kicking

Rudimentary

Kicking the ball from the knee

Functional

Kicking the ball with minimal follow through

Stands near ball with knee bent

Straightens knee before touching the ball

Kicks with minimal arm-leg opposition

Continues to move kicking leg forward after the kick

Mature

Walking forward, stopping and kicking the ball with follow through

Self help skills: dressing

Dressing is a complex perceptual motor activity. It is best practised when in real situations eg. changing for P.E, swimming, dress up games etc. Clearly, this is a skill area that should be supported sensitively and in line with all health and safety and child protection guidelines.

Clearly, most children will increase their dressing skills if they have opportunity to practice using them regularly and with sufficient time and support to organise and dress in an effective way. Adults who do too much or too little can be inadvertently maintain a child at a lower level of independence.

Dressing skills can be supported through dressing specific activities but there are a number of component parts to help develop dressing skills. If any of these skills are absent or poorly integrated, a child may have difficulty trying to dress successfully.

Below are the components which give the child a base to develop their dressing skills. It is worth investing time to check these skills and use the programmes outlined below to develop these component skills. By practising component skills can facilitate better dressing skills when the are practiced.

Checklist

What to do next

When developing dressing skills, remember focus on:

Also:

Preparation

If the child has difficulty with organisation - give clear instructions. If the child has difficulty getting things in the right order,

try pictorial representations of the correct sequence as listening to instructions and doing, may be too difficult. Checklists and visual schedules are very helpful in supporting organisation and it may be helpful to teach a routine to help shape organisation.

Ensure they have all clothes together when going to change for P.E or back. Sitting down with back against wall prevents overbalancing or getting into other children's body space.

If the difficulty is with getting things the right way round, mark back and front as necessary.

General ideas if a child is having a lot of difficulty

Suggestions:

Avoid complicated garments

Buy clothes on the large size

Shirts, T-Shirts and jumpers with set in sleeves are more difficult than the raglan style

Loose trousers with elasticated waists are easier to manage

Use Velcro for fastening if necessary

Tube socks with no definite heel require less manipulation to get a comfortable fit (but can be difficult to find/buy)

Shoes that slip on or are closed with Velcro are easier to get on and off

Elastic shoelaces are available; these are permanently tied but 'give' as the foot goes back into the shoe

Try backward chaining (see below)

Use visual organisers

Adult starts the task (steps 1,2,3) eg. putting a coat on and half zipping it up. Child finishes the task (step 4) eg. pulls the zip up to the top.

Backward chaining approach applied to dressing/undressing

Example: Goal: Removing a T-Shirt

Backward chaining - adult supports/helps student through entire process leaving the last part or parts for the student to achieve:

Example: Goal: Put on socks

Backward chaining stages:

Example: Goal: Tying shoelaces

Backward chaining stages:

Start to do up the laces: explain what you are doing, i.e 'Cross the laces over, put the lace which is at the back around and through the hole, pull tight, make a loop/rabbit's ear, put the other lace around the loop/rabbit's ear and under the bridge/down the burrow to make another loop/rabbit's ear. This story form may be helpful to a child by linking the parts together in a logical sequence

Ask the child to help you: 'pull the loops/ rabbit's ears'. Praise the child for helping to do up his laces. This is the first step taught

Once the child has mastered this, they may then 'pull the loops/rabbit's ears themselves, then 'push the lace through to make loop/ rabbit's ear' and so on. Eventually, the child will be able to do their laces from start to finish.

General notes

Visual support strategies

Visual support strategies can be used in a variety of situations to promote independence and prompt a child to remember sequences correctly. This is particularly relevant to developing self-care skills such as dressing, use of the toilet, getting ready for school and independent working habits in the classroom.

Visual timetables

A timetable of events can be a helpful reminder and promote understanding of the relationship between events over time. Put simply, knowing when things are going to happen. Drawings, pictures, photos and labels can be used effectively to simply list the events of the day.

Visual schedules

Activities and tasks that have a sequence or can be broken down into steps can be supported through visual schedules (just like a set of furniture assembly instructions). Using pictures and drawings to indicate each step of the task can simplify complex activities such as remembering which order to put clothes on, bathroom routines (including washing hands and flushing the toilet!). Not too many steps should be included and many will help all children eg. a hand washing schedule above the sink would act as a reminder for all children.

Bunny ears method of tying laces

Skill: Fasten shoe by tying laces

Adapted technique: 'Bunny ears' or 'two-loop tie' method

The method requires less refined lead-assist action and fewer different steps than the standard approach.

Materials: Shoe and long shoelaces

Position: A comfortable, balanced sitting posture (remember some children are helped by sitting back against the wall)

Resources

Pre-Dressing Sills by Marsha Dunn Klein Skill Starters for Motor Development by Marsha Dunn Klein, M.Ed, O.T.R Therapy Skill Builders a Division of the Psychological Corporation.

Procedure

This has been presented as forward chaining (this is the child starting from the beginning of the task). Backward chaining could also be used.

Pick up shoelaces

Cross laces, laying them across the front of shoe

Put upper lace under the crossed laces through the cross created with the shoe in a toe-to-tongue direction

Grasp a lace in each hand and pull tight

Make one loop

Make a second loop with the other shoelace

Cross loops across the front of shoe, maintaining grasp on the loops (same action as step 2)

Put upper loop under crossed laces through the triangle created with the shoe, in a toe- to-tongue direction (same action as step 3)

Grasp a loop in each hand and pull tight

Self-help skills: eating and drinking

These activities are complex. This information addresses only the practical aspects involving coordination. Medical, behavioural and sensory aspects may also need to be considered, as appropriate to individual children.

Remember, the involvement of home is very important in the development of a child's self-care skills. This is a skill area that should be supported in line with all health and safety guidelines. Most children will increase their eating and drinking skills if they have opportunity to practice using them regularly

Eating and drinking skills can be supported through specific activities but there are a number of component parts to help develop eating and drinking skills. If any of these skills are absent or poorly integrated, a child may have difficulty managing the tasks successfully.

Below are the components which give the child a base to develop their eating and drinking skills. It is worth investing time to check these skills and use the programmes outlined below to develop these component skills. Practising component skills can facilitate better eating and drinking skills.

Checklist

What to do next

When developing eating and drinking skills, remember focus on:

Also:

Posture/positioning

Table and chair must be at the correct height (see handwriting section on good sitting position). If the child is learning to use cutlery they may work with elbows out to the side, especially for elbow movement. Keep area next to child clear.

Drinking

Drinking is a complex motor task but is perhaps more simple than eating (from an eye-hand coordination point of view).

How to help:

Consider the type of cup

A beaker with a handle may be easier for some children than one without a handle

Make sure it isn't a finger trapping handle

Use a sturdy, broad based cup

Do you want it to be able to bounce?

Do not overfill the cup/beaker! It is better to refill than have a spill. Perhaps think of quarters - a splash, quarter full, half full, three quarter full

Avoid clutter so a child reaching for the cup/ beaker is less likely to knock it over

Wide base and big handles are helpful

Small handle are less useful

Narrow bases can be unstable

Eating

Ensure not too much is going on in the environment to allow the child and adult to focus on the task.

Support the child to organise the task of what they are going to eat.

The child needs to coordinate two hands together and be able to carry out different actions with either hand, eg. hold item with fork and cut with knife.

The child may need to be taught/shown how to cut. You can try and practice with play dough to get the action right (ensure adequate space for elbows so keep the area next to the child clear - nobody likes a low flying elbow in the ear!).

Try different types of cutlery:

Junior caring cutlery (small hands)

Caring cutlery (larger hands) helps child position index finger, which improves hand position

If plates slide, try some Dycem (a range of non- slip materials www.dycem.com) or other non-slip mat under the plate.

Packed lunches

Opening packets etc. depends on fine motor skills and strength of grasp. Clearly fine motor activities could be used to support these skills. Also, the type of lunchbox can cause problems for some children. Some boxes have tight lids or tricky catches; again careful choice of lunch box and fine motor activities will help.

In addition, the actual organisation of what to eat and what order, can be a challenge for some children faced with a full lunch box, especially in a busy, interesting environment and support to focus and organise themselves may be helpful.

Organisational prompts

Some children find sequencing what to eat tricky. This can be supported through organisational prompts:

Visual prompts

Visual prompts can act as a structure for children allowing adults to provide structure without directly guiding the child through the task. It may be helpful to:

Questions

Questions are a very powerful tool for adults to use. If adults are over-directive, children will not necessarily internalise the skills to think through a task for themselves. Adults can use simple questions to help a child plan eating their lunch eg. 'What are you going to eat first?' 'Shall we unpack some of the things to give you more room?' Clearly, working closely with home can resolve a lot of these issues.​

Appendix

1st Move has been developed by Lincolnshire County Council working in partnership with Lincolnshire Community Health Services NHS Trust.

The resource has been produced as the result of joint work involving Occupational Therapists, Physiotherapists, Educational Psychologists and Teachers.

Support agencies

It is expected that most children will have their movement needs met through the implementation of this 1st Move resource and opportunity to practice their skills. Some children's progress will be slow, but in line with their general development, this should not necessarily raise a need for Physiotherapist or Occupational Therapist involvement.

Childrens' Physiotherapists identify the reasons for a child's movement difficulty and give carers the knowledge and skills to address them.

Support may be in the form of general advice on beneficial activities, appropriate changes to the environment or it may be a specific programme of activities/exercises to help the child learn and consolidate new movement skills.

Childrens' Occupational Therapists can offer advice on general hand skills development, handwriting and independence skills.

Educational Psychologists

Educational Psychologists help solve problems which interfere with the development and education of children and young people.

Educational Psychologists are trained in the psychology of learning and child development. Support may be through direct work with a child, parents and teachers or through consultation or developing systems at a class or school level.

Contacts

Up to date contact details for the Children's Occupational Therapy and Physiotherapy Services can be found via the website

The Educational Psychologists team can be contacted via the website

a Division of the Psychological Corporation

Jenkinson, J. (nd) Fine Motor Activity Ideas

Olsen, J.Z . (2003) Handwriting without tears

Useful resources

You may find these helpful:

Handwriting Without Tears by Jan Z Olsen (2003) Dycem

Lucky Letters Programme by Coralee Lawrence Rainbow Road Resources

Write from the start: Unique Programme to Develop the Fine Motor and Perceptual Skills Necessary for Effective Handwriting

Get in contact

Address

Lincolnshire Community Health Services NHS Trust,
Beech House,
Witham Park,
Waterside South,
Lincoln,
LN5 7JH

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