Occupational Therapy Supports

Fine Motor, Visual Motor, and Perceptual Skills

Cutting Tips

  • Bold the outline with a highlighter or marker.
  • Hold scissors and paper with “thumbs on top.” You can place a sticker on your child’s thumb nail as a reminder.
  • 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 or draw a line as a visual of where the glue should go.
  • Try glue sticks for children with decreased strength.

Pencil Grasp Tips

  • Use broken crayons and short pencils to encourage an efficient grasp
  • Have your child hold a small coin or cotton ball with their pinky and ring fingers leaving only their ring finger, middle finger and thumb available to hold the pencil.

Hand Strengthening Activities

  • Hand weight bearing activities, such as wheelbarrow walks, crab walks, push-ups, and crawling.
  • Lego and Playdoh play: roll into balls, make a snake, press with stamps, hide and find pegs or beads, etc.
  • Pinch clothespins, paint with eyedroppers, & pick up items with tweezers.
  • Crafts, such as beading, lacing, ripping paper to make a collage, and hole punch activities.
  • Use a spray bottle to play in the bath, help with cleaning, 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.

Visual Skills Activities

  • When reading use an index card or ruler to help isolate one line or word at a time.
  • Activities such as mazes, cryptograms, Dotto-Dot, word finds, puzzles, ball or balloon toss, etc.
  • To view more visual perceptual activities, visit the free website: www.eyecanlearn.com

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 nonwriting hand.

Letter Formation

  • When printing, prompt your child to use a top down formation: “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.


  • Have child use their finger or a Popsicle stick after each word to create an appropriate space before beginning the next word.
  • Use graph paper to give a visual cue for spacing out words and letters.
  • 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.

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.”
  • 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.

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

  • Play games that reinforce structure and require waiting/ turn-taking: 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.
  • Routines, structure and clear expectations will help your child with self-control. Review any changes to normal routine early.
  • Provide a quiet personal space for your child to calm. Relaxing music, a bean bag chair or soft pillows to burrow in may be helpful.
  • Encourage a variety of play/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 (carrying heavy items, push/pull activities, etc.)

Energizing Activities

  • Have your child jump on a mini-trampoline, perform jumping jacks or play hopscotch.
  • 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, 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. (i.e. Play-doh is less messy than shaving cream or finger paints.)
  • Provide firm pressure rather than light touch when holding hands or giving hugs.
  • 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.)
  • Use unscented laundry detergent.

Attention and Focus

Also refer to the Self-Regulation and Sensory Processing section; strategies may also result in improved attention and ability to 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 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.
  • Use a reward chart with stickers or checkmarks 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; 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 both and see what works best for your child.
  • Be sure laces are long enough so that your child can make large loops if needed.
  • 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 or dolls.  
  • 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 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

  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