For example, a child bangs a spoon on a toy kitchen set instead of using the spoon to pretend to eat the food, or when first introduced to scissors a child only wants to see how they can open and close the scissors (plastic scissors recommend as the first pair of scissors!).

Even in these instances, the child is still learning, and sometimes it’s hard for us to see. To revisit our examples, a child who uses a spoon to bang on a toy kitchen set is learning a cause and effect pattern of their actions: I bang the spoon on the kitchen set, it makes a noise.

A child who first uses scissors to see how they open and close is learning how the mechanism of the scissors works. Here are some tips to help get your child engaged in play by first meeting them at their current level and then helping them to meet greater and greater challenges. These strategies come from a Natural Learning Environment Practice model that focuses on using what your child is interested in.

1. Invite: The first step to engaging a child in play is to invite them into the activity. Some ways to do this include:

-Get down on your child’s level: bend or squat down, or sit at a table with your child so you can see them eye to eye. This will help get their attention. Once you are eye to eye with your child, match their facial expression. Smile if they’re smiling, frown if they are frowning.

-Match the tone of voice of your child (if they’re excited speak in an excited voice, if they’re sad speak in a sad voice).

-If your child is open to taking your hand and being guided to an activity try reaching your hand out to them. If they are not open to holding your hand, gesture for your child to come over and join you in an activity.

2. Engage: See if your child will engage with whatever toys or items are present.

-Once your child starts to engage with a toy in some way (for example, banging blocks together) start engaging with the toy in the exact same way. If your child is looking at a ball, look at a ball with them.

-Respond positively to however your child is engaging with an item or toy. Let your child know that you see what they are doing and you are interested in doing the same thing too.

3. Teach: Add on to what your child is engaged in.

-Once you’re child is engaged, show them a new way to interact with the same toy or item. For example, show them how they can also stack one block on top of another.

-See if your child will take turns with you in doing whatever they are doing. (For example, if your child is looking at a ball see if they will show it to you, pass it to you, or accept help rolling it).

I hope you enjoy inviting, engaging, and teaching your child to play! Get more tips, interact with our OT’s and connect with other parents by joining our Facebook Group Here.

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Low muscle tone, or hypotonia, refers to decreased tension in a muscle when it is at rest. You’re child might feel floppy or it may feel like you’re picking up a child who is sleeping even though they are awake. Children with low muscle tone may also tire more easily because it takes more energy to use their muscles. Muscle tone and muscle strength are not the same thing, as your child can have strong muscles but still have low tone. Low muscle tone is neurologically based and generally cannot be changed. However, children can strengthen their muscles through occupational therapy and learn to compensate for low tone so they can better function in their daily activities.

My infant has low muscle tone. What can I do?

Infants with low muscle tone may have difficulty keeping their head up. One great intervention to increase trunk and neck strength to compensate for low tone is tummy time. Infants can be placed in tummy time on the floor or on their tummy on a pillow. Help your infant stay engaged by presenting toys at eye level (toys that make noise and light up can be a big hit in this position!). You can also try tummy time with your infant lying on your stomach to increase tolerance of this position by adding an element of social engagement (smile, coo, or sing songs with your infant on your tummy).

My school aged child has low muscle tone. What can I do?

One indicator of low muscle tone that I see often in preschool aged children and older is the inability to sit upright for long periods of time. These children are often slouching or leaning back in their chair due to fatigue maintaining an upright posture. Try helping your child strengthen their trunk muscles by having them sit on therapy ball. Sitting on an unstable surface requires activation of all the trunk muscles involved in sitting. Older children can use a therapy ball instead of a chair when doing tasks at a table.

My preschool aged child has low muscle tone. What can I do?

If your child is preschool aged they may require extra assistance sitting on a therapy ball by themselves. Have your preschool aged child sit on the therapy ball while doing a task that can be done on a low surface (a kids table, the edge of a sofa or chair, you may have to get creative!). Position yourself on another chair, on your knees behind your child or to the side of them and hold their hips on the ball. For an extra challenge, move the ball from side to side a little bit to see if your child can catch their balance (always be next to them in case they fall!).

Therapy balls can be purchased on Amazon.com for about $12! Look for one that is about 22 inches or 55 cm in diameter.

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-Weighted lap belt

This is a great tool for the child who finds deep proprioceptive input calming. Deep proprioceptive input can be defined as something that provides “deep pressure” to the joints in our body. It helps us know where our body is in space. Children who may benefit from this tool may enjoy tight hugs, crashing their body into things, and jumping. To make this tool, all you’ll need is a big bag of rice and a long knee-high sock (an adult sock can be used) with tightly woven fabric so the rice won’t come out. As a general rule, weighted items should be between 5%-10% of your child’s body weight. To make this item, you or your child can open up the sock and the other person can pour the rice into the sock. Again, pour the rice over a large open container to reduce the mess. Tie the sock off at the end if possible, or use a rubber band. This is another tool that can be used at school without disturbing other children or used at home during homework time. Ask your child’s teacher before sending it to school.

-No sew bean bags

These bean bags are another tool that can be used for deep proprioceptive activities. They can be made using the same technique as the weighted lap belt. Instead of using a long sock, uses smaller socks (maybe ones your child has grown out of!). These bean bags can be used in a variety of ways to provide deep proprioceptive input. Have your child wear a jacket with pockets and place the bean bags in the pockets as a DIY weighted vest. Weighted vests can be used as a calming tool for children who respond well to deep proprioceptive input. Again, stick with 5%-10% of your child’s body weight. Take the vest off for high movement activities such as running, jumping, or swinging. These bean bags can also be used at home for a variety of games that provide deep proprioceptive input. Scatter the bean bags out on the floor of a room. Have your child walk on their hands to retrieve the bean bags and place them in a container. Having your child walk on their hands (or you can say, “show me how you walk like a bear!”) to provide deep proprioceptive input to their arms and shoulders.

Enjoy! Tip: try using other items besides rice inside the balloon/socks for increased tactile sensation! (Try beans, sand, small pebbles, etc. Just make sure it doesn’t leak through the sock!)

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If your child was enrolled in any early-intervention services, like Occupational Therapy, you have seen the benefits and progress your child has achieved. You may feel nervous about whether your child will continue to receive those needed therapies. One of the best things you can do to prepare to be your child’s best advocate is to collect notes, outside evaluations, and data from your therapists that support your child’s need for services.

The process of transferring from the CDSA to WCPSS usually involves 3 meetings:

1. Referral Meeting
2. Eligibility Meeting
3. IEP Meeting

Both parents have the right to attend each meeting and also to bring with them anyone who will advocate for their child. This is especially important for the IEP meeting, when actual goals will be set and services will be determined.

The Referral Meeting is an introductory meeting in which the Pre-School Services or Special Education Department will receive basic information about your child, discuss your child’s current strengths and weaknesses, and determine if evaluations are needed. Usually, evaluations are necessary. The team will discuss which evaluations are needed and how to get ready for them. You will be assigned a Case Manager who will be responsible for scheduling and coordinating all evaluations. Typically, evaluations are done at a WCPSS location, not in your home or natural environment.

The Eligibility Meeting will occur after all evaluations are complete. The results of all evaluations will be shared and discussed at this meeting. Parents will be given time to ask questions. The main goal will be to decide whether the child is eligible for special education in North Carolina. If yes, then a primary area of disability will be established.

The IEP meeting will be the final meeting before your child begins special education services through WCPSS. In my experience, this is a lengthy meeting and your child does not need to attend, so leaving him with a trusted sitter or relative may be a good choice. Also, if a particular therapist knows your child and his special needs very well, you may invite that person to join you at the IEP meeting. (Please note that you may be responsible for compensating the therapist for their time.) The main goals of the IEP meeting are to establish a list of your child’s strengths and weaknesses that may affect their educational success, and create a list of appropriate goals that your child and his therapists will work towards for the coming year. Services are assigned according to the goals set.

Further information about special education services in Wake County, NC may be found at the WCPSS website:  If you have any questions about incorporating Occupational Therapy services into your child’s therapy plan, please feel free to contact All About Therapy at (919) 448-6018.

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