Provide as much supervision and support as necessary for safety. Provide additional support when your child is fatigued or in an unfamiliar setting.
Use everyday activities
1. Develop trunk control by standing on a “squishy” surface, such as a foam pillow, couch, cushion, or sleeping bag. Next try this activity with eyes closed.
2. Practice sit-to-stand (or stand-to-sit) movements using furniture of different heights and firmness (e.g. footstool, kitchen chair, sofa).
3. Put lines made of masking tape on the floor and practice walking on the line and between the lines. Next, practice walking in defined spaces such as grocery or library aisles, escalators, elevators and public transportation. Finally, practice walking on a variety of surfaces including grass, sand, trails, and ramps.
4. Play catch with different size balls. Set up a target at which your child can aim balls.
5. Play obstacle course games at the park, inside, or in your backyard. Examples include crawling under tables or chairs, through tunnels, over couches or couch cushions, and stepping over obstacles on floor.
6. Give your child chores that involve using both sides of the body simultaneously, such as walking the dog, emptying the trash, sorting laundry, watering plants, picking vegetables from the garden, and washing the car.
7. Practice stretching exercises, especially of the hamstrings, spine, upper trunk, and heel cords. These exercises may be accomplished most successfully when muscles are warm, such as following a bath; or when done “functionally” as part of a goal-oriented task ( reaching for a toy on a shelf).
8. Encourage variety in posture and position, with stretching and extension of muscles. For example, encourage your child to lie on his stomach, or prop himself on his elbows on the floor while watching TV.
9. “Heavy work” activities provide deep pressure to the shoulders and hips , which helps the muscles around those joints become more coordinated. Your child might like:
- Pillow fights
- Carrying heavy items – grocery bags, laundry basket, etc.
- Play-Doh, modeling clay
- Swimming, martial arts
- Wall Push-ups
- Helping to push furniture when cleaning a room
- Pushing a wheelbarrow
10. Engage in activities that require starting, stopping, and changing directions such as freeze tag, hot potato, red light/green light.
Change the environment:
1. Keep your child’s school environment and room organized and consistent to prevent accidental falls.
2. Encourage your child to sit down while dressing. Have him practice the skills while standing near a corner, wall, or near a counter top, for occasional support when needed.
3. Provide a chair or bench near the coat rack at school (or closet at home). Encourage your child to sit while taking his coat and shoes off/putting his coat and shoes on.
4. Allow early release from classes to navigate hallways without crowds.
5. Provide a peer buddy to carry the student’s lunch tray or ask him to carry one unbreakable item while the peer buddy carries the remainder.
6. On field trips and on the playground, provide adult supervision to prevent accidents and falls.
7. Modify individual and group activities to include the student with gross motor difficulties. In gym activities, assign a “handicap” to all participants. Adapt team sports and physical education to accommodate a motor disability without causing embarrassment. For example:
- assign a running speed handicap
- provide a hand support for kicking
- provide a batting tee
- assign this student the job of “throw-ins” during soccer games.
8. Practice navigating stairs and hallways when they are not in use. Assign a peer or sibling buddy if necessary.
Teach new skills:
1. Encourage participation in recreational activities that develop coordination and use of both sides of the body, including pool activities, swimming, Tae Kwon Do, gymnastics, dance, bike riding, hiking, T-ball, and horseback riding.
2. Teach use of a wall for support in crowded hallways, use of a handrail on stairs, and sturdy furniture for support when standing.
3. Locate sporting events and competitions for athletes with motor disabilities, such as Special Olympics, Para-olympics, Easter Seals events, wheelchair sports and camps.
The BrainSTARS manual was written by a team of professionals who have worked for many years with children and young adults who have brain injury. We wrote it because pediatric brain injury is very confusing for parents and teachers — and you are the most important people in the recovery of your child. It is important that a child's parents and teachers are well-educated so that they can work well together to provide the best chance for a child's recovery. Our goal is to make sure that every child has a safety net of support and understanding underneath him as he makes the leap back into life following a brain injury.
From BrainSTARS, Brain Injury: Strategies for Teams And Re-education for Students, © 2002 Jeanne Dise-Lewis, PhD. Used with permission. The manual is available in English and Spanish. For more information or to order copies, call 720.777.5470 or firstname.lastname@example.org. A short video on how to use the BrainSTARS manual is available at www.youtube.com/BrainSTARSprogram.