I have been using handles from detergent, dishwasher soap and other types of bottles for over 20 years to make materials easier to grasp and use. The following videos demonstrates how to make it easier to perform insertion tasks, use a ring stack and sponge painting.
These ideas are described in my book THE RECYCLING OCCUPATIONAL THERAPIST. END OF YEAR SALE
My book sells on Amazon for $35.00, but you buy it through pay pal, here for only $25.00 until the end of the year.
This activity gives lots of sensory stimulation as children or older clients move the heavy ball around, tie or untie the knots and push the black fabric "spider legs" into the web.
1) I wrapped stretchy strips of fabric all over a weighted ball, tying lots of knots so that all stays in place.
2) Punch holes around the top of a container and weave cord to create the "web". Use more cord to increase challenge when pushing the "spider legs" inside.
3) Grade according to the student or client's needs by tying knots loose or tight, one knot or several on each black fabric piece "spider leg".
4) Challenge balance by performing while standing, kneeling, half kneeling or sitting on a ball.
5) I attached the web to the ball with cord so that they don't get separated.......
I created an activity book for my mom filled with pictures, song lyrics, word completions and an illustrated story of her life. At first, she flipped through the binder independently but over time, I needed to read the stories, identify the pictures and sing the songs to her. You can find many of these activities on my website. Just print them out....here are links to some of my favorites:
My mom loved word games. There are many described in my book that involve completing the last word or syllable to a familiar place, name or adage.
Sarah was not born in New York, she was born in Chica..... Illinois.
A penny saved is a penny.......
Somewhere over the rain........
Electronic tablets and phones were not yet widely used when my mom lost her language skills and YouTube was in its infancy. I know that she would have loved the following video, mainly because it starred, her daughter.... ME!
Consider making your own, personalized "word completion" video or use mine. Repeat the phrase after me, pause to give the person time to respond and then repeat it nice and clearly for them. I suggest using a large tablet, like an Ipad rather than a small phone, so its easier to see and read. I don't expect people with memory impairment to learn or remember how to find the video, press pause or repeat it.... that's your job as you engage in a meaningful activity with someone you care about. I hope that you enjoy your time together! I sure did!
Babies begin learning about the spatial relationships between what they see, reach for, grasp and manipulate during the first year of life. My book From Rattles to Writing: A Parent's Guide to Hand Skills describes the development of incredible milestones during the first 5 years so that children can do the following:
smoothly move their eyes across a maze, whiteboard, screen or line of print
stabilize their trunk and shoulders while manipulating objects and writing
Comfortably and effectively grasp writing tools
Process and respond to sensory information in order to tolerate touch and effectively grasp writing tools
discriminate sensory information in order to use the right amount of force-- so that paper doesn't rip and toys don't break
coordinate right and left sides of the body in order to stabilize objects such as paper with the non-dominant hand while cutting or writing
develop a highly skilled dominant hand used consistently for skills such as writing
discriminate right, left, up, down, diagonal directions, clockwise and counterclockwise- all skills required to learn letter and number formation
cross midline (CML) when reaching with the right hand for objects left of the body center and reach for objects with the left hand when located right of the body's center. Children with CML challenges may have difficulty forming letters made up of diagonal lines - such as X, Y and Z
create letters of correct size, oriented to the writing line with even spacing between letters and words.
As an occupational therapist who has worked with children and adults with developmental disabilities for over 40 years, I like to design activities that help children with challenges to develop these types of skills- the skills that prepare children for handwriting. That is why I wrote the book- Flapping to Function: A Parent's Guide to Autism and Hand Skills
The following videos demonstrate few activity adaptations that might be helpful for parents, teachers and therapists to develop some of the skills listed above.
1) Pulling the coil upward provides sensory stimulation to muscles and joints, strengthens the trunk, and arms. This works on visual attention and tracking as student watches the rings spiral downward.
This activity develops coordination between right and left sides of his body as he uses his preferred hand to reach for more rings while grasping the coil with his non-dominant hand. He finds the repetitive motions calming....
Writing letters on the plastic pieces with dry erase marker develops motor control. The student must stabilize the plastic with the non-dominant hand while writing and learn how to form half and whole space letters to fit on the small or large plastic pieces. Then placing the letters on the Velcro strips teaches the skills used to orient letters to writing lines.
Working or writing on a vertical surface helps children to correctly grasp a writing tool with the wrist in the best anatomical position. This can be done when coloring on a white board, painting on an easel or using a 3 sided folded cardboard box as shown in the following video.
Watching the rings spiral down the curvy ring stack (made out of a bird mister) develops visual attention and tracking skills. Many children with autism seek this type of visual stimulation and may attend to this activity better than some others. If the rings are small enough they will have to use both hands together to stabilize the ring stack while pushing each ring on. I also like how this activity is tall, perhaps at eye level- this is helpful to use with highly distractible children because the materials are directly in front of their face..
Pushing objects through the stretchy elastics provides sensory feedback that helps to develop strong fingers and motor control. It encourages them to coordinate using hands together as they stabilize the container. You can up the challenges by using larger objects that require more force to push between the elastics. Many people on the autism spectrum seek out this type of deep pressure sensory stimulation.
After hand surgery my hubby needed a waterproof cast cover so that he could shower and go boating. This video shows how he made an inexpensive cover out of a dry bag and Gear tie.
After his injury heals and cast is removed he will find many other uses for these 2 products. Please check out my occupational therapy website and books for more clever adaptations to solve many types of challenges... http://www.RecyclingOT.com
Children and adults with disabilities typically require a lot of REPETITION to learn concepts and motor skills and they need to practice these skills in a variety of situations and settings to generalize the skills.
The following videos demonstrate adaptations that help learn how to manipulate buttons, zippers and buckles. These strategies are effective because:
1) Materials are extra large to make learning easier
2) The manipulations do not need to occur while one is in a hurry to dress and go somewhere. The learner can take his or her time and more easily see what the hands are doing. In addition, the learners may not view themselves as struggling to dress but rather learning repetitive hand skill and this is good for self-esteem.
3) All of these activities develop skills to use hands together and eye-hand coordination. These skills may carryover into other areas in the person's life, even if they don't learn how to manipulate fasteners at first.
It is easy to add slight variations and sensory stimulations such as:
Open containers with fasteners so that the object removed is desirable and fun, maybe a squishy ball, fidget spinner or motorized toy.
Add cognitive challenges such as color matching
Use materials that can be pushed or pulled for proprioceptive sensory stimulation
Hippotherapy is a specialized treatment area used by occupational therapists, physical therapists, and speech and language pathologists. It involves utilizing the sensory-motor aspects of horses to achieve therapeutic goals such as improving sensory processing to tolerate touch and motor plan sequential movements. Although the horse functions as a therapy tool, it is obviously much more exciting than a swing or therapy ball, offering opportunities to develop an emotional bond, communication and social skills.
Pushing objects into openings between elastics or other stretchy materials is a fun way to provide resistance, proprioceptive stimulation to muscles and joints in the hands and develop eye-hand coordination. I like to create variations of familiar activities and love when I discover new ways to add sensory stimulation to the activity.
Consider placing a motorized pen or toothbrush into the container for even more sensory stimulation!
As usual, I used readily available materials- containers and fabric. You can link up potholder loops or hair elastics to make a long, long, strand of elastics to weave through holes cut around the opening. Another option is to cut thin strips of stretchy fabric and do the same.
First cut to remove one end of the container. Then punch or cut holes around the rim.
If you use thin elastics you can push them through holes made with a heavy duty hole puncher . If you use thicker elastics cut around the holes to make larger.
A first I punched holes around the rim of a Thick-it square container with screw cover (shown in the video) because they are readily available at work. I was planning to cut a flap on the bottom to pull open and empty the contents...... then I realized that if I turn the container upside down and make the activity on the BOTTOM, it is easy to unscrew the cover to empty out the contents.
This photo shows a large clear cheese ball container with large holes cut around the rim. I wove strips of stretchy fabric through holes and over the other strips until all felt secure and tight.
This activity is easy to grade by
1) starting out with smaller or thinner objects and increasing their size so that more force is used to push through the stretchy bands.
2) Make the openings bigger or easier to squeeze objects through
3) Experiment with different types of stretchy materials, some are easier to squeeze objects through than others.......
This activity works on different skills such as:
1) using hands together
3)Eye-hand coordination and motor planning
4)promoting engagement/ visual attention
5) Identifying/naming a variety of objects, shapes, weights, colors, sizes etc. while inserting them. Visually impaired clients might particularly enjoy identifying objects before inserting them.
Objects with greater meaning or words written on them may be used with clients who have higher level cognitive abilities.
This activity is suitable for toddlers or older individuals with developmental or other cognitive disabilities who put objects in their mouths, if you closely monitor to avoid choking risks.
I love to fill bags with sand and then stuff them into socks. If I want larger bags, I use sleeves from old sweaters and fleece works the best since it feels so great. The fastest way to do this is to cut the end of the sleeve and make a few knots. The bags shown in these photos have large buckles attached to the ends. You can attach the buckles by cutting into the sleeve and pushing part of the fabric through the buckle . Or you can cut a strip of fabric to push through the buckle and then tie onto the end of the sleeve. I put some pretty duct tape around the buckles to make them easier to grasp and see how to connect them. This activity provides wonderful heavy pressure sensory stimulation while at the same time developing the functional fine-motor skill of opening and/or closing buckles.
These "buckle bags" can be used in many different ways with people with different abilities and challenges:
1) Place the bags on a client's lap. She will enjoy the weight and be able to easily pick them up to place into a container positioned on the table or floor.
2) Make numerous sets of matching colors. In the photo you see that I used the sleeves from an old blue sweatshirt . Use sleeves or socks to make pairs to match. I have placed one half of the sets along the walls so that my clients need to pick each one up to bring to a table to find its match and then buckle. My clients with autism and a lot of energy benefit from all the sensory input of moving heavy objects high and low and across the room. This can also be done in school or program hallways using a cart or backpack.
3)Some clients are only able to buckle the bags together. Buckling seems to be easier than unbuckling.
4) The man in the photo above is easily agitated, so he is performing this task while rocking in his favorite chair in a quiet area of the room. He is staying in one spot, as he opens the buckles and then pushes them into the bucket opening. Pushing these in takes quite a bit of force. You can grade the amount of force required by making the opening smaller or larger .
5) Some individuals may want to carry these around, drape them around their shoulders or arms or just put them in containers without using the buckles, at all. As you can see these materials are very versatile!
The following video demonstrates an individual who is able to open the buckles. He is blind and enjoys the feeling of the weight on his body and using force to insert the bags.
I collected the buckles from old bags or clothing and also purchased a large quantity on amazon.
If your clients have difficulty positioning the buckles correctly, try adding nail polish so that they can see where to squeeze and match up the buckles before pushing them together.
Gather up your beads, buttons, bottle caps, spare change, Bingo Chips, Monopoly tokens, dice, Dominoes and other extra game pieces. Find your unmatched earrings and other glittery objects that you are sure your clients won't ingest and place in a big container.
Now find a large cardboard, plastic tube or PCV pipe and wedge it inside a box.
This is a simple but effective way to work on fine motor skills, attention and eye-hand coordination. My clients enjoyed doing it together and its so easy they were successful right away.
When I hear
the word autism the image that pops
into my mind is 4-year-old Gary. He is lining up cars, end to end, while
children around him make their cars roll, beep, and drive over paper roads. Gary
doesn’t seem to notice what they are doing, even as he crawls over another
child’s leg to reach the bucket of toys.
Gary glances at a toy just long enough to reach for it before
looking away. He sits with his knees bent and feet outside his hips, in a
position called W- sitting because
his legs form a “W” shape (see photograph 1). While picking up cars with his
left hand Gary shifts his weight to his right side. His wrist is loose and
floppy. He grasps the cars with his fingertips, as though they were slimy fish
he was keeping from touching his palms. When another child jostles the
perfectly aligned cars, Gary grunts and, without missing a beat, adjusts them. Then
he stands up and flaps his hands while walking around in circles.
(photograph 1 Boy playing in W-sitting position)
You may have imagined a similar child—a
child who does not play with toys the way most children do (or spends more time
flapping hands than using them to play). A multidisciplinary team observing Gary
would all contribute important findings. An occupational therapist (OT) would
note that although his eye-hand
coordination seems fairly normal, Gary does not look directly at objects,
he avoids using his palms when grasping and seems unaware when his body moves
into a space occupied by another child, signs of a sensory processing disorder(SPD).
A physical therapist (PT) would note hypotonia
(low muscle tone) and poor postural control,
meaning his muscles seem weak and floppy and he leans on his hands to help
hold himself up. A speech-language pathologist (SLP) would note his lack of
social awareness—he doesn’t even protest when another child bumps his cars. He
doesn’t use toys functionally or vocalize while playing, the way the other
children are making their pretend cars drive and crash while saying “beep,
beep.” Gary’s lack of eye contact with
other children and the way he repetitively lines up his cars would draw a child
psychologist’s attention. Gary’s preschool teacher would be concerned that he
cannot name the colors of the cars or engage in pretend play, such as forming
an imaginary steering wheel with his hands and pretending to drive.
As the team discusses their
observations, the picture of Gary that emerges is typical of children on the autism
spectrum. The way he grasps, manipulates, and uses the cars while ignoring his
peers demonstrates difficulties with
·Postural control: his body and hands seem to be floppy and weak.
·Visual skills: he avoids looking directly at the objects in his hands.
·Play skills: he lines up the cars rather than using them in pretend play.
social skills: he does not imitate other
children or share the play experience with them.
·Sensory processing: he has difficulty interpreting and responding to touch and other
Challenges in all of these developmental
areas contribute to Gary’s difficulty using his hands, which is my particular
interest as an occupational therapist. This book explains how atypical
development affects the way children with an autism spectrum disorder (ASD) use their hands. It also offers
intervention strategies aimed at helping children to experience success and be
as independent as possible in performing everyday tasks such as dressing,
cutting paper, or writing their names.In chapter I you will be introduced to how children use their vision,
think, process sensory information and behave influence hand skill development
and learning in general.
technical term for hand skills is fine-motor
skills, because grasping and manipulating objects uses the small, or
“fine,” muscles of the hands in delicate movements. Traditional examples of
fine motor skills would be stringing small beads or stacking blocks. Effective
hand use, however, requires much more than good motor control. In this book I
take a comprehensive look at how children diagnosed with ASD typically use
their hands, what challenges they face, and what strategies will help them
reach their potential. I stress “reach their potential,” because there is
currently no cure for autism or its associated challenges. There are, however,
many effective and fun strategies that parents can implement.
Who This Book Is For
I wrote this book first and foremost for
parents. When I worked in early intervention and Head Start programs I saw how
family education enabled caregivers to carry over OT strategies throughout the
young child’s day and night, seven days a week, whether at home, in the
community, or on vacation. Many of these strategies are easily integrated into
everyday routines and continue to be useful as the young child grows to
As an example, four-year-old Abdul
preferred to line up objects rather than drop them into a container with a
small opening. Inserting objects is an early skill that develops the eye-hand
coordination to use shape sorters and push coins into a piggy bank. Abdul was
motivated to insert magnets into the can shown in photograph 2 when an electric
toothbrush was placed inside.
Caution: Use larger objects if
there is a choking risk. Magnets are dangerous if swallowed.
photo 2 Vibrating container adaptation
The toothbrush created vibration and
motor sounds that interested Abdul and made him want to hold the container. He had to use both hands together-an
important skill that will be discussed later, in order to separate the magnets.
Pulling magnets apart is an enticing activity by itself, but inserting them
into a vibrating container is irresistible. This is one of my oh-so-simple, yet
oh-so-effective strategies to help children to build hand skills.
This activity is also suitable for older
children or adults who are developmentally ready to learn insertion skills.
Many of the strategies described in this book can help individuals with
cognitive and/or motor delays to develop hand skills typically mastered at a
younger age. However, it is important that the materials be age appropriate and
the person have the prerequisite skills to learn them. For example,
six-year-old Bonnie refused to touch gooey substances such as paint or glue and
she had difficulty learning how to form letters. Her mother filled a sturdy zip
locked bag with paint, and Bonnie imitated her mother using her index finger to
form lines and shapes by pressing. Bonnie
had the prerequisite skills to use her index finger as a writing tool, visually
attend and imitate the movements. Bonnie liked this activity because she didn’t
have to struggle with controlling a pencil, it was fun to feel the paint move
through the plastic and she felt like an artist.
This adaptation is just one of many
strategies provided that may be beneficial to children with or without an
autism diagnosis. Many strategies may also help very young children who donot yet have a diagnosis but perhaps the
parents sense that they should be concerned.Although children with ASD are typically not diagnosed until toddlerhood
or older, some parents may notice developmental differences in their babies.
Therefore, I include red flags and strategies relevant to babies. These may be
especially important if the baby has older siblings diagnosed with ASD. If the
descriptions in this book “resonate” with your child, speak to your
pediatrician or local child development center to get further information
specific to your child’s needs.
Much of the current literature on autism
focuses on the social, communication and behavioral aspects of the disorder. I
have written From Flapping to Function: A
Parent’s Guide to Autism and Hand Skills for the early childhood
professionals, educators, counselors, therapists, and other professionals
working in school, residential, community, or institutional settings who seek a
comprehensive, one-stop resource that focuses on how developmental challenges
impact building hand skills and the strategies that will enable children to
reach their potential.
Its always exciting to find an inexpensive product that can be used when creating or adapting new activities. My clients love to try new activities and get bored doing the same old thing day after day. It is a challenges to come up with new ideas to help people who have limited fine motor skills, but the slapper bracelets have been versatile, easy to grade and a lot of fun.
They offer sensory feedback when simply bending them . Add them to your sensory bin of manipulatives for children or adults who need to fidget and/or relax.
The bracelets come in a variety of sizes, colors, strengths and materials. I recently bought a package of 72 for about 10.00 and use them in repetitive tasks such as the following....
1. I present them on a tray curled up so that the person has to straighten them out and insert into the slot opening. This takes quite a bit of motor planning and is quite challenging for some individuals.
2. I tied strips of fabric all over the bucket because the lid was not staying on and I didn't want my clients to dump out the contents. Then I attached the bracelets all over the fabric so that they need to pull them off and insert. The orange lid stays on the bucket permanently. I cut a circle in the lid's center and pushed the top of a screw cap container through it and taped in place from the bottom. I can screw a cover back onto that white screw piece you see on top to keep the contents inside. Its large enough for me to reach inside and remove the contents.
This bucket was originally used by a client who enjoys inserting the small objects on the yellow tray and he does not have the motor skills to remove the bracelets. So in this way different clients can use the same bucket in different ways according to their skills. Another individual has the skills to attach the bracelets, also a pretty high level fine motor skill.
3) You will see in the video clients removing the bracelets from a tall ring stack. I attached a pin wheel to the very top and asked them to blow after inserting the bracelet. This seemed to be calming as well as funny to them and others watching them. They certainly did really nice reaching and neck extension in the process.
4) Some individuals enjoyed attaching the bracelets to the top of the curvy ring stack. The bracelets functioned as rings but putting them on and off involved a higher level of motor planning and they enjoyed the sensations of bending them in the process. I think that manipulating the bracelets provided the proprioceptive stimulation to the joints and muscles in the fingers helping with coordination and body awareness.
5) The man in the blue shirt is blind and nonverbal but very good at motor planning. He also seeks sensory stimulation by ripping his clothes. We have not found a solution to the ripping behavior (believe me, we have tried a lot of strategies) , but I like creating new sensory based activities such as the one below. I taped a cat toy to the top of a container lid. You can see the yellow lid in the photo below. The cat toy has a spring with a toy mouse on top that makes sounds when moved. The client is able to attach the bracelets to the spring part and also has the skills to remove them, straighten them out and insert into slot openings on the sides of the container. The bracelets are retrieved by unscrewing the cap with cat toy taped onto it.
You will also see in the video a stringing activity made by attaching a heavy duty slap bracelet to the end of cord. The individual in the video has poor motor planning skills but is able to string or remove the large rings. Notice how I tied the bottom of the cord to his chair to make the materials easier to control.
Someone had put a broken toddler toy on my desk at work. The child is supposed to put a ball in the top, it rolls down a short distance and activates music as it lands. I assumed it was broken and came up with the following way to turn a one person task into a partner activity.
Several of my clients enjoy using force to push golf balls into the small container opening. I spread the pile of golf balls on a tray on top of a towel to cut down on noise. The young man on the left in the video is blind and loves deep pressure and resistive materials. He quickly learned how to place the golf balls into the top of the toy so that it rolls down, making a bit of clatter.
The other individual enjoyed watching this process as he took the delivered ball and pushed it into the container opening. When finished they reversed roles so that the blind client on the left had a turn retrieving the balls and pushing them into the container. It was a lot of fun watching them work together but, I do wish the music worked!!!
I can't find this exact toy on amazon but these look similar....
Many children and adults with autism and other developmental disabilities have poor body awareness and decreased motivation to engage in hand activities. They may not stabilize materials with the non-dominant hand and have decreased strength and/or muscle tone.
They don't quite know how to move their bodies effectively. They may walk on their toes with the head leading and look like they are about to topple over. Some people move fast when given the opportunity because it takes more motor control to move slowly and deliberately. In addition, moving fast gives them the sensory stimulation they crave (i.e. vestibular stimulation).
Children may tire quickly, slide down their seats and their palms may look flat because they don't spend a lot of time using their muscles to squeeze, pull or push objects. These individuals often love weighted blankets, vests, collars and objects because muscles and joints are getting heavy pressure sensory stimulation (proprioception).
Resistive hand activities also provide proprioceptive sensory stimulation. "Resistance" means that the activities require FORCE to perform them. Many children find resistive activities and materials calming, as well as strengthening and they become more motivated to use their hands. 1) Popping bubble wrap strengthens the fingers as children PUSH or SQUEEZE IT. Provide lots of squirt bottles to squeeze during bath time, too.
2) Velcro- lots of toys are made with parts attached with Velcro that are ripped off and then re-attached. Many children love that sound.
The photo shows some Velcro backed shapes that are ripped off the ball and then attached to a Velcro board on book stand.
You can also use Velcro to attach toys to a detergent bottle so that children can rip them off before inserting. This is developmentally perfect for the typically developing 18 month old toddler and older children and adults with delays often love it, too. (Be sure to use larger toys and closely supervise to avoid ingesting objects) I also like to attach toys from the commercial shape sorter with Velcro so that they need to rip before inserting shapes. Placing and ripping off the red and yellow strips that form railroad tracks teaches children how vertical lines can fit between horizontal lines.
This helps prepare children for handwriting!!
3) Writing- using crayons or chalk requires much more force than markers. (that is GOOD) .
Working on a vertical surface also strengthens shoulders and puts the wrist in the best anatomical position to grasp a writing tool. Coloring on top of sand paper or fabric also requires using a lot of force.
Many children love to press into a gel pad to form shapes. Drawing in thick pudding or wet corn meal is more resistive than finger paint, although they are all great sensory activities.
4) Toys that involve pushing strengthen fingers. I like the foam puzzles and mushroom shaped pegs that are pushed into foam boards.
5) Children can push Lotto cards or pieces of plastic into slot openings in bottles. You can also use folded cardboard cut out of boxes or plastic from containers. Folding them first strengthens fingers and teaches the motions used to fold paper.
6)Everybody enjoys pushing a whoopee cushion!
7) Squeezing the Hungry Harry tennis ball to open his mouth is very resistive. This person is feeding him pennies. Mix the "food" items inside putty so that they have to remove it before feeding Harry. VERY RESISTIVE AND VERY FUN!
(Make Hungry Harry by drawing a face on the tennis ball and cutting the slit for the mouth.)
8) Opening up slap bracelets to wrap around a tube or inserting them into a container slot provides a special and weird sensation to fingers as they push and pull them.
9) I cut these apples and worms out of detergent and juice bottles. It take a lot of resistive pushing and pulling to insert or remove them!
10) Ordinary ring stacks become resistive when the rings or donut shapes must be pushed downward with force. The one shown on the left happens to be made by inserting a vibrating pen into a swimming noodle wedged inside a bottle.
11) One young lady I work with avoids using her left hand but she will do so in order to pull the lids off of the fabric while grasping the red handle
12) Opening knots in thick cord or pulling cord out of the horseshoe lacing board is very resistive
13) There are lots of sensory toys sold that feel great to pull. The photo shows me pulling some stretchy fabric that I tied onto bottle handles.
14) I tell my clients to smack the golf balls into the bucket opening. They really enjoy it and it helps them to be calmer.
15) Stretching elastics or rubber bands over objects is resistive. The photo shows bands stretched over a ball with fun texture, but of course use any object that your child enjoys. Elastics can be stretched over lots of things including the backs of chairs and your 2 feet....
16) Here is an example of a toy horse that has limbs to pull. When you pull one through the holes, another is shortened.....
17) Cutting: Using thick paper provides more resistance and makes it easier to control. Ripping paper or fabric is also very resistive. I recommend doing this during an arts and crafts group.
Some of my clients love to rip paper or crush it into balls and then push it into bottle openings.
18) There's lots of fun balls that can be purchased. These can be pushed into container openings or try filling socks with sand, marbles, foam or other items.
19) The lady in the pink shirt is stringing large rings. but first she has to push them over the squeeze ball (filled with putty)that I attached to the end of the string.
Sometimes, I attach a vibrating toothbrush to the end of the cord. If you use very thick cord or just tie a bunch of knots in it, the person will need to use a lot of force to make the rings go down.
20) I tied a heavy bag of sand to the bottom of this green watering hose. My client stands on it to keep it stable. Then he pulls the coil upward to make rings go down.