While at the AOTA conference I sat in on a great talk on CIMT (constraint induced movement therapy). While the talk was great, what I loved is that they talked about it in terms of motor control and motor learning and how to maximize what a kiddo is learning in terms of movement. It was so clearly presented a great reminder of little ways to tweak a session so that it maximizes my effectiveness!
In terms of learning a skill there are components to look at.
- Whole Task Practice – When kids are given the opportunity to practice the whole task it makes it purposeful for them. I’m not saying you should never break it down into components but make sure they get a chance to put the task together. Don’t be afraid of them not performing the task exactly perfect. Every opportunity they get to practice not only creates an experience for them, it also provides information for you on areas they may need support in. For instance, we have a kiddo who is learning to walk. Does he walk perfectly? No but he walks around the clinic and while walking we look at what he is having trouble with. This kiddo has trouble with weight shifting so we then create activities where he gets to work on weight shifting separately but he still is able to do whole task practice.
- Variability – By providing variability in the task it allows a child the opportunity to practice problem solving and make adjustments on their own. By giving them the chance to problem solve, they are working on their own solutions and you will see improved performance. Let them make mistakes and learn from them. You can still allow episodes of blocked practice, such as repetitive practice of a component of the skill but then give them multiple opportunities to use what they have learned. With crawling, you can change the environment so that they have different ways that they have to crawl, such as up stairs, through tunnels, over uneven surface, on a slippery surface, on a carpet. All of these work on crawling but change the conditions enough that they kiddo needs to figure out how to move. This is a great way to enhance carryover to new situation.
- Intrinsic Feedback – This goes along with the problem solving. Let the kids make some mistakes. Don’t rush to correct the movement because they can start to figure it out and make last minute adjustments. Provide feedback every few practices and keep the feedback simple. For instance, if a kiddo is trying to put an coin in a toy piggy bank, they may not be successful every time when they are first learning. By giving them the chance to make adjustments on their own they will have more carryover than if you fix it for them every time. If you give them guidance by manual cues or simple verbal cues every few attempts, this gives them some support without letting them escape from the problem solving components. A good rule of thumb is giving feedback 50% of the time.
- Mental Imagery – As kids get older you can have them think about a task ahead of time and let them plan it out. For younger kids, they still do this to a certain extent as well. For instance if you show them a task and give them 1-3 words for cues they can begin to use those words to help themselves self talk through the process. I was working with a girl on skipping and I gave her the cues of ‘step-hop’ and as she went through practicing the task she would say the words to herself (without my cuing) to assist her with planning the movement. Same thing when little kids are learning how to safely crawl down the stairs or get off the couch. I use the words ‘feet first’ and take them through the movement as I say that. Soon when they hear the words ‘feet first’ they know to turn around and can use that cue themselves when they go to get off the couch. Keeping the words simple and consistent (i.e. using the same phrase every time can help with the imagery).
There is more great information on this topic but I will save that for some follow up posts!