Daily Living Activities
Gaining independence in completing activities of daily living is something all parents and educators want for the child. Every child has the potential to make gains in these areas whether or not they become fulling independent in the activity. These activities include things like eating, bathing, brushing teeth, toileting, washing hands, dressing and undressing, and grooming. Adults may be tempted to do these activities for the child, especially when they are young. It is so important to the quality of life the child may have as an adult, to be able to participate in these activities as much as possible. Because many of these activities require personal and intimate touch, they can be startling or somewhat stressful for the child. The more opportunities your child has to explore materials used in activities of daily living and to practice individual skills required to complete these routines, the less stressful these activities will become for the child.
- Work on skills related to activities of daily living at times and in settings other than during the actual event. For example, practice skills related to eating at times other than during the actual meal when getting nutrition in becomes the important goal for the child. This also allows the child opportunities to practice without someone watching or attempting to “show” him/her the proper way to do it.
- Make activities fun and interesting to the child based on his/her preferences related to sound, textures, shapes and so forth.
- Provide many opportunities throughout the day for the child to practice skills related to activities of daily living. This includes things like grasping, kicking legs, putting things on their heads and taking them off, moving arms, and bringing things to their mouths.
- Be mindful of your pace during the actual activities daily living. Give the child lots of time to complete a single piece of the activity before prompting the child. Some children may be able to do more if given plenty of time to try.
Learn more about ways to work on these activities:
- Hair Brushing
- Hair Drying
- Undressing and Dressing
For even more information about strategies and issues related to eating, you should also visit Oral Motor Development and Issues.
Let the child play and explore things with the mouth. Provide whistles, harmonicas, spoons, or favorite objects with food or flavoring on them. You might try apple sauce or yogurt or pudding. Let your child to explore these items in any way that they want to during play activities.
Skye Eating Applesauce
In this video you will see Skye exploring some quack sticks that have been coated with apple sauce. She was just learning to eat from a utensil, and we were having her practice bringing her utensils to her mouth. But you can see during this play activity, she’s feeding herself apple sauce from a quack stick, which was one of her favorite toys.
Provide various utensils (made from different materials like wood, metal, rubber, plastic) for your child to play that are coated with different flavorings. Encourage your child to bang them together, bang on pots and pans, smell or taste the ingredients on the utensil, scoop and stir. You can also hang utensils near your child and let them kick, bat or bang them, practice grasping them, and exploring in other ways. This is how they will learn about the utensil and begin to create more robust concepts like “spoon-ness” or “fork-ness”.
Practice scooping or pouring various materials such as dried beans, rice, and noodles. Dump them onto cookie sheets or other noise-making surfaces. If the weather allows, take tubs of water outside to practice scooping and pouring water or include these opportunities during bath time. Provide measuring cups and other containers with handles; this will help the child learn how to pour his own drinks.
Easton Filling Cups
In this video you will see with Easton and Jessica McCavit, OTR, near his hand to give him the opportunity to use it, but he currently prefers to use his hands to fill the cups.
Stack plastic or melamine plates and plastic cups with your child. If your child is not at that level yet, you stack them and let your child practice knocking them over on to noise-making surface (hardwood floor, a tile floor, a resonance board) using arms, hands or legs. This allows the child to become familiar with cups, saucers, bowls and plates before using them during feeding.
When your child is ready to eat some solid foods, here are some things to remember. In this video you will see Jessica McCavit, OTR, helping Skye eat her lunch. Notice that Jessica holds the spoon steady right by the mouth, and does not chase the child with spoon. Your child may be a little bit hesitant to take food from a utensil, so be patient. After the first bite, the child may be less hesitant to eat. Then position the utensil near the hand to encourage your child to grasp on to it. The child may want to grab your hand and bring it towards her mouth to help us feed her, so hold it at the very end so the child can grasp the utensil instead. Your child, like the child in this video, may still need a little assistance to load food onto the utensil, but as much as possible allow them to attempt scooping and stabbing food and bringing it independently into the mouth.
Skye Holding Her Cup
In the last part of this video, Jessica transitioned to having Skye hold on to her own cup. Prior to this time, she had opportunities play with cups and plates outside of meal times with cups and plates.
If your child can’t maintain a grasp on a utensil (or any object that you are using), , you may want to try using a buncher. Click here to find out more about bunchers or to download directions for making a buncher. You can also create a make-shift buncher using a hair scrunchy. A buncher allows the child to keep an object in their hand, whether their hand is open or closed.
Making a Buncher from a Hair Scrunchy
Hook one end of the hair scrunchy around the utensil. Place the remainder of the scrunchy over the top of the child’s hand and hook the other end over the grasped utensil.
If you use a real buncher, you will see that there are three pieces of elastic. Two of pieces of elastic have button holes and one has three buttons sewn on it. Notice that the buttons are spaced apart to accommodate different sized hands. A real buncher can be used with any object that you are trying to encourage your child to hold. The nice thing about the bunchers is the child can still feel the actual object in the palm of his or her hand as they are practicing grasping and releasing and exploring that object.
Here’s is a video of Jack using a buncher at meal times. Notice that he has a loose grasp on the spoon, but because of the buncher, he’s able to keep it in his hand and practice bringing that spoon up to his mouth. During times when he’s practicing, we will also give him a few bites and then pause our activity so he has an opportunity to practice as well. We always try to make sure that there is food on the spoon. If he does get the spoon up to his mouth, he can tastes. This should motivate him to keep making those movements to bring that utensil up to his mouth.
Jack Learning to Eat Independently with a Spoon
When you are cooking dinner, let your child explore any items that you are using to make the meal in any way he or she can. So, for example, if you are making pizza, let your child play in the pizza sauce, cheese or other toppings. Give your child their own dough and let them poke, pat and squeeze it. If you have a rolling pin, let them experiment with rolling the dough. If they bring these food items to their mouths, they have the added experience of tasting and even smelling the various topping. Think about foods that are appropriate for your child to explore and remember not to let your child have things that may cause him or her to choke if they are not able to chew their food properly.
When your child has developed the ability to grasp utensils, you may want to give him opportunities to practice using utensils to skewer food. Use a piece of Styrofoam about the size of a cafeteria tray that has been secured to a table top. Stick various forks in the Styrofoam with handles up. Let the child practice pulling out the forks. At first the adult might need to put the forks back in the Styrofoam for the child, since it is much easier to take the forks out than it is to put them back in the Styrofoam. The noise created by the forks going into and out of the foam will help to motivate the child. You can mix other things that have a slim profile like toothbrushes with the forks. The child will have opportunities to identify the similarities and differences between the two objects.
Pulling Forks and Toothbrushes from Styrofoam
Offer your child opportunities to play with a variety of brushes and combs in anyway he or she chooses. You can offer brushes that have various purposes such as basting brushes, vegetable brushes, kitchen bottle cleaner brushes brushes, nail brushes, along with hair brushes of different sizes, shapes and materials. Look for a variety of combs and picks to offer such as rattail combs, pocket combs, big combs, little combs, hair picks, decorative hair combs, wooden, metal and plastic combs.
During independent play offer a hairbrush to the child by holding it steady near the hands to let them explore by raking bristles. You may also want to attach the brush to a Velcro Vest or Activity Belt or stick it to the child’s shirt with Duck Tape.
Learning About Brushes
During independent play, allow the child to practice putting two brushes or a brush and comb together by pressing the bristles or teeth and bristles together. Let the child play with pulling them apart of putting them together. The child might also experiment with the different sounds the combs make when raked over a brush, a fingernail, the teeth, or other object. The adult’s role is to replenish the materials as they are explored and discarded by the child.
Offer a variety of hairdryers (both real and play) for the child to explore. This is a great way to make use of all the burned-out hairdryers you have. Consider various sizes such as travel-sized, small and large hair dryers. Also try different types such as ones with brushes, diffusers, and other add-ons. If you can find an old-fashioned bonnet dryer, the child might find it interesting to set on top of his or her head.
During adult-child play, offer the child things that make noises like a hairdryer or things that produce air. This might include small personal fans, handheld vacuum cleaners, paper fans, blenders, or balloon pumps along with hairdryers. Make sure that the hairdryers are taped or otherwise secured so they do not become too hot. Be prepared to turn the device on and off as the child becomes distressed by the sound. Make sure the child has plenty of time to explore the object before turning it on to produce sound or air. The child might startle to the sound or feel at first, but if they are able regulate their contact or the amount of time they have to hear the device by signaling the adult, they may become more comfortable. You might also connect some of these devices to a timer switch so the child can practice turning the device on and off.
Every child can participate in some way during dressing and undressing. It is important to break down dressing tasks into simple skills that a child can do. Start with gross motor movements, like moving an arm or leg, and then begin to introduce easy fine motor skills. These motor skills should be practiced in daily activities and not just at dressing times. This process can take weeks, months, or, in some cases, years to accomplish. Always let your child be successful in many, many attempts before moving to a more difficult task.
Before children learn to put clothes on, they learn to take clothes off. Taking off is always easier than putting on. Let your child have the opportunity to be active during dressing in anyway they can. If you have a shirt pulled mostly off the child’s head, can he pull it the remainder of the way off? Can she bend the leg or pull the foot to remove the shoe or sock while you hold on to it? Any little bit of action on their part is the goal.
Rylan Learning to Kick Legs and Feet
In this video you can see that Patty Obrzut, OTR, has placed a Velcro strap of bells on Rylan’s feet. This encourages Rylan to kick his legs and feet.
The same motion of kicking the legs and feet can be used to remove pants or socks. For a child to participate, the adult needs to pull the pants all they way down until they are almost off the feet, then allow the child to kick the pants off the feet. For socks, pull most of the sock off the feet, so that minimal movement is needed to remove the socks. Remember that a child will only learn to help if he or she is given the opportunity and the time needed to do so.
Demonstration of Kicking Off Pants
In this video Patty Obrzut demonstrates the motion of kicking off pants.
During undressing, allow your child to try and pull a shirt from the face area. If your child is lying down, remove the shirt so that it is lying loosely across the child’s face. Then wait and give the child enough time to attempt to pull the shirt away. This task may be a little easier to perform in sitting. Position the shirt in the same fashion and allow the child to pull the shirt from his face. Over time, slowly lower the shirt further down the head so the child has to pull a little harder. With continued success, eventually the shirt placement can be down around the neck.
Demonstration of Pulling Off Shirt
You may have necklaces or neck ties in your home of varying sizes. Allow your child to play games of taking them off or putting them parts of the body. This will help a child develop the skills necessary for taking off or putting on a shirt.
Demonstration of Putting On and Taking Off Necklaces
Drape lightweight scarves or cloth over the child’s head, making sure part of it is near where the child can try to grasp. Let them pull the scarf off. This might grow into an adult child turn-taking game similar to peek-a-boo.
Put various hats or caps on the child’s head, and let him or her get it off. In this video, you will see how a child might first learn to take off or put on a hat. Instead of using a hat, a child may pull something else off his head. Here tissue paper, pots and pans are used. Introduce large sized hats. Most importantly, allow your child to problem solve getting clothes off and on during play.
Demonstration of Putting On and Taking Off Things from the Head
When children are first learning to dress, it is good to give them practice putting on articles of clothing that are over-sized. This is why dress-up centers are so great for all kids, no matter their age. You can include things in this area like hats, wigs, shoes, shirts, tutu skirts, scarves, neckties, sunglasses, earbobs, flower leis, shawls, necklaces, socks….the list goes on and on. Just like so many Grandma’s know, an old trunk or suitcase full of clothing is a great place to while away the hours.
During play, allow your child to interact and manipulate dressing items. Give your child shoes of many types and sizes. It is much easier to put on an adult’s shoes than it is for a child to put on his or her own shoes. You may put items inside the shoes for removal. You can use tissue paper, balls, or socks, anything to encourage your child to take apart and put together.
Putting on Shoes
Fasteners used in dressing require very complex fine motor skills. These skills are learned in play. Once your child can grasp and let go, start to introduce toys or objects that encourage taking apart and putting together. These simple toys have slots in them. A child who masters these toys will eventually be able to put a button through a button hole. You might also use interesting coin banks that will allow for large coins or metal washers to fit inside.
Here is toy you can make for your child. Button holes are sewn into material, and the material is mounted on a frame. This frame can be placed inside or over a container. As you can see in this video, the button holes are very large to make it easier for the child to practice putting items through the holes. Attaching some of the buttons on elastic, keeps the buttons accessible. Remember a child needs to repeat and practice putting a button or other small objects inside slots many times before he or she masters this skill.
For a child to work any fastener, he or she must first be able to take apart and put together. Use simple toys like pop beads and bristle blocks to help your child get that practice. Then get more complex like items like snapping toys or legos. Find or make toys that have snaps, zippers, buttons or clasps. Use containers of all shapes and sizes that open and close. Old glass cases, wallets, and purses are wonderful toys to explore. Place objects inside the containers for your child to discover once opened. Initially leave some of the compartments open, then start to close them partially or completely. Containers that have lids to snap on and off, tops or panels to open, and lids to screw on and off, also help to develop the fine motor skills necessary to work fasteners.
Finally, to encourage your child to develop dressing skills, introduce activities at your child’s developmental level that support putting together and taking apart. After all, that is what a fastener does.
Activities for Putting Together and Taking Apart
In this video, you will see Patty Obrzut, OTR, manipulating various objects that are related in some way to fasteners.