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What causes temper tantrums?

What causes temper tantrums?

What is behind your child’s tantrums and Meltdowns?


We have all seen it. In a grocery store, a bank or even on the road. Young children experiencing emotional meltdowns, throwing tantrums, crying and screaming. Embarrassed parents are forced to discipline their young child to help them to stay calm. What we don’t see is the underlying cause of this emotional outburst.

Perhaps you have heard of the ‘terrible twos’ and the age bracket defined by bad habits in young children. Tantrums are common during the second year of life when language skills are starting to develop. Because toddlers can’t yet say what they want, feel, or need, a frustrating experience may cause a tantrum. As language skills improve, tantrums tend to decrease. A parent’s ability to understand whether these tantrums, no matter the child’s years of age, are a result of environmentally independent variable or sensory processing disorders.

When a child is experiencing an emotional meltdown this is the symptom of their nervous system being prepped and absorbing varying amounts of stress. When children don’t develop social and emotional regulation as part of normal development, or they feel like they are not in control of their environment, they lash out over the smallest of things. It can be as simple as just saying a plain no and it will present itself as something so stressful and threatening to them that they can’t cope with it.

“I was speaking to someone the other day whose daughter has to have two spoons in her bowl every morning. Never uses the two spoons, but has to have it every morning. And you know, they’re the sorts of things that you get is this controlling behaviour is, you know, it has to be this way and I won’t give into it. Or if you say no, then you know, that’s where I’ve just lost control and that will set me over the edge there.” – Amanda Parson

Majority of us are born with the capacity to receive sensory information and organize it effortlessly into appropriate behavioural and physiological responses. The inability to process sensory information leads to sensory processing difficulties. And if not addressed early, these will manifest into more serious emotional mental health disorders. The biggest reason behind all this is stress and how the child’s brain starts to prepare itself in response to stress. More information starts to alert over responses that wouldn’t normally exist. This is where we get attention deficit disorder and anxiety disorders starting to emerge.

“56% of primary school age children now have diagnosed internal mental health disorders in Australia. 72% of high school students are diagnosed with depression. That’s not even an external mental health disorder. That’s just the internal ones.” – Amanda Parson

What’s the best way to determine if there are underlying sensory processing disorders?

“The best way is obviously to start with behavioural observations. Start to notice those things are there in a kid’s setting or your own kids at home. Fill out a sensory profile questionnaire. If you don’t have access to one, just give us a call and we’ll email you on. It just has five columns: always, frequently, occasionally, seldom or never. You just tick those and to answer different behavioural questions like how his hands are over his ears for loud noises that are acceptable for us, for example. And how, whether you see that frequently, occasionally, seldom or never or always. You’ll start to see ticks alive in different sensory areas. It’s broken into the different sensory categories of like visual, auditory and proprioceptive.” – Amanda Parson

There are 3 main types of sensory processing disorders: Sensory Modulation Disorder (SMD), Sensory-Based Motor Disorder (SBMD), and Sensory Discrimination Disorder. These basically describe the difficulty processing sensory information into appropriate responses, difficulty controlling their movements and difficulty distinguishing between sensations respectively.

A few indicators of Sensory Processing Disorder are heightened response to sound, touch or movement, under-reactivity to certain sensations e.g. not noticing name being called, being touched, and high pain threshold, seeking increased amounts of auditory, tactile or movement input e.g. making noises to self, constantly touching objects and people, and being hyperactive, appearing to be in own world and difficulty regulating own behavioural and emotional responses; increased tantrums, emotional reactive, need for control, impulsive behaviours.

This diagnosis comes as a relief to most parents who have been confused by the behaviour of their children but not all confusing behaviour is related to sensory disorders and some behaviours are actually behavioural issues independent of sensory needs. Sensory processing issues should only be diagnosed by a qualified professional.












Avoiding Tantrums in children not affected by Sensory Processing Disorders:

Try to prevent tantrums from happening in the first place, whenever possible. Here are some ideas that may help:

  • Give plenty of positive attention. Get in the habit of catching your child being good. Reward your child with praise and attention for positive behaviour.
  • Try to give toddlers some control over little things. Offer minor choices such as “Do you want orange juice or apple juice?” or “Do you want to brush your teeth before or after taking a bath?” This way, you aren’t asking “Do you want to brush your teeth now?” — which inevitably will be answered “no.”
  • Keep off-limits objects out of sight and out of reach (ice cream is a repeat offender). This makes struggles less likely. Obviously, this isn’t always possible, especially outside of the home where the environment can’t be controlled.
  • Distract your child. Take advantage of your little one’s short attention span by offering something else in place of what they can’t have. Start a new activity to replace the frustrating or forbidden one. Or simply change the environment. Take your toddler outside or inside or move to a different room.
  • Help your child learn new skills and succeed. Help kids learn to do things. Praise them to help them feel proud of what they can do. Also, start with something simple before moving on to more challenging tasks.
  • Consider the request carefully when your child wants something. Is it outrageous? Maybe it isn’t. Choose your battles.
  • Know your child’s limits. If you know your toddler is tired, it’s not the best time to go grocery shopping or try to squeeze in one more errand if you want to prevent temper tantrums.

Stuttering in children

Stuttering in children

Is my child stuttering or is this normal?

A blog written by our Northern Beaches Sydney local speech pathologist, Michaela Spagnol.

Many parents arrive at this question when they notice their child beginning to have disfluencies in their speech. This commonly happens at a young age, when their child’s language is rapidly expanding and they are starting to put words together in longer phrases.

Determining whether your child is displaying typical disfluency or an actual stutter can be difficult and may require the assistance of a qualified Speech and Language Pathologist. Natural hesitations and repetitions are part of everyday speech for children and adults. However, the basic difference is that stuttering goes beyond natural “um’s and er’s” so much that it gets in the way of the child being able to effectively and efficiently communicate. In my experience, parents generally know when their child isn’t able to get their words out smoothly, which is the biggest indicator of a stutter.

It helps to know the various forms in which a stutter can appear. Stuttering can include:

1) Repetitions of part syllables (Ca- ca- ca- can I have one?), whole syllables (That- that- that- that one is mine), or multiple syllables (But why- but why- but why are we going?).

2) Prolongations and blocks where the child will stretch out a sound, e.g. “I’m fffffishing”, or where they appear to get stuck and no sound comes out, e.g. “I —don’t know”.

3) Extraneous behaviours that may or may not involve speech but may include grimacing, blinking, and other; mouth, eye and head movements. These are more likely to be seen in cases of severe stuttering.

Research tells us that some pre-schoolers who stutter naturally resolve but this research doesn’t tell us how to predict which children will recover naturally and which children will continue to stutter into adulthood. We are far from knowing all the answers to our questions but we do know some things including:

Stuttering runs in families and it can come on suddenly. Stuttering frequency and severity can fluctuate over time. It can be worse when children are excited or tired and is not related to children’s intelligence, language skills or speech sound production. It is likely to be a fleeting error in the way the brain plans speech.

Once it has been identified that a child is stuttering, that next question is often regarding when to begin speech therapy. It is recommended parents seek therapy if their child has been stuttering for more than 6 months, is school-aged or about to start school, is showing signs of distress and frustration when speaking or if there is a family history of stuttering. Studies show that children who stutter are more likely to be bullied by peers when compared to children who do not stutter. Beginning therapy sooner rather than later may help to avoid these negative experiences which can have a lasting impact.

Early intervention for stuttering is important for children in the same way that early intervention for language development and motor development is of crucial importance to their long term outcomes. While stuttering is not caused by anxiety, there is a link between long term stuttering and anxiety. Potential short and long-term impacts of untreated stuttering include increased social anxiety, avoidance of situations, reduced verbal output, reduced quality of life, reduced educational and employment opportunities. Consult a speech therapist about your child now.

Fortunately, evidence-based treatments for children who stutter do exist! The Lidcombe Program, developed by the team at the University of Sydney, currently has the best evidence for treating children who stutter, with a 7-8 times better chance of recovery than no therapy. Working with a Speech and Language Pathologist trained in the Lidcombe Program can help you to find some answers and give your child the support they need to be a smooth and effective communicator. Our Speech Pathologist Michaela is also trained in the Spalding method for literacy development,PROMPT therapy for speech sound disorders and the Lidcombe program for children who stutter.

If you have more questions about stuttering and the Lidcombe Program contact us today at Kids Speech Pathology. Call 9451 5735 or email us at


Kids Speech Therapy

Kids Speech Therapy

Speech and language problems are not uncommon in toddlers and young children, with one in five children showing some sort of delay by the age of 2. This delay disadvantages developing children and can impact their self-esteem and ability learning to read and write by the time they reach school.

For these reasons and others, early intervention is crucial. If you think your child has a speech or communication delay, speaking to a speech language pathologist, such as the Paediatric Occupational Therapists at Kids OT located in Frenchs Forest on the Northern Beaches of Sydney. Kids OT is a great option in helping them to function confidently, optimally and independently.

How Your Child May Benefit from Speech Therapy

So many of our experiences in the world are built around communicating with others, sharing thoughts, ideas and emotions through words and sentences. Being able to articulate, speak and understand language is paramount. Children learn from an early age to express themselves through language, which allows them to form relationships with their peers and helps them develop at school. However, a speech or communication delay can negatively impact this development and cause a child to fall behind others of a similar age, which is why early intervention and action is so important.

Toddlers and young children who have speech or communication delays or a language disorder will often work one on one with a Paediatric Occupational Therapists as part of their speech therapy. Speech therapists are trained professionals who specialise in a variety of speech, language and communication disorders for people of all ages, not just toddlers and young children. Speaking to the professionals at Kids OT will give you the insight as to what treatment would best suit your child, whether it be in a group environment or one on one with a Therapists.

What a Speech Pathologist Will Do

If your child has a speech, communication or a language problem, a Paediatric Occupational Therapists will assess their abilities and design a program tailor made to help develop the skills, abilities and confidence they need. During the assessment, the Therapists will talk with you to find out exactly what your child is having trouble with or what is holding them back, as well as learning their medical history and whether anyone else in your family has had speech or communication problems in the past.

The Paediatric Occupational Therapists might look at how your child responds to and understand instruction or questions. They might also listen to your child talking to grow their understanding of the words and speech sounds your child uses and how they communicate with others. They will then design a professional development program and work with the children and their families to enable them to achieve their true ability and excel in their communication skills.

How to Identify Speech or Communication Delays

Does your child:

Use fewer words than other children of a similar age?
Find it hard understanding what is being said to them?
Find it hard remembering or following instructions?
Show signs of frustration when they can’t express themselves?
Have a lisp?
Mispronounce words and sounds?
Struggle with reading, spelling or comprehension?

Speech Therapy at Home

If you suspect your child has a speech or communication delay we recommend taking them to a professional first, such as the Paediatric Occupational Therapists at Kids OT located in Frenchs Forest on the Northern Beaches of Sydney, 17 minutes drive from North Narrabeen and 40 minutes from Palm Beach.

However, there are speech pathology methods you can use at home.

Firstly, you should download the Linguisystems Guide to Communication Milestones:

This guide summarizes current research about what a child is typically able to do at certain ages, assuming they are developing at an average rate. This will help you identify which skills your child may need help with and give you a place good place to start improving them at home.

When starting out, you should pick 2 or 3 of your child’s areas of weakness that need improving. The best way for parents to decide which areas they should focus on is to pick what’s impacting your child and family the most. Try to avoid choosing areas that are well above your child’s age level or well above what he or she is currently able to do.

If you have any questions about our services or would like to get started with child’s speech therapy, feel free to contact us by email or phone 9451 5735 to speak with our health professionals. We look forward to meeting with you and your family to help them achieve the many benefits that effective communication can bring. It is never too early to seek advice!


fun summer day ideas for kids

Fun summer day ideas for kids

What’s the biggest struggle parents have during a hot summer day? Coming up with new kids entertainment that dosen’t involve ice cream day after day. The temperature is rising and keeping the kids in the house just causes chaos. We feel your pain. So why not embrace the beautiful Sydney sun and plan some activities for kids to get them out of the house and keep them entertained these holidays. We have 6 summer activities for a fun, kid-friendly day out.

1. Go to the beach

The beach is a great day trip for families. The sand and water should keep your kids entertained for hours. Try to plan your trip for the early morning or afternoon when the sun isn’t at its hottest to make the most of your time there. Also, ensure you pack plenty of sun protection; umbrellas, beach tents, hats, sunglasses, rashies and plenty of sunscreen! Bringing a good amount of water is another useful tip, as well as some buckets and spades for the kids to dig with. Some of our favourite spots on the northern beaches are Dee Why Beach, Bilgola Beach and North Narrabeen Beach (all of which have rock pools).

2. Get into the yard

You don’t have to leave the house to give your kids an awesome day outside. Why not get into the back or front yards and teach your kids a thing or two about gardening? Creating a little garden bed for them to plant fruit and veggies will entertain them for weeks to come as they watch their plants grow. If you don’t have a garden bed or space to make one you could use an old wheelbarrow or bathtub as a planter box. Peas, strawberries and radishes are so easy to grow that children can do it and they all grow very quickly. Some radishes can be picked in as little as 25 days! Alternatively, you could build a bird feeder with the kids to attract birds and look at them up close!

PS. Super hot day? Water balloon fights are definitely still a fun activity.

3. Visit an aquatic centre

Aquatic Centres are a great place for kids on a hot day. Save the money of paying for a summer camp and go to the local pool. They have indoor pools to get you away from the sun and the kids will love the whirlpools and slides so much they won’t want to leave! There are a bunch of centres around the north shore and northern beaches areas, including Hornsby Aquatic Centre, Warringah Aquatic Centre, Manly Andrew ‘Boy’ Charlton Aquatic Centre and Lane Cove Aquatic Centre to name a few. For a cheaper alternative, you could visit a water play park instead. Some of our favourite free local parks around Sydney are Blaxland Riverside Park in Sydney Olympic Park, Pirrama Park in Pyrmont, Putney Park in Putney and James Ruse Reserve Water Playground in Parramatta.

4. Watch a movie

Going up to the local shopping centre is always a good idea on a hot day. Just walking inside and feeling the air conditioning will put a big smile on yours and your kids faces. You should definitely have a leisurely stroll through the shops, let the kids look at the toy aisles and have a bite to eat in the food court before heading to the cinemas to unwind in front of the big screen. Some new releases that we like the look of for kids these holidays include How to Train Your Dragon: The Hidden World, Mary Poppins Returns and Ralph Breaks the Internet.

5. Visit a local library

Your local library is a great location to take the kids when the sun is sweltering. Not only do they have air conditioning to cool you down but the quiet and calm nature of a library will help you and your kids forget all about the heat outside. Let the kids explore the children’s section and find a book they want to read (or want you to read for them), find a quiet and comfy spot to sit and enjoy some relaxing summer reading time. Maybe you can find a book about a some local farmers and inspire the green thumb in your children, or a cookbook of healthy recipes you can make at home. Hint: Look for the peanut butter recipes , delicious, energy packed, and naturally yummy!

Let the kids borrow a new book when you leave so they can continue to read at home and hopefully bring that calmness of a library home with them!

6. Go bowling

Your local bowling alley is a great option for a day out with the kids. It’s a sport they can play right alongside you, with the side bumpers and bowling ramp allowing even toddlers to get in on the fun! Play a game or 2 of bowling, have a snack on paper plates and then let the kids explore the arcade games and try to win some tickets. Some bowling alleys also include laser tag for even more fun! The kids will be entertained for hours. A few bowling alleys in the north shore/northern beaches area include ZONE BOWLING Dee Why (has laser tag), Strike Bowling Chatswood (has laser tag) and Strike Bowling Macquarie (has laser tag).

We hope these 6 summer activities will help keep you and your children cool, happy and thoroughly entertained these school holidays with our fun summer day ideas for kids.


How to take a great photo with Santa and our top toy recommendations!

Christmas is no ordinary time of year, it’s the most magical time of year! The countdown is on as children eagerly await a visit from Santa and his reindeers. While it’s a happy and joyous time, for parents it can also be a very stressful one.

Santa photos make wonderful family memories, but getting the right photo can be a challenge with lots of tears and your child clinging on to you like theres no tomorrow. We have put together a few tips on how to get a great photo with Santa without it being a traumatic experience for your child.

Tips on how to take a great photo with Santa:

  1. Talk and plan the visit step-by-step before going
  2. Go at a quieter time within the shopping centre
  3. Go at an earlier time when your child is not tired
  4. Provide immediate positive reward afterwards
  5. Prepare 3 items for your child to ask Santa for

One thing children associate with Christmas is presents! As a parent, the best kind of present is one that’s fun and exciting for your child but still has educational and skill building value. Here are our top toy picks and stocking fillers recommended by our Occupational Therapists that continue to work on motor skills, information processing and concentration and are still FUN!

Kids OT top toy recommendations:

Games and activities:



Speech Therapy

One-on-One Treatment Sessions

Speech Therapy sessions are also tailored to meet individual children’s needs through developing goals closely with parents, teachers, therapists and other allied health professionals. Treatment goals are achieved through involvement in a variety of activities to enhance your child’s learning. This provides them with the tools for learning as well as strategies to assist with their performance during school and in the home environment. Therapy sessions are conducted in a fun and positive environment in our specialised sensory integration clinic and/or the school environment to assist your child in reaching their true potential run by our experienced Occupational Therapists.


Upon initial consultation, assessments are completed to determine your child’s strengths and weaknesses. Our therapists have a vast range of experience in assessing a variety of skills both formally (standardised assessments) and informally (clinical observations) including but not limited to assessing visual motor integration, visual perceptual skills, fine motor skills, fine motor strength and upper limb speed and dexterity, gross motor skills, muscle tone, body awareness, motor planning, bilateral co-ordination, scissor and handwriting skills, written expression, information processing, attention, sensory processing and more. Review assessments are conducted regularly to determine your child’s progress and refocus their goals.


Early Development of Core Muscle Tone in Infants

Wednesday, 28th March 2018

Written By: Katelyn Bentley
Occupational Therapist


The core muscles are in the abdomen, back and pelvis, and are the underlying muscles that contribute to the strengthening of all the muscles of the body. The key to developing and strengthening these muscles begins when you are a baby. Developmental milestones can give us an indication of what a baby is expected to be able to achieve at each age. As baby ages, each milestone builds upon the previous skill laying the foundation for postural control.

Below is a timeline of how babies develop postural control and reach milestones.

With no postural control, motor movements are impossible. Postural control is the foundation upon which other skills are developed and produced. Posture must be stable and ‘switched on’ to allow movements of the extremities such as the arms and legs, enabling the baby to complete complex activities such as looking around, handling objects and moving their body around.

It is essential for a baby to get as much tummy time as possible, as this is where they begin to develop and strengthen their core and postural muscles. When a baby lies on their tummy and lifts their head off the ground as a response to sounds and movements, they are using those muscles to help keep their head up high and developing their neck and back muscles. They are then expected to begin to reach for items, developing their core muscles helps them to use their arms and hands to reach and grasp. The next step of development is beginning to roll from their back to their stomach, using those core and postural muscles to assist. They then need to use those muscles to sit independently and hold their weight and heads against gravity, stabilising those muscles. Next comes crawling, which is another important milestone for children, as it develops all of the muscles around the stomach, neck, back and legs, which are essential for all activities required by children as they grow.

As posture is important for participation in all aspects of life, such as the development of a child’s attention, focus, respiration and extended movement patterns, it is essential to be developed. Posture is also an indicator of an improved life expectancy. As SID’s guidelines also currently state that babies are no longer able to sleep on their tummies, therefore there is much less incidental tummy time.

New parents can take advantage of incidental tummy time ie holding your baby on your forearm when carrying, having your baby rest on your chest rather than in the cot or carrier. As in today’s society mediums of convenience deprives us of core activation from a young age when it matters the most! We tend to carry our children in prams, carriers, capsules, bassinets and cribs, rather than taking advantage of carrying them in our arms or on our hip to support that development of core strength.

To assist your baby and infant in developing and strengthening their core you can do the following:

  • Complete activities in tummy time position
  • Complete activities in high kneeling
  • Crawl on the floor, crawl through tunnels etc
  • Complete resistance crawling (pretend you are a train and hold on to the child’s hips to give them resistance whilst they are crawling and you are crawling behind them)
  • Bouncing on an exercise ball
  • Reach and sit-ups – lie on back on the gym ball. Extend arms to reach toy/object behind and then sit all the way up and throw toy/object to partner in front of the ball. Similar activity can be completed to ‘hi 5’ partner in front of the ball.
  • Reach down and collect objects – lie child on stomach on the gym ball. Place object below. Have child roll themselves forward and collect object then lift themselves up and place in a container. Provide support by holding trunk or hips (as required).
  • Driving car on gym ball – be seated at top of the ball. Hold object as a steering wheel in the midline (middle of the body). Partner holds ankles and moves the child around. Can adjust speed and incorporate traffic lights in (green – fast, yellow – slow down, red – stop).

It is important to ensure that you make all activities fun and playful, to ensure you get the motivation from the child to complete these strengthening activities.

When completing core exercises, it is crucial that the child is breathing throughout the exercises – to make this fun, get the child to make noises, laugh, count out loud, sing a song, etc.

To further assist your baby in developing these muscles, which are needed for holding their head up in the sitting, lying and standing position, and during movement-based tasks, you can complete the following activities:


  1. Happy baby: lie flat on back on the ground and place knees to chest; babies putting their feet in their mouth or play with objects; develops the neck muscles. Ensure they get the chin tuck as it is important for eye contact and eye movements
  2. Tickle monster: lie flat on back on the ground and tickle your baby under the chin and on the feet to ensure they tuck their chin and place their knees towards their chest


Tummy time is HARD! Baby’s let you know that it’s hard, usually by crying or squirming, as they are using those core and postural muscles to help keep them in that position and lift their heavy head off the ground. If your baby is having a difficult time staying on their tummy, place a small wheat bag on the curve of their back to assist with keeping their hips aligned to the floor.


Tummy time is good for establishing the prone extension position, which is a fundamental position for development. It is also important for connecting the eyes, as the baby learns to turn their head from side to side and connect their eye movements whilst visually scanning. It also provides a base for development of shoulder strength which further assists with fine motor skill development.

Activities to make tummy time fun:


  1. Funny faces: Get face to face with your baby and make funny faces to each other; turning upside down etc
  2. Completing simple puzzles in the tummy time position


Imagine what it is like for a child who never develops their Postural reflexes for head movement or is delayed. They may not have muscle movement to lift their head to look at the teacher or to move their head back and forth for reading and writing


Once these milestones have been achieved, and the core and postural muscles are beginning to strengthen, they are assisting children with forming foundations for skills such as fine motor skills, feeding, tabletop activities, gross motor skills, attention, concentration, self-care skills such as dressing.



Sharma, A., Cockerill, H., Ōkawa, N., & Sheridan, M. D. (2014). Mary Sheridan’s from birth to five years: children’s developmental progress (Fourth). London: Routledge.


Adolph, K. E., & Franchak, J. M. (2017). The development of motor behavior. Wiley Interdisciplinary Reviews: Cognitive Science, 8(1–2), e1430–n/a.


Red Nose. (2018). Education, brochures download. Retrieved from Red Nose website:




Core and Postural Tone: Myths and Facts

Written by: Cameron O’Reilly

Paediatric Occupational Therapist (BOccThpy)

9th February, 2018

What is core and postural tone?

Muscle tone is the ability of a muscle to resist a force for a period of time. Core and postural tone refers to the muscles surrounding the spine that hold our body upright. But what does this mean for children? How does this effect children within the classroom and does it have anything to do with their handwriting? We first need to look at the human anatomy to understand where the muscles are located.

The core muscles of the human body are located within the abdominal area of our body and postural muscles along the back of the spine. As seen in the picture below, the highlighted muscles are used to support a child’s posture. These muscles must resist gravity and hold the child’s weight when in a seated position.

Other vital core and postural muscles are located in the neck:

As seen above, these particular muscles are located around the neck and maintain an upright head position in conjunction with the trunk and support stability.

Why is core and postural tone functionally important?

One of the most important functions of core and postural muscles is to flex (move trunk forwards), extend (move trunk backwards) and stabilise the spine. These muscles described earlier work against gravity and are continually active to maintain posture. For a child this occurs when seated at the desk, sitting for floor time and when standing in line. This stable base of posture is imperative for ensuring the child is at an adequate height to perform writing tasks. Children lacking core and postural tone may slouch/lay over the table, even placing their head down or stand when completing desk activities. This can greatly effect written work, as sitting in a seated position (as pictured below) is essential for ensuring handwriting mechanics are correct.

During floor time activities, children with low postural tone may appear to lay on the ground or lean/collapse on other nearby children, causing further distraction. As a lack of tone will result in reduced endurance, increased distractibility may occur from being unable to maintain a still seated position. This further compromising exposure to table top activities thereby reducing opportunities for development. As the human body develops from proximal (close) to distal (far), it is important to develop this stable base. As children with reduced core and postural tone often present with reduced muscle tone in other areas of the body (e.g. hands, fingers, arms, legs). This can further lead to difficulty in other areas such as handwriting, sports activities, coordination and self care.

My child does soccer, ballet, netball, gymnastics and swimming how can they have low core?

Extra-curricular activities are great for supporting a child’s physical and social development. However, whilst these activities are beneficial for muscle development, they may not specifically target previously mentioned muscles to the fullest extent. When deficit does occur specifically within core, neck and postural muscles, often extra-curricular activities will be too general and will not provide enough targeted endurance to allow these muscles to meet milestones.

How do we improve core and postural tone in Occupational Therapy?

Intervention within Occupational Therapy targets these muscles directly within fun, active activities to promote engagement of the children. Additional activities can be seen pictured below;



Cannonballs are performed using a gym ball whilst laying with knees together and on elbows with an upright head position. This targets the postural muscles on the front the body/neck.


Supermans are performed by having the child lay on their tummy with head facing forwards with straight legs and adequate height between legs/arms and ground. This targets the postural muscles on the back of the body/neck.

Alongside this, KidsOT therapists are able to provide K-Tape (Kinesio Tape) services to further support development of the muscle. K-Tape is placed at the origin and insertion of the targeted muscle, on top of the muscle body. K-Tape works by providing proprioceptive (muscle to joint) input to extend muscle length to its potential and provide greater awareness of the muscle. K-Tape can also provide further benefits of lifting the skin between skin and muscle to allow for smoother movements and increased blood flow causing improved muscle repair.


If you have any concerns about your child’s core and postural tone, give our team a call and we’ll be happy to see how we can help.




  1. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. Phys Sportsmed. 2012 Nov;40(4):33-40. doi: 10.3810/psm.2012.11.1986.
  2. A systematic review of the effectiveness of Kinesio Taping–fact or fashion? Eur J Phys Rehabil Med. 2013 Oct;49(5):699-709. Epub 2013 Apr 5.
  3. Brookbush, B. (2017). Kinesiology of the Trunk. Retrieved from Brookbush Insitute:
  4. Liebman, H. L. (2013). Anatomy of Core Stability. Heatherton: Hinkley Books.



Working Memory

Written By Elissa Burleigh

9th January 2018


What is Working Memory?

Working memory is the ability to hold information in our minds, while also manipulating this information to use it for a task. It is a form of short-term memory which is essential for completing many functional tasks.

Why is Working Memory Important?

Working memory is highly important to many tasks and skills, including social engagement, academic learning and ability to complete activities of daily living. This is because working memory allows a person to hold onto information that is essential to a task, while engaged in different activities or different parts of the task. For example, when writing a story, working memory will allow a child to remember the sentence that they were intending to write while asking the teacher how to spell a specific word in the sentence.

Examples of Tasks for which Working Memory is Needed:

  • Following multi-step instructions: a person needs to be able to hold all of the steps of an instruction in their mind, while also carrying out the steps of an instruction.
  • Written expression: a person needs to be able to hold the overall plan for their written piece (e.g. narrative, recount, etc.) while also composing each specific sentence. A person also needs to hold the sentence that they intend to write in their mind, while also putting cognitive effort into how they are holding their pencil, how to form each letter, how to spell each word, how to use correct grammar and punctuation, etc.
  • Retracing a route: in order to return home from somewhere that you have gone for the first time, a person not only has to hold the original directions in their mind but also need to reverse the directions to retrace the route.
  • Engaging in games or sports: a person needs to be able to hold all of the rules of the game in their mind, while also carrying out the steps of the game. When rules change, they also need to hold these changes in their mind.
  • Retelling a story or event: in order to tell someone about a story or event, a person needs to be able to recall what happened, while also composing and sequencing sentences in order to explain it to another person in a way that makes sense.

What does a child with difficulties with working memory look like?

  • The child may often lose the goal of the task that they are engaged in: For example, they may have intended to write a recount, but then start writing about things that are going to happen in the future. This is because they were not able to hold the goal of the task in their mind (writing about things that have already happened) while also completing the task.
  • The child may have difficulty following multi-step instructions: For example, the child may only be able to complete the first step of the instruction, as they are not able to hold the other instructions in their mind while completing this step.
  • The child may appear to have poor focus and attention: If a child is losing the goal of tasks and having difficulty holding onto instructions, then this may come across as poor focus and attention, as they frequently do not stay on task or finish tasks.
  • The child may have difficulty with place-keeping within a task: If a child has difficulty remembering where they are up to, they may be observed to omit letters/words or repeating letters/words.

Strategies to Improve Working Memory

  • Ask the child to repeat the information back to you out loud five times before beginning. E.g. when you give them an instruction, ask them to repeat it back to you five times before they start.
  • Ask the child to shut their eyes and picture the information in their head, or visualise themselves drawing the information onto a pretend whiteboard in their head.
  • If the child says they cannot remember something (e.g. the instruction that they repeated back to you), then gently prompt them to “think to remember” and then allow them time to think. They may just require a bit of extra time to retrieve information from their memory.

Activities to Improve Working Memory (incorporating the strategies above)

  • Verbally present the child with three objects/animals, and then ask them a question about this information. E.g. “Chicken, cow, ant. Tell me which one is the biggest. Now tell me which one comes first in the alphabet”. If three animals/objects are too easy/hard, then increase/decrease the number that you give them.
  • Verbally give the child a multi-step maths equation to complete. E.g. “2+1+3”. Increase/decrease the number of numbers in the equation, or the difficulty of the equation, as necessary.
  • Ask the child to spell words backwards. Choose words that they are already able to spell. To increase the challenge, teach the child how to spell a word, and then ask them to spell it backwards.
  • Complete categorisation tasks. E.g. present the child with picture cards and ask them to put them into two categories. When they have done this, ask them to develop two new categories. Keep repeating this until they are unable to continue developing new categories, and then start giving prompts to help them to continue a few more times.
  • Ask the child to say the days of the week backwards. Make it more difficult by asking them to say the months of the year backwards.
  • Take the child’s favourite song, and ask them to say a line from the chorus backwards. E.g. “you, to, birthday, happy” for “happy birthday to you”.



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