Monthly Archive

Pediatric Therapy Corner: By Hand

By: Loren Shlaes, OTR/L

“Man, through the use of his hands, as they are energized by his mind and will, can influence the state of his own health.” {Mary Reilly, 1962}

In order to do and be our best, everyone needs plenty of sleep, fresh air, exercise, and healthy food.

We also have needs that are less tangible, but no less important, as one of my young friends reminded me this past week. She is a little girl who strikes me, in addition to her sensory processing issues, as being lost and depressed. Her parents are divorced, her father lives far away, and her mother travels all over the world for her work. She is often in the care of nannies. Her attitude is habitually one of indifference, which I think she adopts as a form of emotional protection, and I have found it especially challenging to form a warm connection with her. She may or may not answer when she is spoken to, and if she leaves the gym to get a drink of water, she may or may not decide to return, but instead wandersinto the office area and goes through the items on my colleagues’ desks until I go find her and bring her back.

When I first evaluated her, I was quite concerned about her handwriting, so our work together has always included time spent correcting her habits of letter formation and her tendency to reverse letters and numbers. Her participation in OT has generally been perfunctory and she has rarely made eye contact or initiated any conversation with me.

A couple of weeks ago, coming down with a bit of spring fever myself, I decided to give us both a break from writing and pulled out a potholder loom. I was mainly thinking about how improving her eye hand coordination and the motor planning in her fingers would support my writing goals. I was halfway expecting her to tell me she wasn’t interested and that it looked too hard. To my surprise, she dug right in and worked with absorption and intensity, although weaving the loops correctly was quite challenging for her and she made many mistakes that she had to go back and fix.

The next week, as I pulled out the loom, she sighed happily, “I can’t wait to take this home!” and wove with furious concentration for 15 minutes without a break. When it was time to go, she ran to her nanny for a hug, something I had never seen her do before.

This child needed to connect to a part of herself where no one had abandoned or neglected her, and nothing irritated her skin or hurt her ears.

Through the act of weaving, she discovered that she could tackle an unfamiliar task and stay with it until she had mastered it. She could create something unique by making choices while staying within a specific, structured set of rules. She could recognize and correct her own mistakes, gaining a sense of accomplishment and independence. She could make a positive impact on her environment with a tangible result, transforming a shaggy, chaotic pile of loops into an orderly piece of fabric.

She could look forward to showing her finished project to her admiring nanny, brother, and mother with pride, dropping her pretended indifference.

Using her will and imagination to direct the work of her hands, she opened the door to a whole colorful, creative world inside of herself, and could begin to heal.

Crafts and hobbies allow us to connect to the deeper parts of ourselves. Becoming absorbed in the act of creation helps refresh and renew our minds and spirits and recharge from the stress of every day life. Planning, organizing, making choices, solving problems, using our hands in skilled pursuit of a goal, and looking forward to the reactions of our loved ones as they admire the finished results of our hard work can be an enormous source of pleasure, satisfaction and pride. The special needs children I work with tend to have a severe shortage of pride and satisfaction in their lives.

Children with sensory processing issues who struggle in school, and who are consistently unable to meet the grown ups’ expectations, are particularly vulnerable to succumbing to the belief that they will fail. Success at a craft, with a tangible result, can be a huge boost to morale and very motivating.

Just as it’s important to work on correcting a child’s impairments, it’s critical to help him identify, and practice utilizing, his strengths. A child who feels useful, competent, and confident in his abilities is a child who has the internal resources to face a challenge thinking “I can!” instead of “I can’t.”

Featured Author: Loren Shlaes, OTR/L

Many thanks to Loren Shlaes for providing us with this article for our newsletter and website.

Loren Shlaes, OTR/L is a pediatric occupational therapist specializing in sensory integration and school related issues, particularly handwriting. She lives and practices in Manhattan. She blogs at

PediaStaff hires pediatric and school-based professionals nationwide for contract assignments of 2 to 12 months. We also help clinics, hospitals, schools, and home health agencies to find and hire these professionals directly. We work with Speech-Language Pathologists, Occupational and Physical Therapists, School Psychologists, and others in pediatric therapy and education.


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