Tier OT Services, PC

01/15/2026

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01/15/2026

10 reasons to incorporate prone extension into the day!
1. When the neck is in extension, the brain stem is activated, which in turn promotes self-regulation.
2. Promotes nervous system organization.
3. Prone extension and full body flexion are foundational skills for gross motor development and quality of movement.
4. Supports overall sensory integration
5. A great dose of full body proprioceptive input
6. Promotes and supports body awareness and motor planning
7. Works on core strength
8. Promotes ocular motor development
9. Supports shoulder girdle strength and stability (essential for writing skills and fine motor development)
10. It's easy to incorporate throughout the day, it's free, and fun!

01/15/2026

Attn: parents & OT/PT friends! ✅

Children with CP have 41% LESS muscle growth in their lower limbs.

In this MRI study, those who’d ever had Botox below the knee clustered around the 6th centile for calf muscle growth. Those who’d never had Botox were closer to the 19th centile, while height and tibia growth were similar in both groups.

Is this just CP’s natural history… or are repeated Botox cycles contributing to slower muscle growth?

In all fairness - kid with more severe spasticity maaaay have been more likely to have Botox BUT one thing we can say for sure - Botox is NOT leveling the playing field - at all!

I'll say it again - the cost, risk, trauma, and potential harm of Botox should make you stop and think if the benefits (or lack there of) are worth it (despite their lovely big green circle above the worth it line in Novak's State of the Evidence)

Kids were age between 8 - 18 yrs (n = 66), almost two-thirds were GMFCS Level I, with the rest mostly Level II. Topography was mixed — hemiplegia and diplegia were most common, and over two-thirds of the kids received Botox

https://www.nature.com/articles/s41390-025-04558-0?fbclid=IwY2xjawPCULxleHRuA2FlbQIxMABicmlkETFlQlg1T0VBZzFmUzROV2lJc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHg9-d0bm1iLyVyawgNNyiktQAsoN52A33XfKKfYmSrJGOquRrT07-pPK9rBS_aem_Gqe_Z21-Lio30qdxiVj2Sg

01/15/2026

110% 🙌🙌🙌

01/14/2026

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There can be many reasons a child becomes dysregulated.

Not everything is sensory.

A child might be struggling because they are:
• emotionally overwhelmed
• overtired or didn’t sleep well
• hungry, sick, or uncomfortable
• still building rapport and trust
• lacking structure or predictable routines

In my 10+ years in school-based OT, I’ve seen a huge increase in how quickly we jump to sensory. And while sensory strategies are powerful, they’re not always the whole answer.

Sometimes that pressure to find a quick sensory fix can even make therapists feel like they’re failing. When in reality, many regulation challenges don’t have a single simple solution. More often, it’s a combination of factors that requires a team approach, including teachers, families, and behavior specialists.

Some behaviors are not automatically sensory-based:

• crying when told “no”
• hitting, pushing, or biting when a toy is taken
• throwing materials when asked to clean up
• melting down after losing a game
• refusing to leave a preferred activity

These moments are often about emotional regulation, frustration tolerance, impulse control, and coping skills, not sensory input.

Self-regulation is absolutely critical for our students.
But sometimes it’s more than sensory and that’s okay.
It just means the support needs to be broader, deeper, and more collaborative.

💛

01/09/2026

Wow! This is an incredible resource!!

>>> https://www.educatorstechnology.com/2022/07/a-handy-chart-featuring-over-30-ipad.html

01/09/2026

01/06/2026

One key component to fine motor strength, endurance, and dexterity is refined arches.

"Hand arches refer to the curved surfaces of the palm of the hand, in three distinct planes, or curved places on the hand. The ability to control the hand arches allows the hand to mobilize and hold a variety of objects of different sizes.

Refined hand arches allow the hand to cup water, hold a few coins, gently hold a small firefly, or curve the hand on a golf ball or basketball.

These hand arches are called:

✋Proximal transverse arch- formed by the metacarpophalangeal joints (MCP joints) These are the joints at the base of each fingers. This arch does not mobilize as much as the other two arches, and offers stability.
✋Distal transverse arch- formed by the distal row of carpal bones. These bones make up the wrist.
✋Longitudinal arch- follows the curve of the fingers of the hand, from wrist to MCP joints."

Here's everything you need to know about hand arches: https://www.theottoolbox.com/development-of-hand-arches/

12/13/2025

12/13/2025

‼️ New open access research in Brain Sciences offers a clear decision guide to help primary care notice sensory integration needs early, and refer to Occupational Therapy with Ayres Sensory Integration training.

Impacts for practice:

⭐ Clearer referral criteria
⭐ Informed use of SP-2 or SPM-2 to support judgement
⭐ Co-produced plans centred on everyday participation
⭐ A shared pathway for GPs, Health Visitors and School Nurses to the right OT service

This complements co-produced tools like Sensory Ladders, Sensory Spiders and Sensory Grids used by therapists, parents and teachers.

Read the article: https://www.mdpi.com/2076-3425/15/11/1184