Pediatric Precautions/Activities

Question 1

Muscle Strength
Precautions: Watch for fatigue, shortness of breath, do not offer resistance in the presence of abnormal tone or edema, monitor for pain

Answer 1

Activities:
1. Use a pair of tongs to pick up pom poms and place them in a bottle (Remedial)
2. Go to playground and have child use equipment such as monkey bars, going up stairs to use slides, etc. (Remedial)
3. Do some gardening by digging, carrying some gardening tools, and planting seeds. (Remedial)
4. Tug of war-take a strong piece of fabric or a towel and play tug of war (remedial)

Question 2

Endurance/Activity Tolerance
Precautions: Watch for fatigue, shortness of breath, dizziness, orthostatic hypotension, monitor for pain

Answer 2

Activities:
1. Have dance parties-start with shorter songs and gradually move up to longer songs to dance to (remedial)
2. Play red light green light (remedial)
3. Play jump rope-see how long the child can jump for without stopping. (Remedial)
4. Jump on a trampoline or play hopscotch. (Remedial)

Question 3

Abnormal Tone-Flaccid
Precautions: Do not offer resistance, watch for subluxation/dislocation, do not overstretch muscles, prevent contractures, no MMT, monitor for pain

Answer 3

Activities:
1. Tummy time on yoga ball (for infants) Remedial
2. Do kid friendly yoga positions (child’s pose, cat cow, etc) Remedial
3. Fish for puzzle pieces with magnetic fishing rod while standing on a wobble cushion. Remedial
4. Thread beads onto a string (Remedial)

Question 4

Abnormal Tone-Spastic
Precautions: Do not offer resistance, no MMT, prevent contractures, prevent increase of abnormal tone, do not overstretch muscles, monitor for pain

Answer 4

Activities:
1. Do slow rhythmic movements in developmental patterns (Remedial)
2. Incorporate gentle massage into a simple activity such as playing with play-doh. (Remedial)
3. Play with soothing textures such as rice, beans or sand (Remedial)
4. Do calming breathing exercises while listening to slow, soft music.

Question 5

FMC Skills
Precautions: monitor for fatigue, monitor for overstimulation, monitor for pain, monitor for inflammation, prevent joint/movement abnormalities

Answer 5

Activities:
1. Pick up popsicle sticks and insert them into a bottle through a slit made in the cap (remedial)
2. Roll, squeeze and shape play doh in different ways (remedial)
3. Place cheerios or froot loops on a pipe cleaner. Remedial
4. Have child cut along different lines or shapes. Remedial

Question 6

GMC Skills
Precautions: monitor for fatigue, monitor for overstimulation, monitor for pain, monitor for inflammation, prevent joint/movement abnormalities, monitor for orthostatic hypotension, monitor for imbalance/falls

Answer 6

Activities:
1. Have the child throw a ball into a laundry basket, then switch to kicking it in the basket. (Remedial)
2. Crawl through a tunnel to complete a puzzle. Choose 1 puzzle piece, crawl through the tunnel and insert into the puzzle board at the other end. Remedial
3. Play a game of “Simon Says” that involves lots of different movements. Remedial
4. Hop on one foot to take a ball and drop it into a basket. Alternate feet on each pass. Remedial

Question 7

Visual Perceptual Skills
Precautions: Monitor for vertigo/dizziness, monitor for autonomic disturbance, prevent/monitor for overstimulation, prevent/monitor for fatigue, monitor for safety awareness

Answer 7

Activities:
1. Have the child copy a pattern made with blocks. Remedial
2. Play a matching game with cards. Remedial
3. Play “I spy” to have child search around the room for different objects. Remedial
4. Scatter puzzle pieces around the room and have the child search for the pieces and insert them into the board one by one. Remedial

Question 8

Trunk Control
Precautions: monitor for imbalance/falls, monitor for safety, monitor for fatigue, monitor for pain, enforce proper positioning

Answer 8

Activities:
1. Have the child sit on a therapy ball and have them reach for window stickers, Have them reach to either side to place the stickers on a window (remedial)
2. Wheelbarrow walking race to one end of the room and back (remedial)
3. Have the child lie in prone on a scooter board and retrieve toys scattered across the room. (Remedial)
4. Have the child kneel on a cushioned surface and have them reach for items above their head or to their side (remedial)

Question 9

Sitting Balance
Precautions: monitor for fatigue, monitor for falls, provide adequate supports, monitor for pain, monitor for orthostatic hypotension,

Answer 9

Activities:
1. Play a pretend rowing game by using a rope or resistance band and have the child pull it towards them. (Remedial)
2. Play hot potato with a small group to encourage trunk rotation (remedial)
3. Play musical chairs (Remedial)
4. Sit a child in a chair and place a mirror in front of them and have them try to mimic different movements to challenge sitting balance (remedial)

Question 10

Standing Balance
Precautions: monitor for dizziness, monitor for orthostatic hypotension, monitor for fatigue, monitor for pain, monitor for autonomic disturbances

Answer 10

Activities:
1. Create a “road” for the child to walk along heel-to-toe. Have them walk to the end of the road to retrieve a preferred item and bring it back with them (remedial)
2. Sing a song and have the child march in place and follow movements with the upper extremities.
3. Blow up a balloon and encourage the child to kick the balloon for as long as they can without letting the ball touch the floor.
4. Encourage sideways walking and introduce small obstacles for the child to step over .

Question 11

Cerebral Palsy
Precautions: Monitor for abnormal tone, do not offer resistance in the presence of abnormal tone, monitor for fatigue, monitor for pain, monitor for imbalance/falls, monitor for inflammation, watch for aspiration precautions, prevent contractures

Answer 11

Activities:
1. Do sponge painting with a cut up pool noodle to promote grasp. (Remedial)
2. Hula hooping to promote core strength/coordination (Remedial)
3. Play kid-friendly darts with a felt board and velcro “darts” (remedial)
4. Create a sensory bin with water beads, sand or pom poms (remedial)

Question 12

Autism
Precautions: Prevent/monitor for overstimulation, monitor safety awareness, monitor for reactions to loud environments/loud noises, watch for mouthing/chewing of inedible objects, monitor for behavioral issues (frustration, aggression, etc)

Answer 12

Activities:
1. Sort candies or fake fruits by color (remedial)
2. Complete an obstacle course by having the child crawl through a tunnel, under a chair, and then jump on a trampoline or couch. (Remedial)
3. Play with magnetic tiles to create a tower (remedial)
4. Put up pictures of different animals all around a room, turn off the lights and use a flash light to find the animals that were scattered around the room (remedial)

Question 13

Brachial plexus injury
Precautions: Monitor for pain, monitor for safety (numbness), monitor for/prevent contractures

Answer 13

Activities:
1. Incorporate passive range of motion into an ADL such a dressing. (Remedial)
2. Weight bear into affected limb by pushing up from a therapy ball or crawling from area to another (remedial)
3. Stimulate the affected arm/hand with a soft brush, or soft fabrics (remedial)
4. Use a rolling pin to roll out pieces of play dough (remedial)

Question 14

Prader-Willi Syndrome
Precautions: Do not offer resistance, watch for subluxation/dislocation, do not overstretch muscles, prevent contractures, no MMT, monitor for pain, monitor for behavioral issues, monitor for issues with sleep, monitor for food-seeking behaviors.

Answer 14

Activities:
1. Follow a simple recipe to prepare a healthy snack (remedial)
2. Use tongs/tweezers to pick up small toys or pom poms and sort them by color.
3. Place the child in a swing or in a blanket (in supine) and have 2 adults swing the child back and forth.
4. Play a simple card game or board game to encourage turn taking and following rules.

Question 15

Rett Syndrome
Precautions: monitor for pain, monitor for joint stiffness, watch for issues with breathing, monitor for seizures, monitor for safety awareness (diminished pain response), check for aspiration precautions.

Answer 15

Activities:
1. Encourage the child to blow bubbles to strengthen oral/facial muscles (remedial)
2. Visual stimulation with black/white activities or toys (remedial)
3. Make a. “No bake” cake in a microwave. Have the child mix the ingredients/pour with assistance if needed (remedial)
4. Use a pegboard to insert pegs and have the child reach to remove them from a vertical surface (remedial)

Question 16

Down Syndrome
Precautions: Do not offer resistance, watch for subluxation/dislocation, do not overstretch muscles, prevent contractures, no MMT, monitor for fatigue, watch for safety awareness

Answer 16

Activities:
1. Use dot markers to encourage the child to raise and lower their arm to create dots on a paper (remedial)
2. Play a memory game with memory cards (remedial)
3. Create an herb garden, create labels for each herb on popsicle sticks. Create a schedule for when to water the plants (remedial)
4. Insert different sized coins into a piggy bank. You may also incorporate counting or sorting into the activity. (Remedial)

Question 17

Fragile X Syndrome
Precautions: Watch for behavior issues (frustration, anxiety, depression, obsessive compulsive behaviors), Prevent/monitor for overstimulation, monitor safety awareness, monitor for reactions to loud environments/loud noises, watch for mouthing/chewing of inedible objects, monitor/prevent subluxation/dislocation, do not offer resistance in the presence of abnormal tone

Answer 17

Activities:
1. Practice using glue and scissors during an arts & crafts activity. (Remedial)
2. Coordinate a group art project to encourage social interaction (remedial)
3. Hop through hula hoops placed on the ground (remedial)
4. String beads to help with fine motor coordination, change the size of the bead to upgrade or downgrade (remedial)

Question 18

Seizure disorders
Precautions: Avoid flashing lights or visual stimulus that spins, monitor for proper positioning during a seizure, be aware of medications that may trigger seizures, watch for fevers, watch for abnormal blood sugars, monitor HR & BP

Answer 18

Activities:
1. Play with kinetic sand and create sandcastles with different molds (remedial)
2. Create a visual schedule with the child’s help decorating/drawing (remedial)
3. Created scented rice with calming essential oils, just be sure to watch for skin allergies (remedial)
4. Do a scavenger hunt outside to find different outdoor items (remedial)

Question 19

Fetal Alcohol Syndrome
Precautions: Watch for issues with coordination, monitor for behavior issues, avoid overstimulation, monitor for safety awareness, monitor for falls/imbalance

Answer 19

Activities:
1. Create a sensory bin with beans or pasta to help with sensory exploration (remedial)
2. Promote the use of a stress ball, fidget toys or breathing techniques to promote self regulation (compensatory)
3. Have a basket full of different foods and sort by fruits/vegetables or by color. (Remedial)
4. Build a simple lego figure by following the instructions booklet (remedial)

Question 20

Sensory Processing Disorder
Precautions: Prevent/monitor for overstimulation, monitor safety awareness, monitor for reactions to loud environments/loud noises, watch for mouthing/chewing of inedible objects, monitor for behavioral issues (frustration, aggression, etc), Watch for sensory avoiding behaviors

Answer 20

Activities:
1. Create “noisy” toys by putting beans or rice into a toilet paper roll and sealing both ends (remedial)
2. Create an image using different colored straws.
3. Create scented play doh and have the child explore the different scents (remedial)
4. Have the child push/pull a laundry basket filled with towels to provide proprioceptive input (remedial)

Question 21

ADHD
Precautions: Avoid overstimulation, avoid having too many distractions when attempting to focus, watch for safety awareness, watch for behavioral issues

Answer 21

Activities:
1. Play Simon says and gradually increase the amount of time the game is played for (remedial)
2. Place letters around a room and have the child jump to each letter and name the letter as they go (remedial)
3. Play a game to have the child list as many animals as they can in 60 seconds (remedial)
4. Place light plastic balls into a large bin with water and have the child scoop the balls with a large kitchen spoon into a muffin tin. (Remedial)

Question 22

ADD
Precautions: Avoid overstimulation, avoid having too many distractions when attempting to focus, watch for safety awareness

Answer 22

Activities:
1. Build a fort out of cardboard and create a space with less distractions (compensatory)
2. Make a paper airplane by following instructions and then fly the airplane outside.
3. Have the child point out their top 5 favorite things that they see outside and have them take photos of those items.
4. Paint by numbers with watercolors (remedial)

Question 23

Spina Bifida
Precautions: Monitor for seizures, monitor skin integrity (incontinence), monitor for fatigue, prevent joint deformity/dislocation, monitor for imbalance/falls

Answer 23

Activities:
1. Use modeling clay to create animals (remedial)
2. Play bowling with 2 liter bottles and a ball (remedial)
3. Play an adapted version of “Simon says” to move body around while seated or while in a wheelchair (compensatory)
4. Do different yoga poses with the help of pillows or bolsters.

Question 24

Muscular Dystrophy
Precautions: monitor for fatigue, monitor for orthostatic hypotension, prevent/monitor for contractures, monitor for imbalance/falls, monitor for pain, watch for issues with breathing, watch for aspiration precautions, monitor HR/BP

Answer 24

Activities:
1. Play different sports using a Wii or VR system without straining the muscles (compensatory)
2. Practice using build up/adaptive utensils by having a tea party and pretend feeding preferred toys/stuffed animals (compensatory)
3. Play a wind instrument like a recorder, harmonica or flute to work
4. Play a large scale version of tic tac toe (remedial)