Meeting Milestones in a Covid World; How PT and OT Services Can Help

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PT and OT services for milestones

Have you ever wondered if your child is developing appropriately?  Sometimes a developmental delay is obvious—but a lot of times it looks subtle. That voice is your head says, “Is this normal?”  As parents we second-guess ourselves all the time. There is so much natural variation between kids. Often we convince ourselves that “it’s nothing” or on the flip side of the coin, that something is ‘wrong’ when it’s really not.  It can be hard to tell if we’re being too vigilant, or not proactive enough. Just add it to the list of things parents have to worry about!

If you’ve ever wondered if your child might need extra help meeting motor milestones, self-care and daily activities, fine motor skills, or regulating their energy and sensory system—physical therapy (PT) or occupational therapy (OT) may be able to help!

There is a lot of overlap in children with PT and OT services.  Generally speaking, when it comes to motor development, a PT works on gross motor, or big body movements, whereas an OT works on fine motor skills, eye hand coordination, and dexterity.  Activities of daily living (dressing, toileting, feeding) all generally fall under the umbrella of OT as well.  When it comes to the sensory system, both services can address these issues; since sensory regulation and awareness also affects balance and coordination!

We’ve been living in an isolated world for some time now. Here are some strategies to work on motor skills in a covid-19 world from Superior Outcomes LLC, which has a pediatric home-based program called “Mobile Milestones”!

Some gross motor suggestions from a physical therapist to build strength & coordination:

  • Obstacle course in your living room. Climbing underneath chairs, walking over pillows, use painter’s tape to put a line on the floor, stepping up/down on diaper boxes.
  • Pretending to be an animal! Crab walks, bear walks, standing on one leg like a flamingo, down dog/up dog, cat/camel stretch.
  • Explore outside! Hiking trails, up/down hills, walking on sand and mulch.
  • Try some wheels! Scooter boards, bikes, pulling a wagon, scooters.
  • Playground skills: hang from the monkey bars, help them climb the rock wall/ladders, challenge kids to do a swing with less assistance, climb the slides!

Some suggestions from an occupational therapist to regulate sensory system and build fine motor skills:

Let’s start with learning environment; this is more relevant than ever these days in relation to PT and OT! 

  • Body positioning with focus 90-90-90–your child should be positioned with feet supported, knees at approximately 90 degrees, with screen at eye line or higher to promote good posture for learning.
  • Fine motor manipulatives paired with concepts, or fidgets to help focus. Have your child count cereal, beads, or something they can touch!
  • Vary their sitting surface (yoga ball, standing up) and use snacks and drinks: cold drinks, crunchy snacks can help kids focus. Think about the overall room temperature, not too hot cold.
  • Try a visual calendar/schedule so kids know what’s coming, balance structured activities with unstructured.

Children can be hypo-responsive or hyper-responsive; is your child sensitive to noises and smells? Here’s some things to try to help regulate your child’s sensory system—remember every child is different so see how your child reacts!

  • Weighted vests/stuffed animals/backpacks, compression
  • Swinging (all directions, try a swing or blanket, in all positions!)
  • Spinning
  • Pushing or Pulling of a wagon/stroller/using bands to push against resistance
  • Carrying heavy items like water jugs/milk jugs
  • In the snow, have them drag their own sled!
  • Sensory play (sand, rice, beans, water beads, water, shaving cream)
  • Weightbearing through open palms (yoga, there’s a great Frozen yoga on YouTube!)

Hopefully these tips and tricks help your kiddos get moving!!!


If you have concerns about your child’s development, call Superior Outcomes’ Mobile Milestones Program at (401) 733-3225 for more information about PT and OT, and for help navigating the assessment process. We treat kids of all ages and abilities. We can help!

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Laura is a thirty-something mom of 2, living in Cumberland RI—only 3 miles from her childhood home. After meeting her husband and briefly living in Plymouth MA, she dragged him back with her to Rhode Island, where they bought their home. Laura attended the University of Rhode Island for both her bachelor’s degree in Human Development and Family Studies and her doctorate in Physical Therapy. She and her husband tied the knot in 2015, and welcomed their first son in 2016. They recently added another son to their family in late 2018, and Laura enjoys being the only woman in her house—the queen of the castle! She works as a physical therapist in an Early Intervention program, work that is challenging and that she loves. E.E. Cummings once wrote “The most wasted of all days is one without laughter,” and these are words that she tries to live by daily.