Children at Play

Occupational Therapy for Kids
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Children at Play provides children’s occupational therapy services in Anne Arundel County. Our Blog covers sensory processing (SPD), sensory integration techniques, autism therapies, home exercise programs, and more.

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Summer Teen & Pre-teen Social Groups

Sam Hyali June 11, 2025

Fun Summer social club for neurodivergent teens & preteens in Annapolis, MD.

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Teen & Pre-teen Social Groups in May 2025

Sam Hyali April 15, 2025

Fun social clubs for neurodivergent teens & preteens in Annapolis, MD.

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Open House - May 4th

Sam Hyali April 11, 2025

We're so excited to welcome families, community members, and fellow providers to our new space and celebrate with you all. This open house is a wonderful opportunity to connect with our team, learn more about our services, and see the play gyms.

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My First OT Appointment Social Story

My First OT Appointment - Social Story

Sam Hyali April 9, 2025

Starting Occupational Therapy (OT) can be a big step for both parents and children. Recognizing that new experiences can be challenging, especially for many of the children we work with, we've created a social story, a great OT tool,  about their first OT appointment. This social story, filled with photos of our clinic, play areas, and tools, provides a visual walkthrough of what to expect. 

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What to

Expect

at your Child’s Occupational Therapy Consultation

What to Expect at your Child’s Occupational Therapy Consultation

Sam Hyali March 26, 2025

Your Child's Therapy Consultation: Tour our play gyms, understand our evaluation process, and learn how we support your child's development. Discover our unique approach to assessing motor skills, sensory processing, and more. Explore our specialized gyms designed for kids' growth.

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Moving

Social Story

We Are Moving to a New Building! - Social Story

Sam Hyali March 23, 2025

We've moved to a bigger, brighter clinic designed just for YOU! Come explore our spacious new play areas, filled with exciting toys and activities to help you learn and grow. We can't wait to see you smile and discover new things in our welcoming and fun-filled space.

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Our Favorite Books for Neurodivergent Kids

Sam Hyali January 8, 2025

A collection of children’s books that celebrate the diverse experiences and strengths of neurodivergent children. 

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Child playing a board game to work on executive functioning skills

Family Play

Nurturing Skills Through Board Games

Family Play: Nurturing Skills Through Board Games

Sam Hyali November 9, 2024

Board games are more than just fun—they're fantastic tools for learning and development. These are our favorite board games to play with kids to build a variety of skills, including social, fine motor, visual-spatial and executive functioning.

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Teen & Preteen Social Groups

Sam Hyali September 20, 2024

Fun social clubs for autistic teens & preteens in Annapolis, MD.

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Parents of Neurodivergent Kids Workshop Series

Sam Hyali August 29, 2024

A parent-clinician-led workshop series is for parents of neurodivergent children in the Annapolis area. We’ll cover a variety of important topics, including School accommodations,  Extended Family Inclusion, Teaching community safety, and Understanding their world experience.

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Child learning to button a shirt at OT

Our Dual Approach

Our Dual Approach

Sam Hyali February 23, 2024

Our sensory systems create the foundation for higher-level integrated skills.  We utilize a top-down and a bottom-up therapeutic approach. A top-down approach helps us meet children and families where they are today and make an impact on their daily lives. A bottom-up approach allows us to use neuroplasticity and sensory integration theory to cause needed nervous system changes.

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Toddlers hands with fingerpaint doing an OT fine motor activity

Checking OT Insurance Benefits

Guidelines for Checking OT Insurance Benefits

Sam Hyali February 12, 2024

These guidelines should help you learn & understand your insurance provider’s coverage for pediatric occupational therapy. Includes a printable insurance checking checklist.

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Adult connecting with two young children

Building Connection without Demands

Building Connection without Demands

Sam Hyali January 23, 2024

Embracing kids for who they are without placing a demand for a verbal response is so important to help kids feel connected. It gives them a sense of safety and belonging. Using low-demand connection-based phrases can help your child regulate and build confidence. These are especially helpful phrases to use after school or when your child is burned out. Here are some ideas:

 Connection-based phrase ideas for parents:

• “I love spending time with you”

• “I’m so happy to see you!”

• “I couldn't wait to pick you up from school today!”

• “You have great ideas!”

• “This family would not be the same without you.”

• “I’m so excited to spend time with you.”

• “I thought about you when you were at school today.”

• “I thought about you when I was grocery shopping today, I bought your favorite ____” 

• “I missed you today while you were at school”

• “I love it when you share your ideas with me”

• “Being around you is fun”

• “I love to watch you play”

• “I am so lucky to be your parent”

As parents, it's so hard to hold back our questions when it comes to what your child did at school and how they behaved. It’s totally normal as a parent to want to know if they listened to their teacher or if they got in trouble, but this really adds to the child’s stress and pressure (which is inevitable when you're having a hard time at school). Instead of asking questions about behavior or open-ended questions that are hard to answer, try some of these connection-based questions.

Connection-based questions for parents:

• What was something funny that happened at school today?

• Tell me something that made you happy today.

• What book did you read at circle time today?

• What did you play during recess?

• What was your favorite thing you learned today?

• Tell me something kind someone did today.

• What did you notice today at school that other people probably didn’t notice?

• Were you able to help someone today with a problem?

• What did you try hard at today?

Praise is a great way to build confidence in kids. Providing a variety of praise, especially praise that builds self-esteem, authenticity, and intrinsic motivation, is key. Here are some ideas:

Praise the STRATEGY:

◦ You found a really good way to do it!

◦ I didn't think of it that way

◦ I love how your mind works

Praise with SPECIFICITY:

◦ You really seem to understand multiplication

◦ I like how you organized your room

◦ I love the way you tell stories

Praise EFFORT:

◦ You worked hard on that

◦ I could tell that was important to you

◦ I notice you have been working on that

Every moment spent together, filled with connection-based phrases and thoughtful questions, allows children to blossom into their truest selves. The power of praise, through acknowledging their unique strategies, specific achievements, and unwavering effort, ignites children's and all people’s self-esteem and intrinsic motivation. 

Parenting is challenging, especially parenting neurodiverse children.  Your intentional parenting, embracing their individuality and celebrating the amazing progress they have already made, is helping your child become more confident, resilient, and full of boundless potential. 

In OT for Kids Tags parenting, neurodiverse children, connection-based parenting
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Child Holiday gift guide

Holiday Gift Guide for Kids 2023

Sam Hyali November 22, 2023

Holiday gift guide for kids featuring our favorite items for toddlers & elementary-aged children. There are so many ways to support learning and development. Our gift guide is organized into Games, Fine Motor Development and building toys. A great resource when shopping for your child or for sharing with grandparents, relatives, and friends who are looking for extra special, fun, and developmentally focused gift ideas!

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Sensory Holiday Gift Guide

Sensory Holiday Gift Guide 2023

Sam Hyali November 22, 2023

Sensory holiday gift guide featuring our favorite toys for infants.   There are so many ways to support sensory needs with toys and tools at home. This sensory gift guide is a great resource when shopping for your child, or for sharing with grandparents, relatives, and friends who are looking for extra special, fun and sensory focused gift ideas!

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Baby Holiday Gift Guide 2023

Sam Hyali November 22, 2023

Baby holiday gift guide featuring our favorite toys for infants.   There are so many ways to support learning and development, and the list below is a great resource when shopping for your baby, or for sharing with grandparents, relatives, and friends who are looking for extra special and developmentally focused gift ideas!

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From Meltdowns to Milestones

Play-Based OT to Prepare for Extracurricular Activities

From Meltdowns to Milestones: Play-Based OT to Prepare for Extracurricular Activities

Sam Hyali November 5, 2023

Parents often recognize that their child could benefit from sports and activities, such as soccer, karate, and gymnastics. For some kids, these activities compound their frustrations.  Regular meltdowns at an activity can indicate that the child doesn't have the needed foundational skills.

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Sensory Bins

Sensory Bins - How to make them & why they're great

Sam Hyali June 21, 2023

Sensory bins provide kids with hands-on sensory experiences and create a multitude of learning and development opportunities.

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Child in a pediatric occupational therapy clinic doing an obstacle course for proprioceptive input.

Proprioceptive Input

What it is & why it’s important.

Proprioceptive Input for Children

Sam Hyali December 16, 2022

All of us learn about and comprehend the world through our senses. We see things, we touch things, we experience gravity, and we use our bodies to move around in it.  One of our seven senses that enables this is Proprioception.

Proprioception refers to the body's ability to sense movement within joints and joint position. This ability enables us to know where our limbs are in space without having to look.  

What is proprioceptive input and why does it matter?  

Proprioceptive input is the feedback received through any activity that requires effort from our muscles and joints,  providing the deep pressure that they require. “Heavy work” are activities that may involve pushing, pulling, lifting, weight-bearing, and compression of joints. These types of input carry messages from our proprioceptive receptors in our body to our brain, to help us feel grounded, know where our body is in space, coordinate our movements, exert an appropriate level of energy for various tasks,  self-regulate, sustain attention and focus throughout our day.  Every body requires a different amount of input, and some individuals struggling with motor planning, body awareness, self-regulation, and attention may require increased proprioceptive input for daily function.

How do I know if my child requires increased input? 

Requiring increased proprioceptive input can display itself in a variety of ways including, sensory seeking, poor coordination and motor planning, and poor balance.

Sensory-Seeking Behavior Examples

  • Playing rough 

  • Hitting, kicking or pushing 

  • Chewing on objects 

  • Jumping and crashing

  • Enjoy being loud or engaging in loud tasks 

  • Fidgeting, rocking, or seeking constant movement 

  • Enjoy bear hugs, tight squeezes of are frequently in others' personal space

Poor Motor Planning and Coordination Examples

  • Frequent falling 

  • Difficulty coordinating movement during sports or exercises such as throwing, catching or hitting a ball, climbing, jumping jacks, hopping or running

  • Difficulty tying shoes

Poor Core Stability and Balance Examples

  • Frequent leaning (slumped at a desk, leaning on the wall)

  • Propping head up on hand or arm while sitting 

  • Laying on belly 

  • Slouchy or lethargic appearance 

  • Low muscle tone 

  • Changing positioning frequently 

Proprioceptive input can be incorporated into daily routines or as part of a sensory diet for your child’s success.                                                                                                                   

Child using weighted ball for proprioceptive input exercise.
Child jumping into a crash pad for proprioceptive input.

our favorite ways to incorporate heavy work

Pushing and Pulling

  • Push-ups - o the floor or against the wall

  • Chair Push-ups

  • Scoot to the very edge of your chair and hold on to the edge tightly with your hands. Adjust your position so your bottom is no longer on the seat and your feet are flat on the floor with a 90-degree bend in the knees. Use your arms to push up and down. 

  • Push a heavy box or basket across the room or throughout the house

  • Push a heavy medicine ball across the floor or as high as you can up the wall

  • Push the doorway

  • Stand in an open doorway. Put your hands against the frame and push outward as hard as you can. 

  • Build a fort with heavy pillows, thick blankets, and chairs

  • Moving heavy furniture around to create the fort is even better 

  • Push the grocery cart while shopping

  • Break down cardboard boxes (using mostly their hands)

  • Rip stacks of unwanted mail in place of a shredder 

  • Move the furniture

  • Rearrange a room, or move the furniture to clean behind or underneath 

  • Yard work: rake leaves, shovel snow, mow the lawn 

  • Push or pull a wagon or wheelbarrow 

  • Tug of war

  • Vacuum the floor

  • Mop the floor

Lifting and weight-bearing

  • Carry a heavy backpack 

  • Carry a stack of books 

  • Carry a stack of plates to set the table 

  • Carry a full laundry basket 

  • Carry the grocery bags 

  • Play catch with a weighted ball

  • Play on the playground (monkey bars, rock climbing jungle gym) 

  • Pour heavy items back and forth (jug of water or milk, rice, beans) 

  • Climb a ladder

  • Yoga

  • Weighted exercises: squats, shoulder presses, or lunges etc. with a weighted ball 

  • Carry buckets of water, sand, or dirt

  • Take out the trash

  • Water the plants with a full watering can 

Resistance and Compression of joints  

  • Jump Rope

  • Hopscotch 

  • Go for a run or march/run in place

  • Jump on a trampoline

  • Stand on a vibration board 

  • Animal walks 

  • Jump and crash: Create a crash pad using sofa cushions, pillows, or a mattress and jump to crash into it

  • Dig in a garden or pull weeds

  • Water the outdoor plants by squeezing and holding the nozzle on the water hose 

  • Go for a swim

  • Stir a thick batter 

  • Knead a thick dough 

  • Pedal a bicycle

  • Drink a thick beverage through a straw (milkshake/smoothie) 

  • Drink from a suction or straw water bottle 

  • Blow bubbles 

  • Chew gum (if age appropriate) 

  • Eat a chewy or crunchy snack 

Note: Activities providing the “compression of joints”, mentioned in this document are not to be confused with the “joint compression protocol”, which may only be administered through licensed professions. 

Ways to incorporate HEAVY WORK into your child’s day

School

  • Arrive 15 minutes early to allow your child to play on the playground before school 

  • Allow the child to assist the teacher to rearrange the room, and move furniture to set up for an activity or time on the mat 

  • Collect the whole class’s lunches in a bucket or wagon and have the child carry them to and from the lunchroom. 

  • Allow your child to take a straw or suction water bottle to school 

  • Incorporate crunchy and chewy foods into your child’s lunch 

  • Incorporate “built-in” movement breaks into the day. Include animal walks, chair push-ups, running in place, and yoga poses

  • Have a few class plants, that your child can water with a full watering can, when they need a break 

  • If allowed and not a distraction, allow your child to chew gum in school

  • Pack your child’s backpack to be appropriately heavy for walking to and from school 

Note: Most children do not want to feel singled out when they require additional help in the classroom. Finding ways to seamlessly incorporate heavy work, like giving the child assigned tasks (ie: carrying the lunch bucket )  or incorporating the whole class during movement breaks are very beneficial. 

Home

  • Create a daily chore list incorporating heavy work tasks. Including doing dishes, setting the table, taking out the trash, cleaning the floors, helping with laundry, and watering the plants. 

  • Allow your child to help with cooking and baking by carrying heavy items to and from the fridge or pantry, stirring stews and batters, kneading, and rolling out dough

  • Have your child help with gardening, weeding, or caring for indoor plants. Heavy work can be incorporated into repotting, watering, pulling weeds, digging, and harvesting vegetables. 

  • Incorporate animal walks into daily routines. For example, during their morning routine, your child can do an animal walk from their bedroom to the bathroom, or from the bathroom to the breakfast table.

Play/Leisure

  • Incorporate heavy work games into your family game night. Twister or, “do a move” Jenga are great options. Heavy work can be incorporated into most games easily (for example: every time you land on blue, you have to do 5 jumping jacks, then take your turn, or every time you roll a 3 or 5 you do 4 heavy ball slams) 

  • Encourage lots of outside play:  digging, climbing, rolling, swimming, biking and building 

  • Encourage participation in individual or team sports. Most, if not all sports or dance provide heavy work to muscles and joints 

Social Settings

  • Have your child participate in heavy work tasks BEFORE social events when they need to be seated for a while. (church, weddings, school performances, concerts)  

  • During prolonged seated events, incorporate movement breaks for your child in the hallway or in a separate area. These can include animal walks, jumping or jogging in place, wall pushups, or yoga stretches

  • If appropriate, allow your child to chew gum during social events 

  • Bring a container of theraputty for your child to squeeze and stretch during social events with prolonged sitting. 

  • Sit towards the back at social events so that the child can easily exit for his or her movement breaks

  • Bring chewy snacks (if eating is permitted) during your outing along with a straw or suction water bottle for your child. 

As you try these activities with your child or student, it is important to note which activities calm them, arouse them, or over arouse them. It is very unique to each individual.  You’ll also want to pay attention to the intensity, duration and frequency of each type of proprioceptive input.

Sensory integration is something most of us do automatically.  All of the sensory input from the environment and from inside our bodies works together seamlessly so we know what's going on, what to do and how to behave appropriately in response to what's going on.  For children with Sensory Processing Disorder, Autism, ADD, ADHD, proprioceptive input & sensory input does not hook up seamlessly with all of the other senses.  They can find it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks.

We hope the ideas in this blog post will help you add proprioceptive input into your child or student’s day & that it helps their self-regulation.  


Children At Play offers workshops for preschool & elementary teachers about the sensory integration approach for classrooms. 

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Zones of Regulation in Occupational Therapy for Kids

Sam Hyali October 12, 2022

The “Zones of Regulation” are used in classrooms, by occupational therapists, school counselors & more.   They were developed by an OT, Leah M. Kuypers, MA Ed. OTR/L, and they are a visual & concrete approach for children to learn about feelings.  

At Children At Play, we choose to use the Zones of Regulation as a teaching tool because:

  • The program is NEUTRAL and doesn’t project judgment of emotions→ No Zone is labeled as “good” or “bad.” Everyone has feelings, and that is OK!

  • Promotes a feelings-awareness including body cues, trigger awareness, and development of self-regulation, sensory strategies, and calming strategies.

  • Children will often encounter it in other places & the zone language is known by a lot of adults which will help the child’s communication be understood.

There are 4 Colored Zones for self-awareness and triggers for the different states of arousal:

My Feelings Chart for Children by Generation Mindful

1) Blue Zone: Describes a low state of alertness; sad, tired, sick. When one’s body/brain is moving slowly, and might need more rest breaks

2) Green Zone: Describes a regulated state of alertness, when one’s body feels “just right;” we are ready to listen and learn. Calm, happy, focused, proud, comfortable, relaxed. (This is the Zone we practice sensory/calming strategies in.)

3) Yellow Zone: Describes a heightened state of alertness, with slightly elevated emotions/states. We begin to feel like we could lose control of our bodies. Stress, frustrated, overwhelmed, worried/anxious, over-silliness, nervousness, wiggly, sensory seeking. This is the zone that we need to pick a strategy.

4) Red Zone: Describes extremely heightened states of alertness or very intense feelings. Out of control, angry, furious, upset. We might yell or throw toys, our heart beats fast, and our muscles get tight. We likely need an adult to help us calm down.

At our clinic, our occupational therapists implement & modify the program to be “the just right” fit making the presentation of information appropriate for different levels of learners. The information is always neuro-diversity affirming.  We also like to add sensory components to feelings education for further integration and expansion of concepts. Feelings are felt and discussed while swinging, tactile play, sorting activities, and more. 

The Zones of Regulation help children gain skills in the area of self-regulation.  They said it wonderfully: “Self-regulation can go by many names, such as self-control, self-management, and impulse control. It is defined as the best state of alertness of both the body and emotions for a specific situation. For example, when a student plays on the playground or in a competitive game, it is beneficial to have a higher state of alertness. However, that same state would not be appropriate in the library. The lessons and learning activities are designed to help the students recognize when they are in the different Zones as well as learn how to use strategies to change or stay in the Zone they are in. In addition to addressing self-regulation, the students will gain an increased vocabulary of emotional terms, skills in reading other people’s facial expressions, perspective about how others see and react to their behavior, insight into events that trigger their behavior, calming and alerting strategies, and problem-solving skills.” - from the Zones of Regulation Website

Because colors are so effective at helping children understand feelings there are many common resources, many of which have slightly different color schemes.  Red is always angry, Blue is usually sad, but after that, the colors are less consistent.  Happy, calm, fear, love are all represented differently in different books, programs and resources.  We always use Zones of Regulation, but if your child confuses the colors someone may have just read them the “Color Monster” or the “Crayon’s Book of Feelings.”  

If you’d like to learn even more about the Zones of Regulation you can read their one-page explanation here,  or check out the Zones of Regulation Website.   To learn about the specifics for implementing the Zones of Regulation, click here to contact us.

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Children at play | Pediatric Occupational therapy | Annapolis, MD 

© CHILDREN AT PLAY LLC. 2014-2025

Children at Play

Occupational Therapy for Kids

Children at Play provides occupational therapy services in Annapolis and throughout Anne Arundel County. We use a sensory integration approach to kids’ therapy and treat children with a variety of special needs.

Children at Play, LLC | 205 Ridgely Avenue, Annapolis, MD, 21401, United States