Nintendo Wii offers Opportunities for Occupational and Physical Therapy

Nintendo Wii offers limitless opportunities for treatment in both occupational and physical therapy. No matter where along the age spectrum your patient population falls, something offered with the Nintendo Wii system can benefit your case load. Two articles in the news today highlight Wii-Hab or ways Wii might be used as a part of occupational and physical therapy.
In the first news article out of Leeds, England, one reads about a new bedside entertainment system for hospitalized Children. This news piece points out that playing games on a Wii system not only reduces anxiety about treatment but also encourages movement.
The second article about patients at Vanderbilt Children's Hospital features a video that focuses on key aspects of Wii-Hab. Watch the video to see and hear both a mother and a physician explain some of the benefits Wii brings during occupational and physical therapy for a child diagnosed with autism. A couple of benefits discussed include improving muscle tone and encouraging physical engagement with the environment.

NASCAR INTERSECTS WII THERAPY (WIIHAB) as KYLE PETTY, Racing's Renaissance Man, meets the "Wii" OT

Sometimes unexpected opportunity and inspiration find you. On a recent Tuesday evening in Williamsburg, Va. I met someone who offers both to anyone willing to make the investment. Kyle Petty, known to many through ever popular NASCAR racing, spoke to the attendees of the Electrical Utility Fleet Managers Conference. His engaging speech explained his family's role in building the sport of auto racing. First, he told of his Grandfather, Lee, who was drawn to racing as a way to provide for his family. Next, through engaging stories, he introduced the listers to his now famous father, Richard. Richard loved the sport and drove for the thrill. Kyle explained that he, personally, also loved the thrill of racing like his father. Both Kyle and his wife were excited that their son Adam dreamed of carrying on the Petty racing legacy. Shock and sadness swept over every listener as Mr. Petty explained how that dream would not be realized. As he continued, Mr. Petty transformed our shock and sadness into admiration and hope as we learned how this amazing family turned tragedy into a vision and then into the reality of helping kids with special needs as a way to honor the life and dreams of their son, Adam.
Victory Junction, a camp for kids with chronic medical conditions and serious illnesses operates near Randleman, NC. Since opening in 2004, over 11,000 children and families have been served by programs designed especially for them. Many different populations are served over the summer as well as throughout the year. One aspect that makes this camp so special is that each week is dedicated to a specific diagnosis category, such as autism, cerebral palsy, and burns, among others. Mr. Petty explained the importance of this model. By bringing individuals who struggle with similar problems together, they learn that they are not alone. As therapists, we recognize that grouping in this manner enhances opportunity for peer modeling and social support.
Hopefully, everyone who reads this blog post will consider becoming involved at some level with this great organization. Occupational and physical therapist and students could volunteer as cabin counselors or in another capacity. Your expertise would be appreciated and you would learn so much. Students considering applying for occupational or physical therapy school could also spend a week with the campers and gain valuable experience while giving back so much. Parents looking for something special for their child may find that this camp would provide the care and respite they seek. I plan to contact Victory Junction about volunteering myself. I want to work with these special kids in the fresh air while they involve themselves in real world golfing, bowling, swimming, driving and fishing ... all the things that in the school setting we are luckily able to do in the virtual world through Wii Therapy.

Funny Videos of Wii Injuries and Accidents

Mention of Wii injuries and accidents frequently occurs in this blog. Check out this collection of funny videos showing accidents as they happen. A clever occupational therapist could employ these videos during a therapy session with a goal of increased safety awareness, improved sequencing, or most any other cognitive focus. A therapist might have the client first review the Play It Safe checklist, second watch the videos and third discuss what unsafe practice led to the accident. Simple, yet effective! Another way to creatively incorporate Wii technology into your day to benefit your client with cognitive issues from TBI, stroke, PDD, Autism, Alzheimer's, and/or change of mental status to name a few. The concept of using Nintendo Wii in therapy, an approach known as WiiHab, Wii-Hab or Wiihabilitation, broadens!

Wii Purchases Bring Therapeutic Benefits Into Homes

New Wii Consoles flew off the shelves at retail outlets during the pre-holiday shopping sales. During one week in December, Walmart offered a $50 gift card for lucky customers who found Wiis in stock. So now many have a chance to experience Wii at home. In a UK paper an article explains ways to avoid injury when playing new games in the comfort of your own home.
New Wii owners, including those with chronic conditions express various ways they hope to use Wii in 2010. One Wii enthusiast with a spinal cord injury uses Wii to build arm strength. In an article entitled Wiiiiii!: Adaptive Exercise That’s Actually Fun the author offers good suggestions for therapeutic uses of Wii applications as well as suggestions for simple ways to make Wii applications more user friendly for this population.
New Wii owners with Multiple Sclerosis also recognize therapeutic value in Wii Sports and Wii Fit activities. Having Nintendo Wii in one's home allows the participant to pace themselves to avoid fatigue while playing many great games. Many Wii games increase flexibility and endurance.
Families with special needs children bought Wiis for home use. These families look forward to increased social interaction with their children. Social interaction in a safe environment may help improve social skills for these children. Wii activities offer opportunities for spontaneity; this area often challenges children with autism and other developmental delays. Also, during these cold winter months, the Wii offers an easy way to add more physical activity into a child's routine, providing an outlet for energy and the possibly of reducing negative behaviors such as tantrums.
While playing Wii participants need to follow safe practices to avoid injury. Players might also want to add wrist weights to increase the challenge. Parents might also want to speak with their child's occupational therapist for ideas for increasing challenge by altering positioning while playing certain Wii Sports activities.

Wii-Hab Meets Medical Illustration

An artist, who received her MFA (Master of Fine Arts) in Advertising Design from Savannah College of Art and Design, which is located in my hometown of Savannah, GA, created wonderful visuals depicting the crucial aspects of Wii-Hab. Angela Moramarco infuses the very human components - the brain, the muscles, the bones and the soft tissue - into the very technical components - the remote and the console - of Nintendo Wii. These great illustrations tell a concise story. Nintendo Wii, when used correctly in a therapeutic setting, helps patients build new connections within the brain and between the brain and the muscles. For some patients therapy can be difficult and repetitious. Wii offers occupational and physical therapists a versatile tool to use as a part of the therapy plan not only for improving strength, endurance, and flexibility but also for improving sequencing and problem solving in a variety of patient settings including pediatrics (autism, cerebral palsey, PDD) and geriatrics (stroke, joint replacement, fall prevention).

Sensory Processing Disorders (Part 3 of 3)

(More on sensory processing disorder…)

 

School-based therapists recognize the entwined nature of the sensorimotor performance components and program plan accordingly.  The Wii provides another tool for the therapists, allowing them to challenge and grade movement through space as well as encourage targeted actions.  Are any readers using the Wii in your setting? 

 

Therapists must also identify issues in other performance areas such as cognitive and psycho-social.   Manifestations of problems within the cognition and psycho-social arenas will be discussed in future posts.

 

Please post your experiences under the comment section because in sharing your experience, you help increase everyone’s knowledge base.

Sources:

·        The Sensory Processing Disorder Resource Center

 www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html

·        Kranowitz, CS., Miller, LJ. (2005). The Out-of-Sync Child.  New York, NY. Penguin Group.

·        Bhojne,U, Chitnis, A. (2002). VESTIBULAR DYSFUNCTION IN CHILDREN WITH PERVASIVE DEVELOPMENTAL DISORDER. The Indian Journal of Occupational Therapy. XXXIV(1).3-6. Retrieved from http://medind.nic.in/iba/t02/i1/ibat02i1p3.pdf

 

Sensory Processing Disorders (Part 2 of 3)

(Continued from last post…)

 

More on sensory processing disorder:

• Visual – Refers to the brain’s interpretation of what one sees
• Hypersensitivity – May be sensitive to bright lights and may have difficulty keeping eyes focused on work.
• Hyposensitivity – May have difficulty discriminating between similar shapes, like a square and rectangle or similarly shaped letters like “p”, “q”, “b” and “d”.  Visual processing deficits result in problems described in the previous post on perceptual processing manifestations.  
• Vestibular – Refers to the interpretation of information gathered from the inner ear about one’s position in space, movement and balance.
• Hypersensitivity – May be overly sensitive to motion, avoiding swings or slides.  May get car sick and may be fearful of escalators.   May also demonstrate poor postural control.
• Hyposensitivity – May crave motion.  May spin, jump, run into walls, or purposely fall without the expected negative reaction.  Again, look at the previous posts.  Deficits in this area are closely aligned to deficits classified as motor problems (see October 27,2008 post) as well as perceptual processing problems described in the October 31, 2008 post.
• Proprioceptive – Refers to the interpretation of information gathered from joints and muscles about one’s position in space, movement, pressure and weight.
• May use excessive force when interacting with objects, animals or other people.
• May seek out activities that provide sensory input, like jumping and banging objects. 

 

Please post your experiences under the comment section because in sharing your experience, you help increase everyone’s knowledge base.

Sensory Processing Disorders (Part 1 of 3)

Therapists working with the K-8 population, especially students with diagnoses across the Autism spectrum must be equipped to address sensory processing disorders.  Sensory processing problems impact all areas of function and must be considered on a case by case basis. Subtle differences between children’s abilities require the therapist to individualize treatment protocols.  Components included in the sensory processing performance area are:

 

• Tactile –  Refers to the interpretation of sensory input, including temperature, pressure, pain, and touch, collected from receptors located in the skin
• Hypersensitivity – Tactile defensiveness- may avoid touch
• Hyposensitivity -  Decreased responsiveness to touch- may seek repetitive tactile input
• Auditory – Refers to the interpretation of  sound
• Hypersensitivity – Auditory defensiveness- may be overly sensitive to background sounds
• Hyposensitivity - Decreased responsiveness to sound – may not respond appropriately when called by name, may not be able to locate the source of a sound, or may make repetitive noises for no reason.
• Olfactory – Refers to the brain’s interpretation of  smell
• Hypersensitivity- May be overly sensitive to smells which others may not notice
• Hyposensitivity – May not notice smells others complain about.

 

(Continued next time…)

 

Please post your experiences under the comment section because in sharing your experience, you help increase everyone’s knowledge base.

Using the Wii Therapeutically in a School Setting: PART 1

Jan from Maine writes on October 23, 2008:

Hi There,

I am an OT who would like to use Wii with my kids in the school setting. I am writing a grant for funding this and would like some feedback as to which program might be the best for my K-8 population and with my Autistic population.

Thank you!

Jan from Maine

Thank you, Jan, for your question. This question, of course, covers a very broad subject, so I will break it down into several important areas.  If more specific or timelier information is needed, Jan from Maine could leave a comment with her email address and I could address those specifics directly.

My response to this question will appear in multiple posts.  In the first few posts, I will outline and define several potential areas for occupational therapy intervention for the K-8 population, with a special focus on areas of OT intervention for those with autism.  The second group of posts will give examples of specific Wii activities to address these areas.  And finally, I will suggest some current research to use as supporting literature for a grant proposal. 

Some potential areas for intervention in the K-8 population include but are not limited to:

• Motor
  
• Perceptual
  
• Cognitive
  
• Psycho Social 

Occupational therapy intervention areas for children in this population with Autism include but are not limited to:

• Psycho social
  
• Sensory (processing) Integration
  
• Cognitive
  
• Perceptual
  
• Motor

Deficits in any of these areas can make classroom and daily activities challenging.  Identified students receive needed intervention from Occupational, Physical and/or Speech Therapists. The Nintendo Wii is emerging as a popular tool for therapists working with school aged children with special needs.  Wiihabilitation incorporating Wii Sports and Wii Fit can be used to address many of these frequently encountered problems and strategies for incorporating Wiihab in School based therapeutic programs will be discussed in detail in the latter parts of this segmented post.

Movement disorders in the K-8 (including those with Autism) may result from neuromusculoskeletal issues as well as from a complex mix of perceptual, muscular and motor issues.  Musculoskeletal involvement may result in:

• Alterations in muscle tone – (spastic- increased or flaccid- low/decreased)
  
• Decreased range of motion and/or strength
  
• Poor endurance
  
• Decreased postural control – alignment (standing or sitting)  

Additional motor or movement problems stem from a complex mix of deficits across several systems and may manifest as problems with:

• Coordination –both gross and fine (dexterity)
  
• Bilateral integration (using both sides of the body cooperatively, either simultaneously or alternately)
  
• Crossing the midline (passing one extremity across the midline of the body into the opposite side)
  
• Motor planning (praxis- the ability to perceive [visualize], organize and execute a motion or action accurately)
  
• Visual motor integration (the combined ability to visually perceive an object while accurately grasping and manipulating the object efficiently to complete the desired task)

Problems in any of these areas contribute to a student’s difficulty with classroom and self care activities.

The Wii and Autism

Occupational therapists provide care in diverse settings for a wide range of ages. One of the most rewarding settings for the occupational therapist involves working with children with developmental issues. OT intervention may be offered as soon as the child arrives in the NICU through a hospital based service, once the child goes home through a birth to 3 program, and once the child enters school within the school based setting.  Children with Autism Spectrum Disorder comprise a growing number of the case-load mix.  The occupational therapists’ contribution to these children’s plan of care or IEP includes activities aimed at improving physical, sensory and social issues.

One mother found an innovative way to help her son improve his ability to filter auditory sensory input as well as a way to increase all types of coordination and encourage appropriate social interactions.  This mother, MaryTara Wurmser purchased an Nintendo Wii for her son to use at home.  She tells about her experience and explains the benefits afforded her son from this activity.  She encourages others to “Consider the Nintendo Wii for Kids with Autism.”