“How to think like an OT”
how we engage in and adapt everyday activities with upper limb differences
Download a free copy of the Fortune Teller for Children with Upper Limb Differences!
What is Overuse Syndrome?
Becoming a Body Sleuth
Hands-On Learning: The Fortune Teller Craft
Tips for Parents & Caregivers
Final Takeaways
Let’s Stay Connected!
Download a free copy of the Fortune Teller for Children with Upper Limb Differences!
Sarah Tuberty, OTD, OTR/L and I teamed up to present at the February, 2025 Helping Hands Foundation Winter Outing in Milford, Massachusetts. Our workshop session was about helping children become “body sleuths” so they can recognize how their bodies feel during and after activities.
As parents, caregivers, and practitioners, we want our children to feel confident, capable, and comfortable in their bodies. That’s why understanding overuse syndrome and how to prevent it is so important — especially for children with upper limb differences.
Let’s dive into what we covered and how you can apply it at home or in practice!
What is Overuse Syndrome?
Overuse syndrome happens when we put too much strain on certain muscles or joints, leading to discomfort or pain. Daily activities can put extra stress on the bodies of children with upper limb differences because the dominant side is always working. In addition, asymmetries on the limb different side(s) can lead to compensations in hands/arms that can cause strain or fatigue in other muscles. The goal is to develop strategies early on so children can move, play, and learn with less strain and pain and more ease. Learn more about overuse syndrome here.
It’s easy to focus so much on accomplishing a task that adults may not realize that children may strain themselves by how they adapt to doing an activity. Encouraging children to tune into their bodies is key!
Becoming a Body Sleuth
Most of the time, children with upper limb differences learn how to do new things from people who have ten fingers and two hands, not from other people with limb differences. Think about when your child first learned how to ride a bicycle, brush their teeth, play baseball, tie their shoelaces – they probably learned from people who have all their limbs!
Every time your child tries a new activity, they have to figure out how to adapt their body. Asking these questions can help your child start thinking like a body sleuth:
- Observe: How does your body feel while doing an activity? Afterward?
- Think: How will you be able to do this in your body? Have you done something like this before? What worked well? What other activities or skills can you use here?
- Plan & Adapt: Can you do the activity as shown, or can you adapt? Would different tools or a different approach help, such as:
- more information or instructions
- different materials or tools
- extra time
- help from others
Hands-On Learning: The Fortune Teller Craft
At our workshop, we practiced these ideas with a fun Fortune Teller Craft Activity! This hands-on experience empowers children to explore how they use their bodies when trying to learn how to do a new activity. Once your child has made the fortune teller, you can use it as a resource with your child as they build their body sleuth skills. You can use this fun and playful tool when you want to ask your child about doing a new activity at school, sports practice, extracurricular activity, camp – whenever!
You can try it at home:
- Download the Fortune Teller for Children with Upper Limb Differences template (above).
- Demonstrate folding the fortune teller (watch this video or view these visual instructions if you need guidance!) while your child copies step by step.
- Once they’ve finished folding, it’s time to use the fortune teller!
- Use the reflection questions inside the fortune teller: What felt easy? What needed adjusting?
Tips for Parents & Caregivers
- Finding the balance – help your child develop strategies and consider their long-term health
- Encourage exploration – your child may find that trying different ways of doing things helps their body; they don’t have to go with the first solution
- Avoid pressure to “keep up” or be “amazing” – each child moves at their own pace. The goals are comfort, competence, and confidence, not speed
- Support their creativity and problem-solving – they may enjoy having a thinking partner, but not someone to do it for them!
- Reflect together – Talk about what worked, what didn’t, and what could be different next time
- Watch out for over analyzing – while it’s not necessary to review every activity with your child, checking in every so often lets them know you care
Final Takeaways
For children:
- Do the things you want to do, while also paying attention to how your body feels!
For parents & caregivers:
- Trust that children are resilient and adaptive
- Celebrate small wins and problem-solving efforts
- Support reflection and self-awareness
Let’s Stay Connected!
We love sharing resources and learning together! Please share your experiences using the fortune teller activity here and follow us for more tips and activities!
and HH member Aiden Plaziak
A huge thank you to Helping Hands Foundation for hosting us! Let’s keep learning, adapting, and growing together!
Many thanks Aiden Plaziak, who volunteered to demonstrate using the fortune teller during the presentation and Joss Hunt, who took photos!
We also wish to thank the amazing pre-OT student interns who contributed to our presentation:
- Zoey Blagrove, sophomore at the University of Pittsburgh, recorded making the fortune teller
- Tiffany Chaplin, junior at University of Connecticut, took photos of the presentation at the Helping Hands Winter Outing
- Maria Chesko, junior at The Ohio State University, assisted with the slides
Download a free copy of the Fortune Teller for Children with Upper Limb Differences!
holding her fortune teller!
© 2025 Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy