OTwithMJ

Who's MJ?

Markus Jarrow is a pediatric occupational therapist with over 20 years of experience specializing in Sensory Integration, Neuro-developmental treatment, and DIR/Floortime. After two decades of integrating these models, he organically developed the The Ground upP approach - a holistic model that seamlessly supports each child through their unique developmental journey.

He’s a published author and a cofounder and former clinical director of The SMILE Center in Manhattan. He has worked extensively with clients from infancy to adolescence with neuromuscular divergences, autism, and sensory processing and learning differences, and has supervised hundreds of clinicians of OT, PT, Speech, Psychology, Social work and Education. 

Having been mentored by some of the top clinicians in the world, Markus considers himself extraordinarily fortunate. In the last decade, he began taking his work to children around the world with clinical intensives as well as designing custom sensory gyms for families both in the US and abroad. His work has taken him to Dubai, India, Bali, the Caribbean, and more.

Approaching therapy with an artist's touch

What's his Story?

Markus, a lifelong skate/snowboarder, surfer and devout meditation practitioner, deeply understands a range of sensory profiles, from the on-the-go thrill-seeking to the calm and regulated. And having dealt with social anxiety, he also empathizes with the emotional challenges and withdrawal many kids experience with verbal interactions, earning him the nickname "the baby whisperer." He has an uncanny ability for understanding a child’s sensory and emotional differences, meeting them where they are, and guiding them to where they want to go.

As a musician, Markus tends to approach therapy with an artist's touch, often using music, singing and rhythms to creatively craft sessions to each child’s individual differences. His unique approach to occupational therapy is as fun as it is effective.

Markus' love for travel, culture, and photography led him to International Therapy Intensives across several continents and in turn, Sensory Gym design. When some overseas clients lacked nearby therapy clinics, Markus began designing sensory gyms in their homes. This allowed him to meet children's sensory-motor needs and train families in effective home routines. Realizing the value of in-home treatment spaces, Markus expanded his efforts and began creating custom Sensory Gyms here in the US as well. His work combines insight, creativity, and craftsmanship to support children from the Ground upP.

Markus Jarrow, a lifelong skateboarder, surfer, and devout meditation practitioner, deeply understands a range of sensory experiences, from thrill-seeking to calm regulation. Having dealt with social anxiety, he empathizes with the emotional challenges and sensory overstimulation many kids experience with verbal interactions, earning him the nickname "the baby whisperer." He has a unique ability to relate to a child’s sensory and emotional differences and meet them where they are in order to support them to where they need to go.

As a musician, Markus tends to approach therapy with an artist's touch, often using music, singing and rhythms to creatively guide sessions. His unique, unconventional approach to occupational therapy is both fun and effective, helping children reach new levels of development.

Markus's love for travel, culture, and photography led him to International Therapy Intensives and in turn, Sensory Gym Design. When some overseas clients lacked nearby therapy clinics, Markus began designing sensory gyms and therapeutic play spaces in their homes. This allowed him to meet children's sensory-motor needs and train families in effective home routines. Realizing the value of in-home treatment spaces, Markus expanded his efforts and began creating custom Sensory Gyms not just for families abroad but here in the US as well. His work combines insight, creativity, and craftsmanship to support children along their unique developmental journeys.

Read More
arrow_downward
Integrating a comprehensive clinical approach that supports the whole child
Clinical Specialties

Treatment Areas of Interest

Clinical SpecialtiesSensory IntegrationNeuro-Developmental TreatmentBaby TreatmentDIR/Floortime
Treatment AreasSensory ProcessingPostural ControlSocial EmotionalBalance / CoordinationVisual Motor / PerceptualGross / Fine Motor MotorCommunicationRegulationExecutive functioningVisual Spatial TriadPlay
Modalities/Areas of InterestTherapeutic ListeningMyofascial ReleaseAstronaut TrainingSPIO SuitKinesioTapingAdaptive EquipmentAugmentative / Alternative Communication Meditation / Mindfulness / YogaNutrition and Wellness
Clinical Specialties

Specializing in the treatment of

the following:Sensory processing differencesAutismMuscle tone differencesMovement challenges Attentional challengesLearning challengesGross and fine motor challengesInfants and babies not reaching milestonesCerebral PalsyOther Neurological challengesGenetic differences

Method
&
Philosophy

Method

&

Philosophy

Tailoring a therapeutic approach to each child's unique developmental journey

Ground upP brings together SI, NDT, and DIR/Floortime with a twist, into a hands-on, bottom-up approach that truly incompasses all aspects of a child’s development. By respecting each child and their unique developmental journeys, we build empowering relationships that become the vehicle for meaningful change. Recognizing the deep interconnection between regulation, social-emotional development, sensory processing, movement patterns, language and learning, we treat the child as a whole, supporting sustainable progress across all areas.

Comprehensive Support

Method

It’s our responsibility to dive deep beyond surface symptoms to support each child’s growth from the bottom up. As clinicians and caregivers, we have to move beyond traditional power dynamics, building rich, meaningful relationships rooted in respect and playfulness. Rather than simply instructing and telling kids what to do, we should become partners and co-pilots in their journeys, honoring their passions to fuel positive change through play.

What is Ground upP?What is Sensory Integration?What is NDT?What is DIR/Floortime?
A holistic approach, forensic in nature

What is Ground upP™?

Ground upP is a holistic approach that evolved organically throughout my career, rooted in SI, NDT, and DIR/Floortime. It’s not as much of a new intervention as it is an integrated blend of these existing methods with a twist. Though child-led, affect-based and often playfully silly on the surface, it’s a carefully calculated and forensic approach behind the scenes.

Early in my career, I realized that working without a comprehensive clinical scope was like cooking without all the ingredients. This led me to spend the next 20 years deepening my knowledge in SI, NDT, and DIR/Floortime. As I saw the potential for these approaches to seamlessly integrate, I noticed that clinicians and therapeutic organizations tended to focus on one. SI lacked the in-depth body and movement pattern components and NDT missed the depth of the sensory piece. But how can you address regulation and the sensory systems without supporting alignment and movement patterns? And vice versa? And with children on the spectrum, how do you address either without navigating the nuanced layers of the social-emotional system? DIR/Floortime then becomes the glue that guides your every interaction.

Over time, I discovered that a strong understanding of these clinical models provides the framework to not only support every child, but support the whole child: mind, body and spirit. This isn’t about managing symptoms or behaviors but treating the root systemic causes - the social-emotional, neuro-motor, and sensory processing. Each child presents with a unique mix of strengths and challenges. It’s our responsibility to dive deep below the symptoms, be playful, fun and respectful, and support each child’s growth from the Ground upP.

Supporting the whole child

Understanding
the these 3

Ground upP is a hands-on, affect-based, relationship-centered approach that supports the whole child from the bottom up. What does "whole child" mean? By integrating SI, NDT, and DIR/Floortime with a unique twist, this approach comprehensively assesses and addresses all aspects of a child’s development.

No. 1 What is Sensory intervention?No. 2 What is NDT?No.3 What is DIR floor time?
1
2
3
Integrating three models with a twist

What is Sensory integration?

Sensory integration (SI) therapy is a play-based approach aimed at helping children of all ages with sensory processing difficulties to better perceive, interpret, and respond to sensory information from their environment. This primarily includes touch, movement, sound, and vision. Each sensory system can present with heightened sensitivity (resulting in anxious avoidance), under sensitivity (resulting in seeking of more of that input) or a mix of the two. Many of the sensory systems work together in various subgroups to support different areas of function and therefore are highly interconnected and dependent on each other. Common issues include: sensory seeking behaviors, always “on-the-go”, balance and coordination challenges, motor difficulties, anxiety and withdrawal, and challenging, oppositional behaviors.

SI therapy aims to normalize any heightened or under sensitive systems and restore the collaborative functions in order to improve developmental areas, including motor skills, attention, and emotional regulation. Children learn to respond appropriately to sensory experiences, thus reducing anxiety, improving focus, and enhancing social interactions. Sensory integration is particularly beneficial for children with neuro-divergences such as ADHD, behavioral and learning challenges, autism spectrum disorder and sensory processing disorder.

Integrating three models with a twist

What is NDT?

Neuro-Developmental Treatment (NDT) is a hands-on approach that helps children with neurological issues improve functional independence. NDT focuses on improving movement, posture, and functional abilities by addressing the child’s unique motor challenges.

The therapy involves trained therapists using guided movements or facilitations to help children develop more efficient movement patterns. This includes normalizing muscle tone and alignment, enhancing postural control, and encouraging the development of both gross and fine motor skills.

NDT emphasizes the importance of the child’s active participation in the process, encouraging them to explore movements in a supportive environment following guided hands-on work. Activities may include balance exercises, mobility training, and functional play that is meaningful to the child. 

The goal of NDT therapy is to improve the child’s overall functional abilities, fostering independence in daily activities such as walking, sitting, play and self-care. By enhancing motor skills and promoting a sense of body awareness, NDT helps children reach their full potential and improves their quality of life. This approach also incorporates the involvement of family members, educating them on how to support the child's movement and development at home.

Integrating three models with a twist

What is DIR/Floortime?

DIR/Floortime is a comprehensive developmental approach that focuses on supporting emotional and social growth in children, particularly those with developmental challenges and autism spectrum disorder. DIR stands for Developmental, Individual-differences, and Relationship-based, reflecting its core principles.

The therapy emphasizes understanding each child's unique developmental profile, including their strengths, challenges, and individual interests. Therapists engage with the child in play at their level, fostering meaningful interactions that build emotional connections and relationships. Through this process, children are encouraged to communicate more effectively, think on their own and engage in problem-solving.

Floortime sessions involve playful activities tailored to the child's interests, encouraging them to explore and learn in a safe environment. The therapist may use various strategies, such as following the child’s lead, introducing new ideas, and playful obstruction to gradually expand their play and communication skills.

The overarching goal of DIR/Floortime is to enhance the child’s ability to connect emotionally with others, develop social skills, and improve overall cognitive and language development by prioritizing relationships and emotional engagement. Additionally, it encourages family involvement, empowering parents and caregivers to continue supportive interactions at home.

Play
Artboard 31
Tab 1
Tab 2
Tab 3
Tab 4
Tab 5
A holistic approach, forensic in nature

What is Sensory intervention?

Sensory integration (SI) therapy is a play-based approach aimed at helping children of all ages with sensory processing difficulties to better perceive, interpret, and respond to sensory information from their environment. This primarily includes touch, movement, sound, and vision. Each sensory system can present with heightened sensitivity (resulting in anxious avoidance), under sensitivity (resulting in seeking of more of that input) or a mix of the two. Many of the sensory systems work together in various subgroups to support different areas of function and therefore are highly interconnected and dependent on each other. Common issues include: sensory seeking behaviors, always “on-the-go”, balance and coordination challenges, motor difficulties, anxiety and withdrawal, and challenging, oppositional behaviors.

SI therapy aims to normalize any heightened or under sensitive systems and restore the collaborative functions in order to improve developmental areas, including motor skills, attention, and emotional regulation. Children learn to respond appropriately to sensory experiences, thus reducing anxiety, improving focus, and enhancing social interactions. Sensory integration is particularly beneficial for children with neuro-divergences such as ADHD, behavioral and learning challenges, autism spectrum disorder and sensory processing disorder.

Tab 2 Content

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Tab 3 Content

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Tab 3 Content

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Tab 3 Content

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Philosophy

Supporting the whole child

Mind + Body +Spirit

Ground upP is a hands-on, affect-based and relationship-centered approach that supports the whole child from the bottom up. What does "whole child" mean? By integrating SI, NDT, and DIR/Floortime with a unique twist, this approach comprehensively addresses all aspects of a child’s Development. DIR/Floortime enriches the social-emotional piece, NDT refines the physical body, and SI organizes the sensory systems.

The Social-emotionalThe PhysicalThe SensoryEssentially: Mind, Body, and spirit
Sensory, Motor and Social-emotional

What exactly does SI, NDT and DIR/Floortime cover?

Sensory IntegrationChild-ledRegulationSensory ProcessingSensory defensivenessSensory seekingBody awarenessVisual spatial triadVestibularProprioceptionTactileAuditoryVision
NDTHands-onAlignmentPostural controlLow muscle toneIncreased muscle toneMovement patternsStrength + stabilityFunctional movementGross motorFine motorMobilityBody work
DIR/FloortimeAffect-basedRelationship-basedSocial-emotionalRegulationEngagementRelatednessCommunicationProblem solvingCreativityPlayPretend playPlayful obstruction
Guiding principles beyond the techniques

Let's get Philosophical

We’ve covered methods and touched on techniques, but what truly defines a treatment approach are the guiding principles and philosophies. Ground upP is rooted in the following:

A strong focus on foundational learning rather than isolated skills
A deeper understanding of development as a whole, not just milestones
Looking beyond surface behaviors to uncover root causes
Addressing system impairments rather than symptoms
Activating sensory and emotional systems to support lasting, functional change

Last but not least: creating a magical and supportive world tailored to each child full of affect, fun, silliness, or zen... whatever it takes to help a kiddo fully lock in, get in that shared zone, and shoot for the stars. Or as I’ve said countless times in supervision meetings: get on the river.
‍
Click below for a deep dive! 

A Deep Dive + Case Study

Want more? Join me for an in-depth analysis of the philosophy and a glimpse of what the approach looks in action 

Click here to enter!
In short, Ground up goes beyond surface-level issues to establish and strengthen the foundational building blocks that support development, adaptation, and generalization across all areas of a child’s growth.

Additional philosophies of Ground upP include:

Focusing on foundational learning versus isolated skillsLooking beyond symptoms/behaviors to assess underlying causesAddressing system impairments to support developmentActivating sensory/emotion systems to maximize functional performance

Give a kid a sandwich, and they eat for a day

Teach a kid to make a sandwich, and they’ll eat when there’s bread and peanut butter

Empower a kid to think and problem solve, and they’ll adapt to any situation and thrive for a lifetime

Most early skills develop naturally through play to solve problems, driven by thought, reason, and intrinsic motivation. This rich emotional process connects our ideas, experiences, and skills, enabling us to learn, adapt, and apply ourselves to novel situations. It’s the essence of early learning and play.
‍
However, when this natural process is disrupted for a neurodivergent child and skills are then arbitrarily taught through a top-down, behavioral approach, they often become isolated “splinter skills” that don’t generalize beyond the context in which they were introduced.

Integration and generalization

Skills vs Learning

While skills are important, they’re only as effective as the social-emotional, motivational, and experiential richness in which they are learned. This richness creates the gray area that supports thinking, problem-solving, emotional range, and promotes integration and generalization.

However, when a neurodivergent child’s natural learning process is disrupted and skills are arbitrarily taught using a top-down, behavioral approach, they often become isolated “splinter skills” that fail to generalize beyond the context in which they were introduced. While skills are important, their effectiveness depends on the social-emotional, motivational, and experiential richness in which they are learned. This richness serves as the glue that supports thinking, problem-solving, emotional depth, and promotes integration and generalization.

While limit setting and imposed structure can be necessary at times, it is our duty as clinicians and caregivers to move beyond traditional power dynamics and build rich, meaningful relationships with our kids. Instead of simply instructing them and telling them what to do, we need to playfully support them as partners and co-pilots in their passions and journeys… play, get creative, try and fail, think and experiment together, laugh and cry, encounter and adapt to problems, and let learning unfold naturally and together. And most importantly, have fun!

Early fundamental building blocks

Does practice really make perfect?

Yes, for children who naturally adapt through trial and error, using feedback to learn and refine. However, for neurodivergent children with differences in strength, coordination, sensory processing, etc. the process can be very different. They may not benefit from the same reliable feedback to support learning and adaptation and instead develop compensations and maladaptive habits. In these cases, routine practice doesn’t make perfect - it simply reinforces those compensatory patterns.

Humans are resilient and will find a way to adapt. Children without arms have learned to play piano with their feet. This is truly remarkable. However, when resilience intersects with neurodivergence, it often leads to maladaptive habits that create a compromised foundation and limit further development. That’s why it’s essential for a child to establish the fundamental early building blocks, ensuring a strong foundation that not only supports skill development but also adaptation and generalization. It is our duty to assess and address the root causes rather than just the surface level symptoms and behaviors. There is always more to the story. 

So what do we do?

Go deeper than the symptoms

When a neurodivergent child struggles with a skill, it’s often a sign of an underlying issue that requires a deeper look. The challenges we see in motor skills, behavior, attention, etc. are usually just surface level symptoms of a more complex issue. Like fixing a leak in a dam, we don’t simply patch the hole – we address the root cause to resolve it and prevent future issues.

In therapy, this means not focusing immediately on the specific skill the child is struggling with. Instead, we need to step back and assess the foundational roots that support the skills such as regulation, strength, alignment, vision, coordination, etc. These almost always play a significant role in the child’s challenges and must be addressed first.

Through strategic treatment, we can target these foundational areas while making the process playful and meaningful for the child. Improvements in these areas often lead to the skills of concern developing more naturally, without the need for repetitive drills. For example, if a child struggles with catching a ball or sitting upright in class, we don’t simply practice those actions; we focus on the underlying challenges, such as visual processing, trunk stability, proprioception, etc. As the supportive foundation develops, refinement of the skills can then be more strategically practiced if needed.

Take it a step further

Activate the systems

How can we tap into a child’s sensory and emotional systems to best prepare them to rise up and reach their ultimate potential in therapy? How can we maximize gains during sessions and in home programs, thus creating fundamental shifts and strengthening those critical foundational areas? Whether dampening hyper-sensitive systems or activating under-reactive ones, the sequencing of our sessions is critical and how we address the relevant sensory and emotional systems to set up a child to optimally perform is key. Here’s a hypothetical case study to help paint a picture:

Background Information

You begin working with a 5-year-old boy whose teacher and parents are concerned about his slouched posture when seated at the table. Improving his sitting posture is an OT goal. He presents with decreased global muscle tone and core strength, often sitting with a posterior pelvic tilt, but has no mobility issues or restrictions. He presents with an under-responsive vestibular system and lights up during movement activities but his system tends to slow significantly when stationary and he can become lethargic. His tactile and proprioceptive systems are hypo-responsive as well resulting in decreased body awareness, which paired with the low muscle tone, does not provide adequate feedback for refined movement, postural alignment and sustained arousal level. He enjoys baseball and sports, being silly, and high energy environments.

Where do we begin?
Think Sensory Systems!
First:

• What sensory systems are relevant to the goal? All
• Do those systems process input typically? No
• What are the child’s passions? Sports and activity

Second:

• Are they over or under-responsive? Under
• Are we looking to amp up a low arousal child or ground an overwhelmed child? Amp up
• What affect ranges get them cooking? High and silly

How do we bring it all together?

Action & Treatment

1

st
Option

Swimming upstream

1

st
Option

Swimming upstream

Aproach:
You engage the child in tabletop activities for the duration of your session while providing verbal and tactile cues to correct his posture each time he slouches

Note: Remember, practice doesn’t make perfect and don’t simply treat the symptoms. There is a reason why he struggles with maintaining an upright posture and simply practicing sitting will not result in any fundamental change. In addition, this approach can be frustrating and disheartening for the child. We have to look deeper.

2

nd
Option

Getting warmer

2

nd
Option

Getting warmer

Approach:
You begin the session with the child lying on the floor in a superman prone position as you playfully roll a therapy ball that he pushes back to you using both hands. Two sets of 20 or until he fatigues, then transition to seated activities and prompt him to sit upright

Note: While this brings an element of play, the child struggles to jump right into a demanding prone position against gravity and fatigues quickly, demonstrating compensatory patterns (shoulder elevation, neck hyperextension, bending of the knees). Once compensations are present, there is little to no therapeutic value. Although a step in the right direction, this option still only addresses the symptoms and doesn’t provide the preparatory sensory activation needed for him to rise to the challenge and make fundamental change.

3

rd
Option

Now we're talking!

3

rd
Option

Now we're talking!

Setup:
Play quickshift tracks like Gravitational Grape or Agile Apricot (Vital Sounds) or any good, bass-driven music to get the rhythmic vibes flowing!

1. Begin with a tornado (Sheila Frick, Mary Kawar) for intense linear activation of the utricle to both organize and activate his postural system. He loves it! 

2. Transition to vigorous trampoline jumping with a weighted ball in both hands (can play catch if able while jumping) to engages scapulae and provides stacking compression around the spine.
‍
3. Follow with deep, alerting tactile brushing (or manual input) along both sides of the spine and neck to activate the deep postural extensor muscles.

4. Next, a fun bungee prone extension game in a hammock swing, à la Jane Ayres, for full range linear acceleration, deep extensor and glute activation and establishment of the center axis

5. Now that he’s cooking, have him lie prone in front of a wiffle ball hanging a foot off the ground. When you say “GO!”, he hits the ball with a bat to the beat of the music as you call out his rising score in an energetic voice. Each time he scores 20/30/50 points, you run and amusingly crash into mats to keep the activity funny and engaging! More utricle and deep extensor, glute activation and center axis work. We know vision guides movement so getting the target up a bit will help facilitate a more extended position.
‍
6. Finally, let’s take all that center axis and vestibular activation work and put it into a dynamic movement pattern. NDT Facilitations for trunk rotation basketball with lateral weight shifts and shoulder flexion beyond 90 degrees - ensuring oblique and transverse abdominal activation. Core core core!

Note: As sessions move along, you begin to spend a few minutes at the end playing a preferred tabletop game to apply the postural gains to the goal area, discussing his new strong muscles and how they help him sit tal. Bottom up meets top down.

1

st
Option

Swimming upstream

1

st
Option

Swimming upstream

Aproach:
You engage the child in tabletop activities for the duration of your session while providing verbal and tactile cues to correct his posture each time he slouches

Note: Remember, practice doesn’t make perfect and don’t simply treat the symptoms. There is a reason why he struggles with maintaining an upright posture and simply practicing sitting will not result in any fundamental change. In addition, this approach can be frustrating and disheartening for the child. We have to look deeper.

2

nd
Option

Getting warmer

2

nd
Option

Getting warmer

Approach:
You begin the session with the child lying on the floor in a superman prone position as you playfully roll a therapy ball that he pushes back to you using both hands. Two sets of 20 or until he fatigues, then transition to seated activities and prompt him to sit upright

Note: While this brings an element of play, the child struggles to jump right into a demanding prone position against gravity and fatigues quickly, demonstrating compensatory patterns (shoulder elevation, neck hyperextension, bending of the knees). Once compensations are present, there is little to no therapeutic value. Although a step in the right direction, this option still only addresses the symptoms and doesn’t provide the preparatory sensory activation needed for him to rise to the challenge and make fundamental change.

3

rd
Option

Now we're talking!

3

rd
Option

Now we're talking!

Setup:
Play quickshift tracks like Gravitational Grape or Agile Apricot (Vital Sounds) or any good, bass-driven music to get the rhythmic vibes flowing!

1. Begin with a tornado (Sheila Frick, Mary Kawar) for intense linear activation of the utricle to both organize and activate his postural system. He loves it! 

2. Transition to vigorous trampoline jumping with a weighted ball in both hands (can play catch if able while jumping) to engages scapulae and provides stacking compression around the spine.
‍
3. Follow with deep, alerting tactile brushing (or manual input) along both sides of the spine and neck to activate the deep postural extensor muscles.

4. Next, a fun bungee prone extension game in a hammock swing, à la Jane Ayres, for full range linear acceleration, deep extensor and glute activation and establishment of the center axis

5. Now that he’s cooking, have him lie prone in front of a wiffle ball hanging a foot off the ground. When you say “GO!”, he hits the ball with a bat to the beat of the music as you call out his rising score in an energetic voice. Each time he scores 20/30/50 points, you run and amusingly crash into mats to keep the activity funny and engaging! More utricle and deep extensor, glute activation and center axis work. We know vision guides movement so getting the target up a bit will help facilitate a more extended position.
‍
6. Finally, let’s take all that center axis and vestibular activation work and put it into a dynamic movement pattern. NDT Facilitations for trunk rotation basketball with lateral weight shifts and shoulder flexion beyond 90 degrees - ensuring oblique and transverse abdominal activation. Core core core!

Note: As sessions move along, you begin to spend a few minutes at the end playing a preferred tabletop game to apply the postural gains to the goal area, discussing his new strong muscles and how they help him sit tal. Bottom up meets top down.

1

st
Option

Swimming upstream

Aproach:
You engage the child in tabletop activities for the duration of your session while providing verbal and tactile cues to correct his posture each time he slouches

Note: Remember, practice doesn’t make perfect and don’t simply treat the symptoms. There is a reason why he struggles with maintaining an upright posture and simply practicing sitting will not result in any fundamental change. In addition, this approach can be frustrating and disheartening for the child. We have to look deeper.

2

nd
Option

Getting warmer

Approach:
You begin the session with the child lying on the floor in a superman prone position as you playfully roll a therapy ball that he pushes back to you using both hands. Two sets of 20 or until he fatigues, then transition to seated activities and prompt him to sit upright

Note: While this brings an element of play, the child struggles to jump right into a demanding prone position against gravity and fatigues quickly, demonstrating compensatory patterns (shoulder elevation, neck hyperextension, bending of the knees). Once compensations are present, there is little to no therapeutic value. Although a step in the right direction, this option still only addresses the symptoms and doesn’t provide the preparatory sensory activation needed for him to rise to the challenge and make fundamental change.

3

rd
Option

Now we're talking!

Setup:
Play quickshift tracks like Gravitational Grape or Agile Apricot (Vital Sounds) or any good, bass-driven music to get the rhythmic vibes flowing!

1. Begin with a tornado (Sheila Frick, Mary Kawar) for intense linear activation of the utricle to both organize and activate his postural system. He loves it!  Finish with rough house in crash mats.

2. Transition to vigorous trampoline jumping with a weighted ball in both hands (can play catch if able while jumping) to engages scapulae and provides stacking compression around the spine.
‍
3. Follow with deep, alerting tactile brushing (or manual input) along both sides of the spine and neck to activate the deep postural extensor muscles. Follow with rough house play in the crash mats. Think playful resistance and squeezes for deep tactile / proprioceptive activation! 

4. Next, a fun bungee prone extension game in a hammock swing, à la Jane Ayres, for full range linear acceleration, deep extensor and glute activation and establishment of the center axis.

5. Now that he’s cooking, have him lie prone in front of a wiffle ball hanging a foot off the ground. When you say “GO!”, he hits the ball with a bat to the beat of the music as you call out his rising score in an energetic voice. Each time he scores 20/30/50 points, you run and amusingly crash into mats to keep the activity funny and engaging! More utricle and deep extensor, glute activation and center axis work. We know vision guides movement so getting the target up a bit will help facilitate a more extended position.
‍
6. Finally, let’s take all that center axis and vestibular activation work and put it into a dynamic movement pattern. NDT Facilitations for trunk rotation basketball with lateral weight shifts and shoulder flexion beyond 90 degrees - ensuring oblique and transverse abdominal activation. Core core core!

Note: As sessions move along, you begin to spend a few minutes at the end playing a preferred tabletop game to apply the postural gains to the goal area, discussing his new strong muscles and how they help him sit tal. Bottom up meets top down.

How did we do?

All systems activated! ✓

By strategically activating all relevant sensory and emotional systems in a deliberate sequence, we maximized his potential for optimal performance. Each new gain in alignment, strength and endurance, as well as sense of pride and accomplishment, becomes embedded in motor and emotional memory, laying the groundwork for even greater success in future sessions and beyond! Ground upP.

Tactile system?  ✓Auditory system? ✓Proprioception? ✓Emotional system? ✓Vestibular system? ✓Relationship-based? ✓Visual system? ✓Motivational play? ✓

Listen to this In-depth explanation of Activate the systems process:

Activate the systems explanation
OTwithMJ
Click here for a tour!

want a particular piece of equipment fabricated?

Reach out !

arc

Connections
that inspire

Connections that inspire

Community

Over the years, I’ve met incredible people in the field, many of whom have become dear friends. This space is a shout-out to those colleagues and friends, as well as the esteemed mentors who have shared their priceless knowledge and wisdom with me. Having people to brainstorm and problem solve with is invaluable. Whether facilitating the learning or being the recipient of it, that collaborative clinical reasoning process is essential for growth and I’ve always been grateful for those opportunities.

Connections that inspire

In loving memory

In loving memory and deep gratitude for two of the extraordinary people who came into my life and left this world too soon. I had no idea that this photo existed until a couple weeks ago when a former employee sent it to me. It will stay close to my heart forever.

Huck, my clinical journey wouldn’t be anywhere near the same without you, and so many others can say the same. Your passion for clinical excellence and sharing your craft as well as your selfless dedication to children and their families was truly second to none. I, and so many others, are forever grateful.

Sylvie, bless your heart. You were truly an angel in my life. I still remember us walking through the SMILE Center during the build out before we opened, choosing wall colors and laying out the lobby. Your loving spirit and artistic eye left a lasting impression on so many people, both in the SMILE Center and the fashion world.

May you both rest in peace xo

Bio
Method
Philosophy
Community
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
AboutServicesTestimonialsFAQsContact usInstagram
Terms Of UsePrivacy Policy
© 2024 OTWITHMJ. All rights reserved