We have all been there as providers to young children--the group of kindergarteners comes to speech and they are absolutely wired, won't sit still, won't keep their hands to themselves, and you are struggling to provide productive therapy.

Background: when I first started telepractice in 2015, more than 50% of my caseload was under the age of five. This was my first time doing telepractice and I quickly learned that sitting still at a computer the entirety of the session was not a realistic expectation of much of my caseload.

With that said, in speech we need to get a certain number of targets and it can be VERY difficult to target phonological processes with a child running around the room.

Here's our top activity ideas, telepractice modifications, in addition to a free printable! Happy moving!

Smash Pads, Roll and Say, and Other Fine Motor Activities

These aren't HORRIBLY active but they keep the little fidgeting hands at bay which is often what young children need. There are some children that get over-stimulated with the addition of the gross motor muscles but adding in a fine motor component seems to do just the trick. For smash-pads, I personally prefer utilizing Play-Doh because they really engage those fine motor muscles BUT circle markers are also a great addition.

Telepractice modification

There are many environmental materials that you can request be brought to therapy such as shoe laces the child can spin around, Play-Doh that can be shaped during rest times, beads the child can place on a string, for example. Stress balls, fidget spinners, pop-its are a great way to keep a child engaged during seated therapy, simply inventory what your e-helper has access to and ask that individual to send it to speech with the child.

"The Floor is Lava"

This was one of my favorites when I first worked with that young caseload I mentioned. Simply place some sort of maze of safety on the floor and have your students/clients jump around. You can utilize floor discs, stability discs, OR if you're a Therapist Support Network member, we have printable pads you can laminate and place around the room (see freebie). Once your client stands on the safe space, have them produce the desired target.

Teletherapy modification

My main experience with "The Floor is Lava" is in teletherapy. I've had parents place pillows around the room my client is in OR have had my students set up the maze for me using paper, etc. Be mindful of device carrying! Personally, I have the facilitator place the device on a table that rolls with the child OR place the "safe spaces" where I can still see the mouth while the student jumps. The maze can also be set up to where the child goes and gets the stimuli by jumping and jumps back to the computer for target production.

FREE PRINTABLE! Test out this activity with these CVC Printable mats.

Simon Says, Red Light Green Light, and Dance Then Freeze Games

These are some classic, no-materials needed games that can easily utilize movement between stimulus and therapy targets. Simply get your students/clients up and start playing. Worried about uncontrolled madness? Place tape circles on the ground and tell your student/clients that they have to stay in that circle. You can make up "only move your legs" rules, as well, to keep hands from going astray to fellow group members.

Telepractice Modification

All of these activities can be done via telepractice. If possible, have your e-helper place a perimeter on the floor and tell your students not to leave the perimeter. If not, ask the student if they're on a tile floor and have them pick a tile to stay on during the activity.

Change Body Positioning (and Talk to an OT)

Often times, getting your student/child away from the sitting at a desk position can assist with decreasing distracting movement during the session. Standing, sitting on a stability disc, sitting on a balance ball, laying on the stomach, jumping on a mini-trampoline, sitting on the floor are all alternative positions that can assist with engagement in therapy. I have received most of my advice from OTs! They typically have some great suggestions for regulation in therapy so you can get your targets in!

Telepractice modification

When I have supervised other providers in teletherapy, I gave the recommendation to change a young child's position to increase attention during the session often, because I've seen how powerful a simple positioning change can help. By the time I ended the school year with my first caseload I mentioned, my students were either jumping on a small trampoline during therapy, laying on the floor during therapy, laying in a play tunnel, or sitting on a stability disc. The majority of students/clients join sessions from a portable device--ensure the device is safe in whatever the position they choose and then let it happen!


Moral of the story--there are ways to activate the fine motor and gross motor muscles while still getting a certain number of targets and structured instruction in.

TSN Members-check out the Therapy Support Network Material Center for some of these activities OR complete the "material request form" if you think of materials we can make to help you with these populations that we can make for you.

Not a TSN Member? Join us now for only $15.99/year and receive access to our material center, collaborative space, and material request form. https://thetherapistsupportnetwork.com/become-a-tsn-member/