Finding the Just Right Challenge
For occupational therapists, it is common to use phrases such as “upgrading” or “downgrading” the activity, believing it is obvious to other professionals. Overall, I am sure our fellow health professionals: speech and physical therapists, would have a close definition of what “upgrading” and “downgrading” activities mean for occupational therapists. But... to be on the safe side, let’s talk about it.
Grading
Grading means modifying activity to match the client’s ability, skills, and current psychological status to meet therapeutic goals. In short, “UP-grading” means making the activity more challenging, and “DOWN-grading” means making it “easier” to ensure success and prevent cumulative trauma. Grading the activity is like adjusting the lenses of your telescope to see the Moon’s craters or Jupiter’s colors. It is a dynamic process, and you are constantly fine-tuning and re-adjusting the lens while remaining calm. To be clear, downgrading activity is still a successful way to meet the goals. It does not mean there is no effort from the client’s side. It does not mean the therapist is cheating and changing the previously set goals. Instead, the therapist modifies the task or environment to meet the client’s capability, keep intrinsic motivation, and keep the activities at the just right challenge. As soon as the clients succeed, the therapists take them to the next level.
Case #1: For whatever reason, your client has difficulties focusing on materials you prepared for reading. Based on the goals, the client is at the emergent stage.
Downgrading tips:
Write only one letter on the paper; then write a couple of two-letter sight words; start knock-knock and write your final answer with the 3-word sentence on the paper in large font; put the ruler under the sentence or folded paper; change the plane from horizontal to vertical; parallel talk on what eyes and brain do together to read; ask the client to stand up and read; praise the effort client is taking; take-turns in reading words; reduce the visual distractions; stand on the right side of the client to reduce the facial distraction; gradually add more words to the sentence and never show the urgency in your voice to complete the task. Be Alexa!
Case #2: Your client is at parallel play but does not cooperate with their peers in school. The goal is cooperation in play.
Downgrading tips:
Start at the solitary level and play in the opposite corner from the client, but do not invite him/her, be busy, excited, and constructive, and have honest fun playing alone (do not fake, and do not look at the client). Gradually become louder and do a lot of self-talk about what you are working on. Because of the fun you are having without the request to join the play, chances are the client will be intrigued and eventually attempt to join.
Case #3: Your client loves jokes, and knock-knock worksheets are the best motivators to keep them engaged for 30+ minutes.
Upgrading tips:
After finishing the worksheet “Handwriting with joke concepts,” you want to move your client forward. The fastest way is to use your laptop. Using Ambiki, you will avoid googling ideas. Instead, open the Activity Lists attached to the “Joke” Worksheets you previously used and pick the upgrading option. Expand the client’s skills and knowledge by adding “Joke” multisyllabic words, multisyllabic phrases, multisyllabic sentences, and paragraphs. You will ensure clients have carryover with their mastery of concepts using inspiring resources for your client.
Upgrading and Downgrading Paradigm at the Ambiki Resources
The team making resources at Ambiki is working to adjust Resources concerning task modification, upgrading, and downgrading activities. If a therapist prints a Resource that includes worksheets, there will be many activities to ensure the transition from easy to challenging levels to fit various students’ ages and interests. Therapists can also use the same resource in Teletherapy.
For example, these Fossils Worksheets. Speech Therapists and Occupational Therapists can use this Resource. Speech Therapists can progressively work from easy to complex reading, answering questions, learning new nouns and verbs, and writing from a single word, to sentences to passages.
Occupational Therapists can use this Resource to work on fine motor skills such as pre-writing, writing, coloring, and cutting. Visual perceptual and visual-motor skills in matching shapes and shadows and imaginative playing. Freezing plastic dinosaurs in the balloon filled with water and cracking ice to find "frozen" dinosaurs can upgrade the activity by adding sensory and manipulative experience.
This Resource can be used for one session that lasts 10 mins or to keep students engaged for a couple of sessions. Additionally, this Resource has attached three digital Activity Lists that can further expand the imagination. With Activity Lists, clients can see images, read short definitions, learn more about living and non-living things, and see some of the nowadays living fossils as an expansion of the Resource.
Living Fossils:
