1

Building Body Awareness and Strength Through Play Program: Development of a

Training and Intervention Program for Preschool Teachers and their Students

Significance
Introduction to the Population
The Children’s Center is a non-profit organization that provides community-based mental
health services to children ages two through seven and their families (The Children’s Center,
2021). The most common diagnoses at the center are unspecified anxiety or unspecified trauma
and stressor-related disorders. Children at this center may also have autism spectrum disorder
(ASD), attention-deficit hyperactivity disorder (ADHD), depression, separated parents, or
emotional and behavioral issues (The Children’s Center, 2017). The center provides a
therapeutic preschool to address emotional, behavioral, and social participation difficulties (The
Children’s Center, 2017).
Public Health Needs
In addition to emotional, behavioral, and social participation difficulties, children at The
Children’s Center with ASD and ADHD may also have additional problems related to these
diagnoses. Blanche et al. (2012) found that children with ASD have difficulties with
proprioceptive processing, leading to deficits in postural stability and motor planning, limiting
their participation in day-to-day activities. The proprioceptive system is a part of the sensory
system that allows an individual to know where their body is in space (Hatch-Rasmussen,
2020). Research also indicates that children with ADHD have increased difficulties with sensory
modulation and responding to sensory information, when compared to their peers (Davies &
Tucker, 2010). The Ayres Sensory Integration Theory emphasizes that sensory integration
difficulties in the school system can lead to dysfunction in postural control, and gross motor
skills, making it difficult to sit-upright and motionlessly when sitting on the floor or at a table
(AOTA, 2017; Roley et al., 2015). To effectively address the public health needs of children with
ASD and ADHD it is essential to include interventions that target postural stability, and
proprioception, since deficits in these factors can limit academic and social participation (AOTA,
2017; Blanche et al., 2012; Davis & Tucker, 2010).
Gaps In Service
In general, mental health services primarily focus on social interaction skills, emotional
regulation, and behavior (Arbesman et al., 2013; Brookman-Frazee et al., 2010). Brookman-
Frazee et al. (2010) identified that community-based mental health services are often not meant
to target developmental disabilities. Interventions for adverse childhood experiences and
pediatric mental health include psychological first aid, parent-child interaction therapy, child-
parent psychotherapy, cognitive behavioral therapy, and trauma-informed care (Costello, 2016).
This demonstrates current service gaps since children seen in mental health clinics may also
have sensory and motor deficits. The literature demonstrates that decreased mental health and
deficits in sensory processing, postural control and attention can limit participation in daily
activities, including academic and social participation (Cahill et al., 2020; Davies & Tucker,
2010; Faraone et al., 2015). Without adequate muscle strength and proprioception in the form of
body awareness, children demonstrate postural instabilities and, due to this, are unable to fully
participate in the evidence-based curriculum that supports emotional and behavioral well-being,
as they are unable to remain seated during circle time and table tasks.
Current Programming and Continued Gaps
The Incredible Years and Theraplay are two evidence-based programs used at The
Children’s Center. Incredible Years develops positive parent-teacher-child relationships,
emotional regulation, social participation, and treats behavioral problems (The Incredible Years
Inc., n.d.). Theraplay consists of playtime activities to build self-awareness and increase
attention, and uses upregulating activities followed by downregulating activities (Theraplay
Institute, 2020). However, these programs do not address proprioception or postural stability.
 2

Outside of the center’s curriculum, research indicates that yoga, weighted vests, air
cushions, and stability balls can effectively be used in a classroom setting to improve attention
and educational participation (Fedewa & Erwin, 2011; Grajo et al., 2020; Lin et al., 2014;
Pfeiffer, 2008). Basic et al. (2012) found that alternative seating improved participation for
children that had vestibular-proprioceptive sensory integration or sensory processing difficulties.
Research demonstrates that sensory integration, sensory processing interventions and sensory
diets, that include heavy work activities, have been shown to assist in regulating the sensory
system which promotes positive classroom engagement behaviors that will benefit the
psychological aspects of these programs (Davies & Tucker, 2010; Pingale et al., 2019;
Polatajko & Cantin, 2010).
In addition to improving attentiveness, yoga programs have also been found to improve
sitting tolerance, bilateral coordination, gross motor skills, motor and perceptual processes,
including proprioception, and social interaction skills in children with ASD (Kaur & Bhat, 2019;
Semple, 2018). Motor programs for preschool children and children with ASD have been shown
to improve gross motor skills, coordination, and dynamic balance (Bellows et al., 2013;
Najafabadi et al., 2018).
Individually, these programs target the skills required of the students at The Children’s
Center. Incorporating these interventions and outcomes into the Building Body Awareness and
Strength through Play program will help to improve children’s strength and proprioceptive
processing, increasing postural stability, motor skills, and classroom engagement. These
existing programs do not incorporate multiple skill areas or implement these interventions in
mental health services. A program is needed that addresses strength, motor, and proprioception
as a combined factor in order to increase classroom participation so that the children at this
center can receive the full benefit of the mental health services provided.
Program Proposal
The Building Body Awareness and Strength Through Play program was developed to
improve strength, proprioceptive processing, and postural control of the students at The
Children’s Center. This program consists of educating the therapeutic preschool specialists
(TPS) on key concepts and terminology related to strength, postural control, and proprioception.
Specialists are educated on how to identify these difficulties in the classroom and how to
implement appropriate interventions as well as track individual student’s progress. The TPS
staff will then implement activity interventions bi-weekly to facilitate postural control, strength,
and proprioception. By educating the staff and implementing specified interventions, the children
will then improve their ability to fully participate in the evidence-based curriculum that supports
emotional and behavioral well-being.
Theories
The Motor Skill Acquisition Theory aims to improve motor skills through practice,
feedback, and learner involvement. This theory utilizes practice and feedback in conjunction
with task and environmental modifications to help improve a child’s motor skills. Motor Skill
Acquisition emphasizes the importance of functional tasks and active learning (Kramer, 2018).
In the program, the TPS staff will be taught how to incorporate functional tasks and active
learning into the classroom while providing positive feedback to facilitate improved postural
stability, strength, and overall motor skills. The children will be provided with daily opportunities
to engage in activities to improve their motor skill acquisition. Environmental modifications
including rearranging the tables and chairs in the classroom, to create large open spaces that
encourage participation.
Dunn’s Model of Sensory Processing will be used to support the Building Body
Awareness and Strength through Play program as this model provides intervention approaches
to promote proprioceptive development. The model describes how the neurologic thresholds
and behavioral responses of an individual interact with each other on a continuum, resulting in
these four descriptions of sensory behavioral patterns: low registration, sensory sensitivity,
 3

sensation seeking, and sensation avoiding (Dunn, 1997). We will use this theory to educate the
TPS staff at the Children’s Center on sensory processing including key terminology and
concepts. We will then incorporate the suggested intervention approaches from this theory
directly into our program and into The Children’s Center’s weekly curriculum. These
interventions will include activities with proprioceptive input, postural control, and motor planning
to facilitate classroom participation (AOTA, 2017). See appendix A for the visual representation
of the theory in conjunction with the program.
Healthy People
The Healthy People 2030 initiative sets goals and objectives to improve overall health
and well-being for individuals in the United States (Office of Disease Prevention and Health
Promotion [ODPHP], n.d.). One of the goals of Healthy People 2030 is to “promote healthy
development for children and adolescents” (ODPHP, n.d.). The Building Body Awareness and
Strength through Play program focuses on promoting and supporting physical and behavioral
development in children, congruent with the goal of Healthy People 2030.
INNOVATION
The Building Body-Awareness and Strength Through Play program combines multiple
areas of intervention into one program to address aspects of strength, attention, and
proprioception. Research has indicated that while programs have been successful at targeting
motor and sensory deficits, these deficits have not been targeted in a combined program and
have not been used in mental health services. Currently, curriculum at The Children’s Center
only targets emotional and behavioral health. This program seeks to shift current practices by
including motor and sensory processing bi-weekly into the therapeutic preschool curriculum.
TPS staff at The Children’s Center are trained in mental health interventions and
services related to Theraplay and Incredible Years. This program will implement additional
training to the staff to better understand motor development and sensory processing. Since
many children at the center have ASD and ADHD, training on these areas of difficulty related to
these diagnoses is imperative. This training will be implemented by an occupational therapist
(OT), which will provide a service that is not currently offered at the center. In addition to adding
a skilled OT, the classroom curriculum will also include yoga, motor movements, heavy work
activities, and environmental modifications.
APPROACH
Needs Assessment
To address the needs of The Children’s Center, data was collected through individual
interviews with the therapeutic preschool staff, the community relations and volunteer manager,
and the clinical team, consisting of the family therapists. For the complete list of interview
questions and responses, see Appendix B. Through these interviews, preschool observations,
and research, it was discovered that this population's major public health needs are postural
stability, proprioception, and strength. These deficits are common amongst all classrooms at
The Children’s Center. This creates an occupational need related to school participation as
children are unable to sit through the duration of circle time or tabletop activities. For example,
one child has difficulty maintaining a tailor sitting position throughout the duration of circle time
due to decreased core stability and body awareness. He does not receive a reward at the end of
circle time like the rest of the children because he is unable to remain on his mat, which leads to
the child displaying negative behaviors. Without postural stability, strength, and proprioception,
the children at this facility are unable to fully participate in the evidence-based curriculum that
supports emotional and behavioral well-being. Currently, no program exists to target these
areas. TPS staff have attempted to learn the information and implement strategies on their own
but have not been successful. A program targeting the education of TPS staff on related
concepts and targeted interventions to implement in the classroom in order to improve these
public health and occupational needs is essential.
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Program Description
The program will begin with the training of all TPS staff one month after the school year
begins. This training will be led by an OT and consists of four separate sessions. These
sessions will include education on the key concepts related to postural control, strength, and
proprioception, creating and implementing interventions, documenting changes, and a question-
and-answer session to address and problem-solve any concerns or difficulties two months post-
implementation. The first three sessions will be held once a week for three weeks during the
scheduled Friday staff meetings. During these trainings, TPS staff will identify the children in
their class demonstrating difficulties in proprioception, strength, and postural stability. For the
full training outline, see appendix C. Once training has taken place, the TPS staff will implement
bi-weekly interventions into the curriculum for the duration of the school year. These
interventions will be at least 15 minutes of structured play to develop the skills related to the
core concepts. The entire preschool classroom will participate in these weekly interventions. To
see the intervention outlines, refer to appendix D.
The TPS staff will briefly document the date the intervention was implemented, the
intervention duration, the intervention activity, and who participated. At the end of every month,
TPS staff will document any changes in the identified children during circle time. The TPS not
leading circle time will start a timer at the beginning of circle time and will stop the timer when
the child moves from a tailor position. This time frame will be documented to track progress as
well as any other relevant observations.
Recruitment and marketing will not be necessary for program implementation as all
participants will be current students in the therapeutic preschool classroom and accepted based
on the center’s acceptance policy and guidelines. All children receiving services in the
therapeutic preschool are eligible for the program as the intervention will include the entire
classroom. Children that are not receiving services through the therapeutic preschool but
through family therapy alone, are not eligible to participate.
Goals and Objectives
● Goal One
○ In four months, therapeutic preschool specialists will implement one mini-
intervention session of the Building Body Awareness and Strength through Play
program twice a week for 15 minutes each session.
● Goal One Objectives
○ 1a. Within 3 months, all therapeutic preschool specialists will demonstrate an
understanding of the Building Body Awareness and Strength through Play
program by identifying a plan to implement the intervention outlined in their
weekly curriculum.
○ 1b. Within 3 months, all therapeutic preschool specialists will participate in four
live training sessions for the Building Body Awareness and Strength through Play
program, including a Q & A session with an occupational therapist.
○ 1c. Within 3 months, all therapeutic preschool specialists will identify five
activities that facilitate postural stability, proprioception, sensory processing, and
strength and report an overall increase in postural stability in their students.
● Goal Two
○ By the end of the calendar year, children in the Therapeutic Preschool will
demonstrate increased trunk control, proprioception, and strength, as evidenced
by remaining seated in a tailor sitting position for 5 consecutive minutes during
circle time.
● Goal Two Objectives
○ 2a. Within 6 months, children in the Therapeutic Preschool at The Children’s
Center will participate in bi-weekly proprioception/trunk control intervention
activities.
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○ 2b. Within 3 months, the children will demonstrate improved trunk control,
proprioception, strength, and sensory processing by maintaining a supported
seated position for 5 minutes.
Potential Problems
Once training is completed, the TPS staff will be in charge of implementing interventions
and documentation. One potential problem is that the TPS staff will not consistently implement
the interventions on a bi-weekly basis or document regularly. Therefore, the TPS staff managers
will be in charge of tracking intervention documentation and implementation at each Friday staff
meeting. Documentation has been made simple to ensure that it does not heavily interfere with
the other responsibilities required of the TPS.
There is also the potential that the children identified as struggling with postural control
and proprioception will choose not to participate in the activity, therefore, all interventions are
group interventions. By providing the intervention in a classroom setting, both TPS’ will be able
to work with the children and the child may be more motivated by positive peer pressure to
participate.
Program Assessment, Evaluation, & Analysis
The Building Body Awareness and Strength through Play program will be evaluated with
a TPS pre and post training scale, the Sensory Processing Measure-Preschool (SPM-P), and a
comparison of pre and post tailor sitting times (Sensory Processing Measure-Preschool [SPM-
P], 2007). The TPS pre-training scale will be completed the first day of training. These questions
will revolve around comfort level and understanding of sensory processing and strength topics,
implementing sensory and motor activities, and documenting changes. The questionnaire uses
a 5-point Likert scale, indicating a range between strongly disagree to strongly agree. The
higher the score represents a higher perceived understanding of concepts from TPS staff. At the
fourth training session, the TPS staff will complete the training scale a second time. This pre
and post data will be collected and analyzed by the OT. This Likert scale will demonstrate
whether the TPS staff gained knowledge and understanding of program topics and interventions
post training completion.
The SPM-P will be provided to the TPS staff during the third training session when
children with difficulties are identified. The TPS staff will then complete the SPM-P School Form
on those identified children. The OT will score the measures and analyze the data related to
body awareness, balance and motion, planning and ideas, and total sensory system scales
included in the SPM-P (SPM-P, 2007). At the end of the calendar year, the TPS managers will
provide the TPS staff the measure a second time during the last Friday staff meeting of the
year. The TPS staff will fill out the same form on the identified children in the class. Once
completed, the TPS managers will send the SPM-P forms to the occupational therapist who will
then score and analyze the data. The OT will compare the results to the measure completed
during training. The pre and post program implementation data will demonstrate functional
improvements in body awareness and sensory processing.
Lastly, on the first day of program implementation, the TPS staff will record the tailor
sitting baseline times of the identified children in the preschool. The TPS staff will start a timer at
the beginning of circle time and will stop the timer when the child moves from a tailor sitting
position. This time will be documented. At the end of each month, the TPS staff will record and
document the consecutive minutes the identified children sat in tailor sitting position during circle
time. These recorded times will be sent to the OT at the end of each month to analyze the data.
This information will demonstrate whether or not the identified children improved in the
consecutive minutes they were able to maintain a tailor sitting position.
Program Personnel & Resources
The Building Body Awareness and Strength Through Play program requires the
assistance of several individuals and resources for it to run efficiently and effectively. The
program requires a consult occupational therapist to provide and run the four TPS training
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sessions, answer questions regarding the program, and provide hands-on training in the
classrooms. The Children’s Center’s two TPS managers will help facilitate the program and
coordinate with the TPS staff and OT. The sixteen TPS staff members, two from each
classroom, will attend the training sessions, implement interventions into the classroom, and
assist with tracking program progress.
Resources for the program include a variety of supplies and equipment. Supplies,
including assessment kits, binders, pencils, paper, laminator machine, etc., will be utilized
during the TPS training sessions, provide valid and reliable test results, measure progress, and
be used to create resources for the TPS staff. Equipment required for the program, such as
projectors, play tunnels, weighted Theraballs, crash pads, mini trampolines etc., are for the
children to use during intervention sessions in the classroom to promote and improve body
awareness, strength, and sensory processing.
Sustaining the Program
Consistency and program maintenance will work together to achieve the greatest client
outcomes. At the end of the four TPS training sessions, all TPS staff will commit to completing
15 to 30-minute mini intervention sessions in the classroom, at least twice a week. TPS staff will
complete weekly logs for which days they complete intervention sessions and which activities
they did as the intervention. The TPS managers will be in charge of helping maintain and
sustain the Building Body Awareness and Strength through Play program at The Children’s
Center. They will gather each classroom’s logs at the end of the week, review them, and make
sure interventions are being integrated into the classroom. The contract occupational therapist
consultant will also ensure the program is being sustained via bi-weekly check-ins.
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Appendix A
Theories

Motor Skill Acquisition Model

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Sensory processing
Sensory systems focuses on adapting or
Dunn’s include: auditory, modifying activities or
gustatory, olfactory, contexts to support an
Model of individual based on their
Sensory tactile, proprioceptive, unique patterns of
Processing and vestibular sensory processing and
integration.

Recommended
Building Body Stimulate children’s
Intervention Approach:
Awareness and Providing rich sensory learning within a
Strength Through opportunities to explore context that is more
proprioception, build synchronous to the
Play (Incorporating
Sensory Processing postural control, and children’s sensory
Theory) gross motor skills. needs.

In-Class Program Interventions Implemented by Teachers:

Teacher education on • Animal Walks
proprioception dysfunction • Yoga
and intervention core • Scooter boards
concepts→ create learning • Obstacle Courses
environments and routines of • Ball play: push and pull weighted balls, lay over exercise
ball on stomach and pick up objects, sit and bounce on
children accommodate therapy ball, throw or kick balls at various speeds
sensory needs to promote • Color or do art in quadruped position
participation. • Twister
• Crash Pads
• Resistance tunnels
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Appendix B
Interview Questions and Responses

Interview Question: Information Gathered:

What are the current programs that you use The preschool shares a weekly curriculum of
with the children in your class? topics and themes. Some of these include the
senses, caring for others, transportation, etc.
The daily projects are based on these
themes, and they are discussed in class.

Invisible Years and Theraplay are also a part

of the curriculum. The use of puppets is
included in circle time at least once a week.
These puppets talk about emotions and the
curriculum for the week. For example, the
focus of the last few months has been on
teamwork. The puppet demonstrates
teamwork to the children.

Outside of current programs, what resources All TPS staff have weekly meetings on Friday
do you have available? afternoons to discuss any questions or issues
in the classroom and share ideas. The
meetings are led by two TPS staff. The TPS
staff shares resources with each other. For
example, a previous Zones of Regulation
course was passed among TPS staff
struggling with behaviors. There is also a
training course for new TPS staff.

What gaps do you feel currently exist within The preschool does not address core
the therapeutic preschool? weakness or body awareness. Mindfulness
strategies were also discussed as an area
that might be helpful. There was previously
an occupational therapist who helped with
motor problems, but they were let go when
the funding ended.
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Are there areas you wish were better Many children that come through the
addressed in the preschool? preschool struggle to sit at the table or during
circle time. Strategies such as using a jacket
to tie the child’s waist to the table have been
used but were ineffective. These children also
have poor body awareness. Yoga and
mindfulness have been implemented in the
past by an outside source but are no longer
offered.

What problems are you seeing in the Difficulties with core stability and body
classroom that have been difficult to manage awareness. The TPS staff has attempted to
or create intervention ideas for? print out information and strategies but finds it
difficult to understand and implement. They
have not seen improvement in these areas.

Are there any occupations (circle time, play, All occupations are addressed and
social participation, dressing, eating, toileting, participated in. However, the center only
art, table activities) that are not currently focuses on the emotional, behavioral, and
being addressed at the site? social aspects of these areas.

What are the goals of the therapeutic Stable, healthy relationships

preschool? Boundaries
Social Participation
Play
Strategies for conflict resolution
Emotional regulation

How do you achieve the goals/mission of The The staff collectively created the goals and
Children’s Center? put certain employees in charge of reaching
those goals. The missions and goals are used
to guide every employee’s work.

What disciplines work or volunteer at The Clinical social workers

Children’s Center? Psychologists
Family therapists
Psychiatrists
Speech-Language Pathologists
Associate Clinical Mental Health Counselors
Clinical Mental Health Counselors
Therapeutic Preschool Specialists (TPS)
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On average, what diagnosis do you see the Unspecified Anxiety and Unspecified
most of? Trauma/Stressor

How common is trauma for the children in Almost every child that receives services at
your class? The Children’s Center has experienced at
least one form of trauma.

What is the most common reason for a child Aggression, defiant behaviors, or they have
to be in the therapeutic preschool? been kicked out of other group settings.

What do you consider the strengths of your The age focus of this center allows expertise
site to be? to build in supporting mental health for
children of this age.
The preschool teaches the children skills that
they need to be successful in the classroom.
Trauma-informed care is implemented in all
services. The children are provided stable,
consistent adult relationships.
Children are encouraged to form positive
boundaries and peer relationships.
The class sizes are kept small, with nine or
less children in a classroom. The children are
able to receive positive praise and adult
interactions on a daily basis with two TPS
staff members and one volunteer in each
class. Each classroom has their own daily
schedule that is reviewed during class every
day.
Classroom toys are rotated on a biweekly
basis to encourage imaginative play and
reduce boredom.
There is open communication about each
child between TPS and therapists.

How would you describe the culture here? Since it is a non-profit organization, people
aren't necessarily here for the paycheck.
People are all very committed to helping
make children's and family's lives better. All
employees are genuinely interested in the
value they can add to The Children's Center
as a whole.

Who funds the preschool? Most of the funds are through donations. The
other portion is through the state or federal
government.
 15

Are the funds adequate for the population No family is turned away for their inability to
you serve or are they lacking? pay. Federal Poverty Guidelines are used to
determine how much a family is required to
pay. 94% of families do not pay anything. 5%
pay on a sliding scale. 1% pay the full price.
Funding is inadequate in many ways,
including staff salaries, limited locations,
inability to reach rural areas, and the building
is not adaptable to changing needs.
 16

Appendix C
Training Session Outlines

Session 1: Introduction and Key Concepts

Purpose: To educate TPS staff on the key concepts of the program.

Key Concepts:
● Postural Control
● Body Awareness/Proprioception
● Muscle Strength

Outline:
● The OT will introduce themself and occupational therapy
● Introduce the plan and objectives of the training session
● TPS Staff will complete pre-training scale
● Present the needs of the site and how it ties into the preschool
○ Include research
■ Needs of the population and the needs of the site
● Introduce the program
● Connect how the program ties into both the research and the needs of the site
● Teach key concepts of program via PowerPoint
○ Complete mini activities to highlight concepts
■ Throwing different size and weighted balls at a target
■ Mirror Games - copying movements
■ Obstacle course
■ Balloon toss
○ Answer questions as a group
■ How did your proprioceptive system/core strength help you complete
these activities?
■ Imagine a child that struggled with the proprioceptive system or did not
have adequate core strength. How would that have impacted their
success in these activities?
■ What difficulties might they have in school?
● Educate on observational signs of difficulties in the classroom
○ Postural Instability
■ Unable to maintain a seated position for longer periods of time
■ Poor gross and fine motor activities
■ Poor balance
○ Decreased proprioception
■ Propping or leaning
■ Bumping into others and objects
■ Runs or walks loudly
■ Postural instability
 17

■ Poor gross and fine motor skills

■ Poor coordination
○ Have the TPS staff identify other observational signs that may be present
● TPS staff for each classroom (2 per class) will get together and identify what
observational signs are present in their classroom currently.
● TPS will present and discuss observational signs together as a group
● Q&A
● Review and wrap-up session
● Preview of the next session

Objectives:
● TPS will understand and be able to verbalize core concepts of program
● TPS will be able to identify observational signs of core concepts in their classroom
● TPS will verbalize how the program benefits the preschool

Session 2: Creating and Implementing Intervention Sessions into the Classroom

Purpose: To educate TPS staff on interventions to incorporate into the classroom to improve
proprioception and postural stability.

Outline:
● Introduce the plan and objectives of the training session
● Briefly review the previous training session’s core concepts
● Q & A to answer any new or remaining questions from previous session
● Introduce Models
○ Motor Acquisition
○ Dunn’s Model of Sensory Processing
● Connect models to classroom needs
● Provide and discuss intervention ideas:
○ Yoga
○ Obstacle Course
○ Ball Play
○ Scooter Boards
○ Animal Walks
● Teach TPS staff how these interventions target the key concepts
● Present research evidence for interventions
● Educate TPS staff on how to set-up and structure intervention activities
● TPS staff for each classroom (2 per class), will create one 15-minute mini intervention.
○ They will be responsible for:
■ Describing set-up
■ Purpose of the activity
■ How they would direct the activity
■ Objectives for the activity
 18

● TPS staff will integrate interventions into weekly curriculum and identify at least two days
per week to implement a 15-minute intervention session
● Q&A
● Review and wrap-up session
● Preview of the next session

Objectives:
● TPS staff with integrate interventions two times a week into weekly curriculum
● TPS staff with identify how interventions target classroom needs
● TPS staff with demonstrate how to set-up and direct intervention activity to target
intervention objectives

Session 3: Keeping Track

Purpose: To train TPS staff on how to keep track of intervention implementation and how to
document improvements.

Outline:
● Introduce plan and objectives for session
● Review information from previous session
● Q & A to address any remaining questions from previous sessions
● Have TPS staff identify children in class that are struggling with postural control and
proprioception
● TPS staff will complete the Sensory Processing Measure - Preschool School Form on
identified children
● Teach TPS staff how to document progress for identified children. The therapist will
either demonstrate progress through a series of intervention activities acted out and/or
show videos. The TPS will write down their observations. For example: Frank can put
his hands down on the floor in animal walks without falling over. Tony can sit in circle
time without laying down.
● Pass the checklist out to TPS staff.
● Review the checklist and educate on how to fill it out. The TPS staff will fill out what days
the mini interventions were implemented, intervention duration, and intervention activity.
● Q & A for any remaining questions.
● Review of session
● Preview of check-in session

Objectives:
● TPS will document progress for identified children
● TPS will understand how to complete checklist
 19

Session 4: Let’s Catch Up (1 month into program implementation)

Purpose: After one month of program implementation, this session will be to check-in with TPS
staff and answer or problem-solve any questions or concerns related to program
implementation.

Outline:
● Q & A to address any concerns or problems related to program

Objective: TPS staff will identify concerns and verbalize understanding of OT’s solutions.
 20

Appendix D
Intervention Sessions

Building Body Awareness & Strength through Play Intervention Session Outline
Each intervention session would last between 15-30 minutes. These eight intervention sessions
are available for the TPS to use in the classroom. The intervention sessions do not require that
the students complete them in any specific order and the TPS have freedom to change, adjust,
or add to the intervention sessions according to the information they learn throughout the four
TPS training sessions.
Intervention Session Goals & Objectives:
● Participation in bi-weekly guided proprioception/trunk control intervention activities.
● Improve overall strength, trunk control, proprioception, attention, and sensory
processing.
Session 1: Animal Walks
● Supplies Required:
○ Animal Walk Cards (Laminated and available in each classroom’s resource
binder) (i.e., crab walks, frog hops, penguin waddle, etc.)
● Set-up:
○ Choose a starting and ending position in the classroom or out in the hallway
○ Place ~5 animal walk cards around the classroom and out in the hallway,
approximately 15-25 feet apart
● Directed Play Instructions:
○ Have the children line up at the starting location
○ Each child will take turns completing various animal walks, starting with the
animal walk at the starting line and changing every time they get to a new animal
walk card, until they get to the finish line (completing one round)
■ Animal walk cards can be changed, rotated, or moved between each
round.
Session 2: Kids Yoga
● Supplies Required:
○ Projector
○ Computer
○ Online Kids Yoga Videos (*see program classroom resource binders)
● Set-up:
○ Choose a Kids Yoga video from the resource binder
○ Follow instructions in the binder to pull up the video on the computer and
projector screen
● Directed Play Instructions:
○ Have the children spread out on the carpet area of the classroom, facing the
projector screen
○ Start the kid’s yoga video
○ Follow along with the video while encouraging, assisting, or providing feedback
to the children while they complete various yoga poses along with the video
 21

Session 3: Obstacle Course

● Supplies Required:
○ Bean bags
○ Ring Toss
○ Play tunnel
○ Resistance Tunnel
○ Small Basket
● Set-up:
○ Place the bean bags at one end of the classroom on the floor
○ Place play tunnel a few feet away from the bean bags
○ Place 5 ring toss rings on the floor in a zigzag pattern, about 6-8 inches apart
○ Place the resistance tunnel a few feet away from the ring toss rings
○ Place basket close to the wall on the opposite end of the classroom from the
bean bags
● Directed Play Instructions:
○ Have the children line up along the wall next to where the bean bags are placed
○ The children will take turns picking up a bean bag
○ A child will crawl through the play tunnel, jump from ring to ring, crawl through the
resistance tunnel and then place the bean bag in the basket until all the bean
bags are placed into the basket
○ The obstacle course can be repeated multiple times with different configurations
■ TPS can rearrange or change the order of the obstacle course/obstacle
course items
Session 4: Indoor Large Play Station Rotations
● Supplies Required:
○ Scooter boards
○ Mini indoor trampoline
○ Small children’s indoor slide
○ Crash pad
○ Painter’s tape
● Set-up:
○ Place scooter boards in a group in the hallway
○ Tape a starting and ending line to the carpet in the hallway using the painter’s
tape
○ Place the indoor slide on the carpeted area of the classroom, with a crash pad at
the bottom
○ Place the mini trampoline in the other end of the carpeted area of the classroom
● Directed Play Instructions:
○ Station 1: Scooter Board Races
■ Have the children sit on their stomachs on the scooter boards at the
starting line in groups of two
■ Have the children push themselves using their arms from the starting line
to the finish line while racing one of their classmates
■ Continue until all children have had a chance to race
 22

● TPS can switch and change the way the children sit or move on
their scooter boards
○ Station 2: Indoor Slider
■ Have the children take turns going down the slide until it’s time to rotate
stations
● The children can go down the slide on their bottoms, backwards,
on their stomachs, etc.
○ Station 3: Indoor Trampoline
■ The children will take turns jumping on the trampoline
● Children will jump for ~30 bounces
● The TPS can help guide the children for how they can try
bouncing on the trampoline (i.e., one foot, two feet, spinning in
circles, etc.)
Session 5: Ball Play
● Supplies Required:
○ Weighted Theraballs therapy ball set
○ Various playground and soft fabric balls
○ Painter’s Tape
● Set-up:
○ Gather required materials
○ Tape various shapes on the walls around the classroom using the painter’s tape
(ex. Circle, triangle, square, diamond)
○ Tape lines on the floor at various distances (3 ft, 5 ft, 8 ft) in front of each shape
that’s on the wall
● Directed Play Instructions:
○ Station 1: Have the children take turns throwing various balls at the shapes on
the wall from all the various distances
○ Station 2: Have one TPS take turns throwing and catching various balls with
each child in a one-on-one setting
Session 6: Go Noodle Dance Videos
● Supplies Required:
○ Projector
○ Computer
● Set-up:
○ Choose ~3 Go Noodle Videos from YouTube or Go Noodle website (see
resource binder for instructions on how to access site as well as a list of a few
video options to choose from)
○ Pull up video on laptop and turn on projector
● Directed Play Instructions:
○ Have children spread out on the carpeted area in front of the projector
○ Press play on the first video
○ Follow along with the Go Noodle dance videos
○ Encourage the children to participate and provide feedback and encouragement
to the children that are following along with the video
 23

Session 7: Indoor Game Play

● Supplies Required:
○ Giant Jenga blocks
○ Twister game
● Set-up:
○ Gather required materials
○ Set up the giant Jenga blocks on a hard surface floor in the classroom
○ Set up Twister game in the carpeted area of the classroom
● Directed Play Instructions:
○ Split the children into two groups
○ Have the first group start at the giant Jenga station and have the other group
start at the twister station, the groups will switch halfway through
○ Station 1: Giant Jenga
■ Have the children take turns pulling Jenga blocks out one at a time, trying
not to knock over the rest of the tower, and place the block on the top of
the stack
■ Help the children restack the Jenga tower after it is knocked over until it’s
time for the children to rotate stations
○ Station 2: Twister
■ Gather the children around the twister board
■ Spin the twister spinner to determine which body part (L hand, R hand, L
leg, R leg) to place on the respective color
■ Continue to spin the spinner until a child falls on the mat
■ Have the children return to the starting position and continue to play until
it’s time to rotate
Session 8: Deep Pressure Mindfulness Activity Rotation
● Supplies Required:
○ Blankets
○ Exercise balls
○ Crash pads
○ Computer
○ Projector
● Set-up:
○ Set up the crash pads around the classroom
○ Lay out the blankets around the carpeted area of the classroom
○ Pull up a guided children’s mindfulness breathing exercise on the computer (see
resource binder for instructions)
○ Pull out exercise balls
● Directed Play Instructions:
○ Station 1: Burrito Mindfulness Breathing
■ Have each child choose a blanket and lay down in the middle
■ Wrap each child up in the blanket
■ Start the guided mindfulness breathing video and encourage the children
to participate while the TPS also following along with the video
 24

○ Station 2: Crash Pad Squish

■ Have one child lay down in the middle of the crash pad
■ The TPS will then take the edge of the crash pad to “squish” the child in
the middle to provide heavy work pressure input to the body, “squish” the
child for 5-10 seconds and repeat 5 times
■ Repeat until all the children have completed the station
○ Station 3: Exercise Ball Proprioceptive Activity
■ Have a child lay down in the middle of a crash pad on their belly
■ Take an exercise ball and roll the ball up and down the child’s back to
provide sensory input, repeat 15-20 times
■ Repeat until all the children have completed the station
 25

Grant Budget
Budget Item Cost
Space:
The Children's Center Preschool Classrooms (8)* $0.00
The Children's Center Conference room* $0.00
The Children's Center Playground* $0.00

Supplies: (e.g., materials, printing costs)

1- Sensory Processing Measure - Preschool (SPM-P) Kit $212.00
8- Sensory Processing Measure (SPM-P) Home Autoscore forms pack of 25 ($85/unit) $680.00

8-Binders- 2 inch ($4/unit) $32.00

4- Sheet Protectors (200 Pack) ($12/unit) $48.00
1- Pencil Pack (150 count) ($13/unit) $13.00
20- 24 Count Crayon Packs (6 pack) ($12/unit) $240.00
10-Reams Copy Paper $34.00
1- Printer $100.00
6- Printer Ink Cartridges (Two pack-XL black & color $56/unit) $336.00

1- Laminator Machine $40.00

2- Laminator Sheet Packets (200 sheets) ($30/unit) $60.00
100- 12 Pack Washable Markers ($8/unit) $800.00

Equipment: (e.g., tablets, computers)

8-Projectors- ($90/unit) $720.00
8-Laptops- ($500/unit) $4,000.00
8-Sets Large Jenga Blocks ($50/unit) $400.00
16-Youth Size Large Sweatshirts ($13/unit) $208.00
10-Rice Bags (20 lbs. each) ($9/unit) $90.00
8- 6 Foot Play Tunnels ($30/unit) $240.00
18- Scooter Boards ($23/unit) $414.00
2- Ring Toss Packs (12 rings/pack) ($10/unit) $20.00
2- Toss Bean Bag Sets (12 bean bags/pack) ($17/unit) $34.00
2- Theraball Weighted Ball Sets (6 balls/pack) ($112/unit) $224.00
8- Crash Pads ($160/unit) $1,280.00
 26

2- Twister Game Sets ($18/unit) $36.00

2- Resistance Tunnels ($65/unit) $130.00
9- Exercise Balls ($20/unit) $180.00
2- 3' Indoor Trampoline ($60/unit) $120.00
2- Indoor Toddler Slides ($35/unit) $70.00

Personnel (e.g., salary with % time/effort, hourly wage, benefits, consultant fees)

1-Occupational Therapist Consultant (4 hours/month, $43/hour) $2,064.00

2- Therapeutic Preschool Managers ($18/person/hour) * $0.00
16- Therapeutic Preschool Specialists (TPS) ($13/person/hour)* $0.00

Total Requested: $12,825.00

*In-Kind Contribution
 27

Grant Budget Justification

Budget Item Cost
Space:

The Children's Center Preschool Classrooms (8)*

Eight classrooms are needed for Building Body Awareness and Strength through play $0.00
program to provide the children in each class with space to engage in activities to support
and promote increased proprioception, overall strength, and attention.
The Children's Center Conference Room*
The conference room at the children's center is required to provide a location for The $0.00
Children's Center staff to gather for the four training sessions that are a part of the program.
The Children's Center Playground*
The playground is needed for the program to provide the children participating in the $0.00
program with a safe, outdoor location to explore and engage in activities that facilitate
improvement in proprioception and strength.

Supplies: (e.g., materials, printing costs)

1- Sensory Processing Measure - Preschool (SPM-P) Kit
This kit will be used to help track progress for the children in the program, regarding body $212.00
awareness, strength, and sensory integration.
8- Sensory Processing Measure (SPM-P) Home Autoscore forms pack of 25 ($85/unit)
The SPM-P autoscore forms are required to score the assessment in order to obtain pre $680.00
and post measures for the children in the program. The scores from the form provide data to
track and mark progress.
8-Binders- 2 inch ($4/unit)
The eight binders will be used as a resource packet to be placed in each of the eight
classrooms with information about the program, evidence-based practice resources, as well $32.00
as several intervention ideas that the therapeutic preschool specialists (TPS) can use to
help set up activities to promote improved proprioception and strength.
4- Sheet Protectors (200 Pack) ($12/unit)
The sheet protectors will be used to protect, organize, and sort the pages that are in the $48.00
resource binders for each classroom.
1- Pencil Pack (150 count) ($13/unit)
Pencils are required so the TPS can take notes during the training session and be used to $13.00
mark and track the children's progress who are in the classroom.
20- 24 Count Crayon Packs (6 pack) ($12/unit)
Crayons are needed for the children to use as a resource and writing utensil during guided $240.00
classroom activities to help with sensory processing, proprioception, and strength.
1- Printer
A printer is needed to produce print outs for the resource binders, assessments, and $100.00
evaluations, as well as any other resources related to the program.
 28

6- Printer Ink Cartridges (Two pack-XL black & color $56/unit)

Ink will provide the printer with the ability to print all the required resources for the program $336.00
(assessments, evaluations, pre and post surveys, resource binder papers, etc.)
10-Reams Copy Paper
Paper reams are necessary so that they can be used to print the required materials on or $34.00
used in the classroom as a writing surface during guided interventions.
1- Laminator Machine
A laminator is required as a supply for the program to laminate any resources for the $40.00
resource binder or therapeutic preschool binders that facilitate the program. It will help
protect the printed materials and allow them to be sanitized.
2- Laminator Sheet Packets (200 sheets) ($30/unit)
Laminator sheets are required so the laminator machine is functional and can perform its $60.00
required function to benefit the program.
100- 12 Pack Washable Markers ($8/unit)
Markers are needed for the children to use during guided classroom activities to help with $800.00
sensory processing, proprioception, and strength.

Equipment: (e.g., tablets, computers)

8-Projectors- ($90/unit)
Projectors are required for each classroom so that program and intervention materials can $720.00
be projected onto the walls for TPS to use and the children can follow (i.e. Kid's Yoga
videos, children's dance videos, etc.)
8-Laptops- ($500/unit)
Laptops are required for each classroom in order to provide input for the projectors and $4,000.00
bring up various intervention materials that facilitate the children's improved overall strength,
proprioception, and attention.
8-Sets Large Jenga Blocks ($50/unit)
Large Jenga block sets will be placed in each classroom to be used as a resource during $400.00
guided classroom interventions to promote improved body awareness and strength.
16-Youth Size Large Sweatshirts ($13/unit)
Youth sweatshirt sleeves will be filled with rice and sewn closed in sections. Two
sweatshirts will be available to each classroom and can be placed on the back of a child's $208.00
chair. When a child is seated to perform guided tabletop activities, the weighted sleeves will
be placed on the child's lap to provide pressure and sensory input to improve the child's
attention and participation in the program activities.
10-Rice Bags (20 lbs. each) ($9/unit)
Rice is required to fill the sweatshirts so they can perform their intended purpose for the $90.00
program.
8- 6 Foot Play Tunnels ($30/unit)
A 6-foot play tunnel will be placed in each classroom, to be pulled out by TPS, and used as $240.00
a resource during guided intervention sessions to build body awareness, strength, and
attention.
 29

18- Scooter Boards ($23/unit)

Scooter boards will be available for shared use across the eight classrooms as a resource $414.00
to be used by the children during the guided intervention session to promote improved
proprioception, strength, and attention.
2- Ring Toss Packs (12 rings/pack) ($10/unit)
Ring toss packs will be available for shared use across the eight classrooms as a resource $20.00
to be used by the children during the guided intervention session to promote improved
proprioception, strength, and attention.
2- Toss Bean Bag Sets (12 bean bags/pack) ($17/unit)
Bean bag toss sets will be available for shared use across the eight classrooms as a $34.00
resource to be used by the children during the guided intervention session to promote
improved proprioception, strength, and attention.
2- Theraball Weighted Ball Sets (6 balls/pack) ($112/unit)
Theraball weighted ball sets will be available for shared use across the eight classrooms as $224.00
a resource to be used by the children during the guided intervention session to promote
improved proprioception, strength, and attention.
8- Crash Pads ($160/unit)
Crash pads will be available for shared use across the eight classrooms (four crash pads $1,280.00
upstairs, four crash pads downstairs) as a resource to be used by the children during the
guided intervention session to promote improved proprioception, strength, and attention.
2- Twister Game Sets ($18/unit)
Twister game sets will be available for shared use across the eight classrooms as a $36.00
resource to be used by the children during the guided intervention session to promote
improved proprioception, strength, and attention.
2- Resistance Tunnels ($65/unit)
Resistance tunnels will be available for shared use across the eight classrooms as a $130.00
resource to be used by the children during the guided intervention session to promote
improved proprioception, strength, and attention.
9- Exercise Balls ($20/unit)
Exercise balls will be available for shared use across the eight classrooms as a resource to $180.00
be used by the children during the guided intervention session to promote improved
proprioception, strength, and attention.
2- 3' Indoor Trampoline ($60/unit)
Indoor trampolines will be available for shared use across the eight classrooms as a $120.00
resource to be used by the children during the guided intervention session to promote
improved proprioception, strength, and attention.
2- Indoor Toddler Slides ($35/unit)
Indoor toddler slides will be available for shared use across the eight classrooms as a $70.00
resource to be used by the children during the guided intervention session to promote
improved proprioception, strength, and attention.
 30

Personnel (e.g., salary with % time/effort, hourly wage, benefits, consultant fees)
1-Occupational Therapist Consultant (4 hours/month, $43/hour)
An occupational therapy consult (four hours a month) is required to provide the staff training
on the Building Body Awareness and Strength Through Play program. An OT will provide $2,064.00
the four training sessions to the therapeutic preschool specialists, answer additional
questions the TPS staff has, provide hands-on training in the classroom setting, as well as
ensure the program is being followed correctly and in an appropriate manner.
2- Therapeutic Preschool Managers ($18/person/hour) *
The therapeutic preschool managers at the Children's Center have already agreed to
volunteer their time to the program. Their role in the program is to help coordinate and act $0.00
as a liaison between the OT and the TPS staff, collect data to track progress on the
program, and ensure the program is being integrated into all eight preschool classrooms.
16- Therapeutic Preschool Specialists (TPS) ($13/person/hour) *
There are two TPS to every classroom. The TPS staff has The Children's Center has
volunteered their time to learning about the program. They will participate in the four training
sessions, will facilitate the mini guided intervention sessions into the classroom on a weekly $0.00
basis, report data for each of the children that participate in the program, as well as
communicate any questions or concerns with the program or children in the program to the
OT or therapeutic preschool managers.

Total Requested: $12,825.00

*In-Kind Contribution