Thursday, December 8, 2016


FREE iPhone Class !!!

Are you or someone you know thinking about getting an iPhone?

Are you interested about learning how to navigate through your new phone in an easy and effective way?

A Community in Motion is an Occupational Therapy Practice that believes all people, regardless of background, resources, and physical or mental ability need to have equal access to daily life. It is essential for the development of a healthy and productive community. The cornerstone of our practice is helping our clients find tools and develop skills needed in their lives. All are welcome to attend our intro to basic iPhone class where we are planning to make using your iPhone easier to use without feeling overwhelmed.

WHEN: Saturday, February 4th from 1PM-3PM 
WHERE: 81 Riverside Drive Suite #1 Lebanon, NH 03766

Monday, August 8, 2016


Pack It Light, Wear It Right

by: Kate LeFebvre OTR/L
A Community in Motion

Take a close look at the photo above.  The Minnie Mouse outfit, the competing plaids, the… oh wait, not the clothing.  Look at the schoolbags.   See my sister in the middle, with her backpack slung oh-so-coolly over one shoulder?  Our fashionista neighbor on the right, whose bag only features one completely unpadded strap?  I’m not actually looking too bad – mullet bangs excluded – on the left, but in another two or three years you would have found me with my straps loosened about as far as they could go, bag slapping against my bottom with every step.  Oh, and five pounds of added keychain weight.

Don’t send your kids to school like it’s 1995.  Incorrectly worn backpacks can actually cause serious problems for people of all ages. In fact, almost 28,000 Americans sought treatment for backpack-related injuries in 2010.  Studies have found that well over half of students surveyed experience some pain or discomfort from carrying a backpack.  Here’s how you can keep your child safe:

  • Keep it light: a backpack should weigh no more than 10% of your child’s total body weight.
  • Choose a bag with two well-padded straps – and insist that your child wear them both.
  • Place the heaviest items closest to your child’s body.
  • Avoid lunchboxes that dangle from the bottom of the backpack, opting instead to place it inside the main compartment of the bag – or have your child carry it separately.
  • Cinch up the straps so the bottom of your child’s bag rests in the curve of his or her lower back.
  • Pick a bag that’s sized for your child.  Preschoolers may look awfully cute in giant bags designed for elementary-aged kids, but oversized backpacks aren't doing their little bodies any favors.
Check out for more information on backpack safety.

               And for those of you who've read this far looking for fashion advice to prevent your kids from being the victims of such tragic first day of school photos as mine? I’m afraid you've come to the wrong place; those Disney character shirts followed me to middle school.


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Monday, December 1, 2014


7 YEARS ~ Thank You for Saving Star Fish!

To: My Co-workers, 

Seven years ago today A Community in Motion had it's Federal ID and I had just received official confirmation that it was a recognized practice by the State of New Hampshire. 

In some ways, it feels like yesterday... and, of course, in others... like a life-time ago!! 

In our line of work, we are often told that we shouldn't take things too personally. The truth is, our work couldn't be more personal. We spend our days searching for ways to improve the quality and the state of being human. Did you know that in the Merriam Webster "the quality and state of being human" is listed as the first definition for humanity?

I honestly couldn't imagine working any other way. I'm so glad you chose to join me in ignoring those who would urge us to be somehow sterile in our effort. I was and continue to be blessed with each of you and the warmth of the gifts you bring. Your students, their parents and a myriad of school staffers are fortunate to have you. 

Please accept my sincere gratitude. 

This past weekend, I had the opportunity to be reminded of a story that I'm going to post a link for here. You've probably read it but please... READ IT AGAIN:) You're all busy but I promise it's short and worth it even if it simply serves as a reminder:

I know it can be a challenge remembering that what you do changes lives. I know remembering can be hard because I'm here too. My constitution is often strained and I fumble through the bureaucracy, sometimes feeling quite overwhelmed. Sometimes, I feel like my contributions are futile. I get it. I really do. 

I know YOU make a difference.  We all make a difference as individuals and as a collaborative body. If you ever doubt that, just ask me to tell you how I know it to be true. I have a "starfish" story about each and every one of you that proves it (even one about John and he's only been here a few months...). 

with my Highest and Most Assertive Regard, 

"To give real service you must add something which cannot be bought or measured with money, and that is sincerity and integrity." ~Douglas Adams 

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Monday, January 13, 2014


Come On, It Can’t Be That Hard

By Kate LeFebvre, OTR
A Communication in Motion

        A few months back, I stayed at a ski condo with some family members.  It had a fairly typical set-up for such rentals, with bunk rooms designed to cram in as many people as possible. Each top bunk was accessible via a ladder, something like this:
Photo credit:

        There were three rungs – one in the middle, one a normal distance above it, and one a normal distance below.  But a standard bunk bed ladder has four or five rungs and thus there was quite a distance from the floor to the bottom rung and from the top rung to the mattress.  Another notable feature is that these bunks, unlike the one pictured above, lacked railings.
Now imagine trying to climb that ladder and coming back down again.  Difficult for a young child with short legs, right?  But surely a twenty-something adult who has slept on numerous top bunks, some without ladders at all, in her lifetime can navigate this simple task without a problem?  Not so, it turns out.

        My sister claimed one of the bunks in mention.  She climbed up to check out her sleeping arrangements, hoisting herself from the top ladder rung onto the mattress, noting a lack of leverage due to the distance and lack of handholds.  But after a slight struggle she was up.  Nothing too taxing.  Coming down, it turns out, was another matter.
She turned around, felt for the first rung, and took another step down.  Before she knew it, she was out of rungs.  She was standing there, her upper body still lying across the bed as she gripped wherever she could reach, one leg dangling down unable to locate another foothold.  She flailed a bit, tried to reposition to see how far she still needed to descend… and got stuck.  The rest of us, of course, laughed copiously at her expense.  Stuck on a bunk bed ladder with her bottom sticking out in the air?  How absurd.  Her husband had to pick her up and place her back on the ground.

        Well, I apparently don’t watch and learn from others’ predicaments.  I thought I’d try this for myself, show my sister how easy a task it really was.  Oops.  I ran into exactly the same thing (rescued by my brother-in-law and all).  Who designed that thing anyway?
The reason I’m telling you this story is that how my sister and I felt stranded on that ladder, unable to navigate our way down to the ground, is how I imagine my students who struggle with praxis feel when confronted with a novel task.  Developmental dyspraxia occurs when a child is unable to create motor plans for new actions.  His muscles and joints work fine, but his brain can’t figure out how to move them in the correct order.  He may intellectually know exactly what needs to be done to participate in an activity, yet the neurons won’t fire to tell his limbs how to move.  Children with dyspraxia do eventually learn new motor tasks with increased support and opportunities to practice.  I likewise could have conquered that ladder if I had scaled it a few more times.  In the meantime, it was frustrating, embarrassing, and a bit scary.

        This is how it can feel every time a child with poor praxis (motor planning) skills faces a new task.  This could be playing soccer, tying shoelaces, cutting with a knife and fork, climbing on playground equipment, stepping over an obstacle, catching a ball, holding a pencil, completing jumping jacks, anything.  He’s helpless in controlling his own body.  This child appears clumsy, uncoordinated, even lazy or obstinate in his refusal to try new things.
Luckily, treatment is available.  In occupational therapy, we break down complex activities into their component steps, use forward and backward chaining techniques so children can be successful at part of a task before doing the whole thing, design sensory-rich obstacle courses and games, and teach new skills through play.  Speech and language pathologists likewise work with children whose motor planning difficulties interfere with forming words. These kids can and do learn to move their bodies.  Given appropriate support, they are able to participate in recess, physical education, rec sports leagues, and play of all sorts alongside their peers.

Interested in increasing your understanding of what it’s like to live with this condition?  Try snowboarding, water skiing, or roller-blading for the first time.  Attempt a gymnastics or martial arts move you've never done before.  Try to keep up with an unfamiliar line dance. Or find that ski condo in Vermont and dare to venture up onto the top bunk.  It’s harder than you think.

Read-aloud version of this post:

Edited, Recorded, and Posted by Noah Morse

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Monday, December 30, 2013


UGG Boots, Skinny Jeans, and ADHD

By Kate LeFebvre, OTR
A Communication in Motion
                    I’m sure you've heard about the increasing rate of ADHD diagnosis over the past decade or so.  I’m equally certain you've heard references to it as a trendy disorder, over-diagnosed by doctors that cater to yuppie parents.  Perhaps the motivation ascribed to these parents was to explain behavior problems created by lack of discipline, to get medication to sedate the kids and make parenting easier, or to obtain accommodations to give their children a leg up in school.  I won’t argue that ADHD is never misdiagnosed, or that there aren’t parents out there who have shopped around for a doctor who would label their child with something – anything.  ADHD, however, isn't just another chevron or moustache*.  Trendy or not, this condition is a real neurological disorder that causes major difficulties in the day-to-day lives of those it affects.
                I recently spoke with a woman who discovered as an adult that she has ADHD herself, as does one of her children.  She described her fears that, had they not been diagnosed, she would believe she was a bad mother, her child wouldn't have learned to slow down enough to speak and read, she could have been prescribed ineffective and potentially dangerous medications, and her children would have been considered “the behavior kids.”  Learning about ADHD allowed her and her family to develop coping strategies so that they can be successful, independent, and, most importantly, happy and fulfilled.
                This family’s lives were changed – at home, at school, at work – because of being appropriately diagnosed with ADHD.  Armed with this knowledge about how their brains function, she was able to seek therapies that made a world of difference.  She and her child now have the tools to manage the symptoms of their disorder and prevent it from interfering with the things they want and need to do.  So the next time you hear of another child who’s been diagnosed with ADHD consider that, although it may seem  as ubiquitous as a fleece North Face jacket on a college campus, this is a legitimate medical condition.  ADHD calls for compassion, accommodation, and coaching – not derision and dismissiveness.

* Moustaches?  Who comes up with these things?

Edited, Posted, and Recorded by Noah Morse

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Monday, December 16, 2013


Holiday Gifts and Tips

By Kate LeFebvre, OTR/L
A Community in Motion

Looking for a few last-minute gift ideas for your child with special needs?  Here are a few of my picks for therapeutic toys your child will be happy to see under the Christmas tree!

For fine motor skills:

For visual processing skills:

For executive functioning skills (planning, organization, and sequencing):
  • Lego sets
  • Craft kits
  • Guess Who
  • Children’s cookbook

For gross motor skills:

For calming sensory input:

Photo Credit:

Also, be sure to check out Ten Tips for Surviving Christmas with ADHD.  This is one of the most practical, specific “surviving the holidays with special needs” guides I have seen.  Most of the information is relevant for children with a variety of other diagnoses (especially autism spectrum disorders or sensory processing issues) and can be adapted for whatever holiday or special event your family has planned.

And perhaps consider skipping that visit to Santa...

Wishing you an enjoyable, calm holiday season!

Click for a read-aloud version of this post!

Edited and posted by Noah Morse

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Monday, December 2, 2013


The Time I Broke My Mother’s Finger – and OT Fixed It

by: Kate LeFebvre OTR/L
A Community in Motion

It was spring of my junior year in high school, and I had the dubious pleasure of taking the SAT IIs; something I had all but forgotten existed until I recalled this story.  Not yet having a driver’s license, I waited outside the school when I was done, pacing back and forth across the concrete until my mom arrived.  At some point, it would seem I stepped in a sticky wad of fresh chewing gum.  I climbed into the passenger’s seat unaware and assumed my typical (and I should note, not terribly safe in the car – don’t do this at home!) posture with my feet tucked up under me.
I suppose it comes as no great surprise to mothers everywhere that I wasn't the one to clean up the resulting gooey mess on the minivan’s upholstery.  In the process of scrubbing some unknown person’s used gum, Mum applied perhaps a bit too much elbow grease.  The result was mallet finger, a tendon injury that prevents the last joint of the affected finger from fully straightening.
       My mom went to see her primary care physician, who told her there was nothing to be done and her finger would never be straight again.  Unsatisfied, she convinced him to write a referral to occupational therapy.  Her OT, specializing in hand therapy, provided exercises to strengthen and repair the damaged tendon.  With a combination of clinic visits and home exercises, my mother restored full range of motion to her finger.  Now she not only has ten equally straight fingers, full function in both hands, and a story to tell about those darn careless kids, but she also had the opportunity to go back to her doctor and say “I told you so.”  Sounds like an OT success story to me!

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