Therapy Thursday: Puzzles

Posted Thursday July 21, 2011 by Melissa

Puzzles have long been a favorite child activity, but I never understood the magnitude of their educational value until now. As Case’s cognitive abilities continue to improve, I am on a constant search for the best activities to stimulate those brain cells to recover after the GAG is removed. In my limited understanding of the science behind the clinical trial medication, the drug can remove the GAG, but it cannot make the cells recover and thus, bring Case new intellect and skills – that is the job of the brain cells. Consistent with strategies for stroke victims and other neurologic injuries, my hypothesis is that if consistently stimulated in a wide variety of ways, we can give those brain cells the best chance at recovering. Thus, the iPad (including puzzle apps), many new and carefully chosen toys and books, and … puzzles, lots of puzzles.

Puzzle skills. But puzzles are not just for a child in a clinical trial. They can be useful for many of our MPS and special needs kids. As anyone in child development will tell you, puzzles are a great source of skill building and brain stimulation. The benefits of children doing puzzles include:

  • Improving hand-eye coordination
  • Learning to recognize patterns, a foundation for reading, math, and logic skills (shape/size recognition, differences and similarities, spatial relationships, analyzing, and trial and error)
  • Developing problem solving skills
  • Rewarding persistence
  • Building a sense of mastery, individual success and achievement
  • Building a level of focused concentration
Melissa & Doug Knob Puzzle

Melissa & Doug Large Farm Jumbo Knob Puzzle

Puzzle difficulty. But what if puzzles seem too difficult? Many of our children lose skills over time and it may seem like puzzles are just a waste of time. Well, there are many different levels of puzzles from single piece peg puzzles to the mega-piece jigsaw puzzles. And, my philosophy has always been that we never know the possibilities of our child unless we try, and try again, and push – but still always having fun in the trying. Puzzles may not be right for every child at every stage, but there are many things I never considered until someone suggested them.

Puzzle topic. The topic of the puzzle is also important in helping your child want to work on it. Pictures that hold no interest provide no anticipation for completing the puzzle. If you child likes animals, pick animal puzzles. If he likes farms, pick farm puzzles. Fish, fish puzzles.

Homemade puzzles. Another alternative, if you’re handy, is to make a puzzle yourself. I stole this idea from another MPS mom (thanks Carolyn!) to make a puzzle with a picture of Case and his brothers on it. It was complex – choosing the right picture, shaping and sanding the pieces, using decoupage glue and silicone spray to adhere and preserve the picture. But, in the end, Case was incredibly determined to work on this puzzle because it included his favorite things – his brothers. However, before the clinical trial, he still could never complete this puzzle on his own. He did enjoy trying though.

Boys Puzzle

Homemade puzzle

Puzzle structure. Something to also consider is the structure of the puzzle itself. I would personally recommend thick wooden puzzles, especially for children like those with MPS who may have difficulty grasping or manipulating pieces with their hands. Melissa & Doug is often a good brand to consider for those kind of puzzles. I’ve found that cardboard puzzles add such increased challenge with manipulation that they should be saved for later when your child has mastered the ability to understand and do some puzzles.

Teaching puzzles. When you are working on puzzles with your child, there is also a structure to teaching them. Start by doing them yourself and showing them, then use your hand over theirs to put the pieces in place, then use a bit less in the way of physical prompts (holding their hand without guiding it), then use only verbal prompts and encouragement (of course, encouragement is always used!!), then letting them go!

Melissa & Doug Farm Puzzle

Melissa & Doug On The Farm 12-Piece Jigsaw Puzzle

Moving past inset puzzles. If your child is able to move past inset puzzles to multiple piece puzzles, then there are some different strategies as well. Start with only a piece or two out and follow the above strategies to help your child place the missing pieces until they can do so by themselves. Wavy side puzzles, especially those that fit inside a frame, are easier to understand and fit together at first (see the homemade puzzle above). Remember that jigsaw puzzles, if you’re doing those, add the additional complication of understanding how to fit the jigsaw pieces together. So for children who struggle with each step, make sure to break that out separately to teach them.

Case and puzzles. We have been working with Case on puzzles since not long after he was diagnosed at age 2. First we did large piece peg puzzles. Then, we moved onto the six piece wavy-side puzzle of him and his brothers. We continued on those and didn’t get to anything above that prior to him entering the clinical trial. He lost interest in puzzles as his cognition was declining.

About 3 months after starting in the clinical trial, however, his interest in puzzles returned. About 6 weeks ago, he showed interest in a 4-piece wavy side puzzle. He was able to complete the puzzle with help but was not able to complete a similar 6 piece puzzle. Soon, he could complete the homemade puzzle we had made of him and his brothers.

I checked with Case’s school and looked online and could not find suitable six-piece puzzles, so I just decided to get some 12-piece jigsaw puzzles. To my utter and complete surprise, within 3 weeks, Case had completely mastered the four 12-piece jigsaw puzzles we had. I realistically thought he’d be working on them for several months at least. In his early work on the puzzles, he struggled a lot with placement, how to know when pieces matched, and understanding that he could turn pieces around to fit – often he made the same mistakes over and over, but eventually, he figured it out. He was learning from doing it and remembering those skills! This is a video of him doing a mastered puzzle – about 2 days after he figured it out. Notice he is stylin’ in the Spongebob pajamas and the not-so-sterile-anymore gloves.

We’ve now ordered some 24-piece jigsaw puzzles and we’ll see where he goes from here!

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2 Responses to “Therapy Thursday: Puzzles”

  1. Elaine Zeighami // July 21, 2011 at 8:23 pm

    this is a wonderful article. It is encouraging me to think about how my MPS grandchild thinks and plays. One suggestion I would make is Lego duplo blocks. Reed absolutely loves playing with the big duplo blocks. Similar to what you said about matching their interests, it’s important to match your child’s interests. Reed loves the cars and animals, and is currently rocking the Firehouse set of Legos.. He amazes me with the creativity he shows in putting them together in different ways, then playing imagination games with his creations.

    • Thank you for he compliment Elaine. Case is also a fan of Duplo blocks and loves the Toy Story sets. I am quite excited about (I hope) meeting Reed at the conference next week – are you coming as well?