I am thrilled to post again from a more clinical standpoint. I’ve been getting a few questions coming in for “Ask an OT”, so let’s bring this series back! Today’s question is: How do therapists get kids to do what they want them to do in therapy? I can hardly get my child to do anything without a temper tantrum. Great question!
First, I don’t want to paint a perfect picture that every therapy session goes 100% according to plan. Any therapist reading this knows sometimes a successful session has more to do with the position of the moon than it does with a foolproof therapeutic plan. Anytime kids are involved, risks for disaster are high! That being said, here are eight useful tips therapists utilize that parents and caregivers can incorporate into every day life.
1. Do not ask a question if there is no choice. This is the hardest and most important lesson in communication for new therapists and, I think, parents too. If a parent asks a toddler a question then the answer must/should be honored. By asking the question, having a choice is implied. In therapy, this may sound like: “Do you want to get on all fours for our next game?” rather than “For our next game, get on all fours! Like a horse/puppy/dinosaur!” Or, at home, if it is time to go inside do not ask “Do you want/Are you ready to go inside?” Simply state: “It is time to go inside.”
2. Be polite. I expect to hear pleases and thank you’s from Waverley as I do my patients and students. However, one can not expect manners from children if they are not demonstrated to them! Saying please and thank you both ways (from adult to child and child to adult) sets a strong foundation for mutual respect as well as teaches valuable life lessons. It is never too early to start this habit. When Waverley requests something without saying please, I usually respond with “I would love to get that for you if you ask politely” rather than the old adage “What’s the magic word?” I feel this instills the importance of being polite over getting anything that is desired simply by saying please.
3. Offer choices appropriate for their age. Sometimes a choice is not an option (e.g., bedtime or crossing the street while holding hands), yet it is extremely important to offer opportunities to make small choices each day. You have to know your audience though and not ask questions that are too open-ended. For example, with 1-3 year-olds, provide a choice with two options progressing to three options as they grow. With Waverley, I present her with two different shirts to wear each morning and then two different bottoms based on what I think goes with her choice. (Sneaky!) When presenting opportunities for choices, avoid overwhelming questions such as “What do you want for breakfast?” yet rather “Do you want eggs or oatmeal for breakfast?” By providing toddlers and older children the opportunity to choose, they are learning autonomy, a sense of control, and the consequences of one’s decisions. Nobody likes to be bossed around all day and by allowing kids to make choices they are likely to take ownership of the activity.
4. Forget the concept of time. Children usually do not begin to comprehend the concept of time, as in passing minutes and hours, until age six. So, do not present tasks or countdowns in minutes. Telling a toddler they have five minutes left to play is pointless. Instead, tell them they can choose one to two things left and then it is time say goodbye. In therapy, this may sound like: “We are almost done with our session. You can choose either the slide or the swing as your choice activity for being awesome today! You choose the slide? Great choice. You may go down the slide two times and then it is time to say goodbye.”
5. Provide clear, specific directions. Since toddlers are just learning language, they are not adept to the nuances of long sentences or sarcasm. Be clear, concise, and specific. For example, when cleaning up, do not just command to “go pick up your toys.” Try specific toys at a time, such as “Please put your blocks in the bin.” (Put in! Put in! Put in! = Every therapist’s mantra.)
6. Roll with it. This is not as much about communication, but just how to promote positive experiences for everyone. If something planned is not going well, abort the mission. If something is going awesome but is taking longer than expected, keep going. Nate asked me if I “run a really tight ship” when he’s not at home because Waverley seems to stall less with me than him. The answer, related to this tip, is that I have very firm boundaries but allow for a lot of freedom within them. We roll. With it.
7. Sing. This is the hardest thing for me! I am the worst singer! However, it’s amazing what turning mundane tasks into a song can do. That is why anyone who works with young children is often singing crazy songs and bouncing around. Is it because they are eternally peppy? Maybe. But, I am not eternally peppy and you will certainly catch me singing “It’s time to put the toys away, toys away, toys away. It’s time to put our toys away because we’re going to eat lunch!” The end.
8. Use visuals. Using visual cues can be extremely beneficial if a child does not speak or understand language very well. This can be as simple as a board with Velcro and a plethora of images with Velcro on them (to put on the board) or just in the form as presenting options to them. A yes/no picture can be added to their high chair in order for them to answer questions about meal time (e.g., do you want strawberries?). Visual cues can be sequenced for a timeline of events or two-step+ activities to assist with learning. Think of it like our version of a grocery list or to-do list, it enhances memory and will help the child to know what is going on.
I hope this helps promote positive and effective communication between you and the toddler/young kiddo in your life! What are your tips for communicating with children? I’d love to hear, as would all the others reading this!
Do you have any other questions you’d like to ask an occupational therapist about development/therapy/anything? Email me at pearls.string@gmail.com for your question to be addressed in the next Ask an OT. Thank you for reading!
PS How to get a baby to nap and when to be concerned with developmental delays.
