Category Archives: life skills

4 Things My Child’s OT Needs to Know

 

Years ago, my family utilized occupational therapists (OTs) for one of my children. At that time, we had fantastic luck as both of the therapists our insurance covered were wonderful, patient, and good listeners. I assumed all OTs were trained to be this way.

Recently we began OT for another of my children. It has been extremely difficult to find someone who can accept the limitations and stressors my sweet kid has right now. I had no idea that others struggled with this issue, too, until I asked in a local mom group. Turns out that many, many people have difficulty finding quality OTs as well as quality PTs (physical therapists) in my area. What I am hearing from others is that the therapists know their field quite well. However, many do not listen to clients and families, so they are unable to learn how best to serve the client.

Based on my experiences and those replayed to me via chat and in-person, I ended up writing this post. I hope it helps give perspective. Families do want to work with therapists, but parents and children become frustrated after going down the list and trying multiple providers, then having OTs or PTs repeatedly fail their kids.

Noncompliance does not equal a naughty child.

When a child has special needs, your family will come into contact with many healthcare professionals who want to help. They are often experts in their field and have an incredible amount of experience. Ready for the “but”?

They may be experts on a topic or diagnosis, BUT they are NOT experts on your child. One huge issue that comes up time and again is the lack of understanding of anxiety. Many children deal with mutism, or selective mutism, due to their anxiety because they literally cannot make themselves speak when extremely anxious or having a panic attack. Another term to know about is Pathological Demand Avoidance (also known as PDA). PDA is, in essence, anxiety. But this kind of anxiety is extreme. A child may lash out, become mute, ignore, or even run away from a situation that gives them anxiety. Many children, mine included, explain this feeling as a growing pressure that escalates with demands for compliance. This creates an extreme amount of stress and anxiety.

The problem is that these behaviors look like naughty behavior when they are actually behavior borne from anxiety attacks and panic. Sadly, it may be difficult to tell the difference between naughty behavior and panicked behavior when they present so similarly and both mean noncompliance and sometimes even unsafe behaviors. The problem that many families run into is that medical professionals, therapists, and teachers often do not realize that what they assume to be a naughty child is actually a child struggling with anxiety or PDA. It is important for therapists and other professionals to  listen to parents, children. Don’t take these behaviors personally or as a refusal to cooperate. Instead, take time to grow a rapport with the child, then things go much more smoothly.

SPD, PDA, and anxiety may prevent touch.

Sometimes touch is seen as part of a physical or occupational therapy session. This is understandable as a therapist may need to show or help a client do something. Some therapists are very thoughtful of boundaries, but others are so focused on meeting goals as fast as possible, that they forget that the clients have boundaries which should be respected in order to build a positive bond.

Children who are sensory defensive will not likely want to be touched. They may have a family member who they tolerate if they need help with writing or buttoning pants. Understanding this is a huge help and knowing when not to push an activity can help build bonds between therapist and client. In short, consent matters. As my child said after a negative therapist appointment, “I am the boss of my own body, not you or anyone else.”

There is plenty of time.

Much of therapy is goal-driven in that there is an evaluation, goals are written, then insurance companies and parents often want to see that progress is being made toward those goals. During the yearly re-evaluation, progress is supposed to be shown. The idea is that, eventually, the client will no longer need the occupational or physical therapy service. However, this is not realistic in all cases.

The problem is that a goal-driven therapy model often does not respect the pace at which a child with special needs can handle demands, changes, and activities. The adults may forget that rapport takes time and working as a team means getting to know the client even if it takes months or years. One of my children recently said, “I don’t think the OT knows me at all. If she did, she’d know not to put pressure on me. It makes me have anxiety and then I can’t talk.” A child having an anxiety attack because a therapist did not take the time to find out that child’s triggers is not going to be successful with the child. Patience is key here. Forcing things won’t help. Sometimes slow and steady is the way to win the race. Yes, even if moving at a tortoise’s pace.

My family will stick up for me.

There is a saying, I’m not sure who coined it, that says something like, “A parent is the expert regarding their child.” I agree. Loving, invested parents ARE experts. They are experts in the child’s special needs, likes, dislikes, and behavior patterns.

If a parent is telling you not to do something, then immediately stop. The same goes for the child telling you no with either behaviors or words. Just as a parent is an expert, so is the child. Your client may have difficulty explaining the issues but learning those behavior patterns and understanding how a child reacts when upset versus happy is a HUGELY important skill for anyone working with clients who are children or who are nonverbal. “Thanks, mom!” That’s what my child said after I had to fire a therapist who thought they knew better than my child and I regarding the child’s needs. The therapist knew us all of 90 minutes total, yet thought they knew more about the child’s needs and caused a panic attack and subsequent regression in the child.

Here’s the thing. An OT or PT may know a diagnosis. They may be experts in their field. That’s wonderful! But they are not experts on each client until they take the time to get to know the client.

This is an ongoing process and forcing a relationship, creating an adversarial process by being authoritarian, and pushing things that trigger a client are never going to help establish rapport. Parents will tell you to stop. Parents will fire you if they see you refuse to listen. The client’s family WILL stick up for them. We are, after all, their best advocates and don’t take that job lightly.

 

As one of my children recently said, “I want them to understand me. Being pushy doesn’t help.” As adults we may get wrapped up in goals and our agenda. But that’s not important. It is important to support clients and clients’ families by listening, observing, and putting the client first. Work as a team to find out how to help. Make goals together. Listen, observe, and use patience. As I mentioned above, slow and steady wins the race.

 

About the Author

Melissa Packwood, M.S. Ed.; Photograph by Alexandra Islas

Several years ago I left my teaching job to spend more time with my children. I was sad to go, but am thankful for the experiences that classroom teaching provided. I now provide Florida homeschool evaluations and homeschool help in the form of consultations, transcript writing,  and tutoring. My educational experiences paired with real world experience give me a unique perspective when working with families to achieve their behavioral and educational goals.
I specialize in tutoring and homeschool help for students living with special needs and am an approved Gardiner Scholarship tutor. I focus on early childhood education, elementary education, reading and literacy, study skills, thematic units, and social skills. I look forward to putting my teaching experience and master’s degree to work for you. Please contact me with questions or to request services.

Phone Number : 407-712-4368

Email : lissa_kaye54@yahoo.com

When A Student Avoids School Work

 

Recently a client’s father was concerned. His child was avoiding schoolwork and becoming very anxious when it was time to complete school or homework. He was at a loss as to why this was happening.  So we had a chat about the patterns of behavior and ways to help.

When kids refuse to complete a school task there is always a reason. No, it is not because they are “lazy” or “bad”. It may take some digging, but finding out why this is happening can help you set up a plan to help your child.

Is there a trigger in the schoolwork?

Sometimes children are unable to complete a task because it is considered gross, scary, or has a topic/word they feel uncomfortable around. Adjust the assignment when possible. If writing about ducks triggers a child, change the topic to a different animal. If writing by hand is a trigger because it hurts or feels weird due to sensory issues, then allow typing or allow the child to speak the words instead.

Image courtesy of renjith krishnan at FreeDigitalPhotos.net

 

Is executive functioning an issue?

Executive functioning skills must be strong in order for children to complete multi-step tasks, especially if they must figure out the steps to complete a task. If a child needs to write an essay, they will need to come up with a topic, outline the main idea and details, create sentences, edit the writing, then turn it in. This can be an overwhelming task if executive functioning skills are not yet strong. Help by sitting together to make a to do list, in order, for the activity. Break the task into different hours or days. Do something fun in between as well to have a break from the difficult task.

Is there anxiety because it is a new task?

Many times people become worried or anxious over a new task. This can occur for clear reasons or simply be a feeling with no clear reason. Either way, it is important to recognize the anxiety and how bad that feels. Ask how you can help. Offer alternatives when possible such as a different topic, different way to show understanding of the material, and offer a longer amount of time in which to complete each stage of the task.

Is there anxiety because someone is demanding the child complete the assignment?

When someone appears oppositional it may be due to anxiety, Pathological Demand Avoidance, or Oppositional Defiance Disorder, as well as other reasons such as feeling ill. Be a teammate rather than someone who demands immediate compliance. What steps can you take together to assist without doing the work for the child? Will taking short breaks in between every 3 sentences written help? Will drawing work more easily than cutting and gluing a project? Think outside of the box if possible. Give time between a task and the completion time for a task. Consider writing it down or using graphics and pictures to show what to do in steps, then give time to complete the task. Pressing the issue and repeating oneself to a child can build pressure in the child and trigger a feeling of unworthiness, anxiety, or even opposition in some kids.

Does the child not see the value in the activity?

Sometimes people need to see the link to everyday life or their goals before a task seems worthwhile. Consider using hands-on activities, creative presentation options, mentorships, real life experience through field trips, etc. These activities can help students see why topics such as division are necessary to their every day lives and motivate them to tolerate or willingly ask to practice life skills and academic activities. Sometimes a new perspective or having someone who is not mom or dad say that a topic is important can help as well. AN internship may be an additional step if a mentorship is working well for your child.

Is distraction happening even when the child is interested?

Distractions can cause a  lot of stress for teacher and student, parent and child, leaving everyone stressed and tired. Consider adding in a favorite type of music at a low volume if our child works better with background noise, but consider taking away sounds like tv or music if they distract. You may want to try using a white noise machine or headphones to block sounds, depending on if your child does better with or without background noise. Remember that becoming distracted easily is not usually something a child can control so punishment and anger will not solve this issue. Take a breath, or 10, then come back to the issue and help your child get back on task. If a task is taking a long time, consider completing the task in short bursts of time. Break down the task. You can also talk to your health care provider if you are concerned about a special need being present and request a referral for testing. If there is a special need, there may be medical and therapy alternatives available to assist your child. This is your choice and I cannot recommend that you do or do not. However, if concerned, consider this option.

Helping our children become life-long learners can be a challenge. Sometimes things do not go as planned, Instead of becoming agitated because our children are seemingly not listening, let’s consider why their tasks are not being completed and work with them to solve these issues. Alfie Kohn and Dr. Ross Green have fantastic books which address some of these issues.

 

For evaluations and consultations, contact Melissa, The Reading Coach!

Melissa Packwood, M.S. Ed. Photograph by Alexandra Islas

Melissa Packwood, M.S. Ed.
Photograph by Alexandra Islas

 

I earned my master’s degree in reading and literacy as well as an ESE graduate certificate. I hold a current teaching certificate and am working on my dissertation for my PHD in general psychology. As a consultant and reading coach, I focus on early childhood education, elementary education, reading and literacy, study skills, thematic units, and social skills. Additional services include public speaking, transcript preparation, and more. I look forward to putting my teaching experience and degrees to work for you.

Please contact me with questions or to request services.

You can also contact Melissa, The Reading Coach at 407-712-4368

Review of “The Smart Kid’s Guide To” Books

One of the issues I sometimes see when working with clients, and saw when teaching kindergarten, is nonverbal and social skill weaknesses.

Social skills are largely based upon nonverbal understanding and hidden societal rules.

These skills and concepts may be difficult for children who have varying exceptionalities or who are English language learners. Social and nonverbal communication skills can help you make friends or cause you to be alienated from potential friends.

That’s why it’s extremely important for kids to have practice with social skills and learn how to understand nonverbal communication cues in their culture as well as when getting to know people from cultures outside of the child’s culture.

I recently happened upon a fantastic set of books which I find really help with nonverbal communication and social awareness. The “Smart Kid’s Guide To” series contains explicit instruction, examples, scripts for practice, and has photographs to assist in understanding.

 

I highly encourage tutors, teachers, and parents to use these books in conjunction with everyday situations to help children understand how society expects them to behave and how to read situations, then respond in a socially appropriate way.

 

 

Using one example script per day can open up a dialog for how to respond to others as well as how responses may vary, yet still be socially acceptable. This is also a great way to foster emotional learning and empathy.

 

It’s okay to be different than someone else, have different interests, and to prefer time on your own. It’s also a good idea to understand social cues so we can respond in a useful way so we can make connections when we want to and grow our village of support. Our kids need that, too, and these books help tremendously.

Teaching Customer Service Skills

Many of my clients who leave public school to homeschool have told me there is less life skills education in their public schools as STEM and other ideals take over.

I have nothing against STEM, focusing on core academics, and other educational philosophies such as these. However, I see the issue with students graduating without life skills such as cooking, money management, and preparation for the workforce. 

It has become necessary for parents to make sure their children learn life skills so they will succeed in adulthood.

 

Teaching customer service skills is a great place to begin. Encourage role-playing games when children are young. Move on to yard sales and other odd jobs. Eventually, teens will be able to hold their own part-time job and practice consistently in a real-world setting.

Skill: Patience and Calm

Encourage children to handle disappointment and rudeness with calm and patience. Practice how to react when someone insults you in a work setting and how to handle this stress. Getting a supervisor or excusing oneself for a moment then coming back with a solution may help.

Skill: Compromise

Have your children practice finding compromises. Give them examples of situations they may encounter and ask how they think these issues ought to be handled, especially when a customer is irritated due to a long wait or poor service prior to meeting you.

Skill: Make It Right

Consider ways to solve customer unhappiness due to mistakes by the business or a delay in products or services. Practice scenarios which put your children in the position of a manager who is dealing with an employee’s mistake and must smooth things over with a customer.

Skill: Communication

After sitting in school and asking for permission to answer questions or go to the bathroom, students are often not prepared for communication and decision-making with a variety of customers with different ages, abilities, and needs. Practicing effective communication, including communicating with those who have special needs, is paramount to customer service success. Learn about varying needs, how to successfully communicate even if that means learning American Sign Language or finding an interpreter.

Skill: Time Management

Those who work in service and retail industries must be able to start and stop projects, change gears, then get back to the projects. Sometimes stocking has to happen, yet there is a line of customers to be checked out. It is important to prioritize, work quickly, and stay focused on each task while remembering the rest of the “To Do” list for the day. The ability to multi-task is highly important.

Skill: Strong Work Ethic

Working is not easy. Working in a field which includes customer service adds to the potential stress. Many times frustration makes people want to quit. It is important to teach our children to work through the stress, take breaks when needed, and help co-workers when they need a break. With support of co-workers and resilience, tough situations won’t keep our children from sticking with a job. Instead of quitting the first time things get tough, they will persevere and learn coping skills which will help them in all facets of life.

Whether we homeschool, unschool, or choose brick and mortar schools, customer service skills are necessary skills for our children to learn. We may have to work on these skills at home, then encourage our teens to get jobs. Early practice of these skills sets our children up for success in adulthood.