When I arrived back to work yesterday after a few days off for Christmas, I noticed this note on my desk “Warning! Huge poisonous spider under here- do not lift“. Of course, I lifted the paper to reveal a large black "spider", expertly crafted from a pipe cleaner, and immediately I knew it was going to be an awesome day. I knew exactly who the "spider prankster" was- one of our second grade clients- a child who we met two years ago who was highly resistant to any writing or fine motor tasks (and who only recently started writing lower case letters from memory). The note on my desk was one in a series of spider-related "pranks" that have been occurring since October, when this child's occupational therapist noticed that the child was highly knowledgeable about spiders and highly motivated by harmless pranks. When I compared this note to the previous "prank notes", I was amazed at the child's progress with his handwriting, his general willingness to write, and his recently reported excitement for coming to therapy. The key to progress and success with this child was to tap into his interest in spiders. Creating handwritten "spider pranks" for staff was the meaningful activity that motivated this child to willingly work on skills that were hard for him.
Occupational therapy treatment is based in choosing and using functional, purposeful and meaningful activities to promote skill building and progress. Especially when working with children, the general tendency is to avoid a task or skill that is challenging, but if the activity that is being used as a therapeutic tool is meaningful, creative and fun, we find that our pediatric clients are more engaged in therapy and make significant progress more quickly. Pediatric OTs tend to use physical games, fine motor toys and theme related craft activities to promote strength, gross motor skills, fine motor skills and written output. To an outside observer, pediatric therapy looks like play- but its important to remember that play is the key component, and occupational therapists who can connect with a child and effectively use play as a therapeutic tool have mastered a skillful art. Effective and purposeful play is how children are able to break through barriers to progress, to build confidence, and to have the inner strength and motivation to continue to face challenges related to skills that are difficult for them.
Using play for skill building is not just a "tool" reserved for occupational therapy. Teachers, parents, grandparents, coaches, etc can all use play and creative activity to promote progress and develop skills. As we enter the new year this week, take a moment to create a 2021 goal with your child.
(1) Identify something that your child accomplished in 2020 that was amazing- and acknowledge it.
(2) Help your child choose something in 2021 that he or she would like to accomplish.
(3) Ask your child HOW he or she would like to accomplish that goal. Together with your child, choose a medium that is interesting, motivating and fun.
(4) Create a simple, concrete, measurable goal that you and your child can attain together.
But how do you create those fun, engaging activities? If your preschooler likes dinosaurs, pretend to be dinosaurs roaming the earth to practice motor planning and to build core strength, balance and shoulder stability. Different gross motor movements like bear walks, crab walks, jumping and hopping can easily become "dinosaur moves". If your child likes mermaids and has sensory processing concerns (easily overstimulated by sights, sounds and movement), create a mermaid sanctuary with your child, using calming lights soft music and textured fabrics. If your teenager has executive functioning deficits, try an escape room challenge to build sequencing problem-solving skills and cooperative peer interaction. The list of activities is endless, especially when you involve your child in creating the games and activities!
In outpatient pediatric therapy, we write functional, measurable, clinical goals all the time. A goal that you create at home with your child doesn’t need to necessarily be clinical, but it should be measurable. The goal can be as simple as "together we will do 10 sit ups every day". Or as complex as "I will help my mom write the grocery list and write 5 words myself". But just remember, whatever activities you use to try to help your child achieve his or her personal goal, make sure your child is a part of choosing the goal AND the related activities. Keep it fun, keep it light and keep it meaningful in 2021! Happy New Year!