Understanding a Child the Occupational Therapy Way

Recognizing and Communicating the Unique Potential of a Child

Sabrina E. Adair

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000465082
• Edition: 1
• Topic: Education
• Subtopic: Learning Disabilities

This book uses an occupational therapy way of thinking to guide the reader towards observing, understanding, and communicating the needs of children to foster a supportive environment.

Presented in accessible, everyday language, this book takes a holistic approach of looking at a child from what makes them a unique person, what activities they are trying to accomplish, and what environment they are in. Each chapter helps readers identify, describe, and clearly articulate a different aspect of the child's environment and how it may affect them, the way that they process different sensory inputs, what their behaviors may be telling us, and how they learn. By recognizing each child's unique story and effectively communicating their story to others, the reader can identify the most effective ways to support a child to meet a child's needs and set them up for success.

Therapists, educators, parents, and childcare workers will all benefit from the simple strategies outlined in this book to enrich a child's learning.

1 Introduction

DOI: 10.4324/9781003166405-1

Years ago, as part of an art class, the teacher showed me a black and white picture of a young woman. It was hand-drawn and was the outline of her face with a feather coming off her hair. The image was so clear to me, but half the class raised their hands when the teacher asked who could see an old woman in the picture. It was the cartoonist W. E. Hill’s picture “My Wife and My Mother-In-Law” created in 1915.¹ As it turns out, in this drawing, the picture’s perspective will change depending on your focal point. If you look at the smaller details, you can see a young woman, and if you look at the bigger details, you can see an older woman. Depending on how we are looking at the world, our experiences, perspectives, and focal points frame the way we see it. What fascinated me about this picture is that we were students in the same class, looking at the same drawing, seeing two different images.

How often do we experience this same story?

Have you ever watched a movie and walked out only to find out the person you went to the film with had a different experience in that same movie?

Or walked out of an exam thinking that was the most challenging test you had ever taken, only to hear your classmate tell you that it was so easy?

Have you ever felt misunderstood or wondered why people don’t see life the way you do?

I am sure your answer is yes to one, if not all, of the aforementioned questions. Each person is looking at the world from their own perspective. This perspective is based on a number of factors, including where you were born, what era you were born in, who raised you, how you were raised, and all the experiences that you have had. Our perspective is formed from our story.

This book is about discovering your story and the story of the children we work with. It is about recognizing and understanding what influences our perspectives and the way we interact with the world. It is about putting down our technology and really engaging in the world around us. It is about helping children who are often misunderstood share their story. Too many times, we get caught up in the moment and what is happening in front of us, and we forget that we may not be seeing the full picture, just like in my art class.

Think about the experience of walking through a grocery store and seeing a child having a tantrum on the floor. People may judge the parent for not having control of their child.

Or the child in your neighborhood who runs around playing with no shoes on. People may think that this child is being neglected.

Think about a child who doesn’t like to speak in public and shies away from groups. People may think that this child is depressed.

These are all examples of how our perception can influence the story we tell ourselves about these children and these situations.

Our own personal experiences, fears, emotions, and perspectives influence what we see. As you go through each chapter, you will be reminded of what other factors may influence a child’s story and, in the same way, your story. We may not realize how differently our brains interpret the world through our sensory system, the way our minds process the information we learn, or the way we interpret a sense of belonging. The child in the grocery story may have been so overwhelmed by the sounds and the lights that he couldn’t handle it any longer. The child running on the street without shoes may be oversensitive to socks and shoes, so he refuses to wear them. Each child’s interpretation of the world is what makes them unique. It also makes each story important to share so that others can be more accepting of our differences. It is our unfolding stories that make this world a more interesting place.

Think for a moment what else can impact your perspective. If you were born before the Internet and before cell phones, when information was found at the library, or through talking with people. Imagine you were born in wartime, and you lived through the great depression, or a time when you had to practice bomb drills and hide under your desks. Or if, when you were little, you were not sure where your next meal would come from, or you worried for your safety when walking down the street. Think about the influence of social media and technology and how they have changed how we communicate and compare ourselves to others.

No matter how minor or extreme, each of these experiences could impact how you see the world today. They are part of what makes your story. It would affect what you value, appreciate, and what is important to you. It would also impact your worries, fears, and reactions.

These reactions can also affect how we raise or influence a child. I still recall when I was little that there were some friends whose parents would not let them make a mess within the home. Their home was always well kept and tidy. In that house, we had to constantly clean up behind ourselves as we went along, or we were afraid we would not be invited back. In other homes, you were not allowed to waste any food, so anything you had on your plate, you had to eat regardless if you were full or not. What were these parents’ stories? What in their past formed their decisions with their children?

What was your childhood like? What influences formed your story?

When my children were little, they loved to get messy when they ate. I would often place some food pieces on their high chair’s tray to encourage them to try and pick it up. I would even place some pieces of spaghetti on their tray. When they were learning, they would struggle to pinch the food, and it would oftentimes be smeared across their high chair. Sometimes, they would manage to pick up a piece and get it to their mouth, but by the end of the meal, they would be covered from head to toe with pasta sauce. Some would even end up on the floor. For some people, they may become upset with a child doing this and making a mess. Yet others may celebrate a child who has just learned how to feed themselves independently. Our response will be reflective of our own story, and how you react is based on your childhood experiences.

Sometimes, it is even just our instinctive reactions that can be a misinterpretation of a situation. I was in the process of potty training my child. We had been working on it for a while, and we were not having any success. Then one day, I hear from the upstairs hallway, “Mommy I went poo!” I ran upstairs and immediately saw a trail of droppings all the way down the hall, and there was my child standing naked in the hallway. Immediately, I got upset, as there was poo on the carpet. I started reminding them in a stern voice that we go on the toilet and not on the carpet and that they need to call mommy if they need to go. After my short rant, I carried them to the bathroom only to discover that they had gone on the toilet, and they were so excited that they immediately got off the toilet and ran to tell me. As a parent I felt horrible. My instinctive reaction was to be upset, when really I should have been celebrating their success. If we turn this story around and think of it from the perspective of the child, they are now confused, as they were being discouraged for something that they thought they were supposed to do.

We can be so quick to judge a situation when it all comes down to perspective. Understanding and looking at the whole story, not just what we see in front of us.

Discovering Someone Else’s Story

Working with children involves the process of discovering and understanding someone’s story. Discovering someone else’s story can feel overwhelming, especially when it is not our child or a child we know. It can be even harder with a child who may not have strong communication skills. So where do you begin to understand a child’s story?

Have you ever been in a bookstore and stood in front of a rack of hundreds of books, not sure which one to pick? We may pick up a book and look at the cover, and if the title or the picture interests us, we may flip it over and read the synopsis. If it doesn’t interest us, we may put it back. Yet how much does the cover of a book actually tell us? As the saying goes, “never judge a book by its cover,” which is true of books as much as it is true of people. How much can you really know about a person by just looking at them?

Just like when you start to read the story, you always begin at the beginning of the book. It is the same with understanding a child’s story. You can’t understand a child’s story by how they look. You always start at the beginning of their story. Understanding who a child is involves understanding who is raising them and the environment that they are coming from.

Susie was a girl I worked with in Grade 1. She was referred for an occupational therapy consultation through the school system, as she was having difficulties staying focused at her desk, trouble with printing, and poor hygiene. Her teacher was concerned with how Susie looked when she came to school each day and was worried about how the other kids in the class were treating Susie.

When I met Susie for the first time, I was struck by the fact that in front of me was a 6-year-old girl wearing soiled clothes, with peanut butter in her hair, and smelling as if she hadn’t showered recently. What I knew for a fact was that a 6-year-old does not come to school intentionally smelling poorly or wearing soiled clothes. She was not intentionally ignoring hygiene, which resulted in her classmates making fun of her and attempting to not sit close to her. There was more to Susie’s story than what I could see from sitting with her at school.

Understanding first who was caring for Susie at home and their perspective was a key into Susie’s story. When I connected with Susie’s parents, I learned that Susie’s mom was undergoing some medical treatments and had limited strength and mobility. To help out around the house, Susie was making her own breakfast and lunches to take to school. Susie didn’t know how to do laundry on her own and had difficulty showering independently. They had some help in the house, but her mom didn’t realize that Susie was wearing the same clothes to school each day.

Susie’s story was an example of how a person’s home life will affect school or community and vice versa. We can’t separate a child from the impact of all the environments that they engage in. When we receive referrals from school, it often has school-related goals. School is a very different environment than home, but what happens at home can affect school.

Susie’s struggle with focusing in class and printing her name had to do with what was going on with Susie at home. Understanding this part of the story helped me and the school staff work more effectively to support her at school.

Looking at Susie and the referral I received, many of the concerns focused on getting her to fit better into school. What those at school didn’t realize is that Susie was trying to help out at home while her mom was undergoing medical treatments. Susie was doing more at home and for herself than many other 6-year-olds. With the family’s permission, Susie was able to share with her class about what was going on with her mom. The perspective of Susie changed, and the class was able to learn empathy and think of ways to help Susie’s family.

Many children have different experiences at home. Often, the first step is understanding the capacity of the family and how it can impact a child’s story. A child’s ability to learn can be affected by the food that they eat, their genetic predisposition, and the nurturing that they receive. A referral for therapy should be about more than helping children to fit in better at school. Our goal is not only to make better students out of children; it is also about giving them the skills for a better future.

Can you relate to a story like Susie’s? A child who is proud of herself for helping out at home, yet judged by others who didn’t know the whole story. Susie smelt of peanut butter because she made her own sandwich for breakfast and had pushed her hair out of her face with her dirty hands. She had taken some creative initiative and showed independence to know what she needed to do before school, and that should be celebrated. How many of you reading this initially thought the case might be due to neglect? Sometimes, that can be our instinctive reaction, and we must always take a moment to think about what else could be going on. As you go through this book, I will outline in more detail all of the factors that can influence how we see and engage with a child. I will continuously emphasize the importance of always looking at the whole picture to help a child achieve their potential.

Understanding What Can Impact a Story

Once you understand where the story begins, it is also important to consider other factors that can be impacting how they behave. When children misbehave or have outbursts of emotion, there is often an underlying cause. Too often, I have watched children be disciplined for their behavior and see their behavior escalate out of control without taking the time to understand what caused the behavior. Our sensory system, our ability to learn, or an inability to regulate emotions can impact our reactions. I will go into detail in this book on how to recognize what could be impacting a child’s behavior and what behaviors can tell us.

Luke was in Grade 3, was very disruptive in class, had difficulty focusing, and was labeled as a child with behavioral problems. Labelling a child can result in prescribing the fate of a child and I will go into this in more detail later in the book.

Luke was referred for occupational therapy to work on his classroom focus. During the first meeting with Luke, it was clear that Luke did have difficulty focusing, but that he also had trouble recognizing numbers and letters. When challenged, Luke would resort to acting silly or deviating from what was in front of him. At one point, he got up and tried to run away.

Luke didn’t have many behavioral outbursts at home, but the environment at school had different expectations than at home. Luke was struggling with comprehension, recognizing letters, and fine-motor skills like printing, which was an obvious sign there was more to Luke’s story than just the fact that he exhibited behavioral issues in class. He was struggling to understand and complete the work he had to do, which was a challenge.

If you or I were challenged with something as adults, at a task we not only didn’t like to do, but also couldn’t physically comprehend, would we stay willingly in that environment every day, or would we give up or try to get away? The negative perception that Luke was not behaving and acting out was missing many parts of that story. It was similar to Susie, who was judged for how she looked instead of looking at what else could be the cause.

Working through and identifying what made Luke who he is was such a valuable part of understanding how we could best support him. The sounds in the classroom and the discomfort of sitting in his chair were also making it hard for Luke to focus. His mind was focused on other aspects of the classroom, and therefore, there was a fight going on with the sensory inputs coming in around him. Each of the sensory inputs was trying to win the focus of the mind at that moment. Luke was feeling so overwhelmed that whenever anyone asked him a question or he had to try to work at his desk, he couldn’t. When we were able to recognize the impact of the environment, we could make changes, including a few simple modifications in the classroom that would set him on the right track. We could then work collaboratively as a team around Luke to help him work towards his goal.

An important part of Luke’s story is to understand that the feelings he was having were very real to him. The chair...