Therapy Tips And Tricks For Kids With Special Needs

This guest post with tips, dos, dont’s for therapy for kids with special needs is written by Loren Shlaes, a very wise pediatric occupational therapist based in New York City. Loren writes at Pediatric OT and is a contributing columnist for PediaStaff, a staffing company for therapists that’s also a great resource for the special needs community. Her advice will help your child get more from occupational therapy, physical therapy and speech therapy sessions. How great is that?

Before a session

Unless you enjoy helping the therapist clean up vomit, DON’T feed your child a heavy, greasy meal like a burger and fries and then come directly to the sensory integration clinic, where the therapist is expecting the child to participate in intense vestibular play. DON’T feed him junk food before a session, either. Just as you don’t expect your car to run well on second rate fuel, your child won’t  be at his best unless he is eating nutritious food.  Give the child a small protein rich snack and a drink of water before his sessions.  Suggestions include a handful of almonds and a banana, a piece of string cheese and a couple of whole grain crackers, some mashed avocado and carrot sticks for dipping, a hard boiled egg and a tangerine or apple, and peanut or almond or sunflower seed butter with dried apricots on whole grain toast.

During a session

DON’T use your cell phone while you are observing your child’s sessions. This includes texting and internet use. Taking a call during a therapy session is extremely disruptive, especially to a child whose ability to attend to a task is fragile at best, and texting and surfing while your child is working hard and craves your attention and approbation is a clear indication that you are bored, uninterested, and checked out. Turn off the sound completely and put your cell phone away until the session is over and your child’s shoes and socks are on, or go sit in the reception area.

DON’T chide, correct, scold, redirect, or attempt to impose discipline on your child during a session unless specifically requested to do so by the therapist.  DO allow the therapist to direct the session. You are on the therapist’s turf, and the therapist is the authority figure during the session. DO NOT yell at your child if he loses interest in an activity and wanders off, fails to obey the therapist’s commands, or picks up a toy that he was not invited to touch. DO let the therapist handle it.  Join in the games and be playful and engaged, but allow the therapist’s clinical judgment to prevail.

Behavior is communication, and the child’s therapist needs to observe how the child responds to the treatment in order to assess how it is working and how to proceed. Opposition can stem from  fear, boredom, confusion, frustration, inability to comprehend and process language, dizziness from intense input from the swings, motor planning issues, or a myriad of other reasons. Let the therapist choose whether to insist that the child continue or to introduce a new activity. Don’t be embarrassed when your child doesn’t do what he’s told. It’s the therapist’s responsibility to either come up with a plan that the child can follow or to turn the child’s ideas into an activity that helps the child become stronger and more flexible. A sensory-defensive child is coping with a nervous system that tells him that everything he comes across is too scratchy, too stinky, too bright, too loud, and altogether threatening, and his ability to initiate play, and to explore his environment, is often severely diminished as a result. When he does have an idea, it’s better for the grownups to run with it than to berate him for having it and force him to follow someone else’s agenda.

DON’T insist that the child’s sibling be allowed to join in. Occasionally I will make an exception when I have a very fearful child and an older sibling can help me convince the child to interact with the suspended equipment, but in general, it’s not a good idea. A child’s fragile pride in his achievements can be shattered in an instant and replaced by resentment and jealousy when his younger sibling breezes through an obstacle course that he has been struggling with for half an hour.

After a session

If your therapist has ended the session with a calming activity and your child is well regulated upon completion of therapy but has a reaction later on, DO tell the therapist, but DON’T insist that the child’s therapy be scaled back unless the reaction included headaches and vomiting, which occur when there has been more vestibular input that the child’s system could handle. A child who is sensory defensive and unhappy in his body will often have extreme emotional and/or behavioral reactions when beginning sensory integration therapy, especially if it includes direct interventions like sound therapy, vestibular stimulation, and therapeutic brushing. This is completely normal and to be expected.  When you prime a pump, what comes out first is mud!  A child who has been shut down and tuned out due to sensory defensiveness and then suddenly starts reconnecting with his body and experiencing his feelings can have a hard, confusing, out of control time of it until he gets used to the new paradigm. Frequency and intensity are what is required to make permanent, lasting changes in neurological functioning, but with change comes chaos until the system can reorganize itself.

In between sessions

DO take your children outside to play every single day, ideally for a few minutes in the morning before school begins. Morning exercise in the fresh air will help them stay focused in the classroom. DON’T allow them to spend huge chunks of time in front of screens. DON’T over schedule them with after school activities. The best thing you can do for them is to keep them outside and active as much as possible.

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  1. [...] Read Loren Shlaes’ Article “Therapy Tips and Tricks for Kids with Special Needs” H… [...]

  2. by Meg

    On March 7, 2012 at 10:13 am

    I think it should be clear that this is good advice but the column is angled toward just sensory integration.

  3. by Using the media to educate others - Media Relations

    On March 13, 2012 at 2:07 pm

    [...] recent blog post in Parents magazine online, “Therapy Tricks and Tips for Kids with Special Needs” (, March 5, 2012) is an excellent example of promoting occupational therapy while [...]

  4. [...] The Parents Magazine blog, to The Max, featured PediaStaff guest columnist Loren Shlaes’s great article full of Therapy Tips for Kids with Special Needs [...]

  5. [...] Therapists can help older people with low vision St. Louis Post-Dispatch3/5/2012: Therapy Tricks and Tips for Kids with Special Needs Parents3/1/2012: ‘I Can We Can’ makes therapy fun ABC-7 News, [...]

  6. by Gail Mershon

    On May 18, 2012 at 12:34 pm

    Clearly a very knowledgeable OT in sensory processing – very good advice, however, if I were a parent I would be offended and maybe intimidated by the rather aggressive tone.
    Also, a parent should always feel free tostop a session if something makes them uncomfortable…that is our chance to educate them and form a better and more collaborative relationship

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