And inevitably, every summer there are always one or two kids who drop out because (as reported by moms), "their feelings got hurt."
On a closer look, these were the kids that really needed the groups! The ones who cracked at even minor frustrations were the ones who were over-sensitive to unintentional "slights" by the other children, who had difficulty following a one-step direction in a one-one setting, and/or whose short-term memory was almost non-existent.
As therapists we are doing our job when we challenge children to make choices that change old, non-productive patterns. The disconnect happens when the child complains to the parent that "everyone is mean to me in the group."
I have thought long and hard about how to circumvent this, and I think I have a solution I want to share. By providing parents a before-group syllabus and letting them know what we are doing in advance, I can help them support the child at home and ask the appropriate questions to counter the complaints. You can see the chart, using handwriting as a sample from my WIN program, at www.advanceweb.com/OT.
Using the WIN program again as an example, I often tell parents that this is a 12-hour program (usually in four, 3-hour days), so here is what you can expect:
• Day One-No writing. We will spend the whole day playing with our hands and bodies and learning how they move and how we can be "in charge of them" instead of having them in charge of us.
• Day Two-Tracing, nonsense shape making, chalkboard activities, blindfolded "writing," gross- and fine-motor fluency activities, and initial workbook activities.
• Day Three-All of the above and new games and crafts to put in our end-of-session take-home bags, "putting our bodies together" games using fine- and gross-motor patterns within one activity, and continuing in our workbooks
• Day Four-Finishing the workbooks, and doing Mad-Glad-Grab Sentences to learn about writing paragraphs with the T-E-C System (Topic Embellishers and Conclusions)-both trademarks of the WIN handwriting system.
Now the parent knows what and when, and has some really useful tools when talking to the child about his feelings about writing, making new friends or tolerating unfamiliar situations.
But that still leaves us with the issue of how to help the child. This is the child for whom everything is upsetting. The very act of walking into an unfamiliar place can be so upsetting that he needs what I call a "first day shadow," or a special "transition toy" to have with him the whole time. For these children creating trust is often synonymous with safety, and both must be in place before learning can occur.
Even so, there will often be that "one child" for whom group therapy settings are just too much. The chaos of the group, the noise level, the stimulation of people moving, the inability to know how to ask for help, etc. can all be influences that impact a child's ability to benefit from a given program.
So above all else, make sure that parents know you are available to them. And you want to know how their child is reacting before they remove him from the group.
Letting parents know that their children's success is your only objective puts you both focused on the same goal-a happier, more functionally secure child.
Susan N. Schriber Orloff, OTR/L, is the author of Learning Re-enabled, a guide for parents, teachers and therapists. Her WIN™ program is available through YourTherapySource.com.