Tips for therapy at home with a frustrated child

By Tara Thompson

Raising children is no easy task; it’s a whirlwind for everybody involved. But when you’re a mum to a child with additional needs this whirlwind can sometimes feel like a full blown cyclone.

There are just those added extras that intensify the parenting journey, one of the main ones being home therapy.

Going to the therapy appointments themselves is the easy part, it’s the following through at home which can sometimes be the most difficult aspect to grasp. You have a child who already has to work that bit harder every single day, who is frustrated constantly and repetitively having to work to develop new skills that come so easily to other children. Then, on top of this they are expected to tolerate home therapy.

It never ends. Of course they are going to get over it, play up and be ‘hard work’, but the reality is that early intervention is crucial and following through at home is essential.

I often have parents say to me ‘I wish my child would tolerate therapy like she does’.

But the thing is, I have catered home therapy around my daughter and her needs. She is a typical 4 year who doesn’t want to be forced to do things she isn’t interested in. She has cerebral palsy which means her body won’t allow her to move how she wants to and to add to the fun has ‘high functioning’ autism which means it can be very hard for her to express her frustrations in an amicable way.

So she actually doesn’t ‘tolerate it’. I have had to come up with ways to make therapy achievable and as enjoyable as I can for all involved – this includes myself and her siblings.

Here are some of my tips for maintaining that home therapy balance for the frustrated child;

• Keep it to their interests. Ok this is an obvious one but is the most important thing to keep in mind. For a while there my daughter was obsessed with dolls so not only did we incorporate them into our therapy I also came up with games, I laminated pictures, I used videos of children playing with dolls on her iPad. If your child happens to have sensory needs and enjoys cars, set up a tray of shaving foam and have them drive the cars through it. Whatever the interest is just get creative and think outside the box.
• Timer. Sometimes we use a timer. My daughter likes visual aids so this can work well when she is becoming fed up. She has that visual reminder that the time is nearly up. So if we are getting closer to the end of our session and she is losing interest I set up the timer as a reminder we are nearly finished. More often then not this makes her even more motivated and we finish off on a high note. For older children you could have the timer on for the whole session and also communicate with them about where they are a,t eg ‘you have already done this for 10 minutes so that means you are nearly half way there’.
• Give them choice. Allow your child the freedom to choose; have a few activities ready and ask what they would like to do first. More often than not if Willow has choices she will get through all of the activities anyway. This allows her to feel that she is very much a part of the process and isn’t just being forced to do things.
• Rewards. Incorporate the use of a sticker chart. Perhaps they get a sticker every time they complete an activity, then after a certain amount of time they might get a reward of some kind.
• Positive praise. Give praise for everything not just if they master or complete something. Say things like ‘I love that you kept trying even though that was so hard’ and let the little things slide. Just focus on the positive reinforcement. I will often tell my daughter things like ‘I am going to tell Nana you were able to do that she will be super proud’ and then I always make sure I follow through, either with a phone call or next time we see her.
• Short sessions. There is nothing wrong with short sessions. A short enjoyable session is far more important to me than a long and drawn out one where more often than not my daughter will lose motivation. Plus, short sessions are more practical and easier to implement.
• Incorporate therapy into daily tasks. Think of the skills that you can work on during the day, for example if a skill is to practice using both hands have your child put their own toothpaste on their toothbrush every morning and night. Little things like this add up. When you begin to really think and take note of all of these little but practical and beneficial moments you will realise that it can be fit into so many tasks throughout the day. All of this adds up.
• Set expectations. Let them know exactly what you will be doing and plan it out for them. Tell them what you will be working on together, show the activities and give constant prompts like ‘we are going to do this 4 more times and then you can choose something else’.
• Keeping on track. Find ways for your child to tick off what they have done, keep score or have a tally. For example, if you want them to try something three times make up a chart and they can put a tick or line, even a stamp each time they have completed it.
• Visual aids. Take photos of some of the activities so they know what is coming up next. You could make up a little routine board of what you will do for therapy that day or week.
• Be silly and have fun. Therapy doesn’t have to be serious. The more fun you have with it the better your child will respond; make a mess and have a laugh. We have a lot of activities where we use pegs, usually she has to take them off something. Instead of putting them on a table I will put them in my hair to make her laugh.
• Engage in dramatic play. My daughter loves dramatic play so if I am starting to lose her attention I will turn whatever we are doing into a dramatic play scenario and we will get into different characters.
• Use favourite toys. Have their favourite toy and tell them when they are finished they can play with it. Or even have a special after therapy box.
• Variety. We always change it up and are constantly doing different things. My daughter often asks if we can do therapy now and I know this would not be the case if we were constantly repeating the same thing. It may take a while to build up resources but that is fine. I usually try to think of one thing new to incorporate each time and this just gets added to our therapy box of goodies.
• Finished box. Make up a finished box so that once they have mastered or completed something they can have the pride to put it away in the box.
• Take a break. If nothing is working and its just not going to plan there is no harm in taking a break. I never push it. Sometimes you both need some time out to recharge and to get motivated again.
• Siblings. Don’t be afraid to get them involved. If my other two girls are home and we are doing some therapy or physio they can take part or more often then not I plan for them to be involved in some way or another.

The reality is that therapy is hard; your child is working on something that doesn’t come naturally to them so it’s perfectly normal for them to resist it. It’s our job to find ways to make it a calm, enjoyable and motivating experience. My daughter actually asks to do therapy now, it’s no longer a fight or feels like a chore. It did take a long time to get to this point but using these tips and tricks has helped us find our balance. It is now something that we can both enjoy.