Top 4 Compliance Tips when Working With Children for Therapists and Parents

In early October, I had the pleasure of presenting to students in the Physiotherapy and Occupational Therapy Assistant Program at Durham College. The instructor, a long time friend of my daughter, requested that I present on the relationship between speech language pathology and these disciplines. It was not to be a theoretical, scientific presentation. After working 38 years as a speech language pathologist, I decided that the most useful information would come from working with children and the joys and challenges that they bring to therapy. 

These were some of the main points that were presented.

1. BONDING.  It’s very apparent that kids have to know that you like them. They will be much more compliant if they feel that you like being with them. That means that you have to have fun. That is my number one rule in the therapy session.  You have to have fun. Most kids are quite agreeable to following that rule. It’s easy to get them to agree to that rule and commit. The second rule is that you can’t be having so much fun that you get goofy. It seems that because they could agree to that first rule, 99% of kids will agree to the second one.  You now both have the same mind set. “We’re going to have fun!”
   
2. EGOCENTRISM   Many kids coming in to therapy are not aware that they have a problem or challenges. Their parents bring them to therapy. A few children over the years have asked to come to speech therapy because peers are teasing them, but for the most part this is the parent’s agenda, not theirs.  Due to the fact that kids are egocentric or focussed on themselves, they do not think that they have a problem. When they speak and you don’t understand, that’s your problem, not theirs. Seeing their world through their eyes is one way to understand why kids do the things that they do. It’s funny to sit upside down in your chair. It’s funny to say that the colour red is blue. (I always tell parents that if they know the answer is wrong, then they have to know what answer is right). Try to enjoy their sense of humour. Otherwise, you end up spending all your time on controlling behaviour and not accomplishing any of your goals. 
   
3. CATCH KIDS DOING THINGS RIGHT   It’s easy to see kids doing things wrong. They don’t say their sounds right. They don’t hold their pencil right. They don’t sit properly on the floor. This focus is so negative. However, what if you got all excited because they used the correct ‘s’ sound or held their pencil the right way without guidance or reminders.  That’s when you really respond with enthusiasm and excitement. This is 100 times more likely to elicit the behaviour that you want to encourage in everyday life than always pointing out what is wrong. 
   
4. WHAT WE DO IS LIFE CHANGING   Some of my clients have been with me for over 19 years. There are days as a clinician that you question whether or not you really make a difference. Believe in what you are doing. Changes can be rapid for some kids but for others with Down Syndrome or Autism Spectrum Disorder the changes are slower.  Clinicians need to be super analytical to break down tasks into tiny steps that kids can master. In some sessions, maybe only a tiny step is mastered, but with perseverance children will attain their goals and what you did is life changing!

It was my pleasure to spend the afternoon with such an attentive and interested group of students. Hopefully some of my stories and experiences of working with kids will come to mind when they find themselves engaged with a child who really is not compliant. Changes in your approach will elicit changes in them. Good luck to all!