Trust in Unpredictable Times: Recommendations from a Pediatric OT

Trust in Unpredictable Times

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Tips From a Pediatric OT on Coping During the Pandemic and Unpredictable Times

This is a different time for all of us. The emotions we are feeling as parents are real and need to be acknowledged during unpredictable times. However, life rarely allows time for one to reflect on their emotions in a productive, safe, and manageable manner. This can also be said about children and their mental health management. The stress in our homes and communities is causing children to feel more emotionally uncertain than ever before. They are experiencing direct changes in their environments such as fewer visits from family and friends, more time with Mom and Dad TOGETHER, not being able to have their favorite snack because they are out of it at the grocery. 

These are shifts to a child’s environment that might throw them into behaviors that are new, behaviors that are suddenly escalated, or behaviors that look like withdrawal or depression. We can do justice to our children by breathing with them during their uncertainty, modeling how to problem solve and “sit” with our emotions. Allowing our children to see our own emotional management and healthy coping skills is essential, although easier said than done.

As a parent I too am fumbling to answer questions. It is hard for me to remember that it is okay to not have the answers. It is okay to share with my child that mommy does not know when grandma can come back over to play. Following up with, “But I DO know that it is my job to keep you safe and I love you”, can help wash away the worries. When I can provide reassurance to my child that her world will still have routines, predictability, lots of love, and time for her to explore emotionally, my child feels reassured that there is a level of control and she can better trust in her chaotic world and sense of self. Providing this social emotional reassurance is important to help children focus confidently on discovering and mastering new skills. 

Skills being developed during a pandemic may take on a different shape than in previous times. Meeting sensory motor needs is more challenging when a family is confined to their home. Exploring peer relationships is difficult with Zoom play dates. Learning to get dressed and out the door to school is halted by not leaving the house and staying in pajamas all day. Just as these skills look different and are being learned and practiced in different creative ways, so are the school readiness skills of play, negotiation, self-regulation, and self-advocacy. 

Play at these early ages is the best process to support many skills. Social emotional learning, global developmental skills such as gross and fine motor, and conflict resolution are all practiced during play. It allows a safe place for a child to act out problems and feelings.

Opportunities for development via play are endless. Children can practice getting dressed by wearing dress up clothes, or practice feeding by mothering a doll. Creating forts and obstacle courses develops executive functioning skills. Practicing these developmental skills through play helps support maturation and independence.

Engaging with your child during play allows you to understand their feelings around leaving the house, going to school, riding in the car, or wearing a mask. By doing this, it offers an opportunity to use social emotional language (naming the feeling) and supports the learning of coping skills. During routines such as self-care (dressing, brushing teeth, toileting) allow choices to be made by your child. Present a choice to brush teeth for 3 minutes or 5 minutes. Building up these reservoirs of self-capacity, self-regulation, independence and autonomy develop flexibility. For example, when it’s cold your child has to wear a coat. This is nonnegotiable. However, having a history of ownership of choices may allow a child to be more flexible, and follow along with a non-preferred plan.

The first step to “learning” is self-regulation, meaning a child must be available to receive new information in a classroom or learning environment.  When a child experiences stress, using coping strategies helps a child move through non-preferred tasks successfully. Having positive experiences with play, negotiation in family relationships, and responsibilities at home provides a healthy foundation for these coping skills.

This year our schools are less available for the soft colorful walls and hugs from teachers. Our remote learners have to develop a new level of parent child relationship as the parent takes on the role of teacher, proctor, and recess supervisor. These are different times and these experiences will challenge our children both emotionally and behaviorally. 

Suggestions to support self-regulation and smooth transitions during unpredictable times:

Social stories: These are stories developed about specific experiences that include the possible repertoire of emotions that may be encountered during a specific experience. These stories validate emotions and discuss strategies to work through the feeling or problems.

Chores and routines: Children are routine based even the kids that don’t appear to LOVE routines still LOVE routines. I believe it is more challenging for parents to find the right routine balance and maintain the routine with a certain level of flexibility. As discussed above choice making is key to successfully establishing and maintaining routine. Children benefit from responsibility, even the youngest child recognizes the “clean up song.” As children get older it is important that they continue to take on responsibility in the form of chores. Chores can be a time to practice executive functioning skills, life management skills, and participating in non-preferred activities. As well as building endurance for daily tasks and fine and gross motor skills.

Carved out time: Carved out time is a reconnection time 5-10 minutes a day when all are present (no phones, half eye contact, or one ear listening). Families that are able to support these carved out times to play, check in, or read a book have significantly enjoyed these moments. This takes practice so, as a parent, offer yourself grace. However, it can be done, and the benefits are great. According to child development expert Dr. Ed Tronick, the parent attunement percentage to support healthy development is 30%. The other 70% of the time we have mismatches and most importantly opportunities to repair. A perfectly attuned parent DOES NOT EXIST. We do try and we do trust the process of making mistakes and once again demonstrating and modeling for our children how to repair these mismatches.

Activity: When we move, we create positive neuroconnections and have the capacity to change our mood, emotions, and motivation. A moving child is a happy child however, safety awareness, and functional movement is important. Some classrooms call these movement times “motor breaks.”  These could be things such as passing out papers to the class, getting up to get a glass of water, or a “Go Noodle” dance break. Whatever it looks like, honor it and allow the child early opportunities to manage and regulate their motor systems responsibly and appropriately.

Other outlets: Play, art, books, and music are amazing outlets to support a child through transitions. These activities are also a great way for children who may have challenges with language to articulate what and how they are feeling. Using these modalities to support the capacity to communicate is another opportunity to connect and develop lifelong regulatory skills.

This is a time of vulnerability and confusion for many of us. It is also a time to support our children so they can continue to develop their sense of self with trust and safety during these unpredictable times.  Take a breath, give yourself a squeeze, and be that secure base for your child. 

Schedule a free phone consultation with us to learn more.

Bridget Caruso MS, OTR/L, IECMLHC Consultant

Occupational Therapist, Infant and Child Mental Health Consultant

Unpredictable_times; International Stuttering Awareness Day

COVID-19 Protocol

We hope you and your family are continuing to stay safe and healthy! We have outlined our protocols for in-person sessions during COVID-19. As you know, the health and safety of our clients and therapists remain our highest priority. As always, please reach out with any questions or concerns. Thank you for your cooperation and understanding as we work together through these unprecedented times.


Hand Washing:
Upon arrival at your home, your therapist will wash their hands with soap and water and/or use hand sanitizer. We ask that you and your child also wash your hands and/or use hand sanitizer upon your therapist’s arrival.
 
Facemasks:
We are asking our therapists to wear masks upon entering your home and throughout your child’s session. That said, we understand that some children have adverse reactions to seeing adults in masks and will leave it up to you and your therapist to decide your comfort level while still taking safety precautions.
 
We ask that parents and caregivers also follow the guidelines and wear masks when sitting in on sessions. We will not enforce that policy, but we do kindly ask for compliance.
 
As for your child, we realize that masks may not be appropriate for every child so we will not enforce the rule that children over the age of 2 should wear a mask.  However, if your therapist insists that your child wear a mask, then that will be a requirement directly between the two of you. We respect our therapists’ individual comfort levels with safety precautions and ask that you respect them as well.

 

Protocol Acknowledgment and Health Certification:

Before your child’s first in-person session, we are asking clients to submit an acknowledgment of these protocols and a health certification, which you can find here. Thank you again for your cooperation and for helping all of us stay healthy!