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presented by Susan Spitzer, PhD, OTR/L
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How can we engage a pediatric client's motivation and self-direction for therapy when what the child wants to do is not what the child needs to do? Children with developmental disabilities such as autism may be uninterested or even dislike the activities on which they need to be working, such as dressing and writing. Disinterest and dislike can be shifted into interest and enjoyment through the application of the clinical-reasoning methods presented in this course. Various cases illustrate how to use personal meaning and interests as strengths to shape activities so that the child experiences them as play and wants to do them. Using this creative strength-based approach enhances meaningful participation in therapy and the child's daily life.
Susan Spitzer, PhD, OTR/L
Susan Spitzer is a licensed occupational therapist, author, and lecturer with expertise in sensory integration, play, and autism spectrum disorders. She has operated her own private practice clinic in Pasadena, CA for 15 years. Her highly creative and individualized approach continues to energize her practice after 20 years of experience. Previously, she directed a hospital…
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1. Introduction
Client-centered care focuses on what the client wants to do, affirming the client’s rights. This creates a dilemma in pediatrics when what the child wants to do is at odds with what the child needs to do, with what the parent or teacher wants them to do. The importance of addressing both wants and needs together is proposed for creating meaningful intervention.
2. Using Personal Interests to Reframe "Work" Into "Play"
Children with disabilities often experience many aspects of daily life and therapy as work. Adapting these “work” activities by incorporating the child’s interests allows the child to experience more play in the activities, which promotes participation. Cases involving the work of self-care, writing, and cutting will demonstrate how to personalize this method.
3. Embedding "Play" in "Work"
Effortful activities tend to be avoided but playful aspects can increase engagement and focus. This chapter will explain how to adapt activities to enable fun moments for the child to enjoy therapeutic work. Several case examples will be used to explain this process as well as identify opportunities for adaptations in "work" activities.
4. Expanding Limited Interests for More Play
Expanding a child’s limited engagement and restricted play repertoire can involve work that the child does not want to do or even resists doing. This chapter will present clinical reasoning for adapting activities for properties that are individually meaningful for pediatric clients. Cases will illustrate how to apply this process for children with constrained interests.
5. Adapting Individual Interests into Shared Social Play
Social play tends to constrain an individual’s interests and desires to some degree as the players must find common ground. In this chapter we'll develop concepts to apply strategies to adapt social activities with individual meaning for children with limited interests.
6. Research on Outcomes
We'll look into core research on the effectiveness of incorporating play, meaning, and preferences/interests in interventions for children with disabilities. Then we'll discuss various outcomes from current research and possible future research. In the end of this chapter we'll tie these outcomes together and adapt them to practices.
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