Feeling stuck? Does it seem like your child isn’t progressing?
When your child started his new therapy program, at first things were going great. He started with the first tasks and kept building on them – until he stopped building and got stuck; and you as his parent feel like you’re not getting any closer to your goals. This can be frustrating because you’re following the therapy the way it was laid out. You know other families who made good progress;
so why is it not working for your child?
I can assure you that most families have been exactly where you are with whatever therapy they have taken on. Progress is not linear, and most people come to a point with a issue they’re working where they get stuck. It’s important that the therapies you take on account for the natural ebbs and flows you will undoubtedly face.
You might be thinking, “Why don’t our children progress the way we think they should when we are paying good money for an expert to guide us?”
We tend to think of progress as the cumulative effects of one step, followed by another, until your goal is reached. When you see other families’ impressive accomplishments, you likely assume they followed logical, step-by-step progressions and programming that helped them achieve the results you hear about and maybe even see. The results you see, however, are only a small part of a much bigger picture.
a winding, zig-zaggy road with lots of switchbacks and detours along the way – for all of us! Of course it is important to follow logical, well thought out, step-wise, developmental progressions. But what isn’t so well understood is the uniqueness that each individual brings to those steps based on his or her developmental history, current sensory and motor function and sensitivities, unique constellation of sensory and motor interdependence, current diet and gut health, and the environment he is spending time in. There’s a lot that goes on with each step of a program that is designed to help an individual do what he or she would like to do with more ease. Some parts of the journey are simple and quick, while others seem to take forever; your child progresses in one area but simultaneously regresses in others. And that’s a natural part of learning because as human beings, we are not linear.
Unfortunately, instead of accounting for this, some therapy programs try to push their clients into a linear and strict program where they are told they must complete A before moving to B; they must follow a certain protocol in order to achieve the desired results. One mother told me that a therapist said it was her son’s fault that he was not able to progress through their program. How does this make any sense? How can it be the child’s fault?
Does that mean that the therapy is “right” and the child is “wrong?”
There are as many different individual responses to therapy as there are individuals who engage in them. So, set-in-stone expectations are simply not useful or helpful.
Skill development or building function.
For some, the gap between progressive activities or exercises may be be too difficult to bridge, in which case it may be important to address other undeveloped areas or sensorimotor systems that are holding your child back. You see, if we look at therapy as simply skill development, the tendency is to break down the skill into its component parts. And the assumption is that those parts are so small, they must be doable and “easy” to accomplish. Just move through these easy steps and presto! But then what happens if even the tiny next step is too challenging? And, even if this does “work”, the individual may simply get good at doing that skill. My preference is to work towards functionality, not skill mastery. That way your child applies learning to all the various things he would like to be able to do, rather than simply having a repertoire of skills to apply. Therefore, a more effective therapy model is to focus not on the steps towards mastering a skill, but rather on the efficiency of the sensory and motor systems that support the ability to do the skill. This invites us to look at underlying sensory and motor systems that may not be seemingly directly involved in accomplishing the task but never the less may be preventing it or making it more challenging.
You may have also noticed that although your child is stuck at a prescribed activity in a linear progression, he might find the next one “above it” easier. If your child is then discouraged from even trying the next activity, he is held back for no good reason and he does not have the opportunity to see and appreciate his strengths. If we discard the linear paradigm and instead see individuals’ function as a unique constellation of interconnected sensory and motor systems, we see that there is no activity that is “above” another.
In some ways, this comes down to the idea of equitable vs equal
when learning new things, each individual gets what he or she needs, which typically looks more like the circuitous path in Figure 2 above rather than the straight line; not just the same thing that everyone else gets because that is the “right” way.
We’ve tried everything!
Given the number of times that I hear parents say, “I tried that and it didn’t work,” I would propose that a rigid, linear way of looking at and addressing issues with development and learning isn’t working. It’s time to try things another way.
The way we help individuals to reach their goals is by progressively building on the sensorimotor pathways that are directly involved in reaching the goals, while at the same time emphasising and developing supportive sensorimotor systems that may be holding things back. While this is in progress, it is important to address nutrition and gut health, because if the body and brain are not getting the nutrients they need, growing and learning is inevitably compromised. And it is also important to address environmental factors, because if things in the environment are causing the individual to go into a fight, flight or freeze response, the most thoughtfully prepared program of activities will be less effective if effective at all.
This way, your child continues to make progress towards what he wants to be able to do.
Rather than having a set series of progressions as the only method of reaching a goal, I find it is much more effective to follow an organised plan that is flexible enough to address each individual’s unique constellation of interconnected sensorimotor systems.
We’ve worked with a lot of families! And even when the diagnosis is the same, even when what the person wants to be able to do is the same, the journey never is.
Mary E. Robson © 2017