Monthly Archive

OT Corner: Saving the Drama for Broadway

1st January, 2008

By: Loren Shlaes, OTR/L
Certified Teacher of the Alexander Technique
Children with low arousal levels are constantly looking for ways to increase their energy so that they can be more alert. Unfortunately, especially when they’re at school and stuck sitting in one place for a long time, we don’t allow them to implement many of the strategies that would actually help them get themselves into a just right state, like chewing gum, going outside for a romp in the park, getting up and walking around, etc. So they’re stuck trying to do anything instinctive to activate themselves and change their internal chemistry.
What is a really efficient way to get a big rush of adrenaline, if you’re a small little person? Do you run out to Starbucks for a venti triple shot half caf low fat extra foam, with a shot of caramel syrup and whipped cream? No. Do you go to the vending machine and chow down on a Snickers bar? No. Do you close the door to your office and take a cat nap, play a quick game of solitaire on the computer, or make a personal phone call? Nope.
None of those strategies, which work well for adults, are available to a small child, nor appropriate for a little one’s nervous system. So what are you left with, if you don’t have the verbal sophistication to tell people you’re out of gas, and no one is letting you run outside and play for a few minutes and you can barely attend for one more second? What requires no special equipment, is one hundred percent guaranteed to get results, and is easy to do?
You do something that makes the grownups mad.
Bingo! Nothing better for producing a big adrenaline rush and increasing your arousal levels than having someone three times your size in your face, yelling at you with an angry expression!
{Who among us has not seen a child sizing her up with a gimlet eye, then deliberately doing something verboten while watching carefully for a reaction? Either the child needs the adrenaline boost that a confrontation would provide, or you are being tested to see how much you are in control of yourself. Which in turn tells the child everything he needs to know about who is really in charge.}
Although it certainly accomplishes the goal, it’s not a healthy way for the child to manage either his internal state or his relationships with others. We don’t want to encourage it by rewarding the child and providing him with the drama he is unconsciously seeking.
What we can do instead is help low arousal children learn to recognize when they need to activate, and to seek our help in healthier ways.
If you are aware of your own tendencies to zone out when you should be paying attention, or to procrastinate when you don’t feel like doing doing something, and to acknowledge how you employ strategies to stay alert and focused like stretching, chewing gum, drinking coffee, and doodling, it’s easier to recognize what’s happening to the child when his needs are not being met and he begins to act out.
When I see this happening, I say to the child in a very calm voice, “It looks to me as if you need to jump ten times on the trampoline before we continue with our handwriting.” {Notice how this is not an open ended invitation to step away from the task. The child jumps, I count. At ten, we’re done, and it’s time to resume writing.} This often works very well. If the child says no, I will say, “We need to come up with something that will help you focus so that you can do your work. You have a choice between spinning ten times, jumping ten times on the trampoline, or playing ‘Head Shoulders Knees and Toes’ with me. Which one will work best?” {Note again that this is still not open ended. And I am teaching the child to recognize his state, employ some strategies to activate himself, and go about getting what he needs in a healthier way. Also notice that each strategy I offer is a different form of movement, so that he can begin to think about and choose what will work the best for him.}
If the child doesn’t think any of those things will help get him into the “just right” zone, there are other options. If movement won’t help, there is music, gum, a lollypop, a drink of water through a straw, a trip to the bathroom. Sometimes I will drop to the floor and we will wrestle for about a minute, I will let the child pin me, and we’re back on track.
Of course the trick here is making sure that we are not so depleted ourselves that we can’t step back, assess the situation, and respond not out of irritated habit, but using a reasoned choice. What can you do for yourself that will help you? As you sit down and think about what works for the children you treat, how about doing the same for yourself?
Featured Author: Loren Shlaes, OTR
Many thanks to Loren Shlaes for providing us with this guest blog for our newsletter and website.
Loren Shlaes is a pediatric occupational therapist specializing in sensory integration and school related issues, particularly handwriting. She lives and practices in Manhattan. She blogs at

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