Monthly Archive

Pediatric Therapy Corner: Get to the Goal

By: Tara McClintick

One of the most important aspects of working with children who have special needs is working towards goals. When progress towards a goal isn’t made, it can be discouraging (to say the least!) The following is an example of an experience I had during my first years of teaching with Sean. Sean was a 5 year old not yet verbal boy diagnosed with autism:
Sean “Speaks” Towards the end of the school year, we went to the bathroom once again to work on Sean’s hand-washing goal. Every day the scenario looked something like this: Sean would come out from using the bathroom and approach the sink. I would say “Reach for the faucet” which Sean did, hesitantly. Each time he’d briefly touch the faucet, then immediately draw his hand back and rub his hands together. I’d say, “turn it” and show him by turning the faucet on, then turning it back off. I’d instruct him again “reach and turn it.” He’d repeat the same hesitant touch while looking towards the floor, appearing hyped and anxious rubbing his hands together. Usually what occurred next is I’d physically hand- over -hand help Sean move through each step, telling him what to do. Not today. We’d done this all year. Today, I wanted him to at least get through step two independently. I decided to get firm. “Sean, TURN the faucet!” I said as sternly as possible. As always he touched and drew back. “C’mon Sean, you have to TURN IT!” I barked, my annoyance obvious. His response sent a chill through my soul. Sean looked straight up at me with wide, serious eyes piercing through his thick glasses and slapped himself across the face quite hard. What he could not say with words was very clear to me that day, “Listen, lady, I’m doing the best I can here. Sorry if it’s not good enough to please you.”
I left the bathroom that day determined to find a more effective approach. Surely Sean had the physical capabilities to maneuver through the hand-washing steps. How could I have supported him better? I had demonstrated what to do at least 100 times or more! What could I have done differently? Well I now know there are LOTS of more positive approaches I could have tried. Here are three valuable tips towards reaching those goals:
We might just as honestly describe a person’s “learning disability” as our own “teaching disability” ~ Herbert Lovett
1. Celebrate. In the example above I wasn’t aware that there was anything to celebrate because I was focused on what wasn’t happening vs. what was happening. I now realize I was just as “stuck” as Sean because I was unconsciously focused on my fear of my own inability to help him learn to wash his hands independently. Instead if I were to appreciate and express my excitement about all the ways Sean was trying and cooperating – this may have gave him the encouragement he needed to break through to another level. Specifically I could have been grateful that Sean was using the bathroom independently. I could have cheered him when he came out and approached the sink. I could have praised him for listening and watching my demonstration of what to do. When he reached out to touch the faucet I could have emphasized that he’s on the right track! That’s a great start! When he allowed me to help him hand over hand, I could have told him with confidence that soon he’ll be able to do this without my help! How awesome this child with significant challenges is trying his best to stay and cooperate with something a teacher deemed important he learn, despite how extremely difficult it apparently was for him. Shifting our attitude to be more gracious, appreciative and encouraging can make a world of difference when we are trying to support someone who is facing a difficult challenge. If this does not come natural to you (it is a learned skill) you can read Choose to Celebrate to read about this powerful approach in more detail. You can also post these Two Pages of Cheers as a reminder. The important thing is to make your appreciation visible and genuine – help that child feel empowered to succeed. As Sean demonstrated by his response, frustration doesn’t make things easier for anyone. Help them feel as though their best is ALWAYS good enough for you.
When it is obvious that the goals cannot be reached, don’t adjust the goals, adjust the action steps. ~ Confucius
2. Motivate. When something is challenging for a child, those of us who work with him/her can strive for ways to make that challenge easier and more fun to keep that child trying. There are countless ways one can do this, and I will illustrate using the example above. Two questions I could’ve considered to increase Sean’s motivation are “How can I make this easier for Sean?” and “How can I use Sean’s interests to make hand-washing more fun?” Making things visual is almost always helpful for a child with learning challenges. I could’ve tried a picture sequence of the steps displayed about the sink. I could’ve drawn a large back arrow curved in the direction I wanted Sean to turn the faucet pointing towards a colorful sticker – paired with my words “Turn it towards the red star!” or “Turn towards Snoopy!” (depending on which sticker might appeal to Sean most) this might have been the cue he needed. I could’ve also brainstormed ways to use Sean’s interests to build skills in a fun way. Since he seemed to be stuck at turning the faucet on, to make this easier I might fill some plastic jars with his favorite snacks. Barely screwing the lids on at first, we could have a “turning” party to practice this skill. Since he’d get to eat a little snack each time it would be fun work ? Knowing Sean was attracted to the other children in the classroom I might line all the kids at the sink at once letting them each play “turn the water on”/ “turn the water off” to a silly song for a group time game. In the spirit of fun with friends, Sean may have tried it too. I might try letting Sean wear ear muffing headphones to see if he was over sensitive to the sound of the water coming out, or see if a different type grip might be needed. Perhaps sensory issues were making this step challenging for Sean to break through. Most importantly, you want to keep trying to find ways to motivate the child just as you want the child to keep trying to break through his/her challenges (model what you are wanting!)
If a child can’t learn the way we teach, maybe we should teach the way they learn. ~ Ignacio Estrada
3. Collaborate. Brainstorming ideas with everyone who spends time working with the child can be exciting and enlightening. Have fun with this process! You’ll be surprised at all the ideas that start emerging once you get in the practice of it! I believe that special children have as much (if not more) to teach us as we have to teach them – one thing we can learn is to be more creative and thoughtful. The brainstorming process can definitely include those who know and love the child most – the parents! For Sean’s hand-washing goal I could’ve consulted with his parents after a few weeks of no progress. Reviewing how things are going in a holistic manner will help stack the cards in favor of success. You can find consistencies and inconsistencies, different perspectives and ideas to try, and how to best work with the child’s strengths. Working as a team to support the child can have significant benefits as the example below illustrates:
Surprise Success! My own son, Jake, was still demanding a diaper for BMs at 7 years of age. Without the diaper he would not eliminate, and would run around in obvious discomfort and distress, too fearful to go in the toilet. Our Son-Rise ® team brainstormed ideas, and Jake’s uncle had the brilliant idea of cutting a small hole in the diaper. We coaxed Jake to sit on the toilet with the diaper on. It worked! One joyous time is all it took, and from then on Jake eliminated in the toilet, no diaper needed ?
Those of us who work with children could easily get discouraged by a child’s seemingly inability to progress. In reality, it is our own failure we fear. Too often this paralyzes us from taking the new steps towards the goals (remember Sean getting stuck at the sink and how I was stuck as well!) Celebrate and motivate yourself and each other as well as that special child as you collaborate. Remember what’s most important is we feel encouraged and inspired to keep trying because you never know when we’ll reach that sweet success. Imagine what life would be like if everyone who worked with children respected and believed in the miraculous unlimited potential in us all. Imagine if we all possessed a joyful determination to keep learning and trying. That can become a reality, starting with you.

This Month’s Featured Author: Tara McClintick

Tara McClintick is an early childhood/special education teacher who is passionate about child development. She is the mother of two boys – Derek (16 yrs) and Jake (13 yrs). Just after the age of one, Jake began exhibiting all the signs of autism, and was later diagnosed on the severe end of the spectrum. Using the home-based Son-Rise Program®, she has worked one-on-one with her youngest son, as well as trained numerous volunteers on how to connect with him. She now creates unique picture books designed to promote awareness, thinking, interaction, and language development. For more information please visit

PediaStaff hires pediatric and school-based professionals nationwide for contract assignments of 2 to 12 months. We also help clinics, hospitals, schools, and home health agencies to find and hire these professionals directly. We work with Speech-Language Pathologists, Occupational and Physical Therapists, School Psychologists, and others in pediatric therapy and education.


Latest Jobs