As an occupational therapist, I hate it when I suggest to a parent that their child may benefit from OT, and they reply “We tried it a few years ago, it didn’t work.”

The truth is that sometimes the benefits of therapy don’t appear the way we want them to. And usually it is for one of two reasons: Either the therapist is a bad fit, or the child isn’t ready.

Respecting the Personalities Involved

The very best therapist in the world is still going to have patients that don’t work well with them. Therapy, any kind of therapy, is a push and pull between two people. The therapist needs to encourage your child along at just the right pace to make progress on their goals while listening to their needs. From there, they can create a “just right fit” of activities to do in therapy. However, underlying the entire experience is the relationship between the therapist and your child. If your child is easy going, they may benefit from therapy with any therapist out there. However, if your child has a personality that is described as “intense” they may clash with a therapist who isn’t the right fit. It doesn’t even mean that the therapist is a bad one–just that they weren’t right for your child.

In a bad-therapist-fit situation, both the child and the therapist end up frustrated and discouraged. Maybe the therapist is trying to use a reward system that your child won’t participate in. Or maybe they are using other therapy tricks: Games and activities that have worked with previous patients. But your child will have none of it. Or maybe your child has decided the therapist is “too bossy” and is refusing to try new things.

Even if a therapist is excellent at their job, a bad fit will lead to little progress towards your therapy goals. Every therapy relationship requires that the therapist and the child feel like a team working together. Therapy can’t be productive if it feels like a battle your child and their therapist are about to fight.

If your child says they don’t like their therapist after a few sessions, it may be worth asking to switch to someone else. A therapist the child likes will get far more effort and participation from the child, which leads to progress.

Taking the Entire Picture Into Account

The other reason that therapy progress can be very slow is that your child isn’t ready to make progress for some reason. My favorite therapy experiences have taken place when a family brought a child to me after they had already done all the other hard work, and OT was their next check on a long list of what they were doing to help their child. What do I mean by hard work? These families had already figured out their child had a food allergy and removed it from their diets. They had figured out their parent-child relationship and were not having daily battles. They had addressed other medical issues and tried to set their child up for success. After all that work, something was still missing. In that case, OT was the missing piece of a puzzle and the child made excellent progress very quickly.

Does that mean that you need to figure out everything going on with your child before you start therapy? No! However, it can be important to realize that therapy has limits. If your child has an undiagnosed food allergy which makes them have a stomach ache, they aren’t going to be able to do their best in therapy or in life. If you are having daily fights with your child about behavior or bedtime, you may have a hard time following through with a home program designed to make therapy more successful. Any complex medical issues can slow therapy progress.

For some families, a therapist can pick up on underlying issues and point you to resources–doctors or books–that can help you find the puzzle piece that will help things come together for you and your child.

Time Can Make All the Difference

Often, families in this category withdraw from therapy because they feel their child isn’t making progress. Taking a year or two away from therapy is sometimes the best choice in this case. It gives you time to address any underlying issues. And it gives your child time to mature to be better able to follow directions. Child development happens in starts and stops. If your non-verbal child stopped speech therapy for lack of progress and suddenly starts saying a few words months later, it may be time to revisit speech therapy to help them progress with that skill. Or if your child with poor fine motor control suddenly starts trying to use a spoon after years of ignoring it, it may be the perfect time to restart occupational therapy to push those fine motor skills along.

All children have windows where they are ready to learn new skills. With children who are special needs, those windows may open later, on their own schedule. The brain is constantly laying down new pathways. And when a child is really ready, having a therapist step in to push those skills along can be a wondrous thing. I have had the joy of working with children at this just right moment. It is fabulous to be part of that. The child who just didn’t show interest in fine motor skills as a 4-year-old is suddenly ready at 6-years-old.

Don’t Give Up On the Process

The reason that therapy can be a huge benefit, rather than just letting the child figure it out on their own, is that the right amount of pushing and pulling in therapy can help the child make progress faster and easier. Parents often don’t realize that once one skill starts to emerge, there are several others that should be encouraged. If your child has avoided or been unable to do certain skills for long enough it may not occur to you to ask your child to now try to do that thing. Therapy can support your child’s growth in a way that takes full advantage of that open window.

So, if you are a parent who feels therapy was a waste, I encourage you to think about whether it was one of these reasons. Was it the wrong therapist or the wrong time? If it was either of those, I hope that you can find the right therapist fit for your child at the right time and get the full benefits of therapy for your child.

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Laura Sowdon, OTR #5SLL #5sensesLL #normalisoverrated

About the Author

Laura Sowdon, OTR/L is an occupational therapist, writer, speaker, educator and creator of the Five Senses Literature Lessons homeschool curriculum. She has worked as an occupational therapist with children in public and private schools, as well as private practice. Laura has taught and managed homeschool co-ops as well as homeschooling her own three children. Laura is dedicated to the idea of educating children at a pace that aligns with brain and physical development milestones and respects neurodiversity in all its forms.

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