Supercharged Early Intervention

As part of my responsibility as a child psychologist on multidisciplinary teams, I have the opportunity to observe my little patients in many settings, including  classrooms, homes, and OT (Occupational Therapy) clinics. I recently observed two different children in their OT treatment and found a striking contrast between the two.

The first clinic at a large public school had a padded floor and equipment lining the periphery of the room; large tubes to crawl through, ramps, and therapy balls.  In the center of the room hung three platform swings, large enough to hold 2 or 3 small children at a time.  On this particular day, three children from a special day class lined up to wait their turns, in pairs, to go on the swing. One child appeared to enjoy the experience, while his peer closed his eyes and kept on trying to lie back, gripping the sides with white knuckles. The teacher and OT conversed with each other while swinging the children for about 5 minutes, without directly interacting or talking to them.

Later in the week, I visited another OT clinic with a similar central gym, but this room included a large bin of toys and dress-up costumes.  When I looked in, a therapist was engaging a toddler who scampered up to the platform swing with a large plastic airplane on it.  The child saw the airplane and expectantly looked at the therapist and his mom, who was included in the session.  “Oh, do you want to fly today?” she asked, in an animated voice that made the child’s eyes light up even more.  She waited until he signaled affirmatively (big smile, moving his arms) before helping him onto the swing with the airplane, and began to slowly pull the swing back.  Then, waiting a bit more, she held the swing without releasing, looking straight into his eyes. You could see the anticipation in his body, trembling with excitement, while she said, ok, ready, set…(she paused) and then the little boy said “go!”  To which the OT said,  “Flight 123 taking off from the airport!”  Giggles erupted and he was off.  The fun continued for over 5 minutes, as the three joyfully interacted the entire time.

Two clinics, the same general activity, and two completely different experiences.  What made them different?   The second clinician embraced the DIR (developmental, individual difference, relationship-based) approach, where joyful emotions supercharge  (and reinforce) learning in the context of loving relationships.

What we saw in the second clinic was a holistic approach that helped the child integrate movement, language, and intention. In my next post, I will list what to look and ask for to supercharge your child’s early intervention.  For more information on the integration of developmental and relationship based principles into treatment, you can visit , and





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