An Organized Child In Therapy and at Home: Is it Possible?

Have you considered the reasons why your child’s behavior at home differs from their behavior at therapy sessions?

Most of us have been there—our children do exceptionally well in therapy, they listen to their speech therapist, look at various objects, they ask what they want and comment on scenarios, and then bam… As soon as you get home, your child seems like another person! Where is the little angel you observed during therapy?

In psychology there is a term “childhood attachment” which means that when children are with those they trust most, they behave differently. The term is less important than the function of this change of behavior. I understand that it might be difficult to respect this rapid change of behavior, but it does mean your child feels most secure with you, their parent. This is a perfectly normal phenomenon. I know, it is easier said than done. No one is ever happy about a sudden outburst, right?

There are a few instances where we should be cautious about a sudden change. For example, a child suddenly crying when you try to generalize any of the strategies from therapy to the home environment. This may indicate that your child is displaying signs of trauma from an intense therapy session. I would request sitting in on such sessions, where possible, and noting the change in your child. You can always ask a professional (such as a psychologist) or an adult diagnosed with autism spectrum disorder (ASD) for advice concerning such sudden changes in a child on the spectrum.

Another scenario where you may want to take note of a sudden change, is if your child starts exhibiting frustration as soon as they know they are heading to a specific therapy. I would suggest voicing your concerns to the therapist. Ask them if there are any strategies that they feel you can utilize before a session starts, to support your child in preparing for the session.

The flipside of the coin is when everything goes well and you get home and your child seems dysregulated. There have to be more reasons for this change, other than your child having a stronger attachment to you as a parent, right? Let’s look at reasons why your child is possibly reacting differently in therapy than at home and some strategies to support you and your child through this.

Reasons child is reacting differently in therapy than at home

• They feel they have to “perform” at therapy and can relax at home

This is a common reason, as contrary to popular belief, most of our autistic children are highly sensitive to people’s emotions and they will adapt to these. Our kids are smart and they know (most of the time) what is expected of them. They understand that a speech therapist wants them to communicate (in their way) more, and an occupational therapist wants them to regulate through play. They will engage in these behaviors and sometimes it will be viewed and interpreted as a “chore” they need to get through. What do we usually do when a chore is done? We relax, we put our feet up and we disengage in our work for a while.

Similarly, we can’t expect our kids to engage in the amount of communication or sensory play that they often do during sessions. After such a session, they often need a break. For many autistic kids certain therapy sessions may feel like a difficult task to stay focused on, and pay attention to “complete”. After the exertion, give them a break in their sensory corner or tent without placing any demands on them. Let them know you’re proud of all the hard work they are doing and that they can relax for the rest of the afternoon.

• They receive specific strategies during therapy that are conducive to their style of learning

Therapists study for years and years, their expertise evolves with their understanding of autism—at least that’s the hope! We’re trained to implement visual strategies, such as countdown clocks, visual schedules, choice boards, etc. We have the time to create these visual aids during our free time as we’re not always parents of children with specific needs. It is our job, just like you have your occupation. It is also our responsibility to provide parents with strategies to generalize these goals at home.

Ask your therapist to provide you with strategies or templates to use at home. It should be a priority for them to provide you with these for two reasons. Firstly, it will help your child (their client) and secondly, it will make life easier for everyone, as there will be consistency, continuity, and less frustration for your child.

• There are too many changes and your child didn’t have time to prepare for these

This is a factor that is often overlooked. In today’s world, we live very busy lives and we have to cope with full schedules—that often change at the drop of a hat. Our kids are not as adaptable to sudden changes and we need to respect this. Personally, I believe the children I work with have taught me to allow myself time to process a potential change.

Sudden changes in our schedule might be upsetting, and we should honor the emotions we feel when this happens. Please prioritize creating a visual schedule (first-then, daily and then weekly) for your child. Make a point of referring to this at the same time in the morning, and again at night time. It could make all the difference in the world! It gives your child time to process what is expected of them on a daily basis, and the opportunity to make peace with a few upcoming transitions.

• Not knowing when a session will end and what will happen next

Similarly to the previous point, it’s important to let your child know how long a session will last and what they will be doing afterwards—it always helps to plan a favorite activity directly after a session. Let them know they need to be with their therapist for 45 minutes, but also tell them that afterwards they can have 30 minutes at the park with you; where you can both decompress. Although we’re used to going into and out of therapy, it’s still an unnatural experience for any child to attend therapy on a consistent basis. We have to provide time for them to play freely and shake off the feelings of working at such a young age. 

I am sure that, as caring parents, you are already implementing some or maybe all of these strategies, but it never hurts to be reminded. Thank you for all that you are doing.