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Actions speak louder than words

December 5, 2012

 After almost 30 years as an occupational therapist, I catch myself wondering “How could we increase her independence?” or “Now that he can do that, how can we encourage him to meet the next step?” when thinking about the children I serve.  I know that some people want to increase their independence.  I understand that some people want to master the next step of an activity.  However, I’m becoming uncomfortable with reinforcing aspects of my culture that I find questionable. 

Who is really independent?  I would argue that no one is independent.  How much independence does our society believe is the ideal?  In my culture, men like my husband are considered independent.  They have full-time, skilled, good paying jobs.  They manage all of their personal care.  However, many of them have children.  They are not completely independent because they have relied on their wives and/or Day care providers to care for their children.  (In my community, most daycare providers are paid less than half what men like my husband earn.)   

Many of the teenagers I serve are considered dependent.  They may be unable to get and maintain full-time, skilled, good paying jobs.  They may need help with personal care.  They are children so I continue to urge them to develop more skills as I encourage my own children to develop more skills.   However, when does this encouragement cross the line and become “disabling”?  I struggle with this question almost every day at work.

I say that I struggle with that question.  Yet, I realize that if the child becomes aggressive, I have crossed the line.  I would like to prevent the aggression.  Maybe the answer is to encourage very small steps towards increased independence and/or skill in an activity.  I do that and often am able to prevent the child from becoming frustrated enough to respond with violence.

But what about the hostile messages my actions send to the child?  “You can’t feel pride and satisfaction with what you have just achieved.  It is not enough.  It will likely never be enough.”  “You should be able to do this yourself.  You are a burden to your helpers.  You can ease the burden on the people who care for you by getting better at doing this by yourself.”  I don’t want the children to serve to believe that is how I feel about them.

I want the children I serve to know that I think things like “I enjoy spending time with you.” “I admire you.  You are such a hard worker.”  “You deserve a rest.”  “You deserve to have fun.  Let’s have some fun.”  “I wish I could think of a way to make this interesting for you.”  “You are a shining star.”  But actions speak louder than words.  How can I make them believe these thoughts?

  1. imgls1989 permalink

    I think by maintaining the client-centered focus, you can see where they see themselves at the end of therapy sessions. This can help to give them autonomy in their therapy as well as allow for their own independence.

    • I think that on an one-on-one basis, you may be right. Maybe my discomfort is more related to the messages that I am sending others. “This child is not enough just as they are.” “Because this child has an impairment, s/he has special needs.” When really, all children have the same basic needs and then every child has his or her own specific needs because of their uniqueness. (Is uniqueness even a word?)

      I don’t want to disillusion you as you go through occupational therapy training. However, I do want occupational therapy students to be conscious of how our profession may unintentionally contribute to our disabling culture. Articles and books by Karen Whalley Hammell, a Canadian occupational therapist with British roots, explain my concerns very eloquently. I highly recommend them to occupational therapists and OT students.

      Thank you for taking the time to think about my post and for commenting.

I look forward to hearing your thoughts!

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