Before we get into this, I need to tell you that I am not only the mother of an autistic child, but I’ve worked with many autistic youth in my role as an occupational therapist. I love my autistic kid, and I have honestly loved working with the majority of autistic kids I have seen. As an OT, I generally love helping them find their own voice. I like sensory play and the games that I know will help them build coordination and muscle control. I even like the challenge of working on skills like shoe tying and dressing so that they can be more independent.
But today, I’m going to tell you about the worst experience I ever had as an OT. I was working in a small private school for autistic students. Most of them were not in public school due to severe behaviors. The school had a great student-to-teacher ratio, and some wonderful spaces, like a sensory room.
Meeting My Patient
On my first day there, I approached a young man who was on my caseload. He was 18 and a big guy. I walked over and just introduced myself. He reached out, grabbed my arm, and bit down. Hard. I wore his teeth marks on my arm for over a year until the scars healed. This young man was non-verbal and known for assaulting staff. There was protective gear to wear when working with him because this was neither the first nor the last time this behavior happened.
I only worked in the school for one year, so I don’t know where this young man is today, but that isn’t the point of this story. I want to explain the implications of this situation—what got him there, and what his behaviors mean for his future.
When I returned to visit this student the next week, I stayed out of arms reach. I observed him and asked his teachers about him. I wrote up his OT time as “acclimating to therapist” because he could see me. The entire staff agreed that was the best I could do for his therapy at that point in time. But I wanted more information about his behaviors and his challenges.
What Went Wrong
What I was told was that this young man, who was a full-sized adult, had a mother who never let him be challenged. No therapist or teacher was ever allowed to make him frustrated or upset. This means he had only to throw a tantrum as a child, and his therapist or teacher would be asked to stop. He generally had the life skills of a 2-year-old. He could walk, feed himself, and point to objects he wanted. Sometimes he used pictures to communicate, but his requests were always simple when I was there.
He could not take himself to the bathroom, dress himself, fix himself a snack, or write any letters. At the age of 18, he lacked almost all basic life skills, social skills, and fine motor skills.
Now, therapy is supposed to be frustrating at times. My goal is to push a child to do things that are new and difficult. It is kind of like having a personal trainer who pushes you to get stronger. The goal is never to harm anyone, but growth can be uncomfortable. I’ve had children become distressed because they touched a new texture or struggled with a new skill. This is normal. This is something to work through. We try the new thing, then we take a break to do something less stressful. We try the hard thing again next week and the week after that. Eventually, things that were distressing and impossible are easy and doable.
Learning to work through frustrations and challenges is an important part of child development. Don’t deny your child that experience. Many things are hard the first time, even for typical children. But we make them try again and again until they learn the skills they need. Pushing a child who is autistic, or has other disabilities can be difficult. It can be difficult to see them struggle. It can be difficult to be patient when they take four times as long to do something as it would if we did it for them. It can be difficult for both the parent and the child to put in the work needed for a child to gain the skills they need.
Lasting Impacts
In this child’s case, the mother not being able to stand the child being upset had dire consequences on his life. Because she made the therapist and teachers stop pushing him every time he had a tantrum, and she wouldn’t push him herself, he lacked all the skills needed to care for himself. Because he didn’t have consequences that taught him not to hurt others when he was small, he is violent. This combination means he will probably not be able to ever live away from his parents.
He is violent because violence has served to get him what he wanted. The day he bit me, he wanted the new “stranger” to go away. His method worked for him. As a parent, it is important to teach your child that hurting others doesn’t get you what you want. If a child learns they can hit, bite, or kick and actually get what they want, whether it is an iPad turn or a cookie, or to be left alone, they will keep using violence to get their way. I never meet violence with violence with a child, but I make sure I don’t give in to it. I never reward it, and neither should you.
This boy won’t be able to enter a group home. He won’t be able to live even a little bit independently. He has no friends because of his violent outbursts. His mother has created a situation where he will depend upon her for his care for the rest of his life. She has created a situation where she herself will be exhausted and unable to get a break once he graduates school. He will need her to be home with him all the time, to attend to his needs that he can’t meet himself. Finding a caregiver willing to risk being injured will probably be impossible.
What To Do Differently
So, I beg of you, if your child has tantrums or becomes upset when pushed to do their own self-care, be strong. Let the tantrum wash over you like water. Be the calm in the storm. Let your child know that there is no amount of screaming and crying that they can do that will sway you from asking them to do things for themselves. You may need to weather that storm to teach your child to bathe, dress, or toilet. You may need to hold strong while an OT puts the crayon back in their hand for the 33rd time and helps them draw a line despite their tears. Leave the room if you need to. But don’t remove your child from therapy just because it is hard.
Don’t let yourself believe there is anything abusive about making your child learn to care for themselves. As long as it is done in a loving and kind way, it is instructional, even if they are frustrated. Yes, your child may cry in the face of kind and firm instructions about how to brush their teeth or put on their shoes. But trust me, they will be so proud of themselves when they develop those skills.
So, push your child. Correct your child. Just because they are autistic doesn’t mean they can’t learn to do things. In my experience, autistic children can learn to do many things, if given the right encouragement. It might be frustrating and difficult and cause you to break down in tears yourself. But push your child to be all they can be, so they can have their best life possible.
One Last Thought
Before I go for today, I do need to mention that as an OT, I have made very few children cry. That isn’t part of most sessions. I’ve waited out a few tantrums. I’ve let children show me their big feelings. I’ve helped them voice their frustrations and anxiety. Usually, helping them to label their feelings allows children to work through those feelings. Most of my OT sessions are fun and the kids are usually happy. If your child is perpetually unhappy with therapy, it may be worth looking into finding a different therapist who is a better fit. While occasional tears and tantrums may be normal, they shouldn’t be constant.
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.
