Last month was Occupational Therapy Month: Do YOU know what an OT is?

If you don’t know what Occupational Therapy (OT) is, you’re not alone. If you thought you knew what OT was but find yourself surprised that my role focuses primarily on family sleep, development, and parenting, instead of handwriting you’re also not alone!

As a belated celebration of Occupational Therapy Month I’m uncovering the way OTs look at solving problems and why thinking like an OT is a great way to support families through the challenges and uncertainties of sleep and parenting in the first three years.

SKILLS FOR THE JOB OF LIVING

Occupational therapy focuses on the ability of a person to do what they need and want to do.  

For an infant or child, things they need or want to do may be learning to breastfeed or bottle-feed, reaching for a toy, negotiating a conflict with a sibling, or learning how to play Snakes & Ladders.

For parents, this may include learning to stay calm during parenting challenges, getting enough sleep, and figuring out how to get dinner on the table!

THREE THINGS I ASK WHEN I WORK WITH YOU

When working towards changing things in order to achieve what you want to achieve as a parent, there are three areas that I address: 

1. Who you are (or who your baby is: temperament, strengths, needs)

2. Where you are (your environment: physical and emotional), and

3. What you want to do or want your child to be able to do (the “thing” that you may find difficult that leads to you reaching out). 

When life is going fairly smoothly, these three areas tend to compliment each other quite well.  

 So what does it look like to work with an occupational therapist for sleep challenges?

Working through an occupational therapy lens to support you with sleep may involve:

1. Exploring your child's environment (e.g. setting up a calm sleep space, removing or reducing hazards, choosing developmentally appropriate toys, improving the air you breath);

2. Exploring your child's activities (e.g. daytime activities that promote sleep pressure, shifting naps, adjusting sleep associations to invite sleep more easily, sensory activities that calm a child for sleep);

3. Exploring your perspectives (e.g. how important is this to me? How might I approach this to get closer to my goals? Is there a different way to look at this that uncovers a solution to the problem that I hadn’t thought of before?)

4. Exploring parenting style (e.g. what has been working, what hasn’t been, and where are you feeling conflict or uncertainty)

5. Explore your child’s development (e.g. what stage of sleep development they are in, and how does that impact your parenting approach, what other aspects of development are changing and how might this be impacted sleep?)

SO, then…….WHAT IS OT?

Occupational therapy is the art and science of enabling engagement in everyday living, through occupation. (Townsend& Polatajko, 2007, p. 372) I often use the word “activity” since most people think of paid employment when they think of “occupation”. Another way to word it is to think about how your time is “occupied”: what do you spend time doing?

OT enables parents and children to perform the occupations that foster health and well-being. In the first three years this means a lot of focus on eating, sleeping, playing, and gaining new skills (babies AND parents!). It means finding a balance with all of our activities and responsibilities during the day, and having flow.

Having flow means that who we are (our temperament, our abilities, our strengths), where we are (our environment), and what we do are all aligned. When these things are not well aligned, changing one of them (ourselves, our environment, or our activities) can make a big difference in how we feel. When it comes to babies and young children, it’s often helpful to focus on changing their environment (which includes changing your knowledge and perspective on things!). But exploring health issues, sensory regulation, and development are all ways to support change too!

it’s rarely just about sleep:

Occupational therapy looks holistically at many aspects of your baby’s and your family’s lives. Here are just a few of the ways that support can extend beyond the main reason a family reaches out for support:

• You want to understand infant development in order to feel informed about how to support it;

• You want to explore gentle parenting strategies to get more satisfaction, joy, and confidence out of supporting your child;

• You have concerns or questions about your child’s development even though things seem to be going pretty well;

• You want to explore ways to adjust your home environment (simplifying, making healthier) to better support your child's development.

• You are concerned about your child’s sleep (wondering if it is typical, and if it is, how to support it and support your own sleep, too!)

The holistic approach of OT allows us to look broadly at the challenges families face, and to appreciate that every family is unique. This means the solutions needed to solve challenges will look unique too.

Sometimes it is about shifting expectations; other times it’s shifting routines; and still other times it is about discovering a root cause to the challenge and making a plan to resolve it. But always, it’s about listening to you and what goals you have for your baby and your family.

Warmly,

Heather

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Natural Infant Development: How Not to Burn Out Helping Your Baby Gain New Skills

There is a lot of pressure on parents these days to be engaged, to be fully present, and to communicate and respond to everything a baby sees, vocalizes, or gestures about. This pressure comes from a good place: the research on parent responsiveness to babies shows that it impacts emotional regulation, communication development, and self-confidence.

However, the pressure to be this responsive can be so intense that it disrupts what ought to be a balance between engaged parenting and helping babies embed themselves into the natural rituals of a family’s day: it can make parents feel guilty about placing their babies in playpens or play fences while they answer the phone, or to lay a baby on the floor while they sip a tea. Or simply talk to another adult without engaging in eye contact and side conversations with their baby to “include them”.

And the pressure is not just on the impact of parents. Children who are constantly expected to respond to a parent’s (loving but nonetheless persistent) verbal volleyball, commentary, or engagement miss out on the opportunity to simply “be”. They are constantly having to respond. They do not get to rest.

In contrast, there is great merit in babies having time to explore, observe, listen, see, and test out motor or vocal skills without a barrage of well-intended social expectations. (Any introvert who benefits from downtime will appreciate what that feels like!). By being invited into the fabric of daily life for your family, whether that is gardening, preparing meals, hiking, reading, writing or talking with a friend over coffee, your baby is getting to observe and learn from you, their first teacher.

Instead of feeling the need to constantly keep babies engaged with us, we can focus on “bringing our babies along for the ride”, embedding them into the rhythms and rituals of our lives, and letting them observe, learn, be curious, and participate as they wish.

Here are five simple approaches to embed babies into the fabric of our daily lives in ways that support their development while simultaneously providing parents the opportunity to pursue meaningful activities themselves.

1. Babywear: by babywearing, babe is present through “daily activities” that allow them to anticipate, understand, and learn, all within the safety of close proximity. Let them see you stirring the soup, let them smell the soup, or feel you bending to plant something in the garden, or peer into the washing machine. Many of these things may feel like humdrum work, but most of them are daily (as any parent knows!) and it is the essence daily living. Babies can learn immense amounts simply by being their with you through daily life;

2. Watch, wait, and and wonder: say less, and watch more. Be curious about what your baby is trying to do with their arms, their legs, their mouths. This curiosity does not need to interrupt the hard and intense work your child is doing just by playing and moving. Watch what they do when they are watching the cat or trying to touch a ball that is just out of reach. Wonder about what they may try next, or how they will solve this problem. You are still there to help them if needed, but it is also ok, and I would say even desirable, to consider waiting for an invitation to help. As an aside, “Watch, Wait, and Wonder” is also the name of a wonderful infant-led approach to infant-parent relationships —if you are working with a therapist or infant development consultant and are struggling with reading cues and building a relationship, with your baby, ask about this approach;

3. Respond to their shared delight. By giving them space to learn and be curious on their own (with you watching quietly close by), your baby will inevitably turn to you or look for you to share the moment: they will want to share a recent discovery (they found their toes!), or something that delights them (that bird in the window. Do you see it too?). They will also have space to gauge your reaction to things that feel threatening to you. If you don’t skip a beat but continue to talk to your friend, your child will know it is not a threat. If you turn to them and calmly share in a calm voice that they just saw and heard a fire truck (“it’s loud isn’t it? There it goes! It’s a fire truck. A red fire truck”) your child will know that this new and strange thing is also not dangerous to them as you watch from the window;

4. Play with no agenda. Spend time playing for the pure delight of seeing the world through your child’s eyes. Lie on your back and look up at what they see. Explore the world down at their level, and make it a world full of simple wonder. Be delighted at how things so simple can be so fascinated;

5. Incorporate opportunities into your daily life. Carl Dunst, an infant early intervention researcher, describes the importance of incorporating “work” (tummy time, therapy and child development activities, etc) into daily life in ways that do not interrupt the rhythms and rituals of your family’s life. Your family’s rituals are so very important, and ought not get squeezed out by otherwise helpful activities that support development. If you find yourself going out of your way to fit “developmental homework” into your baby’s day, take a step back and see where these things can be incorporated into enjoyable activities that you are already doing.

And most of all, have fun!

Warmly,

Heather

(PS If this approach to infant development resonates with you, check here for more information on the upcoming Infant Development Circle, an online group designed to shift parents from concern to curiosity, and to use instincts and evidence to support development without the overwhelm).