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Choosing the right pediatric therapist for your child is a significant and personal decision that can greatly impact your child’s development and well-being. Whether your child requires occupational therapy, speech therapy, or any other form of therapeutic support, finding the ideal therapist match can take time and multiple consultations with different providers. It is important to keep in mind that finding the right therapist can be similar to dating - the therapist may be a great person and good at their job and yet they still might not be the best match for your child/family. In this blog post, we'll explore important factors to keep in mind in order to help you make an informed choice for your child's unique needs.

Does the Therapist Listen to Your Concerns?

One of the first signs of a great therapist is their ability to listen to, and have genuine interest in. your concerns. You can begin to gauge this by having a short consult (either in person or on the phone) prior to the initial evaluation. Typically there is extensive dialogue during the initial evaluation, when your child will first be formally working with the therapist. Consider if the therapist is attempting to understand your concerns and from where they are rooted rather than excessively suggesting - or even imposing - their own goals and milestones. Occasionally, therapists can get “stuck” on what they think a child “should” be doing rather than focusing on the reason families are seeking therapy. For example, you might come into an occupational therapy (OT) evaluation for difficulty managing emotions/behavior and the therapist focuses on fine motor and handwriting differences. During your initial meetings, consider whether the therapist takes the time to understand your child's barriers, your family's goals, and your specific worries. A therapist who listens openly and attentively can tailor their approach to address your child's individual needs effectively.

Does the Therapist Try to Build a Genuine Relationship with Your Child?

Building a genuine and trusting relationship with your child is essential for successful therapy.  Watch for signs that the therapist is skilled at connecting with your child on a personal level. They should create a safe and supportive environment where your child feels comfortable and valued, fostering a positive therapeutic relationship. It is important to keep in mind that your child is most likely going to be addressing difficult and even sensitive issues while in therapy. In order for them to get the most out of therapy, they must feel safe enough to do so. If a child never builds a relationship with their therapist, they will not be getting the maximum therapeutic benefit that they deserve. 

Does Your Therapist Feel Comfortable Being Questioned or Receiving Feedback?

Effective communication between you, your child, and the therapist is vital. A therapist who welcomes questions, feedback, and collaboration is more likely to provide personalized and effective care. Don't hesitate to voice your concerns or ask for clarification during the therapy process. If you find the therapist is uncomfortable when being asked to clarify or even justify their explanations/therapeutic approaches, that is concerning. No one person knows everything, no matter the profession. Therapists best serve their patients when they come from a place of wanting to learn and understand regardless of how long they have been practicing. 

Does the Therapist Use Individualized Treatment Activities/Strategies?

Every child is unique, and their therapy should reflect their individual needs. A skilled therapist customizes treatment activities and strategies to address your child's specific challenges and goals. Look for a therapist who tailors their approach to your child’s strengths and interests while working on their barriers to success. 

Does the Therapist Give You "Homework"?

Supporting your child's progress outside of therapy sessions is crucial for long-term success. A therapist who assigns "homework" or suggests activities for you to practice with your child at home is invested in their progress and understands the importance of caregiver buy-in and consistency for generalization of skills. This approach empowers you to contribute to your child's development actively.

Does the Therapist Make You and Your Child Feel Valued?

Last but not least, a great therapist should make both you and your child feel valued and respected. They should demonstrate empathy, patience, and a genuine commitment to your child's well-being. A therapist who acknowledges your efforts as a parent and the strengths of your child creates a positive and empowering therapeutic experience.

Choosing the right therapist for your child involves careful consideration of these key factors. The ideal therapist will listen to your concerns, establish a genuine rapport with your child, encourage questions and feedback, tailor treatment strategies, provide opportunities for at-home practice, and, most importantly, make you and your child feel valued and supported throughout the therapeutic journey. By prioritizing these aspects, you can ensure that your child receives the high-quality care they deserve.

When discussing stress responses, we often hear about "fight or flight" and "freeze." These well-known reactions describe our immediate, instinctual responses to perceived danger. However, there is another crucial response that doesn’t get as much attention: the "fawn" response. This lesser-known reaction is particularly important to understand as it can significantly impact personal well-being and relationships.

Why the Fawn Response Matters

Understanding the fawn response is essential because it sheds light on a less recognized way people/children manage stress and navigate their environments. Recognizing this response can help identify patterns of behavior that are detrimental to personal well-being and can inform more supportive strategies for managing stress.

Understanding the Fawn Response

The "fawn" response is a nervous system response where individuals attempt to placate or please others to avoid conflict or danger. Unlike fight, flight, or freeze, which are more about self-preservation or avoidance, fawning involves adapting one's behavior to gain acceptance or prevent negative outcomes - sometimes, even at the cost of their own values and boundaries. The “fawn” response has also been called the “please and appease” response as responders are often people pleasing and looking to consciously align with others’ needs and wants. These “fawners” find safety in lessening the threat by aligning themselves with another person to either avoid that person’s upset or to gain their approval. , despite their own preferences. Long term use of this response as a coping strategy leads to chronic people pleasing and codependency. Their consistent efforts to prioritize others (and ignoring their own internal signals and boundaries) can lead to “fawners” feeling drained, resentful, or putting themselves in unsafe situations and relationships. 

The Fawn Response Can Look Like: 

The Fawn Response Can Result In: 

Practical Strategies for Managing the Fawn Response in Children

1. Encourage Self-Expression

Support children in expressing their own needs, feelings, and opinions. Validate their emotions and encourage them to speak up about their preferences and boundaries. I often call this “using our voice”. Allow more space for them to make their own choices outside of peers and make them feel safe enough to even disagree or show a different opinion from the majority. 

2. Teach Boundary Setting

Help children learn to establish and maintain healthy boundaries. This involves teaching them that their needs are important and that it’s okay to say "no" when necessary. You can do this by role-playing scenarios like acting in a play or using toys to act out different scenarios. Practice modeling boundaries for yourself and talk through the process out loud for the little ears to process and build from. 

3. Foster Self-Advocacy

Encourage children to advocate for themselves and their needs. Building self-confidence and self-assertion skills can help mitigate the fawn response. Provide opportunities for children to make choices and decisions, and support them in expressing their preferences. Praise their efforts to stand up for themselves and their needs.

The fawn response is a significant but often overlooked aspect of how we manage stress and interact with others. If you’re finding that the fawn response is impacting your child’s well-being or relationships, the team at Bright SpOT is here to help. Our skilled occupational therapists can offer personalized guidance to help your child develop effective coping strategies and build healthier patterns of interaction.

Warm regards,

Caitlin Sanschagrin, OTR

Occupational Therapist, Bright SpOT

Imagine your child comes home from school, and as soon as they step through the door (or maybe even during the car ride home), they seem to unravel. It’s as if the day’s emotional and physical strain suddenly catches up with them, leading to intense meltdowns or irritability. If this scenario sounds familiar, you might be witnessing what is known as After School Restraint Collapse (ASRC).

In my practice as an occupational therapist, I’ve seen firsthand how challenging this experience can be for both children and their families. After a full day of navigating the structured environment of school, children often reach their limit by the time they get home. This phenomenon, while not formally recognized as a medical condition, has been described by psychotherapist Anthea Nair as a significant emotional and behavioral release that occurs when children are finally in their safe space.

In this blog post, I’ll explain what After School Restraint Collapse is, the signs, as well as some practical strategies to help find some peace in the chaos. Understanding this concept can be the first step in providing your child with the support they need to transition smoothly from school to home.

What is After School Restraint Collapse?

After School Restraint Collapse describes a phenomenon where children, after a full day of exerting self-control and navigating social and academic demands at school, experience a significant emotional or behavioral breakdown once they arrive home. The term "Restraint Collapse" was coined by Anthea Nair, a psychotherapist, who explains that children and adolescents expend a great deal of energy, mental motivation, emotional containment, and physical restraint while at school. According to Nair (2017), this can result in a sudden and overwhelming release of emotions and built-up energy when they finally return to the safety of their home environment.

After School Restraint Collapse (ASRC) occurs when children, having spent an entire day exerting self-control and dealing with social and academic challenges at school, experience a major emotional or behavioral episode upon arriving home. The concept of "Restraint Collapse" was coined by psychotherapist Anthea Nair, who explains that throughout the school day, children and teenagers invest significant amounts of energy, mental effort, and emotional restraint. Meeting the demands at school can require extensive self-regulation and can culminate in a sudden and intense release of emotions and accumulated stress when kids finally reach the safety and comfort of their home environment. And yes, even if the teachers talk about how well behaved they are or how well they perform in the classroom. 

The exact incidence rate of ASRC isn’t precisely documented, but many parents and educators report observing similar patterns in children. It’s an experience that seems particularly common among neurodivergent children like those with high sensitivity, anxiety disorders, and children who may struggle with executive functioning or sensory processing issues. Many parents inform us that teachers often report that their child is fine at school. However, this can sometimes mean that the child is working much harder than their peers—socially, academically, sensory-wise, and emotionally.

An After School Restraint Collapse may look like:

Strategies for Restraint Collapse Support

If your child is struggling with ASRC, there are several strategies you can implement to support them:

Less Questions/Demands: When picking up your child, try to minimize questions or demands. Instead, give them space to process their day. Use statements that acknowledge their experience or affirm their feelings like, “I hear that was tough for you” or “That sounds so frustrating”. 

Create a Transition Routine: Develop a calming after-school routine that allows your child to unwind. This could include quiet time, a snack, or a calming activity like reading or drawing. Providing a structured transition can help ease the shift from school to home.

Accommodate Sensory Needs: Pay attention to any sensory sensitivities your child may have. If your child is overwhelmed by sensory stimuli, try creating a quiet, sensory-friendly space where they can retreat when needed. Ideas can include a kid’s tent with twinkle lights or a large decorated cardboard box with blankets, pillows, sensory toys, books, snacks, and a sound machine or music if desired. 

Satisfy Basic Needs: Plan to have a snack ready for when your child gets out of school. Make sure they have used the restroom recently, and allow for some quiet rest time to either nap to play with favorite items (avoiding overly-stimulating materials). 

Co-Regulate with Your Child (If They Are Open to It): If your child is receptive, and you are in a well-regulated state, engage in co-regulation to help them manage their emotions. This can involve calming activities together, such as deep breathing exercises or quiet time. Your presence and support can help them navigate their feelings more effectively.

Facilitate Room for Connection: Play a game together, spend some one on one time away from siblings where they get your undivided attention. Connection can make a huge difference in repair and recovery. 

Collaborate with School: Maintain open communication with your child’s teachers and school support staff. They can provide insights into your child’s experiences and emotional state during the day and suggest adjustments or supports that might help manage their stress levels.

If you and your child are experiencing the discomfort of restraint collapse often, addressing school accommodations could be a crucial first step in easing your child's stress. At Bright SpOT, our occupational therapists specialize in collaborating with families to pinpoint and tackle the specific factors contributing to these challenges. We offer tailored strategies designed to meet your child’s individual needs and effectively manage After School Restraint Collapse. If you’re seeking expert guidance and a personalized approach, please reach out to us. We’re here to provide the support and solutions necessary to help your child thrive.

Warm regards,

Caitlin Sanschagrin, OTR

Occupational Therapist

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