Why I follow a child’s lead

Nowadays there are many different approaches to working with children, both therapeutically and educationally, particularly for children with special needs.  As someone who worked in various settings (including by using ABA and DIR/Floortime approaches and working in traditional and progressive schools), I have a great deal of perspective and experience about how to connect with children across all ages and all developmental levels.  Regardless of setting, age and developmental level, following a child’s lead is the place to start.  It sets the stage for the crucial relationship between adult and child, and is the foundation needed for progress to be made.  It is at the heart of a child-centered approach.  It expresses one’s respect for a child and attempts to understand them.  It communicates to the child that he/she is a partner with you in his/her journey of growth.

Following a child’s lead is a fundamental principle of both psychotherapy and DIR/Floortime.  It is one of the reasons why using the DIR philosophy and Floortime methodology work hand-in-hand for psychologists who work with children, particularly younger children and/or those who have difficulty with foundation-level social-emotional skills.  From a psychotherapy perspective, particularly a play therapy perspective, letting the child lead the session, allowing him/her to indicate what toys or materials should be used, determining how much to talk or not to talk, is an important guiding principle.  DIR/Floortime, which were developed by psychiatrist Dr. Stanley Greenspan and psychologist, Dr. Serena Wieder, consider following a child’s lead as fundamental to treatment.  Meeting a child where he/she is at, in terms of both their regulation level, their ability to communicate in that moment, and their access to their cognitive abilities is key.  The child then knows that you are with him/her, there for him/her, and are holding their needs with highest regard.

This is certainly not an easy task!  As treatment providers, we aim for success.  We have parents, teachers, insurance companies, IEP teams, and others (grandparents, babysitters, the list goes on) who want and expect goals to be met and frequency of sessions to decrease.  We are a success-oriented society.  As treatment providers, we want to share the news about progress, new skills, and improved functioning.  Some find it great to say, “We got rid of that behavior,” even if that short-term fix means a new challenging behavior emerges.  Sometimes the most difficult thing is being able to sit back and let the child be your guide, showing you how ready and when they are to move forward.  Those pesky lingering challenging behaviors and those little periods of time when an “old” behavior reemerges may not seem conducive to goals and expectations.  However, jumping too quickly to that next step either because, “I just know he is ready,” or, “he did so last week” may negatively impact the therapeutic relationship and progress overall.

Of course, while following a child’s lead is a foundation principle and the right place to start,  it is not the be all end all of therapy or education. It does not mean that limits are not ever set.  It is important to recognize when children and older clients need some supportive “pushing along” (as well as when they are developmentally ready to understand expectations, rules, and consequences; I’ll save this for another post).   Scaffolding is an important part of this work, as we follow a child’s lead long enough to know that we can push a bit further.  That is where the important work and progress happens.  However, treatment providers like myself know all too well what happens when we push too hard and too quickly: the child retreats, clams up, acts out, etc.  In such cases, it is important to reestablish rapport and common ground so that the child feels comfortable spreading his/her wings to then enter challenging or territory, whether its talking about something difficult, trying a new task, or learning a new coping strategy.  The therapeutic dance is so nuanced and must always be held at the forefronts of our minds.

So, when as providers, we feel pressured by the expectations of others (and ourselves), it is important to remember that following a child’s lead, using a child-centered approach, is the respectful way to work with a child and is at the heart of many long-standing approaches to working with children.

For more about following a child’s lead within the context of Floortime, see Dr. Greenspan/What is Floortime?