You’ve been seeing Max and his grandmother for 3 visits now. On each visit, Max completely avoids you. He scoops up his toys and scurries from the room. This grandmother tries very hard to bring him back but he cries each time. Last week she was able to get him to stay on her lap but he turned away from you and buried his face in her shoulder. You feel like you are not being very effective and are very tempted to bring a few toys with you to today’s visit to entice Max.
Stop! Before you pack that magic toy bag, what else could you do?
When we meet children like Max, we have to be very purposeful in how we approach them. It can be puzzling and frustrating for the interventionist, especially if you see yourself as someone who children usually like (which most of us in EI do). I think the best way to approach this scenario is by thinking about how Max must be feeling. He may be fearful of strangers, easily overwhelmed by having someone new around, or find it difficult to engage with others. It becomes your first job, then, to woo him into the interaction and make him feel safe. This is absolutely necessary before you and his grandmother can address his IFSP outcomes.
Consider these 3 “wooing” strategies:
Find out what Max really likes to do – and do that – For a while, forget your intervention objectives (like helping Max learn new words or follow directions) and just get to know him. Ask about his favorite toys and activities. Ask what makes him laugh and what he like to do with his grandmother. Ask about what they’d be doing if you weren’t there. You can provide intervention through his grandmother, without being the person to directly engage Max. It’s possible, especially if you use your coaching skills. In fact, it can be the best way to go anyhow because she will be the person interacting with him when you aren’t in the home.
Proceed very slowly – If Max always runs to his bedroom, ask his grandmother if you can go down the hall with her and peek in on him. Maybe you can just sit in the doorway and watch him play. If you can, try to copy what he’s doing from where you are. Do something funny with the toy, like put it on your head and let it drop, to see if he notices. Pretend to talk to or play with one of his stuffed animals. Use a calm, friendly voice. Or you might find that to woo Max, you need to be quiet at first. Try different things, but try them gently, and see how he responds. I once spent the first 40 minutes of an assessment sitting in the playroom doorway wooing the child before she would let me anywhere near her. I was simply there, observing and playing by myself, with her mother in the room too to help her feel safe. I inched my way into the room, and eventually her mother joined me and the child edged over. By the end of the assessment, we were buddies and the child plopped herself in my lap.
Forget playing in the floor – What? If you coming in and sitting on the floor is stressful for Max, then do something else. Call the grandmother and ask if you can come during lunchtime or meet them at the mall play area. Intervention does not have to happen in any set place or even by playing with toys.
One more thought about the magic toy…
We all have them. Mine were the whistling shape sorter or bubbles. If all else fails, and you think you need to bring that magic toy, just be prepared to leave it. Don’t keep it as the carrot to dangle every time you visit. Your ability to engage with Max shouldn’t be contingent on one toy. Think of that toy as the key that opens up the relationship so that eventually, without it, Max will still be comfortable with you. If you keep bringing the magic toy and using it for intervention, then taking it with you when you leave (so that it retains it’s magic), it could be very hard for Max’s grandmother to learn the skills that work with the magic toy and use them in other routines. Remember that the purpose of intervention is helping her know what to do with Max when you aren’t there so that she can support his development throughout the week. It can be easy to lose sight of that purpose when the interaction is challenging.
Taking it slowly can also be hard because we (the interventionists and sometimes the parents) usually have an agenda and think we need to accomplish things with the child in order to feel like we’re doing our jobs. Switching gears and focusing on just getting to know Max by doing something he loves to do, working with him through his grandmother, and taking your time can be great ways to win him over.
So have you ever met Max? How would you woo him into interacting with you? What are your thoughts about the magic toy?
I wonder if little Shy Guy reacts this way with others? There is a reason (function) for his response to the home visitor but it may not be only this “stranger”. The question to explore is, “WHY is he responding this way?” Perhaps the social/emotional realm is an area to explore deeper. The reaction, “You feel like you are not being very effective” reflects a little too much on the home visitor. Rather than focus on your feelings the focus could be on the grandmother’s feelings…with a question like, “I wonder if I am being effective with the grandmother?” With too much focus on the “absent” child it could be assumed by the grandmother that the primary focus is to get hands on the child. The Magic Toy is out-of-bounds in my mind, because it does not address the core of our work. I LOVE the last paragraph of this blog…and I’d follow that advice every day!
Great points, David. I love your suggestions because both of them involve stepping back and re-examining the situation. I remember those feelings of being ineffective, like why can’t I get this child to interact with me…when really, as you said, there were often bigger things going on which needed to be addressed, or I was taking it personally which made it hard to figure out what to do. You make an excellent and very key point about how the interventionist is or is not supporting the grandmother. Perhaps if the interventionist in this scenario had approached her role with the family differently from the beginning, then things might have been very different. Once that expectation is set up – that the provider is primarily here to “treat” the child – it’s a very hard one to change.