{"id":756,"date":"2013-04-23T10:33:50","date_gmt":"2013-04-23T14:33:50","guid":{"rendered":"http:\/\/veipd.org\/earlyintervention\/?p=756"},"modified":"2020-06-25T02:42:06","modified_gmt":"2020-06-25T02:42:06","slug":"using-pausing-to-encourage-development-examples-from-real-visits","status":"publish","type":"post","link":"https:\/\/www.veipd.org\/earlyintervention\/2013\/04\/23\/using-pausing-to-encourage-development-examples-from-real-visits\/","title":{"rendered":"Using Pausing to Encourage Development: Examples from Real Visits"},"content":{"rendered":"

Examples of using pausing to encourage development are more powerful than me describing why this technique works so let’s start with a few \"Pauseexamples from real intervention visits:<\/p>\n

Sandy<\/strong><\/h2>\n

One day on a visit with Sandy and her nurse,\u00a0we\u00a0played with Sandy’s favorite toy and assisted her as she activated it.\u00a0\u00a0Sandy had multiple disabilities\u00a0and difficulty with communication.\u00a0After she played a little by touching buttons to turn on music,\u00a0I turned\u00a0Sandy’s toy\u00a0off and asked her if she wanted to play again. She sat there, unmoving, so I asked her to show me that she wanted to play. After pausing\u00a0longer than I ever had before, and watching her entire body for clues that she was communicating, she raised\u00a0her left arm up off of her wheelchair tray. I instantly turned on her toy and praised her, asking if she was saying she wanted to play. After a short play period, I turned of the toy again. By now her nurse thought I was just being mean but I explained how I thought Sandy was communicating by raising her arm. I asked\u00a0Sandy to tell me again if she wanted to play more and I waited. Within a few seconds, she lifted her arm again. This was her first “word.” When I showed her mother on the next visit, her mother cried and said that she’d never had a way to communicate with her daughter until now.<\/p>\n

Alex<\/strong><\/h2>\n

Alex had cerebral palsy\u00a0and found coordinating purposeful movement extremely difficult. This led to people (including me) either doing things for him or\u00a0using hand over hand support to “help” him with everything. One visit,\u00a0I was\u00a0amazed that he\u00a0was able to put a shape into\u00a0his puzzle with the piece placed in his hand and his mother providing support at his elbow. It took him easily a long 30-40 seconds to coordinate the movement but he was able to do it. If\u00a0his mother\u00a0hadn’t tried waiting him out, we would have taken his hand and “helped” him do it like we usually did. When we waited, we learned that he could do it himself. He knew more than we had given him credit for, and with waiting, he was able to show us what he knew.<\/p>\n

Jackson<\/strong><\/h2>\n

Jackson was trying out his new gait trainer in his mother’s kitchen. He was smiling and happy to be upright but struggling to move his legs. After practicing\u00a0moving his legs with the PT’s help, we decided to wait him out to see what he could do. After looking at us like “why aren’t you helping me?” and watching as we encouraged him, Jackson dragged one toe forward, clearly attempting to walk. This step was the first of many.<\/p>\n

One more example:<\/p>\n

Devon<\/strong><\/h2>\n

When Devon wanted\u00a0to go outside, he would go to the door that led to the backyard and whine. He did this one day\u00a0during a visit and his mother automatically got up to\u00a0open the door. I hopped up too and we decided to use this as an opportunity to help Devon learn a word. Devon’s mother and I talked and she decided to teach him to say “out.” I suggested she move down to his eye level, prompt him for “out” by enunciating the word, pointing to her mouth, and\u00a0pause with an expectant look on her face for him to imitate. She prompted him\u00a0a few more times before he made an “o” with\u00a0his mouth which we happily took as\u00a0his attempt to say “out.” By the next visit, his mother had taught him\u00a0to say\u00a0“ow” instead of whining to go outside to play.<\/p>\n

How to Use Pausing<\/strong><\/h2>\n

Using pausing requires two things: patience and respect for a child’s efforts, whatever they look like. Pausing doesn’t always work the first time you try it. It usually requires that you teach the child what you expect him to do by repeating the routine, maybe using hand over hand prompting or verbal prompting, then fading out that support. Using the same 1-3 word prompts helps too so that the child associates your direction with what he’s learning to do. Some children can take up to 45 seconds to process what you say and respond so be patient. I don’t remember where I learned about waiting this long, but it worked well over the years, especially with children with more significant developmental needs. Some children will have shorter wait times, and you have to figure how how long to wait before they lose interest or become too frustrated, and before you or the parent provides help. Waiting until the child is completely upset is never effective, but pausing long enough that the child is motivate to act can work well. It’s a balance that you’ll figure out through trial and error.<\/p>\n

Teach parents about pausing. It’s often easy to forget to pause and wait for the child to show you what he can do, especially in the busy-ness of everyday life. Learning to pause helps the parent create the expectation that the child will do something, whether it be look, make a sound, approximate a word, or move a body part. This expectation is critical to the development of independence, self-confidence, and communication. A simple pause can make a world of difference!<\/p>\n

Do you have more examples of how you’ve used pausing with children? How do you teach parents about pausing?<\/strong> Share your ideas and examples by leaving a comment below. Be sure to follow the comments so you don’t miss out on other’s ideas!<\/p>\n","protected":false},"excerpt":{"rendered":"

Examples of using pausing to encourage development are more powerful than me describing why this technique works so let’s start with a few examples from real intervention visits: Sandy One day on a visit with Sandy and her nurse,\u00a0we\u00a0played with Sandy’s favorite toy and assisted her as she activated it.\u00a0\u00a0Sandy had multiple disabilities\u00a0and difficulty with […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_s2mail":"yes","footnotes":""},"categories":[139,12,14],"tags":[26,38,48,50,54,55,62,67,68,78,79,80,100,112,125],"class_list":["post-756","post","type-post","status-publish","format-standard","hentry","category-all","category-intervention-visits","category-practical-strategies-for-intervention","tag-autism-spectrum-disorder","tag-communication-development","tag-early-childhood","tag-early-intervention","tag-embedding","tag-engagement","tag-home-visits","tag-implementation","tag-infants","tag-multiple-disabilities","tag-natural-environment","tag-natural-learning-opportunities","tag-routines-based","tag-strategies","tag-toddlers","clearfix"],"yoast_head":"\nUsing Pausing to Encourage Development: Examples from Real Visits - 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