The Power of Yes

When I am not writing or practicing occupational therapy, I am also the director of a therapeutic dance program for special needs children. I’ve always loved dance, and it was such a thrill when I discovered I was able to utilize my passion for dance in conjunction with occupational therapy.

This dance program serves a variety of needs, ranging from physical disabilities to sensory challenges to speech difficulties. The main goal is to allow children to engage in age-appropriate leisure activities with therapeutic strategies in place to ensure a successful experience. This week I was forced to re-evaluate what success looks like in an adapted dance program

Since the spring season started in January, there has been a new dancer who has joined that has struggled more than others. As a therapeutic program, we pay close attention to the needs of each dancer to determine the barriers to their success, and we make adjustments to get around those barriers.

 In this case, the dancer in question would come to class happy and ready to go but would prefer to spend the class in the corner away from the other dancers. She is an autistic child who is not yet functionally verbal. Due to this limitation in functional communication, she must depend on other means of expressing herself. When her dance teachers tried to help her engage in the class, she began hitting them in response.

Her mother was invited to join the class to determine if this would increase her sense of safety and allow her to participate in class with less frustration. Unfortunately, her mother joining the class seemed to worsen the struggle. This child showed significant aversion to anyone intruding on her space or even attempting to encourage participation.

Naturally, after a particularly difficult day where she smacked two teachers, one hard enough to knock off her glasses, her mother felt very defeated and expressed that she would remove her from the program if her behavior was causing too much trouble. I’m ashamed to say that at first, I felt like her mother might be right. However, knowing that this mother had already tried several other community activities with this child and failed, I did not want to be one more closed door.

As I spoke with the child’s primary occupational therapist and an occupational therapy student currently completing her fieldwork at our facility, we came to the realization that the end goal of our program is not for these dancers to put on pretty costumes and get on stage and perform a dance. Those things are all wonderful outcomes, but this is a therapeutic dance program. The end goal is for these dancers to successfully participate in an age-appropriate leisure activity. Why then could it not just be part of the process for this child to build tolerance to being in a group where she feels safe? What would be so wrong with letting her accomplish this goal in her own way and her own time? What does success look like for this child?

Stephen Porges explains in his polyvagal theory that until a person feels safe, she is unable to learn and adapt to her environment because the brain is in survival mode. I was reminded of this theory as we discussed how to help this dancer to succeed. We decided to adopt a child-led approach and let her engage in the class in her own way, even if that means letting her remain in her safe space in the corner. This did not mean the teacher would neglect her or that she would be excluded in any way. She’d frequently be invited to join but never pushed. This way she is still getting exposure to the music, listening to the instructions from the teachers, watching the other dancers participate, and all the other sensory experiences that go along with a dance class but being allowed to do so in a non-threatening manner.

When I called her mother to discuss this plan, I could tell she was already bracing for the blow of being told this program was not a good fit for her child and that we could try again in the future. She had a guarded tone in her voice. However, the minute I began to explain the plan I had discussed with her other therapists and asked for her input, her tone softened. The relief she seemed to feel was palpable through the phone. She was excited and ready to collaborate on how best to help her child.

It made me realize how many times parents of special needs children are told “we can’t help you” or “we cannot accommodate for those types of needs” or “we just are not a good fit for your child.” It made me see the power of a “yes” for these families. You never know the weight your “yes” or your “no” can carry for someone who has seen a lot of closed doors. Your “no” could be the one that causes that parent or child to lose hope. In the occupational therapy profession, we should be the open doors because we have the training and the skills to think outside the box and to be the “yes.” We must make every effort to be the “yes.”