Many children with movement difficulties are reluctant to engage in new and challenging tasks for various reasons.
- They may have tried and failed before and are not willing to fail again
- The child may have a very cautious nature and avoids situations that are new or perceived as being difficult because it provokes unpleasant feeling of anxiety
- Cautious children often do not like to fail. If they cannot do a task well the first time they are not willing to try again.
Very cautious, highly sensitive children often experience negative emotions when they fail at a task. These negative emotions are experienced as unpleasant body sensations such as tightness in the throat, chest discomfort, changes in heart rate or butterflies in the stomach.
Anxious children need to learn that learning a new task takes practice, persistence, some success and as well as lots of failure. They need to shift their thinking from "I cannot do this - it is too difficult" to I cannot do this YET - it needs practice." Carol Dweck talks about the power of believing that you can improve
Yesterday 5-year-old Angela attended her weekly physiotherapy session. Angela is a slightly built child, with a small pretty pixie face and a wonderful imagination world filled with fairies. She is is also hypermobile, is generally quite weak, does not like running or climbing on the monkey bars and her drawing is very immature.
Angela does not like putting effort into new and challenging tasks: she is very good at suggesting alternative things we can do instead of the more challenging ones that I suggest, particularly after the first 15 minutes of the session when she is starting to get tired and keeping going requires physical and mental effort.
Angela’s avoidance of challenging mental and physical tasks is typical behavior for the many young children whom I see for strength, flexibility and endurance training. Different children employ different avoidance strategies when faced with challenging tasks and parents will recognize one or more of the following tactics:
Motivation, self efficacy and effortful control
Engaging in challenging tasks requires a sense of self efficacy: the feeling that one has the resources and ability to do what is needed to achieve the goal. Self-efficacy is specific to the task: a child may feel competent and be very motivated doing some things and lack confidence and shy away from doing other things.
Self-efficacy is situation and task specific. Angela is a very good swimmer: In the water she is active and brave, diving under the water and swimming lengths of the pool. In the water her self motivation is strong. But when it comes to running and jumping, ball games and drawing she has no confidence in her own abilities at all. She gives up even before she has tried. She has very poor self motivation to work at these tasks.
Some things I do in a physiotherapy session to motivate a child
The first and most important thing is to set goals for an activity.
The child also needs to know what the reward will be for achieving the goal. Children will often respond to a very simple incentive, that is immediate and can be seen.
I have two favorite ways of providing immediate rewards.
Me acting silly:
The marble reward motivation
Once the child has the hang of the “game” I let the him/her to decide on how many marbles an activity is worth, and she gets to move the marbles herself.
I may also add a negative element to the game – whining, whinging or refusal may result in a removal of a marble from the reward bowl. This does not work so well with the younger children, but by the age of 6 children will usually respond by checking their avoidance behavior because they do not like the negative consequence.
It is important to be neutral about failed attempts. Cautious children with performance anxiety often respond to failure with a negative emotional response that may only register as an unpleasant body sensation. The unpleasant sensation may not be obvious even to the child but will have a negative impact on their behavior.
At the end of the session the child may receive a small reward if all the marbles have moved into the red reward bowl. But more often than not the child is quite satisfied with the positive feedback and sense of satisfaction that the goal has been achieved.
Angela working at doing big jumps
Today we are going to practice doing 5 big jumps between two big cushions. The exercise is to jump from one big cushion to the other, taking of from two feet and landing on two feet. Angela does not like doing big jumps. She complains that her legs will break if she jumps too much.
Because Angela is very reluctant to do this exercise, I need to make the reward for each jump instant: so each time she jumps landing on the cushion on two feet, I act silly. She finds this very funny - so keeps jumping to keep me going. She forgets herself and manages 10 jumps.
Angela's mom and I make a big fuss after the 10th jump: she has been very brave and worked hard and her muscles are feeling the burn from all the hard work.
Next week I will only act silly after 5 jumps as Angela starts to learn to be self motivated to achieve a goal that she finds challenging.
Ways to get around a child's negative responses to challenging tasks
Recognize your child's underlying anxiety
Performance anxiety is a major stumbling block to a child's engagement in a learning activity. The first step is to recognize and acknowledge the anxiety.
Next adapt the activity so that the child feels confident that he can do the task and becomes willing to engage. From there you can introduce aspects of a task you would like to improve.
Jonty refuses to even try to catch a ball. He is willing to kick it though, but his kicking is a little wild and random.
So we start by practicing kicking a soccer ball from a standing position into a makeshift goal between two chairs. I am the goalie and catch the ball each time it enters the goal and roll it back to Jonty.
He enjoys this task because he is successful most of the time. He also manages to catch the ball each time even when I roll it a little to th left or right. We end our practice session with a game of dropping the ball into a basket. I retrieve the ball and drop it back into Jonty's hands which are held ready to catch it.
Jonty has had fun and feels good about his small successes. At our next training session Jonty asks to play with the ball again and in fact learns to catch the ball.
Collaborative goal setting
Children are usually more willing to engage in a task that is meaningful and allows them to achieve their own goals. So the first step is to sit down with your child and talk about what he or she would like to be able to do better.
It helps to go through a list of everyday tasks and activities, talk about each one and identify any that the child would like to improve on.
If there is a particular task that you feel the child needs to work at, it helps to discuss the importance of mastering the particular skill and give the child an opportunity to make some decisions about how and when you will work together on the task.
The tasks a child wishes to master may be very different from those that you consider important. Remember that each new skill that is mastered, each new goal achieved goes a long way to improving your child's sense that they can succeed when they set their mind to working on a skill and this in turn will motivate them to work on a new set of tasks.
|Each new success strengthens a child's sense that they have the power to improve|
Adapt the task so that the child can succeed
In order for learning to happen a task needs to be challenging enough to require some form of mental or physical effort to achieve the goal. But it is important that the goal is achieved most of the time.
Succeeding at a task is important for the child's sense of self-efficacy and motivation to try again. But perhaps even more important is that the movement brain needs to make the connection between the planned action and the successful outcome. If an action is nearly successful the movement brain will adapt the motor plan on the next attempt. If the action does not succeed at all the movement brain takes no notice of the feedback.
Provide immediate rewards for success
Brain research has shown that the movement brain has a built in reward mechanism in the form of a burst dopamine in the brain's reward center when a goal is achieved. This is the reason why success feels good. Anxious children seem not to recognize this reward signal and may need an external stimulus to activate the good feeling that should accompany a successful trial.
A brief but clear verbal response sometimes does the trick. Good work!! Children can also learn to give themselves a brief shot of praise. Yes! I did itI
A physical reward sometimes works. A small coin or marble dropped into a bottle allows the child to see and hear his success.
If I need a bigger incentive I will play the Silly Therapist. game. Each time the child succeeds at a task I adopt a very silly funny posture or do a short silly dance. This only works if the child finds my antics funny.
Be careful to respond very gently to failure
Anxious children are very good at beating themselves up when they do not succeed. They literally feel failure very strongly as an unpleasant sensation.
It is really important for a coach to curb any negative remarks when the child fails. Keep your responses neutral and encouraging.
Only praise or reward successful trials
Children know when they have succeeded or have done a good job and respond positively to praise.
It is important not to praise unsuccessful attempts at a task. Respond in a neutral manner such "Oops that did not work, Try again."
Parents sometimes get into the habit of praising everything the child does. The praise looses all its meaning and no longer serves to give the child the boost that should go with achieving a goal.
Give verbal feedback when it is appropriate
Sometimes it is appropriate to talk about the task and help the child to understand the link between their actions and the outcomes. This is particularly important if the child tends to blame an outside agent for a failed attempt.
Keep this brief and to the point. Do not give elaborate explanations.
Set clear goals
Children like to know exactly what is expected. Be clear about the number of repetitions they need to complete. Be clear about when only successful trials are counted. Have clearly marked targets for throwing activities.
Teach children to use visual information effectively
Many tasks involve using visual information for planning and executing a task.
- Throwing accuracy is improved by visually marking the goal for the action.
- Successful catching requires attention the the actions of the person throwing the ball,
- Running and jumping over an obstacle should be preceded by visually marking the position of the obstacle. Walking requires looking ahead to notice obstacles that might lie ahead. Paying attention to the position and width of doorways is important for planning a walking trajectory that avoids bumping into the door frame.
- Interestingly, the length of a jump can be increased by visual targeting the desired landing spot before take off.
Typically developing children learn how to use visual information implicitly as part of their everyday experience. Children with coordination difficulties sometimes need to be explicitly taught to pay attention to important aspects of a task. They need to be taught to look ahead so as to avoid bumping into things.
Be firm about training sessions
Set a time and place for your training sessions and be firm about sticking to you plan. Your child may have other plans or rather be doing something else.
But learning new skills requires dedication and practice and a big part of your child's movement difficulties may well be the tendency to avoid working on difficult tasks. It may also be useful to think about whether you as parents have supported your child's avoidance.
If all attempts to play ball games with your son or daughter have ended up in tears and refusal, it is natural not to try again.
If a child is taking too long to get dressed, it is easier to take over rather than making time for her to practice doing up her buttons and putting on her socks.
Be firm about practicing the skills you have selected. Learn how to coach your child in a way that builds his or her confidence and self-efficacy, increases fitness and shifts the child from avoidance of effortful tasks to engagement with challenges.
Parents and Teachers Handbook Index