How Do I Provide Therapy for a Client Who Struggles with Engagement?🔗

Sometimes therapy sessions don’t go as planned, and the therapy activities you prepared do not interest the client. So, how can you provide effective therapy for a client who isn’t interested in the activities? Use child led therapy!

What is child led therapy?🔗

Child led therapy is an intervention/play approach in which the child’s interests, choices, and natural interactions guide the therapy session, rather than using adult directed activities. A child’s interest and motivation are prioritized, often leading to more engagement and better communication outcomes.

What does this look like?🔗

• The child chooses or initiates activities
• The adult follows and expands the child’s play or communication
• Teaching happens within natural routines and play
• Emphasis on engagement and connection

Example:
 If a child begins playing with cars, the therapist joins the play and models language like “go,” “fast”, “car,” etc rather than asking questions or redirecting the child to a pre-selected activity

How Do I Follow My Client’s Interests?🔗

Making a game out of whatever the client gravitates toward can not only create meaningful communication opportunities but also build stronger rapport. In therapy, some clients may not prefer traditional toys and games. Following their interests may include something as simple as turning a light switch on and off while modeling language (e.g., “light on/off,” “let’s do more,” “stop,” “I like the light”). It can even be as simple as commenting 1-2 words to label their play actions or using the AAC device to talk about what you are doing alongside them!

Tip: Get Moving!

Often movement and sensory based play is motivating to many clients. You can use these simple examples to encourage engagement and model on the device while you play:

Stomping, Dancing, Jumping

• “Let’s move.”
• “I want to jump.”
• “Jump with me.”
• “Up!”
• “My turn!”

Spinning (Chair/Sensory Swing/Trampoline)

• “Go!”
• “More/stop.”
• “Go fast/slow.”
• “The chair is fun.”
• “I like the swing/chair.”

Playing with a Light up toy

• “On/off.”
• “Bright/dark.”
• “I like”

Music Toys

• “Play/more”
• “More music”
• “Let’s listen.”
• “Let’s play.”
• “Loud/quiet”

Total Communication Approach🔗

Total communication includes vocalizations, body language, guiding behaviors, movements (spinning, stimming), etc. By honoring all communication, you are creating an inclusive environment and expanding opportunities for communicative intent.

More often than not, your client will let you know what they are interested in by expressing themselves through total communication. It is important to follow and respond to these cues.

Remember, we often have to prioritize connections with our clients to foster communication. Using preferred activities and special interests is still meaningful work toward communication goals, and modeling language through unstructured play can absolutely yield results!

Written by Katie Fisher MS.,CCC-SLP, CX Empowerment Team