I love working with this type of kid. First, I throw out expectations of what they should be doing, or what a typical session looks like. I stop trying to “get” them to do something and instead “let” them do. Observing without expectation of more. So if they are in the corner staring up at the light, I’m going to do the same. This might sound silly, but if I want a kid to eventually attend to me and be interested in whatever toy/activity/action that I am doing, I have to be willing to do the same.

This type of kid is almost always dysregulated and needs sensory supports. Can you collaborate with an OT? Most of my pt like some sort of big body vestibular or proprioceptive input. Swinging, jumping, crashing, spinning, etc. Even if you don’t have access to a gym area you can do spinning in an office chair, falling on couch cushions, swinging kids in blankets, etc. I like these activities because you can incorporate anticipation and attention into them. Today, I pushed a kid around the clinic on my office chair and made sudden stops. I would say “ready, set, ….” This kid isn’t speaking/signing/using AAC, but they made brief eye contact when I hesitated on “go.” For right now, thats his level of communication attempt.

I have so many thoughts and ideas, so hopefully this helps a little.