REFLECTION - Whether to assist, encourage or observe:

I like to help people. That’s part of the reason I became a physiotherapist. I feel like I have good problem solving skills and empathy that are useful in helping people. One of the reasons I never did tutoring in high school or university though was because I found it hard to relate the fundamentals to students who were struggling. I tried once in Bio 12, I found it really hard to explain how I knew so much and was able to retain the knowledge and to help someone else gain do the same was hard. Even in the physio program I have been asked at least once “How do you remember it all?” My answer, I do this and this and this and I also am blessed with an extraordinary memory.  The thing is though that I am learning (and have been learning since Bio 12) is that you just can’t tell everyone what you do and expect it to work from them and you especially can’t just do it for them if you expect them to get anything out of the exercise.

Being a pediatric physiotherapist presents this challenge to me: being able to watch a client struggle with something as basic as cutting a straight line, put a puzzle piece in the correct spot, or draw a cross and letting them struggle with it.

This week has really been a lesson in when to step in and when to step back, when to encourage and when to be silent. It’s an art really that my preceptors are quite good at. It’s a skill that involves time management, clinical expertise and experience and knowledge of the task. It’s also important when to know when to let the child fail and when to step in and help them find success in a different way. 

So much is dependent on the individual, the situation, the rapport and the therapeutic goals that a formula is useless. If I see a client struggling with a task it is my automatic instinct to want to step in and show them how I would do it. But what will they learn from copying me? They will learn how to accomplish the task my way. They will learn a single strategy for the task. And they may also improve their ability to mimic.

However, it may be far more useful to the child for me to use alternate strategies such as silently smiling and nodding at them or to verbal encouragement from me: “You’re doing well!” or “You’ve almost got it!” And somewhere in between there is the verbal cues of “What if you moved that one just a little bit?” or “Pull just there.” To varying degrees these methods will help the struggling child to problem solve through their difficulties. 

While it may be important to know a single method of tying one’s shoes, it’s also really important to be able to figure out a puzzle using your own unique problem solving strategy. In my opinion this prepares them to be more independent, more ready to handle challenges they face during Activities of Daily Living (ADLs) and sets them up to become critical thinkers and problem solvers in the future.