The following are 3 examples of clinical situations in which your treatment approach is challenged by a child’s reduced or unavailability to process emotion or facial features.

1. When working with Adam on writing, he can become very frustrated. This particular day I set up the activity prior to entrance into the room. He was having difficulty transitioning from the previous activity and when he entered the room he had a melt down consisting of verbally refusing and attempts to leave the room. After his difficulty initially in the sensory room, I had decided we should wait for writing or avoid it all together. As we entered the room, I attempted to explain but he was unable to “hear” me or look at my expression to explain that the planned activity would be altered.

2. When working with Camden I had him practice completing mini-interviews of 1-2 questions of the staff. He is an intelligent boy and would always extrapolate correct information. He would obtain the answers but would never respond to their expressions. He did not understand about others emotions and feelings and how to respond appropriately. As I look back I don’t feel it benefited him, because he wasn’t able to generalize this information to a new or different situation or change the way he responded week to week.

3. Dan was highly agitated in the waiting room and Mom was holding him down. He becomes excited to come back to therapy. As soon as he was released to come back to therapy he ran full force so I had to chase him. I know that he was glad to attend therapy, but as I ran after him to protect himself and others he lay down on the floor and started sobbing. It appeared to be a culmination of prior events plus misinterpreting my running as anger.