The most valuable thing Noah’s Early Childhood Intervention speech therapist taught us was a little trick called hand over hand assistance. We first employed hand over hand assistance when we were teaching Noah his first words in sign language. The idea is the adult comes behind the child and places their hands over the child’s hands. The adult then manipulates the child’s hands into the correct position for the activity and continues to give as much support as necessary to complete the activity (or sign). The adult should withdraw support slowly to the point they are only giving wrist support and then no support at all as long as the child is increasing in his participation. There are a number of concepts reinforced in this method; patterning, motor plan mapping, visual learning, kinesthetic learning, and auditory learning.
An important element of hand-over-hand assistance is that the helper is not facing the child but rather is behind the child. This position allows the child to see and feel the correct positioning naturally versus it being a mirror image.
For me it was also important to train Noah to recognize that when I was attempting an activity with him, it was not an option for him to refuse to cooperate. He could do it on his own, or I would give him as much help as he needed. There were many, many times he was not interested in the sign language I was doing with him, but when he later wanted to use the sign, he was able to demonstrate the very sign that he had learned via the hand-over-hand method. That tells me it was not just a passive experience for him, although he may have thought it was.
These days, Noah is able to imitate the signs I teach him just by watching me as I stand in front of him, so we don’t use hand-over-hand assistance for that. But we still employ it on a regular basis, especially when encountering a new activity or when he does not want to do the activity at hand, like when it is time for him to pick up the bibs and bring them to the table, pick up toys, or work on fine motor activities like sorting. Good timing is essential; I always start the assistance before he goes too far down the road of resistance. A recent day found me jumping in to do hand-over-hand once he started whining about doing a sorting activity I had for him. I placed him in my lap, put my hands over his hands, and moved his fingers to pick up the macaroni we were sorting. At first he was completely passive other than whining a bit, but the more macaroni we sorted, the more independently he moved his fingers. By the halfway point, he was still in my lap, but I had totally withdrawn my hand-over-hand positioning.
This experience and others like it make me suspect that a lot of Noah’s resistance comes from being unfamiliar with or unsure of his ability to complete a task. So I liken hand-over-hand in these instances to warming him up for the task at hand.
I’d love to hear from you what works when it comes to overcomming resistance in your young (or not so young) learner? How about the best trick a therapist ever taught you?