Advice from a Pediatric OT in a Time of Disruption and Uncertainty

Advice from a Pediatric OT in a Time of Disruption and Uncertainty

By: Taelor Millsap, OTD, OTR/L 


“How much longer?” 


“I don’t want to do this!” 


“Can I play on the computer now? *five minutes later* Now?” 


“I’m bored!” 
For those of us who are around children right now, many of these phrases probably sound familiar. This time of disruption and uncertainty can put a lot of stress on our little ones, and many are seeking comfort and controlHi, I’m Taelor! I’m a pediatric occupational therapist and I’m here to help you navigate through this time. 

If you are unfamiliar with occupational therapy, it’s a holistic profession that focuses on people’s “occupations” – what takes up their time, and what people want and need to do every day. For children, many of their occupations revolve around education, basic daily routines (like getting dressed and brushing their teeth), and play. Though I work with childrenI also incorporate a ton of parent education and involvement, as children’s environments and people in their lives are important to how they function as wellAs an occupational therapist, I may see kids 1-2 hours a week, but parents are with them all the time and know them best!  

Parents, you may be thinking, “how can I possibly help my child learn right now?” “This is outside of my comfort zone and I’m also stressed.” Maybe you are noticing changes in your children’s behavior that aren’t typical and don’t know how to support them. Deep breathsI am here to help!  

In this article, I am going to share some strategies to help you navigate through this timeI am going to touch briefly on some changes that you might be seeing in your children, some simple ways to help support your kids in this time, and how the Time Timer is an integral tool to use with the many fun activities provided. 


Before I get into my suggestions, it’s important to understand that everyone is facing a disruption right now. We may see changes in how we act, how we feel, and even what a typical day looks likeBecause our safety and security are being threatenedwe may also notice differences in behavior, attention, energy levels, motivation, social interaction, and more. Our bodies are switching gears, trying to adapt for our protection, getting ready to fight or run, and ultimately, our instinctual survival mode is beginning to kick in.  

That’s a lot.  

Everything you and your littles are feeling are valid, and it’s going to be okay.  

Much of the reason we’re acting differently right now is because so much of our world is out of our control. Though we can’t change the world around us, we can modify bits and pieces of our inner world and our environments to provide an increased sense of control.  

Here are 5 ways to help kids establish a sense of control and improve their engagement that you may want to incorporate into your life: 


 1. Provide a general structure each day.  

Many parents are homeschooling their kids right now, or their children are spending increased time with care providers while their parents are working. Children thrive on routine and structureIt will probably look different than the structure they followed at school. Remember, this is not a classroom. So, I’m not talking about those seemingly perfect hour by hour, color-coordinated charts you may see circulating on the internet. If that works for you and your family, perfect! Use them! If you’re anything like me, that’s unrealistic, and you likely could never stick to that with you and your children’s needs fluctuating each day. Of note, you can still have structured lunch times and regular bedtimes, but not every second has to be planned out with activities. 


Instead, I would choose 3 categories of activities that you want to accomplish each day.  


Some examples include:  

        • outdoor/indoor movement time 
        • school work 
        • creative time 
        • free play 
        • family game night 
        • sensory play 
        • virtual social time (connection via skype, zoom, facetime) 
        • feed your brain time (puzzles, reading, etc) 
        • calm down/relax time (meditation, solo play, sensory activities, etc) 


Provide some variety based on what your family would enjoy and benefit from. I’d highly recommend movement time and outdoor time at least 30 minutes a day. Not only does fresh air help boost your immune system, but getting outside helps regulate sleep and wake cycles as well.  


You don’t have to stick to only those categories. However, once you choose your 3, you know you at least will accomplish those three things today. And that should be a win.  


Within those categories, maybe have a list of potential activities, and let the kids pick what they want to do. Use the Time Timer for transitions, and have the visual timer face near them so they can understand the concept of time themselves and they are not surprised when prompted to finish. You may also provide additional verbal reminders, as needed, for those who need more support in this area 


Remember, we’re all going through a lot. So allow some time in your schedule to do those things that help bring you a sense of calm and joy. Having a flexible schedule with some structure allows everyone to do that as needed. 


2. Allow children choices as much as possible 

How many times as a kid were you frustrated when people told you what to do? It doesn’t have to feel that way for children. Of course, there are times when adults must mandate some things and intervene for safety and completing essential tasks, for instance. However, kids can still get done what you need them do, and still be given a sense of control. How? Set boundaries and yet allow choices. 


For example, if you know your child has to do three subjects in school that day, then you can present them with the three subjects they have to do and ask them what order they want to get them done in. Then, set the Time Timer, for work time (with the sound off so it isn’t disruptive) and start. Even something as simple as asking kids what order they want to do things in, helps them feel some control. You can also have them choose what craft activity they want to do that day or what movement game they want to do for that time. By giving your children the power to choose, you are helping them feel more secure. 


3. Use preferred activities and fun things to break up their obligations 

In my therapy sessions, I have goals to hit every day. However, I don’t just come in and say “we’re doing this my way” and go about my session. It’s a balance and it’s important for children to feel included. Not only do they enjoy being part of the decisions, but also more engaged when it’s something they want to do or the way they want to do it. For some kids, I’ll use preferred activities as a motivator to complete those activities that I know won’t be their favorite. You can set the Time Timer for the time they have to work on that thing they don’t love, and then when that’s over they can set the timer again for their preferred activity. Another strategy is for them to choose what toy or game they want to use, and you can choose how they use it. For instance, if they want to use a ball or balloon, write their sight words on post-it notes and have them throw it at the wall when you call them out.  


Another fun thing I’ve heard is earning screen time by exercising or getting some outdoor time. Be creative! I tried this with my brother, and it was a major success. We went on a walk in our neighborhood for 30 minutes to then earn his favorite activity of going for a leisurely drive. He was smiling and it helped him get out of his room and move his body. There are many ways to do this, so find what works for your family.  


 4. Allow child-led break times  

Sometimes, work can be hard. One of the major things may impact everyone right now is the challenge to focus on those things requiring sustained attention. That’s because your nervous system is more elevated overall and your body is trying to use it’s energy to focus on protecting you – not schoolwork or chores. They still have to get their work done though, right? The last thing that you want is fighting with a child to complete their work. It’s stressful and not fun.  


To accommodate their needs while still meeting your own, you can have a system in place to allow children to choose when they need a break. Some kids may have a hard time telling you that they need a break. Words can be hard when overwhelmed. One thing I love to do is make a “break” card or token. This can be a piece of paper with a drawing, a simple colored paper, or even using a token such as an eraser. Whatever you use, the important thing is the child is not questioned when they present this to you and can take their break as needed. Depending on their age, you may need to provide more or less assistance.   


Bonus: You can make a help card with the same idea, just them giving it to you to ask for help on an assignment during schoolwork time 


In order to still provide some structure in those breaks, maybe create a calming corner or an area in your house for them to retreat to. This can be a corner with some fluffy pillows, a sensory bin with rice and animal toys, or their favorite toy. Whatever helps them feel calm and safe. Then, have the visual Time Timer in that space and let them set the timer for 5 minutes (or whatever you decide). When the time is up, they know it’s back to work. Depending on your child, it may also be helpful to limit the amount of breaks they get per work session or day. You know your child best. Also, the younger the child, the less time they can sustain attention on one task. It depends on the child’s sensory and emotional needs, however, and I’ve had from 2 minutes to 20 minutes of break time if a child really needed that to help their sensory system, emotions, and attention to be balanced and ready to learnBe somewhat flexible with this, yet I also recommend that you have some boundaries in place so this break is not overused or used as an avoidance technique.  


5. Get out from behind the table, and mix up the learning style! 

Use movement activities, chores, helping cook or bake, or any other “not-typical” work tasks to enhance their learning. They are not in a classroom, so use it to your advantage. If they have to do worksheets, maybe switch up your seating options. One thing I really like to do is use a therapy or exercise ball at a table to allow some movement as needed, and also target their core muscles. Another thing you can do is complete work on the floor while laying down on their stomachs and propping up on their elbows. Not only is this a good stretch, it also helps strengthen their core and upper body.  


Another way to promote engagement could be switching up the activity altogether. Do something fun and motivating like making cookies! When you’re making those cookies, they are using coordination and strength to hold the measuring cup, problem solving and sequencing skills to determine what comes next, force control to know how hard to hit that egg… the list could go on. If they have to focus on writing for school, have them write out the recipe you need to follow. Then, use your Time Timer for them to know how long the cookies will take to bake, and work on writing some of the letters they had a hard time with while the cookies are baking.   

Speaking of switching it up, incorporate movement! A movement activity that I love is an obstacle course. You can use any household items to make this. An “obstacle course” doesn’t have to be necessarily what you’d see on American Ninja Warrior, for instance. It can be anything that includes climbing, jumping, pushing, pulling, throwing, moving… and it could be quite simple. An example could be using painter’s tape on the floor to show the path (optional – could also make paper signs with arrows), have the kids decide where it goes next, and put obstacles along the way. Some ideas: climb under dining chairs, jump over couch cushions on the floor, use their sit and spin three times, throw a ball at a target on the wall (could be post-it notes with letters, shapes, sight words, etc.), use jump ropes to make zigzag paths on the floorcollect a piece for a puzzle at each obstacle and finish it at the end, do animal walks between each obstacle, squats on the wall by reaching up high to touch two pieces of paper and squatting down low to touch other targets), ski jumps over toys on the floor. You see? The possibilities are endless! To kick it up a notch, set a timer and challenge them to complete the obstacle course as many times as they can (even more fun and motivating if you make a “world record” for them to break) before it runs out. I would turn the sound on with the switch on the back of the Time Timer, so they can hear the buzzer while moving. You can also incorporate everyone in the family! Break up into teams, set the timer, and see who can do it the fastest! Make sure you cheer each other on and have tons of fun. J 


These are just some ideas that may be helpful for you to implement into your daily lives and those of your children. Every child and every family is going to be different, so it’s okay to adjust to your needs and not do everything I mentioned. Just remember, there’s a lot going on right now and it’s okay to have those moments where you feel it. Give yourself grace! Share some extra hugs, make things fun, and mix it up from time to time. Most of all, remember, one step at a time, and you can do this. Feel free to reach out to me at any point with questions or to brainstorm further ideas. We’re all in this together.  



Taelor Millsap, OTD, OTR/L is a pediatric occupational therapist who resides in Phoenix, Arizona. She holds a Doctor of Occupational Therapy degree from MGH Institute of Health Professions in Boston, MA, where she focused her studies on childhood trauma and mindfulness for at-risk youth. Taelor is passionate about education, advocacy, serving children and their families, and program development. She has presented at multiple national conferences on childhood trauma, and advocates for her profession regularly on her social media accounts for occupational therapy professionals and students.  


You can connect with her on  Instagram, ( Facebook, (, email ( or check out her website ( for more information. 





Previous post Next post