Communication with children

During my last placement paediatrics, most of the clients were children of developmental delay. Most children were not difficult to communicate with, however I found it particular difficult to communicate toddlers who have a mind of their own, only able to follow instructions sometimes and unable to express their ideas and feelings.

One of the regular children I saw on weekly basis. She is a 2.5 years old toddler with global delay. On her medical and psych assessment, her global skills (included motor skills and social skills etc) varied from 10months to 17 months. She has very short attention spam and recognizes very few instructions, for example “more”. During the sessions with her, quite often I have to physically guide her to target. For example walking on balance beam, I have to walk right beside her and often holding her hand so she can’t run off, while her mum waits on the end of the beam encouraging her to go over. This guiding method works very well with her. She does not mind being encouraged repeating the activities and she would otherwise run off. As she gets familarised with the activities, most of the time she requires a lot less assistance and guidance after a few tries.

During one of the weeks of my prac, I had a boy of similar age immediately after her, whom I had not seen before, also with developmental delay, mostly physically and in speech. This boy behaved dramatically different to the girl. I gave him verbal instructions initially for all his activities planned. When he caught attention of other interesting objects in the room and abandons the original exercise, I tried to guide him physically as well. It went alright the first a few instances, however later on he became angry about it. I had to give way and negotiate with him that he could do the activity he wanted to do after he finish the planned ones.

After reflecting both treatments, I realized that I should not starting off treating the little boy the same way as the girl toddler. I was wrong in presuming the little boy wouldn’t mind guiding him in the activities. It is important to give them a sense of choice that they chose what they wanted to do, which will improve their compliance with their activities.
Does anyone have experiences with kids to share? Although I had my paeds prac, I am still not fully confident in treating kids especially toddler aged, would like to hear more strategies =)