No excuses, no pity: Tough love may be tough, but it’s the best thing you can give your child

During a recent session with a young patient diagnosed with cerebral palsy, the child’s father paused in the middle of treatment and said in a half-joking manner: “Ok, time to take a break.”
The session had been going on for only 20 minutes and I knew that this parent was feeling distressed as he and his child went through the steps of the LIFE program, a concept I had created to enable children with neurological disorders to gain independent function. During this session, we were working on teaching my young patient how to sit up by himself, and to accomplish this I had broken down this function into a series of motions. After guiding and talking the child through the motions, the next step was to teach the parents the motions and verbal instructions so they could do the program at home and make it part of their child’s daily activities.

I won’t lie to you. The LIFE program isn’t easy, for either the child or the parents. For the child, it can be both challenging and frustrating as the body and mind learn to function in new ways. For parents, it can be heartbreaking as they watch their child struggle physically and mentally to accomplish each motion in the program. Being a parent myself, I understand this completely this and was not surprised when the father expressed a desire to take a break. I knew that he was not asking for a break for himself; he was asking on behalf of his child.

“Why don’t we do a couple more rounds and then we’ll take a quick break?” was my response to him. Then without waiting for an answer, I went ahead and started working again with my patient.
Why was I so tough? Why didn’t I just let my patient and his parents take a break right there and then?

The answer is simple: I believe that if we are to enable children with neurological disorders, then we need to help them develop the psychological as well as the physical means to function independently. This means teaching these children that if they want something, then they need to do it themselves. We will help and guide them, but we will not do it for them.

Please do not get me wrong. I don’t push my patients to do things they are not ready to do and each patient’s program starts with simple tasks before gradually building up to more complicated tasks. Also, we do take breaks during therapy once a patient has accomplished a particular function. But I won’t call for a break simply because a child is crying or screaming. This is the child’s way of protesting a sudden change of circumstances. Before therapy, the parents were doing everything for the child. So now, why won’t Mom and Dad just sit him up instead of expecting him to sit up by himself?

Changing this kind of thinking is critical to successful treatment. When a child’s mobility is impaired, the ability to discover the world independently becomes lost or reduced, leading to mental deterioration. This combination of impaired mobility and mental deterioration then causes a deficit in function. As an example, imagine being in bed for an extended period, doing absolutely nothing, not even watching TV or reading a magazine. After just a week of this existence, with no stimulation of any kind, your mind and body will start to deteriorate.

I know that there are different forms of neurological disorders and that some kids are more impaired than others. But regardless of the degree of impairment, every child has the chance to become independent when they exist in an environment where therapy is tightly integrated into their daily activities.

Now some of you parents out there may be thinking that there’s not enough time to do therapy at home everyday, especially when your child spends a good part of the day in childcare or in school. I understand and agree that we all have busy schedules. But remember that as parents, you have a critical role to play in helping your child become independent. And the earlier you play this role actively, the higher the chances that your child will gain independence as an adult.
Just as important as taking the time to do therapy with your child is your determination to be strong through your child’s therapy. Remember this slogan: No Excuses and No Pity. Make this your philosophy as you teach your child to become independent in every aspect of life: physical, functional and social. It won’t be easy, but it’s the best thing you can do for your child.


About the author

Natan Gendelman has written 185 articles for Enabled Kids.

Natan Gendelman is licensed as a physical therapist in Russia and Israel. After moving to Canada, he was certified as a kinesiologist and osteopathy manual practitioner. Natan has more than 20 years of experience providing rehabilitation and treatment for conditions such as cerebral palsy, autism, Down syndrome, pediatric stroke and acquired brain injury. He is the founder and director of Health in Motion Rehabilitation, a Toronto-based clinic whose main objective is to teach their patients the independence necessary for success in their daily lives.

6 thoughts on “No excuses, no pity: Tough love may be tough, but it’s the best thing you can give your child

  1. I feel that our kids need to be pushed some to do their therapies, how will they ever learn to use their bodies as best they can if they are not taught. If it’s time to take a test at school we study & practice answering questions that will be on the test we don’t just lay back & let the answers fall out we can’t we have to know it. It’s the same with any therapy it takes work, practice & remembering how we /they have been taught to use their bodies to overcome the tightness & tone from the CP. I pushed my daughter yes l admit it but l know she would not be what she is today if l had not made her do therapy & worked with her at home, l didn’t listen to others when they said leave her alone if l had of she would be a vegetable today , instead she is a bright young lady loves her computer loves to sing like no ones listening & walks with a walker, her scholastic learning is about age 8 or 9 but she makes up for it in other ways.

    • Thank you for your comment Donna! That’s so amazing that you were able to help your daughter work hard through her therapy! It’s so important to push our kids, even if it seems tough, but I believe it is the best thing we can do to encourage our children to become independent :)

  2. Hi Natan,
    We brought our son twice to your place. He has hemiplegia and receives PT, OT and ST. We liked your approach to treatment and thought it was the best thing that our son was getting in years. but he cried throughout the session and did not like doing the therapy without his shirt and pant on. We thought that his crying will have more psychological effect on him than benefits and discontinued.
    I still think, it would have been best if you could have adapted your treatment around the personality of the child. He goes for therapy thrice in a week and toys are a big motivator to keep him going. Your clinic was a total contrast with no toys and not welcoming for a child at all. We tried bringing him back but he cried throughout the way and we had to turn back.

    I hope you find a way out because again I like your approach and I am still confident that it would have tremendously helped my child, if he had remained joyful or co-operative during the session.

    Parent of a 4 year old boy.

    • Dear Parent,

      Thank you for your reply. I do remember your child, and today I still believe that we would have been able to help him. As a part of our practice, there are certain reasons why we only use toys in a certain way during treatment. In our methodology, they are used as therapeutic tools meant to stimulate a child’s brain and help him improve his skills. For this reason, we use objects such as balls and items of different textures and sizes which can all be found and used easily at home.

      Now, my personal opinion is that you cannot hide a child from his condition or the fact that he may be seen as different from other kids. Whether he has hemiplegia or another disorder, the child has to know that when he comes to us, he is not coming here only to play. Instead, he should know that he is coming primarily to overcome any impairment he may be experiencing. Parents play a crucial role in this, and it’s important to explain to a child that he is coming here for treatment and why it is necessary. As a comparison, when we bring a child to the dentist or to the hospital we have to explain why it is necessary to bring him there, what will happen, and what he will have to do. The same should happen when a child is brought to our clinic.

      Under parental supervision, we request that a child only wears his diaper during treatment as the surface of a child’s skin has sensory receptors which give the brain information about surfaces, textures and other aspects of his immediate environment. A child who has sustained a stroke, cerebral palsy or brain injury often experiences alternate sensations due to the impairment in his brain. By exposing the skin to different textures and sensations, our goal is to allow a child to create new pathways in his brain and normalize his sense of touch. In addition, when we work with a child in this way, we can see the position of his body and what is happening as he moves, and there is a big difference in what you can see when a child is covered and when he is not.

      Back in our school days, there were certain things that we thought were fun and other things that we didn’t always enjoy. However, they were all important to our learning. What we teach at our clinic is no different. You have to remember that this is a school–the school of LIFE, which requires hard work both from the kid as well as from his parents.

      Once again, thank you for your comment. I appreciate your feedback. Good luck, and I wish both you and your son all the best.

      Natan Gendelman
      Director / Osteopath
      Health in Motion Rehabilitation

  3. Hi Diane,
    Thank you so much!
    Your little guy is really lucky, because he has you around (despite all the women around him :) ). You, who is trusting and believing in him. This is the most important thing. Believe and trust in your childs’ ability to become the best he can.
    Of course he figured out the locks – these guys are very smart!
    Once again, thank you,
    Best regards,

  4. Thank you for making this blog! I completely agree. My son has myoclonic epilepsy, diagnosed three years ago, and one year ago, we realized that he has a PVL on the left side of his brain. He now has the dual diagnosis of Epilepsy and CP, also known as static encephalopathy. He has been in PT and Ot for three years, and speech therapy for two years. He is turning 4 soon, and he is so used to having lots of women pay attention to him!! All of his therapists and many of his doctors are women, so he makes me wonder, what was Robert Redford doing when he was 4 years old?? My son is a lucky little guy, he is very tough, and tenacious, and at school, they see these qualities too. He gets into mischeif all the time, and we were silly enough to think that we could keep him out of the refrigerator with one of those child resistant locks, he figured it out!! He takes Keppra and he is doing really well, I know things could be worse, and I thank GOD everyday that they are not. Your blog is great!! Diane

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