Your adorable pre-school or elementary school client — the one who lit up when he saw you at clinic or hugged you after her evaluation — is gone. He or she has been replaced by a taller version who makes less eye contact and is no longer charmed by your ability to sing songs from Frozen.
Welcome to the Tweenhood, a landscape that’s always changing.
Hear Tweens Out
Angie Kiger, M.Ed., CTRS, ATP/SMS, says one of the things she enjoyed during her 12-year tenure at a pediatric hospital “was that I was able to watch my ‘kids’ — aka, clients — grow up right before my eyes as they would come back year after year.” But she acknowledges the challenges. “It’s very important to have a basic understanding of physical, social, emotional and intellectual changes tweens go through,” she says. “That Psych 101 class from college came in handy after all!”
Middle school students transform in so many ways. “The tween years are prime time for becoming more self-conscious, experiencing mood swings, and testing the waters in terms of expression,” Kiger notes. So she believes expanding a tween’s role in the seating & mobility decision process can facilitate a more successful outcome.
“While I know clinically speaking there are decisions that need to be made where the client does not have a choice, I would recommend trying to provide the client with the opportunity to make a few decisions in the process, especially related to style and color,” she says. “Tweens absolutely pay more attention to their appearance, including the look of their wheeled mobility system. In this day and age, it’s likely that caregivers and tweens have access to online resources and may come into an evaluation with an idea as to what they believe is appropriate. Make sure you take time to hear out the desires of the client and/or caregiver. There may be pieces of what they desire that can be incorporated into final decisions.”
Appreciate the Age
You and your client no longer bond over SpongeBob SquarePants, but you can find new ways to connect.
“Think outside the box with giving the tween the ability to express himself or herself during the wheelchair evaluation,” Kiger suggests. “For example, consider allowing the client to choose what music is playing during the evaluation. I have stations saved in my Pandora app for artists I only listen to during evaluations. You may be surprised how relaxed and interactive your tween clients become when you validate their choices. Not to mention you will be upping your karaoke game.” She adds a caveat: “Make sure the caregivers are okay with the music selected.”
Brandon Edmondson, OTR/ATP/CRTS, director of clinical sales for Permobil and TiLite, says, “As an ATP, you have to talk to the kid. I always hear out the parent and hear out the clinician, and if you end up with all of them in one room, it’s going to be a long eval. But I always address my questions to the kid, because I want to hear what they have to say, what’s important to them, what they like about this chair, what they didn’t like. I want to hear it from their perspective, even if Mom or the therapist jumped in. I think it’s just good for the kid to start knowing that his opinion matters at this age.”
Edmondson uses tweens’ interest in peers’ activities — an Oct. 5 CNN study found that some 13-year-olds check social media more than 100 times per day — to highlight some very cool functions of today’s power chairs.
“Definitely one of my favorite things is getting them hooked up on their phones through their power chair,” he says. “So kids who generally have no hand function will have the ability to touch the screen and text. That’s a huge social win for them. They do it right through their drive controls. And it’s pretty cheap: Even if it’s not covered, it’s a couple of hundred dollars for the parents, and once they see what it can do, they generally want it.”
Edmondson has sweetened the pot by expanding a tween’s capabilities at home.
“I try to get them to be able to operate the phone, and then I’ll get them started with a couple of apps to give them something at home, like a music player: ‘Hey, if you had a music player in your room, you could just go to the app and your home WiFi and play your music in your room, do your TV.’ They always have their remote with them.”
Kiger says she’s been in evaluations where the seating & mobility team has stepped out to let tween and parent talk privately, and she also knows tweens can be hard work. Still, she believes in including them.
“As difficult as negotiating and explaining things can be with a tween, I much prefer working with a client who is engaged in the decision making,” she says. “There are times when the tween cannot get what he wants, but that’s part of life. My recommendation is listen to the client, validate their desires, and explain what can be done.”