Why We Let Kids Drift: The Therapeutic Power of the Pause in OT Sessions

As occupational therapists working with children and adolescents, we sometimes see moments in sessions where a young person seems to "check out"—they might stare off, fiddle with a toy, slump to the floor, change the topic, or even outright refuse a task. These moments can be framed as "non-compliant," but when we take a step back and look through a therapeutic lens, we know better: these behaviours often carry deep meaning. And sometimes, allowing them—even for just a minute or two—can be the most effective intervention of all.

Sensory Standpoint: The Brain Needs a Breather

For neurodivergent children in particular, sensory processing can be a full-time job. The noise of the room, the feel of materials, the light intensity, even internal body cues—these all add up quickly. Momentary disengagement often isn't avoidance but regulation. These pauses allow for nervous system recalibration. For some children, zoning out for a moment is equivalent to taking a deep breath.

If we press on without giving space for sensory regrouping, we risk tipping them further into dysregulation, making task participation harder, not easier.

Small pauses help us return tot asks more regulated.

Emotional Regulation: Small Breaks Prevent Big Explosions

Young people—especially those still developing interoceptive awareness—may not even realise they’re becoming overwhelmed until it spills over. Allowing a brief moment of ‘off-task’ behaviour gives us the opportunity to co-regulate: to join them, reflect with curiosity (“That felt tricky, huh?”), and support a return to emotional balance.

When we deny this space, we may escalate distress or create shame around struggling emotions. We lose a powerful chance to model emotional attunement.

Pausing gives us the oppoortunity to evaluate and de-escalate emotions

Choice and Control: A Critical Need

Autonomy is a fundamental human need, and it's often one of the first things children lose when they enter therapy or education settings. Giving a child the unspoken message, “You can step away for a moment. You’re safe here.” is an act of respect. It says: Your body and brain know what you need.

When we override this, demanding immediate compliance, we reinforce power imbalances and create learned helplessness or resistance. In contrast, honouring choice fosters intrinsic motivation and trust in the therapeutic relationship.

When we attune to needs over compliance, we say "You are safe here"

A Neurodiversity-Affirming Approach

Neurodiversity-affirming practice asks us to stop viewing behavioural compliance as the gold standard. Instead, we attune to what a child’s behaviour is communicating about their experience of the world.

Allowing these short moments of disengagement respects the neurological differences in processing, attention, and regulation that are inherent in neurodivergent individuals. It challenges ableist expectations of constant focus and task persistence.

By embracing this, we create a therapy space that supports authentic engagement over forced participation.

What Happens When We Don’t Allow This?

When we push through, dismiss, or punish "non-compliance," several things can happen:

• The child may experience shutdown or meltdown.

• We risk rupture in the therapeutic relationship.

• The child may learn that therapy is not a safe space to listen to their body.

• We create a context of performance over process, which limits real growth.

  
  

On the other hand, when we hold space for these moments, we invite real therapeutic work—not just surface-level participation.

Case Study – When It Goes Well

Eli, 9, is autistic and has ADHD. During fine motor tasks, he often rolls under the table or starts spinning in the chair. Rather than pulling him back to the worksheet immediately, his OT says, “Looks like your body needs to move. Want to do 10 jumps first or bounce on the ball?”

After two minutes of movement and a sip of water, Eli returns to the task, completes it more easily, and even initiates the next step himself.

Outcome: Eli feels in control, understood, and energised. His OT has supported self-regulation and built trust.

Case Study – When It Goes Badly

Maya, 11, has a history of trauma and sensory defensiveness. In a handwriting session, she starts doodling on the whiteboard instead of following the worksheet. The therapist, concerned about task completion, says sternly, “We’re not here to waste time. Sit down and finish the page.”

Maya becomes silent and resistant, and after a few minutes, begins to cry. The session ends early with little progress.

Outcome: Maya’s disengagement escalated due to lack of emotional and sensory attunement. The therapeutic relationship was compromised, and her internal experience went unheard.

Planned is not always Perfect, for that day.

Sometimes, therapeutic progress looks like a child not doing the thing we planned—because they’re busy doing something they need. In those moments, giving space for a pause, a wander, a wiggle, or even a defiant “no” can be the bridge back to engagement.

Let’s keep championing an approach that honours body-brain cues, embraces natural rhythms, and centres the child’s experience—because that’s where the true therapeutic magic lies.