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Empowering Futures And Cultivating Self-Determination In Children Podcast

Empowering Futures And Cultivating Self-Determination In Children Podcast
Amy Coopersmith, OTD, OTR/L, MA Ed, Dennis Cleary, MS, OTD, OTR/L, FAOTA
January 26, 2024

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Editor's note: This text-based course is a transcript of the Empowering Futures And Cultivating Self-Determination In Children Podcast, Amy Coopersmith, OTD, OTR/L, MA Ed; Dennis Cleary, MS, OTD, OTR/L, FAOTA.

**Please use the handout to complete the exam.

Learning Outcomes

  • After this course, participants will be able to:
    • differentiate between adult-led teaching strategies and child-led teaching strategies in order to select methods that maximize children's motivation, engagement, and participation.
    • compare and contrast characteristics of self-determination vs. learned helplessness in order to identify children needing autonomy-supportive intervention.
    • analyze one's skills and abilities to provide child-led interventions in order to maximize children's goal attainment.

Podcast Discussion

Dennis: I'm happy to be joined today by Dr. Amy Coopersmith, an occupational therapist with a fascinating career, who will discuss self-determination. Could you discuss your background and what led to your interest in occupational therapy as a profession?

Amy: I had a previous career in health and physical education. During that time, I was exposed to child-led learning approaches. A researcher named Muska Mosston impacted my teaching practice by promoting child-led learning. During that time, I used interesting strategies where the children responded beautifully. I decided that I liked working with children who had special needs and wanted to focus on things that were a challenge for children. In the health and physical education setting, I had 45 children at a time, with one class after another, and didn't get to know them. I loved working with small groups and individual children. I switched and went back to school to become an occupational therapist.

Dennis: Could you tell us a little about your occupational therapist career?

Amy: I worked for the New York City Public Schools for 18 years and had many roles within that timeframe. I started out as a school-based practitioner in two different schools. After a few years, they asked me to participate in the evaluation team. I then joined a group of practitioners who developed materials for the evaluators. These materials were focused on child participation and top-down and strengths-based approaches. It reminded me of the wonderful strength-based approach I used as a teacher, and I started including more of these activities and strategies in my practice. I became a mentor and, eventually, a supervisor. I supervised about a hundred therapists in New York City in all different schools, which was a wonderful experience. I was incredibly impressed with the range of strengths and amazing approaches people used. I decided to introduce practitioners to some of the strategies I had learned as a teacher, which sparked this journey.

Dennis: We all love it when our supervisors are passionate about what they're doing and interested in evidence-based practice, especially for school-based practitioners. Having an occupational therapist as a supervisor is so important to talk our language and communicate that vision, as well as with administrators within the district.

Amy: There is a similarity between how I look at teaching children and how I look at working with occupational therapy practitioners. I presumed their competence, and I believed in their abilities. I always want people to do that with the children on their caseload.

Dennis: Absolutely. Today, we are talking about self-determination. Could you define self-determination and how you became interested in it as an occupational therapist?

Amy: A light bulb went off in my head a few years ago. I've been working on self-determination approaches for probably 30 years but didn't put a name or label on it. As I read more articles and exposed myself to best practices, I realized I was promoting self-determination, eventually leading to research. Self-determination, in simple terms, is a person's ability to figure out what matters to them, go after it, and make it happen. Many of us already do that automatically. However, when working with individuals with disabilities, it is something that we need to bring to the forefront of our awareness. We can notice if they participate fully, are interested, and are motivated. We must dig deeper to determine what might be holding them back from finding important things and their personal goals. 

Dennis: For our Model of Human Occupation (MOHO) fans, volition may not be an exact synonym for self-determination but may be in the same language family.

Amy: Absolutely, it is. This is making choices that many of us take for granted. When we all became occupational therapists, we made a choice of where we wanted to take our lives. However, for some of the children we work with, it doesn't even occur to them to think about what they might want to do with their lives. They're often told what to do all day long, and they're "helped" along the way. I put quotes around helped because it is not always the best help they receive.

Dennis: Like our friends interested in applied behavioral analysis (ABA), what you're talking about is child-directed. By definition, ABA is not child-directed; it is child-imposed. I don't know if that makes sense to you or if this is one of the ways that we can differentiate between these two things.

Amy: Absolutely. We can change the narrative and how we work with children in many ways. We can do subtle but powerful things to motivate and engage children.

Dennis: I work with adults with intellectual disabilities, primarily at transition age. They're still adults. We talk about self-determination a lot, and we use the analogy, you know, for them to steer their own ship or drive their own car.

Amy: Yes.

Dennis: This helps them to have that mindset during their IEP or employment planning meetings. One thing that I've noticed, and I'm sure you've seen as well, is that kids with disabilities oftentimes don't have the same opportunities for self-determination as their general education peers. Do you think this is a problem? And what impact do you think it has on kids that are receiving special education services?

Amy: I think it's a huge problem, and I think it's something that many folks did not anticipate would be a problem. Some of it started with special ed reform around the 1970s. People started to realize that children with special needs should not be separated and shuttled off to different schools and different environments. They should be with their families, neighbors, and communities.

After these changes, certain things happened that were not so wonderful. One of the things that happened with special ed reform was that children were now in either general or blended classes. Sometimes, they're called collaborative teaching, where there's one general ed teacher and one special ed teacher, and they're with their general ed peers. Suddenly, there became a need to hurry up because the curriculum commanded certain benchmarks that had to be done on a timetable. Children who took longer to accomplish tasks were now pressured to hurry up.

How did they do that? They assigned teachers' aides or paraprofessionals to assist those children. I'm not sure if this has happened to you, but I know for myself that when I was in the schools, I observed paraprofessionals helping children by doing their work for them, including taking their books out, turning in their homework to the teacher, filling out the homework list for the night, and packing their backpack. They were doing all these things children should be doing independently. Many children we work with aren't capable of doing all those things. However, we can slowly start to build their ability to do those things by being conscious that we don't want to do everything for them because the outcome is that they learn to rely on other people to do everything. Ultimately, this is not a good outcome in the long run.

There are two other factors that we can talk about as well. One of them is helicopter parenting. I also call it helicopter caregiving because it's not just parents doing it. There are also academic pressures. These were things I looked at in my research study. There's not a lot of research, especially on how helicopter caregiving and parenting affect children in school. There's also not a lot of research on what I just discussed regarding special ed reform. I found what I could, but this area should be studied more because it affects millions of children.

We need to look at how we can change that picture so that children have better opportunities to participate in these ADLs, like completing homework, filling out their agendas, turning in assignments, and getting ready for the day. All those things that are going to make them independent as adults.

Dennis: I think, as occupational therapists, we do this naturally. Obviously, we want to include the students in everyday activities, but not everybody has that training or that experience. My lived experience has been the same thing. Often, paraprofessionals want the child to look good, to do good, and to feel good. During COVID, many entry-level paraprofessionals left to do other things, leaving a huge shortage of personnel to do the important work. This has exacerbated the problems even more. What can we do regarding new school reform to address some of those issues? Also, what does occupational therapy have to help paraprofessionals or others understand how to facilitate deep learning for the students?

Amy: I want to start out by saying that I have been incredibly impressed by the paraprofessionals. I believe that everyone, teachers, administrators, paraprofessionals, and all the practitioners who are my colleagues have the best interest of children in mind. I do not think anybody sets out to try to hold children back. I think it's more of a modern phenomenon that needs more research.

There are definitely some things that we can do. One I call presumed competence. We want to presume that children are capable of certain tasks. It's a change in mindset, thinking they can learn some of these strategies independently. They are learning to manage their daily lives, rather than worrying about and keeping up with them every minute. We need to know that allowing a child to do things independently is worth taking extra time. Now, it's not always going to be possible because we do have schedules and a lot of things going on during the day. Let's say a class is going to the auditorium for an assembly. We can't say, "Well, let's let them take 20 minutes to put things away." We know that's not feasible, but there may be opportunities at the end of the day, at the beginning, or during free time. During these times, a child could practice some skills without pressure. We must change our mindset to think about how children can do things for themselves instead of us doing things for them.

Dennis: Can you talk about how systems are almost created to facilitate that learned helplessness?

Amy: Learned helplessness went way back many years when the researcher Seligman found that animals who were never allowed to do certain things just gave up and never even tried. For instance, if they were in a pen and never were allowed to leave the pen, once the pen door was open, they never bothered to leave. They were stuck, and this can happen to human beings as well.

If you've had repeated experiences where you're never allowed to do something or you've never had an experience of successfully doing something because someone does it for you every time, then there's no motivation for you to even try anymore. The negative message is that you cannot do that alone, so we will do it for you. This message can be internalized. A child may hand you their milk carton or their bag of chips and say, "Open it for me," because nobody has ever thought that maybe they were able to do it. Perhaps they need to be taught differently if their fingers don't work like other children.  We want to always think about how we can change what we're doing to encourage and inspire children not to rely on others.

Learned helplessness is habitual reliance on others and lacking belief in oneself that one can do these things.

Dennis:  Absolutely. I was a consultant at the Ohio State School for the Blind. There was a young man who had an optic tumor at three years old. He ended up having both of his optic nerves and eyes removed. He was also in a state that didn't have a state school for the blind. Thus, he was going through a typical special education experience. His mom was a PT, and his Dad became an OT a few years later.  I remember being part of the assessment team when they were looking to move states so that their child could be in a specific school for kids who were blind. This is because when he couldn't do something in a typical setting, the answer was, "Well, he's blind, and he's not going to be able to do that." As a result, they uprooted their family and moved to a different state so he could be enrolled in the Ohio State School for the Blind, which had specialists. A large part of our job was to be comfortable with kids struggling to the point of almost failing so that they learned their boundaries. They learned to walk with their canes, feed themselves, and dress. He was at the School for the Blind for about eight years. Then, he went to a different high school with continued support, but his parents intervened to get him out of a learned helplessness situation. We're all on teams and have different expertise. Sometimes, kids need a high level of support to do that. Even as occupational therapists, we can contribute to that. Again, we must evaluate our limitations on the young individuals we support.

Amy: For sure. One thing I didn't mention before when we were talking about self-determination is that there are three basic components that many of us automatically accomplish on our own: autonomy, competence, and relatedness. When we perceive our competence and that we can do things, that's a very internal, powerful message. Autonomy is being able to live on a day-to-day basis independently. The relatedness is being able to have relationships with the people around us. Sometimes, all three of those components are blocked or inhibited with children, especially in schools. We all know the importance of client-led practice. Yet, it rarely happens in schools because fitting that client-led approach into a 30-minute session is too difficult. So, I set out to try to make ways easier for OT practitioners to include these different factors within a typical 30-minute session.

Dennis: Could you give some examples of how an OT practitioner might be able to do that?

Amy: I picked ten strategies for a book that I wrote called the "Self-Determination Strategies Toolkit." There were ten of the ways that I felt were very powerful and easy to implement. Within those, if I were to pick three, they would be asking questions, developing choice-making skills, and setting goals. These are powerful tools that can be used.

Dennis: That would be great. 

Amy: First, let's talk about asking questions. You should never start a session saying, "Here's what we're doing today." I think it's much better to come into a session saying, "What are we doing today?" if the child is able to either speak or use an alternative communication device. You can also ask, "What have we been working on?" or "What are you interested in working on?" When we ask questions, we're giving some very powerful messages. We're saying, "I think you know the answer, and you're smart." Also, you are saying, "I value your thoughts," and "I want to hear what you have to say and think." Those are very powerful messages. Some children are never asked these questions and are told what to do all day. "Go here, go there. You need to do this. Here's your clothes. I'm going to put them on for you. Here's your lunch. I made it for you." Everything is being done to them or for them. Asking a question changes the whole scenario.

Another one I mentioned is choice-making. It's more difficult for them to communicate these ideas, but it's usually pretty easy for them to choose. Even a non-speaking child with many challenges in that area can make a choice. For example, they can use choice boards. They can be found on Pinterest or other places. I don't believe there should ever be more than two to three choices at a time, especially in the beginning when a child isn't used to making choices yet. A choice board can give the child something they can point at or indicate their preference. An interesting study from the University of Southern California compared two groups, where one group was told, "Your homework assignment is (I'm making this up) writing three paragraphs on the history of Native Americans in the United States."  The control group was given choices. They could either choose the history of Native Americans in the US or the history of the Revolutionary War. Within that group, those who chose Native American history were compared to those told to do Native American history. They were both doing the exact same assignment, but one group had chosen it, and the other was told what to do. The children who chose their project did way better, as they were motivated and got better grades on the assignments and tests. They initiated better than the other study participants; their assignments were of much higher quality. Across the board, choosing makes a difference. We can easily include this, as it takes such a short time to ask a child their preference, and then they get to work.

Goal-setting is the last one. There are IEP goals that we work on with children in schools. First, the issue with IEP goals is that they're all adult-created. Unless you're in a special progressive school where the child is part of that process, it's usually from the teacher, the parents, or some other practitioner who says, "This child needs to work on this," which becomes their IEP goal. The goal setting I'm describing here has nothing to do with an IEP goal. It's starting a child out on thinking about what's important to them and how they can work toward a goal. Usually, they'll pick something very motivating, like, "Get better at my video game," or, "Play basketball with my friends, and get better at shooting hoops." These are not necessarily IEP goals, but I recommend starting here. When starting with a child, you can ask the child to choose a goal. It should be a goal they can achieve within one, two, or three sessions, or something quick. When they succeed, they say, "Wow, I can do something." So it's this shift in their mindset, that they start to believe they have skills and capabilities. We can shift once they've had one, two, or three positive experiences with achieving a goal. We can say, "Your teacher," or, "Your parents said they think it's a good idea for you to work on this other goal of writing a paragraph," which, we know, is not usually a child's favorite goal. We can add to this by asking, "Where would you like to do it?" "When?" and "Why do you think they wanted you to work on this?" We can then have a conversation about the details. "Where, when, how, what do you want to use?" and "Do you want to write with markers, pencils, on the wall, on the desk?" You're giving them options that might spark their interest, even though it's a non-preferred goal.

These are three simple approaches that can be incorporated into day-to-day practice. It is worth the extra time that it takes to do this because, across the board, every practitioner that I've spoken with who has used this approach has said, "Yes, it took a little longer to do this, but the child learned and generalized it into their day-to-day life because they own it now. It's their goal and their ideas. Rather than having to pull, coax, and trick them into doing things, they're doing it on their own."

Dennis: My master's degree is in adult education. I always thought it was funny that one of the hallmarks of adult education was self-direction and choice. Respecting the history that an adult brings to the educational environment,  I always chuckled because that wasn't what we did with children. With trauma-informed care and the many ways education is changing, we're more aware of bringing in some adult education concepts. We, as adults, like to have our experiences and knowledge respected; I think the kids we're working with certainly do as well.

Amy: For sure. And when you see a child actually respond to this change in approach, it's a very exciting experience because you see their eyes light up. Some schools that have embraced this approach have goal walls and areas where children post their goals and progress charts, and they run their own sessions. Some children who have more challenges need help with that, but we've had children in wheelchairs or with cognitive challenges who still grab their gold card or chart, sit down, and get to work. It can be as simple as an icon or a sentence that tells them what to do. It's inspiring to see.

Dennis: As I said, I work primarily with young adults in employment settings. Self-determination is one of those evidence-based practices we're trying to embed in our sessions. We have even created employment planning meetings, about six times a year. The individual runs each one of those. We have a couple of example videos on our site. It's fun to hear the pride in the person's voice when introducing everyone and going over their goals. They are driving their own car or captaining their own ship, which is an important part of what we're trying to produce.

Amy: Seeing a child's spirit lifted when given a chance to have a leadership role is so impactful. Many of our children are used to being followers. They're not used to having a chance to stand up, talk, and lead the way. I've seen that multiple times in my practice and how that changes things. I have recorded a child teaching other children how to use a laptop. You see them perk up, and they get very excited because they realize that we're valuing and honoring their skills.

Dennis: How do you help embed that within schools as a frontline practitioner and administrator? 

Amy: Fortunately, there is a law called ESSA, the Every Student Succeeds Act. It gives occupational therapy practitioners, other special-related services practitioners, and educators an opportunity to have a seat at the table with other administrators and school leaders. This is a new area for many occupational therapists because we're not used to this. Instead, we're used to being in our own corner. Everybody says, "Wow, you're working your magic. This is great." However, we want to also be able to share this with the broader population, and not just with a few children who happen to be on our caseload. The Every Student Succeeds Act gives us the opportunity to use multi-tier systems of support within a whole school or a whole class to implement some of these ideas. For instance, the choice boards I just mentioned could be done with an entire class. Every school and environment is different, but in the schools where I worked, once they got to know me and my contributions, they allowed me to schedule some of these whole class or school activities into my day. It made such a difference.

One of the programs I have is called "Captain Me." It's a video program for young children, ages three to eight, which helps them learn to be more independent and take charge of things. A practitioner started using "Captain Me" with a couple of the children on his caseload, and the teacher saw it, and said, "I don't want you to just do this program just with him. I want you to do it for the whole class." So, he started doing this interactive program with the entire class. It's an interactive program. Another teacher saw it and said, "We want that in our class." Don't ask me how he's fitting it into his schedule, but he told me he's now doing it with the entire school, and everybody's on board. I give this example because sometimes it takes that initial step, and people start noticing. They start noticing a difference in motivation and participation, which then snowballs. It is a grassroots approach. We can't call up the US Department of Education and say, "Guess what? We have to start using more self-determination today." We would like to do that, but who will listen? However, we can go into our school setting and start using some of these approaches immediately, observe the difference, and hopefully others on the team will also notice to grow from there.

Dennis: Dr. Sue Bazyk was on an earlier podcast on OccupationalTherapy.com. Sue talks a lot about ESSA and goes into a lot more detail.

Amy: There's a Facebook group called the OT ESSA Advocacy Network, and I assist Dr. Bazyk in running that group. We have meetings about three to four times a year where practitioners from around the country share success stories of how they've been able to implement some of these programs. It can be very inspiring, especially if you have a particular challenge in your school. About 500 some-odd practitioners are in that group, and it's a way to bounce ideas off each other.

Dennis: Wonderful. Sue is the creator of Every Moment Counts, which is everymomentcounts.org. What is your OT ESSA website?

Amy: It's not a typical Facebook group because we don't have constant interaction. Instead, we announce meetings about the speakers, and we highlight certain news and articles about ESSA.

Dennis: When discussing ESSA and occupational therapy leadership, you and Sue are at the forefront of helping school-based practitioners see the possibilities. Sometimes, when we're in our individual school districts, we can feel slightly overwhelmed. I don't know if you're on any Facebook or Reddit pages for school-based practitioners, but you hear about some of those challenges. It is nice to get together with other OTs and to see what they've done and how they've helped to navigate some of those waters. And certainly, having people like yourself with a strong supervisory background is useful. For ESSA, I believe you have some documents specific to how you navigate that system, if I'm not mistaken.

Amy: Yes, those are included in that Facebook group and can be downloaded. The strategies that I'm suggesting are all things that can be done within an OT session. There is little to nothing that needs to be done at home to prepare or outside to document, as it's all done. If a child is documenting their own progress, it helps you. While they're documenting their progress, you can be writing your notes because you're watching them write or indicating how they communicate simultaneously. You can even ask them, "This is what I'm writing in my note about our session today. Do you agree with it? Is there anything we should be adding?" We want this to be a partnership, so it's best practice. We know it motivates the child, and it doesn't have to be done outside of a session,

Dennis: We all appreciate it, for sure. Could you discuss the connection between self-determination, learned helplessness, and occupational justice? Can you talk a little bit about the interplay between those three?

Amy: I have been very aware of these topics and have been doing readings about occupational justice and occupational deprivation. It occurred to me recently that there is a major connection between self-determination and learned helplessness. We've talked about children's lack of opportunity in schools to do what their classmates do. When I say classmates, they're general education classmates. For example, if a child is in a blended class with some general education and some special education students, the general education students might finish more quickly and then can choose something they want to do. Meanwhile, the children in special education take longer and never have that opportunity. The other thing is that when paraprofessionals and teachers' aides are doing things for them, that reduces their opportunity to struggle and learn, as you described before. Success after the struggle is a skill. If we deprive children of that, they never have that opportunity. These are just a couple of examples.

There are many occupational opportunities within a person's day; if those are removed, you'll have occupational deprivation. If we look at different political things around the world, there are certain cultures where people are deprived of certain things. Children in our own schools here in the US are often deprived of opportunities. As mentioned earlier, even general education students are sometimes deprived because of helicopter parenting, helicopter caregiving, and helicopter teaching. It's this idea that children are not safe unless we are hovering all the time. They have play dates and activities that are scheduled throughout the day.

When I was a kid, my mother opened the door and said, "Go out, come back when it's dark." If your bike got a flat tire and you were far away from home without a cell phone, you had to figure out what to do. You learned how to solve problems. Perhaps you found a neighbor who had a pump. Children don't have these same opportunities anymore. We can make a difference by being conscious of this and figuring out how to introduce some of these opportunities back into their lives.

Dennis: Yes. A special educator I used to work with at Ohio State did a study where she used an interest inventory for young adults with intellectual and developmental disabilities. She asked them what they liked and didn't like, then intentionally taught them how to do things they said they didn't like, and then redid the interest inventory. Lo and behold, they didn't like the things they couldn't do. This speaks especially to kids in special education. They have fewer opportunities and less exposure to the bigger things in life. Trying to reform as a helicopter parent myself, we want the best for our kids and want to make sure they're safe. That hovering limits their opportunities, especially those in special education.

Amy: It's done with great intentions. People want to protect children, but at the same time, we may be harming them without realizing it. 

Dennis: Post-COVID, we're even more aware of that and want to protect kids. But, what are the consequences of some of the decisions we as adults make on their behalf? Could you talk a little bit more about "Captain Me" and what "Captain Me" is, and maybe if people can get access to "Captain Me?

Amy: Amidst the upheaval brought about by the onset of the COVID-19 pandemic, I was at a professional crossroads. Having departed from my position at the New York City Public Schools in January 2020, my carefully laid plans were abruptly discarded, necessitating a swift recalibration. Drawing upon my musical background and familial ties to show business, I seized the opportunity to create a program tailored for very young children. While programs promoting self-determination existed for older age groups, there was a glaring absence of resources for the formative years.

Recognizing the significance of shaping mindsets early on, akin to addressing handwriting habits in toddlers, I set out on daily walks during the lockdown, armed with my voice recorder. Drawing inspiration from my past success in memorizing academic content through musical mnemonics, I began crafting songs that could engage and resonate with young minds. This spontaneous creative endeavor led to the realization that these songs could be transformed into video lessons.

Seeking guidance from my showbiz family, the consensus was to produce video lessons. With a script, music, and creative input from family members dispersed across the globe, we pieced together the "Captain Me Kids" program. My cousin in Canada, a professor of film and theater, handled the editing and production, while a puppeteer from Brooklyn and a musician from afar contributed their talents. The collaborative effort involved a California graphic artist and a European web designer. Navigating the constraints imposed by the pandemic, we coordinated everything remotely, utilizing green screens and innovative production techniques.

The resulting product comprises engaging and entertaining video lessons lasting approximately five to six minutes. The lessons cover essential topics such as goal setting, embracing differences, making good choices, handling mistakes, and managing everyday challenges. The program is a valuable resource for occupational therapy practitioners and has also found resonance in educational settings. Teachers appreciate the brevity and vibrancy of the lessons, recognizing them as a welcome break that doesn't compromise valuable instructional time. 

Moreover, the program's accessibility is underscored by its availability on various music apps, enabling anyone to access the 12 lively and fun songs free of charge. A simple voice command to devices like Alexa, such as "Play 'My Goal' by Captain Me Kids," makes the songs readily available during sessions or as background music. The positive reception, especially among my grandchildren aged two and five, reaffirms the program's effectiveness in reaching and engaging young minds. This venture, born out of necessity during uncertain times, has evolved into a valuable tool for fostering self-determination and autonomy in the formative years.

Dennis: What I can see, especially when I think of a young child with autism, you know if they like the song, the message that may stick with them. I think it is a positive thing for everybody.

Amy: Yes. When we think about our childhood, I remember "Ring Around the Rosie," and I could sing it to you now. Have I practiced it in 50 or 60 years? No, I haven't practiced it, but I still remember it. I also remember all the songs I mentioned when trying to memorize my insertions and origins of muscles because they live in different places in our brains and can serve as positive reminders.

Dennis: Your research examined how teaching self-determined strategies affected practitioners and the children we serve. What are some of the findings from that? What did you learn, and what are you hoping to do with that information?

Amy: I identified a significant gap in the occupational therapy domain related to self-determination through an extensive literature search. While there was ample literature on self-determination, the existing OT literature was predominantly theoretical, lacking practical guidance on translating these theories into actionable strategies. Recognizing this disparity, I journeyed to bridge the divide between theory and practice.

As a seasoned practitioner, I developed strategies that effectively promote self-determination. However, upon assuming a supervisory role, I observed a reluctance among others to adopt these strategies. Motivated to address this issue, I sought permission to conduct workshops. These workshops, spanning my seven-year tenure as a supervisor, yielded positive feedback, confirming the efficacy of the strategies.

The success of these strategies led to the development of two programs: the "Self-Determination Strategies Toolkit" derived from my research study, and "Captain Me," tailored for very young children with integrated music. Both programs encapsulate ten key strategies identified as transformative in fostering self-determination.

The genesis of these strategies drew inspiration from various sources, including Muska Mosston's work and principles from occupational therapy and client-centered approaches. What set them apart was their transformation into actionable steps, providing practitioners with tangible methods to incorporate into their sessions. The impact of these strategies resonated with occupational therapy practitioners, who reported notable changes in their practice dynamics after participating in my workshops.

Eager to delve deeper, I pursued a doctoral program at Temple University, focusing on evaluating the effectiveness of the "Captain Me" program. Hindered by the COVID-19 pandemic's restrictions on school access, I collaborated with Dr. Susan Bazyk to devise an innovative research model. This model involved engaging 30 OT practitioners nationwide in a pre-webinar survey and a 90-minute webinar detailing the strategies, practical examples, and actionable plans. The practitioners then implemented these strategies for at least a month with a child in their practice before completing a post-webinar survey.

The outcomes surpassed expectations, demonstrating a statistically significant impact on practitioners' confidence, feasibility, and overall mindset toward integrating self-determination into their sessions. However, the most compelling results were observed in the children, with practitioners reporting accelerated goal achievement, heightened motivation, engagement, and improved self-awareness.

Encouraged by these findings, my commitment to advocating for these strategies intensified. I am currently involved in collaborative efforts with Texas Woman's University professors and Cane University to develop a children's self-determination frame of reference tailored for occupational therapy education. This initiative aims to empower future OT professionals with the knowledge and tools to integrate self-determination principles into their practice, fostering positive outcomes for practitioners and the children they serve.

Dennis: Your work is so important because, in my world, I talk about self-determination. However, I think it's a fairly new term within occupational therapy. We certainly use client-centered left and right, but I think self-determination is a better focus for us instead of client-centered, which we're doing. You know, self-determination is more about what the individual is doing. I want to thank you for your time. Are there any resources or places people could go to learn more about self-determination that you might recommend?

Amy: If anybody's interested, my website is called selfdeterminedkids.com. I have a lot of links to other organizations and resources. It's a brand-new website, and it is currently being built up. Eventually, I'll have courses listed on there as well. There are other websites, as you mentioned, like everymomentcounts.org. It is wonderful with many free resources, like the calm moment cards. There are free ways to inspire children to feel better about themselves. The Self-Determined Kids website also has free examples of the "Captain Me" lessons and blog articles that talk about different ways to change what we're doing to improve the outcomes for children. And I'm hoping that there are going to be even more resources. Some of my colleagues are doing wonderful things, like Katie O'Day, out in Oregon, who has the Visual Activity Sort. You know, there are wonderful things that are developing out there. We must be aware and promote each other in this positive pursuit.

Dennis: Well, Dr. Amy Coopersmith, thank you for your time. I'm excited to start using this language within the profession because I think it's important.

Amy: Great. Thank you so much. It was a pleasure being here to talk about my favorite topic.


Please refer to the outline and handout.


Coopersmith, A., and Cleary, D. (2023). Empowering futures and cultivating self-determination in children podcast. OccupationalTherapy.com, Article 5681. Available at www.occupationaltherapy.com

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amy coopersmith

Amy Coopersmith, OTD, OTR/L, MA Ed

Dr. Amy Coopersmith, OTD, OTR/L; MA Ed, boasts over three decades of expertise as a pediatric occupational therapist and educator, dedicating herself to advocating for children's self­determination. Her extensive tenure in New York City's public school system encompassed multifaceted roles as a clinician, evaluator, and supervisor across over 100 schools.

A pioneer in her field, Amy authored the influential Self-Determination Strategies Toolkit and developed the acclaimed Captain Me program tailored for young children. Her mission revolves around empowering practitioners and educators with evidence-based strategies that foster children's autonomy and motivation. 

Amy's academic pursuit culminated in a doctorate from Temple University in 2022, where she conducted groundbreaking research on children's self-determination. Her commitment to knowledge dissemination extends through national conference presentations, mentorship initiatives for practitioners, and the continuous development of materials that bridge the gap between research and effective practical application. 

dennis cleary

Dennis Cleary, MS, OTD, OTR/L, FAOTA

Dr. Dennis Cleary has over 25 years of experience as an occupational therapist.  Dennis’ clinical practice has been primarily with children and adults with intellectual disabilities to encourage their full participation in all aspects of life at home, work, and in the community. He has had faculty positions at The Ohio State University and Indiana University. As a researcher, he has been on teams that have received over seven million dollars in grants from state and federal agencies, including a National Institutes of Health multisite trial of the Vocational Fit Assessment, an age-appropriate transition assessment, which he co-created. He has numerous publications and national and international presentations. Dennis is passionate about increasing the role of Occupational Therapy in transition-age service with the goal of improving outcomes and quality of life for all. 


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