Thoughts From a Therapist: Concrete Operations and Communication Needs

Originally published on Sensory Integration Education on 27 September 2023.

We are thrilled to welcome back our regular contributor, Anna Willis, Occupational Therapist and Advanced Practitioner in Sensory Integration, with her Thoughts From a Therapist series. In this article, Anna discusses concrete operations and communications needs.

Hello – I’m back! Maternity Leave Round 2 has whizzed past in a cloud of nappies and chaos, and I’m starting to pick myself back up and dust my OT brain off. Switching between mum-mode and work-mode is slightly easier this time, as I’d already started to get used to that from my first time returning to work, albeit in a strange Zoom-based world. Given it was the summer of 2020, and everyone else had been online for months, I felt like the new kid at the party, not knowing how to mute myself, virtual meeting etiquette, sharing my screen and so on! However, I’m still finding the usual work-life balance to be elusive.

Having my brain at capacity already has reminded me of attending training years ago, where the trainers mentioned that if parents are stressed (which, despite our best efforts, they usually are during assessments, to a degree), they are functioning in ‘concrete operations’, as per Piaget’s stages of cognitive development. This means they need things WRITTEN DOWN. When working with stressed parents, caregivers or clients, we give so much verbal advice and expect people to remember it, action it and integrate it into their lives.

Recently, I went away with my family and spent a large chunk of time telling my 3-year-old not to lick surfaces of trains/ trams/ bollards – it took me until the airport on the way home to figure out she needed some more oral input. It’s literally my job to give this sort of advice, and yet, in the moment, I couldn’t access that part of my brain. I could have done with someone to prompt me to use my sensory knowledge. 

So this is a reminder to myself, and to you if you need it: take time to understand how each client needs information presented and expect that it may need to be repeated. Emails, post-it notes, reports, WhatsApp messages, visuals pinned to the fridge, voice notes – whatever! Individualising how we give advice makes a difference, and expecting that it may need repeating several times can support more successful interventions.

Thoughts From a Therapist is a regular series written by Advanced SI Practitioner Anna Willis about something that piqued her professional interest or inspired her in some way over the last month. Anna, an occupational therapist and owner of Active Play Therapies, has over ten years of experience working with children and adults with a range of learning disabilities and autism.