When Erin Anderson, OTR/L, works with a child who has trouble sitting still or acts out at home or in school, she often pulls out an interactive card game called Let’s Choose. The game makes learning social skills fun, she says.
“We might use Let’s Choose to demonstrate a specific behavior or as an overall teaching tool to show children how their behaviors affect others,” says Anderson, who is in private practice in Chicago. “As occupational therapists, our job is to help children have the occupation of being students. When we work with these kids, we often try and help them control their bodies and help them to be able to learn and participate in peer relationships. This helps them to be successful participants in the classroom, at recess, in the lunchroom, as well as at home.”
Let’s Choose is the brain child of a teacher, Lisa Maylee, MEd, and Chicago-based speech-language pathologist, Stacey Buck, MA. It was the late 1990s, when Maylee and Buck attended a conference featuring a speaker who said children and adults should not be following societal rules for the sake of following the rules; rather, they need to focus on behavioral choices they make and the consequences that follow. “When I came back to the classroom with Stacey, we thought about how we could get children to start building these ideas in their heads,” Maylee says. “That’s why we developed the game.”
Let’s Choose at Home and Let’s Choose at School (for groups) were released earlier this year. These are takeoffs from the duo’s original version, Choice and Consequence. The latest version is engaging for children, yet visually simple, so the cards are not too distracting for children with autism, or attention or visual learning issues, according to Buck.
Children playing the card game match positive and negative choices with the appropriate consequences. OTs can play the game with a child individually or in a group, and choose a game-show format, role-playing, a memory game or story starters.
Children match each choice to one or a variety of consequences. For example, the choice of putting things where they belong might earn an allowance or giving a friend a high-five might make your friends happy. Let’s Choose provides children with feedback about their responses to a variety of situations, which is especially important to children with sensory processing disorder, according to Anderson. “The game also allows children to see how their behaviors directly affect others,” Anderson says.
Anderson likes to promote the positive and instill in clients that consequences aren’t always negative. A consequence is just a result, she says. And positive consequences result in what children seek from behaviors: attention. “We show them that instead of throwing the game pieces after losing the game, if they use their words and ask to play again, they get so many more responses from that behavior,” she says.
The game promotes high-level thinking, offering solutions that might never have occurred to children, according to Anderson. “There also blank cards to fill in your own choices and consequences, so that can be child-specific,” she says.
Renee E. Keny, OTR/L, MA, a school-based OT in Northbrook, Ill, was introduced to Let’s Choose by a speech pathologist. “I like this game because it’s multisensory,” Keny says.She says Let’s Choose at School includes magnetic cards that therapists can post on a magnet board at the front of the room. To incorporate a fun motor component, children playing hop or skip to the board, for example. They get help from their friends, so they use listening skills. Kids use their visual-motor skills when they go up to the board, scan for the right cards and move the cards into appropriate spaces. Keny also asks the children to think of sensory strategies to emphasize positive choices in school.
“For instance, if I choose the card that says ‘I’m not listening,’” Keny says. “As an OT, I would want them to think, OK, why am I not listening? Do I need a break right now? Do I need to chew some gum to get focused? Do I need to go for a quick walk? Do I need to be in a quiet space for a few minutes so that I can participate in the activity afterwards? I think it kind of gets them to think about: Why am I choosing this instead of this? And what can I do to make a better choice? What does my body need?”
Anderson, who uses the game while working with children ages 4 through 10, says her patients love it. “They’re really engaged, and they think it’s fun,” she says.Keny says while the 7- and 8-year-olds were engaged, 12- and 13-year-olds were not. “It was a fun gameshow format with a toy microphone, so I think this grabbed [the 7- and 8-year-olds’] attention. It lasted 15 or 20 minutes, so it was perfect, as far as timing,” she says.
It wasn’t quite as popular with the older students. They were bored by the game, Keny says. OTs could use the game with young teens as more of a conversation starter — to prompt them to identify strategies they can use to become a more effective participant in the academic environment, Keny suggests.
While it seems simple to implement, OTs planning to use the game in practice should become familiar with it before playing, according to Anderson. “You have to see how you’d want to approach it with your clients, so there is a little preparation time.”
OTs using Let’s Choose in practice for individual patients might want to choose the home version, which sells for $21.50. If they work in groups, the school version, at $32.50, is better suited. The games come with cards (magnetic cards with the school version), a toy microphone and a dry erase marker. OTs need to add the dry erase board, and some say they use a cookie sheet to display the magnetic cards.
“Let’s Choose is really nice for traveling therapists because it’s small and portable. All you need is a small chalk board, erase board or cookie sheet. That’s important when our trunks are full of materials,” Anderson says.
(Source: Today in OT)
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