Before We Add Another Strategy, Have We Examined the Demand

A child begins to unravel halfway through a classroom task.

They leave the table, stop responding to instructions, become silly, refuse to continue or seek increasing amounts of adult support.

Our clinical thinking can quickly move towards intervention.

- Would movement help?
- Do they need a sensory strategy?
- Should we provide a visual?
- Reduce the language?
- Offer co-regulation?

All reasonable possibilities.  But before we add another strategy, I think there is another question worth asking:

What exactly are we asking this child to manage right now?

Consider a child returning to class after lunch.

They need to leave the playground, separate from peers, enter a noisy classroom, locate their belongings, organise equipment, listen to instructions, remember several steps, inhibit competing distractions, sit with the group and begin a written task.

Individually, the child may have demonstrated each of those skills. But participation does not occur in isolated skill units.

The child has to manage the combined occupational demand, in a particular environment, at a particular time, with whatever capacity they have available in that moment.

That distinction matters.

Recent Australian research examining occupational therapists’ work with children with self-regulation needs describes practice as requiring person-centredness, collaboration, coaching and adaptability, with therapists balancing the child’s needs with the systems around them in order to support meaningful occupational engagement.

Similarly, research examining environmental approaches to participation in schools highlights the value of matching task requirements and school environments with the individual child’s needs, rather than locating the problem solely within the child.

That is very much an occupational therapy question.

Not only: “What is happening in the child?”

but: “What is happening between the child, the occupation and the environment?”

Perhaps the child has the handwriting skill, but the task also requires sustained attention, working memory, inhibition, postural endurance, sensory filtering and tolerance of uncertainty.

Perhaps they can manage the transition, but not when it comes immediately after a socially difficult playground experience.

Perhaps they can complete the self-care sequence independently, but not when pain, fatigue, hunger or heightened arousal are already reducing available capacity.

The external environment matters: noise, people, space, predictability, expectations, task complexity and timing.

The internal environment matters too: fatigue, hunger, discomfort, emotions, anxiety, interoceptive state, sensory state and physiological arousal.

Then we add the occupation.

Sometimes the mismatch is not that the child lacks the skill.

The current demand exceeds the capacity available to access that skill. This is where I believe readiness becomes clinically useful. Readiness is not synonymous with calmness or compliance.

It asks whether the child currently has sufficient access to the resources required for meaningful participation.

And recent OT literature gives us good reason to keep bringing the conversation back to participation. A 2026 scoping review examining OT, self-regulation and primary schools found that self-regulation was often poorly operationalised in relation to students’ school-related occupational performance and engagement. The authors called for stronger occupational conceptualisation of self-regulation.

That is important because our goal is not simply to produce a “regulated child”.

Our goal is occupational participation.

So when a child begins to struggle, perhaps our first response should not always be to add something.

It may be to analyse; Is the task too long?  Are there too many steps?  Has the cognitive load quietly increased?  Is the pace too fast?  Is the environment adding unnecessary demand?  Are we expecting independent performance before enough capacity has returned?  Could the task be graded without losing its purpose?  Or is the child actually ready, and are we continuing to scaffold something they could now manage independently?

This kind of reasoning also protects us from reducing “regulation” to a collection of techniques. That is particularly important because OT literature continues to use a number of overlapping constructs, including self-regulation, executive function, emotion regulation and interoception, with inconsistent definitions and measures.

The clinical key point needs to remain occupation.

The next time a child struggles with something you know they can do, I would challenge you to pause before asking: “Which strategy should I use?”

Ask instead: “What is this occupation demanding from this child right now?”

Then examine the child.

- Examine the internal and external environments.
- Examine the timing.
- Examine your own expectations.

And ask yourself: “Does this child currently have enough capacity to access the skills this occupation requires?”

Sometimes the answer will be to stabilise.
Sometimes it will be to scaffold.
Sometimes we will need to grade the occupation or change the environment.
Sometimes it will be time to teach.
And sometimes our clinical reasoning should tell us to step back.

That is not lowering expectations. It means matching demand to capacity so participation remains possible, then increasing demand as capacity grows.

Want to explore this further?

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Before changing the child, examine the demand.
Before adding another strategy, consider readiness.
Participation is always the goal.