What is Choice and Control?
Supporting children to make choices and have some control in making decisions is a big part of helping them to grow as individuals. It is incredibly effective for building self-efficacy, promoting a sense of identity, and fostering trust. Choice and control empower a child to learn the skills necessary to navigate their worlds and have a positive impact on both cognitive and moral development.
What are the benefits?
Providing your child opportunities for choice and control in their daily lives helps develop a mutual respect which sets the foundation for long term relationships. It allows your child to develop problem solving skills and a sense of autonomy. As humans, we have an inane need for control, and we can capitalise on this by providing options that are appropriate for the situation. It helps a child to see consequences of choice and invites cooperation. By including your child in the process, you can help them see solutions and have a sense of achievement as they complete self-directed tasks.
Important things to remember:
· It is important that when offering choice, that we should only give options that we can agree to. If you ask your child, ‘What do you want to do today?’ and they respond with ‘Go to Disneyland’; this may not be an option that you can agree to.
· With smaller children, providing just two options is a good start. Providing more than this can overwhelm them due to their cognitive development. For example: “We are going to the park today. Would you like to go to the big swing park or the one with the lake?”
· It is okay to remind your child that if they don’t want to, or can’t make a choice in a timely manner, you will need to make the choice for them. Give them a chance to respond, but it is okay to step in if they are struggling with the process.
Using Choice and Control in everyday life
Building choice and control into everyday life can help your child realise that this an ongoing role that they can play in their own lives. There are lots of opportunities throughout a child’s day that allow them to make choices.
· Do you want to eat/shower/brush your teeth now, or in five minutes?
· Do you want vegemite or honey on your toast this morning?
· Ask them if they want to set the table or clear the plates.
· Encourage them to choose which book they want to read or have you read to them!
· Clothing choice can be a real battle for some children. Where possible, give them as much autonomy on this as possible to help develop their sense of identity. However, for particular occasions, it is great if you can put out two options and ask them to choose which they would prefer.
· Help your child problem solve by giving them opportunities to work out solutions without you taking control. This can be helpful in sibling disputes, where you can guide them to reach a goal. For example, ‘You both want to play with the toy right now. How could we find a solution so we don’t need to keep fighting about it?’. When you are intentional about letting your child solve their own problems, they begin to learn the effects their choices have on their life.
How can we use Choice and Control in medical situations?
Using choice and control in medical settings can be incredibly beneficial to help your child feel more secure and prepared for medical procedures. When we think about being put into medical situations, a lot of a child’s control is taken away. They may have to sit or lie still. Or be going through a painful procedure. Or be examined. Or just engage with a lot of unfamiliar people. Providing choice in these situations can help the child navigate their experience with more positivity and sense of control.
Sometimes there is a task that needs to be done and there is not an opportunity for choice around a particular medical requirement (eg needle, blood test, operation, imaging). We need to be careful that we only offer choice around the things that the child CAN control. For instance: ‘We need to have a blood test today. Would you like to sit on my lap or by yourself and I can hold your hand? Or, ‘We need to have a blood test today. Would you like to get an ice-cream when we are finished, or would you like to go to the park?’
We can help a child develop their coping skills by modelling and offering choice around ways to manage procedures. This might include asking them whether they would like to engage in a game or watch during a procedure. It could be providing options around comfort positioning or which song they would like you to sing to them. Giving options gives a voice to your child when they are in a position of vulnerability.
A Child Life Therapist can also help you develop a plan with your child, incorporating their options for choice during their specific medical experience. While providing choice is great for children of all ages and situations, it becomes increasingly important and beneficial in a medical setting where there can be a real or perceived sense of loss of control. It is amazing the difference a few simple options can make to empower your child and support their medical experience.
Kate Strickland has a background in Occupational Therapy and Education and has been a Child Life Therapist working with infants, children and young people in the cardiac space for many years at the Royal Children’s Hospital. Seeing the gap in service provision pre and post hospital, she started the organisation Healing Hearts Beyond to provide a community-based Child Life Therapy service to support infants and children along with their families in managing the stresses associated with procedures, hospitalisations and medical trauma.
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