In my (former) work as a school-based occupational therapist, I was saddened daily at the lack of self-advocacy in the majority of the children I was treating. I provide the following as a (fictionalized but typical) scenario where I help teach self-advocacy.
The background information: Sam is 6 years old and in first grade. He spent two months in the NICU due to prematurity and gastrointestinal issues. He has mild motor developmental delays. He is small and adorable, and everyone feels protective of him. His parents, teachers, and peers are always quick to do things for him. He is cognitively intact, although his executive functions have been somewhat blunted through his early learned helplessness, the passivity that accompanies it, and the compensation by people in his environments. He is uncertain of his own abilities. He receives OT once a week through the school system.
Scenario: Sam is sitting at the table. I hand him a piece of paper and tell him to “sign in” (which he does every week). I deliberately turn away and start rummaging through things, clearly busy. After about 30 seconds I turn around and he is still sitting there, and hasn’t signed in.
“Sam, why didn’t you sign in?” I ask.
“I didn’t have a pencil.”
“Oh!” I say in over-exaggerated surprise. I dramatically retrieve a pencil for him “Next time, please tell me right away that you need a pencil!”
We move on.
Next week, I repeat the scenario. I hand him his paper, tell him to sign in, and start to turn away.
This time, he instantly says “I need a pencil!”
I smile and super happily say “Oh! I forgot! Thanks so much for asking! Here you go!”
We continue to work on similar examples each week. Often I am distracted or make lots of mistakes! Luckily, he helps me stay on track by letting me know what he needs.
Sam, like many consumers, was unaware of his power to ask for what he needs. With guidance and education, he is learning how to be a self-advocate.