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Therapeutic Interaction and the Management of Challenge during the Beginning Minutes of Sensory Integration Treatment

In sensory integration treatment, the child and therapist manage challenging tasks in an interdependent process of action and response. This descriptive and relational study examined patterns of child-therapist action and interaction during the management of challenge in videotaped segments of the early minutes of treatment. Two dimensions emerged from these patterns: playfulness and task-orientation. Observer therapist judges perceived that a match between the task challenge and the child's ability was achieved when the child was working hard, showing initiative, and obviously enjoying the process. Simultaneously, the therapist was providing positive support, but not directly intervening to manipulate the child or the task. The validity of the measurement of challenge management is discussed.