Background:
Children who resist or disengage during therapy are often labelled as “non-compliant,” reflecting outdated behaviourist interpretations. Neurodiversity-affirming practice reframes these moments as meaningful communication about emotional safety, autonomy, or sensory needs. This presentation explores how paediatric occupational therapists can move beyond behaviourist interpretations to embrace a relational, regulation-based understanding of participation.

Method / Implementation:
Drawing on contemporary neurodiversity affirming literature and case reflections from paediatric and school-based contexts, this session demonstrates practical strategies for co-regulation, shared control, and collaborative goal-setting. It outlines language, mindset, and environmental adjustments that foster connection and reduce distress-driven behaviours.

Reframing “resistance” as a signal of unmet sensory, emotional, or relational needs supports deeper participation and more sustainable outcomes. When therapy emphasises safety, trust, and autonomy, children are more likely to engage meaningfully and generalise skills beyond the therapy setting. Practical strategies will be discussed for translating these principles into therapy planning, parent coaching, and school-based practice.

Implications for Practice:
By reflecting on the shifts required to adopt a truly affirming stance, occupational therapists can move from seeking compliance toward fostering connection and trust. Challenging traditional expectations of performance and participation enables therapists to better support neurodivergent children’s nervous system needs and sense of agency. Integrating principles of relational safety and co-regulation allows OTs to move beyond performance-based outcomes, embracing approaches that honour each child’s autonomy, regulation, and capacity for choice.

Introduction & Objectives:
This case study explores a flexible, integrated model of service delivery that combines parent coaching with direct child therapy. The objective is to demonstrate how these approaches can be combined and adapted to meet the evolving needs of families. The model aims to balance therapeutic effectiveness with family capacity, shifting power back to the parent while respecting their readiness and expectations.

Methods:
This case study follows a family with two children diagnosed with Autism and a single parent experiencing mental health and medical concerns. The service model adapted over time, blending capacity-building approaches with traditional 1:1 therapy. Decisions regarding method selection were guided by family goals, readiness for engagement, and contextual factors such as school involvement and parent availability.

Results:
The integrated approach allowed for responsiveness to shifting family priorities. Parent coaching was effective in building confidence and skills when the parent was ready to engage, while direct therapy supported progress when coaching was not feasible. Barriers included parental expectations for therapist-led intervention and limited capacity for active participation. Strategies to meet the parent where they were—while gently shifting power back to them—were key to sustaining engagement.

Conclusions:
A flexible, family-centred model that integrates coaching and direct therapy can better meet diverse and changing needs. Recognising and responding to parental readiness, while maintaining a strengths-based approach, supports both therapeutic outcomes and long-term capacity building.

Background: Children's occupations can include daily routines, family customs, learning, play, sport, social participation, community and cultural activities. Aboriginal and Torres Strait Islander children experience high rates of middle ear disease (otitis media [OM]) and associated conductive hearing loss (CHL), more so for children living in remote and rural communities. OM and CHL can have impacts on children’s communication, development, and occupational participation. Families seeking support may experience barriers accessing culturally responsive allied health services such as occupational therapy. Implementation: With the support and guidance of Aboriginal and Torres Strait Islander leadership, families and local partners, an existing family-centred consultation approach that had been researched in an urban setting was piloted in the rural and remote health clinic context. Adaptations, resources and processes were developed using a plan-do-study-act framework. The family-centred ‘yarn and play’ approach has now been embedded into routine occupational therapy and speech pathology practice. Discussion: Key features of the family-centred ‘yarn and play’ approach will be unpacked, including how it aims to strengthen connections and collaboration between the clinician, child and family. How it facilitates shared understanding of the child’s occupational participation and impacts of hearing loss, along with the development of a collaborative care plan will be described. Future research plans will be outlined, including further evaluation of the approach using culturally appropriate methodologies and partnerships. Conclusion: The family-centred ‘yarn and play’ approach shows promise in supporting stronger connections, collaboration and shared understanding for occupational therapists working with Aboriginal and Torres Strait Islander children and families.

Introduction / Background:
At the Victorian Early Assessment Clinic, our transdisciplinary team (including occupational therapists, psychologists, and a speech pathologist) works with families of toddlers referred for possible autism (and global developmental delay). We recognise that the first assessment experience can have a lasting impact, so our focus is on making the process positive and affirming for both children and their families.

Method / Implementation:
Neurodiversity-affirming principles are woven through every stage of our work, from the first phone call to feedback and follow-up. We adapt the environment to support regulation, respond to each child’s unique communication style, and interpret results through a strengths-based lens. Families are active participants throughout the process, with space for reflection and discussion.

Discussion / Outcomes:
Families tell us they leave with a stronger understanding of their child’s differences and abilities. Ongoing team reflection and peer supervision have also strengthened our consistency in using affirming language and setting shared goals.

Conclusion:
Taking a neurodiversity-affirming approach to early assessment builds trust and connection. When we centre the child and their family experience, we move beyond identifying challenges - towards understanding, inclusion, and meaningful support for each child’s developmental journey.