In this episode, we dive deep into pediatric mental health with Nan Arkwright, a renowned Pediatric Occupational Therapist and author. Nan talks about her extensive career supporting children’s mental health and her new journey as an author. With over 50 years of experience, she shares valuable insights and practical tips for parents and caregivers. Discover how her 17 children’s books, available at A Hop, Skip, and A Jump Ahead, are transforming the way families approach emotional regulation and everyday challenges. Join us for an enlightening discussion that promises to equip you with the tools to better support the young minds in your life.
—
Watch the episode here
Listen to the podcast here
Nan Arkwright – Pediatric Occupational Therapist And Author
Nan Arkwright is a pediatric occupational therapist and writer who supports families in regulating emotions and solving everyday problems that come up at home and school. With 50 years of supporting children’s mental health, Nan is launching her writing career with an explosion of children’s mental health books. For each of her seventeen books, she has created videos, fun activities for kids, and valuable resources for adults working with children. Those are all available for free on her website, AHopSkipAndAJumpAhead.com.
‐‐‐
Nan, welcome. It’s great to see you.
Thank you. It’s nice to see you too. Thanks for hosting this.
Thank you for joining us. I’m hoping you can start us off by telling us a little bit about how you got into the work you do and what drives your passion for it.
The Journey Into Occupational Therapy
You mentioned to me that you’ve got more than 50 years of doing the work that you’re doing. It’s the same with me. I started off as a teacher and then I raised my own children, and then I decided to become an occupational therapist. I’ve known since I was in third grade that I wanted to work with children. I have been a pediatric occupational therapist for 28 years, and I have my own practice.
When I first started as an occupational therapist, kids needed a little boost over the hump to be able to be successful in the classrooms, but things have changed a lot over the years. My practice now is supporting them in mental health because they are struggling. They were already having some difficulties before the pandemic, but since the pandemic, I still hear when I get a new referral from a family, “My child is a COVID child,” and you are COVID parents. Everyone is stressed. Teachers are stressed.
Kids are living in a different environment. They need so much more support for their mental health. That’s a big reason why I started writing the books that I’ve written. It’s to try to support not just the kids I’m working with, but other kids as far as stretches I can be with my work to help them know, “You are not alone with these challenges. Here are some tips for adults. Here are some fun ways for kids to learn about it through story.”
Kids today live in a different environment and need much more mental health support. Share on XI like what you mentioned there. In the books, it’s as much instruction for the parents as it is for the kids. You’re offering support for parents and helping their own children navigate these complicated times.
On my website, for every book, I have videos that people working with children can look at to help them expand a little bit on what they might want to talk about with their child. Also, there are helpful tools for parents that I’ve written up for each of the books, and also activities for kids that are meant to reinforce the messages from the books.
I’m trying to provide as many tools as I can for the adults working with children because that’s why they’re calling me. They don’t know what to do. Times are complicated. Things are difficult. Parents don’t have the experience to know what to do. It’s very challenging for them to know. The kids are reacting to what’s going on around them, and they don’t know what to do. It’s hard for the kids and the adults working with the children.
For example, what was one of the first issues you were writing about in children’s books?
Writing About Hard Things For Kids
One of the hardest things is doing hard things for kids. It’s like, “I don’t want to do it. I don’t want to stop watching TV. I don’t want to start doing something that’s not fun for me because right now, I am having a fun time.” It’s helping kids learn how to stop doing something fun and start doing something that’s not so fun, like getting ready for bed.
I see it so much with the kids I’m working with. They have not had the experience of pushing through to do something hard and learning, “I can have some self-control. I can do these things that I don’t want to do even though it’s not that fun.” Having someone to do that with you and having a way to make it as fun as possible are ways that can help.
The first story I wrote is called Mission: CONTROL! A Big Feelings Adventure! The boy in the story goes into his imagination to try to sort this out because he wants to do what his mom is asking, but it’s hard for him. It’s that transition from, “I’m having fun watching TV. I don’t want to be interrupted from that. I don’t like how it feels when I have to stop doing something fun,” and he works it out with the help of his dog in the story who plays the role of the mom. He realizes, “It doesn’t feel good to have this feeling.”
The kids I work with say the same thing. They’re like, “I don’t like how it feels when I’m having an upset like this. I wish that I had the ability to do it differently.” Parents don’t like how it feels either, but they often don’t know what to do. This is modeling for parents through the dog on how to work through a challenge, and it’s modeling for the children.
I’ve done a whole lot of extra little activities for kids to do with their parents. These are all meant to be tools that they can access at the moment and that kids can be reminded, “I want to be like Joseph, the character in the book. I can do hard things like he can do.” Kids like to feel proud of that and feel like, “I can do this and feel the promise of tomorrow. It could be easier tomorrow. It could be a little bit less difficult for me to do something hard because I practiced it today. I had the support today. I felt good after I did it today, so I want to have that feeling again tomorrow.”
The beginning of the story is real life for Joseph and his mom, and the end of the story is real life for Joseph and his mom. The problem is at the beginning. It all gets worked through in his imagination in the middle, and then at the end, all of the processing of what happened with the mom happens. That’s when the boy in the end is like, “I can do this. I feel like I can do this again.”
In the middle, I often say to kids, “When the thing that’s hard for you to do is expected, skip all that middle part, which is the big upset part, and say, ‘Okay,’ and just do it.” Kids try hard to do that. They understand that idea. They do want to do what their parents are asking them to do and their teacher. It’s just hard. All day long, they’ve been expected to do things that are hard for them.
Here’s one more thing. At the end of the day, they’re exhausted. They need to go to bed. They’re exhausted from dealing with this all day. They need support all day long to help them through these situations and for adults to understand that they are having a hard time with a spelling test. They were having a hard time finding someone to play with on the playground.
Their socks didn’t feel comfortable when they got dressed in the morning. Their favorite lunch wasn’t packed for them that day. They didn’t get to be first in line. All those things happen with kids. For many kids, they’re like, “I’ll move on,” but for many of the kids I’m working with, all of that adds up and it makes it hard. It seems often underappreciated for what a day in the life of the children I work with can be like.
You mentioned that your books, instead of giving people a little nudge to get over something, the books you’re writing and you’ve written are mental health support for these children. What age ranges are you writing these for?
I do read them for older kids, but I adapt a little bit. My target is 4 to 8, hitting that target, but I’ve read the books to 3-year-olds and 12-year-olds. I do it a little bit differently. I like to individualize the story. I don’t just read the book, put it down, and say, “Now we’re done.” I like to say, “Has this ever happened to you? Have you seen this happen to friends? How have you been helpful to others? Have you been like this character? When you get upset, how do you handle it? What does it feel like inside your body?”
One of the series that I’ve written is about a giraffe who gets upset. We talk about, “What does it feel like in your body? What can you do with those feelings?” He’s got other animals in the story, but they’re acting the role of a parent or a teacher to help guide. The main idea of the books in that series is that we as adults can help children. First, we have to be grounded and be able to think, “I’m calm myself. I’ve taken care of myself. I can be there for my child. I can listen to what’s happening in my child’s body, help understand their emotions and understand the behavior that’s resulting from all of that, and help them maybe reframe that.”
It is first connecting with them and helping them know they’ve been seen and heard. Someone is there for them, and there’s not a rush to get to bed or a rush to get out the door. The parent is saying, “I’ve got time for you. You’re important. I’m present. You matter. I’m going to help you through this.” Every single time that that happens, kids can move on and solve their own problems or with some help from adults, depending on the child. That part is the easy part.
Often, it’s a temptation for adults to jump in and say, “Do this.” That’s not what makes the child grow. The child grows from someone being there and helping them understand what’s going on for them emotionally and with their thoughts so that they then can move on and start thinking, “What could I do differently so I get a different outcome that feels better for everyone? How can I grow from it?” That’s the role of the adult to help them move into that stage after they’ve had all of the time to listen to their child and be there for them. It’s easier for the child the next time because they have that experience.
Anytime an adult can relate it to one of the stories in the book like, “Are you feeling like that?” The kids sometimes do not know the words, so they can say, “Do you remember in the story about Seymour or Choco the sea star, or whatever it is? That’s how I’m feeling right now.” That helps adults know too. It gives adults tools like, “What did the mom in the story do to help the child? I could do the same thing.” It’s certainly not a formula.
It’s a template.
A little bit, but it has to be modified for each child. First, center yourself so that you can support your child and be there for your child, and then think, “How can I guide my child to figure out what to do that would feel better so they can grow?”
The Importance Of Parental Support
What’s another, of the books you’ve written, a theme that you’re helping children and parents with?
One of the things that I’ve been seeing causing the most challenge for children is waiting. I do have another series, Mindful Seymour Pauses, and then different themes in that. One of them is waiting in line. It’s waiting in line, but it can be any kind of waiting. I have a lot of resources for adults working with children to help them learn about waiting. Kids from a very early age are handed a device. It’s easy for them to have immediate gratification. Amazon comes the next day or sometimes even the same day. Kids are not having to wait without being entertained.
Even five seconds can feel too long for many of the kids I’m working with. If they’re not immediate, they’re like, “Now what do I do?” To some degree, the waiting is, “I don’t know what to do. “ They don’t have the practice of, “Let’s play I Spy,” or “Let’s do a finger play in my head with my fingers,” or “I can imagine something,” or “I have a toy in my pocket that I can play with.” They’re not sure what to do in that waiting period even though it might be very short. They automatically think, “I need help right now. How can you help me?”
Kids often think, “I need help right now!” Teaching them self-sufficiency and patience is key. Share on XThe challenge for them is so hard. Adults often don’t know how to help them too, which is why I provided all the resources for them and the kids also to make it fun for them to think, “I can do these things.” The idea is not for adults to take care of the waiting by saying, “Let me entertain you. Let’s play I Spy,” for example,” but to say, “Here are some ideas. What do you want to do?”
It may be a variety of interactive games that they can do while they’re waiting, something the child can do on their own, or an opportunity for the child to come up with their own ideas. It is helping them learn in the moment, “Here’s how you wait. Here’s what you think about it. This is how you go about figuring out what to do in this blank time that is difficult.”
One of the things that creates such disruption for parents and children is that they each have such different experiences of those 5 seconds or those 5 minutes. For the parent, the time is flying and for the child, the time is dragging or vice versa.
That’s a great point. It’s true. It can be hard for us as adults to slow down and have an understanding of how long that can feel to a child. They’re busy all the time. They’re involved in sports. They’re involved in music. They’re involved with all these extra things. They’re in daycare after school. Their times are very scheduled for them, so they often don’t have very many experiences of, “What do I do now?” even when it’s free time at home.”
There’s some skill building in these incremental steps for them to be able to get used to the feeling of not having some external guidance for what to do and to build the skill within themselves to tolerate and put off that immediate gratification or find an internal source of gratification and then strengthen that.
That’s exactly well said. That’s it.
Another book, another theme. Do your books get into difficult issues like bullying?
That is a tough one because, before COVID, it was already tough. The kids, I used to teach them how to advocate for themselves, speak up, the tone of voice, the body language, and all of that. It has gotten hard truly since COVID to get even siblings to listen. This is one of the things that comes up a lot in my individual sessions. Kids are saying, “My sister doesn’t listen to me,” or “My brother doesn’t listen to me when I say, ‘Stop.’” The sibling will say, “It’s true. I don’t.”
The kids are learning, “I don’t have a voice. My sibling doesn’t listen to me.” When they go to school and say “Stop” to somebody, and they don’t listen to them either, they’re learning, “Nobody listens to me,” which is not the message anybody wants to give the child. We all want our children to be able to speak up for themselves, express their needs, and have those needs met.
I often work with families to help the parents know how to help each child in the family because what happens in the family often happens at school. If they think it’s okay to not pay attention to somebody at home, then they think they don’t have to pay attention to somebody at school. If they think from home, “It’s important to hear what they’re saying. I might not like what my sibling is saying, but I can still honor the request that they don’t like it.”
I can make an alternative plan with my child and communicate, and then they’re more likely to do that at school. It’s the tools. It’s like, “How do I do this?” That skill building comes from home first, and then kids have the tools to do it at school. That’s also a difficult thing for adults to know how to help their kids with doing that.
All of these skills we’re talking about require a lot of attention from the parents to help them learn how to do these things. It also requires a lot of time and repetition of, “This is what we’re practicing. This is what a family value is for us.” Every family wants their children to be able to do those things. It’s not always easy to have the time, know what to do, and have the patience also to do it over and over again, but that is the way kids learn from doing that. As challenging as it is, that is the way that I try to help adults that I’m working with know how they can do that.
Lots of times, I see the siblings together and then we work it out. Usually, what’s at the root of it is one of them feels like their sibling doesn’t listen to them. They do something that feels uncomfortable to the other person in return, and then that person feels like, “That wasn’t nice. The next time you want something from me, I’m not going to listen to you either.” It goes round and round like that. It becomes easy to see when they talk about it or communicate with each other about it that that’s what’s going on. Each feels hurt but neither knows what to do about it.
When siblings talk and communicate, they realize their hurt feelings. Encourage open communication. Share on XA lot of times, adults don’t know what each person is feeling. They’re dealing with the superficial behavioral part. They’re like, “I’m trying to get to the root of it. How does that feel for you? What would you like instead? What would feel different?” Kids are very responsive to that. They’re not trying to be mean to each other, but they don’t always know what to do about it so they’re often in reaction mode. They’re like, “You did this to me, so I’m doing this back.” They’re protecting themselves.
Promoting Sibling Relationships
Your books provide some templates for how to interrupt that pattern and for the parents to be coaching a whole different response pattern.
I haven’t written any books on that yet, but if I had a book, that would be the goal of it.
As I listen to you, I think about Marshall Rosenberg’s nonviolent communication pattern, which is helping people take full ownership of what they’re experiencing, describing it without blaming and then asking a very simple request that you could either decide if it gets met or not. It’s okay either way. It’s just a request. That would be a wonderful thing to have in that child book format for people. A very simplified, “Let’s understand that what’s happening here is neither one of you is feeling heard and understood. If we can make both of you feel heard and understood, it’ll probably lead to a resolution here.”
Parents do report back that their children are trying to do what we talk about in a session with each other. The parents are always in on the sessions too, so they know how to facilitate and encourage that with their children and say, “You did what you and Nan talked about today. Good for you.” They then start realizing, “That feels good to have that recognition of the efforts I’m putting into it.”
Even the siblings recognize the effort the other one is putting into it and appreciate that. What I’m after is a closer relationship between siblings because that matters for a lifetime to have a sibling who has your back and is there for you. That’s what I think is important about this. I’m trying to build the skills for kids to have that experience.
How many books have you written in total so far?
Seventeen.
You’ve got a couple of different websites up. One of them is A Hop, Skip, and A Jump Ahead.
That’s my business, and that’s the website to go to to access all of the books. On my website, I do have all the books listed. They’re all linked to Amazon if somebody wants to buy a book or more. Also on the website is all the information that I mentioned about the free gifts that go along with each book. In addition, the videos tab shows all the videos that I’ve done. I’ve done a lot with the illustrator for Mission: CONTROL! A Big Feelings Adventure!
He and I also worked on a book. It’s called Tijuana Mañana the Anxious Iguana. The story is about a child who is scared of sight words. It’s one of those things that the child doesn’t feel confident about, needs support, needs more practice, and needs more understanding of how to learn to do the sight words because they’re hard for kids. It’s one of the things that kids react to very strongly about school. They’re like, “I don’t want to practice sight words.” Sight words are words that come up frequently in reading that teachers want the kids to know by sight.
Instead of having to sound it out with phonetics, etc.
Some words don’t even sound out. They’re not phonetic at all. It’s a good idea in terms of, “Let’s move things along and make it easier for kids to read without putting in all the effort,” but it’s hard. These are words like “The.” What do you relate that to? There’s no connection. There’s not a picture of the word. It’s a word that is hard to make any association with to help remember. It’s a memorization, a repetition, and a practice thing.
To practice, like waiting, is hard for the kids I’m working with. They don’t want to practice. There’s nothing fun about it. Adults can make it more fun for children by turning it into games. When I see kids and I mention the word, “Sight words,” and see a reaction of fight or flight from them, I know what I have to do. I have to follow up with, “I have some fun games that we can play.” It’s simple games, like memory games with them or things like that that are easy.
As soon as you put the word, “Game,” on it, they’re all in, and then it’s fun for them. Now the brain is ready to learn because the brain thinks it’s going to be fun and not threatening. The reaction comes from, “I feel threatened by these words because I don’t know them. It’s going to take time for me to practice. You’re going to make me sit here and practice this and I don’t like it. It’s going to be horrible.” The brain is never going to learn under those conditions.
Make learning fun, not threatening. A positive environment helps the brain be ready to learn. Share on XThe point of that story is to help kids know, “It’s your brain protecting you at that moment because it does feel threatening, but in reality, your brain doesn’t need to feel threatened in that situation. Let’s talk about that so that we can use our upstairs brain, which is a phrase coined by Dr. Dan Siegel, to help mediate what the downstairs brain is doing,” which is all the emotional reaction, the protection, and the fight or flight.
The adult can help me be that frontal lobe for the child to say, as I said with my example, “Let’s practice some of your sight words.” Their immediate reaction is, “That’s a threat.” I use my upstairs brain to help connect with the child’s upstairs brain and say, “The plan is for us to do it with a fun game.” Since the downstairs brain hasn’t gotten overly energized, the upstairs brain is still available to say, “Game? Okay.” You can shift things like that.
The story is about how the parent helps the iguana do this. It comes with a journal too. There is a too-honest plan for what he’s going to do when it’s time to practice sight words. There’s a page next to that for the child to write their ideas of what they’ll do when there’s a challenge like that with sight words, but it could be with anything. It doesn’t have to just be sight words.
It’s like, “How are you going to handle something that feels threatening to you? I’m going to be right there to help you with that. Let’s make a plan.” The parent doesn’t have to think of something new every single time and the child doesn’t have to react to something. He or she knows, “You got a plan.” Whenever something is predictable, it’s way easier for kids. That’s the idea of Tijuana.
Strategies For Managing Fight Or Flight
You’re right about the idea that when I go into fight or flight, the only thing I learn is more things to be afraid of and how to quickly shut it down and get out of that situation. I’m not open to learning anything new or creative at the moment. Helping the person drop out of or avoid going full into the fight or flight response is genius in terms of opening them up for the capacity of learning.
You’re exactly right. That’s exactly what happens. Since it happens over and over again, it’s a strong pathway for kids. I’m trying to develop a new pathway to building new skills so that that pathway becomes stronger and the other one falls by the wayside because there has been success after success.
That’s wonderful. I wonder if you could take a breath, get centered, and think about whatever we’ve already talked about, what you’ve mentioned, and what I’ve asked you about. Is there something you want to go back and highlight or something we haven’t even touched on yet in your work that we want to get in here before we move to close this off?
Thank you. It has been a lot of time, effort, and money to get all of this into people’s hands. It’s a passion of mine to help children and families. That’s what they’re looking for. They’re like, “How can you help me have the tools as adults so I can help my children?” Every family cares about their child. Every family wants things to be easier for their child.
My job is to try to help them understand what might be underneath the behaviors that they’re seeing to be able to appreciate what life is like for their child. There’s more empathy on the part of the parents because they understand more about the child. They’re not just seeing the behavior, but understanding what’s underneath. That’s what I’ve tried to do in all the stories. It’s to highlight for the kids, “That’s how I’m feeling too,” so that adults can say, “Are you feeling like this? Is it hard for you to let something go? Is it hard for you to wait? Is it hard for you to be able to do this thing?” They’re acknowledging it.
The point of all the books and the efforts that I’ve put in has been how I can help families be able to navigate this tricky, complicated world that we’re in now in a way that feels good to everyone, helps everyone’s brains grow, and takes a moment out of the busyness of life and spend with the child to help them learn these kinds of skills that we’re talking about. The children are able to build on those so that they begin to have more confidence and a strong sense of who they are and who they want to become and are able to learn also to evaluate, “How did I do?”
I ask that question to kids all the time. I’m like, “When we do this, here’s what I want you to think about.” After they do it, I’m like, “Did you think about that?” Because of the outcome of the thing that I asked them to do, I know that they did think about it, but it gives me a chance to say, “You did think about it.” I do want them to think, “How did I do? What did I do that made this successful?” I’m looking for them to identify, “If I do this, then I am successful.”
Even though it’s hard work to remember it and implement it at the moment, that’s why the side-by-side support helps so much because someone can help guide you through step by step. They can’t go from A to Z. They need someone with them for A, B, C, D, and every letter all the way to Z to help them. Sometimes, it is 26 steps to get there, breaking that down, and for adults to understand that that is a lot of support needed. If that’s what the child needs, we are there as adults to help provide the support that’s needed for them.
All the kids I work with and all the kids I’ve ever met want to be successful and want to do what adults are asking them to do. They want to thrive, grow, and learn. They all want to do what the teacher’s asking them to do. They just need the support to be able to do it. Now more than ever, more kids are needing more support in the classroom and outside of the classroom or in the home and outside the home. Everywhere, they need more support.
Our lives are busy. It’s hard to take a moment out of time, truly pause, and take a deep breath. As you said, “Center yourself for a minute. Let’s work through this. Think for a minute.” It’s a great question you asked because it’s different than, “Do you have any other words to say to our audience?” It’s a different approach, and it made a difference in how I heard it and how I responded.
As you’re pointing out, often, the children go through a whole series of steps within them to accomplish something, and they’re not aware of that. If you point out to them, “You did think this through. You did remember what this character did. You did come up with your own solution.” It brings their awareness to that. It helps lock it in for them and put that awareness of where the control is, which most of the time is within them.
Kids go through many steps to achieve something. Pointing out their progress helps them recognize their own success. Share on XThey don’t know how to access that, but it is within them. It’s a great way of saying that.
One more time, please let us have the website you would like to have people go to.
It’s AHopSkipAndAJumpAhead.com. Another one is TheBadgesOfPower.com. That website only has information about my first book Mission: CONTROL! A Big Feelings Adventure! The one that has all seventeen books is AHopSkipAndAJumpAhead.com.
Thank you so much for being willing to share with us. It’s been a pleasure. I look forward to getting the word out there.
Thank you so much. I appreciated having the opportunity.
You’re very welcome. Take care.
‐‐‐
Nan Arkwright is a pediatric occupational therapist and writer who supports families in regulating emotions and solving everyday problems that come up at home and school. With 50 years of supporting children’s mental health, Nan is launching her writing career with an explosion of children’s mental health books. For each of her seventeen books, she has created videos, fun activities for kids, and valuable resources for adults working with children. Those are all available for free on her website, AHopSkipAndAJumpAhead.com.
Important Links
- A Hop Skip And A Jump A head
- The Badges Of Power
- Mission: CONTROL! A Big Feelings Adventure!
- Tijuana Mañana the Anxious Iguana
About Nan Arkwrigh
Nan Arkwright is a pediatric occupational therapist and writer who supports families in regulating emotions and solving everyday problems that come up at home and school.
With 50 years of supporting children’s mental health, Nan is launching her writing career with an explosion of children’s mental health books. For each of her 17 books, she has created videos, fun activities for kids, and valuable resources for adults working with children – all available for free on her website, www.AHopSkipandaJumpAhead.com.
