Play-based therapy can take many forms, from structured games and guided play to fully child-led sessions. But no matter the approach, one of the most common (and sometimes most challenging) moments we face is when a child runs away from an activity, turns their back, or simply seems to “check out.”
It can feel like progress has come to a halt. But what if those moments of avoidance are actually moments of communication? What if a child’s disengagement is their body’s way of telling us something important about stress, sensory needs, or emotional state?
In this insightful conversation from the Play Conference, pediatric occupational therapist Katie Zelinski, founder of The Well-Balanced OT, explores how to understand and respond to these moments using a bottom-up, regulation-first approach. With over a decade of experience in pediatric practice and a passion for mentorship, Katie shares insights on understanding these signals and supporting children in a sensitive, regulation-first way.
Why do some children withdraw?
Why do we sometimes see a child disconnect or remove themselves from an activity? There are many possible reasons and often, it’s not about “noncompliance” or “disinterest.” It’s about what their body is trying to tell us.
- The child may simply need a break
Sometimes we ask children to do really hard things – to focus, play, communicate, and connect all at once. That’s a lot for a little body and brain to manage. Sometimes, they just need a break.
Children don’t always recognize or understand the signals their body sends when they’re tired, stressed, or overwhelmed. So, walking away might be their way of saying, “I need a moment.” When this happens, our job is to observe rather than react – to notice what their body is communicating when their words can’t.
- The child may simply be “done”
Sometimes, the reason for disengagement is simple – the child is just done for that moment. Their body or mind has reached its limit, even if the activity itself isn’t particularly demanding.
Before a child walks away or refuses, there are often subtle cues that tell us it’s coming. This could be a shift in facial expression, slower movement, quieter tone, or less eye contact. These small changes often communicate more than words.
Being attuned to these cues helps us respond with sensitivity rather than frustration. It’s not about pushing them to continue but recognizing when their nervous system is saying, “I’ve had enough.” Observation becomes one of our most powerful tools – helping us learn the child’s unique signals so we can support rest, recovery, and re-engagement when they’re ready.
- The environment may not be supporting their needs
There is research that up to 95% of autistic individuals show sensory processing differences. Of course, not all children with autism experience these differences, and not all children with sensory processing differences are autistic but it’s a reminder that the environment can have a huge impact on engagement.
Let’s think through some sensory systems that might be influencing a child’s response:
- Visual: Is the room visually busy or filled with bright colors? Is the lighting harsh, or are there too many toys or materials out at once? On the flip side, if a child is seeking visual input (drawn to movement, light, or color) we can use that to capture attention and support engagement.
- Auditory: Background noises we tune out like ticking clocks, cars outside, or other children talking, can be overwhelming for a child with auditory sensitivity. If there’s a sound they enjoy or find calming, we can intentionally bring that into our session.
- Tactile: Some children are highly sensitive to touch. The texture of play materials, proximity to others, or even a therapist sitting too close might feel uncomfortable. Being aware of these reactions helps us create a sense of safety.
- Postural stability: While not sensory in the same way, postural control plays a big role in engagement. A child with a weak core may find it difficult to stay seated or balanced, especially on unstable surfaces like a therapy ball. Providing extra physical support helps free up their energy for interaction rather than balance.
So much of our work depends on reading the cues a child’s body gives us especially when those cues speak louder than their words.
- The task may not be just right for the child in that moment
Even if they previously were able to complete a task, they may have been in a different state then they are now. They may have been more regulated before, and now are feeling stressed or overwhelmed so will not be able to engage in the same way or at all.
- The task may be too easy or too hard
If the activity is too hard, too easy, or not interesting to the child, engagement naturally drops. When a child has a say in what they’re doing, they’re often far more invested. That’s where a child-led approach shines as it gives us insight into what’s motivating them, and helps build genuine connection through shared joy and curiosity.
- Are you as the therapist being too much or too little?
We also have to look at ourselves. Sometimes, the difference between connection and disconnection comes down to our own energy. Are we coming in too strong or not offering enough support? Are we matching their pace or overwhelming them with ours?
How we position ourselves, physically, emotionally, and energetically, can either help regulate a child or tip them further off balance. Awareness of our own presence is just as important as awareness of theirs.
- The child’s arousal level
A child’s ability to engage is closely tied to their arousal level – how alert or calm their nervous system is in the moment.
- Low arousal state: The child might seem slow to respond, quiet, or unaware of what’s happening around them. They may not engage simply because they don’t even notice the invitation.
- Low arousal but seeking: Some children move constantly or touch everything, they are trying to move their body to increase their arousal. They are sensory seekers. While this can look like “inattention,” it’s often regulation in action.
- Optimal arousal falls right in the middle of the spectrum: This is the sweet spot for learning and interaction. A child in this state is calm, alert, and open to connection.
- High arousal state: Here, the child may be anxious, overstimulated, or defensive. When a child’s nervous system is in this state, engagement becomes almost impossible as their brain is focused on safety, not learnin
On either end of the spectrum – too low or too high – we’ll see lower engagement. Our role is to help guide them back toward that balanced middle zone where connection and learning can truly happen.
True engagement doesn’t come from compliance, it comes from connection. When we slow down, observe, and adapt to what a child’s body is telling us, we can create the conditions for focus, joy, and genuine participation.
Want to learn strategies to turn these avoidance moments into genuine engagement? Check out Part 2: How to Maximize Engagement in Therapy
This is just a glimpse: get the full interview plus others from leading pediatric therapists inside the Play Conference
About Katie Zelinski
Katie is a pediatric Occupational Therapist specializing in sensory processing and regulation. She is founder of The Well-Balanced OT, an online platform offering mentorship, education and resources to help therapists and parents build their confidence and knowledge.
Katie’s Website: https://thewellbalancedot.com/