Presumed Competence – College Style
I believe so strongly in families and medical professionals working together that I do my part to make those connections better.
Most recently Aidan and I visited a physical therapy class. They were learning how to administer a motor control test. Scoring a test can be very difficult. They have to take in to account how much the client is able to do alone or what kind of assistance he needs. Without a participant who actually has motor control challenges, tuning in to the nuances of these tests can be very difficult.
Enter Aidan. These students now have a subject they can physically get their hands on who does not have typical motor function.
We’ve been to this class for four years now. It’s exciting for me to see how much Aidan has improved. But this year I was most impressed with the PT students. After interacting with this group of students, I have great hope about the level of compassion and professionalism they will bring to the workforce. Without exception, each student said hello and introduced themselves to Aidan directly. Seems like such a small dignity to give, but there are plenty of people who speak to me instead.
They then asked Aidan to perform a task. “I need you to stand up and take three steps.” Now, Aidan can’t do that all by himself. He needs to hold someone’s hands, but I didn’t tell the students that and they didn’t ask. They gave Aidan plenty of time to process instructions and presumed competence on Aidan’s part, as in, I’m going to believe he can do it unless I have a reason to believe otherwise. The PTs were very patient and tried out different strategies to get him moving. They also played to Aidan’s strengths. Aidan wanted to leave the classroom. He’s quite opinionated these days. So, they let him leave and take his steps outside in the common room. Then he wanted to climb stairs, so the students quickly found the test questions that pertained to climbing stairs.
Toward the end of the afternoon, Aidan did a lot of dramatic sighing because he was so tired. I giggled in the corner while the students worked hard to motivate him. If you want my kid to move, you better give him a good reason. This gave them the opportunity to differentiate between what someone can’t do and what someone is refusing to do.
When we went to Yale this fall to speak to the pediatric nursing students, I was very excited to see that we were in a room where Aidan could drive around. These students also presumed competence, believing that Aidan wouldn’t drive into them. While Aidan didn’t take anyone’s foot out, I hope, he spent quite a bit of time driving into empty tables and chairs. It gives good reason to pause and ask why. Was he a lousy driver after all? They quickly caught on, mostly because of Aidan’s infectious giggle, that he was just having fun. He’s a twelve year old boy and crashing makes cool noises and gives some great physical feedback, and apparently I’m an incredibly permissive mother.
Aidan’s actions deserve our thoughtful reflection instead of a quick fix-it reaction. With all of his adaptive equipment and physical challenges, sometimes Aidan’s behavior is really quite typical.