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Empathy, Remorse, and Judgment: Activities of Daily Living beyond dressing and feeding! - December 2009

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Empathy, Remorse, and Judgment: Activities of Daily Living beyond dressing and feeding!

By: Susan N. Schriber Orloff, OTR/L

What makes us social is what makes us human. What makes us healthy humans goes way beyond good nutrition and the absence of illness. It cannot be stated enough that more than any other species, we are social beings as dependent upon connections with other as we are on food and shelter.

We not only need to be cared about, we need to care for others. Those “invisible lines of connection” (Rabbi Lawrence Kushner) are what keeps our mental and spiritual beings intact.

Much has been written about the power of spirituality, and it is not for this article. But anecdotal reports speak to its healing and nurturing benefits. I am not speaking of a particular kind of spirituality, worship or practice; just the belief that we are somehow part of a greater whole and that we belong.

That belonging allows us to develop empathy for others. To read “between the lines”, to understand the unspoken, to project the feelings of others onto ourselves and to do more than hear words, to also listen to the tone of voice and the facial expressions accompanying them.

Good social skills allow us to say we are sorry and mean it. A meaningful “I’m sorry” means “I will really make every effort not to do that again”, “I did not mean to hurt you”. That is remorse.

Knowing when we are about to slip into destructive patterns or repeat a mistake and knowing when to stop ourselves, that is judgment.

Some (read some not all) children need to be taught these qualities. Perhaps their life situations do not afford them the opportunities to practice and learn them, maybe there might be developmental issues delaying the development of these skills, but whatever the reason, some children need help with these necessary life skills.

Occupational therapy has it historical roots in the teaching of activities of daily living, (ADL’s).

Beyond dressing, feeding, and hygiene, getting along with others is an essential ADL.

The child who feels constantly left out cannot settle down in class to learn easily.

The child in a constant power play with parents cannot develop a sense of safety at home.

Children with skewed sensory processing may be unable to organize the world around them and choose to withdraw rather than “sort it out”.

Many children who are bullied may never learn to be assertive without being aggressive.

Many children who are the bullies may never learn empathy and the art of compromise.

A skewed sensory/emotional system can impair judgment impeding the developmental of healthy life patterns.

An impaired sensory system impacts social skills and emotional well-being.

Analogous to the root system of tree, our sensory system provides the foundation upon which other systems (branches) evolve.

Developing productive and healthy living environments is a major general goal of occupational therapy treatment. The following are basic sensory/social-emotional ADL’s to help to meet this objective. (adapted from Smart Recovery: Self-management and Recovery Training Resources)
  • SELF-ACCEPTANCE accept yourself, strive for your personal best, and do not measure yourself against others.
  • RISK-TAKING do not be afraid of being “wrong”, take risks and have a spirit of adventure in trying to do something you have never done before.
  • FRUSTRATION TOLERANCE understand that there are things you can fix and things you cannot and that some things take time to learn and we must try several times before we “get it”.
  • SELF-RESPONSIBILITY before blaming others, try to see how you might have contributed to the (painful/uncomfortable) situation and accept responsibility for your own thoughts, feelings, and behavior. It will help you modify behavioral choices in the future.
  • SOCIAL SKILLS group skills are essential, learning to play with others sharing, respecting space and the thoughts of others makes for being a good friend.
  • SELF-ESTEEM learn to feel good inside yourself instead of the needing the approval of others.
  • TOLERANCE accept mistakes, nothing is ever “perfect”. Our most valuable lessons are often from our “mistakes”.
  • FLEXIBILITY be a flexible thinker — as opposed to having to be “right” or having rigid rules to obey.
  • BE ORGANIZED BUT ACCEPT SOME CHAOS strive for order, but learn that life is about transitions and always requires some “re-organization”

Learning empathy through activity, experiencing remorse through role-playing and increasing judgment through “staged” successes and “failures” may be some of the most important ADL’s we ever teach.

This Month's Featured Author: Susan N. Schriber Orloff, OTR/L

We thank Susan Schriber for providing us with this months article.

Susan N. Schriber Orloff, OTR/L, is the author of Learning Re-enabled, a guide for parents, teachers and therapists. The book is featured by the National Education Association. She also writes “Ask the Therapist,” a column in Exceptional Parent magazine, and is CEO and executive director of Children’s Special Services, LLC, an occupational therapy service for children with developmental and learning delays in Atlanta, GA. She can be reached on the Web at or at

Tags: December 2009 Newsletter Social OT Article