Empathic parenting: a best practice
Helped, heard or hugged?
Before you respond
When you respond: offer choices
When they choose HUGGED
When they choose HEARD
When they choose HELPED
Offer a wide welcome for feelings
Read more

Empathic parenting: a best practice

Over the 25 years that I have been working with children as an occupational therapist and the 21 years that I’ve been raising my two children, I’ve read dozens of parenting books, looking for approaches and strategies that would support children’s emotional intelligence. Incorporating the use of empathy by far has had the most profound effect on my clients’s and my own family’s emotional health and well-being. While it’s challenging for researchers to study parenting strategies, in my personal and professional opinion, using empathy in raising children is a “best practice.” 

After implementing these concepts and practices in my own life and teaching them for many years to the parents of my pediatric clients, I have started to apply them to raising children with limb differences. As a child growing up with a hand difference, here are the empathetic practices and approaches that would have nurtured me when I was sad about my difference as a young one.

Helped, heard or hugged?

When we respond to our children when they feel sad with empathy, love, presence, and warmth, they get to feel seen and heard. This strategy isn’t mine – Jancee Dunn wrote in a NYTimes column (dated 4/23) about this genius empathetic parenting strategy of asking your child: “Do you want to be helped, heard or hugged?”

Before you respond

If possible, take a moment to pause and breathe. Is seeing your child sad painful? Do you want to make it all better? Give yourself empathy: acknowledge your own feelings, recognize that this is hard for you too. It also may help to take perspective; it’s 100% normal for your child to feel sad about their difference.

Consider what would be best for your child in this moment. Offer simple choices to your young child or guess what you think they need/want. Ask your older talking child their preferences, offering empathy, love, presence, and warmth.

When you respond: offer choices

Ask your child, “What would you like first? Do you want to be HELPED, HEARD, or HUGGED?” These work in any order. It’s ok if you have time for just one or two. We will delve into these in reverse order.

When they choose HUGGED

Use physical connection:

• get close to your child
• sit your child on your lap
• hold their different limb
• encourage them to snuggle a favorite doll or stuffed animal
• if time allows, savor this precious moment of connection

If you have time, you can offer choice again: “Would you like to be heard or helped?”

When they choose HEARD

Invite communication:

• Be fully present
  • Put down your phone & step away from distractions
  • Physically get down to their eye level
• Respond with gentle acknowledgement
  • say: “mmm” or “oh sweetie”
  • nod your head” 

Invite their feelings:

• Thank them for sharing
  • “I’m so happy you told me how you feel”
• Use “feelings & needs” cards: this is a tool to help children identify how they feel & what they want. Ideally introduce these in advance. You can make or buy a set.
  
  

Demonstrate you understand:

• Use reflective listening
  • “I hear you say that you feel mad & don’t want help”
• Empathize: “of course …”
  • “of course you want to open the jar” 
• Offer an impossible wish
  • “Do you wish you could use your light saber to …” 

When they choose HELPED

Analyze the Situation 

Is your child’s sadness mostly about social-emotional or physical issues related to their upper limb difference?

Social-emotional issues could be about:

• self-awareness
• self-concept
• community connections
• peer interactions
• self-advocacy & problem-solving
• mental health concerns

Physical issues could be about a physical aspect your child might want help with. Are there activities that they:

• Want to be able to do
• Want to be able to do better
• Want to be able to do more easily
• Want to be able to do with less discomfort or pain

Solutions may include:

• adaptive devices
• home adaptations
• prosthetics
• school accommodations
• technology

We will delve into greater detail about these social-emotional or physical issues related to their upper limb difference in another post.

Offer a wide welcome for feelings

Allow whatever feelings arise for your child and offer them accompaniment as they feel. Offering a wide welcome to feel whatever they feel and accompanying them fully with your presence shows you accept them FULLY – not just when they’re happy. It also helps them manage “big feelings” when you’re not there.

Read the other posts in this series:

• When your child realizes they have a limb difference
• Preparing yourself for when your child feels SAD about their limb difference
• What NOT to say when your child feel SAD about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post What to say & do when your child feels SAD about their limb difference appeared first on On The Other Hand.

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Parental conditioning

Many of us were conditioned to respond to children in ways that aren’t the best for them. Some of the following responses are less helpful in the moment than using reflective listening and offering empathy. Many of us heard these from our families of origin. Knowing why they can be harmful can empower us.

When children feel sad, it’s common to misuse these “strategies” as an intial response

Avoid dismissing & minimizing

Telling them NOT to feel how they feel is harmful – not helpful. For example: don’t feel sad” – “you can’t be angry!” Even if you don’t mean to, dismissing/minimizing teaches that you are uncomfortable when they have “big feelings” and that “big feelings” are too scary, so best to avoid them.

Avoid fixing, rescuing, & giving advice

Trying to “make it all better” is harmful – not helpful. These “strategies” teach kids that solving a “problem” is more important than taking time to express feelings. Here are some examples:
“But you are beautiful!”
“Icecream will make you feel better!”
“Just do this next time”

Avoid “you’re so strong!”

Telling kids “you’re so strong” doesn’t make them strong, such as: “You’ve got this – you are so strong!”
“You’re strong” teaches kids that their feelings are invalid (because if they were truly “strong,” they wouldn’t feel this way)

Avoid unreasonable expectations

Telling them they can do everything is harmful, for example: “You can do anything if you try hard enough”
This is because everyone has limits. “You can do everything” teaches them that their limits are their “fault”; parents usually don’t expect “typical” kids to do everything.

Avoid toxic positivity

This isn’t the time to say how great their difference is, such as: “Your nubby is so great: think of all the things you can do with it!” Toxic positivity teaches kids not to share because others will think they are complaining that people don’t want to hear when things are hard.

Avoid cliches & platitudes

Simplistic responses shut down conversations. For example, “Your difference is what makes you amazing” Cliches and platitudes may be comforting to parents, but may invalidate your child’s feelings.

Complete the form below to download a free printable copy of What NOT to say when your child is sad about their limb difference

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By providing your email address, you agree to receive occasional email correspondence from On The Other Hand. Don’t worry: we will never share your email with any other entity and we will never spam you!

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Read the other posts in this series:

👉 When your child realizes they have a limb difference
👉 Preparing yourself for when your child feels SAD about their limb difference
👉 What to say & do when your child feels sad about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post What NOT to say when your child feels SAD about their limb difference appeared first on On The Other Hand.

Background

On social media, parents often share about the hard moments when their children feel sadness about their limb difference for the first time. Before offering suggestions for supporting children during these difficult moments, I wanted to examine this situation from the parents’ perspective. All children experience sadness about aspects of their life. Is sadness about having a limb difference different from other kinds of sadness? What is it like for parents to hear that their child feels sad about their limb difference? What kinds of support do parents need so that they can meet their children where they are? In delving into sensitive subjects like this, I hope that these posts, even though they can be tough to read, enable parents to gain perspective on important aspects of raising a child with a limb difference that aren’t always addressed.

Planning ahead so you can respond in a positive way

At some point your child will feel sad about their limb difference. It can be hard to prepare yourself for this moment, but planning ahead can help you to respond in a positive way. You may feel a full range of emotions: anger, anxiety, calm, fear, grief, guilt, regret, sadness, or overwhelm.

It’s totally normal to feel conflicted

On the one hand (nub?), it may feel like a big deal to hear that your child feels sad about their difference. It also can be painful. On the other hand (nub?), you may feel like you’re making a fuss over nothing. Many parents go through this, so what’s the big deal?

Anticipating the moment that your child feels sad

Everyone is different, so however it is for YOU is OK. There’s no one “right” way to handle this. Can you allow yourself to feel however you feel? It might vary from seeming like a big deal to not a big deal. Can you give yourself empathy? Ask yourself what your closest friend would say to you. How would they offer you unconditional love and support? Speak to yourself the way your closest friend would, or better yet, can you call that friend now?

In the actual moment that your child feels sad

It may be hard to separate your feelings from your child’s. Being aware of this may help you avoid projecting your feelings onto your child, notice if you’re being hard on yourself, and listen to your child tell you what they’re feeling.

What else might you need?

Perhaps permission to do something later for YOURSELF? Here are some possible needs, even if you have to schedule self care time:

• To express: cry, journal, laugh, reach out for support, or scream
• To create: build, cook, craft, weld
• To move: dance, run, walk, do yoga
  

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Complete the form below to download a free printable copy of Preparing yourself for when your child feels SAD about their limb difference

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Read more

Read the other posts in this series:

👉 When your child realizes they have a limb difference
👉 What NOT to say when your child feels SAD about their limb difference
👉 What to say & do when your child feels sad about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy

The post Preparing yourself for when your child feels SAD about their limb difference appeared first on On The Other Hand.

What parents often ask me
By the time your child is a toddler
Before they are able to talk
How you can help
What to avoid 
What will they say when they can talk? 
Be ready to hear about their pain
Important takeaways
Quick Links
Download the free handout
Read more

Download a free printable copy of the What to do when your child realizes they have a limb difference!

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What parents often ask me

Parents often ask two things:

• What do I wish my parents had known when I was a child?
• How has my thinking changed over the years?

They also want to know how to support their children with differences. I’m here to help answer those questions.

By the time your child is a toddler

Most toddlers with limb differences already know something is different about them. They’ve noticed how people respond to them, and they’ve heard how you talk about their difference. Many families use a nickname like “lucky fin,” “nubby,” or “small hand.” Others may have asked your child, “What happened to their hand/arm/foot/leg?”

Before they are able to talk

Your child is listening. They understand more than just words. They pick up on tone of voice, facial expressions, and body language. They may feel both good and hard emotions about their difference, even if they can’t say it yet. They might show frustration or sadness through behavior or body language.

How you can help

You can help your child feel seen, safe, and loved. Try these ideas:

• Use simple language to name feelings. When your child is crying, say something like:
  “Oh sweetie, I see you’re crying. Would you like a hug?”
• Talk about their limb difference in a positive way—especially in front of others.
• Stand up for your child. Don’t let others decide what your child can or can’t do, whether your child is present or not.

Reading picture books that include characters with limb differences can also help. These stories remind your child they’re not alone—and that they can do what matters to them. You can find book suggestions here.

You may also want to connect with support groups or attend family events. These spaces let children meet others like them and build confidence. Check out Resources for ideas.

What to avoid 

Your child should not have to prove themselves to anyone. Statements like:
“Bet they didn’t think you could do that!”
can make your child feel like they have to earn approval from others. Children thrive when they feel proud of what they do—not just when they impress someone else.

What will they say when they can talk? 

Parents are often surprised by the things young children say. Some children proudly explain:
“I do that with nub!”

Others may repeat something they’ve heard:
“Nubby looks funny.”

They may express love, sadness, confusion—or all of these.
“Me love lucky fin!”
“I sad—no foot, just nubby.”

Be ready to hear about their pain

It can be painful to hear your child express sadness or frustration. But these feelings are normal. Your child is learning to understand their body and identity.

You can prepare by practicing responses with a partner, friend, or therapist. That way, when your child says something hard, you feel less caught off guard.

Some real examples from parents:

• “Why I have to be born like this?”
• “Will my hands/feet be big when I’m 5?”

Important takeaways

• By toddlerhood, most children already notice they are different
• Even before talking, they understand a lot through tone, body language, and experience
• Talk positively about their difference and name emotions when you see them
• Stand up for your child’s abilities—don’t let others decide what they can or can’t do
• Picture books and community events help children feel seen and connected
• Avoid language that makes your child feel like they need to “prove” themselves
• Be ready for your child to say both sweet and hard things
• Practice ahead of time so you can respond with love and confidence

Quick Links

👉 Read blog post Choosing High Quality Picture Books for Your Child with a limb difference
👉 Check Resources for dolls you can customize to have a limb difference like your child’s and for organizations that host events where your child can connect with others like them

Download a free printable copy of the What to do when your child realizes they have a limb difference!

Name *

First

Last

Email *

By providing your email address, you agree to receive occasional email correspondence from On The Other Hand. Don’t worry: we will never share your email with any other entity and we will never spam you!

Download the free handout!

Read the other posts in this series:

👉 Preparing yourself for when your child feels SAD about their limb difference
👉 What NOT to say when your child feels SAD about their limb difference
👉 What to say & do when your child feels SAD about their limb difference

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post When your child realizes they have a limb difference appeared first on On The Other Hand.

Most parents are choosy about which books they read to their children, and for good reason! As a parent, you want to choose high quality books that align with and reinforce your values and steer clear of books that teach messages that you prefer to avoid. That’s being a savvy parent! The same is true of the growing library of books for children with limb differences. I encourage you to watch read alouds on YouTube of any books you consider purchasing. 

It is vitally important that children see themselves represented in books. While some children with limb differences are confident, outgoing extroverts, others are shy, studious, and quiet introverts. There can’t be a one-size-fits-all approach to representing children who have different personalities and differences.

In addition, it is important to watch for ableist and “you can do anything” messages. While these can be well-intentioned, they also can lead to pressure to achieve/perform/prove competency. A quick caveat that focusing one’s praise too much on accomplishments can lead to issues such as the Overachiever Trap.

Questions to consider about books for children with limb differences:

• Does the book imply or explicitly state that children with limb differences are required to work extra hard to make up for their difference?
• Are children with limb differences required or encouraged to prove their competence?
• Are children with limb differences portrayed as having a range of feelings? Do the adults and/or peers validate these feelings? For example, is the child allowed to feel sad about not being able to do something or not having the same body parts as everyone else? 
• Are children with limb differences expected to do everything independently and without help, or are they offered appropriate and needed accommodations and support?
• Does the book share ableist messages such as children with limb differences are superheros whose skills surpass those of their peers?
• Put yourself in your child’s shoes; does the story inspire you? Comfort you? Answer your questions? Share a valuable life lesson?

Here are some of the books I recommend:

• Awesomely Emma: A Charley and Emma Story (Charley and Emma Stories Book 2)
• Baking Up a Storm by Jessica Parham
• Different is Awesome by Ryan Hack
• Goldie’s Tasty Tacos (The Able Fables) by Dr. Nicole Julia
• Uniquely Me by Trace Wilson
• What Happened to You? by James Catchpole, Karen George (Illustrator)
• You’re So Amazing! by James Catchpole (Author), Lucy Catchpole (Author), Karen George (Illustrator)

I would love to hear what books resonate for your child. Let me know here.

Learn more

• Access the Free Handouts
• Check out Limb different toys & dolls matter – here’s why
• Follow the Raising a Child with an Upper Limb Difference parenting series on Instagram
• Learn about Bullying Part 1: Understanding Exclusion and Social Systems
• Delve into Upper body strengthening tools for upper limb difference
• Read Understanding Limb Difference Language & Terminology

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post Choosing High Quality Picture Books for Your Child appeared first on On The Other Hand.

Introduction

In this section I’ve tried to outline some of the major issues that you and your child will face, not only in the next few years, but throughout your child’s life. These issues include: Your child’s hand/arm appearance, how your child develops skills with that hand/arm, how your child feels about his hand/arm, and how your child’s hand/arm affects you. Be wary of thinking that “now you’ve got it all figured out” or “now everything is OK”, because it will change. You will change, and your child will change; but these issues will still be there. Don’t look for a fairy tale ending like “my child was born with a hand difference, grew up, was able to do everything perfectly, and lived happily ever after.” Aviva Bock, a psychotherapist in Newton, Massachusetts, states that it is essential that parents understand that, when raising a child with a hand difference, “These issues become part of the fabric of your life. You will check in with them often. There is no once and for all answer.”

How will my child adjust to having a hand/arm difference?

The attitudes of others toward a child’s capacities are far more important than his possession of particular traits. The fact of any handicap is not nearly so vital as the reactions toward it of those around him.

Your Child’s Self-Esteem, Dorothy Corkille Briggs

Many factors that will help your child adjust well are within your control. These include providing lots of support, helping to create a nurturing and accepting environment, exposing your child to others with hand differences (more about support groups below), and having reasonable expectations of yourself and your child. It is important to help the child to develop a strong sense of self esteem and to monitor the child’s emotional response to his hand/arm/limb difference.

On the other hand, you can’t control your child’s basic personality and temperament. If your child has an inquisitive nature, readily takes on new challenges, and perseveres despite setbacks, she will have an easier adjustment. If your child is temperamentally shy and more on the withdrawn side, she may find social interactions more challenging.

Children with congenital hand and arm differences make adjustments over the course of their development, sometimes in phases. A child who is well-adjusted as a preschooler may face greater difficulty as a teenager or vice-versa. But overall, most children are extremely resilient – a term used in the field of psychology to describe how individuals draw upon a source of inner strength to enable them to overcome hard times.

What do children think about their hand/arm differences?

What a child eventually thinks about her hand or arm is most shaped by the reactions and comments of those around her. Since her parents – and everybody else who interacts with her – knows about her difference much earlier than she does, their reactions cannot help but shape her own feelings about her hand/arm difference. As a sensitive being, your child learns to pick up on subtle things, such as body language, facial expressions, voice intonation, and even emotional responses. In the process, the child slowly internalizes others’ reactions.

Children may overhear things that others say about their hand/arm difference, some true, some untrue. Your youngster may repeat (and believe) what other children, in particular, say. For example, a small child may hear remarks and think that G-d is punishing him or that his fingers magically will grow as he gets older. One mother reported that her three year old girl with a hand difference said, “Mommy, don’t hold that hand. It doesn’t have any fingers.” This comment may have resulted from an unkind remark. Sometimes children try to hide their hand to avoid bringing attention to themselves after hearing criticism or teasing.

If your child says these things to you, or tries to hide her hand, or if you overhear her saying such things to others, it is important to work with your child to dispel such myths. Sometimes it may be necessary to speak to the parents of one of your child’s peers to inform them of the things their child is saying about your child’s hand. Just remember, when you talk to another parent, that most children are not intentionally malicious; that for many young children, reality and fantasy are indistinguishable.

What will & won’t my child be able to do?

Children with hand differences whose hands function well usually adjust well.

Children with Hand Differences: A Guide for Families Center for Limb Differences (1990)

Though your baby may be only two days, two weeks, two months, or two years old, you may be wondering what life will be like for your child with one or even two hand differences, or without any hands at all. I encourage you to write your questions down, no matter how trivial they may seem to be. Parents’ worries about what their child may be unable to do generally fall that into three broad categories: functioning in the world, social/leisure activities, and rites of passage. Let’s explore each of these.

Functioning in the world

How will my child tie his own shoes? How will she zip her jacket? Will he ever be able to open a bottle of soda? Will she be able to drive a car? Parents fear that their child will never be independent, needing to rely on the good of others to manage. My mother told me that whenever it rained, she always felt sad as she envisioned me – as a child and then later as an adult – trying to hold an umbrella with my “normal” hand while carrying a school bag or groceries with my “different” hand. One parent spent the first day of his child’s life practicing tying a shoe with one hand to convince himself that his child would be able to do this someday.

Social/leisure activities

Frequently, what saddens parents is that their child may not be able to participate in the activities that brought them joy, helped shape their character, or created life-long friendships. Playing a musical instrument, joining the cheerleading squad, or participating in a sport would fall into this category.

Rites of passage

Even when their children are young, parents of children with disabilities often wonder if their children will accomplish “typical” childhood milestones:

• Will my daughter be able to climb the monkey bars at the playground
• Will my son be able to go fishing with his grandfather?
• Will either get asked to the prom?
• How will they wear a wedding ring?

Children with hand and arm differences mostly lead typical lives, and they do many of these things. There are no universals here, since there is such range in the type of upper limb differences. For some, tying shoe laces may be difficult, but not for others; thankfully shoes with easy closures are common. The same holds true for manipulating scissors and opening jars; again, there are tools that make these tasks easier. Many children with upper limb differences may have difficulty holding the monkey bars at the playground and grasping handle bars on a tricycle.

A few more things to consider:

Whose agenda?

Watch for things that you may be pushing your child to do — things that may be reflecting your agenda — not your child’s wishes. Your child will want to please you and prove that he is worthy of your love by doing these things.

Tools to succeed

If your child is going to attempt something, give them the proper tools to succeed. Work with them to solve problems creatively; since life will never be tailor made for them, this is an important life skill.

Here are some suggestions:

• Get a sewing machine or find someone who can alter clothes and sports items; check out the Resource Directory to learn about adaptive clothing options.
• Find ways to adapt equipment to your child’s needs, rather than expecting them to find ways to adapt their limb to piece of equipment that doesn’t fit them.

Your child shouldn’t have to be a hero

It is important that all children — with and without limb differences — know at a deep level that it is typical not to be able to succeed at everything. Even if your child loves superheroes and admires their power and strength, your child shouldn’t have to be one.

At the same time, the human body is amazingly flexible, and children with differences often have a resilience and drive that enables them to accomplish incredible feats.

Problem solving

If your child wants to climb the monkey bars and encounters difficulty, try responding like this:

• Name how much they want to be able to do this activity
• Validate their frustration at not being able to do it at the moment, and offer comfort — try not to rush this step
• Once your child has been fully heard, their needs have been validated, and they are in a receptive place, problem solve with your child
• Ask your child developmentally appropriate questions:
  • How important is it for them to master the monkey bars (or other activity)?
  • Do they want help?
  • Why do they want to learn to do this activity?
    • Is their motivation coming from within, or are they feeling external pressure to succeed, such as other children teasing or challenging them?
    • There is no right or wrong with this, but it may be helpful to know whether the child wants to learn for themself or is responding to their desire to fit in or do what others can do. Or it may be a mixture of the two.
• Consider what it might take for them to learn this activity:
  • Would the child need a special tool, regular practice, and/or help from an adult?
  • Do they (or you) need something else?

Modeling this process for problem solving will help your child for their entire life, as they will learn how to approach adapting activities.

Learn more

• Access the Free Handouts
• Check out the Resource Directory
• Delve into “How to think like an OT”
• Explore Seeing the whole child with a limb difference: celebrating strengths & supporting struggles
• Find helpful parenting strategies in Raising a Child with an Upper Limb Difference: 13 Things Every Parent Should Know
• Learn about Winter Care for Partial Arms and Hands: Skin, Circulation, and Warmth
• Peruse Choosing High Quality Picture Books for Your Child
• Read Limb Different Toys & Dolls Matter – Here’s Why

© 2026. Laura Faye Clubok, MS, OTR/L, On The Other Hand Therapy. All rights reserved.

The post Early Years appeared first on On The Other Hand.