Why does one strategy help one difficulty and make another worse?

The short answer

Support can create trade-offs because the same child may need predictability and novelty, movement and low sensory load, detailed information and less language, or help to begin without feeling controlled. The answer is rarely to choose which diagnosis wins. Define the immediate outcome, identify the needs active in that setting and build the smallest workable combination. Keep the stable part stable, add choice or stimulation where it is safe, and protect a route to pause or recover. Trial one change, record the whole effect and revise it with the child. A strategy is not successful if it solves the adult's visible problem while increasing distress, dependence or exhaustion elsewhere.

• A strategy can help one part of a task and create cost in another.
• Support should target a defined outcome, not a diagnostic label in general.
• Combine a stable base with bounded flexibility where possible.
• Measure prompting, distress, recovery and participation as well as completion.
• The child's account is essential to reviewing the trade-off.