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I sat down with Liz Downing, a pediatric occupational therapist from Wilmington, Delaware, whose passion for nature-based therapy and supporting children's emotional and sensory needs shines through her practice, In the Woods OT. We first connected at the American Occupational Therapy Association conference, where we bonded over our shared interest in helping children navigate social and environmental pressures.
In this episode, we dig deep into the realities kids face both in traditional school settings and beyond. Including overwhelming schedules, academic demands, and the increasing lack of unstructured play. Liz explains how children—especially those who are neurodivergent, often feel compelled to "mask" their true selves to meet external expectations, and how this can take a real toll on their nervous systems and emotional well-being.
In this episode you'll hear about:
- Introduction of Liz Downing
- How Sarah and Liz met (AOTA conference)
- Liz's professional background: pediatric occupational therapy, hospital-based experience, transition to nature-based OT
- Liz's family background and experiences traveling during COVID
- Founding of "In the Woods OT" (nature-based practice in Wilmington, DE)
- Focus on emotional regulation and supporting both kids and parents
- Defining Social and Environmental Pressures
- Explanation of "social pressures" and "environmental pressures" from Liz's perspective
- Primary struggles observed in children, especially in school environments
- Growing expectations placed on children (school duration, structured activities, reduced unstructured play)
- The adult perspective: cultivating compassion and re-evaluating expectations for children
- The Concept of Masking in Children
- Definition of masking, particularly among neurodivergent children
- Attempts by children to "fit in" or meet external expectations at the expense of authenticity
- Emotional and psychological impacts of masking: shame, energy drain, and exhaustion
- The daily versus occasional need to "wear a different persona"
- Comparison to adult experiences of situational masking
- The Neuroscience of Masking and the Nervous System
- The nervous system's "safe/connected" versus "protected" (fight/flight/freeze) modes
- How masking keeps kids in a protected, energy-draining state
- Physical and emotional consequences: fatigue and aftermath (e.g., after-school meltdowns)
- The parent's role: understanding, empathy, and recognizing dysregulation
- Parental Strategies for Supporting Dysregulated Kids
- Managing after-school meltdowns: recognizing the need for reconnection and restoration
- Practical strategies: providing snacks, space, co-regulation, and minimizing choices when overwhelmed
- Importance of parental regulation to support the child
- Balancing support with age-appropriate expectations
- Avoiding perpetually low expectations; instead, nurturing growth and capacity
- Practicing body/sensory awareness in regulated moments
- Building emotional language and self-awareness in children for proactive regulation
Links and Resources From Today's Show
Connect With Our Guest, Liz Downing
Liz Downing is a pediatric occupational therapist with 17 years of experience supporting kids and families across hospitals, early intervention, schools, and private practice. She now runs In the Woods OT, a nature-based solo practice in Wilmington, DE, with a focus on emotional regulation and whole-family support. Outside of work, she's a wife, mom to three awesome kids, and a new dog mom to a rescue mini poodle.
