Strategies to Promote Serve and Return in Parent-Child Relationships
Welcome back!
Last week we talked about how foundational early relationships are to development. If you missed it, check it out here! One of the ways that children build solid relationships with their caregivers in the early days and months is through a process called “serve and return.” The name comes from playing a game like tennis- one person serves the ball, and the other person engages in the game by returning the serve. Through repetition of this pattern a full, engaging game is played. Similarly, through repeated engagements in relational serve and return, a robust relationship can develop!
What is “Serve & Return” and What Does it look like?
The term “serve and return” was coined by the Center on the Developing Child at Harvard University to describe the process of “responsive, back and forth exchanges between a young child and a caring adult” (Center for the Developing Child, 2025). A young baby might look toward their caregiver’s face and babble excitedly (a serve) to which the caregiver responds by bringing their face closer to the babies, smiling at them, and talking to them (a return). Later in childhood, a 4 year old might make it to the top of the rock wall at their local playground by themselves and look over to their caregiver and shout “I did it!” and their caregiver mimics their excitement, throwing their arms up and shouting back “you did it! You climbed all the way up that big wall!”
Through these interactions, babies learn so many things about themselves and their caregivers
Language and communication- this is the practice for back and forth communication that mimics adult conversation
Trust in caregivers- through repeated experiences of being interacted with, infants learn that their caregivers are consistent sources of support and nurturing and that they can be relied on
They can impact their caregivers- when a baby vocalizes, moves, cries, etc., it has an impact on the people caring for them. The baby learns that they can impact their world through these consistent interactions
Promoting Serve & Return between Your Clients & Their Caregivers
If you’re an occupational therapist, you may not traditionally think of yourself as someone who’s goal is to build the relationship between caregivers and children. As I’ve mentioned before, I distinctly remember being taught that my client was the child and that my role with caregivers was to provide information & updates and to teach them what OT strategies were working and how they could repeat them at home. But our roles are so much more rich than that! I won’t speak for other groups but I have a feeling it’s similar for early childhood teachers, speech therapists, and others. Our goal should always be that children have strong, resilience-building relationships with their caregivers. Supporting the elements of relationships, such as serve-and-return, is one way to work toward this goal.
Strategies to Promote Serve & Return
There are some core components to supporting serve and return that we can do in therapy as well as support caregivers to do with their children at home.
Respond verbally
Making statements such as “thank you” or “you did it!” when a child does something is a way of engaging them in a reciprocal exchange that models typical day-to-day conversation, making them feel included.
Respond physically
Changing your facial expression, dancing when the child hits the music button on their toy, or pointing with them when they point all demonstrate you are connected and that you are following them in their interests. These physical gestures are a key part of adult communication as well.
Describe what you see
Describing the child’s behavior as it’s happening is a way to let them know you’re seeing them and helps them build language for their experiences.
Describe actions:
You’re running fast to that ball!
You’re building a big tower with those blocks
You’re eating all those pieces of chicken!
Describe feelings:
You’re so excited that mama is home
You’re so sleepy now that we’re laying down
Your head is warm, you’re feeling sick today
Describe objects:
That’s a big blue ball you have
You’re eating cheese and beans today for lunch
Look at this purple dress you’re wearing today, it has ruffles and dots on it
If you’re lucky enough to work with parents and children together, there are countless games and activities you can do to practice this pattern. You’ll notice in the list below, these are probably the most common activities adults do with children- peek-a-boo, play food, building blocks. BUT, I chose to write about these to highlight the power of these simple back and forth activities and how supporting development does not need to be over complicated. It’s not about the activity, it’s about how we engage with children in the activity!
Notice
Use your observation skills and point out to caregivers when you see a rich exchange. Pointing out the moments of “success” when you see them is a powerful way to illustrate the deep impact caregivers have on their children, even if they miss those moments themselves
“I don’t know if you noticed but your little one’s face completely lit up while you were snuggling them like that!”
“Look at the way their arms open and their face brightens when you start talking to them in that soothing voice”
Do activities together that require relational back-and-forth
Peek-a-boo: both you and a caregiver can play with a young child at the same time. Peek-a-boo is a wonderful developmental game for babies and young children because of the instant reinforcement that comes from excitedly reconnecting after brief periods of covering your face. During this game, the dead will have so many repetitions of excitement and joy to see each other and “reconnect”
Play food cooking & serving: in playing with toy food, children get to literally serve a parent a meal they make, giving parents a wonderful opportunity to respond with words “thank you for this pizza!”, with gestures- taking the food and pretending to eat, and facial expressions- smiling and enjoying their food while they eat all while orienting their body and face toward the child. During meal sharing, parents can also initiate by offering their child food.
Children often will copy the way their caregiver enjoys food- pretending to munch, making an “mmmmmm” sound, maybe rubbing their tummy. All a nice reminder of what an incredible impact caregiver behavior and affect has on children!
Play with manipulatives or building materials: when building, there is a natural opportunity to ask for pieces and to offer pieces. When a parent say’s “here’s a blue block” while handing it to their child, they’re inviting their child to take it and use it to build their tower. Similarly, when a child knocks the tower down, they’ll often look to the caregiver, giving them the opportunity to replicate a crashing noise and celebrate the moment together.
The nice benefit of all of these things, especially if you’re an occupational therapist but also for anyone at all, is that these are all occupation-based interventions. Play is the primary occupation of childhood and is well within the scope of practice of OT practitioners! It may seem like “just playing” but this sort of play is well worth the time to promote the developmental goals we have for children and families.
I hope that next time you’re with a young child or supporting the parent of a young child you remember, supporting development is crucial but it doesn’t have to be complicated! Thanks, as always, for being here!
Resources & References
Disclaimer
The information provided on this blog is for informational purposes only. It is not intended to assess, diagnose, treat, or prevent any medical or mental health conditions. The content shared on this site should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental health professional, or other qualified healthcare provider with any questions you may have regarding a medical or psychological condition. Never disregard professional advice or delay seeking it because of something you have read on this blog.
