..but publications and research by OT’s are needed to show ASI is effective!
Submitted by guest blogger, Ruth OT.
In my time as a special needs parent, I’ve had a variety of responses to telling people my child has special needs. Some responses have been great, others have left me crying all the way home. Literally. Some have opened up conversations, others have shut them down. I know that those people who have not been so helpful have just been looking for the right thing to say and found the wrong one. So here are some cues to think about what you’re saying. Remember when the parent says the “we think (s)he might have….” Or “(s)he’s got…” they are very vulnerable. They will have cried and fretted and lost sleep over the information they are giving you and they will be at some stage of processing that information. If they are giving you that information, they either need you to change the way you are interacting with their child, or they need to talk about it. Choose your words carefully to open up the conversation and hear what they’re trying to tell you.
Please don’t say: “(s)he seems fine to me”. I know you’re trying to be reassuring, but by saying this, you imply that you are more able to identify the child’s developmental needs than the parents and the professionals working with the child. It pretty much shuts the conversation down, but if it continues, you force the parent into the role of pointing out their child’s deficits while you defend them. This is not a natural way of things, the parent spends enough time pointing out their child’s deficits with professionals, you need to enable them to big their child up and point out what a wonderful person they are.
Say instead: “I hadn’t noticed. What’s going on?” By saying “I hadn’t noticed”, you can reassure the parent that it isn’t that obvious, but also put yourself not the parent in the position of the person who needs educating about the child. You open up the conversation, and you give the parent the choice about how much information to give you, they might just tell you a load of assessments and appointments or they might tell you what the child is struggling with. It’s up to them.
Please don’t say “I couldn’t do it” the truth is you could. Of course, you could and a whole lot more, if that was what your child needed. Don’t point out how lucky you are that you don’t have to. The parent might well be wondering whether they can do it, and how long they can keep doing it for, they need you to reassure them that they can keep going.
Say instead “I really admire the way you’re doing it” This way, you’re complimenting the parent, you’re recognising how hard they’re working but you’re not sowing that seed of doubt that they might not be able to keep going.
Also, say “how can I help you do it?” they probably won’t know, but they’ll really appreciate being asked. It might be as simple as “watch my child while I have a pee in peace”. Do that. Then offer to do that again, don’t wait to be asked.
Please don’t say “(s)he’ll catch up” (s)he might well not. People were telling me this when the doctors were telling me she might well steadily regress. It wasn’t reassuring, it was frustrating. Again, it puts you in the position of the expert over the parent and professionals and the parent in the role of pointing out the deficits. Parents do not want to point out their child’s deficits, please don’t make them do it. Please don’t encourage the parent to compare their child to typically developing children, the only person a child needs comparing to, to track their learning is themselves.
Say instead “what does (s)he really love doing?” Give the parent a chance to gush about their kid, what they love, how much fun they are etc. Most parents will leap at this chance, it’s so refreshing after appointment after appointment telling professionals what their child can’t do.
Please don’t say “is there a cure?” The child may well not need a cure, they’re probably not ill. If the child is ill and there is no cure, they really won’t want to keep repeating that and if they know there is a cure, they’ll be doing it. Trust me, they will have researched treatment options very thoroughly.
Say instead “what are you thinking about for the future?” Again, keep it open. The parent might be trying really hard not to think about the future, they might well be taking one day at a time or they might be able to think of nothing else. They can choose how to interpret “the future” in your question and might tell you about getting them to eat just one more type of food or school support options, or they might be racing ahead to adulthood prospects.
Please don’t say “have you tried…?” again, you’re putting yourself in the role of expert with this one and the parent in the role of person to be taught how to raise their child. Unless you’re really actually a professional expert in what you’re suggesting, and you’ve spent time really interacting with the child, please just don’t.
Say instead “what do you think might help?” A parent who thinks their child has some additional needs will have done very thorough research, trust me. Give them time to talk about what they’ve learned. They might say “nothing” and then you’ll feel really awkward. Live with that, they feel awkward a lot of the time. They’ll probably tell you things that have been suggested and why they think/ don’t think that’s any good. Listen.
Please don’t say “you won’t want to come” Don’t presume, parenting a child with additional needs is isolating and exhausting. They might say no. Don’t be offended if they do but give them that option.
Say instead “I know (s)he finds this difficult, but I wanted to invite you in case you think they’d like it” Invite the child, acknowledge that it might be hard for them and they might want to say “no” and that’s OK, but make sure they know you want them there and you value time with them.
Please don’t say too much in front of the child. Remember they may well understand more than they can say and for any child seeing their parent upset is confusing and frightening.
Say instead “how am I best to communicate with him/her?” Then get down on the floor and do it. Playing with a child, talking with them on their level and really getting to know them is the biggest compliment you can pay the child and the parent.
My biggest advice if someone is telling you their child seems to have additional needs or a developmental difficulty is to listen to them, make them feel validated, treat them as the expert on their own child and don’t belittle their experiences. Your role is not to fix the child, you can’t do that. Your role is to support the parent, build their confidence and to be their friend.
Slime is a good way to unwind. It is satisfying, gloopy and fun to play with. You can make it in many different colours, amounts, smells, and textures. There are many different slime recipes, here is one we made earlier.
We added some shaving foam to make it fluffy (but it isn’t fluffy slime) and smell nice.
Here is our homemade slime:
If you make slimes, here are some rules to follow, so it doesn’t make too much mess:
If you want more slime buy this book by Karina Garcia:
For a number of years, OT’s have been talking about the risks of loss of occupation, social connection and homelessness for their clients with Autism. We know once the structure, safety and services of childhood and school and sometimes higher education are gone, things can become tricky. And we know about Ayres’ Sensory Integration, can help minimise the impact of sensory differences on development and skills necessary for everyday life.
In 2015 a briefing for frontline staff on Autism and Homelessness suggested that 12% of people diagnosed with autism in Wales had experienced homelessness. while among rough-sleepers in Devon, 9/14 might be classified as being on the autistic spectrum.
“The profession of occupational therapy should now wholeheartedly embrace the opportunity to grow our profession’s reputation – addressing sensory difficulties that challenge our clients with autism and prevent them from full participation in the occupational activities they choose to engage in.” Smith @ ISIC 2018
“Sensory Integration sorts, orders and eventually puts all the sensory inputs together into whole brain function. What emerges from this process is increasingly complex behavior, the adaptive response and occupational engagement.”Ayres 1979
A recent research study from a randomised control trial (one of the best types of research there is) in the USA by Schaaf and colleagues; An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial has shown Ayres’ Sensory Integration* makes a big difference to some of the skills children need to develop to become increasingly independent from caregivers as they get older.
Young people in the study group scored significantly better after therapy with Ayres’ Sensory Integration than young people in the care as usual group. Goal Attainment Scales scores and scores about self-care and socialisation skills all showed that after Ayres’ Sensory Integration Therapy* there was a significant improvement not seen in those just getting care as usual.
*Ayres’ Sensory Integration Therapy is usually a postgraduate qualification, and it is recommended that practitioners have qualifications equivalent to ICEASI Level 2. Please ask your therapist about their level of education in Ayres’ Sensory Integration.
Executive function skills help us plan, focus attention, switch gears, and juggle multiple tasks—much like an air traffic control system at a busy airport.
This downloadable paper provides a great way of explaining executive function to teachers and parents, drawing on the latest neuroscience and research in early development. The air-traffic analogy makes is a great tool in the therapist tool box when education parents about the importance of early development, the environment in which we learn and develop and how to support and promote development, ultimately enhancing participation in all activities and occupations of daily life – you can download the free resource here: developingchild.harvard.edu/resources/building-the-brains-air-traffic-control-system-how-early-experiences-shape-the-development-of-executive-function/
Supporting development is everyone’s business. If you are a therapist practicing Ayres’ Sensory Integration, parent education and support between sessions with sensory rich activities to support development through ploy is likely to be a part of what you do. The resource includes downloadable printable activities guides for different ages, that will make great handouts for parents and teachers. Another great resource from Harvard..
Parents bringing their children to therapy are dedicated – no matter who is funding the therapy. A weekly commitment to therapy sessions while juggling family life will test even the most organised Mum or Dad’s diary and working day. Fun easy to do activities that can support therapy and provide ideas for what to do when the ideas run out are a bonus.
These activities in this resource from Harvard are just so much more. Research has shown that this collection includes age-appropriate activities and games that adults can use to support and strengthen executive function and self-regulation skills in children.
Follow this link for more information and access to these great downloads: developing-child.harvard.edu/resources/activities-guide-enhancing-and-practicing-executive-function-skills-with-children-from-infancy-to-adolescence/
More about sensory play spaces:
Post the places and sensory friendly initiatives you know about here in our sense-able and safe spaces community group on FB.
This is a great article about a study Lucy Miller has conducted in a playground.
It also talks about Lucy’s motivation to study OT because of personal experiences when she lost her vision, including a summer mentorship to learn from Jean Ayres
You can read more here: landscapearchitecturemagazine.org/tag/sensory-integration-disorder/
Where is neuroscience going in the future, how will we get here? Sam Rodriques talks to us about problems with current research methods, and why outcomes for clients haven’t changed in years. He proposes what the year 2100 might look like from the weather, to vacuum cleaners and finally what we will know more about Alzheimer’s and how we got there using more up to date risk-free methods.