Our Special Needs Kids on TV, Something Special and Pablo

Submitted by guest blogger Ruth OT

Our daughter recently appeared on a UK Kids TV show called  Something Special. I was ridiculously excited CBEEBIESabout it and told lots of people who never usually watch CBeebies, the BBC children’s channel, that they just had to see her.

Filming was brief but exciting. We got to meet Justin briefly (one child was very disappointed Mr Tumble wasn’t there too) and the team were genuinely very lovely.
Some of the people who would never normally watch CBeebies were surprised there is a programme which exclusively features children with special needs and/or disabilities, they felt that pointing out the difference wasn’t kind and the kids should be encouraged to blend into a typically developing world. This was a good opportunity to explain how the show “Something Special” had helped other children to understand the way our girl supports her speech with signing and to not be phased by her difference. We’ve often heard comments like…“oh look! She signs like Mr Tumble does!”.
Then a friend asked what I thought of “Pablo”, another CBeebies programme about a little autistic boy and the imaginary world he creates to navigate the confusing things around him. Of course, I had to investigate. I watched a little video of the autistic boy who plays Pablo explaining that he thought it was important for other children to understand autistic children so that they would want to play with them and that Pablo helped that, and I was ready to investigate.
So, I sat down with four kids to watch. The 8 and 10-year-old exclaimed in unison “Oh, I love Pablo!” so of course, I asked them what the show is about “a little boy with a really good imagination who draws stories about things”. Fair enough. And so we all sat and watched the show together…

In the episode, Pablo and his mum are going about really everyday things (cleaning a bin in the first one we watched) and Pablo’s mum uses a phrase he doesn’t really understand to explain what she’s doing. He knows he mustn’t touch the “smell gobbler” but doesn’t understand why. Pablo draws his fears, in this case, he is concerned that the “smell gobbler” might eat his own familiar safe smell which he likes and then what would he do? He and the cartoon characters that represent aspects of him, problem solve it and trap the “smell gobbler” under the laundry basket. Mum comes back and is amused to find her air freshener trapped.

I actually loved the show. The kids who told me they loved Pablo hadn’t spotted that he’s autistic (the 8-year-old is usually quite a diagnostician) and yet they loved that he has such a really good imagination. watching the show together opens up a way to talk about autism with her and how her autistic sibling and friends might see the world a bit differently. It touched on the sensory differences that can come with autism and the importance of sameness for people with autism and modelled a useful way for children with autism to reason through problems and confusions they encounter.

I have a speech therapist friend who is very keen on creating comic strips with children as a method of problem-solving and reasoning through PABLOsituations before they happen. I could do that or I could just let my kids carry on enjoying a funny cartoon about “what if we really meant exactly what we say?”.

It’s my job to watch what my kids are watching and use it to start those conversations with them. I’m so glad these programmes give us a platform to start that.

 

 

 

 

Crawling, Sensory Integration and Child Development

Submitted by guest blogger Ruth OT 

I meet so many parents who are concerned about their children’s motor or sensory processing skills who tell me their child never 4-point crawled, or did so only briefly. They proudly tell me how their child was ahead of their motor milestones and walked early, and never realise how important crawling is.

What is so special about crawling?

In crawling, the baby supports their weight on their hands and arms, this works wonders for developing shoulder girdle stability and proprioceptive awareness of the hands and arms which is foundational for fine motor skills like handwriting, fastening clothing, threading, sewing, crafting etc. Crawling also requires the baby to hold their core flat and stable off the ground, developing core stability against gravity. It also puts the baby’s neck into extension (ie bent back so that the baby is looking forwards not at the ground), this activates areas of the brain stem and supports baby’s developing understanding of their relationship with gravity and thus vestibular processing.

But what good is telling you all this now if your baby wasn’t a crawler? My youngest child was a very proficient bum shuffler, he could get anywhere over any surface (but not steps!) very quickly shuffling along on his bum. If I put him into the tummy time position, he just laid there and cried until I sat him up. I knew crawling was important for his development and that bum shufflers are late to walk, but I couldn’t make him do it once he’d learned a really efficient way to get where he was going!

So now that he’s a confident walker, we’re going back to crawling activities, and I thought I’d share some of the activities we do without any extra equipment at home to get those crawling benefits…

Going back to crawling…

  • Climbing! There’s a lot of motor planning and problem-solving in this as well, depending on where you climb. Over rocks, up muddy hills, up slides (you will get looks from other mums), in soft play, anywhere where they need to use their hands to support their movement is good by me crawling 1
  • Cars and small world toys- some kids I know will squat down on their feet and use their hands to play, if this is your kid try setting up a small world where the kid has to reach far enough that they have to support their weight with their hands to reach the middle.
  • Big floor art, floor puzzles etc. We love messy art at the best of times, but if you can get a roll of lining paper on the floor to do your art on, you can work on shoulder girdle stability, prone extension and motor planning while you do it.
  • Tunnels, those pop up tunnels you can get for kids are great for encouraging crawling (you can’t bum shuffle through one, we speak from experience!)
  • Ball pools, he loves falling face first in them and then crawling back to standing up.

Ditch the train tables, lego tables and tuff tray stands. I know they make tidying up easier and are more comfy for parents, but playing on the floor is about so much more than the game.

crawl 2

Supporting People with Anxiety, Using Sensory Integration and Other Strategies

Submitted by Guest authour Jane OT

As I read the recent article “14 Phrases Kids Said That Were Code Words for ‘I’m Anxious from The Mighty, It felt familiar – like I had met every one of these responses to anxiety and not just from children.

 “What’s wrong with me?”… “I’m tired.” … “Can’t we stay home?”

“I don’t feel well.”

Anxiety affects so many people and they are not all confident naming and talking about it. Some may know they are anxious but be embarrassed about telling people, for others, it may be that long-term anxiety is new to them and they haven’t really grasped that the physical symptoms are related to their anxiety.

So how does anxiety play out in real life and how can we help?

The elderly lady who has had a reduction in her mobility now feels sick when she goes in the car (but her doctors can’t find anything physically that would cause this), may not understand that her body and brain has become accustomed to less movement and so is less able to integrate vestibular stimulation with other sensory stimulation hence she feels sick now avoids leaving her chair for fear of some as yet unidentified illness but is embarrassed to say she feels scared. Her fears about illness then generate yet more anxiety symptoms e.g. Feeling sick racing heart and more, confirming that she really has got some mystery illness that the doctors are missing, so she avoids leaving her chair whenever she can. This leads to a further loss of integration between her senses as she is not moving much (vestibular) and she is not using her muscles much (proprioception) and will eventually lead to loss of function.

Or that friend who is always tired or busy when you want to go out (there might be other reasons) and cancels at the last minute. But to be honest, as a mother to a lovely but anxious young lady it is the young people who concern me most

My concern for young people is driven adult-cute-face-female-41522by the knowledge that the young brain is primed to learn (Jenson 2015)… And learn it will – either good things or less good things, so if like the elderly lady the young teen avoids activities there is a good chance that these coping strategies will become an ingrained life pattern.

So what can we do to help?

  • First get to know the symptoms of anxiety there are numerous self-help books and Web pages e.g. The NHS Web site, Web MD, mind etc.
  • Second help the young person to choose activities that are likely to reduce anxiety… From a sensory integration perspective, these are likely to be ones that involve heavy muscle work and muscle stretch (proprioception) and ones that make the young person think like Martial arts, dance, rock climbing gymnastics etc. Will be better than just proprioception alone. We do dance and acrobatics.
  • Consider 1 to 1 tuition if they need to gain skills to catch up with their peers… But if you do this it’s good to plan to reintegrate the young person into group lessons… So that they can deal with social anxieties. We went to a group lesson and it was clear my daughter had a lot to learn so we had a year of individual lessons (and still supplement the group lessons with the occasional individual lesson). But then we went to group lessons, it took half a term but now she is enjoying doing acrobatics duets which brings me to my next point.
  • Make sure the young person attends regularly and on time for a good chunk of time…..
    Be prepared for ongoing anxiety and be firm that they go… My daughter frequently tells me on the way home “oh sensory mum you’re right I do feel better.
  • Try to avoid surprises… We have a wall planner for the term and all activities are written on it… And I have noticed my daughter (and I am) much calmer knowing what needs to be done and when.
  • Discuss and consider professional help… Some Ayres’ Sensory Integration trained occupational therapists use other techniques in conjunction with their sensory integrative therapy, others will work alongside mental health professionals and for some people, Ayres’ Sensory Integration therapy will be enough on its own.
  • You may also decide to work through a self-help book and this can be a good option… But if in doubt always consult with your GP or/and any other health professional who is working the young person.

So what about those adults… Its a little different to the young people but listening and understanding or trying to understand is a good first step. Giving them information about sensory integration and mental health issues can also be helpful. Then asking them what they want you to do and staying in touch with them even if it’s difficult. And always remember it’s never too late for someone to get help.

what anxiety loks like

Reference The teenage brain by Frances Evans Jenson. L

Sensory Integration and Tourette’s

An interesting explanation about Sensory Integration and Tourette’s.

For more information, you can read the reports from these studies:

This first study explored the lived experience of people with Tourette’s who report that sensory sensitivity is more disruptive than their motor tics. The study describes this lived experience and proposes two hypotheses regarding why this might happen.

Sensory sensitivity to external stimuli in Tourette syndrome patients

The second yet unpublished study from Teeside University, is summarised on Tourette’s Action website, and explores sensory processing of adults in the UK.

The sensory processing of adults with Tourette Syndrome

 

Resources for parents and families about Occupational Therapy

It’s the Easter break, after all the fun, reality often sets in and parents start to think about back to school. The summer term with SAT’s and exams can often be a time of worry and anxiety for older primary and secondary school-aged young people.This week we will be featuring a range of resources, including from our colleagues across the pond…

At ASI Wise we also support parents with a FB page “Through the Senses” and a closed group “Sensory Parents Support – Through the Senses.

Our first is resource is this superb brochure from AOTA:

This slideshow requires JavaScript.

To print click here What-is-OT-Peds

Reprinted with permission from AOTA for educational purposes.

 

 

 

 

 

 

How a Little Jaguar with Poor Proprioception Learnt How to Walk and Swim.

Do robots dream of electric sheep? Do jaguars get dyspraxia? A show that started being just a bit of a fun watch with cute baby animals may suddenly have you looking again with your sensory goggles on.

big cats

 

“Mummy, you will love this programme, it’s about a jaguar cat who has poor proprioception, he doesn’t know where his legs are in space and he has to go to therapy to help to rewire his brain!”

 

 

Giles Clark is a big cat expert who runs Big Cat Sanctuary. Suddenly he is called to look after 5-day old Maya, whose jaguar mum isn’t caring for her. Soon it is apparent that Maya doesn’t always play as expected. She brought to the vet and has visual and neurological assessments including an MRI. I especially felt for Maya and Giles as a mom who recently had similar assessments carried out on one of my own kiddos.

Their end assessment for Maya the jaguar? A difficulty with proprioception (yes, the word proprioception was actually used) and some ataxia in her back legs. A sensory rich environment was created including some of the things we might recommend for our human service users: swimming and an obstacle course.

Those of us who use Ayres Sensory Integration (ASI) to inform our practice with people may have found ourselves ticking off the fidelity tool boxes:

A qualified therapist? … Giles is definitely a cat expert
A thorough assessment? … Maya hasn’t been SIPTed but it is heartwarming watching her be attentively assessed throughout the process.
A safe environment? … Yes!
A therapeutic alliance? … Yes!
and goals? … Definitely

A just right challenge is quickly found too when Maya attempts to drag something along her obstacle course.

Do you see more ASI links? Post in the comments section and let us know

Watch here on BBC iplayer

For those of you  who are not in the UK, I have embedded youtube links below to the same programme

 

Episode 1

 

episode 2

Access to ASI Wise Workshop/Course Materials.

Have you recently attended one of our courses? Some institution and business emails do not allow invitations to our online course resources. Apply below for access to course additional printable resources for the course you attended and we will be in touch.

These applications will be checked against other details we currently hold for you, so access will not be immediate.

 

The “just right challenge” is not just about equipment and activity, it’s about our therapeutic use of self – as OT’s doing ASI we need to be shapeshifting chameleons.

The skillful therapist is like a chameleon – able to shapeshift and turn their hand to any and all presentations; artfully engaging with, weaving and drawing out magical cooperation; making it fun. The art of both assessment and therapy are to make sure whatever we do, it is the “just right challenge”. Whether it’s just the right way of being to connect to a child, preparing a room for the initial visit with a swing or ball pool that’s likely to entice play and engagement, aiming for the “just right challenge” is essential.

Doing parent training in a school recently reminded me again how important it is that we ensure what we do is the “just right challenge” for parents and teachers too. While we are very good at simplifying what we do to make it understandable and accessible for all, sometimes parents need to trust us because we have knowledge and skills beyond what they can read in books and on social media sites.

The “just right challenge” is critical to the therapeutic relationship; too much or too little challenge and too much or too little safety, and we don’t create the right brain chemistry for engagement and participation. Remember last time you were frightened and scared, in an interview – How was your performance, were you able to be who you usually are?

This includes making sure we choose the right assessment tools and therapy activities, the therapist ensuring the ‘just right challenge’  – not too tricky, but also not too easy.

I explained the Sensory Integration and Praxis Test, Clinical Observations and the Sensory Processing Measure to a group of parents, and why we won’t always use the same test for each child, because each child is unique.

Critically, not every child can be assessed with a standardised norm-referenced test like the SIPT or Movement ABC, some assessment can only happen in a different way – with equipment and games, through play – play and assessment served up with artful skill so that the assessment can happen unnoticed by the child.

I was reading a report written by another OT, and her artful use of self to get a thorough clear assessment in a situation just like this. It reminded me about what is special about being an OT. We are trained to problem solve and think outside the box  – perfectly placed to creatively choose from the many tools we have in our toolboxes and mix and match them to each person’s unique needs.

Each child is so unique and different – some are clearly children with obvious sensory integration patterns that link to their Autism, just like the research predicts. Some children have had trauma, some have genetic differences, and their patterns are more complex, needing different lenses, and a skillful combination of assessment and therapy approaches. Others need us to wear different hats, combining what we know – Neurodevelopmental Therapy interwoven with Ayres’ Sensory Integration or ASI woven with just the right amount of attachment theory, or just a cognitive behavioural approach coupled with backward chaining to learn a new skill. Skilled experienced therapists know the “just right” combination.

 

fun-is-the-child-s-word-for-sensory-integration-ayres-2005-2

 

 

It’s not about our own stress, it appears stress can be catchy too.

Is your stress changing someone else’s brain? A research study by Jaideep Bains and a team at the Hotchkiss Brain Institute (HBI), at the University of Calgary, has suggested that stress can be transmitted from one person to another, changing the brain of the other person too. The study shows that social contact by female mice reverses the effects, but not for male mice.  

A full article “Social transmission and buffering of synaptic changes after stress” can be found at https://www.nature.com/articles/s41593-017-0044-6.

 

pexels-photo-349494.jpeg
Scientists have discovered that stress transmitted from others can change the brain in the same way as a real stress does.
 https://www.sciencedaily.com/releases/2018/03/180308143212.htm

What happens when I take my child to have Ayres’ Sensory Integration Therapy, what can I expect?

Do you want to find out a bit more about what happens when your child attends a therapy session with an occupational therapist, Physiotherapist or Speech Therapist doing Ayres’ Sensory Integration therapy?

Ayres’ Sensory Integration therapy is highly specialised and deeply rooted in neuroscience.  Before therapy can start, it is essential that a thorough assessment is undertaken. Thorough assessment saves time and money, as when therapy is purposefully targetted as a person’s own sensory difficulties, then it is most efficient and most effective. The art of a good therapy is that the therapist can engage with your child in a playful and motivating way, while directly targetting your child’s sensory challenges.

Watching from the outside, the play may appear unstructured, relaxed and just a lot of fun. However, the therapist will have planned specific goals with you that they will work on, determined by the assessment. The therapist will interweave these with your child’s ideas and choices of activity, incorporating ways to address the sensory challenges identified in your child’s assessment. This is the exquisite art of ASI therapy – it should, for the most part, look effortless.

Each sessions therapy aims will have been chosen to support the ability of your child’s sensory systems to register, process and integrate sensory input for use, to support improved participation in activities of daily life. The therapist will offer your child a ‘just right challenge’ – enough of a challenge to extend their skills, while safe enough so that your child feels comfortable and not overextended.  The OT will be closely monitoring your child’s reaction and arousal levels during the therapy session.

Ayres’ Sensory Integration Therapy is very individualised to every child and relies upon the close therapeutic relationship your child has with their therapist. The therapy is not about a set of repeated exercises, and every therapy session will look slightly different, with different equipment and story themes, enticing your child on that day, in the moment. However, the therapist will keep in their head overarching goals and aims, these drive the deliberate choices about what equipment to use.

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You can read more about what Ayres’ Sensory Integration therapy is on Sensory Integration Global Network’s website 

Below is a video from Ann & Robert H. Lurie Children’s Hospital of Chicago which gives a fantastic example of what Sensory Integration Therapy might look like for a child.