Wednesday, 12 September 2018

Special Needs Development - its a marathon, not a race!

It’s a Marathon, not a Race…

Children’s development often follows a set of pattered “milestones” set forth by the medical establishment.  These milestones seem to be imperative and predict later success as a youth or adult.  However, for those with special developmental needs or delays this simply is not the case.  Developmental milestones seem to aid in diagnosis and comparative analysis child to child, yet do little for achievable perspectives for the families with special needs.  Once a child becomes 8, 9 or 10years the differentiation between neurotypical and special needs widens, which causes distress among the families of these children. What will happen in 5 yrs, 10 yrs…?

There are two important premises to remember with special needs children:

-         It is never too late to work on something

-         If you do nothing a lot, improvement will not occur

The above sounds simple, but in actuality most families still believe they may outgrow these delays or it is too late to try.

In the past, the assumption was that challenged kids would eventually outgrow it, but research is now telling us that these challenges persist throughout the child’s life.  Studies have also found that children who have motor skill deficits as children are less active as they grow older. Children with *dyspraxia are especially at risk for developing sedentary lifestyles because of their lack of success being active and interest in peer interaction.  Progressive intervention therefore aims at improving motor skills, social and emotional capabilities, improving problem solving when approaching a motor task, and helping children find recreational activities that will prepare them to be active for the rest of their lives.  
How can this all happen?  Well, only with a long-term perspective.  Remember it’s a marathon, not a race. An intervention that last 8 weeks will not affect a long-term change.  A child needs frequency, repetition, relationship building and solid strategizing by professionals.  From our experience, we see long-term progressive change and improvement compared to those who do not participate.  Such things as resolving fear of heights, running and gait improvements, focus and attention increases, relationships, enjoyment of activity, confidence, knowledge, skipping, biking and other complex motor skills. We have seen the results of a long term perspective and know its really the best way to help families.

 written by the team at the BODiWORKS Institute

*Dyspraxia is a term used to describe children who appear clumsy, have poor balance, and have difficulty performing activities in their daily lives, such as dressing, self-care, toileting, coloring, and playing on the playground. Children with dyspraxia often have challenges with visual perceptual skills, motor planning, and academic demands. Dyspraxia falls under the diagnostic term Developmental Coordination Disorder (DCD), but is also frequently seen with other developmental disorders (ie.GDD), including ADHD, hypotonia and autism spectrum disorders(ASD).

Thursday, 2 August 2018

GDD Diagnosis - Now what?

A significant number of children a year are diagnosed with Global Development Delay (GDD) or some version of development delay issue.  We commonly see children in programs with this diagnosis.

If you are reading this blog you are probably aware that a child may be described as having global developmental delay (GDD) if they have not reached two or more milestones in all areas of development (called developmental domains). These developmental areas are:

motor skills - either motor skills like sitting up or rolling over and finer motor skills, for example picking up small objects

·       speech and language - which also includes babbling, imitating speech and identifying sounds, as well as understanding what other people are trying to communicate to them. Oral motor included here.

·       cognitive skills - the ability to learn new things, process information, organise their thoughts and remember things

·       social and emotional skills - interacting with others and development of personal traits and feelings, as well as starting to understanding and empathy
The causes of GDD vary depending on Congenital or Acquired determinants.  Essentially the child is affected by some sort of "insult" to the nervous system during development.  Often the exact cause of GDD is never identified. This is contributes to difficulty in treatment and outcomes prediction
Developmental disabilities are relatively common in children, with a 5-10% prevalence. GDD is estimated to be prevalent in 1-3% children < 5 y.o, and it is estimated that between 40,000 - 120,000 children born each year in the U.S. and Canada will manifest GDD. There are many possible causes for the clinical picture of GDD and some causes are treatable. Therefore, early recognition and diagnosis is important. In addition, some of the etiologies are genetically transmitted and may affect future family members. An underlying etiology can be identified in approx 25% of cases of developmental delay, with higher rates (50%) in GDD and motor delays, and lower rates (<5%) in children with isolated language disorders.
What if catching up is desired??...As a parent the emotional strain occurs when becoming aware of the issues your child has, especially as they enter the school system.  The common clinical understanding is that the child may never "catch up" to their developmental milestones.  This is very difficult to hear, especially if the goals of therapy are measured in this way.  What if the goals are measured another way? 
Individuating the goals are most important. Focusing on multiple levels of development.  Child development is extremely complex and ever changing.  A standard of focus is best on a global neurological perspective with "microassessing" (identifying small components of change).

For global muscle adaptation, simultaneous engagement of multiple motor neurons (within muscle) is helpful for development.  The 'old' idea is we avoid or negate many activities in replace of the one to encourage improvement.  Unfortunately, we have seen the long-term result of this type of therapeutic approach. Children who develop into adults this way have very limited neurodevelopment and therefore function.  For MOST GDD children, the delays are significant enough to warrant caution, however this should not translate into lack of neuromuscular stimulation. 

The newest science is changing the way we think and understand adaptability in neurotransmission in the brain. In delays or neurological disorders it was known that synaptic activity was impaired and in some instances non-existent.  Now we know this not true. (myelin facilitation of whole brain neuroplasticity J Lieff, MD. Feb 2016) In fact we can produce new transmission through stimulation with a global use of the brain's synapses, therefore a multifocal approach to stimulation! This is the simplest way to explain a very complex neuroplasticity process in the brain and nervous system.

About GDD Treatment... the child will NOT grow out of the issues, nor will placing them in sports to fix the physical delays nor general education.  The speed at which a child with GDD learns is a major part of their impairment.  The idea of a multifocal approach and stimulation offers the child an opportunity to improve.  Focus on frequency, intensity, consistency and global stimulation when in comes to physical therapy-type programs.  When it comes to additional needs a Paediatric Occupational Therapist who knows about GDD can be extremely helpful. Additionally the use of Music and Art therapy by qualified professionals will enable advanced brain activity even beyond neurotypical counterparts.

written by the Team at the BODiWORKS Institute, 2018

Tuesday, 15 May 2018

Adaptive Programming for Expression - ALL ages

The Importance of Adaptive Programming

Art and expressive therapy can seem like an illogical choice for special needs individuals. As it can require vocalization, social participation,  and motor skills.
What people may be unaware of is... how adaptable the expressive arts programming is to special needs individuals, as it can adapt/change/incorporate limitation by using non-traditional material.

For example... painting with string instead of a brush, or using masking tape or stencils to create shapes and patterns to paint in.

As well expressive arts can incorporate sensory materials to engage in self soothing techniques like shaving foam, beads, and clean hands programming. The ability to adapt and change materials, techniques, make programming inclusive is why art therapies is a great and valuable addition to therapeutic programming.

Setting goals that anyone can achieve despite their limitations, and providing support so no one feels struggle or frustration is vital to our therapeutic perspective.

We can all participate together at our own levels and abilities and feel a sense of inclusion and pride in what we are able to create. It is important to support individuals and provide them the opportunity to learn, express themselves, and be included in a community. As well as present everyone with the opportunity to feel pride in what they can accomplish no matter the outcome.

Our perspective of: 
  • support,
  • inclusivity
  • adaptation to needs... is what sets us apart from other services supporting special needs individuals.

We aim to provide service to whoever needs it and support them achieve and succeed in their therapeutic goals. Whether behavioural, motor skill development, language acquisition, emotional and contextual expression. Expressive arts therapy can be beneficial in all these areas, creating a well rounded perspective to therapy and developmental treatment.

written by Emily McLennan - Art therapist - BODiWORKS Institute

Sunday, 15 April 2018

the Power of CONTEXT for Expressive Language

The Importance of Making Contextual and Social Connection in Expressive Language

When we teach a child, we want to develop their ability to communicate and use their language. We first focus on receptive based learning, labeling items, colours, numbers and letters etc. We do this to teach the child how to label things, how to ask for what they want, and these are the basics of how they can communicate. Although teaching children how to memorize and label pictures and items which is the building blocks to their language skills, it is not the whole picture.

It is important
that we add and build on their receptive language.  This is accomplished by adding how to use these labels in context. If they know the colour blue, can their experience painting with the colour blue change how they use it. Can they paint blue sky, or blue flowers, what else can they paint blue? These social and expressive experiences expand the way children understand the receptive language they have learnt.  *Within the Autism brain it is particularly important to incorporate expressive tools such Art. When well directed, this allows the ASD brain's 'limbic system' to be overridden (calmed Amydala) so that the context can be learned and create a potential pathway for the expression.*

What do we play music with:
instruments, our hands, our fingers, our breath? Do we hit a drum, push a key, or blow a whistle? It is experiencing, music, painting, and other artistic ways of expressing ourselves that we learn the context of how things go together. By teaching children cause and effect of how things work, our aim is to build on receptive language to broaden the range of experiences.  Without exposure to new experiences, and social settings children don't have the ability to learn how to use acquired language in context.

“As we interact in a contextually rich learning environment, we
pick up relevant jargon, imitate behavior, and gradually start to act in
accordance with the norms of the cultural setting.”
—Source: Contextual Learning Strategies

written by Emily McLennan - Art therapist - BBAIM team
BODiWORKS Institute

Friday, 6 April 2018

Expressive therapies for Brain development

Expressive Language Development
through Expressive Therapy

There are many therapies offered to children who are delayed with speech and
language. The prevalence of ABA therapies dominating the industry right now is
only part of brain development in children with special needs such as autism
and other language delays.

It is important that we give children language, as well opportunities to use it in context.
We may teach children colours and words, but unless we put them in the environment
with opportunities to use the language in context. These children will struggle to
develop the spontaneous expressive language we will see in neurotypical in children.

Where your child grabs your hand and says I want to draw with blue paint today.

This is an example of spontaneous expressive language. In our program we aim to
develop the skills for our kids to spontaneously express wants and needs in the moment.
By providing opportunities, exposure to contextual language, and new experiences.
We will use art making with a variety of materials, as well as music to expand contextual language development.

Your child whether verbal or not will be involved in music making, singing,
dancing and social play that will give them ample opportunities to express themselves.
As well as art making that will not only work on motor skill development, sensory play etc.
It will provide them with opportunities expand language expression using colours, textures, and context of verbs, adjectives and nouns. Having language is great, but it is using language in social and situational expressive context that is the overall goal with
'neuro-diverse children' which means an expanded brain.

The more opportunities we contrive for our children, the more we give them the ability
to thrive in their environment. Teaching language is only half the equation, it is in the
opportunities to learn context and to apply that language in context, that children are able to really develop expressive language skills.

written by Emily McLennan - Art therapist - BBAIM team
BODiWORKS Institute

Time to Balance the Brain !

The brain needs balance for development

All the memory tasks and “do-overs” in the world will not develop the brain patterns of thinking, expressing and expanding.
Many special needs children, particularly those in the Autism Spectrum, are subject to repetitive tasks, some with hand-over-hand as their main operative developmental tool.  These do serve a very important purpose however. The brain’s intellectual part of the overall child’s ‘behavioural’ profile needs repetition. This helps in areas of daily activity skill with time dependencies and also for safety aspects. Assimilating what is safe and unsafe to do etc.  Then why is this not sufficient?
In the brain, when we repeat, contrast and correct, it learns to use minimal ‘facilitation’. Which means most of the brain lies unused in order to simplify the pattern.  Over time the neurons are ‘suppressed’ for other abilities, in favour of the easier, simplified processing.  Simply put…Much of the brain’s capabilities for emotion, physical and metaphysical remain underdeveloped. 
...Researchers have demonstrated that children with Autism who have undergone extensive “behavioural training”, which works in the areas of suppression, have reduced memory for complex thinking, cognitive organization and poorer spatial awareness.  ...This has a profound negative effect on social function, sensory management and physical motor development.  There is recent appreciation for researching the effects of suppressive brain training and the development of the overall brain…which ultimately affects behaviour.
A brain-based model approach to overall ‘excitation’ of the areas of the brain to facilitate expression, motor skills, creativity, spirituality and problem solving is very necessary for all children especially those with special needs…particularly Autism!
c/o BODiWORKS Institute

Friday, 26 January 2018

Occupational Therapy for kids - What it is?

When you hear the word 'occupation', what do you think of? You may be thinking along the lines of 'work skills' and wondering, what does that have to do with my child? Occupational Therapists define the word ‘occupation’ as the activities and tasks that individuals perform in their everyday lives that have value and meaning for them. This can include looking after themselves (self-care), enjoying life (leisure) and contributing to their communities (productivity) (CAOT, 1997a).

For a child, their main occupation is PLAY. It is through play that they grow and learn to experience the world and how things work. Play has a huge influence on many domains of child development including:
-          Gross and fine motor

-          Sensory processing

-          Cognition

-          Language

-          Social-emotional

-          Perception

-          Behaviour

Children with disabilities often face many barriers to play – these can be physical, social, cognitive, etc (Majnemer, 2010). These barriers often are associated with issues in development that cause difficulties in their ability to carry out their daily activities. This is where Occupational Therapists can help! By using a client centred, evidence-based and holistic approach, Occupational Therapists assess the child, in their occupations, within the context of their environment to determine where the difficulties may lie. Then they set goals and collaboratively determine practical solutions to enable the child’s engagement!

To help guide our practice, we use the Person Environment Occupation Model (Law et al., 1996). Here’s an example: A child is having trouble putting on their velcro shoes which in turn is leading to the frustration of not being able to go play outside with his friends as fast as he would like (their occupation). In this case, the Occupational Therapist would work with the child to provide activities to improve his hand and finger strength (the person) as well as search for environmental modifications that could help with the task i.e. providing larger velcro straps (their environment).

Occupational Therapists are always working towards helping to enable independence for children to learn the skills that will lead to increased confidence, self-esteem and overall quality of life!

written by Rachel Tavares Reg.(OT)
BODiWORKS Institute