Speaking from personal experience as I’m a newlywed of a month, transition can be fantastic…and frustrating. As excited as I was to be a wife and move into a home with my husband and continue my career, I had to keep in mind that this was an important transition in my own life and it was going to take some work! Organization has been an enormous help and I find myself making checklists for so many things (Alaina’s previous blog on checklists is excellent)! We have also been maintaining a monthly calendar in the kitchen which has proven to be quite beneficial. Not only does it keep me on track with what I have going on throughout the month, it allows my husband to be in-the-loop with my schedule and me with his. We are learning to work together to make this new season of life wonderful!

One area of transition that I see so often around this time of year is that school will soon be out for the summer! If entering a new grade in the fall may be making your child, or you, anxious, don’t be afraid to do some prep over the summer. If your child is going to a new school and they are feeling unsure of the layout and where classrooms are, work together to draw a map and practice drawing routes to and from different classrooms! If social communication and challenging situations are areas of concern, create some social scenarios and act them out and problem solve together. Be sensitive to listen and provide honest, constructive feedback.

Finding time to be alone is something I find to be crucial in preparing for any transition, whether it be for just myself or others. It is difficult enough for you to sort out the millions of thoughts running through your own brain, let alone 5 other people asking you “What’s for dinner? Did you do the laundry? Can I have a sleepover? He keeps poking me!! Do I have to go to the dentist?”  Try to find an hour or two each week for yourself to reflect and get your thoughts in order in a pleasant and non-stressful environment. Your organization and understanding of the change taking place will positively affect those around you. Suggestion: Grab a cup of coffee or tea, find a notepad and/or calendar and head to a quite place with minimal distractions. Let your thoughts pour onto your notepad in whatever order they land and then prioritize. If you begin to feel overwhelmed, don’t hesitate to take a break and work on it later.

Embrace and learn from new opportunities as they provide growth and strengthen who we are as individuals.

On the journey,

Andrea

Most of us intuitively learn the basis of communication long before we learn to speak.  We begin our lives crying to get our needs met, express pain or loneliness.  Soon, mutual engagement begins, to share an experience through eye gaze, cooing, and touching.  Our nonverbal communication is reinforced through consistent responses and positive outcomes.  However, as we recognize National Autism Awareness month, we may pause to understand how this primary modality to share our thoughts and feelings is not always readily available to individuals on the autism spectrum.  Missing key  information contributes to communication breakdown, misinterpretation of messages, behaviors and the resulting consequences of a message poorly sent or poorly interpreted. 

In "be different:  Adventures of a Free-Range Aspergian", John Elder Robison shares his experiences related to the neurotypical ('nypicals', as he refers to those not on the spectrum) assumption about the role nonverbal communication plays in the life of an individual on the spectrum.  Robison writes, "Don't worry, he doesn't even notice" was a common refrain when people talked behind my back.  Well, let me assure you, I may not have been able to read from people's subtle clues their thoughts and feelings or their expectations of me, but I absolutely noticed when they rejected or disregarded me, and I still do.  I may seem robotic and mechanical sometimes, but there is nothing mechanical or cold about my internal feelings.  I am just as sensitive as anyone to snide remarks and criticism.  I cried inside fifty years ago, and I still do today" (page 86).  He goes on to explain, "The worst thing is when I completely miss something because I'm preoccupied and my senses -  such as they are - are almost turned off."  "...I think my life experience shows that I feel things at least as deeply as anyone else." "I know there is nothing at all wrong with my ability to feel joy or sadness or love or anger or anything else.  All that's missing is the trigger.  With a nypical person, one look from someone else can set those emotions roiling.  With me, it takes more than a glance.  But once my emotions get going, they are as strong as anyone's" (96-97). 

As we recognize Autism Awareness month in April, let us keep an open mind, embracing neurodiversity, as we seek to understand one another better, communicate our thoughts and ideas more succinctly, and recognize all of us can miss a beat here and there.  The goal is to pause and reflect, give one another benefit of the doubt, and commit to helping one another participate in the dance of all forms of communication and connectedness.

The Philosophical Baby, Alison Gopnik (2009)
The Scientist in the Crib, Alison Gopnik, Andrew N. Metzoff & Patricia K. Kuhl (2000)
Einstein Never Used Flash Cards, Kathy Hirsh-Pasek & Roberta Michnick Golinkoff (2003)

These books present interesting research and concise narrations about how children’s language and cognition develop, and how parents/caregivers can best support their children’s learning. Moreover, the information within these books is presented in very non-technical language. Irrespective of our academic and professional background, or our interest and experience with child development, we can call appreciate the art of transforming something complex and involved to an idea that is easily parsed.

Within the general (and vast) field of ‘child development’, I have been thinking more specifically about a term that is attributed to Lev Vygotsky (a psychologist who, in the early 20th century, studied child development). The zone of proximal development is the knowledge and skills that a child is approximating. Without the support (‘’scaffolding’’---a term used by Jerome Bruner of New York University) provided by caregivers, the child is not able to perform successfully or demonstrate her understanding. However, with the support of a caregiver, she is within range to be successful.

Clearly, the zone of proximal development is a more theoretical construct than a concrete strategy for providing meaningful and appropriate learning supports for a child. However, I think this idea is important to consider because it reminds us that we constantly have opportunities to provide support for a child to develop skills and learn new information. Perhaps it is analogous to opening a cupboard and getting down a phone book such that the child is at the ‘right’ height to see what is on the table. (May I just say, are phone books becoming an antiquated reference? Do our young children know what a phone book is?) Once the child is at the right height, she is in a better position to learn. In essence, she is better able to create reinforcing learning opportunities for herself once she is in a certain place, and it is as a result of the adult’s scaffolding that the child is at the right place.

Continuing this analogy, within the context of the busy-ness of life, it is probably and frequently easier to just give the child whatever it is they are reaching for on the table. That is, it requires more energy and thoughtfulness to apply an appropriate support for a child that allows them to be more in control of their learning (e.g. allows them to be at the right height at the table) than it does to just give them the answer and move on. However, I believe that allowing learning opportunities to unfold naturally (and allowing the child to be in control of their learning is arguably natural) perhaps is more beneficial for the child’s cognitive development (in the long run). It seems to me that intrinsic to the zone of proximal development is the development of problem solving skills and higher order thinking (e.g. planning, implementing strategies, and assessing performance)—highly valued cognitive and linguistically based processes.

Our children’s interests will change. I like thinking that it is in their best interest to meet them in their zone of proximal development. In fact, as adults we could probably do a better job of meeting one another in a zone of proximal development. Think of what we could learn. . . HJ

I personally am excited about checklists, because the only thing I know that is more complex than doing surgery, building skyscrapers, and flying airplanes is the cognitive processing required to maintain day-to-day human interactions.  Consider that by age 9, typically developing children speak at a rate of more than five syllables--more than two words--per second (Sturm'>http://lshss.asha.org/cgi/content/abstract/38/1/47">Sturm & Seery, 2007), and that this torrent of words rides on a vaster swell of loaded nonverbal cues like tone of voice and body positioning. 

Yet we can forget about the complexity of language sometimes, because sometimes it comes easily to us and those around us.  But the truth is that learning to communicate and teaching someone to communicate can be, at times, frustrating, discouraging, and overwhelming.  It is a big job that we undertake, and we undertake it with the highest hopes and the highest aspirations: to connect with the people we share our lives with.

Amidst this task, I find calmness in checklists. There are many that I have found or made and now keep at hand, and consult regularly as I plan, carry out, and review a child’s speech, language, and communication therapy.  These checklists help you address a task that is huge, but keep you focused on something simple.  They give you a task manageable enough to ensure your, and the child’s success.  When you check something off the checklist, you know that you are completing the task at hand in the way that you planned, and in the way that you will be proud of.

Parents of children with special needs, I know that you are forever called upon to do specific homework activities or to practice new techniques for communicating with or teaching your children.  Checklists are a handy way to implement therapeutic techniques successfully.  I want to share three of my favorites here.

Checklist One: The book “Play to Talk” by James MacDonald and Pam Stoika has my favorite 5-step checklist for communicating and interacting with a reluctant or late talker.  If you find that you’re not getting as much communication as you want from your child, take time to ask yourself these five questions (paraphrased):

[] Am I balancing my communication so I say about the same amount as the child?
[] Am I matching my communication so I don’t say things that are too complicated for the child to say?
[] Am I responding to the child about the things that he/she is paying attention to?
[] Am I sharing control so that I choose activities half the time and the child chooses half the time?
[] Am I enjoying myself and showing that to the child?

Checklist Two: Especially when working with children and teens with autism, I adhere strictly to this 2-part checklist:

[] Would the chosen activity or routine be normal for a typically developing age-peer?
[] Is there one target communication skill for me to focus on? (Even though other communication skills may be improving through the activity.)

Checklist Three: The SCERTS model offers a beautiful list of “social-emotional growth indicators” that I think should be made into a universal checklist for all parents and educators working with children who have autism and other developmental delays.  Here is my adapted version of this list.  My suggestion is to ask yourself these questions and make sure you are checking off one or two of the items each time you undertake a therapeutic activity.

[] Am I attempting to increase my child’s happiness?
[] Am I attempting to help my child gain insight into his/her own thoughts?
[] Am I attempting to help my child gain access to information about other people’s thoughts?
[] Am I attempting to help my child find ways to cope with and adapt to challenges?
[] Am I attempting to help my child increase his/her mastery of an activity so that he/she can complete it without your prompting?
[] Am I attempting to bestow my child with friendships and a sense of belonging to a social group?

You take on a big job but checklists can keep your success rates high.  Happy checking!

As I sit warm and cozy with my husband and dog nearby on this Christmas Eve I feel stirred to ask, what is ‘enough’?  For children, this time of year, the list is endless.  It is indeed a magical time of cheer, hope, promise and dreams.   No matter what your faith, the spirit of giving and receiving is contagious, be it a smile, a door held or a plate of cookies.  All are gifts of the heart and gifts of generosity.  Enough is then, that which warms the heart, feeds the soul, and compels us to pass on the joy of being.

Enjoying our families through the holidays helped me realize that “enough” for our children with challenges and disabilities is often a welcome place to go, where learning is accepted on their terms and some days just showing up is the best we can do.  “Enough’’ is the effort to try…time and time again. 

It is the knowledge that growth is gained incrementally, quietly and with pride.  It is knowing that behind each triumph is a parent, grandparent, or friend who believed it could be done, just now always knowing how. 

It is the grace of accepting setbacks and roadblocks as paths to greater strength.  Believing that when ‘enough’ has been ‘enough’ we will prevail somehow, someway. 

It is knowing we have a circle of people who care, support, and tenaciously protect our dreams for us when we are tired.  Those who bring us laughter, a hug, a cup of coffee or smile…that is ‘enough’.

So as I ponder this and all the blessings in my life, I know I have ‘enough’.  I have family who love and support my dreams, accept my quirks and eat my cooking.  I have a staff that is talented and committed beyond compare, and have the very best sense of humor and love for one another.  I have clients and families who believe in us, care for us and trust in us ‘enough’ to share their precious children week after week.

Yes, I have more than “enough’’ and for that I am grateful and content.

Have a blessed new year full of ‘enough’ for you and your loved ones!

Laurie

I'm excited to write this blog post - I have been thinking about it all morning.

After I woke up, as I waited my turn for the shower to be free, I got out of bed and chose a living room chair to sit in and think. My usual sleepy morning habit is to find my laptop, and wake myself up by with a few minutes of entertainment for my mind. I check my email and read news. When I remember to, I look at The Writers' Almanac, and feel dignified to be entertaining my mind with poetry.

But this morning, I let my laptop lie where it was, because I wanted to prepare for writing this blog post today. I had decided that the topic for this post would be braving boredom. So as I was waiting for the shower to be free, I chose to sit in the comfy blue chair, and...

...sat.

It was boring. But I challenged myself to brave it - to stay in that comfy chair until it was my turn to shower, and sit with no outside sources to occupy my hands, ears, eyes, and thoughts. And after a minute, I had some great ideas of what to include in this post. Braving boredom is something that I have come to enjoy, because it has such a big payoff.

The Payoff of Braving Boredom

Braving boredom exercises inhibitory control, which is one of our executive functions. Executive functions are our brains' main tools for success - current research is beginning to indicate that executive function skills are more important than IQ when it comes to academic and workplace achievement.

Inhibitory control improves social skills:

• Stops us from disrupting a group, like a group of students listening to a teacher. Michelle Garcia Winner reminds us that boring moments are an unavoidable part of living in a social world.
• Stops us from blurting out inconsiderate observations about strangers who look different.
• Helps us quietly listen to a friend who needs to talk
• Lets us momentarily put aside our thoughts and feelings in order to see the world from another person's point of view, which is a main focus of this clinic's social communication therapy.

Inhibitory control increases personal satisfaction:

• Motivates us to see a school or work project through to completion, even though there are tedious parts that we have to slog through.
• Helps us wait all day without eating the birthday cake sitting on the counter because the party's in the evening.
• Lets us save up money for weeks, months, or years in order to make an important purchase.

Inhibitory control helps our children meet their speech, language, and occupational therapy goals:

• A child inhibits the grammar of "her go to school" after learning how to say "she goes to school" in language therapy.
• A child inhibits writing "s" backwards after learning conventional letter formation in occupational therapy.
• A child inhibits sliding off their chair and under the table when their homework gets tough, after learning to request a sensory break in occupational therapy.
• A child inhibits challenging behavior like hitting or biting after learning to push a button on their augmentative communication device that says, "Let's go swing."

In addition to all of this, inhibitory control is an executive function that's important for careful thinking. Creative thinking. Problem solving. When you devote yourself to just a couple minutes of silence, there is something amazing waiting for you on the other side of the boring moment: your own inspiration, and the pleasure of listening to the intuition of your voice.

Luckily, inhibitory control and the other executive functions get stronger with practice. They get easier and easier for people who practice regularly.

And so, this morning, I braved the boring moment to plan out the structure of this blog post. At work, I brave the boring moment at my desk, when I need to go beyond my repertoire of therapy activities in order to successfully help a child learn. Let's make it a priority to teach our children to brave the boring moment, and remember to push ourselves to do the same.

How to be Brave in the face of Boredom (Practicing Inhibitory Control)

Study a painting, a leaf, a vegetable, a bicycle - any object, manmade or from nature. When you feel bored, don't take your eyes off of it. Just keep looking. Notice your boredom, and bravely, in the face of it, keep looking for a minute longer.

Talk with your child about what thinking is. Teach the child to sit still with you, looking at a picture or object, quietly thinking. With a child, start with seconds at a time. Afterward, praise a job well done, and encourage your child to share what they had been thinking about.

Go for a silent walk with someone else. Challenge yourselves to silence until you get to a certain landmark on your walk - then, when you get there, talk as much as you want.

For older children and adults: set a timer for two minutes, five minutes - or whatever amount of time you are up to. Place the timer out of sight, and challenge yourself to sit until you hear the beep.

I am strong enough to admit that when I was younger, I ran around the house asking my parents a million and one questions about our plans for the holidays: “What/Who should I dress up as? Where are we going? What are we doing? Do I have to eat that? Who’s coming with us? Do I have to go along?”

My advice to parents this season is to take a moment and be aware of your child’s sensory level. We can use 3 terms for this:

Too fast: Anxious, fidgety, decreased focus, increased rate and/or volume of speech and frequent movement/restlessness are just a few behaviors associated with a body that is “too fast”.

Too slow: Lethargic, decreased focus, slow and sluggish movements and lack of motivation can be indicators of a body that is “too slow”.

Just right: Good focus and attention to task, cooperative, calm and controlled behaviors, good ability to follow directions and participate in activities appropriately are some of the delightful signs of a body that is “just right”.

As children begin to look through the costume catalogs, toy catalogs and the cookie catalogs (my personal favorite), sensory overload can begin to take hold. With the many limitations and expectations placed on children and even caregivers during this time, it is important to be aware of sensory needs. When experiencing a body that is “too fast”, try to participate in activities that require heavy work and/or deep pressure such as: climbing a jungle gym, giving yourself a big hug, deep breathing, wall push-ups, doing the crab walk or army crawl or wrapping up in a tight blanket. Heavy work involving muscles and joints is always great and aides in bringing a body from “too fast” OR “too slow” to “just right”.

When you notice your child has a body that is “too slow”, try activities such as: swinging, rolling down a hill, riding a scooter or a bike, participating in a music and movement activity, playing catch or jumping on a trampoline. These activities help “rev” up the system and are most beneficial when followed by heavy work or deep pressure to reach a body that is “just right”, as it can be over-alerting to complete motion activities with too great a speed or duration.  

Please remember that each child is unique; what works for one child may not work for another. A certain sensory activity may work to help regulate the body one day, but not the next. Take things one day at a time, learn and grow. I have been using children as my primary example throughout this blog, but these techniques can also be used with adults! Be self-aware, because the person who knows your body best is you! Take a look at your To-Do List and after crossing off a task, take a short break and do something for YOU. Motivate yourself to complete an activity to receive a reward, be it a snack, a delicious cup of coffee or a favorite TV show.

Again, my best wishes to you throughout this lovely season. May you enjoy your time with family and friends and take joy in the little things, as it is the littlest things that sometimes make the largest impact.

On the journey,

Andrea

With some children, it is important to be explicit about what flexible thinking ‘is’ (that is, what it looks like, feels like, sounds like etc). With other children (and arguably, with all children), simply modeling flexible thinking and behavior gives them great learning opportunities.
On a related, ’back- to-school’ note, I recently read an article, ‘Back to School Transitions: Tips for Parents’ (Feinberg and Cowan). The article was about easing what can be a difficult transition for both children and families. There is also some useful information about organization (both of space and schedules). One of the suggestions I interpreted as most functional and healthy was a consideration for how to start each day. The authors suggest starting the day with an activity instead of the television, for example, coloring, looking at a book or engaging in a preferred play routine. This is a way to better prepare the child for the academic, social and mental stimulation that awaits them during the school day.

I am a language ‘geek.’ (I suppose that is one reason I love being a speech-language therapist.) Language and cognition are tightly coupled. For these two reasons, I really liked this idea of mental preparedness, but in a fun way (of course!), at the start of each day.
If you would like to read the article in its entirety, you can find it on the National Association of School Psychologist’s website.
Here is the URLhttp://www.nasponline.org/resources/home_school/b2shandout.aspx

Once again, happy back-to-school. I look forward to seeing you and your family around the clinic. Happy Birthday to Micah (as per his request)!

Be flexible. Be kind. Be well.

Hannah

20 WAYS TO GET MENTALLY TOUGH

- read this each morning and whenever you need a reminder to keep you thinking positively and moving ahead!  By Jon Gordon
Excerpt from Training Camp: What the Best Do Better Than Everyone Else

1. When you face a setback, think of it as a defining moment that will lead to a future accomplishment.

2. When you encounter adversity, remember, the best don’t just face adversity; they embrace it, knowing it’s not a dead end but a detour to something greater and better.

3. When you face negative people, know that the key to life is to stay positive in the face of negativity, not in the absence of it. After all, everyone will have to overcome negativity to define themselves and create their success.

4. When you face the naysayer’s, remember the people who believed in you and spoke positive words to you.

5. When you face critics, remember to tune them out and focus only on being the best you can be.

6. When you wake up in the morning, take a morning walk of gratitude and prayer. It will create a fertile mind ready for success.

7. When you fear, trust. Let your faith be greater than your doubt.

8. When you fail, find the lesson in it, and then recall a time when you have succeeded.

9. When you head into battle, visualize success.

10. When you are thinking about the past or worrying about the future, instead focus your energy on the present moment. The now is where your power is the greatest.

11. When you want to complain, instead identify a solution.

12. When your own self-doubt crowds your mind, weed it and replace it with positive thoughts and positive self-talk.

13. When you feel distracted, focus on your breathing, observe your surroundings, clear your mind, and get into The Zone. The Zone is not a random event. It can be created.

14. When you feel all is impossible, know that with God all things are possible.

15. When you feel alone, think of all the people who have helped you along the way and who love and support you now.

16. When you feel lost, pray for guidance.

17. When you are tired and drained, remember to never, never, never give up. Finish Strong in everything you do.

18. When you feel like you can’t do it, know that you can do all things through Him who gives you strength.

19. When you feel like your situation is beyond your control, pray and surrender. Focus on what you can control and let go of what you can’t.

20. When you’re in a high-pressure situation and the game is on the line, and everyone is watching you, remember to smile, have fun, and enjoy it. Life is short; you only live once. You have nothing to lose. Seize the moment.

Laurie Johnson, MA, CCC-SLP, CEO