Posts made in August 2010

When it comes to challenges..especially with handwriting tasks listen to your child’s complaints…carefully

Sense-able feelings—when learning new skills

In addition to individual therapy, I also provide therapy camps and groups. These groups help children with sensory processing (Play YOUR Way to Sensory-motor Success), handwriting (Write Incredibly Now WIN™) and social skills (Personal Options and Preferences POP™) in a supportive peer/task environment.

And inevitably every now and then there is at least one or two kids who drop out because (as reported by mom), ‘their feelings got hurt’.

On a closer look these were the kids that really needed the groups! The ones that cracked at even minor frustrations, were over-sensitive to unintentional “slights” by the other children, who had difficulty following a one-step direction in a 1-1 setting and/or whose short term memory was almost non-existent.

As therapists we are doing our job when we challenge a child to make choices that change old, non-productive patterns. The disconnect happens when the child complains (often tearfully) to the parent that “everyone is mean to me in the ___________group”.

I have thought long and hard about how to circumvent this and I think I have a solution I want to share. By providing parents a before group syllabus and letting them know what we are doing in advance they can support the child at home and ask the appropriate questions to counter the complaints. I use the following chart form.

Using handwriting as a sample (from my WIN™ program)* I offer this example:

What activities Purpose Anticipated (child) Responses* (all activities are new to the children and have never been tried before) Functional Goal
Sliding a straw between three fingers In hand translation skills Awkward motor skills-some frustration Increased in hand fluency
Paper cup button catch Visual tracking

Timing

Competition with peers

Some possible frustration

Increase in-hand timing and visual tracking
Paper cup shell game Visual memory

Visual tracking

Visual spatial organization

Acting silly

Reluctant to try (some)

Peer helpers

Increased visual skills with constancy and movement
Water bottle rock turning Increase palmar “apple hand” position

Increase finger individuation

Increase wrist stability

Fun to make

Hands get tired

Decrease wrist rotation

Hard to keep wrist steady

My fingers won’t move “right”

Making choices

Estimating skills (when bottle is “heavy enough”

Prepositional understandings with movement

Increase isolated finger movements

Wikki-Stix relief rubbing Increase tactile awareness

Increase kinesthetic skills

Automatic pride in being able to make a complex form Learning shapes automatically without vision a foundation skill of automatic writing
Workbook To systematically introduce formation and fluency Hesitant at first

May rush through to get it done

May not want to correct self

Learning that to do it right is more important than to do it fast

Pride in a job well done

Self-measure progress

*This is only a partial list

Now that the parent is aware of what is going on in the class, it is also important to let the parent know when all this is going to happen. A timeline of what to expect can be very helpful for the parent to help the child through frustrations and expectations. Using the WIN™ program again as an example, I often tell parents that this is a 12-hour program offered (usually in 4 3-hour days) so here is what you can expect:

  • Day One—NO writing we will spend the whole day playing with our hands and bodies and learning how they move and how we can be “in charge of them” instead of them being in charge of us!
  • Day Two—tracing, nonsense shape making, chalkboard activities, blindfolded “writing”, gross and fine motor fluency activities, and initial workbook activities.
  • Day Three—All of the above and new games and crafts to put in our end of session take-home bags, putting our bodies together games using fine and gross motor patterns within one activity, continue in our workbook
  • Day Four—finish the workbook, and do Mad-Glad-Grab Sentences to learn about writing paragraphs with the T-E-C System (Topic Embellishers and Conclusions)—both trademarks of the WIN™ handwriting system.

Now the parent knows what and when and has some really useful tools when talking to their child about their feelings about writing, making new friends or tolerating unfamiliar situations.

But that still leaves us with the issue of how to help the emotionally fragile child. This is the child for whom everything is upsetting. The very act of walking into an unfamiliar place can be so upsetting that they need what I call a “first day shadow”, or a special “transition toy” that they can have with them the whole time. For these children creating trust is often synonymous with safety and both must be in place before learning can occur.

Even with all this in place, there will often be that “one child” for whom group therapy settings are just too much. The chaos of the group, the noise level, the stimulation of people moving, the inability to know how to ask for help, etc. can all be influences that impact a child’s ability to benefit from a given program.

So above all else, make sure that the parent knows that you are available to them by phone, email, written note, whatever works for the both of you. And YOU want to know how their child is reacting before they take action to remove him from the group. Letting the parent know that their child’s success is your only objective puts you both focused on the same goal—a happier more functionally secure child.

School is starting…translation…worksheets and homework!!

Handwriting: Why is something so “simple” so hard?

The controversy over handwriting is clear evidence that computers have not “killed” it.

Handwriting is more than pen to paper.  The lack of the ability to write has a diagnosis: dysgraphia. Dysgraphia is “…a learning disability resulting from the difficulty in expressing thoughts in writing and graphing. It generally refers to extremely poor handwriting.” (Medical Dictionary definition)

Keith E. Berry, Ph.D., author of the Developmental Test of Visual-Motor Integration, known as the VMI, is a “gold-standard” standardized test often used by psychologists, occupational therapists and other professionals to evaluate educational abilities. He addresses the issue of handwriting, citing that is a “natural vehicle for teaching” and that it is “frequently an indicator of children’s mental and social foundations.” This visible, graphic, tangible illustration of performance is a powerful reinforcement that can be either positive or negative.

Dr. Berry writes, “Because it is so visible (in contrast to spoken language), poor handwriting often operates as a self-fulling prophesy. If a child is allowed to continuously portray his mental and social inadequacies graphically, he may come to increasingly believe that he is an inferior person and to behave accordingly.”

Concurring with Dr. Berry, Jeanette Farmer, and pediatric handwriting expert in Denver, Colorado states that “handwriting is as important in the development of other intellectual faculties.”

In other words, what your child produces is how he or she sees themselves and that translates into a major influence on how he or she behaves. It is also important not to underestimate the influence of peer appraisals. The kid sitting next to your child probably has more influence over their self-esteem than you

(i.e. parent, teacher therapist) do. Pride in one’s work and feeling peer competitive is at the foundation of solid social and emotional well-being.

There are other concerns as well. Sensory-motor development is intrinsically linked to ones’ fine motor ability to being able to successfully manipulate environmental elements. Handwriting is the constant thread that links these various fine motor demands. A child can have difficulty dressing, but that happens at home, in private, no one really knows. A child has difficulty writing, that happens in school and everyone can see it. Poor handwriting cannot be hidden, ignored, or avoided. It is “in the face’ of the child for the entire school day. No wonder homework becomes a fight. They cannot fight the teacher; but Mom and Dad are easy targets for their frustrations and fears.

Learning issues are often reflected in motor performance, and the most visible school-based motor performance is handwriting. Handwriting is the task of putting something on paper. Handwriting difficulties graphically confront the child with his/her inadequate abilities. This graphic confrontation is often emotionally bruising.

Children with LD “look” like they understand, they are smart, and yet they seemingly, willfully, just don’t do their homework and if they do, it is often messy.

There are real neuro-motor reasons for handwriting difficulties that cannot be out-grown and that will not self-resolve. Understanding this neuro-motor system is key to teaching handwriting to children who find handwriting difficult and painful.

Sloppy papers are not on purpose. Addressing these issues frustrates teachers and parents; but most of all it impact the child in many negative ways. Punishment does not help.  Often the (younger) student misses recess and the older student gets detention. And still, the homework remains messy, late and incomplete.

The student is subsequently labeled lazy, uncaring, willful, and the list goes on.

The child seems to be lost in a sea of unattainable expectations.

While no assisted device should be discounted, it is important to note that computers, Alphasmarts®, and the like cannot eliminate handwriting.  Therefore the appropriate teaching of handwriting must be addressed for all children, and especially for the LD child experiencing developmental sensory-motor issues.

With Occupational Therapists and teachers, working closely together, can embed  regular classroom tasks with simple everyday activities and techniques that can help children write more securely, getting their thoughts, ideas and feelings down on paper readily.  Related handwriting skills also teach how to visually scan and copy, thus helping the student express his/her full potential and to be more peer competitive.

Resolving the homework issues is often resolved when handwriting is remediated.  Knowing how to write must be paired within knowing what to write.  And knowing what to write must be taught with an understanding of the obstacles to the actual task of writing.

Understanding and identifying those obstacles are essential for helping children overcome their resistance to both handwriting and homework. It often takes the trained occupational therapist to guide the child through the maze of developmental issues impacting the realm of fine motor issues.

Often children with handwriting difficulties have a real discomfort with pencil in their hand.  We can see these children at a glance in the classroom, they have a “death grip”, a flimsy wobbly pencil, a wrapped hand that hides the pencil, their sitting postures are reflective of their hands, stiff, floppy, squirmy, etc.

Their issues aren’t just happening in their hands, it is happening in their physical bodies, and their emotional beings as well.

Addressing their physio-emotional issues while giving them a structure to assist with their organizational abilities helps them to become more confident in their abilities, thus able to demonstrate their actual competencies.

Those competencies: physical, emotional, neurological and intellectual interact concurrently and constantly in all of us.  For children with LD, facilitating the expressions of these competencies is the essential first step to resolving the handwriting, homework and self-esteem issues.

And changing a child’s handwriting from scribble and scratch…slow and labored…to legible…Can be life-altering.

Can something that is so important really be useless? The argument that doctors have poor handwriting is invalid. They write in a fast coded shorthand for pharmacies, this is not if you ask them, representative of their personal handwritten communications.

Besides, my elementary teacher, Mrs. Buckingham of treasured memory, who insisted on precise formation and penmanship used to stress “we are what we write”. And we are so much better than sloppy papers and defensive excuses.

Handwriting matters, and school is starting….

Handwriting: Why is something so “simple” so hard?

The controversy over handwriting is clear evidence that computers have not “killed” it.

Handwriting is more than pen to paper.  The lack of the ability to write has a diagnosis: dysgraphia. Dysgraphia is “…a learning disability resulting from the difficulty in expressing thoughts in writing and graphing. It generally refers to extremely poor handwriting.” (Medical Dictionary definition)

Keith E. Berry, Ph.D., author of the Developmental Test of Visual-Motor Integration, known as the VMI, is a “gold-standard” standardized test often used by psychologists, occupational therapists and other professionals to evaluate educational abilities. He addresses the issue of handwriting, citing that is a “natural vehicle for teaching” and that it is “frequently an indicator of children’s mental and social foundations.” This visible, graphic, tangible illustration of performance is a powerful reinforcement that can be either positive or negative. 

Dr. Berry writes, “Because it is so visible (in contrast to spoken language), poor handwriting often operates as a self-fulling prophesy. If a child is allowed to continuously portray his mental and social inadequacies graphically, he may come to increasingly believe that he is an inferior person and to behave accordingly.” 

Concurring with Dr. Berry, Jeanette Farmer, and pediatric handwriting expert in Denver, Colorado states that “handwriting is as important in the development of other intellectual faculties.”

In other words, what your child produces is how he or she sees themselves and that translates into a major influence on how he or she behaves. It is also important not to underestimate the influence of peer appraisals. The kid sitting next to your child probably has more influence over their self-esteem than you

(i.e. parent, teacher therapist) do. Pride in one’s work and feeling peer competitive is at the foundation of solid social and emotional well-being.

There are other concerns as well. Sensory-motor development is intrinsically linked to ones’ fine motor ability to being able to successfully manipulate environmental elements. Handwriting is the constant thread that links these various fine motor demands. A child can have difficulty dressing, but that happens at home, in private, no one really knows. A child has difficulty writing, that happens in school and everyone can see it. Poor handwriting cannot be hidden, ignored, or avoided. It is “in the face’ of the child for the entire school day. No wonder homework becomes a fight. They cannot fight the teacher; but Mom and Dad are easy targets for their frustrations and fears.

Learning issues are often reflected in motor performance, and the most visible school-based motor performance is handwriting. Handwriting is the task of putting something on paper. Handwriting difficulties graphically confront the child with his/her inadequate abilities. This graphic confrontation is often emotionally bruising.

Children with LD “look” like they understand, they are smart, and yet they seemingly, willfully, just don’t do their homework and if they do, it is often messy.

There are real neuro-motor reasons for handwriting difficulties that cannot be out-grown and that will not self-resolve. Understanding this neuro-motor system is key to teaching handwriting to children who find handwriting difficult and painful.

Sloppy papers are not on purpose. Addressing these issues frustrates teachers and parents; but most of all it impact the child in many negative ways. Punishment does not help.  Often the (younger) student misses recess and the older student gets detention. And still, the homework remains messy, late and incomplete. 

The student is subsequently labeled lazy, uncaring, willful, and the list goes on.

The child seems to be lost in a sea of unattainable expectations.

While no assisted device should be discounted, it is important to note that computers, Alphasmarts®, and the like cannot eliminate handwriting.  Therefore the appropriate teaching of handwriting must be addressed for all children, and especially for the LD child experiencing developmental sensory-motor issues.

With Occupational Therapists and teachers, working closely together, can embed regular classroom tasks with simple everyday activities and techniques that can help children write more securely, getting their thoughts, ideas and feelings down on paper readily.  Related handwriting skills also teach how to visually scan and copy, thus helping the student express his/her full potential and to be more peer competitive.

Resolving the homework issues is often resolved when handwriting is remediated. Knowing how to write must be paired within knowing what to write.  And knowing what to write must be taught with an understanding of the obstacles to the actual task of writing.

Understanding and identifying those obstacles are essential for helping children overcome their resistance to both handwriting and homework. It often takes the trained occupational therapist to guide the child through the maze of developmental issues impacting the realm of fine motor issues.

Often children with handwriting difficulties have a real discomfort with pencil in their hand.  We can see these children at a glance in the classroom, they have a “death grip”, a flimsy wobbly pencil, a wrapped hand that hides the pencil, their sitting postures are reflective of their hands, stiff, floppy, squirmy, etc.

Their issues aren’t just happening in their hands, it is happening in their physical bodies, and their emotional beings as well.

Addressing their physio-emotional issues while giving them a structure to assist with their organizational abilities helps them to become more confident in their abilities, thus able to demonstrate their actual competencies.

Those competencies: physical, emotional, neurological and intellectual interact concurrently and constantly in all of us.  For children with LD, facilitating the expressions of these competencies is the essential first step to resolving the handwriting, homework and self-esteem issues.

And changing a child’s handwriting from this:……

Sample of messy handwriting

to this……

Can be life-altering.

Can something that is so important really be useless? The argument that doctors have poor handwriting is invalid. They write in a fast coded shorthand for pharmacies, this is not if you ask them, representative of their personal handwritten communications.

Besides, my elementary teacher, Mrs. Buckingham of treasured memory, who insisted on precise formation and penmanship used to stress “we are what we write”. And we are so much better than sloppy papers and defensive excuses.

You are NOT a Bad Mother!!

You are NOT a Bad Mother!!

Motherhood is tough business and I wrote this article originally for Exceptional Parent Magazine, but I wanted to share it with all of you who may not have seen it, and may benefit from it.

You are NOT a bad mother!!— Exceptional Parent 2008

Whoever said, “motherhood is not for wimps” had it right.  You are loved.  You are hated. You are needed.  You are rejected.  You are thanked.  You are ignored. You cannot eat, go to the bathroom or have a conversation, that there is not an audience otherwise engaging you.

And you chose to do this (90% of the time)!!

It is not a “25-year” job, it is lifetime and it has been my experience, perhaps beyond.

It is a commitment unlike any other and it carries with a responsibility that can be, at times, overwhelming.   Even all the more so when that little bundle you carried home from the hospital with such promise begins to grow and develop behaviors, or concerns that weren’t part of the “original bargain”.

“Mrs. _________, your child is acting out in class.  He hits (or bites) other children.  Mothers are complaining.  If you don’t do something we will have to ask you to take your child out of the school.”

“Mrs. ____________, Sally just isn’t trying.  She is obstinate and oppositional and you must do something about her behavior!”

These and similar comments are devastating.  What are you doing wrong that every other child can function in school, but yours?  The one thing you really set out to do well you are failing at.  There, conspicuously out in the open for everyone to see—that, YOU ARE DOING IT WRONG.

This leaves you feeling that YOU are a bad mother.  Everyone else does it better and why is it only your child who is acting out.

Well, I am here to tell you, you are not a bad mother. So “GET OVER IT”. Your child is who they were meant to be—flaws and all.  No one is perfect and that is true for you as well.

The issue isn’t  “is there something wrong”, but how can my child be nurtured so that they can become what they want to be?

The Silver Screen version of childhood is an illusion.  It is hard work growing up.  In the short span of those first five years children have to learn to eat, play, listen and get along.  And if that child has a learning issue the job of growing up is all that much harder.

A child with an auditory processing disorder may not hear the world as you and I, making verbal directions may sound like static on a bad radio.  Visual processing disorders may cause a child not to be able to hold a steady gaze so everything may appear as if it is on a rocking boat.  Sensory motor disorders may make them more sensitive to the touch, so a “bump” may feel like a  “hit”.  Word retrieval issues can easily be interpreted as a child who is shy (or aloof) when in fact, they cannot find the words to say. These children are often seen as “acting out”, when in truth they are only reacting to what they perceive to be “reality”. Albeit their reality is skewed, but it is real to them.

It is essential for these children to have structured learning situations so that they can thrive and not just survive the school day. 

But how do you get there, and to whom do you turn to for guidance?  Seeking out occupational and speech therapists are wonderful first steps.  They can help explain to both you and the teachers how your child is seeing their world.  Once that vision is established understanding can evolve and accommodations can be made.

In order for children to learn, they must first know how to play and in order for children to seek to play, it must be fun. A child coping with developmental issues is not having fun. Everyday is a struggle.  Every interaction is potentially threatening, holding within it the possibility of failure, ridicule and rejection.

If you felt that way how would you act?  Think about that!  This is not about you, Mom, and those that want to make it a reflection on your ability as a mother, are deeply misguided.

So suck it up, hold your head high, and be proud of your child and yourself. Your child is busy doing the job of becoming—and it is just harder for some children than others

Why I work with kids!!

I am starting this blog because I work with kids and daily I get phone calls from parents who are confused, angry, upset, bewildered or just plain tired!!
Raising children is hard enough but when you add in the challenges that come with navigating the issues with a youngster with special needs the issues become complex and often confusing.
In a rush to fix things…isn’t that what mothers are supposed to do???? I hear about a lot of money being spent on fake promises ….
     *your child will gain 6 months of skills in 6 weeks!!
     *this program is totally fool proof!!
     *we can train your child to succeed!

Golly if they can really do all those things why are they advertising??

I know as a parent I would have been camping on their doorsteps and promising the moon to help my child quickly and completely!!

But alas, after 3 kids and umpteen tutors, and a lot of money spent on testing, some helpful some not, I have found that nothing works like work.

What that work is depends on the child. But none the less it is work.  It is what we as parents need to do, and what we need NOT to do.  Both are equally important!!

One thing I did learn is that parents cannot be therapists, and they cannot be tutors.  At least not in my case.  It blurred the lines between nurturer and “demander”.

It made the the relationship with one of my children one where I was more about getting “it” done –the end product–get this assignment in on time–and less about the process which is all about what learning should be.

One thing parents CAN do is be supportive, loving and structured.  Let your kids know where the boundaries are.  Nothing gives a kid security like knowing what is expected of them to do and not to do.

I used to say to my kids “care–share–and obey”–care about yourself and others, share things and feelings and obey the rules (mainly me).

So as a veteran mother, Occupational Therapist and advocate, I share this blog so we can grow together and perhaps I can take the fear out of different and put fun in instead.

I will be talking more!!  BE Brave!! Susan N. Schriber Orloff, OTR/L