Connecting with a Multidisciplinary Approach
By: Stephanie Magnussen
Although it may seem apparent that a child needs specific help, there usually are many layers to an individual’s needs. For example, if a child has a speech delay, the parent may request that he sees a speech pathologist. But why does this child have a speech delay? Is there is a sensory need that is not being met, or are there developmental delays or behavioral issues at work? Kids are complicated little people, and it’s important to remember that what we see is only the tip of the iceberg. It’s really beneficial for a group of therapists to explore what lies beneath the surface to give the child the most effective strategies to thrive academically, socially, and mentally.
Perhaps the short term goals for a child with Autism Spectrum Disorder are maintaining eye contact and increased vocabulary, and the long term goals are independence and integration into a typical classroom. The speech pathologist will develop activities that increase vocabulary, while the occupational therapist creates drills for promoting eye contact, and the psychologist may make social stories that build confidence and promote more appropriate social behavior. Just having one therapist would not be the most advantageous for the child and family in this case. The parents are also part of the multidisciplinary team. They must be on board with practicing what the therapists are working on and provide a supportive environment for the child to thrive under this team approach.
At Connecting Dots, all of the therapists are registered health care professionals with Master’s level education. They all work together and share ideas on how to set a child up for success by using each of their expertise. If a child is exhibiting disfluent speech or a stutter, and therefore struggling socially at school, of course we want to promote smooth speech, but there may be other issues to address. The child may have motor planning deficits which result in disfluent speech. The speech pathologist can work on an action plan for smooth speech, while the occupational therapist develops a plan to promote increased ability for the muscles to make the correct movements for speech. Psychologists are also a key part of this multidisciplinary approach. Communication is not just the words that we speak, but also our ability to interact with those around us. Any disability can be stressful for a child, and may result in anxiety and social isolation. A psychologist can identify activities and games that will help a child excel socially.
As an aide at Connecting Dots, I have been fortunate to work with speech pathologists, occupational therapists, and psychologists and have seen the gains my clients are making by working on each piece of their puzzle. Every child’s background and needs are so diverse, and an individualized plan with input from different types of therapists allows the team to work on gains for the child in a holistic manner. It is truly a team approach between the therapists, aides, and family members.
Story Cubes: A Play Based Learning Opportunity
By: Stephanie Magnussen
At Connecting Dots, the therapists are skilled at creating play based learning activities based on the individual child’s needs. When learning is play based, the child looks forward to sessions with the therapists and this excitement makes it easier for the child to be engaged in the activity. Based on each individual’s contract, the therapists will work with the child a few times each month. I work as an aide, and am therefore with the clients and families multiple times a week, enacting the therapists’ and family’s goals through creative and play based approaches. I was looking for a game for one of my clients that promoted long sentences, complex ideas, and smooth speech when I found Story Cubes. Story Cubes are affordable and fun and have been working really well with my clients!
Story Cubes are a set of nine, six-sided dice that have an image on each side. Each player rolls three to four dice at a time and has to create a story based on the images. When I use it with my clients, I have a sheet of paper next to us that has the important elements of a story: Plot, Setting, Characters, Conflict, Solution, and Theme. Based on the developmental goals of the child, theme is optional to include as it can be abstract. In the first roll, player one must create the setting and identify the main character. The second roll introduces more characters, and expands on the plot. The conflict is introduced between the second to fourth roll and the solution is achieved in the fourth to eighth roll. Of course there can be as many rolls as one likes, but I find that kids can get distracted by too many details, and the stories make more sense when there are six to eight story turns total. After ever two turns, I refer back to the piece of paper that has the list of important story details and the child recounts what has happened so far and identifies each of the major components of our story. If I am trying to promote smooth, clear speech with my client, I keep a tally of all of the smooth sentences that are over eight words that my client has said. I involve the client in this, so it isn’t anxiety provoking for him or her. I’ll say things like, “Wow! That was a really smooth sentence! I think you should make a tally on the smooth sentence side,” or “Take a deep breath before you start your next sentence because it is going to be a long one!” After a few sessions, I can see the progress of smooth versus bumpy sentences during story cubes when comparing the smooth vs. bumpy tallies. For older children and when appropriate, after the game is finished, I ask what the theme of our story was. It is always so interesting to see how creative kids can be and it makes for more speech opportunities to give the client the chance to describe the theme.
Story Cubes have been a great tool to use with my clients because it also allows them to be creative and silly. It promotes organized thinking because although it is a free flowing game, certain components of the story have to be identified by certain rolls. Also, the child can’t just create a nonsensical story. I make sure to check in with him or her after ever two turns so that they have a clear understanding of what is happening in the story and what needs to happen to reach a resolution. I make sure to remind each client before his or her turn to take a breath and think about what they are going to say and how each story cube will relate back to the story itself. This has been a great game for kids that are having trouble expanding on ideas, creative writing, are exhibiting non fluent speech, or need help organizing their thoughts or with memory. I bought mine at Wal-Mart, but there are lots of options on amazon.ca as well!
BUY: https://www.amazon.ca/s/?ie=UTF8&keywords=rory%27s+story+cubes+actions&tag=googcana-20&index=aps&hvadid=208374709405&hvpos=1t1&hvnetw=g&hvrand=10784001746003414714&hvpone=&hvptwo=&hvqmt=b&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9001318&hvtargid=kwd-301462617545&ref=pd_sl_5xic1vikrd_b
The Importance of Serve and Return
By Simran Saroya
We all know that a child needs nurturing relationships to help them grow but to what extent does a child need the caregiver there? The basic concept of serve and return will explain how important it is for the caregiver to be present AND engaged with the child.
What is serve and return?
Serve and return is about building relationships and strong brain foundations. During serve and return, the child’s brain is forming many connections. These connections start very early, as soon as the child “coo’s” and the adult responds to the child. The child may serve using various forms of communication such as: eye contact, touch, through games or verbal cues. This serve is an indicator that the child is interested in something or that they want to engage in an activity. Think of it as a game of tennis, where the child serves the ball and the caregiver receives the serve and then serves back.
Why it is important:
Healthy brains are built by forming healthy foundations which all start with daily human interactions. Being present physically and emotionally will benefit the child and strengthen the relationship between the parent and child. Staying attentive and responsive to the child’s needs helps the child make and build strong and solid foundations for brain development. These strong foundations will help build strong relationships as well as better the child’s learning and understandings. Always keep in mind that these interactions must be positive, meaningful and directive to help create strong brain architecture within the child’s brain. Emotion, visual, language, memory, motor skills and behavior control all depend on the neural connections the child makes while engaging with their caregiver. For example, if your child has picked up an animal book and has brought it over to you, that is their serve. The adult can then take the book and read it to the child or go through the pictures with the child, which is then returning the serve. It is as simple as paying attention to their interests. This will lead to more learning and more experiences. Being responsive and acknowledging the child’s interest in wanting to read that book will lead to recognition of letters and reading.
Negative factors:
Sometimes we forget that engagement from a parent holds so much importance especially among the young children. A parent may be exhausted from a day at work and not think twice about what their five-year-old is bringing over to them. This disrupts the relationship building, instead of avoiding the child or being passive about it, acknowledge that they have brought that story up to you and set aside a better time to read it together. Being enthusiastic and interested in what your child is interested in will help build a stronger connection. Putting the child by a computer screen or TV will hold their interest and have them engaged but will not build healthy brain development. This is called passive communication, where you may be present but not fully engaged. There may be barriers that sometimes permit the serve to be responded to such as a phone call or text but there is a difference between being responsive and distracted or just being unresponsive. Passive activities will not build healthy and strong brains. Our goal is to build healthy brains.
Children need positive interactions and positive environments around them to thrive. It is our job to ensure that the children in our life have adults who consistently engage in serve and return with them to build healthy foundations in the brain for all their learning, behavior and health in the future.
Connecting with OT
By Tammy Cheng
“What is Occupational Therapy? Do you help people find jobs?” These are the questions I get asked the most when people ask me what I do, or they may just agree in silence pretending they know what Occupational Therapy is.
Occupation is not just about work or productivity. It is anything we do that occupies our time! Think about what you do in a day… you get out of bed, brush your teeth, make breakfast, drive to work, go to school, meet your friends, go to yoga classes, play sport, and the list goes on. These are some of the occupations that are meaningful to us, and the list looks different for everyone. Now think about a person who is wheelchair bound or has a mental illness. Getting out of bed may seem impossible; the sink or the counter may be too high and not accessible; how is he/she getting to work or school? How can he/she participate in sports? This is where Occupational Therapy comes into play.
Occupational Therapists (aka. OTs) help people of all ages to do things that they want or need to do regardless of their abilities. We help people function in their environment and address the physical, psychological, and cognitive aspects of their well-being. Some common Occupational Therapy interventions include helping children with disabilities to participate fully at home, school and social situation, helping people recover from injuries and return to work, recommending strategies at workplace to prevent injuries, and supporting seniors with physical and cognitive limitations to ensure they live life to its fullest.
What do OTs do at Connecting Dots?
OT services at Connecting Dots focus on enabling children to participate in meaningful activities through play. We help children with:
- Cognitive skills – remembering letters, shapes and sequences
- Fine motor skills – hand writing, finger and hand strength, wrist and forearm control
- Gross motor skills – balance and body coordination
- Self-care skills – dressing, toileting, feeding, sleeping, routines
- Social skills – play, taking turns, sharing, listening, following directions
- Sensory regulation- responding appropriately to your environment and experiences
We work closely with other team members to provide you and your child with coping strategies to deal with day-to-day challenges. Every child is different and we tailor the goals around your needs. We help you problem solve and put the FUN into functions!
What influences my child?
By Simran Saroya
The world of a child is just as busy as the world of an adult. Sometimes we forget how many factors a child has to take into account while going about their day. It is important to understand that the child is influenced by many things outside of their immediate environment. Well, how is the child’s development effected by the people and world around them? Let’s take a look at the Ecological System’s Theory. The concept is simple. It is a model that is made up of five systems. These five systems are the microsystem, mesosystem, exosystem, macrosystem and chronosystem. They explain how everything inside the child and the child’s environment affects their development and growth.
So, in a child’s microsystem they might have immediate family, caregivers, teachers or peers in environments such as their home, daycares, schools and more. This system is the most influential on the child. These are the people and places involved in the child’s everyday life. In their everyday life, there are settings where a child may feel a sense of security, comfort, happiness and love. It is crucial to recognize that the environment that you provide or choose for your child, supports the child’s physical, emotional, social, and cognitive development. In the world of play, there is a lot more going on than what we see.
The second system is the mesosystem, it is simply two or more microsystems and their relationships. This will have indirect impact on the child. An example of as the relationships between the child and the child’s teacher. Parents may take an active role in the child’s school life by taking part in parent teacher conferences and volunteering in the classroom. This will be a positive impact in the child’s life because his/her microsystems are working together. This could also be a negative impact if the microsystems were working against one another instead of together. This is why it is important to have all supports and people in the child’s life working together to ensure all responses are positive.
The third system is the exosystem. This system looks at external factors and how they influence the child such as the parents job or neighborhood influences. A parent’s promotion or loss of a job may not directly influence the child, but will have an indirect effect. If the father of the child is very busy and tends to come home really late from work and doesn’t have time to spend time with the child, this will have a negative impact on the child. The child might start to feel sad, anxious or guilty.
The fourth system is the macrosystem, this system is a part of our “bigger picture”. This includes cultural aspects and all other influences in the child’s life. Some examples of the macrosystem are: the economy, cultural values and politics. These factors can have a positive or negative impact.
Lastly, the chronosystem talks about the time in relation to development. This could be something such as the death of a parent. Now, your two-year-old will react differently to this than a teenager would. They might not know exactly what is happening or understand it as a child but they may have an empty feeling inside. This could also be growing up in different historical events such as war. This is uncontrollable and just dependent on the time and place you are in.
All five of these systems go hand in hand in the growth and development of your child. Being aware of the external influences as well as internal will not only help benefit your child but also help benefit you.
Connecting with Psychology
By: Alshaba Billawala
Here’s what you need know about Psychology services at Connecting Dots!
Psychologists can be found in several different settings – they can be found in schools, private clinics, community organizations, small or large businesses, hospitals, etc. However, our psychologists at Connecting Dots play a special role. At least we like to believe so! So, what exactly do the psychologists at connecting dots do?
Psychology services at Connecting Dots focus on helping families and children overcome the various challenges they may face. They provide counselling and/or play based therapy to individuals, families and couples and often they do so in your natural environment(s).
What’s a natural environment? We’re glad you asked!
Simply put, a natural environment is where we would naturally find you at a given time. For children, this is often in their homes or at school. The advantage of working with someone in their natural environment is that the strategies and ideas your psychologist proposes are usually with consideration of the environment in which they are meant to be used. This typically allows for increased effectiveness and more wiggle room to troubleshoot anything that is not currently working.
There are various roles that our psychologists can play in supporting you and your family.
Some common examples of areas that a psychologist may be able to support you include:
- Emotion regulation– supporting children and family members in being able to identify their feelings and learning tools and strategies to cope with them
- Behavior management – supporting families with identifying creative ideas to reduce any problematic behaviors their children are engaging in
- Developing play and social skills – supporting children in developing advanced play skills (e.g., moving from solitary play to parallel and interactive play) and learning ways to improve their ability to interact with others in meaningful ways
- Developing independence – supporting families with identifying tools to improve the independence of their children in various areas (e.g., in completing activities of daily living)
- Identifying resources – supporting families in becoming connected with various organizations that may be able to further support your child/family
- Providing counselling support to family members of a child with special needs. As discussed further here, having a child with special needs impacts not only the child but also the broader family. As such, having support from a professional for the parent(s) or siblings can often be very helpful.
Collaboratively, our psychologists can work with your family to identify the areas with which your child is struggling and help you come up with creative approaches to move in the direction you want.
If you are interested in learning more about how our psychologists can support you, please feel free to contact us!
Connecting Without Screens
By: Elizabeth Wotherspoon
In that moment when you’re passing off the iPad to your little one just to get a minute of peace, have you ever wondered what our parents did to occupy us without having access to screens?
Smartphones, tablets, TVs, and computers have become SO prevalent in our everyday lives. They hold our schedules, contacts, entertainment, and so much more and having everything in one spot makes our lives a little easier. The advances that have been made in technology are both incredible and useful, but we need to be careful about how much our children are interacting with screens.
I’m a new speech-language pathologist (SLP) and just like you (probably) I wondered, “What’s so bad about a screen? They keep kids busy and lots of the apps, videos, and TV shows target learning!” BUT, since I began working with children all day, every day I have come to learn (by seeing firsthand) that too much screen use can put children at risk for problems with language, attention, and cognitive and/or physical development.
How much is too much?
Based on recommendations in the Canadian Paediatric Society Position Statement – Digital Health Task Force Research Review (2017), children under the age of 2 should not be exposed to screens at all and children ages 2-5 should have exposure to screens for less than 1 hour per day.
Anything over these guidelines is simply too much screen time for a young child’s brain and body.
Some Good Things
There is some quality TV that is well-designed and age-appropriate for children beginning at about age 2. Some programs have specific educational goals and can be used as an ADDITIONAL route to early language and literacy for young children. Some programs include positive racial attitudes, imaginative play, and social-emotional development. Here are a few of some educational TV shows and WHY they can be beneficial for a child to interact with:
- Super Why!
- The Super Readers (the stars of the show) solve mysteries by finding super letters, adding them together to make simple words, and then choosing the word that will fix the problem. A great, literacy-positive message!
- Daniel Tiger’s Neighborhood
- Using the puppets, dolls, and theme song used by Mr. Rogers, this show focuses on social and emotional learning through short songs and stories.
- Octonauts
- Through the crime-solving sea creatures, kids learn about teamwork, empathy, and that all the characters serve a purpose.
- Word World
- The letters of a word are put together to form an image of that word. For example, the letters “p-i-g” are put together to look like a pig. This is helpful in teaching children that letters make words and that words have meaning!
As the Canadian Paediatric Society outlines, certain TV shows and interactive ‘learn-to-read’ apps and e-books can be helpful in building early literacy but ONLY when parents:
- Watch screens together with their child and TALK about what is being seen and learned
- Know what their kids are watching – ensuring it is age-appropriate and interactive
- Combine screen use with active or creative play
BUT, research still proves that preschoolers learn language best from live, direct, and dynamic interactions with caring adults.
When to Avoid Screens
Even though screens are a central part of our everyday life and there is likely one in every room of the house, some times when screens should remain black include:
- During mealtimes
- During book sharing
- Within 1 hour of bedtime
- When trying to help children calm down
These are sacred times for a child and their family – not to be invaded by screens!
It is important to choose healthy alternatives as a family. Some activities to do instead of focusing on a screen could include reading, outdoor play, crafts, and hands-on activities.
Challenge Yourself
Just as your child may copy EVERYTHING they hear, they also copy actions so it is important that you are modeling healthy screen use. Be sure to limit your own screen use when children are present, turn off devices during family time, and turn off screens when they are not in use.
Check out this questionnaire you can do to assess your family’s screen use. Challenge yourself to complete the questionnaire and use it to come up with some family screen time rules!
Family Screen Time Self-Assessment
- Circle the types of screens that can be found in your home.
- TV
- Tablet
- Computer
- Smartphone
- Other
- Circle the types of screens your child uses.
- TV
- Tablet
- Computer
- Smartphone
- Other
- Would you consider watching TV programs or movies a shared family activity (whether watching on the television or other devices)?
- Yes
- No
- Would you consider watching TV programs or movies a common way to relax for your family?
- Yes
- No
- How often is a screen on in the background although no one is really watching?
- All the time
- Most of the time
- Some of the time
- Only while others are watching
- Never
- Does anyone in your family use screens during mealtimes?
- Yes
- No
- What do you watch with your child?
- What does your child watch alone?
- Choose one:
- I encourage conversation with my child while I am using screens
- I discourage conversation with my child while I am using screens
- Do you ever watch adult/commercial programming with your child?
- Yes
- No
- Does your child use screens while you do household chores?
- Often
- Sometimes
- Never
- Are there any screen-based activities in your child’s day care program?
- Yes
- No
- Not applicable
- If yes, do you know how much these screen-based activities are used?
- Does your child use any kind of screen before bedtime? If yes, How long before bedtime?
- Circle all that apply:
- There is a TV in my child’s bedroom
- There is a computer in my child’s bedroom
- My child takes mobile devices into his/her bedroom
- My child takes tablets into his/her bedroom
- Does your family have rules or guidelines for screen use that everyone understands and shares? If yes, what are they? If no, write some that you think would work for your family in the space below.
The impact of disability on caregivers
By: Alshaba Billawala
Having a kid with a disability can have a great impact on parents and the family unit overall. Often when parents find out that their child is diagnosed, their attention and time is dedicated to ensuring that their children are connected with resources that will help foster their development. After all, it is well known that early intervention can be integral in impacting outcomes for children with disabilities.
What is often less frequently talked about however, is the impact that caring for a child with special needs can have on the entire family. When working alongside families of children with disabilities, the attention is directed towards caring and supporting the child and less attention is dedicated towards ensuring that other family members are also taken care of.
Some common difficulties that families experience include:
- Emotional and physical exhaustion
- Breakdown in family relationships
- Increased marital conflict
- Financial burdens
- Increase in behavioral problems among siblings
- Anxiety and stress
Although, in small doses, these difficulties can be manageable, over time these can lead to adverse effects (e.g., caregiver burnout). It is therefore extremely important that family members ensure that they are receiving adequate support for themselves. Some helpful first steps you can take are:
- Schedule time for yourself. Often times when talking to parents, they report that it seems impossible or even selfish to take time to do something enjoyable for themselves when there is so much to do. The downside of giving without taking time to replenish your own energy is a risk of caregiver burnout. If you take some time to replenish your resources, even if it’s a half an hour a week, you will notice that you may have more energy and grace to tackle your various tasks and to-do lists.
- Identify positive coping mechanisms. Balancing various appointments, caring for your children, etc. can be extremely taxing and stressful. Therefore, having some proactive ideas of things that can help you cope with stress (e.g., relaxation, exercise, journaling) can be very helpful.
- Get connected to support groups. There are various support groups around the city that bring together families who are fighting similar battles. Having a group of supportive individuals who can understand your struggles and can support you can be priceless. See: https://autismcalgary.com/upcoming-support-recreation-groups/
- Become informed about resources available to you. Often, it can be overwhelming to navigate various programs to figure out which ones will best meet your needs. Luckily, there are several professionals on our team who have years of experience who may be able to connect you to the resource you need.
- Identify if you are experiencing any signs of caregiver burnout and ask for help. Some common warning signs include: changes in weight, appetite, or energy levels, increased and prolonged sickness, increase in use of unhealthy coping mechanisms (e.g., alcohol), increased irritability and emotional exhaustion.
If you find yourself experiencing any of the difficulties listed above and are interested in learning more about resources that may be available to help you and your family, contact us anytime. https://www.connecting-dots.ca/contact-us/
Social Skills Group
What: A social skills group designed specifically for children with special needs to teach social thinking, social communication, friendship, and problem solving skills. The program will be delivered by registered psychologists with the assistant of developmental assistants.
Who: 8-12 year olds with special needs (e.g., autism spectrum disorder, attention deficit hyperactivity disorder, learning disability)
When: The group runs weekly for 6 weeks starting November 6th 2018, from 6:30-8:00 at Vivo in Calgary NW
Why: Research shows that many children with special needs have difficulty learning social skills intuitively which can result in bullying, poor self-esteem, lowered self-confidence, and poor mental health. However, studies show that children can be explicitly taught these skills which an assist in their social development. The focus of our social skills group is to foster the development of social skills in a structured and supportive small group that allows for fun, learning and chances to practice! Participants will have a chance to practice important skills like friendship skills and having conversations.
Registration Process:
To register or learn more to see if your child would benefit from this unique opportunity, please contact:
Stephany Huynh: stephany.psych@connecting-dots.ca OR
Alshaba Billawala: alshaba.psych@connecting-dots.ca