Thursday, April 23, 2009

A Journey Through Infant Development: The Tenth Month

A Journey Through Infant Development: The Tenth Month
By: Michelle VanderHeide, BSW

Curiosity is something that is developed very early in life and becomes very evident once a child starts to move. Although it can be very annoying to pull babies out of cupboards, dishwashers, refrigerators and toilets, curiosity is an extremely important foundation to a child’s neurotypical development. Curiosity allows discoveries – it offers children those “ah ha” moments in life. If a child doesn’t explore his/her environment ¬– in safe circumstances only of course – the opportunity to make discoveries is lost!

  • I can’t seem to get anything done while you are awake! Anytime I try to work in the kitchen, you are immediately into what I’m doing. I open the refrigerator, and there you are pulling something out of the door. I try to prepare food, and you empty every cupboard. I empty the dishwasher, and YIKES – you’re going for a sharp knife!

  • You’re not only into my stuff all the time, but your sisters’ as well. If they are doing a puzzle, you sit on it. If they are playing in their room, it isn’t long before I hear, “Mom!!!!” We all love you, but your sisters have appropriately changed your name from little brother to little bother.

  • Balls are so intriguing! If there is a ball or anything that resembles a ball, you crawl quickly to it. Once you pass it to me, you’ll look right at me and throw your arms in the air and scream. It’s so fun! If there isn’t anybody available to play, you’ll accept that and play catch with yourself. You’ll throw it; go and get it; and then throw it again. It keeps you busy for a long time! That lasted for about a week, and now you’re onto new things. You get bored easily.

  • Brushing teeth is a very interesting event as well. Dad will hold you while he brushes his teeth, and gives you a toothbrush as well. You’ll look at him so intently while he brushes, and then put your toothbrush in your mouth. You think you are so cool brushing your teeth like dad. The look of accomplishment on your face is priceless.

  • You are really getting into playing games, and find it so funny when the game changes. I handed you the top to a jar, and you handed it right back. I handed it to you, and you handed it right back (much like how we play ball). I then put it on your knee. You thought that was so funny, you grabbed it and handed it back. I put it on my knee, and the game continued. When I put it on my head, you got up, grabbed it, and tried to put it on your head – all while cracking up.

  • I can no longer leave the room without you getting upset. It seems as though separation anxiety has kicked in. It’s very apparent that your awareness of your surroundings has gotten much better!

  • You are beginning to cruise around now. Your crawling has gotten faster, and you can pull yourself up to stand with ease. It allows you to feed your curiosity about what’s going on in the rest of the world, and you love it! Now that you can do that much, let’s just get to walking.

If your child is always fixated on one thing when entering an environment, s/he is being robbed of making daily discoveries: How does my mom greet people? Do I greet grandma the same way I greet a cashier? How am I supposed to act in a gym as opposed to church? These sorts of skills are often taught if a child lacks it; but when not discovered in a natural environment, these skills can look very awkward or be inappropriate in different settings! Even in a gym, the expectation of how we’d behave changes according to what is happening in the gym. We are constantly appraising our surroundings to determine the appropriate way to act. Through the use of RDI strategies, these discoveries can be made for a child who wouldn’t otherwise make them on his/her own. Give us a call if you want to know how!

Friday, April 17, 2009

Optimism versus Pessimism

Optimism versus Pessimism
By: Erin Roon, MA CCC-SLP

Is Your Glass Half Full or Half Empty?

Are you a glass half full or a glass half empty kind of person? Does it really make a difference? I think it makes a huge difference in your overall functioning, and the quality of your life.

Optimism can lead to accomplishment. If you think something is possible, you will generally work harder to achieve it. Believing in the positive allows you to feel good about life in general. Being optimistic can lead to an overall mood of happiness, and enjoyment in life. While most optimists understand that not everything works out as planned, they recognize that some good can come from the unexpected.

Pessimism can lead to defeat and despair. When you are doubtful that things will happen or be accomplished, you tend not to try as hard - which then leads to failure. Approaching everyday tasks with a negative attitude quickly leads to a negative outlook on life.

I see optimism in the faces of those with whom I work each day. I think it is this positive upbeat attitude that allows us to be productive and love the work we do with families. Oh, we feel frustrated and concerned from time to time; but we have been in this profession long enough to know that if we just stay positive and wait it out, we will either find a solution or the difficulty will pass. I truly believe that our optimistic attitude is what provides us with our sense of fulfillment, and improves our overall quality of life.

Unfortunately, I encounter many pessimistic people in a variety of settings. It may be that some of those people are just having a bad day; but so often it is a way of life for people. We can become pessimistic about things we have no control over - like the economy and the weather. We do not have control of either; but we can determine what it is about those two things that we do have control over, and take action there. I can manage my own finances, for example, and make sure that I am spending within my means. I can also make sure that I am putting money aside in the event that something unexpected happens. In terms of the weather, I cannot control the temperature or even precipitation; but I can decide how I will dress each day based on what is happening outside. If I spend all of my time focusing on and worrying about all of the things that I cannot change and do not have control over, I create an even bleaker picture; and other parts of my life begin to suffer.

We all have moments of optimism and pessimism; what it comes down to is how the scale is tipped. Is your cup half full or half empty? If you feel that you are more of a pessimist than an optimist, are you able to pin point ways you could make a change? Whether you are feeling pessimistic about many things or even just a few, try the steps below to see if you can tip the scales back in the favor of optimism.

  • Make a list of all the things that you are concerned or worried about.

  • Determine which of the things on your list you have control over. Cross out the items that are truthfully out of your control.

  • Of the remaining items, take some time to think about what you can do to change those situations.

  • Choose one or two items from the list, and begin working to improve those situations.

  • Take some time every so often to reflect back on your list. Have you been able to make some changes? Are you feeling more optimistic about the items that are left? Are you ready to begin working on another item?

Taking it one step at a time, taking charge of the things you can control, and making changes can lead to a more optimistic attitude. Often times we try to take on too much at one time, which leads to failure and more pessimism. Taking it slow, and working only on the things that we have control over, brings success that leads to more optimism and a willingness to keep moving forward.

I am thankful for the many things I have, and am hopeful that the problems of today will no longer be problems tomorrow. As I sit here gazing out the window at the beautiful sunshine and lack of snow, I am hopeful that this is a sign that spring is just around the corner. It is with this optimism that I can tolerate the endless cold weather that seems to have plagued Michigan for longer than usual this year. It is this optimism that improves my mood, and gives me the hope that strengthens my overall quality of life.

Are you a glass half full or a glass half empty type of person? To find out more about how optimism can propel you forward and improve your overall quality of life, please visit our website at

Friday, April 3, 2009

Prioritizing Needs and Treatment for Children with Autism

Prioritizing Needs and Treatment for Children with Autism
By: Nicole Beurkens, M.Ed.

I recently had a parent refer to the many needs of her daughter in this way: “It’s like there are three floors of the house burning! Where do we start and which level do we fight the fire on first?” This provides an excellent visual metaphor for determining priorities in treatment.

When a child has autism, or another neurodevelopmental disorder, there are many areas of need to consider. The pervasive nature of the diagnosis leaves little unscathed in terms of development and functioning. The extent to which each area of functioning is impacted varies, but it’s safe to say that all children on the spectrum are affected by their autism in numerous areas. There are communication problems, social interaction problems, restricted behaviors, rigid thinking, and other issues that come from having the core deficits of autism. Then, for many kids on the spectrum, there are the co-occurring problems to address such as impulsivity, feeding problems, sensory processing problems, motor deficits, academic problems, and more. The list can go on and on depending on the child and it can, indeed, feel like all three floors of the house are burning.

Once you have carefully and thoroughly identified the conditions and areas of functioning that require treatment, the question becomes what to treat, when to treat it, and how to treat it. The pervasive nature of these disorders is the equivalent of a house that burning from a fire that started in the foundation. There are a few options to consider when making these decisions:

  • If all three floors are burning, there may be a tendency to decide to try to throw a lot of water on everything in an effort to put the entire fire out at once. I have seen parents do this and the result is generally unfortunate for everyone involved. Parents can become completely overwhelmed trying to address everything at once; comprehending multiple therapies, driving to get to therapies, having many people in your home, paying for services, and trying to stay emotionally stable in the midst of it all. Trying to treat everything at once can lead to burned out parents and burned out kids. It can also lead to the house burning down, because by throwing water at the whole fire at once you will not be able to concentrate enough in one area to make a real dent in the fire. You might keep the fire from spreading, and you might reduce the flames a little on each level, but the fire itself will keep on burning on every level.

  • One could also decide to concentrate water on the area that seems to be the most obvious – the top of the house where the flames are shooting out. This can be thought of as the approach of treating the most obvious problems first – my child isn’t talking, doesn’t look at me, doesn’t know how to make friends, and/or doesn’t behave normally; so we’re going to treat those things right away. That seems like a logical plan on the surface, but the problem is that it is the equivalent of putting out the fire from the top floor first. You might save the top floor, but there is no foundation to hold it up. What you end up with is part of a house that is salvaged, but can’t support itself. This is what happens when we choose a skill-based approach to treatment that does not focus on core developmental issues that need to be addressed.

  • A third approach is to concentrate efforts on the base of the house first by putting out the fire there, and then working your way up to the higher levels of the house. This approach is the equivalent of working on the foundational developmental skills, abilities, and milestones that must be achieved in order for a child to make long-term developmental progress. It can be a difficult choice to make because it feels like the things that are most obvious are not being treated right away. It can feel like too much of the fire is allowed to burn while efforts are concentrated on one area at the base. However, this is the choice that must be made for long-term gain. It is in focusing on the core deficit areas of autism in developmentally appropriate and specifically targeted ways that we move forward.

As parents and professionals we have to recognize that there is only so much “water” to go around – only so many hours in the day, energy to expend, knowledge that can be absorbed, money that can be spent; the list goes on. We need to consider the idea that it is not necessarily about getting more water, it is about how that water is used. It is about:

  • Understanding exactly what needs to be treated and prioritizing those needs so that a treatment plan is developed to work in everyone’s best interest, without extending beyond resources that are not there.

  • Understanding that by treating foundational developmental issues, many other problems begin to fall away. By taking a bottom-up approach we address areas of development that snowball and create change across the board in the way a child thinks, communicates, and behaves.

  • Prioritizing family health above all else. We must recognize that if the needs of everyone in the family unit are sacrificed in the name of doing “more” to treat autism, then in the end everything can be lost.

  • Knowing how to make the most of the time, energy, and finances you can in targeting the core issues of the child’s disability.

  • Refusing to run around trying anything and everything; making yourself, your child, and everyone around you irritable, tired, frustrated, and financially drained in the process.

Think about how you are prioritizing the needs of your child. Are you able to rest assured that you are targeting what needs to be targeted for now, and that everything else needs to be left for later? Do you have a strategy that is allowing you to put out the fire from the source instead of blindly aiming water at the obvious flames? Do you have a good balance in your family where autism is one part of what you focus on as a family, and not the thing that takes up everyone’s time, energy, and finances? These issues are critical to consider when initially making treatment decisions, and must be revisited frequently along the journey of providing for the needs of your child and family.