A Journey Through Infant Development: The Eleventh Month

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

“I’m looking for fun and adventure! I’m looking for more!!!” As children develop on a neuro-typical pathway, they begin to look for activities to be more elaborate and exciting. The same old games become boring – it’s time for adventures and more challenges. This becomes especially true as a baby transforms from an infant to a toddler. As parents, we naturally begin to add these challenges as our children begin to show readiness. My son continues to enjoy the exciting new things of life, but one monotonous thing he loves is his grandma!

• You love your grandma! We took a vacation to Florida, and had a ball! It became extremely evident to me that you know what you want! You were attached to grandma like glue. You’d be playing nicely on the living room floor, and if grandma entered the room you’d scream and go crawling over to her (screaming the entire way). Once you were in her arms, there was no putting you down! When we returned home from Florida, you didn’t see her for nearly 3 days (eternity to you). When you saw her again, you did the same screaming approach that you did earlier – but held on even tighter! When you were sitting in your chair eating, you actually had to have her right there by you. When she waved like she was going to leave, you reached out and grabbed her arm and pulled her to you – all while shrieking. Although I’m a little jealous, I’m happy to see that you are forming a special bond with her, and that relationships are important to you.


• There’s excitement in moving While crawling is still the preferred method of movement, you notice that this isn’t the way the rest of the family gets around. If there is a couch or table to hold on to, you are walking. It shouldn’t be long before you are walking on your own. I hope it’s sooner than later, simply because crawling outdoors is hard on the clothes!


• Extreme Peek-a-boo You love playing peek-a-boo; but if I run off and hide while the blanket is over your head, you laugh even harder. The challenge of finding me is so fun, and the reward in finding me is priceless. I like this game better, too, because it gives me more exercise running from you and a bigger reward when you find me – there’s always a big laugh and gigantic hug!


• Adding humor You are so funny. You are beginning to do things intentionally to make me laugh. The other day, you and I were picking up some Easter eggs off the floor. Initially you were putting them away with me; then suddenly you grabbed one, looked at me to make sure I was watching, and then crawled away with it. You then “hid” it under the couch, looked back at me, and laughed. You thought you were so funny. It’s amazing to me how much you understand about human interaction already, and how to enhance it.

If a child has fallen off this neuro-typical path of development, these activity changes can be overwhelming. The dynamic, fast moving, adventurous life is then too much, and there is a tendency to become trapped in the monotonous way of doing things – just to feel safe! This is another reason that I love Relationship Development Intervention (RDI): nothing new was created, just slowed down enough so that what happens naturally in neuro-typically developing children can happen for those who missed it the first time. Through a very careful approach, challenges are added to every day life in a supportive and trusting environment. Because of this, kids who normally fear change, challenges, and other dynamic attributes can slowly become successful in adapting to our fast changing world. The transformations are amazing!

Building a Foundation

Building a Foundation
By: Erin Roon, MA CCC-SLP

Now that spring has arrived here in Michigan, many construction projects are once again underway. Land is being cleared, holes are being dug, and foundations are being laid. Each time I see a foundation being poured for a new home, school or business, it makes me think of the foundations we must lay in our own lives in order to be successful.

Children begin right after birth developing the foundations that they will need to be successful in life. Babies quickly learn, “When I cry, my caregiver comes to comfort me; when I drop something, someone picks it up; and when I make noises, someone responds.” These back and forth exchanges lay the foundation for long-lasting relationships. Foundations continue to be laid throughout the time children are growing and developing in a variety of areas.

For some children, solid foundations are not laid in the early years. Reasons for this may be due to internal disregulation (ex. reflux or sensory difficulties), some type of trauma, or an environmental influence (e.g. living conditions). Whatever the reason, trying to build upon a less than solid foundation is very difficult. Children who are missing solid foundations will need a chance to go back and build those foundations. That is where the concept of remediation is critical.

Many of the children I see in my job are missing foundational pieces needed for developing long-lasting relationships and a quality of life. For this reason, their parents have sought out a remediation program. What we tell parents is that building a solid foundation for their child first begins with them.

I spend a lot of time talking with parents about building the foundation that will support the rest of their remediation program. We talk a lot about the fact that without a solid foundation, the treatment process is doomed to fail from the start. For the consultants at Horizons, a solid foundation is built on a well established master/apprentice relationship and a commitment to experience sharing communication within the family. Without this foundation, the house will eventually crumble.

Once parents have built their own foundations, the job of building a more solid foundation for their child doesn’t seem so daunting. The process of laying the foundation can be done one step at a time, and with each individual child in mind. Some children might be missing the left cornerstone, while others might be missing a piece here and a piece there. Wherever the pieces are missing, parents can be guided to support their children in shoring up the foundation that support to a stronger structure in the long run.

I found this quote, that I think speaks to the topic of foundations in relation to remediation, and what we at Horizons are striving to achieve with the parents and families with whom we work.
“The loftier the building, the deeper must the foundation be laid.” (Thomas Kempis)

To me, this quote says it all. The greater the quality of life each parent wants for their child, the more solid the foundation will need to be. As far as I’m concerned, the sky’s the limit! Now that spring has arrived and warmer weather is upon us and many new construction projects are springing up, it might be an excellent time for you to think about the foundation you are building for your child. Is your foundation solid enough to support your lofty building? If not, what can be done to firm up that foundation? Are there things that we at Horizons can do to help you establish a firmer foundation? Let us know how we can help!

Finding Peace

Finding Peace
By: Nicole Beurkens, M.Ed.

As I was wandering around the Minneapolis airport recently, I found a store with a variety of posters, cards, and wall hangings with quotes and sayings on them. As I perused the options, I found one that I had to purchase and bring back to the office. Here is the quote:

Peace. It does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of those things and still be calm in your heart. (Author unknown)

This conceptualization of peace resonates with me in all aspects of my life. As a parent to four children under the age of 9, there are many times when there is noise, trouble, and hard work all at once! Yet, I am still able to be at peace, knowing that this is part of the process of parenting, and that this too shall pass. Parenting is generally far from an easy or trouble-free process, but knowing in my heart that I am doing the right things for my kids allows me to be at peace during the messiest parts of the journey.

In my life as a professional there are also many times of noise, trouble, and hard work. Yet, even in the midst of those times I am able to be at peace knowing that I am doing what I was meant to do, and that everyone involved will grow through the problems we are facing. Feeling confident about my abilities to manage and overcome the obstacles that present themselves allows me to feel at peace amidst the challenges that arise.

Life wouldn’t be very interesting if everything was quiet, trouble-free, and effortless. We may wish at times that this were the case! However, there is much growth and triumph to be gained through the more chaotic and difficult times. The problem comes when we are unable to be at peace with the process as we are living through it. When noise, trouble, and hard work fall upon us, how we perceive it and react to it makes all the difference. I find this to be especially the case when these situations come along and we feel ill-prepared or incompetent to face them. These are the times when we fail to grow and develop increased strength and perseverance through the process. The challenge is to learn how to be at peace inside ourselves, even when things around us are far from peaceful.

For parents of children with autism or other disabilities, moments of noise, trouble, and hard work come more frequently. There are inherent challenges that go along with raising a child with developmental disabilities, and these challenges can easily result in a lack of peace both internally and externally. These disabilities tend to rob parents of their sense of competence in raising their children. While parenting other children may seem intuitive and an internally-peaceful process, the challenges of a disability can make even the most self-assured parents feel unsettled.

How do we get to the point where we can appreciate the process and be at peace with it, despite all the noise, trouble, and hard work?

• It’s okay not to have all the answers Sometimes parents think they should automatically have all the answers to the issues that arise with their children. No one ever has all the answers, and we cannot live believing that we are supposed to – or that someone else does. We cannot allow a lack of definitive answers or solutions make us feel incompetent as parents. The important thing is that we don’t give up trying until we find a solution that works.


• View life with children as a process, not an endpoint We must be careful to view parenting and the development of our children as an ever-evolving process. If we continually live with the goal of “getting through” the trying times with our kids, we will be perpetually frustrated and disappointed. There will be a constant sense of “we’re not there yet,” as opposed to expecting that there will always be challenges in one way or another.


• Stop and take a deep breath Sometimes when we are facing challenges with our kids, the best thing to do in the troublesome moment is nothing at all. Many parents think that they are supposed to jump up and “do something” when problems arise with their children. Obviously this is the case if a child is going to do something to harm himself or others. However, a lot of the time the problems are not life-or-death, but we act as if they are. Taking a moment to just stop, breath, and think before you rush off to do something allows a sense of peace to prevail in otherwise un-peaceful moments.


• Seek out supports for building competence as a parent If we aren’t feeling calm in our heart despite the noise, trouble, and hard work of raising children, it is important to access support. If we find that we feel guilty not having all the answers; or we are living with a vision of our problems having an endpoint rather than being a process; or we struggle with allowing ourselves to stop and think amidst the chaos, then it’s time to reach out to someone who can help address those areas and develop a feeling of peace as a parent. This can be a family member, friend, or professional, but it must be someone who can provide insight and guidance, and create a plan for achieving peace despite the messiness of life with kids.

As we go about day-to-day life with our children, we should keep in mind that “Peace does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of those things and still be calm in your heart.” For our children to thrive, we need to be able to be peaceful in the midst of the challenges of parenthood. We should strive daily for this sense of calm in our heart.

How Do I Know if My Child is Anxious?

How Do I Know if My Child is Anxious?
By: Courtney Kowalczyk, M.Ed.

When thinking about autism and all that is involved with it and other similar neurodevelopmental disorders, we sometimes overlook the possibility of co-occurring conditions like anxiety. All too often I hear responses about a child’s odd behaviors in relation to him or her “being naughty,” or that “it is just his or her autism”; but, in many instances, that is not the case. Anxiety is a complex disorder that can manifest itself in many different ways, especially in children and adults affected by autism and other neurodevelopmental disorders. My goal over the next couple of months is to share with you information related to anxiety, and how you can help your child or student who may be affected by it.

Neurotypical individuals affected by anxiety on a day to day basis have varying symptoms. We often see individuals who perspire or use avoidance techniques to escape or withdraw from what makes them anxious, like social settings and large events. Others deal with their anxiety in different ways, and can become excessively chatty or extremely quiet. Whether it be withdrawing, perspiration, or becoming excessively talkative, many individuals are able to cope somewhat with their anxiety. Children and adults with neurodevelopmental disorders also have ways of expressing their anxiety and attempting to cope with it. When thinking about your child or student, here are a few ways that they may express their anxiety:

• Increased self-stimulatory behaviors. Many individuals affected by autism and other neurological disorders will use self-stimulatory behaviors like rocking, flapping, hand flicking, and talking to themselves from time to time. Self-stimulatory behaviors are often static in nature, and are used by individuals to avoid situations that are too difficult for them to process and understand, as well as to deal with anxiety. When you see an individual begin using self-stimulatory behaviors or an increase in the behavior intensity, it may be helpful to ask yourself if this person is anxious and why.


• Odd intensity of verbalizations. Most individuals within society today use talking as a way to deal with anxiety. Individuals with neurodevelopmental disorders who have the ability to express themselves verbally often use talking as a way of dealing with anxiety, too. When you notice a drastic increase or decrease in communication, or an individual talking about odd sorts of things for a lengthy period of time, it may be a good indication that the individual is anxious.


• Acting out behaviors. When thinking about behaviors, it is important to look at “why” the behavior is occurring instead of just examining what the behavior is. When individuals with neurodevelopmental disorders become increasingly anxious internally, they often attempt to find ways to decrease their anxiety externally. A good analogy is to think about a pot of water that you are heating to the boiling point on the stove. An individual becoming increasingly more anxious is like the water getting hotter; and we are going to start to see things happening externally as well like increased talking, perspiration, and agitation that are like the bubbles in the heated water. At some point, the individual can no longer handle the level of anxiety that they are feeling, and thus acting out behaviors occur. We would consider this to be the “boiling point.” If you can examine your child or student’s behaviors and begin to notice when they are feeling anxious, you can often prevent the “boiling point” from happening by helping the individual reduce his or her anxiety.


• A need for control. Individuals affected by autism and other neurodevelopmental disorders often attempt to control the actions of others as well as materials in their surrounding environments. When we see an increase in the need for control, it may be a good indicator that the individual has become anxious. Is there a change coming up of which they are fearful? What other sorts of things in the environment could be causing the anxiety?

When examining the behaviors and actions of individuals affected by autism and other neurodevelopmental disorders, it is important to examine whether or not the individual is affected by co-occurring conditions as well. All too often, we come across individuals who are affected by co-occurring anxiety issues that go undiagnosed. By examining the behaviors and actions of our children and students, we may find that the acting out behaviors are not because of his or her autism or neurodevelopmental disorder, but rather because the individual is extremely anxious and has reached the “boiling point.”

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!

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 www.horizonsdrc.com.

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.