As a Developmental Learning Specialist, I treat children of all ages, from infancy to University and beyond. Often treatment starts with the child; the parents notice the benefits for other siblings, themselves, and I end up treating the whole family! A level of intimacy very quickly gets established, one that under normal circumstances would require years of interaction. Each child is treated as unique, meriting the highest level of my acceptance, commitment, and support.
Over the years I have met many wonderful families. Most often I meet the mom first, but dads, grandmothers, sisters, other siblings, neighbors, professionals and support workers have been known to show up accompanying the child. This has given me the opportunity to observe families “in action”, and the differences between behaviours that work and those that don’t in support of the child’s treatment. I would like to share what I have learned over the years.
The treatment protocol*
Although the format is the same for both children and adults, treatment of the child client brings its own challenges, especially for non-verbal children. Each session runs like a mini workshop: we start with a goal, use our noticing skills to understand where the child is now in their development (what is working, where they are stuck), intervene with a learning menu (interventions to support change), notice positive results, follow with integration techniques to support the new homeostasis, and finish with establishing next steps (home program for children, home play for adults).
The goal establishes the focus for the session. What does the client want? What aspect of their development are they working on? With children who are verbal, I will invite them to talk first about what activities they enjoy. What would they like to be better at? If they are in school, what subjects do they like best, which ones present a problem? Of course, I have already communicated with the caregiver regarding what brought them to treatment. For children who are non-verbal, I rely on the child’s history, parents’ goals for the child, and my own observations.
Where is the child developmentally?
But there is another underlying level needing to be brought to light: what specifically is the child working on? Often this level is unexpressed. This can be determined through astute observation by the caregiver and the therapist. During the initial assessment, I will observe how the child moves, engages and relates to their environment. Information is gathered from observing the child climbing stairs, walking, catching and throwing a ball, and other movement patterns as well as the assessment of postural and dynamic reflexes. Observing the interaction between caregiver and child and how the child relates to the environment gives me valuable information about their emotional state and level of safety.
I recently worked with a 12 month old child who parents would assist her in standing on her two legs, albeit wobbly, because they thought this would help her to learn to walk. But looking at the child it was evident that her stability and balance reflexes where not integrated making for a very poor basis for standing and walking. She had no idea that her arms and legs were part of her core and that they could all work together. Any attempt to stand up would be counterproductive and give the child a sense of insecurity in the standing position.
Fidgeting, pushing back, hitting, in constant motion, incessant crying, constant talking, or refusing to move at all are all indicative of a child not feeling safe. New learning cannot take place until the child feels a deep sense of safety. For the child at the emotional level this translates into, I am heard, my caregivers know how to listen to and meet my needs. At the physical level, I know where I am in space; I feel connected to all parts of my body and I move gracefully and effortlessly. I feel supported by the ground. I feel safe in my body. When not feeling safe, we activate the stress response system in the brain and go into survival mode. No new learning can take place since in survival mode, we shut down the higher brain functions responsible for new learning.
What attitudes support learning?
Over-focusing on the outcome:
When we are able to set the intention for the therapy, but have nothing invested in the outcome, this leaves freedom for growth and development to occur. We simply do not know the timing or the form that growth will take. Over-focus on specific outcomes puts pressure on the child to “perform” in order to please the caregiver and can give the child a sense of inadequacy. By believing in the child’s innate capacity to learn and grow, we give them the confidence and the space needed to follow their own path of growth. We will often notice improvements in other unexpected areas. For example, working on improving the flexibility in the fingers, open and closing the hands, we notice that math skills improve.
Non-judgmental: Accept that your child is at the level of functioning that they are and that it is OK to be there. It’s not their fault; it’s not your fault. When we are non-judgmental, it teaches our children to be accepting of themselves and their own limits. It also teaches them not to judge others.
My child is whole: My child is a whole and complete human being. It is easy to focus on the disability, on the difference, but your child is NOT their disability. Seeing them as whole will allow them to see themselves as whole, to embrace their differences. It will teach them that it is normal to be different; they are not a label. One thing I often do when I first meet a new client, child or adult, is to explain that I have a hearing disability. I often take out my hearing aids and show them to children and share with them how cute I think the hearing aids are. Then I explain to them how to best speak to me so that I can hear them. This normalizes our differences and allows my clients to relax around their own differences.
To sum up, whether you are doing the Home Program you received from me for your child, physiotherapy exercises assigned by your child’s PT, or simply helping with homework, I believe you and your child will benefit by adapting a non-judgmental attitude, giving the child the space and time to makenot getting to focused on the outcome, being non-judgmental, and seeing your child as a whole and complete human being at each stage of
*The treatment protocol is adapted from Brain Gym 101 Balance for Daily Living, student manual by Paul Dennison and Gail Dennison, Edu-Kinesthetics, Inc., 2007: 5 Steps to Easy Learning