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Thursday 8 December 2016
What I Hear, I Learn!!
Sunday 20 November 2016
A newly discovered Tool for therapy- SNAPCHAT!!!
It is amazing when we can use social networking applications as a part of therapy. I used Snapchat as an activity with a 3 year old child diagnosed with Autism. In the last few months we worked on his intent and language development. He now rightfully makes a choice and expresses his opinion as a part of the activities.
While trying different filters on Snapchat, I told him the sequence to follow to click a picture- click, save and next. He observed me following the sequence, and we clicked some nice pictures too.
He got really interested and then started to observe himself more mindfully and follow the sequence of Click, save and next. He first practiced the sequence with a couple of filters. As he became comfortable, he started to chose the filters on his own. He looked at himself with different filters and only clicked and saved the pics where he really liked the filter for e.g. the dog with the tongue, or the rainbow tongue or the fat red cheeks. He skipped some of the filters and some, even if he tried, he didn't click. He laughed and shared the ones he liked, while we clicked pictures together. He also turned to look into the mirror and then laugh seeing his face in place. He found some of the filters very funny and laughed. The play looked so happy and fun like any other kid.
I loved seeing all skills that he has learned in last 9 months in place. Intent to play, Joint attention, sharing joy and excitement, choice making and executive functions of staying on the task, sequencing and memory too.
Thanks Snapchat, It was total fun : )
While trying different filters on Snapchat, I told him the sequence to follow to click a picture- click, save and next. He observed me following the sequence, and we clicked some nice pictures too.
He got really interested and then started to observe himself more mindfully and follow the sequence of Click, save and next. He first practiced the sequence with a couple of filters. As he became comfortable, he started to chose the filters on his own. He looked at himself with different filters and only clicked and saved the pics where he really liked the filter for e.g. the dog with the tongue, or the rainbow tongue or the fat red cheeks. He skipped some of the filters and some, even if he tried, he didn't click. He laughed and shared the ones he liked, while we clicked pictures together. He also turned to look into the mirror and then laugh seeing his face in place. He found some of the filters very funny and laughed. The play looked so happy and fun like any other kid.
I loved seeing all skills that he has learned in last 9 months in place. Intent to play, Joint attention, sharing joy and excitement, choice making and executive functions of staying on the task, sequencing and memory too.
Thanks Snapchat, It was total fun : )
Tuesday 16 August 2016
PLAY AGAIN: It surprises all the Time
Harshit
(name changed), a 6 year old kid, joined Potentials in the month of April,
2016.
He
has been consistently taking Occupational Therapy for Sensory Integration and
ABA therapy outside Potentials. At potentials, he began with Play-Social
Communication- Language Therapy in April, and Speech Therapy in June.
His first session with me was on 1st April,
2016. As we begun, Harshit only wanted
to jump. So therapists joined him. When I insisted on him to sit, he again got
up. It was as if we had springs. It was a super jumper session, with 3 of us
jumping all over the room.
I was told that Harshit is here till
September, 2016. I can deliver as much as I want in these few months. In the
beginning, I was a little scared, as understanding the kid, and the autism
specific to him will also take some time. Initially his sessions, and thinking
of goals and activities was becoming cumbersome, because all my thoughts were
revolving around the deadline “September”. Hence, his sessions were boring. In
retrospect I would analyse the session to be boring. I didn’t enjoy at all.
Something was missing. Then after a lot of introspection and analyzing, I realized that Play with him was becoming a task. My focus shifted from the
deadline to co-creating joy and having fun with him.
This
one thought made all the difference. The sessions were transformed. Since he
loved to jump, we kept different things to jump on. So once we kept pasta. Raw pasta
from the market was the play material. We first explored it and found that it
makes a sound when it breaks. I threw some on the ground and started to stomp
my feet on it. Harshit joined in, and he wanted more. So with one activity that
was fun, we could target his joining in the game, body orientation towards the
play partner, asking for more pasta when it was all crumbled. Now when he was
tired, we sat and broke the pasta with our hands and heard the sound, and felt
the texture. I broke a pasta piece close to his ear. So we could also target
proximity, and tolerance of another person close to him. Gradually we
introduced bubble paper and thermacol balls. Playing with all these things was
total fun.
I
started looking forward to Harshit’s session. Earlier he had a blank face or a
frown at times, but now the facial expressions where easing down. We started
seeing an Ok face, and gradually we saw Harshit smile more. The expression of
joy changed into sharing of joy with the therapists. With consistent
Occupational therapy, his sensory needs were also getting fulfilled, and he was
learning new skills. Harshit was sitting willingly now, so we did some
structured sitting tasks. Narrations
before an activity were helpful. The narrations helped Harshit know about the
activity, what is expected out of him and what might be difficult for him. This
strategy eased his anxiety of the newness of the task. A clear start and stop
was also defined for structured activities. For unstructured activates we told
him the activity that followed. The confusions in his mind were getting clear,
the uncertainty of the moment, that time or class was becoming easier to
understand, and his verbalization was increasing too.
One
fine day, I happened to talk to Harshit’s mother about his progress and present
skills. The mother was elated to share that Harshit has started playing, though
for shorter intervals, with his cousins. The best part for the mother was that
he has started tolerating children around him. I took this as an opportunity to
ask mama to write the progress that she sees in Harshit. I gave her a sheet of
paper to write. I am so glad to share with all of you. The mother wrote: Small
improvement in joint attention and eye contact.
1.
Has
started tolerating other people around and also let them play with him for
short duration. Was playing with his cousin with ball.
2.
Lately
we are also observing playing appropriately with toys and showing interest in
them.
3.
Listening and following commands.
I
was so happy to read the progress that the mother shared. I was glad to see,
how the mother could observe the small changes in Harshit that will make a big
difference to their life. Harshit’s family has preponed his trip, and they are
leaving in August itself.
From
a therapist’s point of view some changes that I saw in Harshit over a period of
4 months:
- He has calmed down, and jumps in excitement.
- He is willing to sit and do a task.
- He makes an attempt to play, or do the work given, even though he finds it difficult. This is a wonderful thing about Harshit, because until someone tries, how will they know how much fun can the task be, and what to improve upon.
- He will also reach out to the play partner or therapist for help if he finds the task difficult with therapist facilitation.
- He joins into take out pre-speech sounds with us. He attempts to produce a sound, and we can see that with his mouth shaping.
- Harshit has been able to internalize the point that- when he speaks, uses his words, people understand him better. He picks up words from his exposed language and says something when he wants a reaction, or asking for something (need based communication) or asking for more play. This is a beautiful skill that he has picked up. He learned to say chapak chapak (Hindi words for splash splash), when it was time for water play.
- He has started doing reciprocal coordinated play. Like ball catch and throw with 2 play partners, sliding a ball over a slant surface taking turns. He waits for his turn, and observes the play partner with therapist facilitation.
In
35 sessions across a period of 4 months, with 2 sessions in a week, Harshit
could learn some basic foundation skills that will help him in his growing up
years. Harshit left to his home town, leaving a beautiful experience of play
with me.
Monday 25 July 2016
(Un) Realistic Expectations: Expanding My Version of My Own World
Another
day passed at work. It was a day full of action including parent outburst,
dialogues and discussions amongst Team Potentials, some play and more play. While
driving back I was thinking about a set of parents, who comes to us. It’s not
just about this set of parents, but most of the parents with children with
special needs, who struggle to strike a balance between ‘Who their child really
is?’ And ‘What they want their child to be?’ Let’s understand this through a
child’s life who comes to us for therapy.
Prateek
(name changed) is a 4 year old boy, with a diagnosis of Autism. He started
coming for therapy 1 and a half months back. The child is yet to open up for us
to know the real Prateek. To support the child to be more of him, we need to
know the real child.
The
first goal sheet[1]
I have prepared for him are generic goals that are targeted with almost every
kid. While noting down observations about him, I struggled to zero down on even
one favourite toy of his. Things specific to the nature of his disorder are yet
to come out. Prateek's parents are very anxious about his current state. They opened
up while talking to us at Potentials that they are depressed and sad about his
diagnosis. They are giving their best to cope up with the situation and do
their best for Prateek's growth.
Being
weighed down by the tag attached to Prateek now (of being diagnosed with
Autism), the mother is typically unable to sense Prateek’s own potential,
giving up on any real possibility of transforming their current situation and
instead passively accommodating themselves to others and their immediate
surroundings or to the larger trends in society. Mother's thought process about
diagnosis, therapy and the social stigma attached to it, the social trend of
making him join school like any other child his age has made her way of life
dependent. She wants the situation to turn around completely 180 degrees, and
at the same time she is losing belief in the unbound possibility of life which
is only giving rise to anxiety in her own life.
In
her own way, mother is giving her best for her child. She is trying to protect
her child from any real exposure that might hurt him in the environment around
him. My team together could join the dots to see many such instances of how the
mother is trying her best, but her restricted and protective vision for her
child, is not letting them break the barriers and remove road blocks for
Prateek. This is making it difficult for her to develop her trust in people around.
She is becoming over powered by the negatives of the situation feeling she has
been put into the situation to suffer, with the thought of ‘WHY ME’.
The
pressure of time running out at a fast pace, and expectation, that Prateek must
go to a regular school is stopping the mother to see the real potential of her
own child. Grasping the true nature of our child, weighing his relative
strengths and weaknesses will only help us be more realistic about the expectations
we can have from him. She deals with Prateek as his mother, where as I play the
role of a therapist. We both are equally sensitive towards the child, with a
minor difference. The mother and the therapist would want best for the child
but from different perspectives. I see the child keeping my emotions on one
side and bringing every rationalisation in, which keeps me aware of child's
strengths and weaknesses.
Being
empathetic towards the child, and getting emotional about his condition are two
very different things. Being emotional towards his lack of skills will only
create a road block for mother and child to move ahead. That's the role a
therapist plays. Rather than seeing the child in comparison to others his age, we
would be realistic and view him and the nature of his disorder to remove the barriers
that are stopping him to bring out his own potential, in his own unique way. Dr
Daisaku Ikeda says, “Each of us is different, but we are all alike in that we
possess tremendous potential. The truth is, you can do almost anything if you
set your mind to it. The worst thing is to lose confidence in yourself and
limit your own potential.” Each of us are born different. Understanding ones potential
needs a realistic picture of who am I? To see the real picture, one needs
wisdom.
The
perception that I make of the child, should not be focussed on short term goals
(Unrealistic expectations), for e.g. he/she must start going to school by age
of 4, s/he should start talking like others, s/he should behave nicely when we
go to a relatives place, s/he should start playing with toys quickly. This is
liking posing your expectations of who the child should become without an eye
on the long term goals that will lead to holistic growth of the child. The
parents transfer their anxiety into the child, which hampers his/ her growth.
Rather, one must focus on life skills that helps the child express him/ herself
better, be comfortable in his/her own being rather than running in a rat race
of being like other children his/her age.
This
whole dilemma of where I am? And where I am heading to? Can only be sorted with
a Dialogue. The parents who feel stuck in this space must continue to talk to
other parents at the therapy centres they visit, and the therapists they are
trusting their child with. Society as a whole has seen a lessening of our
capacity to appreciate others- as they are and who they are. I believe that the
surest way to change this is by carefully attending to the stories of each
other’s lives through one on one dialogue. Forming my point of views in
isolation can be very scary. Then I view the situation from a subjective point
of view. In order to construct societies that are resistant to judgement and
embrace people as they are, people need to be exposed to and reminded of
different perspectives. Face to face dialogue can play a crucial role in this. In order to break through our self-imposed
limitations, one needs to break through every obstacle and every intrigue that
seeks to block our advance and boldly and courageously win. Talking to more and
more people, making friends and sharing my heart out will only help me expand
my version of my own world.
[1] Goal
sheet: from the point of view of therapy, a goal sheet includes childs present
behavior, a goal based on that and the strategies therapists will use to target
the goal. This gives a clear picture to the parent of the current state of
their child, and where are we approaching.
Friday 22 July 2016
Who am I? A Surprise Package
Some
of us are born with a difference. Our mirror is tarnished and it needs to be
polished. This polishing of the mirror brings out our true nature.
With small
steps that a child takes each day through parent’s support and various
therapies he is accessing- a new, dynamic, and a happy child is born. It is
amazing to see the true nature of the child. This transformation in the child
is a relief for the parents, the therapists and loved ones. The child struggles
to adjust in his new identity. It is like exiting a comfort zone, because of
the time he has spent there and learned ways to cope up with difficult
situations in that. Exiting this not so easy comfort zone to enter his real
zone is a challenge.
The
new zone is the new way of life the child learns. Entering that, breaking the
barriers of the old him, where he has been for the longest time, is not easy.
But with correct direction, and facilitation, he enters. That’s how a child
might feel: “Wow!! That’s a new me. I am
still learning to be the new me. It is sometimes frustrating since I am not
able to gather the courage to exercise the newly learned skills with complete
confidence. But at times, my parents and teachers around me hold my hand
through the path, and once I exercise the skill, that’s the moment of extreme joy
and elation. I just love it.”
The
play way method of ‘Eye to I’ helps the child come across the real him. By co-
creating joy while playing, the child explores new things, exercises his own
ways of doing things, breaks the monotony, makes mistakes and in that learns
new stuff, makes his favourites, likes and dislikes and enjoys the good things,
pushes away the not so good ones. He shares how he feels in his own unique
ways. That’s what makes him more human. When the children come alive, the one
who is relieved the most is the parents.
I
have a child coming in for therapy since last 5 months. Parents were so stiff
in their body language and expression of thought, that it made me worry. But
feeling bad for them was not the solution. All teachers taking the child were
observing the discomfort of the parents. We gave our all, brain stormed and
came up with best ways to support the child. Once we could understand the
Autism specific to the child it was easier to take action. We found reasons
behind the behaviour he exhibited. It goes like: When the Why is clear, the How
will follow. The child became easier to understand, and our ways and strategies
for therapy were altered at all levels. This integration of therapy, helped us
see beautiful holistic development for the child. The causes we made to help
the child be more comfortable in his own self, had clear effects not only on
him but on his parents too.
The
child has become more assertive. He laughs more, and expresses anger. He shares
things he knows and enjoys every moment of it. Seeing him is a treat. He is
getting to know his true potential which he is exercising. Actually he is
exploiting his new found talent where ever he can. Laughs!! I am loving it as
his play and communication therapist. It’s an important milestone we have
achieved together.
The
parents came in for a meeting, where in they wanted to share how is the child
doing at home, and wanted to ask about his progress at Potentials. We were all
amazed to see how comfortable the parents have become in last 5 months. Their
body language was relaxed, they made eye contact and smiled and laughed. They
had their questions and doubts. They could also see, that they discovering a
new, more vibrant, happy child in their boy. They laughed sharing their
experiences with him at home, and we cherished listening to them.
My
goodness!! He is a surprise package!! Keep watching, there is more to come.
Friday 15 July 2016
Wonders of Play
Wonders of play amaze me all the time. Little Kian (name changed) came in as a passive kid with his
head hung low most of the times. He would submissively engage in activities,
start and finish them following the therapist.
His obedience at times
made me feel frustrated. My goal sheet was getting achieved (he was learning to
make two word templates, his sustenance was increasing, and he was also
becoming more aware of his surroundings) but my anxiety was increasing at the
same time. His passive approach was dull. This is not how one can be. He is
born to smile and enjoy. He must explore new things and find his likes and
dislikes, passion and struggles. As I sat to make the next set of goals for
him, I brainstormed with my boss, as to what next. There was something amiss.
Kian is moving towards
becoming active and aware of his surroundings. He is more aware about the
people surrounding him, noticing movement, people coming in, or leaving the
room while he is playing in the session. But he would not look and had no idea
that he can make a choice and express his opinion.
The next goal I wrote
was- Kian will be more aware of people around him (his therapists) and he will
also be mindful of activities he is engaged in. He will be an ACTIVE
PARTICIPANT in connect to his environment, and people around. It is usual that
we use the strategy of choice making for a passive kid.
As I went on to
understand the Autism specific to Kian, after repeated discussions and joining
dots of how the session flows my boss said, “Kian
needs to know that he can have an opinion.” This touched my heart, and now
I exactly knew how to approach him, and even guide other therapists across
sessions for integration, as it would lead to holistic growth for the child. We
started giving him opportunities to make a choice out of few games and toys. We
give him clear narrations to know that he can ask, and make a choice. His facial expressions started becoming freer
and less restricted. He smiles often to the therapist now. With increasing opportunities,
he has now started to initiate a game and therapist joins in and builds up interactivity.
This also helps Kian sustain on an activity that he has chosen. Intensive
therapy in the month of June worked wonders. He has started expressing his
choices across a range of material. His father shared that earlier he would eat
whatever we gave him. But now, he spits the food out, if he doesn’t like it. I
loved the smile on his dad’s face. Kian is finally opening up to become aware
how who Kian is, what he likes and what he doesn’t like.
I love it, now when he
is happy choosing and playing what he wants to play. He laughs out loud. I also
love it when he gets angry on something, pushes things away or tells me in his
own unique way, I don’t like this. Yeyeye!!!
Yes, we will now be
working on refining his communication skills and integrating his existing
skills with the new found Kian.
I am so happy. I just
love the wonders of “Eye to I”.
Thursday 14 July 2016
Work and Play
I am a Child
Psychologist, working with children with special needs for last few years now.
After completing my
post-graduation, I have been working with a private organisation engaging in
therapy with children with ASD, Down's Syndrome, Learning disorders, ADHD,
Cerebral Palsy, social anxiety etc. I have had a major experience in working
with children with ASD, from ages 1.5 years showing red flags, early
intervention with children for ages 3-5 years, for diagnosis to 16 years of age.
I am skilled in working
with toddlers since I enjoy working with them the most. We use play as a medium
of work with children. The philosophy is all about playing with the kid with
ASD to connect to the play partner, and then coming closer to knowing one’s own
self.
Play is the most
exciting part of my work. I have seen play working wonderfully with children
with ASD. In the last two years, play has enhanced my personality for good. I
have become more confident of myself, now am more comfortable while using my
body space etc. Play excites me, as I enjoy everything about it. It compels me
to think out of the box to create play of the smallest of and not so obvious
things, for example, thermocol balls, sand, water; boxes etc. Through play I
have been able to break my inhibitions and enjoy myself in the last two years.
It gave me the joy of being me.
I am excited to research the powerful positive
impact of play with different populations.
Eager to explore, study
and learn more and more
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