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Declarative Language Handbook by Linda K. Murphy MS, CCC-SLP                                                                                   An excerpt from Chapter 5: Appreciating Different Opinions

9/24/2020

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For kids with social learning challenges, taking the perspective of others is a common area of difficulty. As you work to improve an individual’s perspective taking abilities, you may feel the need to make them see things your way. But consider again the fight/flight/freeze response that can be triggered in the face of a perceived threat. If we push too hard, forcing kids to accept or see things that they may not be able to see naturally, we can activate the fight/flight/freeze response. As a result, kids may become defensive and, instead of being open to our viewpoint, they dig in their heels even more. The result is conflict and negative exchanges as views diverge. This is not what we want. Fortunately, there is a better way!
 
We don’t want to force our views on kids. Instead, we want to create an environment where kids can lower their guard and feel safe to be curious about the thoughts, opinions, and feelings of others. We must create a positive backdrop so that kids do not feel threatened when others have a different thought, opinion, or feeling. We want them to discover, at their own pace, that opinions and perspectives are not right or wrong. They are just different. We want kids to understand that I can think one way while you think another, and this does not mean we are enemies. We can share space and hear what each other has said, respect it, and allow this to strengthen our relationship. As we find our mutual connections, it feels comfortable. But as we discover interesting differences, it helps us grow. We develop friendships and relationships that are interesting because two people are never completely the same.
 
So, how do we help kids who may be naturally defensive in the area of different opinions, get to a place of openness? The answer is to truly model being open. Show that you can share space and be with the child through the ups and downs of different opinions, without judgement. Give kids many opportunities to hear your language, as you notice different opinions, and as a result, many opportunities to feel safe in that space. Give kids experience disagreeing with you while observing that all is okay. Show how you won’t have a big emotional response when they think differently about something. Show how you will note it, and embrace it. 
 
To learn more about Declarative Language Handbook and to download some free worksheets to help kids learn, share and appreciate different opinions visit Declarative Language
​

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Help! My child is regressing academically!!                              by Dr. Karen Levine, Ph.D.Psychologist

4/17/2020

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​Just a few weeks ago we all, parents, educators, advocates, were fighting to improve children’s school experience, fighting for more inclusion or more pullouts, more social skills teaching, better accommodations, so the children could learn more effectively. Now it seems we are all fighting for our sanity, for our country’s and our family’s health, for moments of not panicking, and for moments, here and there, of well-being. 
 
Many parents are expressing concern about their child falling behind academically, regressing. Some parents and some kids really take to this home-schooling like a duck to water and that is amazing, admirable and wonderful. But many do not. Some children have little interest in the online learning, in schoolwork at home, or in being taught by Mom or Dad. Many parents do not feel qualified to be their child’s teacher. Many parents are also suddenly dealing with huge emotion-consuming and time-consuming crises, (e.g., their own or loved ones’ health or mental health or financial challenges). This makes home schooling pretty impossible, at least for now.
 
While many kids will very likely be further behind in school curriculum than they would have been without this pandemic, behind who will they really be?  Kids across the country (around the world) across all grades are all missing out on months of school. This creates a new norm in this generation of students. This does not mean these children will achieve less in the long run, or will be less capable as adults. This only means that at time X, let’s say September 2020, they may not have mastered curriculum items D through G.  By September 2021 most will have mastered what they would have by September 2020. In the scheme of things, I do not see this as a meaningful problem.  
 
Imagine if the government were to fund every kid to have an extra year of school. Then by graduation they would have had more schooling than the last generation. This lost time of school would be automatically regained. Behind is a relative term. It is not a race.
 
We really have no idea the potential negative or positive impacts of this time.  Very likely, as we see with dire events in general, different children will be impacted differently. This generation of school kids is having a unique, massively intense, and globally shared experience.  I think we have no idea yet what the impacts will be. Here are some possibilities that come to mind and I know there are a gazillion potentially positive impacts I have not thought of:
 
Maybe this generation, or a cohort of it, will have a deeper understanding of how interconnected we all are. This is the first time all children share a life altering crisis with children around the world. Maybe we are harvesting a cohort of more compassionate kids who will be overall more inclusive, compassionate, adults.
 
Maybe a cohort of this generation will have a deeper understanding that all of the massive advantages we had in our day to day lives that for now we no longer have, are something special to appreciate, not to be taken for granted. They are also learning quickly that we can get by just fine without many of these luxuries, and that what matters is your relationships. Maybe a more grateful, more spiritual, less materialistic cohort will emerge than otherwise would have.
 
Maybe a cohort, with more time on their hands across fewer places, will develop deeper appreciation for, deeper understanding of, or deeper curiosity about something in their now smaller worlds (e.g., some aspect of nature, of cooking, of food chains, of world geography, of dogs or cats or fish).
 
Maybe a cohort will grow up with greater awareness of and appreciation of the people who provide the services keeping us all going, such a grocery-store workers, farmers, delivery people, truck drivers, trash collectors, in addition to doctors, nurses, scientists and so on. Maybe there will be common new answers to the ‘what do you want to do when you grow up’ questions. 
 
There is no doubt this generation of children will have computer literacy beyond our wildest dreams!
 
Of all of the potential impacts, I don’t think being 6 months or a year behind the supposed grade equivalent curriculum established based on assuming no pandemic/school closures, matters much at all.
 
I guess my point is that there are many different ways to learn and many different domains of learning, and that yes, less school curriculum learning will be happening around the world for these however many months, but other kinds of learning will be going on in ways we can’t yet know or even imagine.  Kids are learning all of their waking hours. We just don’t know yet quite what they will be learning. There is not yet the Pandemic Curriculum, the goals and benchmarks, the scopes and sequences developed for children across each grade in the time of coronavirus. 
 
I think essentially what we all want is for the kids to be ‘OK’. I think this is what we want from their school experience and this is what we really want for them in their lives, now and in the future. We are very used to measuring ‘OK-ness’ in terms of meeting academic milestones, keeping up with the curriculum, meeting IEP goals and so on. But I think there are far more important measures of OK-ness.  
 
Here are some Goals that might be on that Pandemic Curriculum
 
Avery will set up 2 video chats, with 3 relatives, with fading adults supports.
 
Martina will participate in 3 activities, with adult support, that contribute to the community impacted by Covid-19.
 
Chen will sustain play with his little sister for 10 minutes 2 times/day with fading adult support.
 
Josh will learn to manage anxiety as evidenced by being able to sustain an activity, with fading adult support, in 2 out of 3 instances.
 
Keisha will cook three items weekly, with her older brother, with less than 4 arguments per item needing adult intervention.
 
I think the fight for more successful school experience was excellent preparation for the fight now to help children be OK. I think it is the same fight really, to make the children’s world a place where they can be successful, happy, contributing people.
 
Children who are finding new ways to be happy, who are learning, through this intensive pandemic experience, to better manage anxiety, to gradually adjust to huge changes, who are experiencing being valued members of their family, who are learning all kinds of things that were not on their IEP, are probably, mostly, doing OK. And you, as parents, who are helping the children and yourselves to get through most days and nights, mostly intact, most of the time, are doing amazing.  
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Help!  My child is regressing behaviorally!                             By Dr. Karen Levine, Ph. D.  Psychologist

4/13/2020

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I have heard from many parents that their child with special needs is regressing behaviorally. For some kids, old behaviors have returned, for others new ones have appeared. Here are some behaviors some parents have mentioned:
 
  • Asking endless repetitive questions
  • More ‘stimmy’
  • More tearful; crying more easily
  • Can’t sleep in own bed again
  • Can’t focus on schoolwork
  • More easily angry, hitting again
  • Low frustration tolerance, giving up more easily
  • Refuses to do mastered things (dressing self; putting clothes in hamper)
  • Glued to old favorite videos over and over
  • Needing hugs, reassurance constantly
  • Hyper focused again on old cause and effect toys
 
Unfortunately, I don’t have quick solutions for fixing this, but I can tell you that:
 
It is normal, expected, for kids to be having a really tough time right now, for their baseline anxiety level, even depression, to go up, and for old behaviors to resurface. Here are some of the reasons why we are seeing this. None of this is anything we don’t all know but when you list it all out, it makes total sense that kids may be showing more behavioral challenges:
 
  • Kids are experiencing sudden unexpected and drastic changes in their daily lives, and of course kids are hugely helped by the predictability of their lives.
 
  • Most kids are also experiencing many abrupt losses of important relationships. There are many adults at and outside of school who kids have relationships with that are important and suddenly disrupted, such as teachers, instructional aids, various therapists, even neighbors, medical people, and then also friends and other peers at school. These are hopefully not permanent losses, but suddenly having these people not in the child’s daily life with uncertainty about if and when the child will see them is, naturally, a big deal emotionally for many kids. 
 
  • There is huge uncertainty about when we can do normal things again like go back to school, maybe go visit grandparents maybe go on a planned trip, and so on.  This uncertainty is challenging for all of us, but more so for kids with anxiety. We can’t really, at this early point in late March, even give kids a good time estimate about this.
 
  • And then there are, for many kids, the real fears related to coronavirus, whether they might get sick, and especially whether parents or grandparents could get sick, whether anyone could die. We certainly didn’t intend for kids to be worrying about all this.
 
  • And of course, kids now have parents with all sorts of huge and unexpected worries and responsibilities. Finances, extended family well-being, family health, global health, just to name a few things that are worrisome for most people these days. As we know, so many kids are super sensitive to the moods and anxieties of their loved ones.
 
This list is not to get us all down, or to say kids can’t manage this, but to spell it out why it is not surprising that we see emotional and behavioral regression, and related spikes in anxiety, in emotional dysregulation, in many kids. While it may not be easy to fix this, it may help keeping in mind the following:
 
  • These behaviors are happening for a specific known reason.
 
  • Kids (and adults) will likely over time increasingly adapt to the ‘new normal’ hard and different as it may be, and be less anxious or distressed.
 
  • For kids showing returning behavior issues, these are the issues they did overcome once and so they can again. They have the capacity, when the world is less upsetting, to overcome this. 
 
  • There are strategies to explore now that may be helpful.
 
 
While each child, each problem and each situation is different and will warrant different approaches, some general strategies for decreasing baseline anxiety may be useful:
 
Try having many short-sweet moments per day with your child that are just enjoying something, however small, together.  This might be three minutes here, five minutes there. This can reduce that high baseline of stress that builds up in all of us these days.
 
Consider ‘savoring’ times when the child is happy, is doing well, doing something they enjoy. There is a lot online about savoring and I find it a strong helpful technique that I use myself and with my patients.  Savoring is about deeply mining, and stretching out moments of joy. These can be social or sensory experiences or both. The idea behind this is that for the time of savoring, for those moments, the child is filled with good feelings, together with you, anxiety and dysregulation are down.
 
For instance, let’s say you and your children are having eggs for breakfast and you put your fork down to help a child with something and the dog sneaks in and gently licks the egg off your fork without making a mess or taking the fork. You and the children crack up laughing at how clever and sneaky the dog was. This is a shared moment of joy. You draw it out by re-enacting the dog’s sneaky ways. A child wants to join you in this and you act it out again, everyone laughing. Another family member, a grumpy teen or spouse stumbles in and you share this with them. You take a picture of one of the re-enactments. 
 
You can savor tasting food treats or something you or someone in the family has cooked, seeing if the kids can notice the taste, the texture, the after taste, the way an oyster or a good wine might be savored, the tastes analyzed for deeper enjoyment. There are lots of online guides to this, often called the raisin meditation https://ggia.berkeley.edu/practice/raisin_meditation
 
When you pull off a nice moment together, capture it any way you can, with a picture, a quick video, share it with other family members later, talk about doing it again and so on.
 
Consider for old behaviors what helped last time and see if trying the same strategies might help this time.
 
Then there are the recommendations below that you probably hear over and over that may or may not be do-able:
 
      Try to have somewhat of a schedule that is somewhat predictable in these days.
 
      Try to include regular times of outdoors if you are able, of movement, of music and dance.
 
      If school work is stressful explore if there are other ways of doing it, if you can cut back in amount of the stressful    subjects and so on (see my  ‘Help! My child is Regressing Academically” handout)
 
      See if your child would enjoy doing something to help others, such as making a video for a nursing home where they may have worked, or making a video card for a teacher etc.
 
      Explore face-time or other video chat with familiar beloved people even if they can’t do it regularly, such as an assistant or school tutor who may not be involved in online work

      Try scheduling video chats that are predictable and generally in your control, at   predictable times (e.g. Grandma every Tuesday and Thursday after breakfast) even if you also chat with this person at other times. Spend a few minutes planning things your child might show or tell or ask with this person.
 
      Have some weekly ‘special’ things to look forward to in these less marked weeks (e.g Wednesday mac and cheese night)
 
In general, it is likely adults and kids will gradually adapt to this ‘new normal’.  And one day life will be much more like we knew it. At that point, if the behaviors haven’t resolved, they will likely become much easier to treat. 
 
We all need to remind ourselves often that just getting through these days with everyone intact, just finding a few minutes of happiness for ourselves and with our kids, is an enormous accomplishment. 
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Why Vacation Camps are Important for Kids Development        by John Chambers OTR/L

2/13/2020

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Camps are a unique opportunity for your child's development.  They build a child’s self-esteem and their sense of belonging and contributing to a group.  They also build new friendships, confidence and independence.  We have outlined below some of the therapeutic benefits of our upcoming vacation camps.
 
Boxing Camp: The goals of the participants are to improve strength, coordination, body awareness, self-regulation, stress and anxiety. Participants will be given the opportunity to go over the upcoming session during the introduction working on public speaking and organizational skills. They will be required to follow a group plan and will have the opportunity to work with other peers to achieve a common goal. Boxing provides individuals an “outlet” or direct strategy to relieve aggression and “red zone” feelings in a safe and organized environment. 
 
Play Ball Sports Camp: For kids who want to play structured sports through the town recreation department, there is very little understanding from the Rec coaches for adapting the flow of the game for kids with different learning styles and abilities. This camp will break down each sport into its rules, flow of play, lessons of the game and be a safe space for learning and practicing.

Improv. Camp: Participants will learn the basics of improvisation through theater games and performance exercises. Lesson topics will promote a “Yes, And” mindset, listening to others, and flexible thinking. Children will benefit from opportunities to build self-confidence and emotional regulation during group activities, as well as motor planning skills for ideation, imitation, initiation, and attention/emotional shift in acting out functional activities of daily living. 
 
NO SCREENS Strategy Board Games Camp: In this camp, kids will have the opportunity to develop higher level problem solving and social cognitive skills including perspective taking (i.e., what might my opponent do?), thinking in alternatives and possibilities (i.e. what are my options move to move?), weighing the pros and cons of our possible choices (i.e., there are a few possible moves, but which one is best right now?), predicting (i.e., what might happen if I make this move vs. that one?), and thoughtfully working towards a specific goal. Board games also offer kids many opportunities to work on important social skills such as turn taking, being a good sport both when we win and when we lose, and working through disagreements calmly. As kids are exposed to and learn more old-fashioned board games in the supportive environment of this camp, our hope is that they will more readily play these types of games with peers in their natural environments, and come to realize there are many great choices out there that don't involve screens!  
 
For more information on our camps and to register please visit our website http://www.peerprojectstherapyfromtheheart.com/february-program-2020.html
​

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Why Family Routines are so Important by Mary Lou Gagnon OTR/L

10/18/2019

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​At this time of year, when the weather changes, and we head back to school and prepare for upcoming holidays, routines create a sense of predictability and stability for children. (And parents!)  This is the perfect time to work as a family to create routines and structure that will help all stay on track, reduce anxiety, and avoid conflict.  
That being said, creating new routines and sticking to them is hard work! Conflict in the home is what makes many parents shy away from enforcing specific routines and structure. I encourage you to remain calm and logical, take lots of deep breaths in these challenging moments and model the behavior that you hope to see. Remind the child that you have faith in his or her ability and reassure him or her that you will help.
The best way to establish routines is to start with something really simple and easy to understand, such as taking off shoes and leaving them at the door on a mat or in a cubby. Putting a backpack in an assigned spot as Mom puts her purse in an assigned spot is another easy one.  Offer to help the child if the task appears difficult, and try not to assume that any given task will be easy.  Ask for help yourself as you work on developing each individual routine.  Nothing else happens until the task is done.  No snack, no iPad, no nothing until this is done by both parent and child. Gradual, simple changes in routine can serve to reduce anxiety and irritability and give each family member a sense of ownership and control.  
If you establish routines using tiny, tiny steps, you are less likely to get pushback in the form of tantrums or meltdowns.  Other examples include taking a bath at the same time each day, setting the table at the same time, reading a favorite book as soon as the child is in bed. Sitting together at the table every night is a well-recognized, and valuable routine that provides a good opportunity for families to discuss needed changes in routines.  For some families, this means doing homework, for others, eating dinner. With reduced demands, children are frequently eager to make suggestions that can be beneficial to the whole family. My son once suggested that we buy silly alarm clocks that he had seen at a dollar store, and that all alarm clocks be set to the same time.  Between Charlie Chaplin, Betty Boop and a loud Dinosaur, everyone was up, checking their individual charts and on the move in plenty of time for a family breakfast. Even though the novelty wore off in a few weeks, the addition of an incentive (putting a poker chip in the Friday night pizza and game night jar) helped establish the routine well enough so that mornings were easier for all.  
Most kids will respond to a reward and this can help to reinforce the development of each routine. It may vary for each child. At my house, a marble in a jar worked for my son, a check on a list of tasks worked for my daughter.  Both served as a simple reward that resulted in a preferred shared family activity.  If a reward helps, don’t hesitate to reward children for their new positive habits.
It takes time for a behavior to become a habit. Even bad habits do not happen overnight. Research has shown that if we carry over a simple routine for a week consistently, habits are formed.  Take your time and feel out the types of routines that might be missing in your own home.  Maybe you need a better morning routine? Or maybe you need a better bedtime routine? Sit down and think about what behaviors or habits could make your life less stressful.  I promise, the struggle is worth the end result.

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Episodic Memory Part 4

4/11/2019

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Linda K. Murphy, MS, CCC-SLP continues with part four of her series on one of the core deficits of autism – episodic memory. To read the other parts, scroll down.

As discussed in previous articles, episodic memory is the story we create about ourselves over time. We may use this story to share ourselves with others or we may use this story to form a plan of action when faced with a problem. We need our memories to assign meaning to events in our lives and to negotiate new situations in the future.

As children form relationships with their peers, they use their episodic memory to create stories of developing friendships as well as narratives of themselves as desirable play partners. This is a process that unfolds over time as children have repeated opportunities to play with others in increasingly dynamic situations. Early on in peer interactions, all children are concerned with the immediate gratification that comes from events such as going first, playing what they want to play, winning a game and using a toy when they want to use it. However, as children get practice in the realm of peer dynamics, they come to observe unwritten rules and subtle yet ever present patterns:
* Sometimes I win, sometimes my friend wins.
* Sometimes I go first, but sometimes my friend does.
* Sometimes we play what I want to play, but sometimes we play what my friend wants to play.
* I can use a toy that I want to use, but it is also important to take turns and share.

Parents and teachers help to teach these lessons both directly and indirectly and over time, children come to trust that even though they did not get to go first this time, they will probably get to go first another time. Or even though their game was not chosen this time, it will most likely be chosen in the near future.

Because children with ASD may not easily notice the unwritten patterns of turn taking over the course of time, these lessons are much harder to learn. They may be quite good at noticing and understanding turn taking within a structured game in the here and now, but patterns over a longer period of time are more elusive. What children with ASD do notice, however, is when their preference is not honored because this has strong personal meaning to them in the moment. When this happens, we may see a big, negative reaction that leads all involved to form unpleasant memories. Subsequently, no one wants to rock the boat again and we may tread lightly or even avoid teaching those vital friendship skills of flexibility and fairness simply for the sake of keeping the peace.

So, how do we teach these vital peer interaction skills in a way that is not so unpleasant for everyone? For those of you following this series, the answer will be a familiar one: Use declarative language to mindfully make explicit memories that are easily perceived by most, demonstrate how we can use these memories to inform our decision at hand, and engage our kids with ASD in this decision making process. Here are some examples from our trip to Boston:
* Hmmmm… Freddie got to sit by the window on our last ride on the T so I think it would be fair if we let Annie have the window for this ride.
* I know that Trixie was first in line for the Swan Boats, so I’m thinking that it would probably be fair to let Lucy be first in this line.
* I remember yesterday Christopher got to choose which dessert we would share, so hmmm… I’m wondering what might be fair today…

Once these patterns are spotlighted, children learn to self narrate and notice more implicit turn taking opportunities over time. They learn to talk themselves through turn taking that is outside of a particular game, the type of turn taking that is woven throughout life and friendships. They can and do rise to the occasion and become fair decision makers because they now understand and trust the process.
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But, if we don’t make a point of helping them notice and subsequently form these memories along the way, they become stuck in the moment at hand, the moment of crisis, the moment when they panic because the thing they want to do is not going to happen. We have to give them information as it happens and mindfully help them recap so that they can learn how to give back as a true friend.


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Episodic Memory Part 3

11/28/2018

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Any time we are faced with a difficult situation, or if something keeps us from doing what we are planning to do, we come to a crossroads. We think: What should I do next? What are my choices? How does one option compare to another? This can include big problems, such as what to do after losing a job, but it also comes into play in the small decisions we make day-to-day. For example, when driving to work, what route do we take? If there is a traffic jam, do we take a different route? How do we decide? Or, if an item breaks, how do we decide whether to fix it or throw it away? If we decide to fix it, how do we do it? New batteries? Scotch tape? Glue? There are so many decisions we make moment to moment based on what we know about possible outcomes. Furthermore, we make most of these seemingly small decisions in a calm, deliberate manner, and don’t expect perfection. We know that often, good enough is okay. So much of what we do depends on our subjective appraisal, and our subjective appraisal is based on our previous experiences, or episodic memory.
 
Now, let’s think about children with autism. Often, problems are addressed when they are at crisis level. If we go back to our trip to Boston: maybe the child is screaming because he was planning to take the T and it has broken down. Or, maybe he is expecting to go to a particular restaurant in the North End, but it is closed for renovations. Maybe he lost his souvenir from the Swan Boats. In these moments, when expectations are not met, a child with ASD has trouble coping and emotions escalate. We may then address the particular problem by writing a social story, creating a behavior plan or explaining to the child why it is not a big deal. These strategies can certainly help, but they are reacting to a particular problem rather than proactively teaching kids how to cope with the unexpected in life.
 
We can help our kids with ASD become on-line problem solvers by including them in our own problem solving opportunities day-to-day, when there is no crisis around events that are not emotionally charged. Using declarative language, we can invite children to understand how we are thinking as we approach a problem. We can model how we are not looking for the perfect solution, but are satisfied with “good enough”. As we include children in these moments, we are building their episodic memory around managing challenging situations. We are mindfully helping them form memories by including them in moments they may have otherwise missed. Then, when a similar but different problem comes their way in the future, we can help them pull memories from our shared experiences: “Oh! Your toy isn’t working. Hmmm… I remember when my watch stopped working. We figured out it just needed new batteries. Let’s see if your toy needs new batteries.” Or, “Oh – you can’t find your doll. Hmmm … I remember last week when I lost my wallet. That was scary! But after we retraced my steps, we found it in the car. Let’s see if we can retrace your steps.”
 
It is important to remember that building episodic memory is a process that unfolds. It does not happen overnight, but as we see children with ASD use their episodic memories to problem solve, there is no doubt it was worth the wait. Using episodic memory to increase problem solving abilities and experience sharing are main goals of Relationship Development Intervention®. RDI consultants guide parents on how to authentically include their child in these moments day-to-day so that episodic memory can develop.


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Why Teach Cursive Writing? by Mary Lou Gagnon OTR/L

7/19/2018

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​As a society, there is an ongoing debate about whether or not cursive writing needs to be taught in our schools today. Many of my friends who are teachers tell me that they do not have the time to teach cursive writing, and that cursive writing is a dying art. Others argue that cursive is no longer relevant because it isn't included in the Common Core Standards of many states. Although this is true, it is important to remember that these standards only include skills that are testable and measurable in the classroom; they do not address basic foundational skills, like handwriting or even spelling. As students and teachers turn more and more to communication through tablets, phones, and computers, many feel that students should be focusing more on keyboarding skills than cursive writing. However, we should not lose sight of what handwriting, especially cursive writing, brings to the table in regards to educational skills, communication skills, and overall development.
 
Many long time teachers feel  that children struggle more now than they did 30 years ago with fine motor skills, which impacts legibility in both manuscript and cursive handwriting. Occupational therapists attribute much of this to the “back to sleep” movement, the frequent use of a variety of infant seats and carriers, increased screen time and decreased “typical” childhood play. So many of a child’s foundational skills are built during the first five years of life through play. Tummy time, creeping, crawling, climbing, running and overall coordination play helps build core strength, balance, oculomotor and coordination skills, while manipulating toys of various shapes and sizes helps to develop fine motor skills. If these foundational skills are not fully developed, we cannot produce proficient writers or keyboarders. It goes without saying that handwriting itself is much more than just a fine motor skill. Therefore, in order to build the fine motor skills that are critical to writing and keyboarding, it is important to establish good foundational motor skills. 
 
In a 2013 New York Times article by Suzanne Baruch Asherson OT, the importance and relevance of cursive writing was discussed.  Research has shown that puttingpen to paper stimulates the brain like nothing else, even in this technological age. In fact, learning to write in cursive is shown to improve brain development in the areas of thinking, language, and working memory. Cursive handwriting stimulates brain synapses and synchronicity between the left and right hemispheres, something that is absent from printing and typing. In a 2006 Chicago Tribune article, it was reported that students who learn both cursive and print perform better on reading tests. Many educators, including those at the Landmark School,  use cursive to help students with dyslexia.
 
It is felt that the physical act of writing in cursive leads to increased comprehension and participation. Interestingly, a few years ago, the College Board found that students who wrote in cursive for the essay portion of the SAT scored slightly higher than those who printed, which experts believe is because the speed, automaticity, and efficiency of writing in cursive allowed the students to focus on the content of their essays.  Cursive, therefore, is vital to helping students master basic written expression and critical thinking; life skills that are crucial throughout life.
 

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Episodic Memory Part 2

3/20/2018

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​Linda K. Murphy, MS, CCC-SLP continues with part two of her series on one of the core deficits of autism – episodic memory. To read part one, scroll down.

In a previous article, the critical role that episodic memory plays in life and in developing social relationships was discussed. The second part in this series will discuss how to help your child develop and use episodic memories for the purpose of experience sharing.

One of the biggest shifts that social partners need to make in order to support a child with ASD to develop and access episodic memories is in their own communication. Often times when we are trying to help children access memories, we ask a lot of questions or use imperative statements: “Who did you play with at school today?” “What did you have for snack?” “Tell Daddy what movie we saw.” It goes on and on. We try so hard to get information from kids with ASD. Sometimes we get it, sometimes we don’t, and even when we do get an answer to our question, we are not getting at what we truly want to know. Don’t we instead want to know how the child felt throughout the day? What made the child smile or laugh? About connections the child shared with their friends? We want more than a one word answer, but don’t know how to get it. One thing is clear though: imperative questions and statements do not get at the heart of what we all use memories to do: share who we are!

Because we don’t always know what a child with ASD is remembering about an event – he may remember the ceiling fan that he watched or the numbers he noticed on the outside of a house – we have to mindfully spend time helping socially meaningful memories go in. We can do this using declarative language to observe, reflect and share subjective appraisals alongside the child. We can do this by becoming generous with information. This means we are sharing and not expecting anything in return. We are moving from getting to giving so that the child can truly learn to give back.

Once we have done this – once we are sure we have spent time giving – we can engage children in specific activities that support them to share what they remember. Here is one such activity:
Share memories in partnership with the child. This means, you are collaborators in the task of weaving a story. It is important to do this within a context where you were present so that you can truly support the child to succeed. Let’s go back to our trip to Boston to illustrate this idea. As you are on that trip, offer information along the way that not only recaps what you are doing, but communicates a subjective appraisal: “Wow! I can tell you really liked riding on the T. I think Park St. is your favorite stop.” … “Oh look! There’s a line for the Swan Boats, but it isn’t that long. Let’s wait because I think it will move quickly” … “You really like pizza! We should go to the North End because that’s where the best pizza in Boston is.” While on this trip, you could also easily take snapshots with your phone or PDA, capturing moments of the child in action, moments that are socially meaningful. Once your trip is complete, you remember and recap as a team. Maybe you look at the pictures together while riding home on the T, or do it as a bedtime activity. You continue to share what you remember using components that make storytelling more interesting and fun for everyone: animated facial expressions, rich intonation, gestures and dramatic pauses. Here and there, give space for the child to chime in, or even to just communicate that they remember too. This is how sharing of memories begins.

As a team, you could later tell a family member or friend about your day. You share some memories, and pause to see if your child wants to add a related memory. Your memories are triggering the child’s, and they may add a thought when you invite them to do so. You may even scaffold an idea for the child: “We went on the T and stopped at your faaaaaavorite stop ….” Or maybe you say, “We decided to eat in the North End because….” and your child chimes in: “I love pizza!”

These kinds of memories are so much more meaningful than simply stating the details. By sharing in this way, we are teaching children to share what each detail means to them on a very personal level. We are teaching them to share who they are.
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Upcoming topics in this series: episodic memory and problem solving, episodic memory and peer interaction.


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Episodic Memory Part 1

11/20/2017

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By Linda K. Murphy MS, CCC-SLP
 
This is a four-part series on Episodic Memory and how it effects individuals with autism spectrum disorders.
 
Memory is important for everyone in terms of learning, growing and managing more complex social and emotional situations in life. We use our memories to build and strengthen relationships, to reflect on what we’ve done in order to make plans for the future, and to problem solve based on past experiences. If we didn’t have memories to draw from, we would hardly move forward in life. Developing meaningful memories is a critical skill for all people including children with autism.
 
Imagine this: you spend the day in Boston with a friend. You take the T there, walk around Faneuil Hall, do a little shopping on Newbury Street, have lunch in the North End and visit the swan boats in the Public Garden. In that one day, the memories formed and memories used span a variety of topics. You probably remember the things that you talked about with your friend or the laughter that you shared, more than you remember any particular item that you looked at while shopping. Or you probably remember how good your meal tasted, but maybe not the other items that were listed on the menu. Maybe when you got to the swan boats there was a line and you used your memories of waiting in other lines to appraise how long you might need to wait in this line. Each of these memories is an example of episodic memory.

Episodic memory refers to one’s autobiographical memory. As we move and do things throughout our life, we are creating a story about ourselves. We use this self narrative to share our experiences with others and to negotiate new situations in the future. Without memories to pull from, the world would be a scary place; any new situation would leave us feeling lost. With episodic memory, we can enter a new situation and figure out what to do because we remember a similar situation from our past. Now imagine you took that same trip to Boston with a child who has ASD. His memories may instead be the names of the T stops you rode through, how loud the restaurant was and the anxiety he felt waiting in line to go on the swan boats because he didn’t know how long he was going to have to wait. What is meaningful moment-to-moment to a child with ASD may be different from what is meaningful to another person. Instead of forming memories that will later help with problem solving and planning, a child with ASD may be forming memories that lead to fear of the unknown. Developing episodic memory is difficult for people with autism, yet it is a critical skill needed for living an independent, happy and stress free life. It is also one of the foundations of the RDI® Program, and something  we continually keep in mind at our practice.

The next parts in this series will discuss how to help a child with ASD develop episodic memory to experience share, problem solve and develop peer relationships.

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