ADHD and the pandemic

 

7 months in and we are still in a pandemic. We have some schools that are fully in person, some are doing a hybrid model and some fully remote. Whatever the option, many kids are still struggling. Especially if they have any kind of diagnosis that requires a 504 or an IEP. In the spring it was mad chaos of trying to figure our how to get everyone online and fully remote. Teachers did their very best trying to get everyone on the same page, but honestly, even they were still trying to figure everything out. As consequence, some states had grades and tests not count towards the students grade at the end of that quarter. 

The fall is different. Everyone has (mostly) gotten their bearings, figured out this pandemic learning and how they are going to teach. So, now students are being graded and expected to stay in class, whether that class is fully online, hybrid or in person. This is good and bad. It presents some challenges to certain students and families. Lets specifically talk about ADHD. Kids with ADHD already have issues with executive functioning skills. What are executive functioning skills and why do they matter, you ask? Glad to help! Here is an article from additude magazine explaining just that Executive Functioning. When kids are in person, they have many supports written in to a 504 or IEP, such as sitting next to a teacher, having frequent checks that they are doing their work, asking them to hand in their work, extra time to do their work, etc. Not all of these transfer over to an online format if that is what your child is doing right now. And this can make for a very frustrating year! 

What is different during online learning and how can this go wrong? Well, lets see...With online learning, students have to have organizational skills as well as be able to focus without interruptions and without impulsively looking at something else like going to another tab like YouTube or looking at a book, etc. They need to have the ability to manage time. They are in their own house, so it is very easy to get caught up with going to get some food, see something interesting and forget that they have to log back on to the computer, whereas in the school they had 5-7 minutes to get to class before a bell rang notifying them they were late.  It is MUCH different than being in a real classroom. And yet, I get the enormous pressure teachers are under to cater to ALL the different styles of teaching they have to do. And I get that there also are tons of different kids who have tons of different needs. Recently I was talking to a mom who said that her child was having a lot of difficulty staying in class and she got an email telling her that his grade went from a B to a D because he didn't stay in class or finish any of the work. Come to find out (he's 9) she had no idea he wasn't finishing the work because there was no communication about that and he was telling the teacher it was too hard and all the teacher would say is "if you focus it wouldn't be." He has severe ADHD. Lack of focus is part of his problem as is impulsivity. He gets bored, he turns off Zoom. And mom works during the day, at home. She is not always there to watch him every second. Mom told the teacher that online learning is really difficult for him due to his ADHD, but he is trying. The teacher went on to say, "online learning has been shown to be easy for everyone and has proven benefits." Now, clearly this is not true. There are many students that are struggling with this. How do we help them? How do we make it easier for them to succeed? 

One thing we can do is ask for more online learning friendly accommodations in the IEP or 504 plan. Currently, the only accommodations in my daughters' plan are "teacher check in throughout the day particularly during independent work time" "Abby will keep her camera on" "teacher reminder to turn in work" ""homework calendar updated weekly that parent can access" "teacher reminders  to go re-check work". Yet, despite these, my daughter failed to turn in work for over a month. So, something is happening that she is losing focus, her impulsivity is making it harder to do her work and she is not self-motivated. So now, we are way behind and playing catch up. She was impulsive and had a lack of focus in person, this is true, it's why we got the 504 in the first place. BUT, she turned in her work and had good grades. So, we can see there is a change. But, in a pandemic we need to keep everyone safe, so she is still at home. How do we help her, and children like her to either get their grades up, keep their grades up, or not lose hope?

One thing parents can do at home is having timers and rewards. So, when the timer goes off at the end of class, give a movement break, give a little fidget, anything to help get them moving a little bit since they are mostly sitting in front of a screen all day. Kids with ADHD also have trouble with intrinsic motivation, so sometimes extrinsic motivation will be needed to get them started with self-motivation. This can be whatever you decide. Little toys from the dollar store, a handful of M&M's for finishing all their homework or staying in class the whole time, it's really up to you and your family. Another thing you can do is chunking assignments. So, if your child is like mine and missing a ton of assignments, having them break them up in to chunks so they don't freak out and say "OMG I have HOW MANY assignments to finish?!? I'll never be able to do that!" and just shut down. Chunking the assignments in to bites of 3-4 or however many you think your child can handle will make it more manageable. And this can work even if your child has no missing assignments, but usually gets a lot of homework, or the homework they get is really long. Break it down in to answering 3-4 questions, take a 5 minute movement break and answer 3-4 more. It may seem like it will take a lot longer this way, but, it beats the "I can't do this so I won't even try!" battle. And now is the time for a lot of positive praise for the assignments they DO finish! The other thing you can do is find out where their interests lie, and if they are having a lot of trouble with a subject, see if you can incorporate their interests in to that subject to show they have mastered it. For instance, if your child has trouble writing, but loves to talk, have him do an oral presentation to show what he learned, or a podcast, or pretend he is a radio host. If your child loves art, have him draw an artists rendition of his interpretation of what is going on in a story they learned about. These are just a couple of ways that you can alternate the homework, but still show mastery. And these can all be incorporated in to an IEP or 504.

As I said, Executive functioning skills are hard for kids with ADHD. But, there are ways to accommodate for them whether at home or in school, or if you are doing a hybrid option. We are all going through a massive change right now, no one likes any of these options. One thing I have found helpful is helping my daughter prioritize which assignments need to be done right away, with need to be done soon, and which can wait a day or two. This also helps her not be overwhelmed and helps her finish more work. And the teachers have noticed her progress and have started praising her more, which gives her some of that extrinsic rewards, which hopefully will transfer over to becoming intrinsic eventually and she will want to finish it for the reward of being successful. What have you found to be helpful for your child with ADD/ADHD? 

Why wait?

 

Many times, parents that I help are concerned that their kids are not speaking, or are not speaking in sentences that are understandable enough to get their needs met. Let me stop right here and say, I am not a speech therapist. I have worked with many great speech therapists and speech therapy assistants over the years and learned a lot from them, but when there is a speech concern for any of my kiddos, I call in the experts. That is their field. That being said, I do work on language during play with kiddos. Especially social language. We also work on language to get needs met such as either using signs, or words like "help" "want" "more" "all done" etc. Using language during play, talking about what children are doing is something that comes natural to me, but doesn't always come natural to everyone else. And I am also a talker when playing with children, so when I learned about expectant wait times, it was something new to me too. 

Expectant waiting is when you say something to the child (or person you are talking to) and give them time to process the information and respond. This can take any amount of time you feel the child may need but usually we start with about 10 seconds which when you think about it seems like nothing, but when you put it into practice feels like a really long time! And when you have parents that are also talkers (which is nothing bad at all! As I am a talker as well, and exposing a child to language is always a good thing!) having them slow down and wait for a child to process the information that they have given, and answer a question or respond to a command, can be difficult at first. I know it was a little hard for me at first too! 

Children who have any kind of speech delay, receptive or expressive, or are hard of hearing, will especially need wait time to process information or questions that you ask of them. When we ask questions of our younger children, I like to try to phrase it in smaller bites "you want milk?" "give me ball." "go get doll." while they are still working on learning to answer questions or follow directions. Then as they get better responding to these directives, start to expand the language. "Do you want your ball?" "Go get your doll." "Give me your blue block." Starting with longer requests can work, but if they are getting frustrated because they don't understand or are having a harder time processing too many words, breaking them down in to smaller chunks may help them have an easier time processing and giving an answer or responding to your request. And giving the time they need, even if it feels like a really long time for you, will help your child have decreased frustration levels and everyone will be happier as your child learns to express themselves and get their wants and needs met. 

*Again, these are things that have worked for me as a Developmental Therapist, having worked in EI for 8 years. I have worked alongside many great speech therapists, and speech therapy assistants, but always refer my kids to speech therapists when there is a speech concern. 

Getting ready for school

 How does school look for you this year? For us, all 3 of my kids are starting online. Which I, personally could not be happier about right now. I have been hearing so many reports of kids going back to school and being sent home the first day with civid. Or just in our school district, they haven't even started and there is a case of covid at one of my kid's schools. We are fortunate that our kids are able to do online school while I and my husband work from home. I am able to make my job flexible enough that I can help out all 3 kids and take an hour here or there to also do my work via zoom, or once or twice a month see a kid in their home. I understand not everyone has that ability. Nor does everyone have the patience for it. Many people have to work right now and are unable to be there while their kids do online schooling. Making it impossible for their kids to get any work done. It's a difficult situation all around. The teachers can only work so many hours in a day. But parents may not be home until 4-6 pm in order to help their children. And in the instances of younger children or children with executive functioning issues, that means school is not getting done. At lest not until the parents are home. And by then everyone is exhausted. It is a very difficult situation this year. I think the best we can do is concentrate on making sure everyone is healthy, both mentally and physically, and feels loved and appreciated (teachers, parents, and kids), and try to get a little leaning in there as well ,while respecting it may not look the same for all families. I've set up some cozy corners with what space we do have in our house. Admittedly we do have a lot more space that our old house, but not a ton to make a whole school room. But, this is just an idea of what we have done with some of our space with the items that we have. And I know that all the kids teachers will likely give is more stuff to include as well. I also have items to supplement learning as need be if the stuff they are learning is too hard and we need to take a step back to re-learn some things. Because lets be honest, last spring was hard! It was hard on teachers figuring everything out. It was hard on parents figuring everything out. And it was hard on the kids just trying to muddle their way through. We may need to review a few things. And that is perfect OK! 

Changes

How do you feel about changes? Do they make you excited? Or do they make you anxious? For me, change always makes me kind of anxious. Any change really, whether it's rearranging something in my room, or something big like my daughter starting high school next year, (not this year. Phew! The 2021/22 school year). So, needless to say, the changes in the past 5 months (has it really only been 5 months?? it feels like 5 years!) have brought about their own anxiety for me. We went from being in school in February, my middle daughter at Natures classroom at the beginning or March, to her coming home and full blown pandemic and all online school. We muddled through and made it. 2 of my kids did better than the other one. One is not great at online schooling due to executive function issues. But we made it to summer break. And we thought, "ok, we did it! We made it through. Now we will enjoy the summer, (even though we couldn't go much of anywhere due to still quarantining most of the time because of my son's heart transplant.) But we still went and did things like bike rides, walking in the forest preserves and thought, we would be going back to school in some form in the fall. 

That idea brought with it it's own set of anxiety. Do I send all 3 kids to school? Do I just send my girls to school? Do I keep all of them home and do remote learning? Would that even be an option. Needless to say, I overthought about this  lot during the summer before the school districts even came up with their options. I kept thinking I had the right answer and would see someone else online saying something that made me think I was making the wrong choicer, no matter which choice it was. 

Finally my oldest daughter's school came out with their option A/B schedule with online learning 3 days of the week. Which made it easier, sort of, to decide what to do with my younger two. I would put them in their private Montessori on the same days as their older sister, and this would minimize risk. But still, I kept overthinking should I even have my son go to school at all? Maybe I should have him stay at home? Again, I would see things online saying I was wrong either way I thought about it. 

Then, my oldest daughters school came out with their new schedule. All remote learning until at least October 30, and they would reassess then.  Well, this made it a lot easier for me. All 3 kids would stay at home. With the possibility of my middle daughter going to school at the end of September. So, I started getting things ready for my son, since I knew I would need to have some things for him to do during the day. His teacher is, after all, teaching 5 days a week. It's hardly fair to expect her to teach him during the evening as well too. Though he is going to be able to go in his class remotely some days to get the classroom experience. But, I am also going to substitute some of his learning as well so he can keep up. My middle daughter is going to have stuff that I will pick up to help her learn at home and she will go in to the class remotely some days as well. But I have stuff to substitute her learning as well just in case. 

Why do I mention any of this? Because we all have doubts. Everyone is out here trying to figure out what to do with their kids right now. Working parents, stay at home parents, part time working parents. We are all in this together trying to figure out what will be the best option for out kids. And whether that is remote learning, hybrid option or full day in class, what you pick is what is best for YOUR family. Let my overthinking be a lesson to you so you don't go through what I did. Pick what you think will be the best for your child, for the health ands well being, and go with that, and don't look at comments on facebook, twitter, instagram or whatever else that are talking about how this one is better than that one. You know what is best for your child. You are their best advocate. And even if they don't like the option you may pick for them, in the end, it's only one year.Yes, it may be senior year, or 8th grade year, or some other special year. But only you and your family can decide what is best and right for your family. 

Add caption

Working on Identification Skills

Parents often wonder how to start working on identification skills. Many times they think they need to buy fancy flashy cards, or new games and toys. But none of that is really all that necessary. We've talked before about using items in your own home for many different ways to play. Now, let's talk about how to use items in your home, or even own your own body to work on identification skills. If your child is not yet talking we can work on this in different ways, either through gestures, or by your child giving you an object or touching an object. When working on body parts, you can do this in the bath tub to make it more fun. You can work on telling your child which body part you are washing and after a while say something like "I'm washing your tummy, where is tummy" and see if your child points to his tummy. You can also do imitative play in the bathtub if you have a doll, so wash your child and have your child wash the same body part on the baby doll. This way he is learning the body parts, but is also learning some imaginative play skills at the same time. You can also work on making choices in the bat tub, if you have colored cups, asking your child which cup he wants you to use to pour water with (or use to pour water on his doll with), if you have different colored washcloths you can ask your child to point to which colored wash cloth he would like you to use to clean him, all the while you are naming the colors and he is listening, so even though he may not say the name himself yet, he is understanding that there is a difference between these two items you are asking him to choose from. 

Some things you can do to work on identification skills with items you have around the house outside of the bathtub, during mealtimes, you can ask your child what he wants between two or three items. If he is speaking, he can tell you what he wants. If he is not yet speaking, he can point too or gesture towards what he wants. If your child is not yet gesturing, but you know what he would prefer, you can help buy using hand over hand to help him touch the item and saying the name of it (touch the carrots and say 'your want carrots, ok, lets eat carrots') and then give him the item so he associates the gesture with receiving the item, and will start to try to point or gesture on his own. This will start to help him more independently get his needs met. You can also play matching games with clothing items. You do not have to go out and buy fancy puzzles, or shape sorters. if you have different colored clothing or socks, you can work on matching this way. Just take 4 socks, 2 colors of each, so maybe one red pair and one white pair and show your child how to match them together (don't worry about folding them, that a much higher level skill than we are working on). you can then ask your child to find certain colored socks. IF this is too difficult, go back to putting 4-6 socks in a pile and having your child match them. Or 4-6 colored shirts in a pile and have your child match them. 

Once your child is able to put things in a box without taking them out again, and is able to match, you can work on cleaning up and sorting. This should come as a relief to you. You can have your child start to clean up their own items! Now, I wouldn't try to have them clean up the whole living room. Especially if they are still on the young side (under 3). But, they can certainly put away a few items. It helps if a picture is on the box of toys to show where each item goes. Or, if you just have a general box where everything goes, then that's ok too, you can just let them know "clean up, put in box" But, if you have a separate box for separate toys, for instance, legos in one box, dolls in another and trucks in another, it helps for them to see some of the item in the box already so they know what goes in each box and how to match it to each one, or have a picture on the front of each box so they know what to match the toy they are putting away. 

What to buy?

I get asked a lot by parents what they should buy their children. Whether it be during the holidays or birthdays, or more recently during quarantine to keep kids busy. I have done videos in the past on how to use items you have in your own home, but decided to also do a video on my favorite toys if parents really want to buy toys and don't know what to buy. These are just a few things to have. And if you don't feel these are appropriate to the age range of your child. please feel free to contact me and we can discuss ways to use toys or objects you have, or age/stage appropriate toys to buy!

What does inclusion look like in a classroom?

Schools and classrooms talk about being inclusive, or having inclusive classrooms, but what does that really mean? Does that mean that they have kids with learning disabilities in the classroom? Does it mean that they just sit kids with learning differences alongside their peers and clan this inclusion, because they are included in the class? Not exactly. 

Being an inclusive classroom means that it is all inclusive of everyone's abilities. Not just by proximity, but by learning abilities, physical abilities and any emotional consideration as well. This is different from integration. Integration attempts to absorb the child with special needs in to a mainstream classroom. Making the child accommodate to the classroom, rather than the other way around.  In an inclusive classroom of 20 kids, you might have 6 of them have IEP or 504 plans. And you would have your classroom planned out in ways that are accepting of and accommodate these abilities, as well as plan and differentiate for the whole classroom. An inclusive classroom is one where the education of the students benefits all of the students in the classroom. 

So for a child that has to use a wheelchair, to make them feel included, you would have bigger spaces between all of your shelves and areas in order for them to have complete access to get around the classroom. You also might have things that are needed more in the classroom on a top shelf so that it is more easily accessible without them having to ask for help in getting it, since reaching down in a wheelchair would prove difficult. For a child with sensorial or emotional needs, you might have a calming space, or an aide that can sense when this child needs a break and takes them for a walk, or to the gym to run around. They would not be punished for things that are out of their control such as needing to stand during circle, it would be explained to the classroom, "this is how Johnny learns best, just like you learn best sitting down, and Suzy learns best on her wobble chair, and Bobby learns best on his yoga ball, we all learn differently." And all of these things would be accessible to not only the child that has the disability, but to the whole class. That's the difference between integration an inclusion. With integration, you are making the child fit to the classroom. With inclusion, you are making your classroom fit the needs of not only the children with learning differences, but all of the children in your classroom. 

An inclusive classroom is accessible to all leaners. So, this could mean differentiated learning, accessible seating, seating near a teacher, giving a child fidgets if needed. Most of all, a child should be pulled out of the classroom as little as possible for extra learning time. Instead the teacher should "push in". What does this mean? If a child has speech services for instance, whenever possible, the speech therapist should come to the classroom to help the child with speech and language. This obviously might not always be possible as they may need to work on specific skills in a quieter environment. But, whenever possible, the speech therapist should work on speech skills in the classroom where the child is working on speech with his class. Just like a physical therapist would try to work on gross motor skills while the child is at recess or in gym class with his classmates. Again, there may be some instances where the child needs time to perfect some skills in a more individualized situation where the therapist will pull him out, but to all degrees possible, the classroom is more inclusive, when the therapists push in. 

It also makes it more inclusive when the general education teacher and special education teacher and related professionals co-plan lessons together. This way, the general education teacher is better able to teach to the whole class, while being able to take into consideration the individualized needs of the children on her or his caseloads with IEP plans or 504 plans and how to meet their needs and the whole classrooms needs auth the same time. The general education teacher will be able to differentiate her plans to meet the needs of all the students in her classroom. In this way, all of the students may work on the same subject, but in different ways, and possibly at different paces. 

In inclusive classrooms, children should not be grouped together by disability. There may be some cases where children are put in a certain seat for a certain reason, such as when a teacher places a child closer to her due to the child having ADHD and needing less distractions and closer monitoring.  There may also be cases where children are places together by abilities during parts of the day, such as during reading groups. But, for most of the day, children should be mixed together throughout the class so that they feel that they are all included as one classroom. In this way, students needs are accommodated and all children are still all to access the general education curriculum. Some children may do so at a different pace, or may do so with assistance, but they are able to be in the classroom accessing the same curriculum as their peers as much as possible. 

Most of all, an inclusive classroom is one where every student feels loved, accepted, connected and part of the whole classroom! 

Wednesday Wisdom

Working on matching and receptive language skills

In this video, my son, who is 8, was helping me by showing how to work on matching, color identification, gross motor skills, and receptive language skills. He had to really think about which body part to put on which color (working on receptive language skills, identifications skills, and gross motor skills-it was a little hard for him to balance for some of them!). He also worked on throwing different color bean bags in to different colored circles which not only works on identification skills, but gross motor skills throwing the bean bag at a target).

This can be modified for different skill sets. For younger children you can just have the circles set out in front of you and have them match beanbags to circles. If they are ready to identify colors you can choose colors for them to throw in to the circles or put in the circles. You can also say "give me x color" when you are cleaning up the beanbags to check for accuracy in identification. If they are walkers you can have them walk over to a certain circle that you put out. Or use it for positional words by putting the circles or beanbags in different parts of the house and tell them "go put the beanbag in a circle that is under the chair/on the couch, next to the tv, etc." Or even play a game of I Spy with older children telling them "I spy a beanbag that is red and it is in a room that we eat in." And you don't have to use this specific toy. You can use colored construction paper and have your child jump on it. Or cut the pieces in half and have them match pieces together. as well as work on the same positional words as above. There are so many fin ways to use this to get your child moving and working though play!

Covid and ACES

What are ACES and how do they relate to Covid right now? ACES are Adverse Childhood Experiences. Almost everyone has gone through some Adverse childhood experience at some point in their life, whether it was their parents divorcing, a parent losing a job and that creating financial instability, perhaps a parent being incarcerated, there are many of them that are in this link. ACES

How does this relate to Covid right now? Well, one of the things that can cause an Adverse Childhood Experience is parents losing their jobs, homelessness, not knowing whether you will have enough food to eat. As well as being scared you or your family members will get sick or being scared of your family members dying. And we are all dealing with that in some manner or another right now. Whether you have lost your job, or are underemployed, whether you are worrying about your or your child's health, whether you have a family member that is sick with Covid and your child knows this and is afraid that they may die. These can all contribute to adverse experiences. The other thing that can happen, and is happening right now, is parents may be having a hard time with their children home all the time. They were used to the 6-7 hour break they would get while their child was at daycare/school. And we have seen a spike in child abuse cases. It's more difficult to ask for help form elderly relatives, due to not wanting to get them sick. Perhaps home visiting programs have been converted to teletherapy, and many people are not used to reaching out to ask for help when they need it. So, we have seen an increase in parents abusing their kids and mandated reporters having calls to DCFS and the children are placed in foster care.

Right now is a stressful time for a lot of people. Many people are finding that they are having to try to do their work from home, as well as help their kids with remote learning, and if you have a child with a 504 plan or an IEP, you are trying to individualize their learning so that you can best help meet their needs. And if you don't have an education degree, that probably seems next to impossible. Never mind all of the regular stuff like cooking, cleaning, grocery shopping, etc. No one would blame you if you just said "oh forget it," and let them watch tv while you finished your work.

Here's the good news. Adverse childhood experiences do not have to be forever. I love this quote in this article Adverse childhood experiences "If the brain can be hurt, it can be healed" How? Be using positive childhood experiences. If you are having too hard of a time with your child's trigonometry homework, and you feel you both getting frustrated and you want to blow, set it down. Stop what you are doing and take some time. If you are not working at the moment, maybe go for a walk around the neighborhood just the two of you, go get some ice cream together, watch a tv show together. Do something that makes the two of you feel good. If your infant is crying and crying and crying and you are at your wits end, put your baby down and walk away for a bit. I promise you, your baby will be ok. Also, right now, you can utilize The Fussy Baby Network for free during Shelter in place. Utilize them! They are a great resource of infant specialist and are there to help with no judgment!

Here is another great article about ways to avoid aces during covid. Doing positive things together such as baking, coloring with your children, playing games, doing puzzles, will help heal the brain., Look, no one is perfect. If you lose your job, or have food insecurity, or you become underemployed, or worry about your child getting sick, you are going to have feelings about that and your children are going to know. This is not saying do not feel your feelings because it will traumatize your children. This is just giving you advice on where to go and how to also create positive experiences for your children so that we don't continue seeing spikes in child abuse cases, so that we don't see spikes in domestic violence cases. There are resources out there for you. If your child is in Early Intervention, utilize your therapists, ask them for resources for your child for while you are sheltering in place. If your child is in school, utilize the teachers. Ask for activities for your child to do indoors to keep them active while you are working. If your child's teachers or therapists are creating more stress because they are scheduling all of your child's meetings during your work time, and you have to help facilitate this, talk to them and explain that this will not work for you. If you can come up with a plan, great. But if not, let them know that you will work on what you can, when you can, but first and foremost, what matters is your child's mental and physical health. And yours as well!

You have to Maslow before you can Bloom

For many of us, we have never homeschooled before. We had no plans to ever homeschool our children, or teach them at home. We wanted our children in schools with teachers. And let me tell you, your children's teachers are missing them too! Right now, what you are doing is not homeschooling, it is crisis schooling. And it can look different for everyone. 

As an educator, I learned a lot about many different educational theorists during my undergraduate and graduate days in school. This saying speaks to me, especially now! Students must Maslow before they can Bloom." What does this mean? Well, Maslow believed in a hierarchy of needs that had to be met before you could advance to the next one. And he did explain later on that not everyone moves through the hierarchy in the same direction and some may move back and forth through the hierarchy (think of someone who is in the fourth level but then becomes homeless, all of the sudden, food and shelter are going to become much more important to them than esteem and self-actualization.) So what are Maslow's Hierarchy of needs and how does this pertain to our situation with the coronavirus right now? Maslow's Hierarchy of needs start at the bottom and go up starting with 1) Physiological needs-food, shelter, clothing, sleep 2) Safety needs- predictability, feeling safe and secure, having order and control over their life 3) Love and belongingness- friendships, trust, giving and receiving love and acceptance, being part of a group 4) esteem needs-esteem for oneself (mastery, achievement, independence) and desire for acceptance from others (status, prestige) 5)self-actualization needs- realization of a persons potential, self-fulfillment, personal growth https://www.simplypsychology.org/maslow.html 

Right now, many of our  students that may have been at step 5, or even in the Bloom stages (which I will get to next) have gone back to stages 1 and 2. They are having trouble meeting physiological needs. They may be getting 2 meals a day from the schools, but not have enough for everyone. They may be receiving food for just the kids that go to school, but the parents don't have enough to eat. They may overhear their parents talking about how they are going to make rent. They may be worrying about a relative that is sick with coronavirus, or they themselves may be sick with coronavirus. They may also be worrying about safety and security. They doun't have any sense of predictability right now. No one was given a chance to say goodbye to their friends, or teachers. Some were given no guidance on how to complete schoolwork. Parents with multiple kids in the house who may have varying degrees of disabilities are having trouble keeping all of them on tasks and this is creating chaos in the minds of the whole family. Kids of all ages (whether they want you to believe it or not) like a sense of order and control. They may tell you "stop trying to control my life!" when they are in their teen years. I'm sure you have heard that one more than enough. But, when there is no order, and things have no sense of control at all, it can cause a sense of instability that causes children to act out. It causes them to sometimes act what we would consider "younger than their age," even though this is typical behavior. 

What does Bloom have to do with all of this? Blooms taxonomy has stages as well 1) Factual- knowledge of terminology and specific details 2) knowledge of classifications and categories, principally;ilizations and generalizations and knowledge and theories of models and structures. 3) Procedural) Knowledge of subject specific skills and algorithms, subject specific techniques and methods, criteria for determining when to use appropriate procedures 4) Metacognitive-strategic knowledge, knowledge about about cognitive tasks including appropriate contextual and conditional knowledge, self knowledge. https://www.celt.iastate.edu/teaching/effective-teaching-practices/revised-blooms-taxonomy/ 

Let me start off by saying, I think our teachers are amazing! What they are doing is a herculean feat! Trying to find work that is going to help our children learn through distance learning, being available for questions during the day, helping them with whatever they need so they can get it right. They are doing amazing jobs that they never wanted to do. They wanted to be in classes with their kids. No one signed up for this. I have to say though, that some kids are back in the 1st and 2nd stage of Maslow while being asked to do things in the 4th and 5th stage of Bloom. And this is darn near impossible. We need to give our teachers some grace, but we also need to give our families a lot of grace! This is not homeschooling! This is trauma schooling! Children may or may not have a complete understanding of what is going on, especially the younger ones and when they do not understand, they sometimes are prone to make ideas up in their head. And sometimes those ideas could be worse than the actual thing that is happening. We need to work on Maslow before we work on Bloom. This is NOT to say that we should just tell the teachers that we aren't doing any schooling at all anymore (though for some families, I will say, this may be appropriate. And this is coming from an educator). But, we need to meet families where they are. With my EI families, some of them just do not want teletherapy. At all. They don't want to chase their kids around with a phone, they'd rather I provide suggestions through weekly or biweekly calls. And that is ok. Some people want teletherapy because it is easier to copy and imitate and learn from the therapist. And thats ok. With teachers, I think it is also ok to meet the children and families where they are at as well. If a family is telling you, "I have 3 kids at 3 different ages and 3 different ability levels that I am trying to help and I am swamped and can not get this done, do you have any ideas?" Sending 3 more emails with more homework is probably not the best plan. Trying to meet them at their level by reducing the amount of homework, or making some of it hands on and having the parent take a video (if that would help the parent because that particular child will not do worksheets) of their work may help. Remember, some kids are feeling the stress of their parents right now, and they are back at Maslow's level 1 or 2. They are also missing their friends. If they don't have a phone at home, or a good wifi connection they may not be seeing their friends right now so they are also not getting the love and belongingness from their friends. They may be getting it from their families, but it is a different kind of belongingness that comes from children friendships. So, trying to find ways to let the kids talk together when you can will help too (Skype, FaceTime, googlemeets, etc). This is a marathon, not a sprint. So we want to be sure to help our kids the best we can. We want to help them go back up that ladder, not slide down it even more. Lets try helping them by also helping their families. Let's meet people where they are instead of trying to push them to where we think they should be. 

Monster Meditations

Sesame Street and HeadSpace have teamed up to create Monster Meditations to help younger kids in this time of chaos. There will be 6 guided mediations released on YouTube, biweekly for kids to follow (and adults to, if you'd like!) The muppets will experience some common emotions and will be guided through mindfulness techniques to help them through these emotions. This is really great for kids who are stressed right now at being out of their routine, anxious from missing their friends and not being in school, sad at not being able to see relatives or friends or go on that special trip they were looking forward too. I would encourage anyone with young kids to check it out. Or even if you have older kids who like Sesame Street, have them check it out too! https://tinyurl.com/Sesame-Street-Mindfulness 

Reading With Kids

I've posted before about the importance of reading to children. This includes babies and young children. But all children benefit form being read too. When babies are young, they benefit from reading the pictures, just talking about the pictures in the book, patting their hand on any sensory pictures so they get the idea of pictures and words having meaning. As they get older, children can sit in your lap or next to you, wherever they are most comfortable, and if you have a hard book, you can let them try to turn the pages, so they learn this important skill of how to hold a book, how the pages turn from left to right, that the words go from left to right and still learning that the words have meaning and connecting pictures to the words.

Reading to children at a young age also turns them in to lifelong readers. Exposing children to books and having them see you reading books and making these happy memories will help make it more likely that they will have a lifelong love for reading.

Reading also increases children expressive and receptive language development. As you are reading to children they are connecting the pictures to the words, especially if you are helping them touch pictures and labeling them at the same time. They may start practicing saying sounds and imitating you as they are hearing you say words while they are listening to you read. So when you are saying "car", after reading a vehicle book many times, you may hear your child start to say "cah" one time. This is what repetition is so important.

Reading is also a great way to bond with your child. You are sitting there with them one on one, showing them pictures in the book, showing them the words on the page and helping them learn about different things. As they get older, you can share more in depth stories with them that have more chapters and more imagination to them, and you are still able to bond with them. Reading to your child before they go to bed can be a great soothing way to end the day with your child.

With that. I have included a video of myself reading Mo Willems "Let's Go for a Drive!" In it, I included some ways to do hand motions with your children, to get them more involved in the story, and to help them stay more attended. You can do this with any story that you read to your child. If you have a story that you feel is too long for your child and they won't attend to it, just read the pictures and perform hand or body motions to it. Any time you get moving with a story, or there is a sensorial aspect to the story, a child is much more likely to pay attention. I hope you enjoy the story!

https://vimeo.com/408190209

IDEA and 504 Accommodations

Have you seen this graphic? I'm sure you have, it's been floating around in many different forms for quite a while. It shows how equity and equality are not the same thing.  Many times in schools we will hear teachers say "I can't give Johnny a fidget because then everyone will want a fidget and I need to treat everyone equally." Or, "I cant let Sally sit on a yoga ball, then everyone will want a yoga ball and I treat everyone equally here." But, equality is not the same as equity. We see in the first image, that by treating everyone equally, only two of the children are able to see the baseball game. In the second image, all 3 are able to see the game by each one being given the support they need. So let's talk about this for a minute.

Let's pretend you have a child in your classroom who is 8 and has ADHD. Your child has a 504 or IEP meeting with you where you start to work on accommodations and modifications to make sure everything is equitable and accessible. As you start the meeting you hear modifications such as having Sally do only odd numbers on the worksheet at home, having her sit next to the teacher, bring in fidgets, sit on a disco sit, draw her answers for reading instead of writing them down. You start to speak up, "wait, but then all of my students will want to do that. How is it fair that she should only do half the work that they do and get to draw in class instead of write her answers down?" Well, Sally has a much shorter attention span than the other students, so when she gets home, it takes her 2-3x the time to do her work that it does her classmates, so reducing the workload, makes this equitable. Sally has a hard time writing out the answers to her reading questions, though she understands the questions and knows what she wants to say, she can't put it to paper. But, she is great at art. So, you are capitalizing on her strength in art, and using that to assess her understanding of the reading. If you were to make her write out her answers, which is more difficult for her, she would get a lower grade, even though she has the understanding, she just does not have the ability, right now, to dictate that understanding. This makes her learning more equitable. You are also letting her have fidgets because her mom has found when Sally has something to do with her hands, she is able to better focus on whoever is speaking. So, she will be able to listen better to what you are saying in class and will remember more of the content.

Many times when you explain to children that you are giving them each what they need to succeed, they will understand. They understand the Johnny speaks in Spanish and that is why the assistant translates things in to Spanish for him. They understand that Susan wears hearing aides and these help her to hear better in the classroom. Or that Bobby is in a wheelchair because his legs do not work in the same way that ours do, so this helps him to be able to get around the class. If you explain that other things like having fidgets can help someone learn, or that drawing helps someone who can't write as well, children will understand a lot more than we give them credit for.

What to do with all these eggs?

Now that Easter is over and you have all these eggs left over, what should you do with them? Depending on your child's age, there are many things you can do with them. If you already have a sensory bin set up, you can add the eggs to your sensory bin to use to scoop items (if you are working with families that have, or you have food insecurity, you can use non-food items in your sensory bin to scoop and pour, or even water), you can hide the eggs in your sensory bin and have your child try to find certain colors of eggs, you can work on open/close, in/out. For younger children you may need to do some hard over hand assistance to help them to work on opening and closing the eggs as you say "open" "close". You can put items in the eggs, but if your child still mouths items, please be watchful so they don't put anything in their mouth. You can count how many of the eggs they find in the sensory bin. If the egg tops come off, you can try putting different colored tops to bottoms, (such as yellow with blue, red with orange, etc) and see if your child can take them off and match them with the correct colors. You can also add them to your child's pretend play and have them use them to feed animals, babies, etc.

If you have older children you can write down things to do or find on pieces of paper and put it in the eggs. Such as "go find something small" "do 10 jumping jacks" "find 5 red things" and so on, and your child would have to do the item that they picked. Older children can also use these to do an egg race, where they put the egg on a spoon and try to balance it while walking. It can be done solo or against a sibling to race and see who does it faster without dropping their egg. You can also hide the eggs in certain places and work on positional words, giving clues like "it's on top of something brown." Or for the younger ones just saying "it's on top of the couch." Or "it's under the table" and having them run to get it, crawl to get it, jump to get it, etc, so they work on identification skills, gross motor skills and receptive language skills at the same time. You can also have children with expressive language delays try to imitate the name of the colored egg after you, or the first part of the word, or any sound.

These are just a few ideas of what to do with all of those eggs. What are some things you have done?

Play is the Work of the Child

Mr. Rogers said it best, "Play is the work of Childhood." As Developmental Therapists, we often come in to a child's home to help with many needs and may hear from some parents, "so, you're going to just play? We play all day." But, there are many different types of play, and children go through stages of play, from cause and effect play (what will happen if I drop this toy off my high chair, what will happen if I press this button?) to functional play (pushing a car back and forth, putting items in and out of containers, and stacking items) to imaginative play (making dolls talk to each other, pretending to feed animals, pretending a fire truck is saving an animal or person), to more evolved symbolic play (playing house, using items for things other than their intended purposes-a block becomes a phone, a circle becomes a cracker, etc, playing dress up and creating characters and align about what they are doing, pretending the child is a fireman and saving people). 

Why is this important and what do  DT's have to do with this? Sometimes children are stuck at a level of play younger than their age level. So a 2 year old may still be at a cause and effect stage, when they should be doing more imaginative play. We can't just go in and make them start playing imaginatively. We need to scaffold these skills. So, we start out showing parents how to first help them play with toys functionally. Not just dumping them out and running away, but taking one out at a time and using it for it's intended purposes, then working to put that away (or, if it's being used with another toy t play, that's fine too). Once we can see that the child has accomplished each stage, we are able to help move on to the next stage of play. And while we are doing this, we are constantly assessing other areas as well. Is the child using their hands appropriately,? Are they able to cross the midline to grab toys? Are they able to navigate their environment to gain a toy? Are they able to pick up small toys with a pincer grasp, a fist grasp or a raking grasp depending on age level? 

All of these are things necessary for the child to grow and develop appropriately and DT's can help in this area. Now, more than ever, children need play. Right now, we are in a time of crisis where we cannot see family members that we may have seen daily or weekly. We are FaceTiming instead of seeing people face too face. Your therapists may be doing phone consults instead of seeing you face to face in order to obey the shelter in place order (depending on your state). Children need play in order to work out their feelings as well. Children use play not only to gain skills but also to work out anxieties. You may see children using dolls to express emotions such as sadness or being scared. You may see children doing more crashing play because that is how they know how to express their anger and anxiety if they don't have words yet. You may also see more meltdowns if your child has sensory issues. And play involving heavy work can help with this as well. 

A good play activity to help Self-Regulation from the book "70 Play Activities," by Lynne Kenney, that you can adapt to different ages is called "walk with me". What you do is call the child to walk with you and as you walk to their pace, add something on the fourth beat like a clap, stomp, or whatever feels appropriate. Then ask if they would like to be the leader (depending on age appropriateness.) They can add anything the like from stomping, to animal sounds, animal walks, etc. You can adapt this to slightly older children having them start off walking like certain animals, add in jumps, skips, and then do 2 steps like one animal, a jump, a step like a different animal. You can adapt this however you like. "This activity moves around the defensive brain to engage the thinker in a connected and collaborative way with a child who may be anxious, nervous or sad."