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Archive for November, 2009

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I am a huge believer in the positive influences music has on a child’s development.  The impact of learning rhythm, movement, and melodies  on a young child’s brain is well-researched.  For many years, I have enrolled my own children in Music Together® programs, attending classes in both San Francisco and Chicago.  In these classes I watched my boys learn to sing along with a group, explore and play instruments, internalize a sense of rhythm, dance, and discover the joy that comes with a wonderful musical experience.  We were given CDs of each semester’s songs so that we could continue to listen and enjoy the music at home and in the car. Music was an everyday part of our lives and I found that when I was taking those classes with my kids I more naturally incorporated singing and rhythm into my speech/language therapy sessions, too, with great results.

But over the years I saw children in our classes who had challenges that simply made the classes too difficult for them to manage week after week.  Sometimes I suspected that the transitions happened too quickly for them, and in other situations I could see that sound sensitivity was causing discomfort as a child had to leave the room for the loud or high-pitched songs.  Maybe the group was too large for some.  The teachers were fully open, welcoming and warm with all students, but I saw some kids who eventually just stopped coming.  This always upset me, because I felt that with some specific modifications, those kids could have gotten just as much enjoyment and learning out of the classes as the rest of the children.

This past year I approached the directors of a fabulous local Music Together® program I am familiar with on the north side of Chicago, Merry Music Makers, to discuss what we could do for these kids in order to create a more comfortable environment for them.  The outcome is a brand new class for ages 0-5 that will be taught by my fabulous associate, Laura Allison, who happens to be a talented musician in addition to her amazing skills as a speech-language pathologist!  Laura has completed the intensive Music Together® training and will be teaching this fantastic 10-week class at our clinic on Saturday mornings, starting in January.  Here is our official class description:

MIXED AGE – Supportive Environment
This Mixed Age Supportive Environment Music Together® class will offer increased support to children exhibiting regulation disorders, speech issues, sensory processing disorders or developmental delays. They will attend alongside their typically developing siblings. Adaptations will be made so that each child can participate to the best of his or her ability. The instructor will use visual aids to accompany music and activities, adjusting sensory input as needed to maximize the engagement and enjoyment of each child. Communication between parents and the instructor will provide parents with strategies to increase engagement and participation of their children. It is our goal to offer an experience rich in music, movement and interaction in a fun and supportive environment.

If you or someone you know is in the Chicago area and would be interested in this class, please visit the registration page at the Merry Music Makers website!  Registration opens on Monday, November 16.

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A couple days ago I was asked by a fellow parent at my boys’ school if I could fill a last-minute hole in the Career Day schedule at school.  In the interest of full disclosure here, I will admit that I tend to skulk around on the sidelines wearing dark hooded cloaks and huge Hollywood sunglasses when those notices and emails come out about the school’s annual Career Day.  Why is that?  I love my job and I don’t mind talking to people, especially kids, so I couldn’t tell you.  Believe it or not, I have a fundamental shyness that sometimes takes over, and this is one of those times.

But I like this mom who’s organizing it and I didn’t have anything going on that I couldn’t rearrange, so I said yes, sure, I’d talk about my job for 20 minutes to a second grade class.

Every few hours over the past couple of days I suggested to myself, You should really think about what you’re going to talk about on Thursday morning, and then promptly didn’t.  Seriously, I had no idea.  No notes, no particular structure to what I wanted to tell them.  I had more questions than answers: Do I stop and talk about autism, or is that my whole 20 minutes and not really the point of this? What do I do?  How do I put that into words for little kids? And so I truly walked in there with a head full of questions and absolutely no plan this morning.

I realize now that I probably did this because I knew on some level that I didn’t need a plan.  After all, I am comfortable performing, I regularly spend many hours a day talking to large groups of adults, and I am extremely used to being around groups of children.  It’s what I do all day.  I might be reticent about signing myself up for this, but when asked, it’s not actually a challenge.

So I walked in with all sorts of bubbly enthusiasm and asked them if they knew why I was visiting.  The first boy to raise his hand told me, “Because it’s Caweew Day!” (Sign him up!)  Next, I told them what I do for a living.  Half a dozen kids yelled, “Ooooh!!” and  jumped out of their seats waving their hands at me, like they had been in a secret club for years and I was their long-lost leader finally come to claim them.  Those were the kids who go to speech therapy.  I knew that before they told me, and so I let them tell the rest of the class what I do for a living.  They did a pretty good job, describing work on /r/ and /l/ sounds, writing, letter sounds, and sign language.  I talked to them about all the names for my job: speech-language pathologist, speech therapist, speech teacher. And then I told them that I prefer to be called something different.  A hand shot up. “Mom?” asked one of the boys confidently, sure he had it right (I had told them that I have two children in their school).  Delighted, I ran over and gave him a high-five, telling him that yes, absolutely, I love to be called “Mom” at home, and then told them that I prefer to be called a Communication Therapist at work.

I explained to them what communication is all about and the importance of non-verbal communication.  I invited my little “Caweew Day” pal to come up for a role play. I had him ask me to play with him on the playground and I demonstrated how I could answer him in various ways without words, and the fact that he was watching me and understanding my facial expressions and gestures without my having to instruct him to do so.  I explained how important that is, and that I teach kids to do that and to pay more attention to it.  We talked about play groups and AAC devices and good toys for therapy.  I let the kids who go to speech be the superstars and tell their friends their favorite speech games.

There were some wonderful questions.  One girl up front raised her hand and asked me if the job is “Fun — or scary?”.  I asked her what she thought might be scary, and she suggested that when a new kid comes in I might feel a little scared sometimes because I wouldn’t know what they’re like.  What an astute question.  I suppose it was a window into how the kids feel when they walk in to the clinic for the first time.  I explained that I don’t feel scared about any kids but that if I ever feel nervous around a new student it would only be because I might wonder if I’ll be able to help them enough (although I pointed out that the longer you do the job the less you worry about this).

Next, a boy raised his hand and asked the apparently all-important second grade question: “Who’s the boss at your work?”  When I answered, “I’m the boss there,” 25 heads snapped to attention and 25 pairs of eyes stared at me in wonder.  Another boy shared, “My dad’s the boss at his work.  You have to get there first to be the boss,” followed by a rambling explanation of his father’s career history.  Okay!  Then another worldly wise boy asked, “So did you buy the shop?” which prompted me to describe the clinic where I work and explain my space rental and share set-up.  (See, it’s really good that I didn’t plan anything, because how could you plan for this?)  I must’ve described the environment and tone of our clinic really well because suddenly a sweet boy who’d been bouncing up and down on a slanted foam cushion the whole time made a strong association – he raised his hand and told me he goes to my favorite local OT clinic and and who his therapist was, and I told him to tell her “hello” for me.  We had a moment, he and I.  I loved that these kids were all proudly sharing their therapies with each other and I can tell you for sure that the kids who’ve never gone to a therapist for anything were dying of jealousy.  I might’ve emphasized how awesome it is just a little bit here and there.

Before I left I asked how many of them thought they might want to be speech therapists when they grew up and at least 90% of their hands shot up.  I’m guessing the response was going to be 100% if asked by the guests who came in after me – musicians with props – but given the fact that I didn’t know about speech pathology as a career option until my senior year in college, I figured this was pretty good.

Something tells me I’ll put away the dark cloak and sunglasses and volunteer to spend the whole morning doing these talks next year.

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My own 5-year old son Lyle recently expressed an interest in playing the violin.  Having played violin and viola myself growing up, I was absolutely thrilled.  I signed him up for some private lessons and rented violins for both of us.  For a few weeks, I’ve been relearning to play some simple pieces of music and he has loved listening and learning the little things I can teach him while we waited for our class to begin.

His first lesson was last Monday, at a reputable music school here in Chicago.  I sat in and observed.  His teacher moved fast.  She was intense. She wasn’t “mean”, but there was no small talk, no friendly chatter.  She moved right into work on posture  – holding the instrument properly – and told me that he wouldn’t pick up the bow for at least 2-3 weeks.  She spent the full thirty minutes on a sequence of movements required to move from “concert rest position” to “playing position”.  Each time Lyle moved his arm into a correct position he also accidentally moved one of his feet a step and had to start over from the beginning.  It was a bit like boot camp and hard to watch, but I was impressed that he stuck with it and cooperated so beautifully.

However, the instant she told him he was finished, he rushed across the room, fell into my arms, and sobbed.  She didn’t address this, simply let the next student into the room and pushed us quickly out the door, Lyle still crying.  He cried all the way to the car, raging at me, saying he never wanted to take another lesson, never wanted to go back.  He asked if he could keep his violin, but I told him we couldn’t keep the rental instrument if he didn’t take lessons.  I assured him that we could find another teacher, however.  Much to my shock, by the time we got home he told me determinedly that he would go back.  I was simultaneously impressed and appalled.

All week I grappled with this.  Was the teacher too harsh? – or is this the way you teach a young child a challenging instrument like the violin? I don’t remember starting out that way, but perhaps I’ve forgotten.  A friend told me it reminded her of early ballet lessons, in which you must master the positions before you can dance.  But shouldn’t she have established some sort of rapport with him first, made a connection with the child? – or was I applying what a good therapist does to a different situation, one that doesn’t necessarily require it?  She was teaching him skills and he was capable of learning them with repetition, I saw that.  But was it meaningful to him? No.  Was he motivated to learn from her? No.  So how could it be different from a negative therapeutic situation, then?

In fact, although he was determined to continue so that he could keep his beloved tiny violin, I watched my son struggle more and more as the week went on.  His anxiety grew more with each day, and his behavior became extremely controlling and defiant.  He wanted to be in charge of every conversation and everything anyone asked him to do.  The closer we got to the second lesson, the less tolerable his behavior.  On Saturday morning, we had to leave a Halloween festival we’d invited friends to because he was acting downright belligerent.

I could see it quite clearly.  He was turning the tables on us, acting out exactly what he felt the teacher had done to him.  She had controlled every move he made for thirty minutes straight.  He’d never seen an adult act like that with a child.  Each time I tried to discuss it with him, he waffled painfully; on one hand, he never wanted to go back to that teacher again. “I HATE violin,” he shouted at me angrily, at least once a day.  On the other hand, he was asking to go back to her rather than another, unknown, teacher.  He didn’t want to give up that violin.

And I still wondered: Can he do it?  Should he do it?  Is this how he needs to learn?  Will he simply get used to her style?  Should he?  After all, we need to be able to learn from different kinds of teachers, don’t we? Do we pull the plug this fast, or give him one more week, especially since he says he’s actually willing to go back?

But I watched my son and saw how incredibly dysregulated he was becoming, and noted that it was worsening every day, and decided to cancel the lessons.   I realized suddenly that this is exactly the kind of thing I talk about at work all the time with families.  The violin teacher did all of the things I warn against in therapy:  she was introduced to a brand new child and immediately started drilling discrete skills (e.g., posture and movement sequences) without establishing any rapport whatsoever, without placing those skills into a meaningful context (e.g., music), moving too fast, and talking too loudly (not adjusting pace and volume to a child’s developmental level and temperament).  There wasn’t a word of praise. When he had a negative reaction to the session, she did not address or acknowledge it even for a moment.  And, thanks to these missteps, my child’s behavior took a huge turn for the worse in a matter of only 5 days, even with me processing it with him every day.  (Imagine a child with a classroom teacher, therapist, or aide who behaves this way towards him at school?  Think about the “naughty” behavior we’d be seeing!  What if a parent didn’t see it, and so didn’t know what accounted for his sudden change in behavior at home? All that I have described was observed after only a single 30-minute session with the wrong teacher.)

Maybe what my son’s violin teacher was doing is considered to be an optimal way to begin this particular instrument and some kids can learn that way, but my kid clearly isn’t one of them – and I simply cannot feel bad about that.  A good teacher or therapist of any kind doing individual work is going to assess a student long enough to figure out who this child is and meet him right where he is developmentally in order to move forward.  I don’t think that would’ve taken more than five minutes in this case.  This is exactly why I always do a free initial session with a new client: to make certain that both the child and the adult are comfortable with each other.  No therapist or teacher is going to be a good fit for every child.

Once Lyle knew he’d never see that teacher again, he was able to relax.  His behavior was back to normal within 24 hours.  I have a couple other violin teachers for us to meet with this week and he’s happy about that.  Maybe one of them will be a better match and we’ll continue on this road, and maybe not.  In the end, it doesn’t matter.  But one thing is for certain: we are not going to suffer through 8 weeks of lessons with the wrong teacher.  Lyle showed us very clearly how he felt about that.

Kids will tell us when they’re comfortable with an adult; it’s our job to listen to them.  Their learning depends on it.

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Charlotte hiking with her dress

I am somewhat horrified to realize that two months have passed since I promised you Part 3 of the “Transitions and Emotional Processing” series I began last summer, but I see that Part 2 was posted the week before school started.  I can now safely say that it takes me two full months to get myself and my family into the school routine before I can get back on track!

If you didn’t read Part 1 and Part 2 (or need a refresher on them), I recommend going back to read those posts before reading this conclusion.  As promised I can give you some follow-up information about how the suggestions I gave goodfountain in those first two posts worked out for her daughter Charlotte.

The day after I gave her my recommendations, I received a copy of the heart-warming photo above, attached to the following email:

We went to a nature preserve today to walk one of the trails.

When it was time to get dressed, I started talking to Charlotte about how this was a place that was for shorts and tennies, not dresses and slippers.

She said, “Can I take it with me?”

And with the memory of your email in my head, I said, “Sure! You can take it!”

She went and found her backpack and packed her dress, her shoes and her necklace in it and carried it the whole time.

Not even a single whine about getting dressed.

The following week, I checked in with goodfountain again about how things were going and received more information:

What I am seeing is that I have to basically use ALL of these strategies and rotate among them. Carrying the dress in the backpack worked a couple of times. Referencing the little card with things to do when she feels angry has worked a few times. I haven’t had a chance to do any big feelings discussion, but I did make a list of where we can and can’t wear the dress. That helped some, for a couple of days, along with not ignoring the dress issue. I just bring it up right away and we tackle it head-on.

Another thing that has helped is giving her some good motivation. The other day I got no complaints from her when we went to return the guinea pig to school because I let her ride in the back next to the cage (I folded half the third row down and put cage there). She changed out of her dress right away.

It seems that the best thing is having an arsenal of things to try while we weather out the “storm” of these passing phases. She’s not going to be obsessed with a Belle dress forever, but she’ll move on to something else. And I’ll adapt the strategies. And eventually it will all sink in.  Having a variety of different things to try with her has made getting through the difficulties a lot easier.

This is an excellent point.  It is so helpful for caregivers, teachers, and therapists to have that “arsenal” of strategies to try when things get challenging.  No one strategy will work every time – we need to be on our toes and think flexibly in the moment.

I’m curious: what other strategies have you tried in a situation like this?

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