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Enju

那些時刻是如此難得，所以如此珍貴。

那些時刻是如此難得，所以如此珍貴。
Enju

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  1. 網誌
網誌區塊

一年過去了

2008年10月05日
公開
13

上課的時候, 好像聽見時間咚一聲落入水中央. 一年了!!! 這一年小圓變了很多, 現在我去找她玩, 或去接她下校車, 圓妹妹都偏頭看著比較高的馬麻, 眼瞇瞇笑的好開心. 今年初記了一段演講, 現在看起來, 仍然是當時的心情. -------------------------------------------------------------------- "聽演講, 大致的內容是這樣: 當父母開始到地板上來, 跟自己的孩子面對面玩耍的時候, 這個時候, 是你真正看到, 你的孩子, 並不是你當初希望的那個健健康康的孩子, 而是一個有發展障礙的小孩, 父母在這個時候, 幾乎都會經驗到巨大的, 海嘯般可以將人擊倒的悲傷, 我完全可以了解. 有些父母選擇走開, 因為他沒有辦法面對面的看著孩子"受苦於"障礙, 這樣走開矛盾的地方在於, 如果你不跟你的孩子玩, 不面對他的障礙, 不幫助他的話, 你的孩子不會進步. 而後父母會有另一種焦急感, 於是開始想用各種方法來矯正(fix)你的孩子, 如果你想到的只是矯正, 那麼, 這個時候矛盾的地方在於, 你其實並沒有真正照孩子的樣子接受你的小孩, 而只把他看成一個待矯治的對象. 強調以玩耍做為介入方法的好處是, 你一方面尊重到了孩子的自我, 同時也能夠幫助孩子向上發展. 在幫助孩子的過程中, 你會經驗到種種情緒, 疲倦, 憂慮, 忿怒, 覺得不公平, 還有, 深刻的悲傷. 當你看著自己的孩子必須在成長上一再面對克服障礙的辛苦時, 這種深刻的悲傷, 我也可以了解, 而我認為, 面對這種種情緒最好的方式是, 去感覺, 然後癒合, 在你能做到的範圍裡, 幫助孩子達到"他的可能", 你會看到你的孩子一個禮拜一個禮拜, 一個月一個月進步, 但不會是一天兩天看的出來的進步, 所以, 不要太快用盡你的精力, 你們要面對的, 是長期的努力, 在努力的同時, 跟孩子要做到的, 是在彼此身上得到快樂, 幫助對方, 這是一個希望的旅途. 演講者是Richard Solomon."

notes

2008年10月05日
公開
14

筆記(待譯) “A good program need not be expensive. Human energy is the most important element in a program.”- Dr. Greenspan Think of a tree growing. The roots of our tree are our foundation. If we don’t have strong roots we won’t grow-big, tall and strong. We are using DIR to build the child’s roots. The therapists are the fertilizer that come in and occasionally feed the root system. The parents are the sun and water-the constant food that feeds the tree. Without them the tree dies. The root system is comprised of the sensory system, visual-spatial relations, etc.-all the systems that allow us to engage, communicate and relate. This is what we are working on. 1. When I am playing with my child how much do I playfully obstruct? Playfully obstruct almost to frustration, BUT not quite to frustration. It is a very fine line, but after trial and error you will know when you are there. If you push to frustration you will lose the child and it will take some work to get her back. 2. My child seems to be engaged with an object instead of me. How do I get in there and become the toy (parent) my child plays with? Example: A little boy is completely entranced with a fan. Things you can try to do is go over by the fan and stand in front of it and move to the side and repeat this until your child engages with you, hide behind the fan and then peek out, move your body like a fan . . .whatever your child is wrapped up in use as your tool to engage your child. Use the object to your advantage. 3. Want to work on your child’s speech and get things going at home, but don’t know where to start? Try building a few words per week that your child needs: Example: OPEN Put a toy outside the door and keep working through gesturing and then “o” up to “open”. Your child will be learning the word through the emotional experience and then the word will become generalized. 4. What are some semi-structured Floortime things I can do at home to help my child work on visual-spatial, sensory and other processes? Obstacle courses and treasure hunts can be great ways to get your child working on these types of issues. 5. Trying to figure out if your child is ready for inclusion? Dr. Greenspan’s School Rule of Thumb: Be at solid level 4 and starting 5 before you do inclusion. If you are working on the lower levels then your child really still needs a 1:1 ratio. The child still needs that intense intervention and the 1:1 relationship. Even though, your child may do some parallel play she is not ready for inclusion in the school setting. The adult relationship is still the jost important at the lower levels. 6. How many playdates/wk should my child have when we are working on the higher levels? If your child is on level 4 and higher then your child should have a MINIMUM of 4 playdates per week. 1:1 becomes more important than some therapies. 7. When might it be appropriate to start doing/introducing some medical and/or biomedical interventions? Dr. Greenspan: You should have a solid Floortime program for 3-4 months before you consider starting to explore any medical or biomed interventions. DO YOUR INTERVENTIONS ONE AT A TIME. --------------------------------------------------------------------- Rosemary White, OT, from Seattle gave an excellent presentation. She gave a very good explanation of PRAXIS, the vestibular system and how to do some OT work at home. She asked the audience to not take notes and just sit and listen so here is what I am able to remember and add to from my notes that I took from her talk on the sensory system presented in Fall ’05. : Some suggested reading from Rosemary White: On Intelligence by Jeff Hawkins It will help you understand how your child’s brain takes in info. I have read it and it really helped me. The Explosive Child by Russ Green Google: vestibular system Google: Dr. Margaret Baumen http://www.ladders.org/whatwedo.php Read to find out about Mirro Neurons which new research tells us is the foundation for all our interactions. Both Serena Weidner and Rosemary White are very excited about this research. Check out this NOVA link for a 14 min. explanation How can I do OT at home? Seeing an OT for an hour/wk is fine, but it isn’t as valuable or useful as a parent’s interactions. You don’t need a lot of fancy equipment. You need make yourself available and be actively playing with your child. Parents need to be a stronger magnet for their children. Do the OT work with your child at home. Join your child when lying upside down on the couch or jumping, etc. This will also help you learn your child’s rhythms. If your child is making very slow motions, make your voice and motions match your child’s very slow motion. This then allows you to join your child in a meaningful joint experience. If you are moving very fast and your child is moving slowly then you may be overwhelming your child. Having a hard time understanding your child’s vestibular system and sensory system? Or don’t know what it is? The proprioceptive, oral factory and vestibular systems are the earliest to develop in the course of evolution. Your vestibular system is in your ear canal, but connected to every other part of your body. It is very complicated. Basically, it is what allows you to feel grounded, centered and tells you where your body is in relation to the world. You have right and left vestibular systems. Inside there are tiny hair like follicles that bend. They can cause you to feel inhibited or excited. The vestibular system also allows you to move in space. Think about the proprioceptive (crawling, joint compression) give information to your vestibular system. Wow! That is a lot going on, especially when you are looking at your child! Check out some links for more info and pics: http://www.braintraining.com/vestibular.htm http://thalamus.wustl.edu/course/audvest.html Want to understand your child’s sensory system and how it affects them? Our sensory systems give us a sense of whom and where we are in the world. Taste is how we interpret the world. Our sense of smell is very emotional. Your tactile system is the body’s ear- it is protective and a discriminatory system. Let’s talk about the "I" in DIR, our individual differences. To do this we need to look at how we organize our bodies in response to stimuli (Praxis): - Praxis is ideation, motor control/planning, flexibility, sequencing and adaptation. It allows you to problem solve. -Ideation -Sequencing -Adaptation/Flexibility When you have effective Praxis you can adapt your plan in response. If your body is not getting clear information then you can’t make a plan. We have to help our children use their bodies and clear out the junk so that they can be able to make a plan. We have to help them with a sensory diet and emotionally. Sensory and emotion are tied together. Many OT’s put too much emphasis on sensory and not enough on emotion. When we look at the brain we should realize that the cerebellum plays a huge role in rhythm, pacing/timing, in being social humans and social expectations. The cerebellum is the organizer in the brain and this has deep emotional connections. If you don’t feel organized then you are an emotional mess. Be aware of all of speech, visual, sensory etc. in all aspects of your child’s development. Think about more than just a sensory diet. The sensory system is also about emotional regulation. Being regulated means being calm. To assess your child’s sensory system ask 3 questions -What is the child attending to? -What is the child over responding to? -What is the child under responding to? Think about: what are the components of your child’s “comfort zone” or what your child’s “magnets” are. Then as parent think about how you can become the bigger magnet than the object. This may involve playful obstruction with the object or moving like the object. Remember that music can be very emotional experience. Hyperfocusing allows your child to ground herself when her vestibular and sensory systems are on overload. That uis why our kids often choose activities that are organizing: lining up cars, puzzles, etc. Also, keep in mind that the visual system is a very dense system. Autistic children have a hard time linking their visual system to their other systems-vestibular, sensory, oralfacotory, etc. The visual system is often their anchor. Harry Wachs, O.D. and author of Thinking Goes to School (about visual-spatial relationships and exercises) and Serena Weidner gave a presentation Building a Visual Spatial World. How do we build a visual spatial world? By building meaningful experiences in our world. Without visual spatial relationships we feel like we are lost-just floating in space. Pretty scary feeling! Some children need to look in mirrors so they can watch a picture of themselves to do it. Ever wonder why your child may experience severe separation anxiety or always want you take the same route when driving? They may have visual spatial issues. Some children rely so heavily on their parents to know where they are located in space that when Mom leaves they feel immediately lost and are terrified. The parent has become their child’s guide in the world and without panic sets in. Imagine not feeling grounded or knowing where you are! If your child has memorized a certain route and then you deviate from it then your child may feel absolutely overwhelmed and not be able to sense where her body is in relation to everything else. Harry Wachs believes: Affect + Intellect = Knowledge Affect is the triggering mechanism for developing knowledge. It starts the minute the child is born. It is very important. All knowledge requires meaningful intelligence. You create meaning by experience.