| In aiding children with developmental challenges, | | | | In order for children with developmental concerns |
| we must first realize that this requires a team | | | | to be able to integrate more into the social |
| effort and a strengths based approach. It is | | | | sphere, it is necessary that they not be isolated |
| necessary to not focus on what the child cannot | | | | into situations where they are labeled and shuffled |
| do but look at what the child can accomplish and | | | | away from typical peers. Rather, they should be |
| build upon this. Parents can enlist the support of | | | | included as much as possible with typical peers. |
| professionals but must realize that it is they who | | | | They may need additional support and |
| are the most important persons in the child's life | | | | accommodations, but how will they begin to learn |
| and that furthering the development of their child | | | | important skills unless they have frequent and |
| is not just the work of professionals but is a | | | | continuous exposure to the world around them. I |
| collaborative effort from everyone involved with | | | | have developed the use of what I term 'real life |
| the child. It is necessary that for any interventions | | | | rehearsals', where we may set up a particular |
| to truly be effective and helpful, that they must | | | | social scenario for a child. It may be such a thing |
| be consistent and constant. The interventions | | | | as being able to make a purchase at the grocery |
| must be the same throughout all domains that the | | | | store. The therapist and parents guide and coach |
| child is present in. | | | | the child ahead of time in how to go about such |
| It is crucial for us to understand the | | | | an activity and then have them actually |
| environmental responses that children have, | | | | demonstrate it. Social stories and comic strip |
| whether they have developmental concerns or | | | | conversations are very useful in conveying |
| even if they do not. If a teacher, parent, or other | | | | information as these children tend to be visual |
| person has a hostile tone, a poor demeanor, a | | | | learners. Social stories can be simply made |
| loud voice, etc. All of these things can be | | | | booklets that the child helps to create where a |
| overwhelming to the child and can provoke a | | | | particular task or scenario is outlined with what |
| behavioral response. All behavior is purposeful and | | | | behaviors are expected. The comic strip |
| should be looked upon as so, even negative | | | | conversation is helpful in building empathic skills as |
| behaviors. Behaviors are a way of the child | | | | well as reflective thinking as we ask the child to |
| speaking to us about a distressing situation or an | | | | develop captions for what different individuals |
| apparent need or desire when they may not be | | | | may state and think in various situations. |
| able to convey this to us verbally. Light, sound, | | | | Lastly, I think it is crucial, though it may appear |
| and other sensory stimuli can also produce | | | | controversial to some, to state that children with |
| distress for a child. We need to create awareness | | | | developmental concerns can and will be benefited |
| of what in the environment may serve as | | | | from a psycho-social and relationship based |
| triggers to distress and seek to modify the | | | | approach alone. Some have decided to resort to |
| environment to make it a more comfortable and | | | | medications, and I am placing no blame or |
| safe place for the child. We must also be cautious | | | | condemnation on those who have made this |
| in how we view children. If we look at a child | | | | decision, however making a suggestion that there |
| displaying negative behavior as a 'monster' or feel | | | | are alternatives and informing of these |
| that because a child may be rambunctious at | | | | alternatives as well as the hazards of |
| times that we must automatically resort to | | | | psychotropic medication usage. First, I will not |
| medicating them, then we have taken a | | | | argue that medications can 'work' in the sense of |
| negativistic attitude that will surely be passed on | | | | subduing behavior. However, strapping a child to a |
| to the child. Children are keenly aware, even | | | | chair would also work in regards to subduing |
| those with communication struggles, of adult's | | | | behavior. This would be aversive and quite |
| perceptions of them. We should look at our | | | | possible illegal. I see little difference between such |
| children through the eyes of delight and address | | | | an approach and that of using psychiatric |
| behavioral difficulties not in terms of how we can | | | | medication. The difference is that one is a physical |
| subdue, but rather how we can meet needs and | | | | restraint, the other a chemical restraint. When we |
| resolve conflict and remove distress. | | | | say that something 'works', often we are not |
| The floor time model is of particular usefulness in | | | | looking at the mechanism by which it works. Dr. |
| working with children with communication and | | | | Peter R. Breggin, MD compared the use of anti |
| social struggles. For those children who are | | | | psychotic medications in children to 'chemical |
| non-verbal, we can begin to introduce hand signals, | | | | lobotomy' as it blunts the functions of the frontal |
| moving to use of pictures, and then gradually | | | | lobes. The risk of tardive dyskinesia, a permanent |
| encouraging the child to make use of words or | | | | disfiguring neurological impairment exists with |
| phrases to indicate desires. It is not important | | | | these drugs. In addition, such drugs as Risperdal |
| initially whether the verbalizations are correct but | | | | are prescribed off label and are not indicated for |
| rather that a verbal attempt was made. When a | | | | anyone below the age of 18 but continue to be |
| child displays such a behavior as spinning objects, | | | | prescribed. |
| in the floor time model, we would not be | | | | It may require more diligence, effort, and |
| aversive, but rather gently introduce a new toy | | | | patience, but I remain convinced after working |
| or object and seek to divert the child to a more | | | | with over 40 children with developmental |
| productive activity. In situations of echolalia, we | | | | challenges, that relationship based approaches, |
| can say such things as 'that's TV talk', and | | | | rather than chemical restraint, prove to be a true |
| provide means to divert this to a different means | | | | means to teach our children skills, to focus on |
| of conversing. It is important to provide the child | | | | their strengths, to build on their development, and |
| with understandable signals and meaningful | | | | to help address challenging behaviors and to |
| statements and phrases when we are desiring | | | | address the real source of conflict and distress |
| them to behave in a different way. | | | | rather than just blunting it. |