Ian – Spontaneous learning

Posted on July 16, 2012 by vivien-lim

April 20, 2012.

Ian was not well. His sister has hand-mouth-foot disease last week. So his mother quarantined Ian from school for a day after the weekend. What a responsible mother to think of other children as well! Many parents will still send their kid to the centre if the kid is not well, but they fail to understand that when  a child is not well it needs to have enough rest to recover better. Also the ill child can infect other children..

As usual, Ian will come to centre with a cheerful smiling face. He will put his belongings away properly.  Thereafter he will look for a broom to sweep the leaves in the garden. I think of coordination development as he holds the broom and try to sweep the floor in the garden. These little activities come spontaneously, it will improve his motor skills,  coordination and attention span.

In Rebound Therapy, Ian will say “high” to indicate he is interested to start RT. When we start RT, Ian will count the number of bounces: 1, 2, 3, 4, 5, 6, 7, 8, 10. On certain occassions I purposely recite the number counting in Mandarin. His mother said Ian begins to count in Mandarin. I smile and say I use Mandarin counting while Ian does RT bouncing.

Most of the therapy is done spontaneously while the child is actively involved and engages with other children. Ian has become more aware and socializes with other children.  He can  accept instructions.

When therapy becomes second nature and is really integrated with the child’s spontaneous behavior, the it becomes most effective and the best results are obtained. However this “spontaneity” does not comes by spontaneously: it takes many hours or even days of careful observation by a skilled therapist to adapt the therapy to each individual child.

 

 

 

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Caleb – Evening meals

Posted on July 16, 2012 by vivien-lim

March 31, 2012

Time passes very fast,  three weeks ago when my god father came to take me to visit a doctor with his cousin, Caleb’s mother and Caleb joined us. Again this is an observation I did for Caleb. After visiting the doctor, we headed for a late dinner around 9.20pm. During the dinner Caleb will stay seated for the whole meal  of 40min time. Wow this is amazing. His mother and I was astonished by this improvement.

What happened next? The following night we went back to the same shop for meals but now Caleb failed to sit, he just wanted to rush about. The shop owner told Caleb’s father that yesterday Caleb behaved, he was able to sit.  Is Caleb an ADHD child? This is a not a new place for him. If it  is a new place then I could maybe understand he wants to tour around the shop. How can I understand him?

On the same weekend we went back to the same shop, this time he behaved properly. Why? My cousin has a smartphone. I was thinking, maybe Caleb wants her to show him the phone so he behaves. She did show him her phone and allows him to touch it with a game. Caleb was able to sit for the whole meal.

After careful observation I told Caleb’s parents that he is a smart boy:  in front of guests he will behave well, this gives a good image of good parenting to the guests, but when he is with his parents only maybe he wants attention. Is this a good conclusion from these few observations? Can we accept it?

Last week I gave an intensive therapy to Caleb, and told his parents what to do at home with Caleb and they noticed an improvement in him. Caleb begins to be aware of his body’s reaction. Before he couldn’t understand that he is tired. But now he knows. This week we went out for meal two times. First time he is able to sit without a guest with us for 35 minutes.Wow, not bad. Good record. Friday night we went out for a steamboat with  a huge crowd in the shop. This is a great and amazing, he is able to accept the crowds which before he could not. He let us finish a whole meal with more than 90 minutes in the shop. He father was happy, at least they can go out for a relaxed meal without having to chase him and keep him under close watch all the time.

This episode shows that a good therapist has to be first and foremost a keen observer. It is easy to follow a therapy course but that does not make you a skilled and successful therapist. Knowing when to apply which therapy, needs careful observation of the child and the ability to see beyond the “labels” (ADHD, autism, …) many people want to stick on children. The label is not the child and blindly using a therapy because it fits the label is no guarantee for success.

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Caleb – settle to focus

Posted on June 26, 2012 by vivien-lim

May 6, 2012.

It has been weeks I have not updated my blog about Caleb. Does he improve in attention span? Is he able to sette down to focus and associate with other children in the centre? Many times we as an adult can’t wait to see the child improve as the day goes by. Obviously Caleb has improved from an outdoor boy into a boy who begins to like books. Daily Caleb will go through all the therapy programmes such as character building development, physical development and cognitive development. He is able to listen to storytelling, reading,  movement activities and creative play.

Caleb has also learned to accept instructions, eg after playing Caleb no longer just walks away without putting the playthings away. Even if he was not able to tidy it up well, when being called, he will come back to tidy up. He learned to be a responsible young kid.

I also do therapy to improve his physical posture,  I noticed he is able to walk in a better position, at least his hunch-back is improving with better posture. He is also able to focus a longer time. Feedback from his parents learned me that Caleb is able to attend their church children class without his parents to be with him. Before Caleb came to attend the therapy lesson, he couldn’t fit into sunday school class as he will move around. This happened to him also when he attended the pre-school before he was send to my centre for intervention. He used to move around and couldn’t sit to finish any activities.

The way he expresses his need also improved by using the word “please” eg:  “please help me”, “please open the gate”, Compared to previously, Caleb only said “open gate” but now he says “please”. Proper manner has to be cultivated when a child is young.

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Ian – speech development

Posted on June 26, 2012 by vivien-lim

May,2012

I received feedback from Ian’s mother: she said Ian is more vocal, and takes the initiative to talk. His stereotype pattern also reduced. Ian has a tendency to arrange animal toys in a row. With every toy he plays, he tries to arrange them in a row. A very repetitive symptom of Autism. I always remind myself: it is pointless to label a child but when a child does things that are not acceptable in the so called “society”, the therapist has to break the repetitive pattern which may draw him into his own world without him realise it. His parents have shown a great support in continuing therapy with Ian at home.

During Rebound Therapy, I always encourage Ian bounce freely … so I always say “Ian jump high, higher”. His mother told me that she heard Ian say “Jump higher”. Well I told her, this is what I say to Ian during rebound lesson. Ian’s speech is more clear compared to before he attended my lessons.

In general most of the speech delayed children may have poor balancing, coordination  and rhythm. Using rebounding as part of the therapy helps to teach the child’s mind and body to communicate more effectively and helps the children to develop muscle control and improve coordination and balancing. Each movement helps the child to stay focused.

Neurons in the brain - illustration

Neurons in the brain – illustration (Photo credit: Rebecca-Lee)

When a child is rebounding, he/she is moving and exercising every brain cell just as they are exercising each of the other body cells. Heavy toxic metals are leached out of these brain cells to free up the neurons to work more effectively. Rebounding has the child to  work from the outside, from the nerve endings in toward the brain.

Ian is also more focused, at least his parents are able to take him for a weekend meal in the shop. Without focus, how can a child learn other skills? Adults many time rush a child towards academic results without laying a basic foundation for them to grow and excell. The worst I have ever come across is parents expecting the child to be able to write before developing the skills that are needed for writing.

A developing child is in a delicate balance: it is easy to upset its development by rushing it into territory that it is not yet ready to explore. A balanced learning process will ensure the most optimal results. For children that have development problems, the therapist must use all her skills of observation to find out to what areas more attention needs to be given and sometimes it is necessary to follow an indirect path before the main problem can be tackled.

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Ian – Continuing development

Posted on May 29, 2012 by vivien-lim

April 6, 2012.

This month Ian attends the lessons during 4 morning sessions each week. The lessons include holistic development with therapy. I have seen that Ian is now more focused and will finish a task before proceeding to another task.

The tunnel in the garden

The tunnel in the garden

In the morning, Ian will play with the other toddler in the garden. In the garden I have a tunnel. Inside the tunnel there is an outlet hole for water to drain out after cleaning the tunnel. Ian has been  walking into the tunnel to put things into the drain  hole. I wonder why? As in the play pool I have also a fountain with a little hole. On one occasion out of curiosity I walk into the tunnel to see what he is doing. Ian is playing with the outlet which contains a little water. Instead of using water to wash the tunnel I now sweep it with a broom and Ian walks less into the tunnel to play with the hole. The tunnel is fun as one can see thru the window of the tunnel and and through a hole on the top the sun shines in. It is like a play house.

Ian used to be very much on his own, but since last week I noticed he is increasingly able to interact with others. He engages them to play, Ruth leads the team. With the pretend play to sit on the pool beam with hands holding the fountain and pretending to fall down into the pool and screaming for help. Ian imitates the action and says “help”. The toddlers engage in the dry play pool for a period. They walk on the beam of the pool for balancing and come down into the pool and pretend swimming.

Much effort  is put in therapy for Ian. He will now start talking and use single words like, tiger, fox, elephant, open, giraffe and apple. Apart from using English, on one day while we were doing rebound therapy with him, I was counting in Mandarin. Ian remembered it and counted in Mandarin at home. His mother was amazed to hear that her son was counting in mandarin, as at their home they speak English.

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Caleb – Fear of heights

Posted on May 29, 2012 by vivien-lim

April 9, 2012.

It takes patience to observe learning disorder children. The case of Caleb is a good example. On the surface he may look tough, but internally Caleb has fear of heights. Little children in general like to climb up ladders but Caleb knows his own limits, hence he does not climb up the ladder when I diud some gardening with his parents.

On one occasion I took all the children to the public playground with various slides. I noticed Caleb only went to explore the lower slide, then he moved to the swing and see-saw. Thereafter he went to sit in the shade and wait for us. I went over to invite him to join the group, I put him up the high walk way to the slide (4 feet high). Caleb did not dare to walk: he crawled to the slide. Wow how can this happen? This is a little developmental disorder.

From that week on I have put Caleb unto different dimension therapy with rebound therapy and gradually he builds his proprioception and confidence. He is now able to walk to go to the slide instead of crawling. I may seen only a little improvement, but for Caleb it was a big step forward.

In doing therapy with Caleb I develop one skill after another, this also helps Caleb to focus on what he is doing and learning. Currently he will manipulate the creative blocks to assemble things and he does so much better compared with the first month he joined these therapy lessons. He is more focused, after assembling the block he will use his imagination and play a story to share what he is doing. This I name “creative play”, which many adults have forgotten about. We tend to get structured toys which fail to allow the child to use its exploration skills, fantasy and imagination.

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Ruth – creative and writing skills

Posted on April 10, 2012 by vivien-lim

April 6, 2012.

The satisfaction to work with learning disorder children kept me focused on how to help them improve each day. This happened in my work with Ruth, she is not just improving her writing skills, she also learns social life.

Her writing skill are improving each day, her father works with her at night and the next morning I provide the intervention including writing skills. Ruth is now able to trace words. Instead of prepare writing worksheet in alphabetical order, I have prepared word tracing sheets with a focus point on certain alphabets. When she done the tracing Ruth is able to recall certain alphabet.

Ruth is not just good in memory and reading, she is creative and invents new games. E.g. she sits on the side of the playpool and pretends she fell into the pool, she says “help help help me” to Ian and other children. Ian will learn to say the word of help and try to imitate what Ruth has done like fall into the pool. (pool is without water).

She also leads the other children to walk along the side of the pool, this really develops their focus to walk and balance as the pool has a depth of 2 to 3 feet. They walk one by one. It is such a natural development therapy. Many time we adults crack our head to think how to help the learning disorder children. I see  that Ruth and other children have improved by playing and exploring the garden with the plants. Some children will pick up leaves to observe and touch.

ruth in autumn

Different colors and shapes of leaves (Photo credit: Wikipedia)

Touch is a sensory stimulus. Different leaves will have different textures and shapes. Fresh leaves have green color and dry leaves turn into brown. Ruth learns the color of the leaves as she explores. It may seem simple, but really there are no short cuts to improve a learning disorder child. In this writing one may think it is so easy. But again it takes hard work to observe and think what is the appropriate therapy introduced at the right time for these children.

 

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Ruth – writing

Posted on April 10, 2012 by vivien-lim

March 23, 2012

Parental feedback on their child’s improvement in therapy is very important as well as their support in carrying on simple therapy at home. Ruth’s father has been working hand in hand with us at home to carry out some therapy which can be done at home. This definitely has helped to improve Ruth.

Ruth’s ability to read and communicate has continued to improve. Her reading ability is beyond what a age 5 years old can achieve. She is able to do simple spelling. How can she do spelling when she can’t write? I have used 3 D’s characters to work with her. when I say a word, she will have to arrange the characters into the word. There are times I will write the word and she has to choose and circle the correct word.  However I look beyond this ability. Her ability to trace the printed alphabet has improved with proper alphabet strokes. In reality many children even have attended two year of preschool and are still unable to write properly with the right stroke.

In the centre I use much play and nature based therapy with Rebound Therapy incorporated in. Rebound Therapy is very new in my country. It is so important for a child to be able to integrate into his/her environment. In one occasion, I noticed Ruth walked upstairs. I wonder why? Instead of stopping her I watched what se was doing. Oh, she took the funny block which Jack did not keep properly stored in the box and left on the table. Ruth went to put the piece of block into the box. This is responsibility. In real life many adult do not realize this little conduct of Ruth is important for her later development. Many will rush the child into academic performance. I am not saying academic performance is not important but living skill is also important.

Ruth also develops good manners. When she wants something from me, she will say “Please give me”. After I give her, she will reply “Thank you”. There are times when I do therapy with a child and the child resists it, Ruth will walk over and tell the child: “Say, ‘Please let me go'”. Wow it seems to me, this is peer to peer learning.

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Speech and Communication

Posted on April 6, 2012 by vivien-lim

March , 2012.

This month is a busy month. My team and I review our cases. I am surprised to notice that in our society, there are so many children with learning difficulties. I have seen many unresponsive children, without eye contact, with speech delay or disorder, global developmental delay, some even being labeled as autistic child at age 2 year plus. Some really lack basic communication skills. I wonder what will happen to those children when they grow up? If they cannot speak, how will they be able to integrate into the society?

Some parents will say, when the time comes, the child will be able to talk. Will this happen automatically? Some parents will tell me it is expensive to send their child to a therapist. I think it is more cost effective to send the children for early intervention compared to the cost to care for them when they grow up in adult hood.  Again I asked myself: what will happen to the child when they grow up if they don’t improve. Will they be able to integrate into the society? What  future will they have in this competitive modern living world.

I have also seen children attending preschool for two year and still don’t have a proper pronunciation. Wow, what happened to their pronunciation? I am totally in shock to see all these learning disorders. I name the children with special need as children with learning disorder. What will happen to  the society if these children with learning disorder do not receive proper help and become “adults with learning disorders”?

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Caleb – problem solving skills

Posted on April 6, 2012 by Vivien Lim

March 19, 2012.

Parental support is such important in developing a child. Caleb’s parent took him to the beach over the weekend. It is such an adventure to take a ride with them and observe how Caleb behaves and explores the beach. Caleb did enjoy walking on the sandy beach. However he did not dare to walk to a place where there is sand mixed with mud. The place is far from the sandy beach.

It was good to see Caleb’s mother walk with him to the beach with little mud with  sea water, sand around.

Caleb and his mother at the beach

Caleb and his mother at the beach

By holding Caleb’s hand and walk to that place, it give Caleb’s a confidence to step in the mud and slowly let go of her hand and explore himself. Caleb was able to walk by himself with confidence.

Then Caleb walked to the beach where his father made a hole up to Caleb’s waist. Both parents put Caleb into the hole and covered it with sand. Wow that is a great challenge to Caleb to overcome all the obstacles and get himself out of the hole. Of course he cried and asked for help.

Into the hole

Into the hole

His mother comforted him by saying to dig out the soil, mother initially showed him a small fork, then Caleb tried to remove the soil but it was too tough. Then mother offered him a spade to dig the soil. Caleb removed the soil in tears, he really worked for it. Finally he removed the soil and was able to get out from the hole. He was very happy.

Later his father puts his own leg into the hole and allowed Caleb to cover it. Caleb was enjoying covering it with sand.

How to get out?

How to get out?

Later his father removed the sand and took out his leg. An experimental learning between father and son. It also creates a good close bonding between father and son in a very natural way.

Caleb’s parent truly walk with Caleb for his developmental needs. How many urban parents are willing to take their child out of the city to have a better air quality? Will this beach adventure with sand stimulation and therapy be able to help Caleb to focus? We will find out later.

 

Burying his father's leg

Burying his father's leg

 

 

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