Children struggle with problem solving and self-regulation at all ages and Michelle Garcia Winner has created a wonderful creative resource for children to learn to become better social detectives, social thinkers and problem solvers. Michelle has created many different characters within her Social Thinking framework and two that I most commonly used within my work with children who are struggling within social settings- children with and without diagnoses.

Super-Flex is one of the names of a superhero character who teaches kids they have a superhero inside their own brains (who looks just like they do) helping them learn about their own and others’ thoughts and behaviours, strengthening their flexible thinking, and giving them strategies to self-regulate in challenging times. We can encourage children to call on their Super-Flex and thinkable powers anytime, anyplace, to help coach them along the expected social route and avoid unexpected behaviour.

Super-Flex can give children the opportunity to have fun while learning to self-regulate and become flexible thinkers. They can learn and practice Super-Flex thinking and strategies during adult driven activities at home that can then be generalised to all social settings such as school and the wider community.

Social thinking characters can be useful to keep in a child’s room or on the fridge as a reminder of who they can be when they are finding themselves in a problem-solving situation. It helps to talk through what she/he looks like and what he/say may say if they find themselves in a difficult situation.

Michelle Garcia Winner has some wonderful resources available for parents and therapists on her website- https://www.socialthinking.com/  There are books and posters for parents, schools and therapists to use with children which can be super helpful reminders.

Written by Psychologist Dominique Dolcetta for De Silva Kids Clinic.

The concept of the Zone of Regulation is to support individuals who have difficulty self-regulating and manage their feelings.

The Zones are a categorical and cognitive behavioural approach that therapists use in order to support and teach self-regulation. This approach is aimed to categorise 4 coloured zones which provide strategies to support individuals identify, acknowledge and explore their emotions, feelings, behaviours and manage their sensory needs. The Zone of Regulation is a concept that uses visuals to help individuals understand and express their feelings and level of alertness and explore how it may influence their behaviours.

The four zones that are:

The Red Zone: This is used to identify when an individual is in their heightened state of alertness and feeling intense emotions. These emotions may include anger, physical behaviour, terror or rage.

The Yellow Zone: This is used to identify when an individual is in a state of emotion that is elevated and nearing the Red Zone. An individual may experience sense of worry, excitement, silliness or nervousness.

The Green Zone: This is used to identify when an individual is in a state of calmness. Individuals identified in this zone may display feelings and behaviours of happiness, content or focused. The Green Zone is the zone where optimal learning will occur.

The Blue Zone: This is used to identify when an individual is in a low state of alertness. The emotions or behaviours shown may be the individual feeling sad, tired sick or bored.

Written by Amie Li, Occupational Therapist for De Silva Kids Clinic.

Sleep is such a common problem area highlighted by parents and families. There are many reasons why children may be having difficulties with their sleep cycles. Below are some areas that may impact sleep and wake cycles for your child.

Weighted Products

• Try a big teddy bear or some plush toys in bed, added some weight to the toys stuffing (sand or rice bags).
• A weighted blanket or body pillow in their own bed.
• Weight works for us, heavy doona or cushion to cuddle.
• Deep pressure input such as weighted blankets, tucking in sheets firmly, sleeping in a sleeping bag or hugging a body pillow can sometimes be helpful.
• Some might be comforted by the closed space between mum and dad. Try long pillows on both sides in their own bed. Sometimes it also helps if the pillows smell like the parents so getting the parents to sleep with the pillows one night then having the pillows in the child’s bed the next. Also such things as weighted blankets and tight tucking in can help.

Proprioceptive Input

• Lots of vestibular – hammock spinning, scooter board etc during the day for a few weeks might be worth a try.
• Proprioceptive work – pulling/rowing works to calm prior to sleep along with
  the ‘routine’ that the family are doing.

Break the Cycle

• Break their sleep cycle by waking them at 7 am and not letting them sleep until 10 or 11. It will be a few horrible days but it may break the cycle.

Sounds

• Does Dad snore?  Are they comforted by the rhythm or sound of Dad’s breathing or snoring?
• Try some white noise recordings eg. surf crashing, womb sounds or fan.

Social Stories and Rewards

• Try a bit of a reward system for them to provide some extra incentive to stay in their room. Providing them with a “what-to-do story” or social story outlining calming options they could do if they wake in the night might help. Calming options if they wake may include those that you, the family or your child have already identified; however, some ideas may include things like: listening to relaxing music, hugging a favourite toy or pillow firmly, rolling themselves firmly in their blanket etc.
• Social stories and sticker charts have also helped lots of children be motivated to stay in bed.

Light

• Play around with lighting to check if this is an environmental factor affecting sleep. If inside light is becoming distracting leave an outside light on and note the difference in sleep behaviours.
• Try a ‘Groclock’ – this is a light which changes from a blue night face to a bright sun face to give children a visual cue as to when it is the correct time to get out of bed. You can set the times and durations to your needs and your family schedule.

Written by Alannah Sofianos, Occupational Therapist for De Silva Kids Clinic.

The following are suggestions to assist with making different activities at home and in the classrooms more manageable.

• Break down the task or activity: when getting a child to do something at home or at school, simplify the task you need to do. Only give part of the instruction, or make the child only complete the easiest part of a task. This makes the task more manageable and minimises the stress in an activity.

• Make sure that you finish one task before you move onto the next task. This way confusion is minimised and the child is not left confused with having to follow through with different levels of instructions.

• Don’t overload a child with multiple instructions: use one specific instruction at a time.

• If a specific task or activity is difficult, talk through the stages of the task and discuss what steps need to be taken to complete the task. Alternatively, you can work through the activity or task together with your child, taking one step at a time.

• When doing different activities, try to at all times use the natural setting to practice ie. the time and place that you would usually be doing an activity anyway, rather than setting aside a separate time to doing skill work. This way, stress is reduced for you and your child and “extra work” time is not needed.

If your child is having ongoing issues with this please speak to your Occupational Therapist, Speech Therapist or Psychologist who can assist you with different ideas to approach the challenges.

Written by Alannah Sofianos – Occupational Therapist for De Silva Kids Clinic

As another school year commences, parents of kinder kids may already be putting in school applications for 2021. Lots of parents ask therapists for their advice around preparing children for their best start at school.

If you child has just started a 4-year-old kinder program, here are some ideas that you can use at home to help you child get ready for school:

• Social skills: Start playing board games with your child, and let the whole family join in. This will help your child learn about winning and losing, turn taking and engaging in a game with others.

• Self-care: Encourage your child to use public restrooms to help them feel comfortable using toilets that aren’t their own. It also gives them an experience out of their comfort zone and gets them used to turning on taps and using the hand dryer.

• Language Skills: Start asking and encouraging your child to ask ‘wh’ questions including who, what, when and where. This will encourage them to communicate effectively in the classroom. Use pictures visuals to help your child understand the different ‘wh’ concepts.

• Phonological Awareness: Encourage your child to sing their ABCs and give them opportunities to match letters to letter names. Studies have shown that early acquisition of letter and sound knowledge, are likely to make a difference in successful transition to school. Also read to them to encourage their knowledge of literacy and language.

If you have concerns about your child’s language, literacy or motor development and are unsure if they will be able to start school next year, book an appointment with either a Speech or Occupational Therapist. Targeting these skills early will enhance your child’s success in the first years of school.

Written by Speech Pathologist Carmel Walsh for De Silva Kids Clinic.

Dealing with Behaviours: Steps to take BEFORE implementing strategies

Step 1 – What is the behaviour of concern?
Examples of challenging behaviour are as follows:

• Hitting/punching
• Throwing objects
• Biting
• Pinching
• Vomiting/spitting
• Yelling
• Crying
• Swearing
• Scratching
• Kicking
• Head butting/banging
• Absconding
• Soiling self
• Threats

Step 2 – Define the behaviour
Frequency – how often does the behaviour occur?
Intensity – Rate the intensity of the behaviour out of 10.
Duration – How long does the behaviour last for?
Severity – Assess the risk of harm to the child and to those around them
Does it interfere with family life functioning?
Does it interfere with the child’s ability to learn?
Example: Mary bit her brother hard (drew blood) 1 time when he tried to play with her blocks
NOT: Mary was very naughty when her brother wanted to play

Step 3 – Collect Data
1. Date and time
2. Who did the behaviour occur with and where?
3. Antecedent/Trigger – What happened immediately before the behaviour?
4. Behaviour – What did you OBSERVE the child doing?
5. Frequency/Duration
6. Consequence – What happened immediately following the behaviour? i.e., what did you do?
7. Result – Did the consequence change the behaviour?

Step 4 – Identify the function of the behaviour
Why does the child engage in the behaviour? There is a function/purpose to ALL behaviours. Behaviour is communication.

Functions of behaviours can be broken down as follows:

Function 1: To obtain or seek
– External: food, toy, attention
– Internal: sensory stimulation, sleep, hunger, thirst
OR
Function 2: To avoid or escape
– External: work, demands, change in routine, transition
– Internal: sensory overload, noise, pain, fear

Step 5 – Generate a hypothesis (A statement as to why the behaviour is occurring)
Define the behaviour, collect data, look for patterns, and identify the function
Example:
From the data gathered it is suggested that Johnny is hitting and pulling hair to avoid transitioning to new activities or environments.

Written by Psychologist Marisa Donnoli for De Silva Kids Clinic

We often have referrals to OT to support children to ‘sit still’ when learning. This is often an important goal for many teachers as wriggly bodies can be disruptive to class learning. From an OT perspective, every person uses a variety of strategies to maintain attention.

Often, we are unaware as to what these may be, or even that we are using a strategy!

Movement is well known to support organisation and attention. Particularly, rhythmic, linear and repetitive motion. Movement however often does not fit into the social structure of learning environments.

Schools and workplaces are now becoming more aware of the positive influence of dynamic workplaces, spaces and access to movement has on productivity.

Some ideas to introduce to your learning spaces include:

• Keeping seated time to a minimum, between 5 and 15 minutes is a great length
• Offer movement breaks every 15 minutes of seated learning for junior years and every 30 for senior years
• Complete work in a variety of spaces and body positions, such as lying on the floor, working on the whiteboard, working outside
• Offer bouncy bounders on the bottom of chair legs (as pictured)
• Offer wobble stools, cushions, fitballs, etc.

Should you need further assistance or want to make an appointment to see an Occupational Therapist please contact us.

Written by Occupational Therapist Laura Taylor for De Silva Kids Clinic.

Many people don’t really know what a Speech Pathologist does.

A Speech Pathologist (also called a Speech Therapist or a Speech and Language Therapist) can work with children or with adults.

They can assess if a person has difficulties with any aspect of communication.  This could include forming speech sounds, understanding and speaking in sentences, stuttering, voice and social communication.

Social communication is an area that children with autism often find difficult.  They may find it hard to make eye contact, greet people, pay attention to others, follow routines or understand emotions and facial expressions.

Speech Pathologists find fun and creative ways to help children communicate and interact with the people in their lives. They help families and schools to understand better ways of supporting children with communication needs.

Something most people don’t know is that Speech Pathologists also help people who have difficulty swallowing. To find out more about Speech Pathologists, visit the Australian professional association, Speech Pathology Australia at www.speechpathologyaustralia.org.au

Written by Speech Pathologist Eleanor Brignell for De Silva Kids Clinic.

As language develops, many children may show signs of “typical disfluencies”, in their everyday speech. These are natural disfluencies, which occur when the child’s speech system is working overtime to combine words in a variety of ways.

Typical disfluencies occur between the ages of 2 ½ and 5. They can include:
-Repeating words with lots of syllables (e.g. “Gimmie gimmie that toy”)
-Using filler words (e.g. “I um want the toy”)
-Repeating phrases (e.g. “I want, I want the toy”)
-Changing the sentence structure mid phrase (e.g. “I want…can I have the toy?”)

Typical disfluencies are normal among young children and are not a cause for concern.

The disfluencies consistent with childhood onset stuttering are different to typical disfluencies. Some examples seen in childhood stuttering can include”:
-Repeating whole words (e.g. “I-I-I-I-I-I-I-I want the toy)
-Repeating sounds/ syllables (e.g. the-the-the-the toy is over there)
-Prolonging sounds (e.g. IIIIIIIIIIIIIIIII want the toy)
-No sounds coming out also known as a speech block.

These disfluencies may be combined with:

-Signs of physical strain (can include blinking, grimacing facial expressions, head/ body movements or making sounds)
-Perceived fear of talking.
-Avoiding saying certain words or sounds/ and avoiding certain speaking situations (e.g. show and tell in front of the class).

Having an understanding of typical developmental disfluencies vs childhood onset stutter can help you identify if your child would benefit from therapy.

If you’re unsure about your child’s fluency in speech, contact a Speech Pathologist at De Silva Kids Clinic.

Written by Speech Pathologist Carmel Walsh for De Silva Kids Clinic.

Holidays can be an exciting time but they can also be stressful!

This is especially true for children who thrive on routine, supportive boundaries and predictability.

Here are some tips to minimise stress and help you get through the silly season with your child:

1. Keep things the same:

• As much as possible, stick to your daily routines. School may be finished but try and have a similar morning routine and sequence of events during the day on the holidays.

2. Prepare for things that are different:

• Talk to your child about days that will be different ahead of time. Explain how the day will be different and when things will go back to normal.

3. Use visuals:

• Show your child pictures of new places they might go and people they might meet (they might not remember all the family and friends they saw last year). Set up a calendar to help them countdown to key dates. Use social stories to prepare your children for going back to school/kinder. Click here to download a social story to use at home.

4. Set expectations around treats:

• As adults, we’re able to enjoy different foods and gifts knowing that it won’t last. Your child may find it difficult to understand why these things are given to them one day and taken away the next. Set expectations in advance about when and how much they will get.

5. Don’t judge your reactions:

• Be kind to yourself and your child. Don’t expect things to be like a romantic movie. Its okay if the holidays aren’t always relaxing, you can still enjoy moments of fun with your child!

Written by Eleanor – Speech Pathologist at De Silva Kids Clinic