Category: Children with Special Needs

Of green screens, face masks and shields

What COVID-19 has led us to, is unprecedented. From a worldwide healthcare concern, it has evolved to social, political and economic concerns. Just as our understanding of the virus evolves, its effects on us also evolves. How we do things as human beings drastically changed. We are social by nature but this virus prevents us from being physically together. We love to talk and communicate our thoughts and feelings but this virus placed a mask on everyone. When we are allowed to finally see our friends and relatives in person, the mask continues to hide that smile or frown that is the overt manifestation of how one feels. The mask can now serve as a guise on how vulnerable we truly are in the midst of the pandemic.

As a professional whose main job is to help people communicate, we are now tasked do things online, facing the screen with our clients on the other side of the line. Armed with our creativity and clinical judgment, Speech Pathologists are now digitalizing materials, designing online cards and games and even donning costumes to provide more engaging therapy sessions to children online. Now more than ever, we get to work with our clients’ family directly, we see their home environment and observe the family dynamics when it comes to teaching children. When we see children in person, we are tasked to do our job while donning personal protective equipment (PPE). The mask and and the face shield were initially bothersome but one gets used to them. Things can get overwhelming and tiring but the realization of one’s vocation is what matters most. We are able to support families, provide our services and give intervention to those who need it most. The mode may be different but as therapists and educators, we continue to be in the helping profession and this pandemic challenged everyone to level up in terms of service delivery. We have to continue to hold the door, for every person with disability and for every family who feels lost. We also need to hold the door for each other, to remind each other that in the midst of our wanting to give more of ourselves, we have to be kind to ourselves too.

A Sense of Urgency

It was June 1993, I was 20 years old when I officially reported for work in a special school in Quezon City. I requested for a month-long rest after graduating in UP Manila so I can enjoy my summer vacation with my family in Albay. The internship program was a roller coaster ride for me so I thought one month would be enough to recharge. It was not too long to forget the knowledge and skills I gained from the internship year and not too short for me to still feel exhausted.

A week before my first day, my mom and I looked for a place for me to stay in Katipunan. Since I will be working full-time in Cupertino Center for Special Children, she advised that I might as well live in Katipunan so it will just take 5-10 minutes for me to travel to work. I was under a return service program because I was a scholar of the Macapagals aside from receiving a scholarship from the University through the Socialized Tuition and Financial Assistance Program (STFAP). I would always ask my parents if I can convert their budget for my tuition fees to my personal savings but of course, they would just smile and give me a hug.

It was in Cupertino where I came across Mistral’s “Su Nombre es Hoy” (His Name is Today). It was written at the back of the special school’s packet for parents. Knowing Cupertino’s mission and vision for children with special needs, I knew I was in the right place. Our team was composed of mostly special educators, occupational therapists, speech and language pathologists and psychologists. We were trained by varied institutions like UP, Ateneo, UST and Miriam. It was such a joy to work with people who want to give the best service possible. The child was at the core of our endeavors. I learned a lot from colleagues and the children of Cupertino. It was such a happy place for me that I stayed for seven years.

Much of what Trails Center is today is because of the things that I learned in Cupertino. Our programs were heavy on parent participation. The importance of the parents’ involvement in their children’s education and therapy is consistent with evidence-based practice. Researchers agree that caregiver participation and higher levels of engagement of parents in their child’s therapeutic setting lead to better outcomes (Doss, 2016).

Guided by Mistral’s words, “Many of the things we need can wait. The child cannot”, Trails specialized in Early Intervention. We created programs for children as young as 2 years and 6 months. Most of the running group programs for children with delays are provided once to twice a week. Parents are given feedback at the end of the session as well as suggestions on following through at home. We believe that parents are their children’s best therapists and educators. That is why I pray for the parents who have initially inquired about intervention because their children were diagnosed with a developmental disability but they opt to wait and hope for their child’s skills to get better. Acceptance of what your child can and cannot do is the key to better outcomes in terms of intervention. Sadly, there are a lot of people who still think that developmental disability is like a communicable disease, “mahahawa ka sa classmate mong may Autism”. Others don’t want their kids to be labeled or associated with children having disabilities. In the age of Inclusive Education, educators and therapists have so much more to do.

To parents who have children undergoing therapy, I hope these reminders will help you.

BE GUIDED. Your therapists received specialized education and training to do the things they are supposed to do but as parents, you spend the most time with your child. Ask your therapist for ways on how you can integrate specific goals into your daily interaction with your child. Your therapist can formulate a therapy plan but you have to help your therapist in carrying them out.

PATIENCE IS KEY. Therapists cannot “fix” your child overnight. All the problems and concerns will not disappear with a magical therapy wand. Journey with your child in unlocking his potential. A positive attitude towards therapy and possible outcomes help in achieving goals for your child.

CHECKLIST. Make a checklist or schedule of the things that your therapist has suggested to include in your child’s daily routine. For children with motor delays, specific exercises may be given. For children with speech delay, increasing opportunities for interaction with other children may be recommended.

COMMUNICATE PRIORITIES. Your therapist will surely appreciate your input regarding your family’s priorities in terms of expectations. I have had a father come up to me and say that he wants his daughter to learn a sense of privacy before teaching her the other concepts in social language. Since there are non-relatives staying in the house, he wants her preteen daughter to learn the importance of privacy. Together with the parents, I came up with a program.

COMPARE NOTES. One feature of a mastered skill is generalization. We can say that the child has mastered a particular skill when it is exhibited in varied contexts. It is important to provide feedback if the skills you were able to observe at home are also exhibited in school and in other non-structured contexts. This is our rationale for school and home visits because we may have children who are highly verbal in the clinical setting but they do not recite or talk in front of his class.

The bottom line is, parents are the first advocates of their children. If we want children to advocate for themselves, parents have to pave the way.

 

 

 

 

21st Century Skills

According to the book Growing Up Wired by Lee-Chua, et al., parents of today are called digital immigrants while our children are digital natives. They have never known a world without the Internet.

I have heard parents complain about their children’s short attention span and lack of social skills because of their preference for gadgets. For me, these five points have made it easier to for me and my child to know our boundaries regarding gadget use.

TEACH. Teach your child that gadgets are merely tools. The advantage of having internet access is that you can retrieve information in just a click of a button. As a therapist and a mom, I use images and videos to unlock new vocabulary. When my two-year-old son asked about the sound he heard while it was raining, I searched for YouTube videos on thunder and lightning. Since he is still young, we make sure that adult supervision is given 100% of the time. We watch with him so we can talk about Baby Bus videos and sing Dave and Ava songs together.

MODEL. As parents, we cannot expect our kids to limit the use of gadgets when we ourselves are glued to them. Research has shown the benefit of introducing picture books to children early in life. It is easier for children to exhibit emerging literacy skills when they are exposed to parents who also read with them. We also have to expose them to varied types of texts. Needless to say, we actually have to buy books for our kids, we have to provide a print-rich environment if we want to have young readers at home.

REGULATE. Just like any other activity, regulation is key. We cannot allow our kids to stay online just because it gives us the peace and quiet we long for in the household. Make sure your young children develop their communication and social skills through constant interaction with people. Ample studies have supported the importance of play. According to a recent study, “the important thing is not just talk to your child, but to talk with your child”. In the study, cognitive scientists from the MIT McGovern Institute for Brain Research linked interactive dialogue (versus just exposure to words) to improved language skills in  children.

PRIORITIES. A lot of parenting websites have already shared developmental milestones so parents can monitor their children’s performance. Priorities change as the child grows older. I have met parents who were successful in implementing gadget-free weekdays to prioritize homework and family bonding time at night.

OPPORTUNITIES. Provide choices as alternative to games and time for gadget. We cannot expect our kids to just turn off their gadgets without providing alternative activities. We cannot expect them to stop and reflect. Provide a schedule for sports or any outdoor activity, reading time, pretend play, and simple board games.

Technology will always offer something new, its novelty has always attracted children. It is then up to us, the significant adults in their lives, to teach them the importance of filtering important information, identifying good sources of data and being in control of one’s time. After all, thinking critically, making judgments and making innovative use of knowledge, information and opportunities are part of the 21st century skills that they are expected to learn.

In sum, my dear parents, we cannot expect the mastery of skills that we did not teach.

 

Therapy is not life-long.

Signing discharge notes for our kids never fails to make my heart happy. Duration of therapy is dependent on the severity of delay or disorder but for most kids who received early intervention, they should “graduate” from therapy. We do not expect our special kids to be perfect because the truth is, no one is. Therapy should not be life-long, LEARNING is.

Social Skills

I saw a child with special needs today. The 6 year-old boy displayed good retention of vocabulary and concepts taught but he had difficulties in understanding questions and following commands. He is good in memorizing concepts taught in school ergo he is doing well academically. When I met him for the first time, he was not engaging in conversations, he was just expressing his preferences and would comment on things that would catch his attention. The boy has been receiving individualized intervention everyday. He was an only child so he was interacting with adults most of the time.

I have also encountered neurotypical kids who do not engage in conversations anymore. They excel in academics but seem to have lost interest in establishing meaningful relationships with siblings and friends. I wonder if grades were more important for them and their parents because when I meet them, I certainly do not see the advantage of getting As when kids cannot even look me in the eye when I ask questions and they have difficulties in sustaining conversations. What happened to developing our children’s social skills?

As a therapist, I know the child with special needs will receive intervention to help him engage in meaningful conversations. What about our neurotypical kids?

As a parent, I have to make conscious effort to expose my child to varied situations to help him adapt. Now that he is just two years old, these learning situations have to be “set-up” so he will learn the ropes of communicating with adults, children older or younger than him, people with authority, etc. What I would like him to learn is the importance of interacting with people and use his toys and gadgets as merely TOOLS.

In the end, I have always believed that we have to value people and relationships. We cannot show how we value people if we do not communicate our thoughts and feelings. Old-fashioned as it may seem, engaging children in conversations during meals, while playing and before bedtime develops social language skills that they will never get from gadgets.

Different for Different People

One of the difficult questions usually posed by parents when commencing therapy is when will their child talk, walk or be regulated enough in varied situations. After practicing the SLP profession for more than 2 decades, I cannot answer this question because each child has his or her own pace. Some are more receptive to therapy than others. Varied factors come into play and one pressing factor is the severity of the problem or degree of delay.

Specialists are backed with years of study and training.

To our dear parents, your OT, PT, SPED and SLP professionals have studied and have been trained for 4 to 5 years to be able to assess and manage clients with different types of disorders or delays. Some of us even specialized in specific therapeutic approaches, just to make sure that we are able to match our program with our client’s current needs.

My analogy is simple, do you go to a plumber when your car breaks down? Professionals handling your child have their own specialization, be cautious when somebody says he or she is a plumber/mechanic/electrician/carpenter/barber rolled into one.
Dear parents, ask for credentials. It is your right to do so.

I believe that when clients/parents are more informed, they will also make informed decisions. In this day and age of fake products and professionals, we have to be more vigilant.