Child Caregiver Relationships An Interdisciplinary Presentation

Transcription

1 Shoreline Special Needs PTSA January 24, 2018 Child Caregiver Relationships An Interdisciplinary Presentation Rosemary White, OTR Alek Adams, MA MHP LMFTA Pediatric PT and OT Services Shoreline, WA

2 Rosemary is an Occupational Therapist who brings in her work in Neurodevelopmental Therapy, Sensory Integration and DIR Flooritme. Alek a Licensed Child & Family Therapist Associate who studied at Antioch, brings Family Systems Therapy into her work with children and their caregivers. She also has worked in homes and schools embracing the DIR Floortime Philosophy in interactions in these settings. n Rosemary will address the sensory and motor profile and how to tailor interactions to support you and your child. n Alek will bring the reflective component related to the caregiver s experiences, enabling the caregiver to be present in the moment with each and every child.

3 RELATIONSHIPS The foundation for life is built on the ability to attain & sustain a co-regulated interaction. Relationships are the vehicle for creating multiple opportunities for learning & understanding people & the world Thus creating every individual s unique & meaningful perceptions & memories.. Pediatric PT & OT Services The Offices of Rosemary White & Associates

4 Social and Emotional Development Social and Emotional Development is a turbulent journey that begins at birth and continues through the entire lifespan. Learn to communicate and express feelings. Learn to engage and manage feelings. Learn to understand and respond to other s feelings. Social and Emotional Development does not happen on its own it is cultivated through important relationships in life (parents, teachers, and other caregivers).

5 Self Awareness and Engaging in Relationship As a parent and/or a teacher it is crucial to begin the practice of introspection. Introspection can be defined as the examination or observation of one s own mental and emotional process. So why is this important as a parent, teacher, or caregiver?

6 Being with and working with children elicits huge emotional responses both good emotions and hard emotions. How we parent and teach is influenced by what was modeled for us, our culture, and how we think and feel both emotionally and physically. If we are not aware of our own emotional tags and triggers then we are going to find it challenging to support our children with their big emotions and subsequent behaviors.

7 DIR Floortime is a treatment philosophy for parents & professionals that supports the development of children who have challenges in relating & communicating, including autism. Pediatric PT & OT Services 7 The Offices of Rosemary White & Associates

8 Developmental, Individual Difference, Relationship Based Model R Affective Interactions MH - Understandng the R Part of the I R Relationships D Functional Emotional Development - Levels 1-9 I Biologically Based Differences Bio-Medical (MD, DO, ND) OT/PT Speech & Language I Individual Differences D Emotional Level Pediatric PT & OT Services The Offices of Rosemary White & Associates

9 DIR /Floortime MENTAL HEALTH & DIR Affective interactions R part of the I Development of relationships - child/caregiver interactions, - family patterns, - child/peers Emotional range, Symbolic capacities, Abstract thinking Creativity relative to oneself & to others. Pediatric PT & OT Services The Offices of Rosemary White & Associates

10 DIR /Floortime OT & DIR Neurobiological Factors: Sensory Processing sensory discrimination, modulation & regulatory capacities, interconnectivity & perceptions Motor Control muscle tone, righting & equilibrium, gross & fine motor skills Praxis Including motor planning & adaptation Visual Spatial Capacities - Ability to visually attend, share visual attention, assess visual figure-ground & integrate visual with other sensory stimuli Pediatric PT & OT Services The Offices of Rosemary White & Associates

11 The Sensory Systems Vision Hearing Smell Taste Touch Movement/ Vestibular Proprioception Visceral Affect/Emotion Touch, smell, movement, proprioception, visceral & affect senses dominate early in life & continue to exert influence in critical ways as the visual & auditory systems gain ascendancy.

12 DIR /Floortime COMMUNICATION & DIR Pediatric PT & OT Services The Offices of Rosemary White & Associates Communication depends on the capacity to: Share Attention Read & Use Gesture Use Vocalization Use Tone of Voice Use Language to Communicate

13 DIR /Floortime FOUNDATION FOR COMMUNICATION & DIR Capacity for Shared Attention & Engagement Share attention & respond to sound, & later, use gesture, tone of voice & verbal communication Engage in fun, playful, interpersonal interactions Intentionality Show intent through gesture, vocalizations, words Shared Meaning Understanding & creating new ideas & meanings Comprehension Understanding the meanings of others Production Use gestures, vocalizations, & later, words & language for communication Pediatric PT & OT Services The Offices of Rosemary White & Associates

14 DIR /Floortime EDUCATION & DIR Brings DIR & the lens of all of the disciplines into the Education Setting & Every Learning Moment In the classroom In the lunch room In PE In Music At recess & Social Interactions Throughout the Day Pediatric PT & OT Services The Offices of Rosemary White & Associates

15 We learn from the Interdisciplinary Team!! Understanding the I from each member of the Interdisciplinary Team is essential to support everyone (parents/play partners & providers) to tailor affective interactions to engage to strengthen everyone s developmental capacities in their relationships. Pediatric PT & OT Services The Offices of Rosemary White & Associates

16 Changes in Arousal over Time Behavioral Disorganization Optimal Level of Arousal Low Arousal Wilbarger & Wilbarger, 1991 Sensory Events Over Time

17 Narrow Range of Optimal Arousal Behavioral Disorganization Optimal Level of Arousal Low Arousal Wilbarger & Wilbarger, 1991 Sensory Events Over Time

18 Anxiety Feedback Loop Environmental influences Challenging Sensory Processing Challenging Sensory Processing Poor Comprehension Situation Poor Motor Planning Add fuel to the fire Anxiety Physical Symptoms Mental Symptoms Emotional Symptoms Bolting Aggression Self Absorption Repetition (calming) Tantrums Ricki Robinson MD

19 Memories = Joseph LeDoux, The Emotional Brain Sensory fragments Low Road sensory with emotional stimulus goes directly to the Limbic System & emotional response Memories is to the = single sensation. Sensory High Road sensory with emotional passes through the sensory cortices & interconnectivity between the cortices supports a comprehensive perception Pediatric PT & OT Services The Offices of Rosemary White & Associates

20 The Limbic System is the Road to the Prefrontal Cortex n Limbic system: Reading nonverbal signals. Emotions Gut responses Assessment of safety Long-term memory n When your child feels connected and protected, his/her limbic system can do another job coordinate communication between all parts of the brain. (Wipfler, Schore, 2016) n Again there is a parallel process going on for child and the caregiver.

21 Pediatric PT & OT Services The Offices of Rosemary White & Associates AFFECT, FEELING, EMOTION ARE RELATED BUT SOME INDIVIDUALS ARE PRIMARILY RESPONDING TO.. n The Emotion, the broadest concept & most abstract concept the physiological response, The trigger of awareness in consciousness The emotions around the experience The association of past experiences & memories When affect, feeling and emotion are synchronous we experience... sensory, awareness emotion memories Thinking in the moment! Al Gil Foley, 2012

22 Yeal Bruck Binya, OTR/L, Head of DIR Israel Yana Peleg, PhD., Clinical Psychologist, Israel

23 Yeal Bruck Binya, OTR/L, Head of DIR Israel Yana Peleg, PhD., Clinical Psychologist, Israel

24 Yeal Bruck Binya, OTR/L, Head of DIR Israel Yana Peleg, PhD., Clinical Psychologist, Israel

25 Yeal Bruck Binya, OTR/L, Head of DIR Israel Yana Peleg, PhD., Clinical Psychologist, Israel

26 Yeal Bruck Binya, OTR/L, Head of DIR Israel Yana Peleg, PhD., Clinical Psychologist, Israel

27 THIS IS A DYNAMIC PROCESS FOR ALL OF US. Observation of behavior in response to the sensory environment guides us, parents & clinicians, to understand an individual s sensory profile. As a human being, it is important to KNOW HOW TO READ EACH INDIVIDUAL As we interact with the children & families.. The understanding of their UNIQUE INDIVIDUAL PROFILE will inform us.. How to tailor our interactions to support the relationship. & their functional emotional development Pediatric PT & OT Services The Offices of Rosemary White & Associates 27

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29 LIKE US ON FACEBOOK Rosemary White, OTR/L & Associates Pediatric PT & OT Services ww.pedptot.com Pediatrics Shoreline, WA Pediatric PT & OT Services The Offices of Rosemary White & Associates

30 n Profectum comes from the Latin for advancement or progress, & Profectum Foundation is dedicated to advancing the development of all children, adolescents & adults with autism & special needs. n Our work builds upon the DIR Model - Developmental, Individual Differences, Relationship model developed by the late Stanley Greenspan & Serena Wieder which is central to all our work. We also believe that the interventional approaches that parents & practitioners use to help individuals with special needs must advance & evolve to incorporate new ideas, new knowledge & reflect the most up-todate research & neuroscience they should never be static & must grow as our population grows. n Profectum Foundation records most conference presentations & other sessions & makes them available as webcasts so that they can be more accessible to a larger audience. Profectum has over 200 video resources from our conferences & lecture series. 30

31 Training Opportunities for Professional n Profectum Online Training n ICDL Online Basic Certificate Online Fellows Certificate Online Trainers Certificate Online Clinical Seminars Online training 4 stages Pediatric PT & OT Services The Offices of Rosemary White & Associates 31