Happy New Year 2017

The holidays can be so much fun. Food, parties, gifts and traditions! What is not to love? But there is something to be said about the calmness on January. No pressure to be busy. A clean slate of a new year opening itself to hopeful possibilities. I love to be wrapped up in a soft blanket, safe at home with the ones I love. I love the return of normalcy and routine. January lends itself to quiet contemplation and reflection. Of course it is a great time for setting goals and making resolutions. I would argue that January is also a great time to consider how far we’ve come. For those of us blessed with a child who has challenges, it can be a time to take a breather and quietly be grateful for the milestones often missed by those who develop easily. Every goal met, every challenge faced, every problem solved is reason to celebrate and cherish. Our loved ones who have greater challenges teach us how much we take for granted. Their progress teaches us about perseverance. Their struggles teach us about strength. And our presence, guidance and un-willingness to ever give up hope teach us about our own capacity for divine love. January is the perfect time for remembering experiences. For organizing our photos and memories that remind us of who we are. And January allows us to slow it all down, organize and find our footing for the busier months. I am so grateful to be a witness to the development of your children through your guidance. All of you fill my life with such joy. I pray that 2017 will be the best year yet for your family.

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Silent Meatloaf

Recently I made a silent meatloaf. I was home alone and just had to turn off the news. This terrible political season has been so filled with unhappiness and hate, that I just reached a saturation point. Normally I would turn on music, or a pod cast, or an audio book. I might play a webinar or have Hulu playing re-runs in the background. But that night, I decided to listen to nothing. To simply make the meatloaf. It was actually pretty interesting. Smashing eggs and breadcrumbs into meat and getting my hands dirty. And being there for it. My head wasn’t somewhere else, worrying about the latest antics of Donald Trump or dancing about mindlessly to Justin Timberlake. Just me and the meatloaf. I actually heard the shell break when I cracked the egg. I heard the weird slurping noise of the meat getting squished. And the almost silent begging of the pugs at my feet. When my teenage son came in the room, he asked what was wrong. I told him nothing was wrong, I just needed some quiet. Which got me wondering when silence became equated with wrongness. When every moment of life needed to be filled with information. Why do I fill every minute with sound and information that is above and beyond the moment? My son stood there in silence with me, watching me smash the meat with bare hands. We caught each other’s eye for a long moment there. Just me, him, and meatloaf. It was great. Just being together for a minute. No demand. No inquisition about his day, grades, homework. It was a great mothering moment for me. Silent meatloaf. Only to end when he said “that is so gross”, smiled, and walked off. I think tonight I’ll make silent chicken.

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Boundaries

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I once drove a friend to her psychologist appointment. While she was with her doctor, a man with a tri-cornered hat and ascot (think Ben Franklin-fashion) came into the waiting room and sat next to me on a sofa. He … Continue reading

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Baton Rouge

When we have traumatic, painful or emotionally negative experiences, our brain and body help us cope.   The reflexes commonly known as fight/flight/freeze step in to protect us from the overwhelming information.  When the brain perceives danger, it activates the sympathetic nervous system and the adrenal-cortisol system.  The activation of these systems will give protection to the body and the brain while experiencing the immediate trauma.  Digestion slows down, heart rate goes up, blood pressure rises and the body is activated for action.  These things happen automatically.  I am grateful for the wisdom of the body and brain and for the protection it provides to all of us.  It is only when the reflex of fight/flight/freeze stays around too long that we begin to see problems.  It’s when the fight/flight/freeze is occurring on an ongoing basis that we see long term diseases (heart problems, high blood pressure, auto-immune diseases) as well as diseases normally considered “mental only” processes like anxiety, depression, aggression and attention issues occur.  Back in the caveman days, danger encountered on a daily basis were obvious.  Lions, tigers and bears.  Now we encounter stress (aka to the brain as danger) in very different ways.  Traffic, financial issues, work.  And we also continue to encounter natural disasters, mass shootings, car accidents, rape.  Our bodies and brains continue to do their best to protect us from these types of tragedies, but the world today is so different.  We are not as physically active as we were, we do not live surrounded by support systems, and we are expected to carry on despite whatever tragedy we have endured.  Modern medicine has done its best to help.  Pills of all kinds are available to increase absorption of good neurochemical and in some cases to simply shut down the feelings associated with the “bad” neurochemicals.  The problem is, that in a long term way, our brains and bodies are not learning to cope more effectively with stress.  This is the purpose of the Masgutova Neruo-Sensory Reflex Integration (MNRI) Post Trauma work.  To take the automatic protective reflexes of the body and brain, and re-pattern them to release when in safety and remain when in danger.  Bodies and brains recognize these patterns.  They are universal and the language of the areas of the brain that function automatically.  When we provide this information in a systematic, reliable way through the body, we can help the brain to remember that it is safe and will be called upon the next time we really need it for protection.  But for now, it is ok.

I recently had the opportunity to help coordinate efforts to help people who suffered from massive flooding in Baton Rouge, Louisiana.  Ten days of huge rain caused flooding in areas that had not flooded in over 500 years.  Over 50,000 homes were completely destroyed.  Many lost everything that they owned and many had to be rescued by boat and helicopter.  The loss of schools and jobs and normal life for these victims was devastating.  My dear friend, Dr. Vicky Roy lives in Baton Rouge, and along with her business partner Stacy Levy, donated their clinic space so that we could come together and work with folks to release the fight/flight/freeze reflexes associated with this tragedy.  Dr. Svetlana Masgutova, a true humanitarian and the master of this work, flew herself in and donated her precious time to this cause.  Amazing MNRI therapists from around the state of Louisiana volunteered and worked many hours.  Healing began.  What an honor to see happen under the skilled, working hands re-patterning brains and bodies that were safe but still perceiving danger.  The release of the fight/flight/freeze responses provided a basis for organization and thoughtful processing about how to move forward.  And move forward they will.  Baton Rouge is full of resilient people who will rebuild and be better and stronger than ever.

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Listen Up!

I found a really nice article on the web talking about 10 skills we need to be a good listener. I think the author does an excellent job pointing out the skills we need in order to really hear what others have to say. When interacting with a person who has autism, it is so essential to listen. Even if that person is not verbal, they are communicating in ways that deserve our attention and respect.

The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention.
-Rachel Naomi Remi

I am adapting the list from the website (www.skillsyouneed.com/listening.skills.html/) to listening to our children with special needs. I think it is a great list and quite relevant for all people.

1. Stop Talking
When communicating with someone who has Special Needs, it is easy to over talk. If that person is slower to respond or takes more time to say something, our natural response is to talk even more. If you are talking, you are not listening.

2. Prepare to Listen
Relax. Focus on your child. Try to clear your mind of the many distracting thoughts and plans running through your mind. Invest in what your child has to say and give your attention to it fully.

3. Put the Speaker at Ease
Show your child that you are listening to them. Smile and nod encouragement. Show your interest and investment in what he is saying.

4. Remove Distractions
Put down your phone. Turn off the computer and tv. Listen with your whole body and mind.

5. Empathize
Try to take your child’s perspective. Imagine how they feel and how things seem from inside their body. Drop pre-conceived notions of what you think they are going to say and actually listen to what is said and why.

6. Be Patient
Give your child time to formulate what they want to say. Silent pauses are ok, even if they feel too long for you.

7. Avoid Personal Prejudice
Your child is an individual. He may have different ideas and opinions than you. Listen to what he tells you so you can have a better understanding.

8. Listen to Tone
The way someone says something, their emphasis, timing, volume adds a lot of information to what they say. Conversely, some people with challenges have a hard time with their emphasis, timing and volume. Take it within context and listen to understand.

9. Listen for Ideas, Not just Words
Link together ideas that your child expresses to you. With children who have difficulty with communication this can be quite difficult to do. Try.

10. Wait and Watch for Non-Verbal Communication
Listen with your eyes as well as your ears. Facial expressions. Gestures and body language all deliver very important information in the communication package.

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The Innate Intelligence of Nature

 

I love birds. April is my favorite time of year in North Carolina because this is when the birds lay their eggs and these beautiful creatures emerge. I ran across the nest in the video below while on a walk. These babies couldn’t have been more than 24 hours old. They were so precious and fragile. When I whistled, they lifted their tiny heads and opened their mouths to feed. It was amazing to see. This pure expression of innate knowledge of these tiny babies. (I promise, I left them in peace and mama bird is happily nurturing them.)

http://www.youtube.com/watch?v=5qpn

birdvideo

 

This interaction got me thinking about the inherent wisdom of nature. How many things our bodies and brains do without being taught. When we hear a loud noise, we cover our ears. When we trip and fall, our hands come forward to protect us from hitting our heads. Our bodies and brains act automatically for our safety and protection. These are primary reflexive actions that do not leave us, they remain in our systems and show up only when called upon. That is the nature of development.

If, for some reason, development of these reflexes is interrupted, the safety and protection that we depend upon no longer available to us. Many reasons exist for interruption of the development of primary reflexes. Disease, damage, and toxicity to name a few. When this development is blocked, the body is obliged to stay in a constant state of protection. We are playing defense. Tendons are pulled tighter and protective neuro chemical release is triggered. And in this state, the body and brain are unable to be open, safe, and ready to learn. A prolonged period of time spent in this protective state has negative impact on the person’s ability to participate in relationships and experiences that allow for dynamic, flexible thinking.

sadmouse

A mouse in “freeze” protection or playing dead.

 

At Pathways, we use the Masgutova NeuroSensory Motor Reflex Integration (MNRI) program to find what works to release the protection and find the movements which are safe, easy and natural. We look at what works for that individual and build on that structure to activate the innate, natural maturation of the body and brain system. When that body and brain are feeling safe and open, it is free to experience, explore and participate in relationships and learning. The MNRI Program used at Pathways relies on a strong parent training component that gives the tools and skills to parents to play the most important role in their child’s safety and development. If you are interested in learning more about MNRI, you can find more at www.masgutovamethod.com

hm

The same mouse feeling safe and exploring. No therapy done on mouse 🙂

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What is the purpose of therapy?

I have been thinking about this a lot lately. Maybe because it is the beginning of the year and insurance is demanding treatment plans. As a Speech and Language Pathologist and an Autism Specialist, insurance is telling me that therapy is all about what is researched, deemed appropriate by their “experts” and measurable within a specific time period. As someone who has worked with hundreds of families impacted by autism, I am certain that the primary needs of people with autism have nothing to do with what is easily measured, researched, and achievable in a specific time period. This has me wondering about the purpose of therapy and why anyone does it. When I ask clients, what is the purpose of therapy, I get a variety of answers. Some people believe that it is to gather strategies that help their child. Others say it is about somehow helping their child. Some even say it is to fix their child or making him/her better. As a Speech and Language Pathologist, I absolutely agree with the strategy and helping thoughts. I know that I can give people strategies to become more effective communicators. I know that helping with communication helps everyone. But how do I “fix” a child with more severe disability such as Autism or Cerebral Palsy? And how do I do this in a way that insurance deems reimbursable? When we realistically look at the needs of people with more severe disability, it is impossible to pinpoint and measure one achievable goal at a time. The needs of people with disabilities are not tied to only their mouths or ears or hands.  Any disability is embedded in a real, living and deserving person. Within their body and mind. Brains and bodies are connected. If one is struggling, it is impacting the other. Every person with disability is embedded in a family. Every member is affected to a degree. The entire system is made of living, deserving people who are suffering and deserving of help. Can that help be fit into a list of black and white achievable goals that are worthy of insurance coverage?

Everyone wishes for magic pills to fix everything. Everyone knows that it is a fantasy. In my opinion, therapy is about working hard to remediate suffering and damage resulting from a disability. As a therapist for people with Autism, Cerebral Palsy and other significant disabilities, that means I need to address the whole system. Body, brain, family context. Hundreds of additional training hours and multiple certifications along with common sense support this thinking. Remediation or change (real true change in the body and brain system) requires a bigger picture of the human who is suffering. It requires individual consideration of that person in the context of their body and life. Therapy is a whole person process. And it requires hard work. Hours and hours of dedicated work to achieve change for those who have severe issues. And it is heartbreaking to see those hours spent trying to fit in the paperwork and endless phonecalls to insurance companies. Because I believe the purpose of therapy is to bring positive change and relieve suffering. I wish the funding for this change and relief was more readily available so the real work of therapy could happen for all those who need and deserve it.

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Happy Holidays 2015

Dear Pathways Families,

As the year 2015 comes to a close, I wanted to thank you from the bottom of my heart for sharing your children with us.  It is a blessing to work with your families and learn so much from your journey.  I wanted to share a few things that I have learned this year because of your precious children.

-Bodies and brains are connected

-A “diagnosis” label means very little in the big picture

-Smiles mean a lot in the big picture

-Trying is not always easy but is always worth it

-Optimist Prime is a Transformer and has a square head

-You can build an oil rig out of legos

-Ramps are super fun

-The rectigular activating system (RAS) can make or break a visit to a loud place

-Being kind is something that is felt by others

-If you play Minecraft, your name is Steve

-Slowing down will not kill me

-Not eating gluten is possible

-Someone named Kylo Wren is in Star Wars

-Pixels are important

-Being asked too many questions feels like an assault

-The medulla oblongata is in the upper brainstem

-Singing usually helps

-Parents are the best teachers

-Quickbooks is annoying

-It’s ok to feel more than one way about things (for example, YouTube)

-the purple minion is awesome

-Writing things down can be very useful

-The ocean is the best place

-The ocean is the worst place

-Parents can function on very little sleep, but it sucks

-Talking can be over-rated, but communicating never is

-The biggest hearts are inside of the families that come to Pathways.

 

Happy Holidays!

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Visualization 2

Last month I wrote about one of the processes that help with language comprehension called visualization.  As a Speech-Language Pathologist who specializes in autism, language comprehension is a topic that comes up on a nearly daily basis for me.  We know that the brain not only hears (or sees in the case of writing) words, but that our brain also works to create visual images from those words to create an overall understanding of the person is saying (or writing).  Within that visualization process is another process in which our minds use “memory matching” to give a starting point for visualization.  For example, when I listened to the book “The Martian”, I had no problem visualizing the word astronaut.  I could picture the space suit, the straight-armed, floaty walk and the bubble helmet.  When the writer began speaking about Oxygenators, however, I did not have a clue.  I had no memory or experience to match with that word, so I had to just get past it in my mind.  If there were too many words that I had to get past, I believe I would have easily given up on the book.  Luckily this was not the case, and I had enough experiences with books and movies to know I would like the movie better that the book.   I knew that the technical things that I could not visualize would fall into the capable hands of the director, and that could sit back and enjoy.  Which I did.  Matt Damon is awesome.

So how can we help a child with autism to visualize?  I think we first have to realize that the child’s experience bank is likely different than what we expect.  Memories based on experience can be limited and more narrowly focused in people with autism.  Many of my friends with autism have the ability to remember minute details, but struggle more with the overall picture of things.  An important step in helping children to visualize is to provide the child with rich experiences in a safe and deliberate way.  When experience sharing with a child, keep the wording to a minimum and the pace slow.  Use words and labels with care to spotlight what is important in the experience for your child.  A wonderful way to help build your child’s experience bank is to take photos of important parts of the experience to look at later with your child.  Reviewing the experiences gives you another chance to spotlight and label memories that will later serve as anchors in the visualization process.  Another way to help your child begin to visualize is to use previews before doing something. Just like the previews at the movie theater, you can provide your child with a few images to connect to so that he can understand and look forward to more experiences.   For example, we can preview a visit to Gramma’s house by remembering what it looks like, things we will see there, and what we might do there.  “We are going to visit Gramma’s house.  She has a big, white swing on her porch.  She always keeps her fluffy blue blanket there.   I bet you get to snuggle Gramma on the swing.”

If your child has a good experience bank to pull from, you can use visualization in more complex ways to improve comprehension of language.  The Visualizing and Verbalizing Program through Lindamood-Bell has excellent ways and strategies for helping your child to grow visualization skills.  At Pathways, we use this program and adapt as necessary for the individual child’s needs.  Here is a link:

http://lindamoodbell.com/program/visualizing-and-verbalizing-program

 

 

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Visualization

I just finished listening to the audio version of the book “The Martian” by John Weir. It is about an astronaut that is trapped on Mars and all the detailed science that he uses to survive. The movie that is coming out soon will star Matt Damon (swoon). Usually I think the book is better than the movie. However, in this case, I am pretty sure that the movie will be better than the book for me. First, reading all that detail and math and formulas bored me to death. Second, the concept of someone actually surviving alone on Mars is dramatic and interesting to me. And Matt Damon is cute.

So what does this have to do with autism? Quite a bit actually. As a Speech-Language Pathologist who specializes in autism, I get a lot of questions about language comprehension. It is almost always an issue for people who have autism. And, it’s a very broad issue. Language comprehension is the ability to connect and interpret meaning for oral and written language. It includes things like recalling facts, getting the main idea, making inferences, borrowing perspective, making predictions and coming to conclusions. It is clear that language comprehension is tightly tied to understanding, thinking and relating. These are areas that can be difficult for someone who has the diagnosis of autism. Language comprehension issues lead to frustration, disconnection and embarrassment. It places distance between the person with the issue and those who do not have it. It is an “invisible” disability that most people do not know how to detect or empathize with.

Language comprehension difficulties can stem from a variety of sources. It can be about the way the person hears or filters sounds and it can be about how the person processes what they hear. Dr Allen Paivio writes about language comprehension issues using his “Dual Coding Theory”. His theory states that language processing stems from two distinct cognitive subsystems. One is verbal and one is non-verbal. The verbal system is specialized for language. For understanding the actual words and syntax of what is being said. The non-verbal system is specialized for the understanding of the world in the form of mental imagery. So one system is what we hear being said, and the other is about picturing it and deriving the meaning from it. Sometimes a person with language processing issues has difficulty because the mechanisms of the ear and the processing of the sounds is different. Almost always a person with language processing issues has difficulty understanding the big picture due to lack of visualization ability. Visualizing what we read and hear is necessary for interpretation, critical thinking, empathy, reasoning and problem solving. We imagine or visualize what we read or hear and that gives us the context and connections to understand the language. Its why the book is almost always better than the movie. We can imagine and visualize in ways that are not limited by the physical world or Hollywood’s budget.

So what happens when visualization is difficult? In the case of the Martian book, I could not follow or understand all the formulas and science the author wrote about in detail. I couldn’t picture it. So during those parts, I disconnected. I pushed fast forward until I found what was of interest to me. Sound familiar? Since I was unable to visualize what he was talking about, I focused on the parts I could visualize. And I am sure that the movie will be better for me, since the visualization will fall to Ridley Scott (director) and I can sit back and eat popcorn. In my next blog, I will write about how to help your child with visualization to improve language comprehension. And, I will fill you in on Matt’s performance as the super resourceful astronaut.

matt-damon-The-Martian-still

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