Therapy 101: Cognitive Activities—Make them think!

What happens at therapy? Is it just some games? Or hands-on activity to get the child the think? Surely you can do that at home? Do you really need a therapist to do that?

 

These are some questions that are thrown to me when people find out that Nadine goes for therapy. I know they mean well, and I appreciate that. Just to answer the questions:

 

Sometime therapy happens behind closed doors. I’m sitting at the reception area, and I can hear the session, but can’t see what’s happening. I can hear Nadine squealing in delight sometimes when she gets excited, or I can hear her frustration when she’s made to repeat certain phrases that’s difficult for her (e.g. words that start with L and Y). I get to find out what happened in that one hour, only after the session, when the therapist does her end of lesson summary with me.

 

The following is my (and Nadine’s) favourite activity:

 

It’s really fun and you can try it too! Each shape represents an activity. Your child has to remember, in this case, Square: JUMP, Triangle: KICK, Circle: CLAP & Star: STAR JUMP.

 

Round 1: You draw out various sequences on a paper. As you point to it, your child does the sequence. This is the simplest portion. Keep it to 3-4 actions per sequence

 

Round 2: You do a sequence of action, and your child will draw out the correct sequence. (you can see the part that she drew vs the part the therapist did!)

 

There are various adaptations that you can do. Generally, the child gets to do crazy actions and at the same time, hone her skills to remember cognitively and sort out her thoughts.

 

For Nadine, this was very effective. In her jumbled up brain, she has a mish-mash of information that is not sorted out. This activity helps her think through in a fun way, and teaches her basic categorisation.

 

So since I can do this at home, why does she still need therapy? Cos this is one of the many many activities she does during her session. Cos I can do this activity, but I couldn’t possibly come up with it. Cos even if this activity is found in Therapy activity books, I wouldn’t have known what level of difficulty I should pitch it at. Bottomline, unless I’m trained in childhood development and therapy, it would be really unfair to Nadine if I am her only source to help her through her developmental journey.

 

Do you have a favourite interesting activity that helps a child’s cognitive skills? I would love to hear them! Leave me a comment if you are have and if there is sufficient contributors, I will start a linky to share our resources! I will share more in my future posts!

 

Leaving you with a picture of Nadine recently, co-ordinating her hands! She had a blast!

 

This is part of a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers.

 

 

 

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Therapy 101: The Dance Performance

I’ve received some lovely emails and comments about Nadine and I thought should do one post that made me a super proud mummy.

Well, Nadine, with all her therapy sessions have improved tremendously. And here’s a short video of her performing during the school’s Chinese New Year concert. Check out her smile and her enthusiasm!

Can you see her very much improved co-ordination? Her deep concentration to get the steps right? Her attempt to make the entire dance look natural? (I thought the dance steps were a wee bit challenging for a 5 yr old!) And can you see her trying hard to keep smiling throughout? (probably the teacher’s very important instruction to the class!)

So with such little milestones, we just keep giving thanks. Every bit is an improvement, every bit is a testament to God’s faithfulness!

This is part of a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers.

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Therapy 101: Ask a question and wait

It’s been a while since I’ve blogged about Nadine’s Therapy sessions. In my last post, I mentioned that she has low muscle tone, and her weekly Gym sessions does wonders on her.

Another area that Nadine has to work on is her speech and language development. After assessment, she has delayed language skills and delayed cognitive skills. One of the issues is for Nadine to answer WHAT questions. This includes “WHAT do you want for lunch?” “WHAT is that animal?” “WHAT toy would you like?” “WHAT is your teacher’s name?” 

For example, if we are at the zoo and we point out the zebras to her. She needs to a lot of time to find the right word for that animal. You see, she had a whole chunk of vocabulary in her mind, but it’s all mixed up!

Many of us have a filing system in our mind. Animals, Food, Colours, People, Things that move etc. For Nadine, everything is mumbo jumbo in her brain. She knows what is a zebra, she knows what is a strawberry, she knows what is a slipper, but all these words are mixed up to her. When we point out a zebra to her, she has to go through all these words in her mind, and match them correctly. As there is no filing system in her, she has to go through a banana/snowman/fish/purple/finger/barbie before she finds the word ZEBRA.

Over time, (before therapy started), she stopped trying. It took too long, took too much effort. Often, she bursts into tears, we give up and just tell her point blank, “It’s a Zebra”. I mean, it’s a zebra, the sun is shining, it is hot, we are impatient. ok. sometimes we help her by asking “Is it an elephant?” “Is it a giraffe?” Or most of the time, Nicole and Nathan would have shouted out ZEBRA! And we think that by jumping in the answer, we are helping. After all, who doesn’t know that black and white striped animals are zebras? Clearly this made her less confident and less willing to try.

But thank God for the therapy sessions. We understand what’s happening, and she built her confidence in her conversations. She can reply much quicker now and she is learning to “file” words in her brain.  In the past, she would just go “I don’t know” after thinking for a few seconds. Now, she spends a little more time, as she has the confidence to answer, and answers correctly! (9 out of 10 times, her first answer is correct. She just needs a bit more time and encouragement)

Now Nicole and Nathan know that when we ask Nadine questions, she has to try and answer them herself. And no one is allowed to say things like “Easy Peasy” or “I know I know”. Every one has a turn at answering questions. We also told grandparents, aunties, uncles and friends around. This helped as they too, learn to ask, and wait.

So now when you spend time with our family, you will see sometimes we are all just looking at Nadine, smiling. You see, my little girl is thinking.

This is part of a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers.

 

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Therapy 101-My Special Child

Sarah has a 9 year old boy who diagnosed with Dyspraxia. This is a neurological disorder beginning in childhood that can affect planning of movements and co-ordination as a result of brain messages not being accurately transmitted to the body. The journey of discovering why and how Sean is different was one filled with ups and downs. This is Sarah’s story to encourage other parents who are going through this same journey of discovery.

Every good and perfect gift comes from our Father in heaven.

Good and perfect... When my 1st born son, Sean, was diagnosed with at the age of 6, I asked God countless times why did this happen to the child that He has given me. Isn't every good and perfect gift comes from Him? To me, this was less than perfect.

At the age of 3-4, we noticed that our son has symptoms of an ADHD child. As 1st time parents, we did not know what to do. We checked with his preschool teacher. She had the opinion that Sean was possibly an autistic or ADHD child. But sadly, she was later rebuked by the principal for giving such opinions. So nothing was done to follow through her observations. Then we had nice aunties who were helping out in the church crèche who told us that Sean showed signs of a special need child. But our parents dismissed the remarks, commenting that Sean is a bright and intelligent child. So, we let go of the thought until things got worse when he turned 6.

That was when my second child was born and my attention for Sean was divided. My mum, whom Sean was very close to, had to leave Singapore for a long period of time. And Sean had to prepare for Primary 1. This proved to be too many transitions for Sean.

It was then that my husband and I noticed a downturn in Sean. He started going toilet to relieve himself almost every 10 minutes. He kept having the urge till he felt so angry with himself. We brought him to the doctor who advised that it was most likely due to stress and it should go away soon. His problem persisted and he developed an OCD symptom. He kept smelling his hands and thinks that it stinks. Sean would repeatedly wash his hands again and again. He even had suicidal thoughts. All these raised the alarm bells and troubled us greatly.

We brought Sean to a psychologist who diagnosed him as a dyspraxia child. As he was unable to cope with the multiple transitions and it resulted in him breaking down in such a manner.

For the next 3 years, Sean went through occupational therapy that helped his motor skills. There were also social behaviour therapy and counselling given to him. Life was never easy for Sean. He was not able to perceive things like how other normal kids do. Due to his motor skills impairment, he was not able to keep up with his peers and thus often being rejected by friends, who blame him for any accidents that happened. He developed low self-esteem and a lack of confidence.

Being an anxious mother who had high expectations of Sean did not help him at all... I became quite a "monster" to him. Wanting to speed up the therapies, I instilled a "tiger mum" discipline on Sean. Our relationship was hurt... There were times I even wondered if I love this child.

Indeed, it has never been easy, for both Sean and me. Many times, I felt so tired and discouraged. But I thank God that He opened a door for me to spend more time with Sean. I thank God that He sent a "not-so-perfect" mother to encourage me that I am not alone. I got better and had a breakthrough in my relationship with Sean. (Friends around me seemed to be perfect mothers who are ever so patient and loving to their kids. So I had never really shared with them my struggles.)

Sean is now 9 years old. Is he a good and perfect gift from God? In the past 3 years, I am totally convinced that YES YES YES, Sean is a good and perfect gift from God. Sean is a beautiful child. He has a big heart. A heart that allows me to make mistakes while in the pursuit of wanting to be a perfect mother. A heart that always love and forgive. A heart that always hold his mother so dearly. Sean is my special child. Through him, God taught me how to love.

There are so many things that I would love to share about a dyspraxia child. I will when there is another opportunity. But very importantly, for every child out there, every special child has a special need. A need to be loved.

I thought the best thing for me to do now is to share a little of my story to encourage mothers like me. Many times, so much focus is on the child that mothers do not get the "therapy" themselves.

If you feel that you belong to the "not-so-perfect" mother like me, remember that in every mistake we make, we can only get better. You are the best mother for your child. No one can ever replace you.

This is part of a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers. We have occasional guest posts to share other stories of parents with children going through therapy.

 

 

 

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Therapy 101–So What Is Wrong?

One of the questions that come my way about Nadine is “What is wrong with her?” Sometimes it is phrased in more politically correct way, “What happened?”. Nonetheless, many want to know why is she different.

Is she autistic? Is it Dyslexia? ADHD? Asperger? What is it?

Well, this is what her therapist put in her report:

Nadine is found to have delayed speech and language development. Her language skills were found to be moderately delayed. It was also noted that Nadine has motor coordination difficulties. She was subsequently referred to our Physiotherapist for an evaluation…was assessed to have delayed motor skills development.

The therapist explained that motor skills development is closely linked to a child’s speech and language. I thought it would be good to list out some challenges that Nadine faced with her physical motor skills:

• She hardly crawled, or rather, her crawling period was really short. She went straight to cruising.
• When she was 3.5 year old, she still has to hold the railing while walking down the stairs. And even then, both legs had to land on each step has she walked down.
• She only learnt to jump when she turned 4.
• When she walked, it always looked unstable. It was as if she may fall or trip soon.

There are probably other signs but we didn’t take note or didn’t realise we had to be concerned. One big factor was she had low muscle tone. She has floppy limbs and loose muscles. That’s characterised by problems with mobility and posture and poor reflexes. She has poor trunk support, which means she has trouble holding her body upright. This affects her speech and cognitive skills.

Gosh! When we found out, my first thought was, is it genetic? Was it because of something I ate when pregnant? Was it something we didn’t do when she was a baby? It was a barrage of thoughts that came. (For the record, it’s none of the above. It’s just something she’s born with)

One of the important therapy she has to go for now is Physiotherapy, which would work those muscles, strengthen the limbs and give her a greater sense of balance. Along with Physio, she attends GYM classes twice a week.  The work out is necessary to improve motor control and body strength. Check out the gym!

Isn’t it massive? Nadine has a blast in this old school gym! It’s not expensive (about S$20 for 1.5hours) and she gets to do forward roll, cartwheels and work on all these wonderful gym equipment!

In the end, we sent Nathan for gym too! We figured that bit of exercise won’t hurt, since our family is on the high inertia side! Nicole is in a different league as (in her own words), “I’m in the school Gymnastics team already!”

Does the Physiotherapy and Gymnastics help? Definitely. Over the last month, the gym was closed for renovation. And during the regular therapy sessions, Nadine has issues concentrating and focusing. We all can’t wait for Gym to start again. Cos when she was in it, she had a chance to tone her muscles and work on her balance. This invariably helps her to co-ordinate, and builds her cognitive skills (more on that in my future post).

We are going more daily exercises now: Hop on one leg 10x per leg, balance on one leg for as long as you can, sit-ups, play catching in the pool—get her to catch us via ‘running’. We pale in comparison to those gym instructors.. haha! But really anything is better than no exercise at all!

So what’s wrong with my baby? Simply put, she has low muscle tone. It can be a lifelong condition, but with physical exercises, the muscle tone can strengthen and improve over time. That’s what the books and therapists say. What do I say? I say she will get better, she is getting better and I have faith to believe her muscles are toning up each day. I have nothing to lose but everything to gain when I believe for this miracle. My God reigns, in every situation.

 

 

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Therapy 101-Thankful for Therapy

Every Thursday, Nadine goes for her therapy session. It has come to a point where I look forward to Thursdays. It’s a Nadine day in that sense. She gets really stretched mentally while going through her sessions. Some days, she goes through simple his/her/it differentiation. Some days, it’s memory work of shapes and sizes. And some days it’s just 1 full hour of chatting. The range is wide, the work is hard.

That’s how it is for her. Hard work every Thursday.

For me? It used to be a day of kicking myself. When I see what the therapist does, and the activities they go through, I go “Why didn’t I pick that up about Nadine?” “Didn’t you notice she couldn’t do this?” “And look at that! Such an easy task, and you could have taught her!”

But I passed that. *phew* It was no point berating myself. It didn’t help me, and it didn’t help her. Guilt is not a part of therapy. It does hit you. I mean, which parent wouldn’t feel the entire responsibility of the child on his shoulder? I won’t even want to dwell on that, cos it depresses you, and it’s just going through cycles of “What ifs” and “I should haves”. This looking back mentality has gone on long enough.

Now Thursdays are a celebration days. We celebrate the new stuff Nadine can do, the achievements she has made and the milestones conquered. (Thursdays are also homework days. The therapist gives us—parents—work to do at home for the coming week) But it’s great joy.

I don’t focus on her being slower than her peers. I don’t sigh at how she has only mastered stage 2 when her friends can do stage 5 backwards. ohhhh but that doesn’t mean I’m not aware of the above. I am aware, and I have to be aware. Those are the yardsticks of society, those are necessary to measure her progress. But focus on them and push her to reach them? Nah…

I thank God daily for what Nadine has accomplished. And on Thursdays, I thank God a little more! I get to see in my untrained eyes (erm.. after 3 months, it’s a little more trained now), the little steps of progress. I stand amazed every Thursday at how God made us—that every tiniest little word/act plays a part in a person’s development. He’s really in control. There’s no doubt about it.

This is part of a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers.

And linking up with

 

 

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Therapy 101–Does my child need therapy?

Nadine is Mei Mei in our family. We call her Mei Mei, so do the grandparents, aunties, uncles, church friends, neighbours etc. I know this was quite common, cos when we call her, “MEI MEI”, many little girls do look up! (guess it’d be the same, if we called out “BABY”)

Well, Mei Mei is 4 this year, and just two months ago that we found out she needed therapy to aid her cognitive development. This is a big word which simply means she needs help with “information processing, conceptual resources, perceptual skill, language learning, & other aspects of brain development”. Now, that’s just about everything that our brain does ya? So how is it that we only found out this year?

We realised something was amiss when she was three. She was friendly and cheery but very quiet, and only spoken when spoken to, and even then, only answered Yes, No or Don’t Know. We always attributed that to her quiet introverted character. We did our due diligence and checked with the PD and her childcare teachers, and everyone said, it’s normal. She’ll speak more soon, she’s a late bloomer. Friends with kids said the same thing, it’s normal, don’t worry. And the big word. W.A.I.T

We had relatives who told us we were worrying over nothing. We had friends who cited examples of Einstein and his golden mouth at 3 years old. We had concerned personnel who told us we were pushing our child and expecting too much, and stop comparing. All of them told us W.A.I.T

Most people say there are children who are late bloomers. There are those who suddenly blossom at the magical age of 4 or 5. These are those whose parents are enthusiastic to share their stories, that it’ll all get better. Please. Don’t worry. W.A.I.T

But it doesn’t help at all. It makes it worse. I learnt that the sooner we parents get the answers, the sooner our child gets the help she needs.

You know, waiting is easy. It doesn’t require any monetary investment, it doesn’t involve my emotions. Waiting is optimistic. Waiting is just that. Waiting. You don’t have to sit a test with your child, watch him being scrutinised by the specialist. You don’t have to cringe in your seat when your child tries again and again at a simple mundane task. You don’t have to blink back tears when the therapist explains what’s wrong. And, you can go on life with no change if you just W.A.I.T

Some are asking, but why did the PD/Childcare educators say W.A.I.T ?

My all time favourite book that I’m referring to now Debbie Feit’s The Parent’s Guide to Speech And Language Problems has the answers:

1. They’re not trained to identify speech & language & learning disorders
2. Mild Delays are difficult to detect
3. They don’t conduct screenings
4. They don’t know where to refer you
5. They’re afraid of making you anxious
6. They already think you’re overly anxious

Don’t wait. Please don’t.

If you ask, WHEN is the right time to go seek help? Trust your gut feel. If you think something is wrong, go and see a therapist. Don’t give excuses like, “maybe after Christmas, he’ll be better”, “he’s just the not so active type”, “he’s like grandma, the quiet type” etc etc etc.

The author says this—to all parents who do not know if they should bring their kids for any assessment or therapy:

The difficulty lies in distinguishing between the kids who are delayed and the kids who have a disorder…The reality is, with nearly 3-6 million children under the age of eighteen with speech and language disorders in the United States…So if you suspect a delay or a disorder, it’s critical to have a qualified speech therapist make a diagnosis and suggest treatment if appropriate. Even if your child has only a simple delay, a good therapist will send you home with plenty of ideas on how to jump-start or improve your child’s communication.

I hope this helps. Please know that I am not advocating that all children need therapy. I’m just big on early intervention. It is something that I regret because I could have started earlier on Mei Mei but didn’t…and I can only do catch up now, and can’t turn back the clock.

This is a first on a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers. 

 

 

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