In the recently concluded 8th Biennial Convention of the Philippine Society for Developmental and Behavioral Pediatrics, many ideas were conveyed with scientific and factual data. It has been an enriching 2-day event attended by Pediatricians, Therapists, Educators and Advocates.
There is a study on the effects of an enriched environment to the brain of children. Dr. Joel Lazaro provided an insight on a study that the brain has a phenomenon called “Use it or Lose it”. When you provide an environment that stimulates the mind of a child synapses are formed. Early experiences matter because it influence brain architecture and function. Take for example Tiger Woods, a champion golfer. He was given an opportunity to play and be trained by his father, also a golfer. At a young age, he was already performing at par with other pros. The first five years of the child is an essential time- the foundation years. There is an interplay of nature versus nurture. The brain is developing during those years. Learning starts at home – his first school.
Furthermore, the plenary became more active and participative when the topic emphasized on early intervention and stress. Early intervention starts when the therapists commences their programs, when the child receives education in regular or progressive schools, when parents are equipped on new parenting techniques and when the family adjusts to accommodate the child’s individual and unique needs.
Stress can be acquired by children too. This can be seen by physical manifestations. It can be positive, tolerable and toxic stress. Positive stress is felt when the child undergoes natural course, events that are necessary for his development. Tolerable stress can be a loss of something dear to him like a loved one, a toy, a change of residence or parents separating. Toxic stress is the severe form where the child experiences emotions more than he can handle. For example, physical abuse. Verbal abuse in my opinion may fall in this category. Ridicule, shaming, bad-mouthing are some habits that can lead to stress.
Finally, “less is more” as what Dr. Lazaro emphasized. We live in a world where there is an abundance of almost everything. For me, when we take control and appreciate the little things we have and use it to our advantage, that is to allow more time for stimulation. When we have lots of technological armours, what is left is little quality time. When we have lots of dreams and demands to our exceptional children so they can be achievers, what is left is little quality time for play.
Success! It is a word to describe our first SPEDition just in time for the celebration of National Disability Prevention and Rehabilitation (NDPR) Week 2015.
Public SPED Teachers, parents, grandparents, guardians, friends, interns and students have attended the seminar entitled MATER QUO VADIS?: A PRACTICAL PARENTING GUIDE TO RAISING AN EXCEPTIONAL CHILD held at the Conference Room of Holy Cross of Davao College on July 24, 2015.
A hundred participants from different Public SPEd Schools in Davao City particularly SPED Bangkal CES, Buhangin CES- SPED Center, F. Bangoy CES-SPED Center, Kapitan Tomas Monteverde CES- SPED, Sta. Ana CES- SPED Program, SIR Elementary School, Ma-a CES-SPED Center and Bolton ES-SPED Program and our clients from Shapingpro Integrated School and Child Therapy Center have responded and benefited from this seminar which was in partnership with SPED Major interns, students and SPECS organization of HCDC.
We would like to thank the parents, grandparents, teachers and students as well as Ms. Alexandra Go, Dr. Emma Unciano and Personnel of HCDC, Public School Principals and SPED Coordinators, Staff of Shapingpro Integrated School and lastly to the children with exceptional needs to whom this seminar is dedicated.
BALANCE BETWEEN POSITIVE AND NEGATIVE REINFORCEMENT
“Dolor complains that his son is way out of the line. She loses patience and applies corporal punishment. But, the behavior persists. She finds herself at the receiving end. Her son controls her.”
There is something in between that is very hard to balance. One side weighs heavier than the other.
For a parent raising a child with conduct problems, the search for equilibrium can be so extreme when one is bombarded with negative events everyday.
When the child is behaving well, we tend to overlook it and disregard his simplest effort to be good. When the child misbehaves, the intensity of anger explodes. There is an imbalance between the two essential behavior modification tools.
To modify the behavior, explode rather with praise and joy for his good conduct. Sitting quietly, reading, playing peacefully, writing with much gusto, helping in chores, sharing thoughtsare among the behaviors that Dolor should flood with praises without sarcasm and monetary reward.
On the other hand, if he misbehaves, explode not with words of ridicule but with techniques such as removal of privileges, toys, TV time, play and bombard him with chores, errands, more academic time with less litany of previous mistakes.
As Albert Einstein illustrated balance as if riding a bicycle, you have to keep moving forward to achieve it. Once the mistakes are done, apply these techniques, forget it and move forward. It may be easier said than done. But if we look outside of the situation, these are all you’ve got. Punish him and the vicious cycle will continue. Be passive and lenient and the boy can never be disciplined by you. Seek a path of true balance – a homeostasis.
* Dolor is a fictional character used for emphasis.
The parent who has a child diagnosed with a developmental condition should undergo parenting classes. Traditional skills in child rearing may not always be applicable due to the complex nature of this childhood disorder. As a proactive parent, one must research in order to find light to unending questions and confusions surrounding this new chapter in his life.
PARENT AS A RESEARCHER
Create a network of friends, teachers, professionals who share the same passion for special needs population. Join associations that share common goals for your child.
Educate yourself about your child’s condition, i.e. definition, characteristics, interventions and prognosis using books, journals, TV shows, youtube videos, and helpful internet websites, example Https://shapingpro.wordpress.com.
Write down your observations in a journal notebook or diary. Writing is effective in monitoring recurrent behaviors. Your observations and interventions on that situation are recorded emphasizing the frequency, intensity and duration of maladaptive behaviors.
BEING AN ADVOCATE.
Help others in early detection using A-E-I-O-U.
Problems and difficulties with articulation, eye contact, imitation, obedience and use of hands and feet which persists in 6 month are red flag signs. Through this, you will realize that sharing one’s thoughts could prevent further deterioration of the condition since early screening is paramount to positive prognosis.
Walking, strolling or traveling, one can find interesting idea. Enriching your mind with fresh scenery, new events, and new itineraries can make your plight less depressing. Raising an exceptional child sometimes creates walls and boundaries and cut off communication lines and destroys paths. Go to church, malls, parks, parties.
SEEK PROFESSIONAL HELP
Find professionals who are expert in the field. Developmental Pediatrician, OT, Speech Therapists, Physical Therapist or Behavioral Therapist, SPED Teachers, Psychologists are among your options. Find competent, experienced and knowledgeable people to help you. Do not allow this problem to overshadow your judgment. Act the soonest possible time.
LEARN NEW SKILLS
There is a major shift in education. Allow yourself to be trained in technical-vocational skills. Age is not a deterrent. Your skills can be of big help for your growing kid.
PARENT AS AN ACTOR
Implementing interventions at home and community can be pleasurable if we provide humor and creativity to a stressful task. We are already acting before – but it was more emotionally charged. This time, providing alleviation to problems should not raise our pulse, heart rate and blood pressure.
The eyes are the window of the soul. It is often underestimated but for children with special needs, it is key for learning. Establish eye contact consistently during conversation, tutoring and emphasis on shown materials.
Adjust your voice modulation to moderate in normal discourse, energetic in ecstatic mood and subdued in depress tone. The child finds cue to your feelings. Verbalize, express and speak your hearts out.
Emphasize and exaggerate your appreciation through your action and words; exaggerate your displeasure to emphasize that inappropriate behaviors are not tolerated.
You can certainly influence your child through your actions and words. Demonstrate the behavior you want your child to perform. Act until it becomes part of his repertoire of skills.
Suiting up as a chef in the kitchen or wearing basketball jersey while playing add to the motivation and interest of the child to you. Bring back the positive relationship through creative approach.
Speech and language deficits are present in every disorder. In this intervention, pile up beautiful stories or purchase simple story books and read it every night before he sleeps. You can make your own story.
ARTS AND CRAFTS
Provide materials and make a product out of it like a project. To add skills, try selling it for training purposes in communication and social interaction.
MUSIC AND MOVEMENT
Singing and dancing are innate for us Filipinos. Make it an instrument of growth and creative development. You may look for people to teach your child the basic steps or purchase materials to improve his craft.
PARENT AS A TEACHER
As a teacher, you facilitate learning. You guide the child and make learning enjoyable. Use multi-sensory approach, i.e. all senses are given stimulation – hearing, vision, tactile and kinesthetic. Reinforcers, visual aids and environment modification are needed to augment learning materials.
Break complex tasks into simpler, doable and achievable piece.
Assign points for tasks and assign equivalent rewards for corresponding number of total points.
Seeing an image or picture of actions, achievements, prohibitions, schedules posted in a wall as a reminder of your expectations can be a good reinforcer for the child.
A contract is a written agreement stating behavioral expectations, rewards for compliance and punishments for defiance and signatures of both parent and child.
This is the most commonly used form of reinforcement. Verbal expressions as well as physical expressions are readily available with no expense at all. Pat on the back, high five and smile are some examples.
This method can be used as an exchange of good behavior. Any activities that are pleasurable to him can be used as reinforcement. Example are watching TV (3 years and above, limited) and playing a game with peers.
Examples are toys, board games, marbles, stickers, art materials and edibles. Computer, tablet and cellphone games are highly discouraged.
It is a stimulus given before a behavior to assist the child in performing that behavior. Examples are verbal, gestural, pictorial and physical prompts.
It must be brief and direct to the point. It shows your disapproval. I can be in the form of scolding and just saying “No”.
It is the removal of a child from a situation in which reinforcers are available. It also includes withdrawal of attention, physical isolation, ignoring, seat time out (taking a nap position), facing a wall or corner and removal of materials from his environment.
It is the quickest way to reduce unwanted behavior. Remove the reinforcers from his line of vision.
To create an engram or memory trace, there should be a minimum of 3 repetitions to ensure adequate time for the brain to process. It can be incremental to test his endurance and tolerance.
Using “I” messages to convey your idea without shouting or ridicule. This is a mature approach where the child is treated with value.
MODIFYING THE ANTECEDENT
Ensuring safety and anticipation of what might happen; re-designing the area to lessen distractions and unnecessary movements; and organizing sharp tools and fragile materials to prevent the behavior from happening.
SOCIAL SKILLS TRAINING
Socially acceptable learned behaviors that enable a person to interact with others in ways that elicit positive responses and assist the person in avoiding negative responses.
ACTIVE AND PLANNED IGNORING
This technique which the attention is withdrawn from the child especially if he is throwing tantrums or crying is a powerful tool for behavior change.
PARENTS AS STRATEGIST
As a strategist, you have to know your PURPOSE. It means you have to prepare ahead to be on guard for possible negative events. You have to understand the strengths and challenges of this disorder. After that you rehearse, putting yourself as a doer and an empty chair as your subject. By this time you are ready to place it in real scenario – perform it with your child. Overcome obstacles surrounding your idea. Select the best strategy based on your knowledge. Use it. Evaluate after doing it. Some parents find it hard, but as a strategist you decide, choose and execute and be accountable for positive or negative results.
There are five stages that one has to undergo when there are events that are not favorable to our expectations. These are denial, anger, bargaining, depression and acceptance.
Pica, picky eater, junk foods, soda and swallowing problems are issues faced by parents daily. It is imperative that the parents use reinforcers to ensure compliance.
BEHAVIOR TO PUNISH
These are dangerous behaviors such as running into the street without looking and intolerable behavior such as hitting other children to hurt them. It must be immediate. Do not punish frequently or its effects are diminished and child may no longer respond.
The diagnosis is a ticket for the modification of unhealthy lifestyle. The focus of modification are home errands, communication, independent function in all aspects of daily living, scheduled trips, medical check-ups, school conference among other issues that must be addressed.
The home is your child’s first learning environment. Organize your home to accommodate your child’s special needs. It has designated and safe areas for playing, studying, putting toys or books and placing in time-out.
The primary occupation of the child is play. Adequate and quality time is needed to enter into their world without intruding and controlling the game or mood. The child is observant and open for learning in this period of pleasurable activity. Integrate teaching of concepts in a similar way.
General instructions for Jacobson’s technique involve tightening one muscle group while keeping the rest of the body relaxed, and then releasing the tension. Professionals who use this technique often combine it with breathing exercises or mental imagery.
8-9 hours of sleep is recommended for children. Nap time is discouraged for children 4 years old and above. Lack of adequate sleep disables repair of tissues thus inhibit healing. Imbalance of neurochemicals in the brain promotes irritability, lack of focus, aggressiveness and short attention span. Learning is difficult as the brain processes are disoriented.
It is a psychological technique that consists of identifying and then disputing irrational or maladaptive thoughts. It is a way of viewing and experiencing events and emotions to find more positive alternatives. Change the conceptual and/or emotional setting or viewpoint in relation to which a situation is experienced and to place it in another frame to change its entire meaning. In teaching, reframing explains a point in a different way (analogy, association), thus helping those who did not understand it.
MATER QUO VADIS? MOTHER, WHERE ARE YOU GOING?
A PRACTICAL PARENTING GUIDE TO RAISING AN EXCEPTIONAL CHILD
JULY 24, 2015
HOLY CROSS OF DAVAO COLLEGE
PARENT SEMINAR IN CELEBRATION OF NATIONAL DISABILITY PREVENTION AND REHABILITATION WEEK (NDPR) 2015
Pagpapaunlad sa Kasanayan ng Bata ay Magsisimula sa Bahay
(Developing skills of a child begins at home)
The SHAPINGPRO Family Education Guide
Ang pagkakaroon ng problema sa “development” ng inyong anak o kamag-anak ay kailangan tingnan sa iba’t-ibang bahagi. Hindi dapat panghinaan ng loob, sa halip tingnan ito na isang malaking hamon sa inyo.
Ang “development” ay isang mahabang proseso. Ito ay napagdaanan natin. Kung ang inyong anak ay may kakaibang development keysa sa ibang bata, tayo ay komunsulta agad sa isang espesyalistang duktor para sa mga ganitong kondisyon na ang tawag ay “Developmental Pediatrician”. Sila ang may kakayahang malaman at masuri kung anong klaseng kondisyon mayroon ang bata.
Bilang pagpapaalala, kung ang “development” niya ay kakaiba sa ibang bata, halimbawa, hindi pa siya nakakasalita at hindi mo maintindihan ang kanyang “behavior”, ito ay ating bigyang aksyon sa pamamagitan ng pagsuri sa ating sariling kakayahan. Kung itong mga problema na inyong nakikita ay hindi nadadaan sa “traditional” na pamamaraan, iyong karaniwang pagpapalaki sa atin, siguro ay kailangang gumamit tayo ng estratehiya na maaring kombinasyon ng pangkaraniwan at iyong pinag-aralan ng mga dalubhasa na tatawagin nating “technique”.
Una, tanggapin natin na kailangang may pagbabago. Kung naghahangad kayo ng “progress” sa kondisyon ng bata, nararapat lamang na pag-ibayuhin natin ang ating kaalaman at pagtibayin ang paniniwala na makakamtan ng bata ang “development”, maaring dahan-dahan, mabilis, o minsan ay wala – pero sa ibang aspeto ay nag uumapaw naman.
Itigil na natin na ikarga at ituring siyang “baby”. Tanggalin na ang “diaper” at ang “milk bottle” kung saan siya dumedede na parang sanggol. Sa ating pagtitiyaga at sakripisyo, na turuan siya araw-araw, ang bata ay matututo. Inuulit ko, mas mabuting magsimula sa inyo ang “development” na inyong hinahangad sapagkat ang bata ay tumatanggap lamang ng mga bagay at eksperyensya na tayo ang nagtatakda. Kung itatakda mo na siya ay magdede, subuan ng pagkain, gawin ang aktibidad na dapat siya ang gumagawa, ikaw lang ang magkakaroon ng “development”, hindi ang bata. Kaya simula ngayon, tayo ang magtatakda ng “development” para sa bata.
Pangalawa, kung maari ang TV, cellphone, laptop, tablet at kung anu-ano pa ay dapat para sa matatanda lamang. Ang para sa bata ay libro, lapis, papel, krayola, at mga kagamitang makaka “develop” sa kanyang isipan. Kung may problema sa pagsasalita ang isang bata, mas lalong walang ganyang uri ng teknolohiya. Ang dapat gawin ay kausapin ang bata at kailangang hindi mabilis at dapat maririnig niya. Isang libo at limang daan na salita sa loob ng isang araw ay makakatulong sa bata upang maka impok ng lengguwahe. Hindi pwedeng pagsabayin ang TV viewing at dayalogo ninyong dalawa. Ang ingay sa TV at salita mo ay nagpapagulo lang sa daluyan ng “sound” papunta sa tenga. Sa ating pagtitiyaga at sakripisyo, na turuan siya araw-araw, ang bata ay matututo. Inuulit ko, mas mabuting magsimula sa inyo ang “development” na inyong hinahangad sapagkat ang bata ay tumatanggap lamang ng mga bagay at eksperyensya na tayo ang nagtatakda.
Panghuli, ang “behavior” ay nahahati sa dalawa – “appropriate” o katanggap-tanggap at “inappropriate” o iyong hindi kanais-nais at kakaiba keysa karaniwang bata na ka-edad niya. Ito ay mahirap unawain sapagkat hindi natin mabubuksan ang utak upang ito ay makita o ma “predict”. Subalit, may mga “behavior” na pwedeng matutunan. Pero ito ay nangangailangan ng matinding sakripisyo at tiyaga, “consistency” at palaging gagawin sa oras na ito ay magpapakita. Itigil na natin ang “spanking” o palo sapagkat ito ay panandalian lang at takot ang mamayani sa kanya. Ito ay negatibo sapagkat hindi pa niya kayang intindihin ang anumang “traditional” na disiplina na ipapataw sa kanya.
Ang dapat gawin ay purihin o “praise” kung siya ay nakakagawa ng “appropriate” na gawain. “Ignoring” o sadyang hindi pagtingin at pagpansin sa kanyang “inappropriate” na ginagawa. Ito ay para sa mga hindi delikadong aksyon lamang at iyong hindi nakakasakit sa kanya at sa ibang bata. At pangatlo, “consequence” o ang pagbibigay ng parusa sa kanyang ginawa na hindi nararapat. Ang consequence ay maaring “time-out” o ang walang gagawin sa loob ng limang minuto, “response cost” o pagkuha sa mga kinahihiligan niya sa panahong iyon. Hindi na daanin sa pagsigaw at pangangaral. Konting salita lang po – ITO AY EPEKTIBO.
Sa loob ng isang linggo, ito ang inyong gagawin upang matugunan ang “development” niya. Kailangan na siya ay may “endurance” at “resiliency” na ang ibig sabihin ay may pasensya, may kakayanan na tanggapin ang iba’t-ibang eksperyensiya.
1. Huwag ibigay ang gusto niya. Kailangang pumunta siya sa iyo. Huwag siyang pansinin kung iiyak. Tingnan siya at hintayin kung ano ang hakbang niya. Huwag mangangaral, sisigaw. Konting salita na mahinahon at maiintindihan niya ay mas epektibo. Bumilang ng 50 bago ibigay ang pagkain o inumin o laruan. Kailangan matuto siyang maghintay at mag “communicate” sa gusto niya.
2. Maglaro kayo kahit sampung minuto at obserbahan siya sa sahig ng inyong living room. Hindi ka magtuturo. Masdan mo lamang siya. Ikaw ang kanyang magiging kalaro. Huwag mangangaral. Konting salita na mahinahon at maiintindihan niya ay mas epektibo.