| In aiding children with developmental | | | | labeled and shuffled away from typical peers. |
| challenges, we must first realize that this | | | | Rather, they should be included as much as |
| requires a team effort and a strengths based | | | | possible with typical peers. They may need |
| approach. It is necessary to not focus on | | | | additional support and accomodations, but how |
| what the child cannot do but look at what the | | | | will they begin to learn important skills |
| child can accomplish and build upon this. | | | | unless they have frequent and continuous |
| Parents can enlist the support of | | | | exposure to the world around them. I have |
| professionals but must realize that it is | | | | developed the use of what I term 'real life |
| they who are the most important persons in | | | | rehearsals', where we may set up a particular |
| the child's life and that furthering the | | | | social scenario for a child. It may be such a |
| development of their child is not just the | | | | thing as being able to make a purchase at the |
| work of professionals but is a collaborative | | | | grocery store. The therapist and parents |
| effort from everyone involved with the child. | | | | guide and coach the child ahead of time in |
| It is neccessary that for any interventions | | | | how to go about such an activity and then |
| to truly be effective and helpful, that they | | | | have them actually demonstrate it. Social |
| must be consistent and constant. The | | | | stories and comic strip conversations are |
| interventions must be the same throughout all | | | | very useful in conveying information as these |
| domains that the child is present in.It is | | | | children tend to be visual learners. Social |
| crucial for us to understand the | | | | stories can be simply made booklets that the |
| environmental responses that children have, | | | | child helps to create where a particular task |
| whether they have developmental concerns or | | | | or scenario is outlined with what behaviors |
| even if they do not. If a teacher, parent, or | | | | are expected. The comic strip conversation is |
| other person has a hostile tone, a poor | | | | helpful in building empathic skills as well |
| demeanor, a loud voice, etc. All of these | | | | as reflective thinking as we ask the child to |
| things can be overwhelming to the child and | | | | develop captions for what different |
| can provoke a behavioral response. All | | | | individuals may state and think in various |
| behavior is purposeful and should be looked | | | | situations.Lastly, I think it is crucial, |
| upon as so, even negative behaviors. | | | | though it may appear controversial to some, |
| Behaviors are a way of the child speaking to | | | | to state that children with developmental |
| us about a distressing situation or an | | | | concerns can and will be benefitted from a |
| apparent need or desire when they may not be | | | | psycho-social and relationship based approach |
| able to convey this to us verbally. Light, | | | | alone. Some have decided to resort to |
| sound, and other sensory stimuli can also | | | | medications, and I am placing no blame or |
| produce distress for a child. We need to | | | | condemnation on those who have made this |
| create awareness of what in the environment | | | | decision, however making a suggestion that |
| may serve as triggers to distress and seek to | | | | there are alternatives and informing of these |
| modify the environment to make it a more | | | | alternatives as well as the hazards of |
| comfortable and safe place for the child. We | | | | psycotropic medication usage. First, I will |
| must also be cautious in how we view | | | | not argue that medications can 'work' in the |
| children. If we look at a child displaying | | | | sense of subduing behavior. However, |
| negative behavior as a 'monster' or feel that | | | | strapping a child to a chair would also work |
| because a child may be rambunctious at times | | | | in regards to subduing behavior. This would |
| that we must automatically resort to | | | | be aversive and quite possible illegal. I see |
| medicating them, then we have taken a | | | | little difference between such an approach |
| negativistic attitude that will surely be | | | | and that of using psychiatric medication. The |
| passed on to the child. Children are keenly | | | | difference is that one is a physical |
| aware, even those with communication | | | | restraint, the other a chemical restraint. |
| struggles, of adult's perceptions of them. We | | | | When we say that something 'works', often we |
| should look at our children through the eyes | | | | are not looking at the mechanism by which it |
| of delight and address behavioral | | | | works. Dr. Peter R. Breggin, MD compared the |
| difficulties not in terms of how we can | | | | use of antipsychotic medications in children |
| subdue, but rather how we can meet needs and | | | | to 'chemical lobotomy' as it blunts the |
| resolve conflict and remove distress.The | | | | functions of the frontal lobes. Thr risk of |
| floor time model is of particular usefulness | | | | tardive dyskinesia, a permanent disfiguring |
| in working with children with communication | | | | neurological impairment exists with these |
| and social struggles. For those children who | | | | drugs. In addition, such drugs as Risperdal |
| are non-verbal, we can begin to introduce | | | | are prescribed off label and are not |
| hand signals, moving to use of pictures, and | | | | indicated for anyone below the age of 18 but |
| then gradually encouraging the child to make | | | | continue to be prescribed.It may require more |
| use of words or phrases to indicate desires. | | | | diligence, effort, and patience, but I remain |
| It is not important initially whether the | | | | convinced after working with over 40 children |
| verbalizations are correct but rather that a | | | | with developmental challenges, that |
| verbal attempt was made. When a child | | | | relationship based approaches, rather than |
| displays such a behavior as spinning objects, | | | | chemical restraint, prove to be a true means |
| in the floor time model, we would not be | | | | to teach our children skills, to focus on |
| aversive, but rather gently introduce a new | | | | their strengths, to build on their |
| toy or object and seek to divert the child to | | | | development, and to help address challenging |
| a more productive activity. In situations of | | | | behaviors and to address the real source of |
| echolalia, we can say such things as 'that's | | | | conflict and distress rather than just |
| TV talk', and provide means to divert this to | | | | blunting it.Dan L. Edmunds is a doctoral |
| a different means of conversing. It is | | | | candidate (abd) in Pastoral Community |
| important to provide the child with | | | | Counseling. He is Board Certified in Sexual |
| understandable signals and meaningful | | | | Abuse Issues via the American Academy of |
| statements and phrases when we are desiring | | | | Experts in Traumatic Stress. He has served as |
| them to behave in a different way.In order | | | | a therapist with a diverse population of |
| for children with developmental concerns to | | | | children and adolescents including many with |
| be able to integrate more into the social | | | | developmental challenges. Edmunds serves as |
| sphere, it is necessary that they not be | | | | the county autism specialist for a private |
| isolated into situations where they are | | | | agency in Northeastern Pennsylvania. |