children and surgery 22 May 2019

BY: admin

Psychology Team

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Medical operations – how much should we tell our children about their procedures?

Traditional thinking used to be that sparing young children details about their operation or serious medical procedure was the best course of action. Many parents and carers saw this as a way of avoiding unnecessary stress for the child. Parents would then shoulder the burden of worry. All of which makes a lot of sense, given our need to protect our children.

The problem with this approach is that parents are always left wondering whether this is the best course of action. Sometimes it comes down to working out just how much information is the right amount of information.  Medical staff have different views on this issue and often err on the side of less information being better than more.

So what does this research say?

A study earlier this year tried to answer the questions of  how much information to give children. The results were really interesting. This study included 91 children and parents of children (between 3-13 years of age) about to have surgery. Prior to the operation, the researchers held an information session which included an interactive video about the specific procedure and a discussion with an allied health member. These sessions involved both parent and child. They then followed up the child and parent after the surgery and compared how they fared on various psychological measures. In this study, the researchers were very interested in symptoms of trauma in children post surgery.

Using all the information collected above, the researchers then compared the results of their participants to the results of children and parents who had been approached but opted out of the study. The results showed significantly higher rates of distress (post-operation) for children who did not receive the full information about their surgery.  Even the younger children (3-5 year olds) had more positive outcomes in this study. The researchers noted that the findings in their study were consistent with previous studies focusing on children with HIV and  with cancer.

Of course this study, like all studies has limitations. Firstly there was a wide range of surgical procedures that may have been a factor in recovery. The time in hospital also varied greatly. I suspect, level of parental stress and anxiety may have been a factor too.

How can we best help children?

What this study does show is that children are more resilient that we think they are. Even at a young age, they have capacity to process more information than we think they can about their treatment. What the emerging research is showing is that when children understand what is about to happen to them are less likely to experience psychological distress post surgery.

It’s something for us to think about as parents should our children ever need major medical intervention. It’s also something we should be talking through with their medical staff as we help them prepare for up and coming surgery.

As always you are very welcome to contact the Centre for information on our psychology service on 9274 7062.

Naomi Ward

Clinical Director

Ref: Amichi et al (2019) Should parents share medical information with their young children? A prospective study. Comprehensive Psychiatry, vol. 88. Pages 52-56.

scissor skills and learning to write 11 Apr 2019

BY: admin

Occupational Therapist Team

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Scissor skills and learning to write

Did you know that practising the movement involved in scissor skills can help children write. Learning to use scissors develops the skills required to control a pencil. Both motions need the muscles that oppose the index and middle finger with the thumb working together.

learning new skills can sometimes feel monotonous to children. However it doesn’t have to be this way.

Helpful Scissor Activities

The following activities are designed to develop the muscles and movements required to manipulate scissors. In time, the ‘open close’ squeeze action of the arch between thumb and fingers will become stronger.  You may need to help your child make the movements with some hand over hand guiding to get started.

1) Tongs

Use tongs to pick up large pom poms, aluminium foil balls, lightweight plastic toy items, blocks, lumps of play-dough. You can also incorporate food play e.g. picking up cooked spaghetti.

Once skills with the activity improve, you can use smaller items,  cotton balls, small pompoms. Food items can be used such as marshmallows, small fruits, large nuts, pieces of bread, using the tongs to dip into sauce or icing sugar onto a plate or ice cube tray. It is important to always place items working from left to right, top to bottom, because later when a child learns to read, scanning left to right is required.

2) Water pistol play

These can be used to shoot balloons, or paint with water on the concrete. If you are game, supervised painting activities are fun on an outside easel with different colours for little water pistols. It is very good for index finger strength. Make sure your child is using their dominant hand.

3) Ripping activities

Cut strips of coloured paper to rip into small pieces. Some types of paper for example crepe or tissue paper, have a grain and are easier to rip in one direction. Grasping the top of the paper strip with both hands and moving the hands in opposite directions to rip it. Small pieces can be used for collage, the long pieces can be ripped to make jelly fish tentacles, cloud with rain, pretty bird with a long tail, or long hair, grass and so on.

4) Hole punching

A single hole punch is good to improve palm strength. Holes can be punched in a line on card, or make patterns. Lace the card with shoe lace or string, or connect the holes with crayon lines.

5) Bubble wrap

Small size bubbles, these are perfect for pinching with the index finger and thumb, this strengthens the muscles within the finger and thumb, which will help scissor skill development as well as controlling a pencil.

6) Monster ball 

You can use a cheap tennis ball and cut a slit for a mouth and stick on eyes. Squeeze the tennis ball thumb and fingers,  using the dominant hand. With the other hand ‘feed the ball’ with small pom poms, dice, .  The resistance of the tennis ball will be determined by the length of the slit; the longer the slit the easier to open the ‘mouth.’

7) Hand puppets

Making hand puppets talk encourages practice opening and closing the fingers and thumb in time with speech. You can make one using a single spare sock, buttons for eyes and wool for hair. Make it eat and grab, bite and tug.

8) Playdough

Play dough, especially extra firm dough is excellent for improving fine motor strength. Use a garlic press to squeeze playdough through and make spaghetti hair, squeeze the handles using both hands together.

For the Beginner starting with Scissors

Keep in mind, “both thumbs up”, the dominant hand does the squeezing action “open-shut” steady at the midline of the body, the other “helping” hand manipulates the item to be cut.

1) Snipping

Practice cutting action using small sized scissors, cutting strips of playdough, cutting a circle of playdough into ‘pizza’, snipping pieces of straw, coloured wool, spaghetti!

2) Snipping short lines

Make strips of light coloured card narrow enough so that one snip is successful. Draw horizontal lines. These can be snipped off and artwork can be created with the geometric pieces cut.

Collect paint sample cards from your hardware shop for cutting practice, snip between the colours.

3) ‘Stop point’. Put a sticker or draw a face at the destination point for the end of one snip, with no line as a guide.

Early scissor skills involves ‘snipping’, first things like playdough, spaghetti, wool, straws…then develops to just one short line. More information on the next stages of scissor skills is to come in a later post.

And of course if you are worried about any aspect of your child’s fine motor skills you are welcome to contact Reception for more information about our occupational therapy services on 9274 7062.

Madeline Minehan

Occupational Therapist

https://www.childwellbeingcentre.net.au/services/occupational-therapy/

provisional psychology 01 Apr 2019

BY: admin

Uncategorized

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What are provisional psychologists?

A provisional psychologist is someone who has completed their tertiary qualifications and is undertaking a program of supervision as they develop their applied skills “on the job”. Typically this can involve one to two years of weekly supervision with a senior psychologist.

Supervision is where the provisional psychologist discusses the work they are doing with clients (in our case children and young people) with a senior colleague. It’s a space for them to check in that they are being helpful for the client. It’s also a space for the supervisor to make sure that client’s needs are being met by the provisional psychologist.

Who are the provisional psychologists in the Centre?

At the Child Wellbeing Centre we have  four provisional psychologists on our team. Two have completed masters level qualifications in psychology & two have extensive experience working with children in other behaviour therapy roles. Our provisional psychologists are:

Carl Tolomei

Simone Healy

Penny Wong

Toni Schmitz

Each comes with their own background of qualifications and experience. The one thing they all have in common is an enthusiasm and commitment to work with children. You can read a bit more about them on our website:

https://www.childwellbeingcentre.net.au/about-us/

Why might I consider a provisional psychologist for my child?

As provisional psychologists aren’t eligible to offer Medicare rebates, they charge out at a much lower rate than the registered psychologists in the Centre. They aren’t limited in the number of sessions they can provide either. When working with families, they are still doing exactly the same things a fully registered psychologist would be doing with a family. However they have a psychologist on call that they can check in with to make sure they are heading in the right direction.

They are also required to do extensive professional development each year which means they are regularly learning about different ways to help their client.

Not all clients will be referred to our provisional psychology team in the Centre. We try to make sure that clients are matched with the psychologist with the right skills mix. However you are welcome to enquire about seeing a provisional psychologist if you think this is an option for your child.

Please contact reception for more information about our provisional psychologists or any of our other services on 9274 7062.

Naomi Ward

Clinical Director

ABA early interventions 26 Mar 2019

BY: admin

ABACAS Team

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ABA Early Interventions – What do we focus on?

Applied Behaviour Analysis (ABA) is often misunderstood. Parents say to me “well you work on behaviour don’t you, so how will that help my child socialise, or communicate?”  What a good question! Let’s look at the history a little to clarify. Behaviour Analysis goes back a long way, but the most revolutionary (in my opinion) was B.F. (Burrus Frederic) Skinner. Skinner was the first to define the Verbal Behaviour Operants, which we have talked about in previous posts (Mands, Tacts, Intraverbals). He was also the first person to accept thoughts as behaviour.

You can count something as a behaviour as long as it is objective, observable by at least one person (hence observing your own thoughts), and measurable – even heart rate is a behaviour. Now that we’ve broadened definition, I can begin to explain what this means for your child and their development.

There’s more to ABA than behaviour in early intervention

ABA early interventions focus on a whole range of skills.  I’m going to break down how these are behaviours.

Vocal Language
  • Vocal language, or speech, is a behaviour that is measurable, observable and able to be objectively defined. ABA works on increasing children’s communication by increasing their repertoire of sounds or words, and providing meaningful functions for these.
  • There are many types of vocal language, labelling items, requesting items and answering and asking questions. Children with Autism sometimes need specific teaching to be able to use the same word in different contexts.
Play
  • Play can be broken down into many, smaller behaviours, which we can then teach into a one big complex behaviour. An easy example would be doing a puzzle; you can measure how many pieces a child can accurately place and teach matching skills to support children identifying which pieces together.

In summary, ABA is definitely focused on behaviour, but that means something different than just looking at tantrums, or problems. Please come and talk to us about what skills we can teach, not just what problems we can help with! You can call the team on 9274 7062.

Jasmin Fyfe

Program Manager, ABACAS

https://www.childwellbeingcentre.net.au/services/aba-child-and-adolescent-services-abacas/

19 Mar 2019

BY: admin

ABACAS Team

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The benefits of intensive early intervention

Intensive Early Intervention is critical for young children on the Autism Spectrum. A 2015 study found that the average age for children to receive an Autism diagnosis was 4 years and 1 month (Bent, Dissanayake, & Barbaro, 2015). In the scheme of a lifetime this seems early, however in the scheme of Early Intervention, it is a great deal of time lost. We know more about development than ever before, the brains plasticity, and crucial developmental windows. Although we can continue learning our whole lives, the early years are most formative for our language development, and many other skills.

How much intervention?

Intensive Early Intervention, starting as soon as possible, will provide your child with the best opportunity to start their life with a solid foundation of skills. The Behaviour Analysis Certification Board (BACB) recommends a minimum of 10 hours per week of ABA, starting as early as 18 month, with new research looking at starting even earlier. Here at ABACAS we can provide you with an Intensive Early Intervention Program, which addresses multiple domains of development, is motivation-based, and works with you and your family to set and meet achievable goals.

So why do an Intensive Early Intervention Program?

It sounds like a great deal of stress, and financially can be difficult. There can be a lot of appointments and you might have other children to consider too. These are all valid concerns, and we will work with you to address them. However when we look at the benefits, there are many. A meta-analysis (which means that someone read all the recent and historical research on one topic) found that “…long-term, comprehensive ABA intervention leads to (positive) medium to large effects in terms of intellectual functioning, language development, acquisition of daily living skills and social functioning” (Vitues-Ortega, 2010). This study also supported that dose and intensity (frequency and length of therapy sessions) are important factors in whether ABA produces clinically significant outcomes.

If you’re interested in knowing more about Intensive Early Intervention please call one of our team to discuss. We will be addressing a few different area’s of early intervention including expressive and receptive language, social skills, verbal behaviours, echoic repertoire’s, play skills and imitation over the next few posts.

You can also read more about how we work by following the link:

https://www.childwellbeingcentre.net.au/services/aba-child-and-adolescent-services-abacas/

Jasmin Fyfe

ABACAS Program Manager

References

Virués-Ortega, J. (2010). Applied behavior analytic intervention for autism in early childhood: Meta-analysis, meta-regression and dose–response meta-analysis of multiple outcomes. Clinical psychology review30(4), 387-399.

Bent, C. A., Dissanayake, C. and Barbaro, J. (2015), Mapping the diagnosis of autism spectrum disorders in children aged under 7 years in Australia, 2010–2012. Medical Journal of Australia, 202: 317-320. doi:10.5694/mja14.00328

 

14 Mar 2019

BY: admin

Occupational Therapist Team

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Handwriting-When are children ready?

Many skills have to be developed before children are ready to learn to write.

Learning to write is not just about fine motor manipulation. A child is absorbing language from everyone around them at a very young age.  Much later they reach the stage of babbling and  imitating those around them. This is the beginning of expressing themselves through language.  Children have to practice expressing themselves through speech for many years before they are ready to translate those sounds and abstract symbols of speech into letters. During those early years, through crawling, climbing and progression through physical milestones, they are learning with their whole body.

How whole body development helps handwriting

Once children become confident with their body and their language understanding, they can learn 3 dimensional concepts such as ‘up’ and ‘down’, ‘top and bottom’ ‘over’ and ‘under’, ‘left’ and ‘right’. It is only when a child has become fully aware of their body and how it moves through space, can they begin to grasp drawing symbols that represent these directional concepts.

Children need to be drawing for several years before they are ready to learn to write, drawing at a vertical surface is particularly helpful to develop sufficient shoulder stability to help control the pencil. Working at a vertical surface is also much better for visual attention and eye tracking skill development. To be able to learn to write, a child has to have matured in their eye movements. Along with this, they need to build a ‘stable base’ or strong core, which develops through plenty of physical play every day.

Preparing for writing

With sufficient drawing practice behind them, a child is far more confident attempting to learn to write letters. There are 9 developmental forms that a child needs to be able to draw independently and spontaneously by the time they are around 5 and a half years old.  By the time a child is 4, they need to be able to cross their midline. They will then be able to draw a cross and then they can draw a square. By the time they are 5 they are attempting the more complex triangular shape.

The best preparation for handwriting in young children is many hours of physical play, balancing, climbing, spinning, swinging and ‘heavy work’ every day. Drawing skills are best learnt using whole arm movements at a vertical surface. Blackboard, whiteboard, paper attached to an easel or wall is the way to go. Shaving cream on a glass sliding door is really fun and provides a lot of tactile feedback. Activities such as sandpit play, making roads and tracks, drawing on a concrete path with stubby chalk is excellent practice for developing shoulder strength. These activities, along with plenty of one on one time being read to,  are the best basis for learning handwriting.

Needing help with handwriting?

Occupational Therapists can help assess a child’s handwriting skills and provide therapy to correct any difficulties. For more information about our services at the Centre, please call Reception on 9274 7062.

 

Madeline Minehan

Occupational Therapist

13 Mar 2019

BY: admin

ABACAS Team

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Fantastic Friends – Social Skills Programs for 8-11 year olds

In Term Two, our group social skills programs start up again. Social skills are what we need to be able to make and keep friends. For children the emphasis is developing play and conversational skills with peers.

Fantastic Friends sessions will be run by two facilitators  (Simone and Toni). The program aims to build and develop more complex social skills. For this age group, we will focus on a range of skills including starting and maintaining a conversation, introducing self and other people, asking questions, and apologizing. At the beginning of each term, the specific skills being taught will be customised to the group needs.

Who is suited: Children aged 8-11 years of age who need help with making or keeping friends.

Where: Child Wellbeing Centre at our Tuohy Lane offices, Midland.

When: Friday afternoons during school Term Two, 4-5.30 pm

How much: $87.80 per session

How to get involved: Contact our Reception on 9274 7062 to book an initial appointment with Simone or Toni.

At the initial appointment we will talk to you about your child’s needs so we can work out whether the group program is what they need.

For more information about our other social skills programs, please follow the link:

https://www.childwellbeingcentre.net.au/services/social-skills-programs/

13 Mar 2019

BY: admin

ABACAS Team

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Best Buddies – Social Skills Programs for 6-8 year olds

In Term Two, our group social skills programs start up again. Social skills are what we need to be able to make and keep friends. For children the emphasis is developing play and conversational skills with peers.

Our “Best Buddies” program will help to build your child’s confidence. We will be using modelling, and role playing to practice new skills and refine existing skills.

Who is suited: Children aged 6 to 8 years of age who need help with making or keeping friends.

Where: Child Wellbeing Centre at our Tuohy Lane offices, Midland.

When: Thursday afternoons during school Term Two, 4.00-5.30 pm

How much: $87.80 per session

How to get involved: Contact our Reception on 9274 7062 to book an initial appointment with Simone or Toni.

Best Buddies sessions will be run by two facilitators  (Simone and Toni). The skills being taught in each term will be determined by the needs of the children in the group. However, we will be looking at a range of skills including introducing yourself, conversation skills, play skills, helping a friend, sharing, and turn-taking.

At the initial appointment we will talking to you about your child’s needs so we can work out whether the group program is what they need.

For more information about our other social skills programs, please follow the link:

https://www.childwellbeingcentre.net.au/services/social-skills-programs/

12 Mar 2019

BY: admin

Uncategorized

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Making school fun again with ABA

In today’s blog we will talk about how to make school fun again. Many children enjoy school but some will struggle at school. This can be very stressful for children, as well as parents and teachers. Applied Behaviour Analysis (ABA) can help to make school fun again, addressing both engagement in school activities and enjoyment.

Where to start with school difficulties?

The first thing to address is why your child isn’t enjoying school. Maybe they are bored, over taxed or having difficulties with friendships?

Our ABACAS team consultants will want to develop an individualised, function-based plan to reduce any barrier behaviours to learning and friendships. This might involve breaking down new skills into easier to learn chunks in consultation with teachers and parents. It might also include looking closely at reinforcers.

Depending on the target behaviours, reinforcers can include social activities with peers (something the child may not be able to access at home!). We might also look at special items or activities at school as reinforcers.   As you know from our other posts, the aim with reinforcers is to make them special for the child. Typically when we are working with schools, we look at reinforcers that aren’t available at home. That way we start to build up reasons for the child to look forward to  going to school.

Where to get help for school issues?

School needs to be associated with positive experiences, people your child likes to be around and fun. An ABA Consultant can work with the school and their teacher to adjust your child’s environment to suit their needs, and increase their skills. They will also work to fade out extrinsic motivators, and find a balance between inclusion and environmental modifications that suit your family and its values.

If this sounds like something we could help you with, please contact Jasmin Fyfe or Rachel Puan (9274 7062) for further information and support. We can help you understanding the reason why your child doesn’t like going to school, finding the right reinforcers for your child and coordinating with school.

Jasmin Fyfe

ABACAS Program Manager

(with help from Verena Hoffman, our psychology intern)

11 Mar 2019

BY: admin

ABACAS Team / Psychology Team

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Amazing Amigos – Social Skills Program for 4 to 6 year olds

In Term Two, our group social skills programs start up again. Social skills are what we need to be able to make and keep friends. For young children the emphasis is on learning how to play co-cooperatively with other children.

Our “Amazing Amigos” groups is a social skills group targeted at Kindergarten & Pre-Primary students. Children in these groups don’t need to have a diagnosis to benefit. We will teach social skills using modelling, role playing and hands on skills practice. Children will be able to try new skills and polish existing social skills amongst peers and supportive adults. The program is 10 weeks and fits in with school the school term. Sessions are run after school on a Wednesday afternoon from 4.00pm.

The specific skills taught each term will be determined by group needs. In general, we will be looking to teach or refine skills such as: asking for help; sharing; greeting others; turn taking and protective behaviours.

Where: Child Wellbeing Centre at our Tuohy Lane offices, Midland.

When: Wednesday afternoons 4.00pm – 5.00pm during the school term

Who is suited: Children aged between 4 and 6 years old who need help with their social skills. Diagnoses are not essential.

How much: $58.53 per session, to be paid each week of attendance.

How to get involved: Contact our Reception on 9274 7062 to book an initial appointment with Simone or Toni.

At the initial appointment we will talking to you about your child’s needs so we can work out whether the group program is what they need.

For more information about our other social skills programs, please follow the link:

https://www.childwellbeingcentre.net.au/services/social-skills-programs/

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