A Journey Through Infant Development: One Year!

By: Michelle VanderHeide, BSW

It seems like only yesterday that I started this series on infant development, and now my baby boy has turned a year old. It’s fun to look back and reflect on how much has changed from one year ago. No year is like the first in the amount of growth and development a child makes, although the next several years are still critical and substantial in human development. Instead of writing about what I saw in his development over the past month, I’m going to reflect back and summarize my son’s development during the past year.

The first month: I was worried about how I could find more love in my heart for another child. The minute you came into our lives that worry was gone – you stole all of our hearts! You are so small, unresponsive, needy, and very fought over. Everyone wants to hold you as you have become a very important part of our family. Basically, all you do at this point is eat and sleep; but you are a very content baby. The joke is that as we carry our car seat from place to place, we are afraid that we are going to leave you behind one of these days because you are so good.

The second month: You began to smile this month! What a beautiful thing. It takes a lot of effort at this point, but it’s well worth the time to get it. Now that I am getting a smile, I’m already anticipating the next thing – a giggle! You are trying to giggle, and will grunt and move around when being tickled; so I know it won’t be long now!

The third month: You smile so much now that you have been nicknamed “guy smiley.” What a joy you are to have in the family! You are obviously very aware of people around you, as the minute you see somebody you give them a huge radiating smile. You are also giggling a lot now, and really love being tickled – especially by daddy. You are picking up on patterns, as you know that once daddy is done tickling you he’ll come back and do it some more. You giggle in anticipation of what is to come. The way you shriek when daddy walks in the door is also evidence of your growing awareness. There is nothing better than daddy coming home! Your sisters also offer a lot of entertainment for you. Watching them play is so fun for you. One will say or do something, and then the other; and you will shift your gaze between them rapidly. You are evidently seeing people as very important elements of your environment and as important learning tools!

The fourth month: You have found your voice, and are doing a lot of playing around with sounds. You have also discovered how to get a reaction out of people. If you don’t like something, you scream in hopes that it’ll stop. If I respond to something you’ve done, you’ll recreate it to continue getting a response. You are also becoming stronger (you rolled over for the first time) and are beginning to reach for toys. You also discovered who you are through some mirror play. Early on, you dismissed yourself as though the reflection were an unimportant person; but later in the month, you realized that what you were seeing was yourself. You found yourself to be quite entertaining. The gaze shifting and emotion sharing that took place between you and me in the mirror was priceless!

The fifth month: You have become quite the little entertainer! You want to be center of attention, and always have to know what’s going on! Feeding you has become a challenge, as you want to see what’s happening at all times – no time to stop for a bottle! You are also more of a pain bring to restaurants, because you want to touch and grab everything in sight. My earrings, saltshakers, grandma’s glasses – you name it – all are considered toys to you, and you want them all! Social routines (such as patty cake and peek-a-boo) are very much a part of your daily routine. Foundational aspects of communication are becoming more evident. You are doing a lot of babbling, especially when laying in bed after you’ve woken up.

The sixth month: It’s very evident now that you love the fast paced, dynamic life. Keeping things the same is boring. Peek-a-boo is so much more exciting when you don’t know what to expect. Will the blanket come off fast or slow? Will it be on my head or daddy’s? The giggles are priceless! You are also aware of people that you do and don’t know. Watching you interact with another infant is also very intriguing – the two of you have your own little way of communicating by copying each other’s actions and sounds.

The seventh month: You are beginning to initiate play now by taking an action to a familiar routine, and doing it to start the game. Humor is also more evident; I’ll ask you to do something, and then you don’t do it and laugh – knowing exactly what is expected of you. My favorite part of this month is that when I say “kisses,” you lean over to me with your mouth wide open for a sweet little kiss. This is one of the times you’ll use your humor though, and turn your head away from me or just look at me and giggle.

The eighth month: You are watching everything that we do, and know that other people are a source to learn from and receive help from. You got a ball stuck the other day, and looked right at me for help – clearly gazing between the ball and me. You are also watching what your sisters are doing, and want to do the same thing they are. If they are working on a puzzle, you are trying to play along; and you get upset when you aren’t invited to join. Physically, you are beginning to use the army crawl as your primary mode of movement, and it’s quite effective for you.

The ninth month: You are so interactive now, and it’s more evident that you are crawling with ease. When I come home from work, you immediately crawl up to me for a welcome home hug – which I love! Being able to crawl also means you can be more interactive with games. You now love to play hide and seek – you crawl behind a chair and peek out for my reaction. I love it!

The tenth month: Curiosity is the theme for this month! Now that you are mobile and can pull yourself up, you want to see everything! When I am in the kitchen working, you are emptying drawers. When I am in the bathroom getting ready, you are pulling everything out of the cupboards. You have been appropriately named “little bother” by your sisters, as you are into everything!

The eleventh month: Separation anxiety is at its peak. You want to me be with mom, dad, or one of your grandmas only. Everyday you pick a person to be your favorite, and you will attach like glue. That person needs to be around you at all times; and if s/he has to go somewhere, you have to go along or you are very upset. I’m just glad that you have found such a wonderful bond with all of us!

I have been so honored to have a neurotypically forming child to watch develop over the past twelve months. I have never understood or appreciated the complexities of development as I do now. So many critical and foundational milestones are met during this first year! If, while reading this year in review, you still have questions or wonder if you child is developing along a neurotypical pathway, we would love to sit down and talk with you about your concerns.

What Should I Do When My Child is Anxious?

By: Courtney Kowalczyk, M.Ed.

Anxiety can be debilitating for many individuals, especially those affected by autism and other neurodevelopmental conditions. Last month, I shared specific symptoms and changes in behavior to consider when determining whether or not your child or student is anxious. Now that you know what to look for in relation to anxiety symptoms, the next step is to understand ways in which you can help your child or student work through and reduce that anxiety.

Individuals cope with anxiety in many different ways; and as parents and teachers, it is important for us to guide our children without exacerbating the level of anxiety the child is experiencing. The most important person in helping someone work through anxiety is you. You, as the guide, can make the difference in increasing or decreasing anxiety for your child or student just by the way that you interact with them. Here are several suggestions and ideas for you to keep in mind when your child or student becomes anxious.

• Stay calm. As a parent or teacher, it is important for you to act confidently as a guide to your child or student. If you become anxious when your child or student becomes anxious, then their anxiety level is going to continue to increase. As guides, it is our job to remain calm and composed during stressful situations. It is important for you to model for your child or student how to behave calmly and not overreact.
• Be quiet. During moments of anxiety, adults tend to cope with the stress by talking more; however, this is not helpful in relation to reducing anxiety for children, especially those with neurodevelopmental disorders. Language can take quite a bit of effort to process; and if someone is already anxious, it is going to take even longer and may exacerbate the situation. By remaining calm and using as few words as possible, you can support your child or student in a more effective manner.
• Slow down. When a child is anxious, he or she may not be able to process information as effectively as normal. For children with neurodevelopmental disorders, processing can be significantly altered when feelings of anxiety are present. It is important for you to remember that as the guide, you need to slow down everything that you are doing and saying in order to give the child time to process. If you tend to wait 5 seconds for a response during typical interactions, then wait 20 to 30 seconds during moments when anxiety is high.
• Be observant. When a child’s level of anxiety is increased, there is some reason for the mental state change. As the guide, it is your job to take a step back, look at the situation, and try to figure out what may be causing the anxiety. Is there a transition approaching? Does the child need more sensory input? If you can pinpoint the source(s) of anxiety, then you will be better equipped to help the child cope.
• Know your child or student. As individuals, we all have different forms of relaxation that we enjoy. For some it is reading a book, and for others it may be bouncing on a trampoline. Whatever the preferences are, it is important to know what strategies help your child or student to relax and calm down. This may include deep breathing, quiet time, physical activities, deep pressure, swinging, or being left alone for a period of time. These are just a few examples of different strategies that can be used with children during anxious time periods; however, it is important for you as the guide to know what will work best for him or her.

Over the past few months, we have examined what anxiety is, the symptoms of anxiety, and suggestions for helping individuals cope with anxiety. As the guide for our children and students, it is our job to recognize moments when they may be facing high levels of anxiety and then guide them through it. The way we react and guide our children or students during such times can make a big difference in their level of anxiety.

A Journey Through Infant Development: The Eleventh Month

By: Michelle VanderHeide, BSW

“I’m looking for fun and adventure! I’m looking for more!!!” As children develop on a neuro-typical pathway, they begin to look for activities to be more elaborate and exciting. The same old games become boring – it’s time for adventures and more challenges. This becomes especially true as a baby transforms from an infant to a toddler. As parents, we naturally begin to add these challenges as our children begin to show readiness. My son continues to enjoy the exciting new things of life, but one monotonous thing he loves is his grandma!

• You love your grandma! We took a vacation to Florida, and had a ball! It became extremely evident to me that you know what you want! You were attached to grandma like glue. You’d be playing nicely on the living room floor, and if grandma entered the room you’d scream and go crawling over to her (screaming the entire way). Once you were in her arms, there was no putting you down! When we returned home from Florida, you didn’t see her for nearly 3 days (eternity to you). When you saw her again, you did the same screaming approach that you did earlier – but held on even tighter! When you were sitting in your chair eating, you actually had to have her right there by you. When she waved like she was going to leave, you reached out and grabbed her arm and pulled her to you – all while shrieking. Although I’m a little jealous, I’m happy to see that you are forming a special bond with her, and that relationships are important to you.
• There’s excitement in moving While crawling is still the preferred method of movement, you notice that this isn’t the way the rest of the family gets around. If there is a couch or table to hold on to, you are walking. It shouldn’t be long before you are walking on your own. I hope it’s sooner than later, simply because crawling outdoors is hard on the clothes!
• Extreme Peek-a-boo You love playing peek-a-boo; but if I run off and hide while the blanket is over your head, you laugh even harder. The challenge of finding me is so fun, and the reward in finding me is priceless. I like this game better, too, because it gives me more exercise running from you and a bigger reward when you find me – there’s always a big laugh and gigantic hug!
• Adding humor You are so funny. You are beginning to do things intentionally to make me laugh. The other day, you and I were picking up some Easter eggs off the floor. Initially you were putting them away with me; then suddenly you grabbed one, looked at me to make sure I was watching, and then crawled away with it. You then “hid” it under the couch, looked back at me, and laughed. You thought you were so funny. It’s amazing to me how much you understand about human interaction already, and how to enhance it.

If a child has fallen off this neuro-typical path of development, these activity changes can be overwhelming. The dynamic, fast moving, adventurous life is then too much, and there is a tendency to become trapped in the monotonous way of doing things – just to feel safe! This is another reason that I love Relationship Development Intervention (RDI): nothing new was created, just slowed down enough so that what happens naturally in neuro-typically developing children can happen for those who missed it the first time. Through a very careful approach, challenges are added to every day life in a supportive and trusting environment. Because of this, kids who normally fear change, challenges, and other dynamic attributes can slowly become successful in adapting to our fast changing world. The transformations are amazing!

Building a Foundation

By: Erin Roon, MA CCC-SLP

Now that spring has arrived here in Michigan, many construction projects are once again underway.  Land is being cleared, holes are being dug, and foundations are being laid.  Each time I see a foundation being poured for a new home, school or business, it makes me think of the foundations we must lay in our own lives in order to be successful. 

For some children, solid foundations are not laid in the early years.  Reasons for this may be due to internal disregulation (ex. reflux or sensory difficulties), some type of trauma, or an environmental influence (e.g. living conditions).  Whatever the reason, trying to build upon a less than solid foundation is very difficult.  Children who are missing solid foundations will need a chance to go back and build those foundations.  That is where the concept of remediation is critical. 

Many of the children I see in my job are missing foundational pieces needed for developing long-lasting relationships and a quality of life.  For this reason, their parents have sought out a remediation program.  What we tell parents is that building a solid foundation for their child first begins with them. 

I spend a lot of time talking with parents about building the foundation that will support the rest of their remediation program.  We talk a lot about the fact that without a solid foundation, the treatment process is doomed to fail from the start.  For the consultants at Horizons, a solid foundation is built on a well established master/apprentice relationship and a commitment to experience sharing communication within the family.  Without this foundation, the house will eventually crumble.

Once parents have built their own foundations, the job of building a more solid foundation for their child doesn’t seem so daunting.  The process of laying the foundation can be done one step at a time, and with each individual child in mind.  Some children might be missing the left cornerstone, while others might be missing a piece here and a piece there.  Wherever the pieces are missing, parents can be guided to support their children in shoring up the foundation that support to a stronger structure in the long run.

I found this quote, that I think speaks to the topic of foundations in relation to remediation, and what we at Horizons are striving to achieve with the parents and families with whom we work. 

“The loftier the building, the deeper must the foundation be laid.”  (Thomas Kempis)

To me, this quote says it all.  The greater the quality of life each parent wants for their child, the more solid the foundation will need to be.  As far as I’m concerned, the sky’s the limit!  Now that spring has arrived and warmer weather is upon us and many new construction projects are springing up, it might be an excellent time for you to think about the foundation you are building for your child.  Is your foundation solid enough to support your lofty building?  If not, what can be done to firm up that foundation?  Are there things that we at Horizons can do to help you establish a firmer foundation?  Let us know how we can help!

Finding Peace

By: Nicole Beurkens, M.Ed.

As I was wandering around the Minneapolis airport recently, I found a store with a variety of posters, cards, and wall hangings with quotes and sayings on them. As I perused the options, I found one that I had to purchase and bring back to the office. Here is the quote:

Peace. It does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of those things and still be calm in your heart. (Author unknown)

This conceptualization of peace resonates with me in all aspects of my life. As a parent to four children under the age of 9, there are many times when there is noise, trouble, and hard work all at once! Yet, I am still able to be at peace, knowing that this is part of the process of parenting, and that this too shall pass. Parenting is generally far from an easy or trouble-free process, but knowing in my heart that I am doing the right things for my kids allows me to be at peace during the messiest parts of the journey.

In my life as a professional there are also many times of noise, trouble, and hard work. Yet, even in the midst of those times I am able to be at peace knowing that I am doing what I was meant to do, and that everyone involved will grow through the problems we are facing. Feeling confident about my abilities to manage and overcome the obstacles that present themselves allows me to feel at peace amidst the challenges that arise.

Life wouldn’t be very interesting if everything was quiet, trouble-free, and effortless. We may wish at times that this were the case! However, there is much growth and triumph to be gained through the more chaotic and difficult times. The problem comes when we are unable to be at peace with the process as we are living through it. When noise, trouble, and hard work fall upon us, how we perceive it and react to it makes all the difference. I find this to be especially the case when these situations come along and we feel ill-prepared or incompetent to face them. These are the times when we fail to grow and develop increased strength and perseverance through the process. The challenge is to learn how to be at peace inside ourselves, even when things around us are far from peaceful.

For parents of children with autism or other disabilities, moments of noise, trouble, and hard work come more frequently. There are inherent challenges that go along with raising a child with developmental disabilities, and these challenges can easily result in a lack of peace both internally and externally. These disabilities tend to rob parents of their sense of competence in raising their children. While parenting other children may seem intuitive and an internally-peaceful process, the challenges of a disability can make even the most self-assured parents feel unsettled.

How do we get to the point where we can appreciate the process and be at peace with it, despite all the noise, trouble, and hard work?

• It’s okay not to have all the answers Sometimes parents think they should automatically have all the answers to the issues that arise with their children. No one ever has all the answers, and we cannot live believing that we are supposed to – or that someone else does. We cannot allow a lack of definitive answers or solutions make us feel incompetent as parents. The important thing is that we don’t give up trying until we find a solution that works.
• View life with children as a process, not an endpoint We must be careful to view parenting and the development of our children as an ever-evolving process. If we continually live with the goal of “getting through” the trying times with our kids, we will be perpetually frustrated and disappointed. There will be a constant sense of “we’re not there yet,” as opposed to expecting that there will always be challenges in one way or another.
• Stop and take a deep breath Sometimes when we are facing challenges with our kids, the best thing to do in the troublesome moment is nothing at all. Many parents think that they are supposed to jump up and “do something” when problems arise with their children. Obviously this is the case if a child is going to do something to harm himself or others. However, a lot of the time the problems are not life-or-death, but we act as if they are. Taking a moment to just stop, breath, and think before you rush off to do something allows a sense of peace to prevail in otherwise un-peaceful moments.
• Seek out supports for building competence as a parent If we aren’t feeling calm in our heart despite the noise, trouble, and hard work of raising children, it is important to access support. If we find that we feel guilty not having all the answers; or we are living with a vision of our problems having an endpoint rather than being a process; or we struggle with allowing ourselves to stop and think amidst the chaos, then it’s time to reach out to someone who can help address those areas and develop a feeling of peace as a parent. This can be a family member, friend, or professional, but it must be someone who can provide insight and guidance, and create a plan for achieving peace despite the messiness of life with kids.

As we go about day-to-day life with our children, we should keep in mind that “Peace does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of those things and still be calm in your heart.” For our children to thrive, we need to be able to be peaceful in the midst of the challenges of parenthood. We should strive daily for this sense of calm in our heart.

How Do I Know if My Child is Anxious?

By: Courtney Kowalczyk, M.Ed.

When thinking about autism and all that is involved with it and other similar neurodevelopmental disorders, we sometimes overlook the possibility of co-occurring conditions like anxiety. All too often I hear responses about a child’s odd behaviors in relation to him or her “being naughty,” or that “it is just his or her autism”; but, in many instances, that is not the case. Anxiety is a complex disorder that can manifest itself in many different ways, especially in children and adults affected by autism and other neurodevelopmental disorders. My goal over the next couple of months is to share with you information related to anxiety, and how you can help your child or student who may be affected by it.

Neurotypical individuals affected by anxiety on a day to day basis have varying symptoms. We often see individuals who perspire or use avoidance techniques to escape or withdraw from what makes them anxious, like social settings and large events. Others deal with their anxiety in different ways, and can become excessively chatty or extremely quiet. Whether it be withdrawing, perspiration, or becoming excessively talkative, many individuals are able to cope somewhat with their anxiety. Children and adults with neurodevelopmental disorders also have ways of expressing their anxiety and attempting to cope with it. When thinking about your child or student, here are a few ways that they may express their anxiety:

• Increased self-stimulatory behaviors. Many individuals affected by autism and other neurological disorders will use self-stimulatory behaviors like rocking, flapping, hand flicking, and talking to themselves from time to time. Self-stimulatory behaviors are often static in nature, and are used by individuals to avoid situations that are too difficult for them to process and understand, as well as to deal with anxiety. When you see an individual begin using self-stimulatory behaviors or an increase in the behavior intensity, it may be helpful to ask yourself if this person is anxious and why.
• Odd intensity of verbalizations. Most individuals within society today use talking as a way to deal with anxiety. Individuals with neurodevelopmental disorders who have the ability to express themselves verbally often use talking as a way of dealing with anxiety, too. When you notice a drastic increase or decrease in communication, or an individual talking about odd sorts of things for a lengthy period of time, it may be a good indication that the individual is anxious.
• Acting out behaviors. When thinking about behaviors, it is important to look at “why” the behavior is occurring instead of just examining what the behavior is. When individuals with neurodevelopmental disorders become increasingly anxious internally, they often attempt to find ways to decrease their anxiety externally. A good analogy is to think about a pot of water that you are heating to the boiling point on the stove. An individual becoming increasingly more anxious is like the water getting hotter; and we are going to start to see things happening externally as well like increased talking, perspiration, and agitation that are like the bubbles in the heated water. At some point, the individual can no longer handle the level of anxiety that they are feeling, and thus acting out behaviors occur. We would consider this to be the “boiling point.” If you can examine your child or student’s behaviors and begin to notice when they are feeling anxious, you can often prevent the “boiling point” from happening by helping the individual reduce his or her anxiety.
• A need for control. Individuals affected by autism and other neurodevelopmental disorders often attempt to control the actions of others as well as materials in their surrounding environments. When we see an increase in the need for control, it may be a good indicator that the individual has become anxious. Is there a change coming up of which they are fearful? What other sorts of things in the environment could be causing the anxiety?

When examining the behaviors and actions of individuals affected by autism and other neurodevelopmental disorders, it is important to examine whether or not the individual is affected by co-occurring conditions as well. All too often, we come across individuals who are affected by co-occurring anxiety issues that go undiagnosed. By examining the behaviors and actions of our children and students, we may find that the acting out behaviors are not because of his or her autism or neurodevelopmental disorder, but rather because the individual is extremely anxious and has reached the “boiling point.”

A Journey Through Infant Development: The Tenth Month

By: Michelle VanderHeide, BSW

Curiosity is something that is developed very early in life and becomes very evident once a child starts to move. Although it can be very annoying to pull babies out of cupboards, dishwashers, refrigerators and toilets, curiosity is an extremely important foundation to a child’s neurotypical development. Curiosity allows discoveries – it offers children those “ah ha” moments in life. If a child doesn’t explore his/her environment ¬– in safe circumstances only of course – the opportunity to make discoveries is lost!

• I can’t seem to get anything done while you are awake! Anytime I try to work in the kitchen, you are immediately into what I’m doing. I open the refrigerator, and there you are pulling something out of the door. I try to prepare food, and you empty every cupboard. I empty the dishwasher, and YIKES – you’re going for a sharp knife!
• You’re not only into my stuff all the time, but your sisters’ as well. If they are doing a puzzle, you sit on it. If they are playing in their room, it isn’t long before I hear, “Mom!!!!” We all love you, but your sisters have appropriately changed your name from little brother to little bother.
• Balls are so intriguing! If there is a ball or anything that resembles a ball, you crawl quickly to it. Once you pass it to me, you’ll look right at me and throw your arms in the air and scream. It’s so fun! If there isn’t anybody available to play, you’ll accept that and play catch with yourself. You’ll throw it; go and get it; and then throw it again. It keeps you busy for a long time! That lasted for about a week, and now you’re onto new things. You get bored easily.
• Brushing teeth is a very interesting event as well. Dad will hold you while he brushes his teeth, and gives you a toothbrush as well. You’ll look at him so intently while he brushes, and then put your toothbrush in your mouth. You think you are so cool brushing your teeth like dad. The look of accomplishment on your face is priceless.
• You are really getting into playing games, and find it so funny when the game changes. I handed you the top to a jar, and you handed it right back. I handed it to you, and you handed it right back (much like how we play ball). I then put it on your knee. You thought that was so funny, you grabbed it and handed it back. I put it on my knee, and the game continued. When I put it on my head, you got up, grabbed it, and tried to put it on your head – all while cracking up.
• I can no longer leave the room without you getting upset. It seems as though separation anxiety has kicked in. It’s very apparent that your awareness of your surroundings has gotten much better!
• You are beginning to cruise around now. Your crawling has gotten faster, and you can pull yourself up to stand with ease. It allows you to feed your curiosity about what’s going on in the rest of the world, and you love it! Now that you can do that much, let’s just get to walking.

If your child is always fixated on one thing when entering an environment, s/he is being robbed of making daily discoveries: How does my mom greet people? Do I greet grandma the same way I greet a cashier? How am I supposed to act in a gym as opposed to church? These sorts of skills are often taught if a child lacks it; but when not discovered in a natural environment, these skills can look very awkward or be inappropriate in different settings! Even in a gym, the expectation of how we’d behave changes according to what is happening in the gym. We are constantly appraising our surroundings to determine the appropriate way to act. Through the use of RDI strategies, these discoveries can be made for a child who wouldn’t otherwise make them on his/her own. Give us a call if you want to know how!

Optimism versus Pessimism

By: Erin Roon, MA CCC-SLP

Is Your Glass Half Full or Half Empty?

Are you a glass half full or a glass half empty kind of person? Does it really make a difference? I think it makes a huge difference in your overall functioning, and the quality of your life.

Optimism can lead to accomplishment. If you think something is possible, you will generally work harder to achieve it. Believing in the positive allows you to feel good about life in general. Being optimistic can lead to an overall mood of happiness, and enjoyment in life. While most optimists understand that not everything works out as planned, they recognize that some good can come from the unexpected.

Pessimism can lead to defeat and despair. When you are doubtful that things will happen or be accomplished, you tend not to try as hard – which then leads to failure. Approaching everyday tasks with a negative attitude quickly leads to a negative outlook on life.

I see optimism in the faces of those with whom I work each day. I think it is this positive upbeat attitude that allows us to be productive and love the work we do with families. Oh, we feel frustrated and concerned from time to time; but we have been in this profession long enough to know that if we just stay positive and wait it out, we will either find a solution or the difficulty will pass. I truly believe that our optimistic attitude is what provides us with our sense of fulfillment, and improves our overall quality of life.

Unfortunately, I encounter many pessimistic people in a variety of settings. It may be that some of those people are just having a bad day; but so often it is a way of life for people. We can become pessimistic about things we have no control over – like the economy and the weather. We do not have control of either; but we can determine what it is about those two things that we do have control over, and take action there. I can manage my own finances, for example, and make sure that I am spending within my means. I can also make sure that I am putting money aside in the event that something unexpected happens. In terms of the weather, I cannot control the temperature or even precipitation; but I can decide how I will dress each day based on what is happening outside. If I spend all of my time focusing on and worrying about all of the things that I cannot change and do not have control over, I create an even bleaker picture; and other parts of my life begin to suffer.

We all have moments of optimism and pessimism; what it comes down to is how the scale is tipped. Is your cup half full or half empty? If you feel that you are more of a pessimist than an optimist, are you able to pin point ways you could make a change? Whether you are feeling pessimistic about many things or even just a few, try the steps below to see if you can tip the scales back in the favor of optimism.

• Make a list of all the things that you are concerned or worried about.
• Determine which of the things on your list you have control over. Cross out the items that are truthfully out of your control.
• Of the remaining items, take some time to think about what you can do to change those situations.
• Choose one or two items from the list, and begin working to improve those situations.
• Take some time every so often to reflect back on your list. Have you been able to make some changes? Are you feeling more optimistic about the items that are left? Are you ready to begin working on another item?

Taking it one step at a time, taking charge of the things you can control, and making changes can lead to a more optimistic attitude. Often times we try to take on too much at one time, which leads to failure and more pessimism. Taking it slow, and working only on the things that we have control over, brings success that leads to more optimism and a willingness to keep moving forward.

I am thankful for the many things I have, and am hopeful that the problems of today will no longer be problems tomorrow. As I sit here gazing out the window at the beautiful sunshine and lack of snow, I am hopeful that this is a sign that spring is just around the corner. It is with this optimism that I can tolerate the endless cold weather that seems to have plagued Michigan for longer than usual this year. It is this optimism that improves my mood, and gives me the hope that strengthens my overall quality of life.

Are you a glass half full or a glass half empty type of person? To find out more about how optimism can propel you forward and improve your overall quality of life, please visit our website at www.horizonsdrc.com.

Prioritizing Needs and Treatment for Children with Autism

By: Nicole Beurkens, M.Ed.

I recently had a parent refer to the many needs of her daughter in this way: “It’s like there are three floors of the house burning! Where do we start and which level do we fight the fire on first?” This provides an excellent visual metaphor for determining priorities in treatment.

When a child has autism, or another neurodevelopmental disorder, there are many areas of need to consider. The pervasive nature of the diagnosis leaves little unscathed in terms of development and functioning. The extent to which each area of functioning is impacted varies, but it’s safe to say that all children on the spectrum are affected by their autism in numerous areas. There are communication problems, social interaction problems, restricted behaviors, rigid thinking, and other issues that come from having the core deficits of autism. Then, for many kids on the spectrum, there are the co-occurring problems to address such as impulsivity, feeding problems, sensory processing problems, motor deficits, academic problems, and more. The list can go on and on depending on the child and it can, indeed, feel like all three floors of the house are burning.

Once you have carefully and thoroughly identified the conditions and areas of functioning that require treatment, the question becomes what to treat, when to treat it, and how to treat it. The pervasive nature of these disorders is the equivalent of a house that burning from a fire that started in the foundation. There are a few options to consider when making these decisions:

• If all three floors are burning, there may be a tendency to decide to try to throw a lot of water on everything in an effort to put the entire fire out at once. I have seen parents do this and the result is generally unfortunate for everyone involved. Parents can become completely overwhelmed trying to address everything at once; comprehending multiple therapies, driving to get to therapies, having many people in your home, paying for services, and trying to stay emotionally stable in the midst of it all. Trying to treat everything at once can lead to burned out parents and burned out kids. It can also lead to the house burning down, because by throwing water at the whole fire at once you will not be able to concentrate enough in one area to make a real dent in the fire. You might keep the fire from spreading, and you might reduce the flames a little on each level, but the fire itself will keep on burning on every level.
• One could also decide to concentrate water on the area that seems to be the most obvious – the top of the house where the flames are shooting out. This can be thought of as the approach of treating the most obvious problems first – my child isn’t talking, doesn’t look at me, doesn’t know how to make friends, and/or doesn’t behave normally; so we’re going to treat those things right away. That seems like a logical plan on the surface, but the problem is that it is the equivalent of putting out the fire from the top floor first. You might save the top floor, but there is no foundation to hold it up. What you end up with is part of a house that is salvaged, but can’t support itself. This is what happens when we choose a skill-based approach to treatment that does not focus on core developmental issues that need to be addressed.
• A third approach is to concentrate efforts on the base of the house first by putting out the fire there, and then working your way up to the higher levels of the house. This approach is the equivalent of working on the foundational developmental skills, abilities, and milestones that must be achieved in order for a child to make long-term developmental progress. It can be a difficult choice to make because it feels like the things that are most obvious are not being treated right away. It can feel like too much of the fire is allowed to burn while efforts are concentrated on one area at the base. However, this is the choice that must be made for long-term gain. It is in focusing on the core deficit areas of autism in developmentally appropriate and specifically targeted ways that we move forward.

As parents and professionals we have to recognize that there is only so much “water” to go around – only so many hours in the day, energy to expend, knowledge that can be absorbed, money that can be spent; the list goes on. We need to consider the idea that it is not necessarily about getting more water, it is about how that water is used. It is about:

• Understanding exactly what needs to be treated and prioritizing those needs so that a treatment plan is developed to work in everyone’s best interest, without extending beyond resources that are not there.
• Understanding that by treating foundational developmental issues, many other problems begin to fall away. By taking a bottom-up approach we address areas of development that snowball and create change across the board in the way a child thinks, communicates, and behaves.
• Prioritizing family health above all else. We must recognize that if the needs of everyone in the family unit are sacrificed in the name of doing “more” to treat autism, then in the end everything can be lost.
• Knowing how to make the most of the time, energy, and finances you can in targeting the core issues of the child’s disability.
• Refusing to run around trying anything and everything; making yourself, your child, and everyone around you irritable, tired, frustrated, and financially drained in the process.

Think about how you are prioritizing the needs of your child. Are you able to rest assured that you are targeting what needs to be targeted for now, and that everything else needs to be left for later? Do you have a strategy that is allowing you to put out the fire from the source instead of blindly aiming water at the obvious flames? Do you have a good balance in your family where autism is one part of what you focus on as a family, and not the thing that takes up everyone’s time, energy, and finances? These issues are critical to consider when initially making treatment decisions, and must be revisited frequently along the journey of providing for the needs of your child and family.

Spring Break is Back

By: Courtney Kowalczyk, M.Ed.

The weather is warming up here in Michigan, and it is hard to believe that spring break is right around the corner. Spring time can be a season of change for many children, and it is important to try and maintain some consistency and routine. Whether you are going away for spring break or staying home, here are a few fun ideas to help you and your family maintain consistency as well as to enjoy the time off.

• Set up an indoor treasure hunt. We all know that the weather during the spring season can be somewhat unpredictable, which means that you may find yourselves stuck indoors whether you are at home or on vacation. Wherever you are, you and your family can have a great time with an indoor treasure hunt. Each family member can take turns hiding their own personal items, and giving clues to the other family members about where the “treasures” are hiding.
• Camp out! Whether you sleep on the floor in your living room or outside in a tent, camping out can be fun for everyone. You can set up your own campsite indoors or outside with a tent, sleeping bags, and snacks. As a family, you could sit around a real or pretend fire and take turns telling stories to one another. You can even make smores over a fire or in the microwave.
• Do some spring cleaning! We all could take a day or two to get ourselves and our households organized and thoroughly cleaned. Here are several spring cleaning ideas that may help you and your family get organized: clean the refrigerator, organize the junk drawer, put away winter gear and bring out the spring clothes, wash your window coverings, dust your ceiling fans, change the batteries in your smoke detector, dust your light fixtures, clean out your flower beds, organize your garage, and rake your yard.
• Write your family story. Each year, families grow, change, and make new discoveries. Spring break is a great time to either start or continue writing your family story. You can do this by keeping a photo album with pictures and comments to which each member contributes, or you can use many of the new photo book computer programs that are available online. It is so neat to look back at previous years to see how family members have grown or changed, as well as to see the fun adventures that your family had together.

Besides planning fun activities to do together, it is also important to keep in mind the importance of consistency and routine during this vacation time. Even though you are on vacation, it will be helpful to try and keep similar wake, sleep, and meal time routines. You may also want to consider planning only one or two activities for you and your family to do each day. If you try to pack too many things in, spring break can become stressful for everyone instead of restful.

By using the activities and ideas listed above, you and your family can make plans together to enjoy the spring break vacation!