TBL Newsletter – October 12, 2020
Here are a handful of great ideas for pediatric therapy, business and life:
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JASPER: JOINT ATTENTION, SYMBOLIC PLAY AND ENGAGEMENT REGULATION
Dr. Connie Kasari is one of the world’s leading experts in the diagnosis and treatment of autism. She runs the Kasari Lab at the University of California, Los Angeles, where she has developed a method of intensive treatment that combines the principles of DIR/Floortime with the principles of traditional behavioral therapy.
The JASPER approach (Joint Attention, Symbolic Play and Engagement Regulation) seeks to improve the core deficits of autism: the lack of joint attention, engagement and symbolic play skills.
If you’ve had any training in DIR or with the STAR Institute, this approach will feel very familiar. The treatment sessions tend to focus on the following:
- Matching the therapist’s language and pacing to the child’s language capacities
- Adjusting play routines based on the child’s interests
- Improving pretend play and symbolic thinking through modeling and imitation
- Respecting the child’s individual differences and preferences
- Developing the child’s ability to take the initiative in communication and play
“These sessions utilize a naturalistic play setting with a balance of structure and flexibility. There is flexibility in that the adult is continually following the child’s lead, playing with toys that appeal to the child, shifting attention as needed, and imitating language and play acts. But there is also structure and support in that the adult must frequently rearrange and adjust the child’s environment to promote engagement.”
Her research outcomes are compelling. Children who received the JASPER treatment intervention made improvements in joint attention and symbolic play skills, and demonstrated more progress with other concurrent therapies (ABA, OT, Speech) than children who did not receive the JASPER treatment intervention.
POST-IT NOTES AND SPATIAL ORGANIZING
I am a post-it note hoarder. It’s an obsession. I cannot leave a store without visiting the office supply section to load up on more post-it notes.
This is really odd for me, because my whole life is digital. I’ve even transferred all of my notebooks and journals to GoodNotes on my iPad Pro. I have no real use for post-it notes.
Spatial Organizing is a technique developed by Dan Shipper of Superorganizers for organizing thoughts and ideas into something cohesive. I love the approach because 1) it relies on your intuition and 2) it requires post-it notes.
Let’s say you’re trying to write a book. You would write each topic for the book on a post-it note. You would then begin to move the notes around, grouping each note with other notes that “felt” like they might go together.
You take your overanalyzing brain out of the mix and just let your intuition direct the organization of your ideas. There are no right or wrong answers. The themes and patterns emerge through moving around your post-it note stacks.
The act of moving the post-it notes around actually helps you to think through how your ideas could fit together and lets you visualize what they would look like if they were grouped together.
It’s the kind of tangible, multi-sensory experience that typing just can’t replicate.
I think this strategy could work really well for group therapy sessions with older children.
Group sessions often involve having the kids come up with a plan for the day and figuring out how to logically implement their ideas.
Instead of being stuck around a whiteboard, you could hand out some post-it notes and have the group move the notes around themselves to plan the session. Anything that promotes active thinking is a win in my book.
You can listen to the podcast about spatial organizing here (it’s a short one).
NO THERAPY FOR KIDS IN THE HOSPITAL
If you’ve ever worked in the rehab department of a hospital you know that it’s rare for an adult patient to be admitted without getting an OT or PT evaluation.
It turns out that doesn’t really happen for children who are hospitalized.
“…a multicenter study led by researchers at Johns Hopkins Medicine shows that 65% of the PICU patients examined did not get physical or occupational therapy, or adequate opportunities to be mobile, while hospitalized during the study period.”
There’s widespread news coverage about the toll that quarantining takes on a child’s development, but we never hear about how hospitalized children are dealing with even greater developmental deprivations.
What if every child in the PICU got an automatic OT evaluation the same way adult inpatients do? It seems like a no-brainer for the prevention and remediation of motor, social and cognitive issues.
“Despite the evidence that early rehabilitative therapy and mobility provide benefits to adults in ICUs, and despite the fact that it is known to be safe and reliable for children, our findings reveal that patients in PICUs are not getting the rehabilitative care they need.”
That sounds like outright medical malpractice and a fantastic opportunity for OT.
You can read the article here.
SOMETHING TO THINK ABOUT
“When children’s problem behavior persists despite rules and consequences, it often means that they do not have the skills to cope with challenging situations. We must either change those situations or teach better coping skills.”
REFLECTIVE PRACTICE QUESTION
How do you feel about your career? Do you have 2 minutes to answer our anonymous, 2-question, job satisfaction survey? We will be sharing the results of our survey with our subscribers once the survey period is closed.
Have a great week!
Ashley King, MSR, OTR/L
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P.P.S. Animals like to play, too