Developmental Basics & Autism

Show Description:

Join Lynette and Rich as they explore an intervention model for Autism called The S.U.C.C.E.S.S. Approach (SM). The model is designed to help you understand, respond, and help those in your world who live a life with Autism. Our goal is to help expand your thinking to better serve these amazing people, and to support you in your daily struggles and celebrations.  In this episode we discuss developmental basics as it affects those on the spectrum. We discuss being intentional in forming your plan for development and your team in knowing where your child is as an individual and forming a plan for SUCCESS.

If you or someone you know could benefit from the full training for The S.U.C.C.E.S.S. Approach (SM), you can take the course online.  Just go to https://www.thesuccessapproach.org/online-course for registration and other details.

As heard on the podcast:

B-Buzz Baseball: https://www.bbuzzbaseball.org/

About Jean Ayres: https://www.britannica.com/biography/Anna-Jean-Ayres

The S.U.C.C.E.S.S. Approach is a registered Service Mark protected under intellectual property law unless otherwise specified, all music, audio visual, and proprietary content shared in this podcast is property of AWEtism Productions, LLC and it’s sister agency Integrations Treatment Center. The use of this content is unlawful without the expressed written consent of the proprietor.

Transcript

Connect with Success Podcast - Episode 8, Launch Date: June 23, 2021

With Dr. Rich Smith and Dr. Lynette Scotese-Wojtila
Guest: Ellen Winney

Subject: Developmental Sequence

Want to help your child and your whole family using The SUCCESS Approach? Check out our online course: https://www.thesuccessapproach.org/online-course

Welcome to Connect with Success with Dr. Lynette Scotese-Wojtila where we help connect you with knowledge. Our mission is to lead you to a new and exciting way of understanding, responding to and helping all those with autism. We hope to expand your thinking about how to best serve these amazing people and how to support you in your daily struggles and celebrations.

 Welcome everyone to the eighth episode of CONNECT with SUCCESS podcast, built around The S.U.C.C.E.S.S. Approach (SM), and the person who coined it, Dr. Lynette Scotese-Wojtila. In Episode Seven, we introduced the next foundational application of The S.U.C.C.E.S.S. Approach (SM) which was built around socialization in autism, and in this episode we're going to build on this discussion by adding developmental basics to our talk as part of The S.U.C.C.E.S.S. Approach (SM). Let's take a moment before we jump in to talk with Dr. Lynette about today's term for the show.
 
 Dr. Scotese-Wojtila
 

Today's term is developmental sequence. Developmental sequence is basically a concept that all professionals who serve children are trained to know and should be operating under. And what it means, though, is that skill acquisition happens in sort of a step-by-step fashion. So we might consider it sort of like a linear process. And a quick example would be, we absolutely would expect a child to be able to sit before they could run. And that seems obvious to us as we think about the sequence of skill development, but it becomes a challenge, and we're going to talk today about how that challenge manifests for kids with autism, when we're not really solid on the developmental sequence, and we might accidentally expect a child to be able to perform a particular skill before they're really ready developmentally. 

Dr. Smith

Wow, so we've got some steps to take then for this episode. And we're going to introduce in just a moment here, back to the show is Ellen Winney, so hold on one moment, we'll get right to the message. 
 
 Welcome back to the message, and I'm very fortunate again to have in the studio with me not just Dr. Lynette Scotese-Wojtila, but Ellen Winney, who I consider a master teacher in developmental model, and so we're so excited to have you back Ellen.

Ellen Winney
 
 Thank you so much for having me back. It's good to be here. 
 
 

Dr. Smith

So tell us a little bit more about developmental model and the sequencing of events.

Ellen Winney

Well as Dr. Lynette said a developmental model is something that all professionals should be trained in and really anybody who took a human development class in college. It should be a concept that is familiar. And it’s the idea that the brain development dictates our skill development, and things should happen in a step-by-step process. And so if we look at many different areas, whether it be, as Lynette said, physical motor development or fine motor development, social development, cognition.  All of those skills within there, happen in a very linear fashion, in neuro typical development. And so, it's a concept though, that we might lose sight of a little bit even when there are typical children, that also becomes more complicated when we add in the autism, and some of the challenges that are experienced there.

Dr. Smith

So this is another situation where in the last two episodes we talked about this as a normal process for everyone. We all go through this. It just might look different for those on the spectrum.

Ellen Winney

Absolutely, and our goal when we're treating from The S.U.C.C.E.S.S. Approach (SM) is to honor that developmental sequence because it's a neuro developmental model it's right in, in the wording of it. We are going to honor the natural, normal development that the human brain goes through even when there is a diagnosis. We're still going to honor that, because that's how we're designed to work.

Dr. Smith

So how would you say if affects those who are trying to develop, and in general, just walk us through an example of what that might be.

Ellen Winney

So for example, if we are to look at handwriting skill development (as an OT, it's kind of in my bag to be very familiar with it). There's a very typical developmental sequence that a child needs to go through before they're ready to actually write their letters, and so they need to first be able to imitate a vertical line and then a horizontal line that a circle, a diagonal line, square, triangle x, and then they need to be able to copy that where you show them a picture of it and they will be able to do that. 

 All of that should be acquired before we would ever have the expectation that they would be able to write their letters, and then even within that capital letters would come before lowercase letters. Unfortunately we've lost sight of that. A lot of times and hand writing is a skill that's not always taught anymore and so a child gets plopped into a kindergarten classroom, and it's “journal time” first thing in the morning and they've never been properly taught their letter formation, and we get all kinds of interesting variations and or kids that are getting referred for services because their handwriting is atrocious when they've never actually been, you know, checked to see “Do they even have the developmental skills” 

But I'll tell you, a lot of times those children don't have those skills until five or six, and that's just the way we were designed; and yet even now in preschool, in the name of kindergarten readiness, we're expecting, you know, three and four year olds to be able to write their first and last name proper case. And so that's where we can kind of see some of these issues come up that if we don't honor developmental sequence, we not only frustrate the child and set them up for failure; but we put unfair expectations on them, we frustrate ourselves, and we really kind of get in our own way of really helping the child to succeed. 

Dr. Smith

For those who struggle with it, the developmental sequence, who are on the spectrum. What else, how else would that manifest?

Ellen W

So interestingly for our kids that are on the spectrum, they oftentimes develop what we call Splinter skills, where it almost seems like they skip part of the developmental process and they get like this really higher level skill that emerges; but they don't have the foundational skills below it to support it. And so there's not a lot of real meaning and function around it.
 
 So, for example, our kids, as you guys talked about information processing because of their episodic learning style, they're fantastic at memorizing rote facts. So a child could, you know be four years old and know all their timetables and to be able to say, you know, two times two is four. Two times three is six, two times four is eight. And we believe, “Wow they're a math genius! They know all their math facts,” -- but they don't understand the concept that two times four means you have two sets of four items each and able to know [understand] what does that actually mean. And so then we're like well you know, we can just put them in third grade math because clearly they know their multiplication facts but they don't actually have that deep learning occurring, and that foundational skills to build on.

Dr. Smith

They are missing that connection of what that actually means. It is not so much the math facts per se but how that is derived. 
 
 

Dr. Scotese-Wojtila

And because of that, our kids on the autism spectrum in particular, are “foolers.” They're not trying to fool us, but they end up misleading us if we don't ask the right questions and if we're not the just-right kind of detective to see what really is in their brain in terms of knowledge and deep understanding of a concept, we can be fooled. And it's not a good outcome. It's a disservice to a child to assume, or wrongly infer, that they have the capacity to be at a higher level math, when they really don't understand that numbers represent things, and quantity is just that – it can be abstract – and our kids struggle with abstraction, we know that.

Dr. Smith

Absolutely. And then you later on in math, you’re throwing in variables into the situation. How do you rectify a variable that looks like a letter, and correlate it to a number to someone who doesn't understand how to put those sets together.

Dr. Scotese-Wojtila

So, as Ellen is talking about some of the struggles that our kids face in terms of developmental sequence. And let's say the hand, not being ready so to speak, she's very much talking about, and we know it's a tease, about a kind of readiness that's almost mechanical. Like is the hand ready to perform this kind of grasp to imitate this kind of stroke, and are the eyes, working with the hands to do all that.

And I want to point out the term readiness, because in Episode two, to talk about readiness sort of like, a moment-to-moment sort of thing. Readiness to mobilize to make contact with something. Or a readiness to take in information, that kind of moment-to-moment brain readiness; but this is skill readiness, and one of the things that we've run into, whether it's a parent, a teacher, or really anybody who's trying to serve a child and help them, they want the child to do something that is standard and appropriate for their age, like cutting. And so they may want to work on cutting in school, and what they may not be thinking about is the child's readiness developmentally to do that well, not so much from the hand perspective, but from the cognitive perspective.

So what that means, is in order to know what to do with scissors, and to use the scissors properly, you need cognitive skills and motor skills. A little bit of visual motor skills too as you know, but what happens for our kids: if a teacher, or a grandparent, or a daddy, or a therapist or anybody puts scissors in the hands of the kid, let's say is five year old body, or even a six year old body, which clearly by six a child should be able to cut right, and they don't understand tool usage, or what it's for, that child could accidentally cut anything. Like a wire, or someone’s hair, like their skin. And so, they're exploring so to speak, because we're giving them access, but we might only be giving them access because we want them to develop or show a skill that they're not quite ready for.

Dr. Smith

Let's take a trip back for a second too because, as you mentioned, that's another gross motor situation, that they might not be prepared for because developmentally they are just not there. So, I can just speak from experience with looking at my own child’s development. You feel a little less than parent-wise because you feel like you’ve done something wrong in not preparing them for that level, or for that gross motor skill... or it could just be something that’s out of their control.

 Dr. Scotese-Wojtila

Fine motor skills, specifically, because it’s scissors, as opposed to gross motor, bigger movements, walking and running, that sort of thing. But, same kind of thing, let's put it in gross motor terms because that's really a good segue, Dr. Smith. We are talking about kids who might be the last child picked for the soccer team. Right? And it's because their gross motor skills aren’t so developed. And so we have parents who understandably and teachers and staff want these kids to be involved with some of those extracurricular activities, or something social, especially in the summer right. But what we're doing is almost setting a child up to fail if the focus is “go perform this gross motor skill, just like everybody else, run the bases, just like everybody else; hit the ball just like everybody else. And when I say “everybody else” maybe there's variations: mediocre, really great, not so great, whatever. But if they are already disadvantaged motorically, it almost sets them up to not perform like their peers. And so you have to ask yourself a question: if I want my child to be involved in a program like that, soccer, baseball, what is my expectation of that? Is it social? Great! Do they actually need to play baseball for it to be social? Maybe, maybe not, depending on the league or the parent or the child or the team. Maybe they can be the water person, or the treat distributor or the mascot. Like, if your goal is socialization, then that's a different reason to enlist in that kind of activity or group.

Dr. Smith

And that takes us all the way back to Episode 1. Because if that is your goal, then you need to set up the team in order to help provide the services necessary.

 Dr. Scotese-Wojtila
 
 And that's, that’s exactly right. So let me talk a little bit about an amazing program called Be Buzz Baseball. My amazing friend, in one of the fields, is just this mastermind behind this program. And it's basically a youth baseball organization. And it’s all volunteers. It’s so wonderful. About four years ago, a wonderful person came to me and said, “You know, we're trying to provide this baseball playing opportunity, and read the history of the game, and the love of the game, the camaraderie and the community and all this wonderful developmental things that it can do to these kids that otherwise probably wouldn’t have a lot of social outlets or easily available social outlets available. And we have one who has special needs, and how can we include them? and I was so grateful to Wendell his infinite wisdom for eliciting our support because, through that we were able to help the mom and the child, send their staff to those, some of those games and such, and we worked with the child, a little bit outside of that, to understand things like “how to run the bases” and why that is part of the game and what it means to run the bases. So we almost took it a part in baby stepped it, kind of like the skill acquisitions in developmental sequence. Baby step it. Understand how little pieces and parts of the game of baseball come together for the whole thing of baseball. 
 
But the point I want to make is what you talked about in our first episode -- of this transdisciplinary team --this collaborative process. Wendell knew to come to us as specialists and brought the Mom to us so we could have a hand in shaping the child’s success. Because otherwise, I think they would have inadvertently set him up to fail. And who wouldn't? If you don't know, how that child processes best based on their condition, or their autism, or their special need, then you're almost providing an opportunity without that kind of support to see that. 
 
So thank you to Wendell and his amzing Bee Buzz Baseball. Shout out: great program and it runs every yea. It’s great and available for many folks for people around the Cleveland area.

Dr. Smith
 
 We will put information right in the show notes.
 
 So we've talked about, individuals and their struggles with developmental sequence, but are their types or different variations of developmental sequence, and how does that play out in coaching someone?,

 
 Ellen Winney
 
 Absolutely, you know if you think of really any type of skill acquisition, there's a developmental sequence that goes along with it. And I want to tie back, a little bit, something we talked about the last time I was here when we talked about sensory processing and that being the thing that underscores, every aspect of life. It’s the foundational skill for everything.

So when we see a child, as so many on the spectrum are, that have apparent sensory processing, we can expect that they're going to have impaired development across many domains, so it may be as we talked about then, you know, some of their motor skill development or their social development, really you know, their activities of daily living, their feeding, their toileting -- all of that -- each of those areas has its own kind of developmental sequence; and when we have impaired sensory functioning, they're going to have hiccups along the way.

And so our job as interventionists, and as parents, and everything, is to look and say what is normal skill development, what is the normal developmental sequence that if my child didn't have a diagnosis, what they would be going through? And where are the holes, you know, our kids sometimes a very Swiss cheesy, where they are, you know, they get some of these splinter skills, or rote skills, or whatever, but we have to go back and look and say, yes, we use the example of math, they know their math facts in terms of multiplication, but they don't have one-to-one correspondence where they know that if I have one physical item in front of me, then one is number, the verbal one; two is two. When we have actual physical objects in there and so we can really look at any area of life that you would expect a typical child to be developing and say, “Where should they be progressing and where is their foundational holes?” With kids, where we really need to focus on is “play.”

Dr. Jean Ayres, who is the founder of sensory integration theory talks about play being a child's work. Like that is where a child should be learning their motor skills, their social skills, their cognition, and I do think we've lost that, not just in the field of autism, but really in just our society in general for children. Not truly understanding the importance of play for skill acquisition, but particularly if they're kids on the spectrum we really need to be looking at that -- and that's where our treatment needs to lie is in play because it's where we can get all the other skills in.

Dr. Smith
Yes, there's a resurgence in education right now because we've seen trends over the last couple of years where they're just killing the idea of recess. And just being able to cope with some of those social skills there, but then how that play relates to practice, and then later on, as they get older, that relatability of what you’re learning, coming back to doing.


And so we're starting to see that coming back in education, because for so long, the questions we are seeing that research come back to how important play is.

Ellen Winney
Yeah, absolutely, there needs to be a focus on, and not only with recess being taken away and what that does from a sensory perspective for our kids, in terms of getting them to a place of readiness, they need the sensory experiences to be able to be ready to sit and attend in a classroom.

I would say to the introduction of screens to our kids, you know how many kids are spending more time on an iPad or playing a video game than outside climbing on playground equipment or digging in the dirt, or you know, playing kickball with the neighborhood friends, and the impact that that's having across the board. And you know, of course this past year has done us no favors in that some of the developmental sequences of their kids are going to have some holes that as a general society, autism or not aside, we are going back to address -- the social development of our toddlers, who have spent a year only seeing people behind masks and the importance of the facial recognition and facial expressions and social development. There's definitely going to be work to do and it starts by acknowledging that there are developmental sequences, that there is a role in neuro development in human formation.

Dr. Scotese-Wojtila

That’s right. And I think parents should not put the burden on themselves. Should be accountable to know all of that. It's okay to recognize that a sequence exists or that development is linear, skill acquisition is linear; but that's where the professionals, like occupational therapists come in, and other professions that know the developmental evolution of how children develop. And parents need to rely on that knowledge, and work within that understanding, applicable to their child. They don’t need to become developmental specialists for the world; they need to understand their child and the trajectory their child is on. And then follow the advice of the professionals and try to fill those holes in the foundation. She's absolutely right.  In my course, and over the years, just as speakers in different places, where we have presented, we often talk about Swiss cheese: they are solid in some areas, but they are holey in others. And another analogy that we have used for parents out there and teachers can relate to -- it's like having a foundation of a house -- if there's a holey foundation, or some boards that are weak, or something that is not quite nailed or glued together properly, you're not going to have a secure first, second, third, or fourth floor.

And so we want to make sure that we are developmentally approaching the child, seeing where the holes are in their foundation. Finding the “just right” cement or glue or nails, if you will, to make that foundation solid. And then systematically, build one layer after the other. And that's going to help the child become the best version of themselves. This house will be the best, most solid version of the house that can be when we're sort of done with the development process.

Dr. Scotese-Wojtila
I think adding on to, going back to what I've talked about, the scaffolding approach-- it's okay to double back, if the first approach doesn't work as well as you want it to. Let's take a step back and see how we approach this.

Dr. Scotese-Wojtila
And sometimes, you know, the best of the best out there in terms of professionals, they only know what they know. You know, if you go to a special ed person, they're going to know how academics and cognition evolves. If you go to an occupational therapist, they may know how the nervous system and sensory systems, and motor systems, work together and cognition because we get a little bit of everything together in OT. If you work with a PT, they are certainly going to know the motor system well. So all we know is what our disciplines teach us. It is this trans-disciplinary, cross-training, role releasing of many different professional perspectives that helps us be whole in our approach and comprehensive in our approach to assessing for and caring for children.

 Ellen Winney

And the key to all of that is the parent. They are the glue that holds it all together because while they may not have been taught all these different developmental sequences, because you know maybe they're an accountant, they know their child for sure; and so they are the ones who are oftentimes the go between the different therapists because unfortunately not everywhere has adopted a transdisciplinary approach, so they might be going to one center for OT and the school has the intervention specialist. And all that so the parent is the glue that holds it all together and keeps everyone focused on the child and where they are at. 

Dr. Smith
 And we need to do a whole episode on parent advocacy. You know your own child. Even if you don’t know them that well developmentally. WE need to do a full episode just on parent advocate, advocacy, you know, just to let them know that sometimes, you know your own child, you don't know them that well, you know, developmentally because you're still trying to learn how they operate right.
 
 Dr. Scotese-Wojtila
 And, you set the standard for the culture in your family. You set the standard for the culture. And so that means: how does everybody wake up and start their day? How does everybody approach mealtime? How do people deal with stress, trauma, joy and celebrations? Those thing make a difference. I’ll speak to this quickly and then we'll move on to some other important developmental things we want to talk about, like the different developmental sets to develop in children.
 
 But if sitting at meal time isn’t important to a family, because they are a family on the go, and it's okay if they sit in front of the TV and catch the news while they are eating; or if the child stands or grazes all day. That is a personal to-be-respected cultural choice influence. And so, if we go in and try to structure up mealtime as the therapist or the psychologist or whoever, it may not fit the culture of the family and therefore it is not going to be adopted and embraced. Developmental skill aside, you have to be able to match where the family and the child are at. So knowing what influences affects the child, can't sit or can’t use a fork, is that maybe that culturally not expected to. And that's certainly the case for different places across the world where people live, I found that working in a hospital setting where here I am like a one-year grad, bushytailed, bright-eyed occupational therapist, ready to take on the world, and then go into a feeding unit where I was with the family. Literally, the grandma of a different culture, picks up the food and puts it in the child's mouth. Well the child was like seven or six. I'm like, “Oh no, we need to have a fine motor skill or self-care skill for utensils.”  In this culture, we know who are you serving. But, okay, I get it, it's not necessarily necessary.
 
 Dr. Smith
 So let's get back into the developmental model then. Let's talk about the different areas, where would you like to start now?
 
 Ellen Winney
 Let's start at play just since as I alluded to earlier it's really where the child should be developing all these other skills. We need to look at the different types of play, and when we say play, there's actually several types of play. In the class that we teach online, you get into all those different things a little bit more detail, for sure in how to facilitate that; but suffice to say now there's cognitive play, there's social play, there's motor play. And each of those have their own developmental sequences within it. So just to give like a quick example, if we’re talking about social play, we start with child in solitary play, one that they, you know, don't play with anybody, as we think of an infant, they don't really play with toys with anybody else and then they'll go off to play where they are watching other children play while they're playing with their own stuff, and then we get into parallel playing, book term before where children are actually really playing with each other to play next to each other. Then they go into associated play where they start sharing materials, so if you have a child in the sandbox, they're parallel play everybody has their own tools, their own pile of sand, they're doing their own thing. And with associated play there might be a big pile of different buckets and shovels, so they're sharing with that and saying oh, can I borrow your shovel, those sorts of things; but everyone's building their own castle, and then there's cooperative play where they're all building the same castle together. 
 
And so when we look at developmental sequences, we would never expect that a child who is in onlooker play, should be expected to be in cooperative play and write a goal for them to be in cooperative play or when their cousins come over to say, “Look! Everyone is building a house out of legos. Go join them!”  Because we need to honor the developmental sequence and a child who is developmentally at an onlooker status needs to go through parallel pla, associative play before they are ready for cooperative play.

 Dr. Scotese-Wojtila
 And that is how developmental sequence is important to parents. They need to know that their expectations – and we talk about managing expectations – you need to know that your child is not aloof. It’s not that they are disinterested. It is not that they are even choosing to be isolated. It is something else. They are not at the developmental level and putting them in the context of cooperative play, building Legos as a group, for the sake of making the just right palace isn’t going to give them that skill.

So, opportunity does not equal skill.  Opportunity plus support and developmental scaffolding support as you like to use the term does equal results. And it's that middle piece of the supporting scaffolding intervention, or play therapy, developmental stimulation comes into play.

Ellen Winney
So I think it's really important to remember more important than age or grade level, is the child's own developmental progress. And so we need to be thinking about developmental sequence because if the child is progressing along the developmental sequence, whether they're you know where a neurotypical fifth grader would be when they're in first grade, but they're continuing to progress, that's what we need to look at -- is are they making it to the next step of that sequence?

Dr. Scotese-Wojtila
Their own trajectory for development.  That's where, you know, you can have different foundations that are holey, but the holes are in different places, different foundations, and all we care about is that particular house.

So really individualizing, as true form to The S.U.C.C.E.S.S. Approach (SM) is, really individualizing how we fill those holes with what, and with what we don't put in there. We also talk a lot in The S.U.C.C.E.S.S. Approach (SM) about what not to do, just as much as we talk about what to do.

Dr. Smith
If you ever had the opportunity to take the online training course, what I love about most, is you get a chance to reflect for your own personal reasons, where each one of these theories and models as they relate to you.

Dr. Scotese-Wojtila
That’s right. Reflect on the seven different theories and models as they relate to your child, but know and embrace and reflect on, if you will, the hundreds and hundreds of methods that go with all of those theories. That you can kind of cherry pick that to apply with the help of the instructor to your child, and that becomes your child's critical curriculum -- your own recipe for their just-right pie or cake that you're making.

Ellen Winney
Right, and I think sometimes as parents that I speak personally as a mom of five, you're just still in the trenches, you're just trying to survive the day. And that, you know you're, it's hard to have this academic kind of exercise. Well, where are they at developmentally and what’s their just-right next step, so I do think the online class offers that opportunity because there's the chance to journal and to the pause and just say, you know, not only to get the information you may never have had or maybe you did but you forgot because you're in survival mode, right, but that opportunity to take the time to reflect on it, and say what does apply to my child and what are concrete steps that I can make to take one thing at a time and just start implementing it. 
 
 

Dr. Scotese-Wojtila
 Step by step for us too.

 Dr. Smith
 What insight would you offer as we start talking about parenting effectiveness, what strategies would you offer?
 
 Ellen Winney
 So some stuff for us to talk to you about. So I think definitely just a generalized understanding of development. Some parents are, you know, it’s their first child, and they have a diagnosis of autism. So, they haven't had the experience of seeing up close and personal what typical development looks like to necessarily even know what should be coming next.
 
 And so, the opportunity that you're in that situation, to educate yourself as much as possible on what is the appropriate developmental sequence, but again this isn't to add one more burden on to already overburdened parents. Take advantage of, you know, there's so many resources out there besides, first and foremost the team that is working with your child and asking the questions of okay this is what they're doing now, what should I be looking for next. That's a great question to ask is, what is the next step and how do we get there? And just look one step ahead. You know, one thing and so trying not to get overwhelmed by: They're two years old and they're never going to get to college because, you know they're not potty trained and they're not speaking, you know, right now, and just say what is the next step in the developmental progression, or one area, and then the other area and all of that? So really familiarizing what typical development is either through your own experiences, talking to you know, your siblings who have kids, friends whatever or but first and foremost, professionals,
 
Dr. Scotese-Wojtila
And I think there’s a simple way to start to understand typical development by watching, and that is, by going to a playground. Go to parties. See how kids are on recess, see how they are in a library, a small group of kids, like, try to be observant. Some parents are so used to performing, managing and it's kind of like a ringleader all the time. This rat race circus, but as you can pull back and just observe, even for literally 30 seconds, you will see this beautiful interplay, regardless of who you're watching, there's a beautiful Interplay especially if you step back and don't govern. You see how kids are with each other, and in so doing, you see: my child is not even in the mix and I can see that this kid is talking to that kid, and they are looking at each other. So a precursor to their conversation, or friendship, or their interaction, is eye gaze. So in addition to looking at children, the second thing you want to do is: when I look at my child, what is missing in his experience as a player that is the common denominator. 
 
So you might notice that your kid does really great from a motor perspective and they're climbing around and they're having a good experience and they're getting some fun outlets happening. And they do this really well alone, but the minute a peer comes in, it’s like they cannot even function. They can’t function anymore. They're kind of stumbling. They have fallen apart. It's not that they don't have a motor skill, it’s that they can't do motor and social together, and if you're watching this and you see, every time when there's a social influence, my child falls apart. That's the kind of help you need, and the holes to fill, are the social holes. And just knowing that, where to attend and where not to attend, can be energy saving and a little bit of a relief because it's not broken. Everything's not broken, because he certainly his motor skills up to par, but not in the context of socialization.
 
Ellen Winney
Yeah, so it is really looking and seeing what do we want to focus on first? Because every play interaction has all these different elements. And anything like a game of soccer, there is the physical, you know, kicking the ball, you there's the cognition, you have to understand the rules of soccer, there is the sensory of, you know, the feel of the uniform, and the cleats and everything that might some of our kids who have sensory issues, might have people brushing up against them, being in their proximity, the social, the communication. There are so many things that go into a simple game of soccer amongst six year olds. So saying, “Okay, you know, I want my kid to play soccer.” We can't attack it all at once, so what is the goal for this time? Maybe it might be practicing drills in the backyard with Daddy just for the voter piece. Maybe it's you know, kind of watching a video, or having a simplified version of the rules, another time or it is, you know, just working with your OT to help to tolerate the high-knee soccer socks. Those sorts of things, and understand there are many components, and that's okay, and we are going to knock them off the list, one by one, so that eventually we get to this point where we're able to have this interplay between all of these different developmental needs.
 
Dr. Scotese-Wojtila
And I think that helps parents manage their own expectations because they have a goal within a goal. So if the goal is to be engaged in soccer, signed up with something, kind of normalizing so to speak, within that, there's a mini goal of: just tolerating the socks this week; and then socks and the shoes and saying hello to a friend next week. Like build and scaffold yourself under the direction of the strongest lead people on your team, hopefully occupational therapists, who can really understand your child and specialize in what we call task analysis; so by trade, we are specialists, breaking down like Ellen said, all the motor things, and bodily things, postural things that are necessary, emotional, social, pragmatic things necessary, visual motor integration things necessary, etc. To say, “Hey, Mom, if I were you, I would be working on blank.”  And then great, you set a goal for blank whatever that is.
 
 

Ellen Winney
 And I think the key then to is to celebrate success. Like, we don't need to be comparing to well you know so and so, at seven years old, is on Travel League. Celebrate that your child wore the socks for five minutes to get their goal, then celebrate each little step along the developmental sequence, that they check off and that’s a huge victory.

Dr. Scotese-Wojtila
 And you know, it goes back to what Dr. Smith said about collaborating. Let your coaches know what you expect too, because then they can reinforce acceptance and some might even help other families to know hey this child's purpose here isn't to be the star player, they want to just need an opportunity to practice XYZ. Can you partner with me helping that kid to know from the stands they did a great job, whatever, wearing their socks or whatever, not that they have to know details, but it can be a very collaborative and supportive environment for the parent. If the parent is clear about what the expectations are.

Dr. Smith
WE’ve talked a lot about developmental development and sequencing. I know there's a lot more to do that, you can probably highlight and talk for hours. So thank you, Ellen, for being with us again today it's been a pleasure having you on the panel again. And you can come back again and again and again.

Dr. Scotese-Wojtila
She's not the instructor of our class by accident!

Ellen Winney
Thanks for having me back.

Dr. Scotese-Wojtila
So today listeners, the challenge is to choose one area of development that you are maybe most concerned about. Discern where your child is at with the help of your team. Celebrate where they are at, maybe even videotape where they're at, so that you can always remember this developmental level, and then do the work of discerning what is the next step in that skill set?

Dr. Smith
This was a powerful episode for me and I was blessed to share the microphone with Ellen and to keep the conversation going. As a parent, the first thing I hope you take away is the beautiful notion of first knowing where your child is. Period. Don't get wrapped up in what you see happening, and just wish for your child. Be intentional and honest in your goal setting to meet your child where they are, and develop your goals with your transdisciplinary team to reach them. Stay the course, and stay focused on your goal, and not societal expectations. Lynette, what are some other takeaways from this episode?

Dr. Scotese-Wojtila
I think we need to always remember and honor the fact that development is driven by the brain. Development is sequential too, so we can expect it to evolve step by step. I think we also need to remember that play is the child's work, and occupational therapists and other professionals who are trained in neuro development can help the child to fill the holes in their development, if there are any. So fill those foundational holes, and then use that new foundation to build more skills so they can succeed as a player and a learner.

We also want to manage expectations by deciding what's most important to your family when it comes to your child's play development, and focus on that single aspect, rather than trying to use the play opportunity to address all of your concerns at once.

We hope that you learned something today to help you on your journey with autism. We'll share more on our next CONNECT with SUCCESS podcast.

Until then, expect success!


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