Simply Me Therapy

Posts Tagged "speech therapy"

4 Stages of Cognitive Development…as it Compares to Children with Autism

As I attend open houses with my daughter seeking out the college of her dreams, it brings me back to my undergraduate years when I was a Psychology major at Wagner College. I ponder on the stages of cognitive development …

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As I attend open houses with my daughter seeking out the college of her dreams, it brings me back to my undergraduate years when I was a Psychology major at Wagner College. I ponder on the stages of cognitive development and compare this to my little ones with autism.

1. Sensory Motor intelligence:  As infants, we are exposed to an influx of sensory stimulation.  Here is where the process of learning about our world, via internal sensory feedback or external sensory feedback.  Internal sensory feedback is when we recognize we are hungry.  As babies, we cry.  And as adults, if we are very hungry, we may cry as well. :). External sensory feedback is when we receive information through visual, auditory, tactile, olfactory, and kinesthetic input. A combination of sensory information leads to cognitive, emotional, and motor responses.  In autism, however, some of the sensory input may be too much information for the child’s system or not enough information, manifesting as a child who lines up cars, flaps, spins, or even smells everything.  The child is really incorporating one sense they can handle and feel in control with, while disregarding other senses that may be too much information, making them feel out of control.  They are interpreting the world differently than the neurotypically developing child, yet they are still interpreting the world.

2. Preoperational Thought: Here is the second stage of cognitive development, where individuals represent thoughts via imitation, symbolic play or drawing, language, and speech production. To process this, neurons are firing in the brain.  In autism, however, these neurons are either under active or overactive, causing difficulty in imitating, utilizing symbolic play, drawing, language, and speech.  Yet, we tend to regard this as though our children with autism do not receptively understand.  How can we know that for sure?  Perhaps, motorically, this child has difficulty imitating.  Or, perhaps the symbolic play we choose to introduce to our kids is being hindered by the sensory input causing an emotional reaction.  We must always assume that our children with autism can learn.  They may learn differently, but nevertheless, they can learn.

3. Concrete Operational Thought: Here, an individual is able to categorize, understand causal relationships, and solve problems as it relates to the physical world. In short, an individual reasons about real objects and the relationships between them. Thinking exists based on exposure through theoretical knowledge and/or personal experience. Yet, many individuals with autism (and lots of neurotypically developing children) who do not have opportunities for exposure to specific experiences, demonstrate a lag at this stage.  Here is where education is crucial. Children who are exposed to more and more education and opportunities for practical application excel at this stage. Our kids with autism may try to gain understanding of their environment by repeating what they hear, or as we call it, scripting.  They may gather information through flapping or spinning.  Let’s take these strengths of verbal, auditory, and kinesthetic input and educate our kids.  We simply can’t stop teaching and moving forward with exposure to learning.  Let’s pick our battles, and help our kids to move forward rather than focusing only on behavior programs because they are not acting the way we expect.  Yes, we want to facilitate socially appropriate citizens, but sometimes, we have to question how we can use the place they are, and build from there to help expose and educate.

4. Formal operational Thought: This stage allows individuals to create laws and rules for problem solving. It is based on reflection of the philosophy of the world we live in. There is a focus in planning and incorporating strategies. In children with autism, the perception of the physical reality may not match the reality one would expect.  This is related to the previous stages being altered, causing this stage to manifest in a fragmented fashion. Again, we need to assess if the reasons are related to motor, sensory, and/or emotional.  From there, we can create opportunities for learning, while accepting the individual differences that make us all unique.

When I look into the eyes of my clients, I see a child.  I don’t see autism or any other label we as a society choose to give.  I see a child who requires a different way of learning, but can learn nonetheless.  I see differences which should be embraced.  Just as I seek out different colleges for my daughter, and respect her choices of which school best fits HER needs, we all must respect that ALL of us have different needs.  Each of us is special.  So, I guess we all have special needs.


  Posted by Simplymetherapy on October 21, 2014  /  Tags: , , , ,

Labels, Labels, Labels…

Labels for Education

Recently, I was asked to get a second opinion on a mammogram and ultrasound that showed a nodule on the left breast.  With barely enough energy to muster the strength to do so for fear of the dreaded label that …

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Labels for EducationRecently, I was asked to get a second opinion on a mammogram and ultrasound that showed a nodule on the left breast.  With barely enough energy to muster the strength to do so for fear of the dreaded label that I faced with my sister experiencing a double mastectomy only two years prior, I somehow managed to make all the contacts necessary to follow through. At my visit, I was asked to wait for the doctor to review my films because a biopsy was needed.  I was seated in a waiting room with several other women awaiting the reports of their films as well. Interesting how the Universe works!! There were lots of technical difficulties on this particular day at the hospital, and we women were waiting together for what amounted to eight full hours; a full work day filled with mental exhaustion and anguish. Among these women were different cultural backgrounds, different races, and socioeconomic statuses. All the preconceived notions for all the different women may have been present, but it was hardly noticed once we all began to converse.  For a moment in time, we all connected with one particular experience…one that we all related to; one that showed no preference for religion, color, or affluence. For this one moment in time, we were one.  There were no labels and no preconceived notions.  We were just women supporting each other through a scary time. In spite of my fears, I reflected on this and thought how fortunate I was to have experienced this connection with no prejudices to speak of. It made me realize the harshness of labels and the injustice it does for humanity as a whole.  And although one may argue that labels have their place, and may be necessary under particular circumstances to move forward, I question what a world would be like if not for the labels we place on it. We spend so much time saying something or someone is good or bad.  But isn’t good and bad a relative term?  For instance, one may believe losing a job is a bad thing.  But, if losing that job opened you up for a new experience and new opportunity that was in fact more fulfilling, would you then label losing the job as bad?

We use labels for so many circumstances.  We read tons of labels for the foods we eat, as is recommended when dieting, yet we are having the largest obesity crisis we have ever known.  Have the labels benefitted us?  We do the same for our children. My client’s mother cries…genuinely cries every three years when her son gets reevaluated.  The tests indicate extremely low scores, labeling him as multiply handicapped or rather many kinds of specific learning disorders.  Are these labels benefitting my client or his mother?  Some may say that it is, so he can be classified correctly and receive the services he needs.  But, at what point can we stop labeling him and just treat him according to his needs?  In other words, his mom was fine and happy knowing she has been doing all she can for her son, and going about her life.  Yet, once the tests were implemented and the labels were passed out, and nothing other than that had changed, she was tormented and needed time to come to a place of acceptance. My heart aches each time she goes through this, and all I can do is be present.  I tell all my client’s parents to let go of the labels.  Your child is simply that…a child! It would be interesting to experience what would happen if we let go of the diagnoses.  Would we treat these children differently?  Would the therapy services differ?  And what would happen if we let go of the religion or color or socioeconomic status of a person, and simply regarded them as…a person?

Sadly, we are a long way from deleting labels in our thoughts and in our vocabulary.  Yet, I had a glimpse of utopia where several people came together and were one.  I asked myself if this scary experience was in fact a “bad” experience or a “good” one.  Once I surrendered the fear and opened up to the love in that room pouring from each and every woman, my name was called.  I am well!  All is well!

  Posted by Simplymetherapy on August 7, 2014  /  Tags: , , , ,

Harry Potter…and the Child with Autism


  As therapists, and moms, and people, one of our goal is to expose our clients, our children, and others to fine literature. My daughter did not enjoy reading AT ALL!  That is until Harry Potter came along!  She loved …

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As therapists, and moms, and people, one of our goal is to expose our clients, our children, and others to fine literature. My daughter did not enjoy reading AT ALL!  That is until Harry Potter came along!  She loved the movies, and asked to read the first book.  She has been hooked ever since.  She has since read every book at least 3 times…and more importantly, has unleashed a love for books…all kinds of books. I thought that if Harry Potter can impact my daughter so greatly, perhaps it can do wonders for my client who is diagnosed with Autism.

My client is now 14 years old. I have had the great blessing of working with him since he was 2 years old.  Throughout the years, he learned to sit and attend, to speak, to take turns, to follow multiple directions, and to engage in simple discourse. He has learned to read and write as well.  I know how intelligent this boy is.  At school, they are reading simple books with him, but I believe that we need to challenge our children regardless of any labels that are put on them.  We need to help them to reach their best…and go beyond. So, I introduced him to the first of the Harry Potter series.  I am proud to announce that my amazing client recently completed the first book.  Fortunately, I am not under any time constraints as can be a potential obstacle in the school system.  I work privately with this boy, and so we slowly utilized so many opportunities during the course of this book, to engage in language therapy.

First, I not only provided the book, but I provided many other tools as resources to facilitate comprehension and expression. Harry Potter FIlm was an additional resource which provided behind the scene pictures and readings.  We utilized the fabulous complement to the books, an online experience, Pottermore.  We used the Harry Potter cookbook, where we cooked and ate treats that were mentioned in the book.  With the support of clips of the film via Youtube, my client was able to grasp a visual understanding.  We played with the Harry Potter lego app as well as the Harry Potter chess game to ensure a full capacity of learning with multiple opportunities for exposure and feedback. As we read, we created a list of all the characters and places we were introduced to, as there are so many throughout this story. We color coordinated these items, and created a flowchart to better understand the layout of the story.  We used thinking maps to facilitate extending our imagination, moving from concrete to abstract ideas.  We discussed fact vs. opinion, fiction vs. nonfiction, and comparisons vs. contrasts. We worked on writing essays based on these language schemes.  Informative essays, persuasive essays, explanatory essays, were a few to say the least. We created advertisements, where we bought and sold items. My favorite piece that we worked on was our quote essays, where we took the wise words taught by Albus Dumbledore to make sense of the world we live in and how it relates to us and those we love.  Additionally, we discussed perspectives and twists at the end of a story. We began journaling throughout this process incorporating the new vocabulary we were exposed to in this reading.

When provided with a multiple choice test I comprised to respond to main events and ideas throughout the story, my client earned an 80%.  With a little cueing and reminding, he was able to achieve 100%.  This has been an extraordinary experience, and I am looking forward to book #2, where we can soon explore role playing, public speaking, and setting up for theater productions for his family and friends.

Harry Potter has been my gift…for my daughter and my client.  It has become the bridge I needed to cross boundaries where no one else dared to go. Let go of the limitations.  Expect great things from this upcoming generation.  When we expect greatness from them, they will soon expect greatness from themselves.  And it can all begin with a boy  who uncovers his potential and his internal power. His name can be Harry Potter or simply Thomas.


  Posted by Simplymetherapy on March 24, 2014  /  Tags: , , , , ,