Tag

autism spectrum

Dec 16
7

Enjoying the Holidays with Sensory Needs

By | NESCA Notes 2018, NESCA Notes 2019

 

By: Sophie Bellenis, OTD, OTR/L 
NESCA Occupational Therapist; Community-based Skills Coach

School vacation! Bright lights! Snow! Holiday cards on the wall! Bells a’ringing!

For many of us, the holiday season is an exciting, family-filled occasion that brings people together to celebrate yearly traditions. However, for some with sensory needs, the season can be over-stimulating, anxiety producing and difficult to navigate successfully. Even children who love the spirit of the season can quickly become saturated with the onslaught of visual, auditory, tactile and olfactory input. Here are some tips to consider as we head into holiday mode!

  1. Make Your Home a Safe Space – Consider reducing decorations, holding off on moving furniture and choosing a select few holiday cards from friends and family to display. With everything from daily routines to the look of familiar neighborhood streets changing throughout the month, maintaining consistency within a child’s home can help offer a much needed respite from the visual clutter. While these changes may seem minor, visual clutter causes some children’s eyes to continuously scan the room, move from place to place and constantly work to perceive all of the information. This is exhausting!
  2. Less is Often More – For a child who is easily over-stimulated, opening two presents can be much more exciting and rewarding than 10. One hour visiting family can feel easy, while two hours feels impossible. And a small tree can look beautiful, while a huge tree feels intimidating and scary. Set children up for success by keeping activities manageable.
  3. Have a Designated Sensory Retreat – When venturing out to visit family or friends, preparation is always key. Discussing a sensory plan before arriving and having supports in place can catch stressful situations before they develop. A pre-planned hand signal or code word can save a child from having to explain that their body feels dysregulated and they are overwhelmed. Children may want to take breaks in a quiet bedroom, bring a pop-up tent to hide in, or eat their meal somewhere quiet before a big sit down dinner begins. For adolescents, this sensory retreat may simply be sitting in the car for 10-15 minutes in silence. Give children permission to take what they need.
  4. Enlist the Help of Teachers – Social stories, modified visual routines and exposure to holiday sensory input are all strategies that teachers and therapists in the school setting can help to develop and introduce to a child. Previewing the plan for school vacation can make the week off go much more smoothly.

In a household such as mine, that celebrates both Christmas and Hanukkah, the month of December is fraught with routine change, decorations and new smells from rarely cooked, homemade meals. Allowing our children with sensory processing disorder, autism spectrum disorder and other sensory needs to prioritize their internal regulation can help make the season fun for everyone!

About the Author:

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. For the past five years her work has primarily been split between children and adolescents on the Autism Spectrum in the United States, and marginalized children in Tanzania, East Africa.

Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists.

Dr. Bellenis has worked for the Northshore Education Consortium at the Kevin O’Grady School providing occupational therapy services and also at the Spaulding Cambridge Outpatient Center. She also has extensive experience working at the Northeast ARC Spotlight Program using a drama-based method to teach social skills to children, adolescents, and young adults with autism, Asperger’s Syndrome, and related social cognitive challenges.

Internationally, Dr. Bellenis has done extensive work with the Tanzanian Children’s Fund providing educational enrichment and support. She has also spent time working with The Plaster House, a post-surgical, pediatric rehabilitation center in Ngaramtoni, Tanzania.

Dr. Bellenis currently works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs and visual motor skills must be taken into account to create comprehensive educational programming. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team.

If you are interested in an Occupational Therapy consultation/ assessment or individualized skill coaching with Dr. Bellenis, please complete NESCA’s online intake form today.

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Dec 10
6

Enjoying the Holidays with Sensory Needs

By | NESCA Notes 2018

 

By: Sophie Bellenis, OTD, OTR/L 
NESCA Occupational Therapist; Community-Based Skills Coach

School vacation! Bright lights! Snow! Holiday cards on the wall! Bells a’ringing!

For many of us, the holiday season is an exciting, family filled occasion that brings people together to celebrate yearly traditions.  However, for some of our children with sensory needs, the season can be over-stimulating, anxiety producing, and difficult to navigate successfully.  Even children who love the spirit of the season can quickly become saturated with the onslaught of visual, auditory, tactile, and olfactory input.  Here are some tips to consider as we head into December!

  1. Make Your Home a Safe Space – Consider reducing decorations, holding off on moving furniture, and choosing a select few holiday cards from friends and family to display. With everything from daily routines to the look of familiar neighborhood streets changing throughout the month, maintaining consistency within a child’s home can help offer a much needed respite from the visual clutter. While these changes may seem minor, visual clutter causes some children’s eyes to continuously scan the room, move from place to place, and constantly work to perceive all of the information. This is exhausting!
  2. Less is often More – For a child who is easily over-stimulated, opening two presents can be much more exciting and rewarding than ten. One hour visiting family can feel easy, while two hours feels impossible. And a small tree can look beautiful, while a huge tree feels intimidating and scary. Set children up for success by keeping activities manageable.
  3. Have a Designated Sensory Retreat – When venturing out to visit family or friends, preparation is always key. Discussing a sensory plan before arriving and having supports in place can catch stressful situations before they develop. A pre-planned hand signal or code word can save a child from having to explain that their body feels dysregulated and they are overwhelmed. Children may want to take breaks in a quiet bedroom, bring a popup tent to hide in, or eat their meal somewhere quiet before a big sit down dinner begins. For adolescents, this sensory retreat may simply be sitting in the car for 10-15 minutes in silence.  Give children permission to take what they need.
  4. Enlist the Help of Teachers – Social stories, modified visual routines, and exposure to holiday sensory input are all strategies that teachers and therapists in the school setting can help to develop and introduce to a child. Previewing the plan for school vacation can make the week off go much more smoothly.

In a household such as mine, that celebrates both Christmas and Hanukah, the month of December is fraught with routine change, decorations, and new smells from rarely cooked, homemade meals.  Allowing our children with sensory processing disorder, autism spectrum disorder, and other sensory needs to prioritize their internal regulation can help make the season fun for everyone!

 

About the Author:

Sophie Bellenis, OTD, OTR/L  is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. For the past five years her work has primarily been split between children and adolescents on the Autism Spectrum in the United States, and marginalized children in Tanzania, East Africa.

Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists.

Dr. Bellenis has worked for the Northshore Education Consortium at the Kevin O’Grady School providing occupational therapy services and also at the Spaulding Cambridge Outpatient Center. She also has extensive experience working at the Northeast ARC Spotlight Program using a drama-based method to teach social skills to children, adolescents, and young adults with autism, Asperger’s Syndrome, and related social cognitive challenges.

Internationally, Dr. Bellenis has done extensive work with the Tanzanian Children’s Fund providing educational enrichment and support. She has also spent time working with The Plaster House, a post-surgical, pediatric rehabilitation center in Ngaramtoni, Tanzania.

Dr. Bellenis currently works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs and visual motor skills must be taken into account to create comprehensive educational programming. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team.

 

If you are interested in a consultation or individualized skill coaching with Dr. Bellenis, please complete NESCA’s online intake form today.

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Aug 20
0

The Northeast Arc Spotlight Model: Drama-Based Social Skills Intervention using evidence-based Socio-dramatic, affective relational intervention (SDARI)

By | NESCA Notes 2018

By:
Rebecca Girard, LICSW, CAS
Licensed Clinical Social Worker, NESCA

Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Community-Based Skills Coach, NESCA

 

This summer, NESCA piloted its first series of social pragmatics groups using the Northeast Arc Spotlight/SDARI model. We are excited to continue offering these groups in the 2018-2019 school year. Please read below to learn more about this model and whether it sounds like to fit for a child or adolescent in your life:

For those of us in the autism community, you may have noticed a lot of buzz recently around drama-based social pragmatic intervention for children on the spectrum. Perhaps this is because they provoke creativity, self-expression of participants, and are often more fun than traditional didactic models. Creating spaces for ASD individuals to practice social interactions in a semi-structured setting while providing fun and interactive activities allow for true, authentic social connection.

The Spotlight Model was originally developed in 2004 at the Northeast Arc under the clinical guidance of Dr. Matthew Lerner and Dr. Karen Levine. Since that time, Dr. Lerner has used the acronym SDARI (Socio-Dramatic Affective Relational Intervention) to describe the model in his past and current research studies. The Northeast Arc Spotlight Model was created in response to children who were not having success in traditional social skills models, and who needed something more engaging and personalized. This method was developed as a way to teach social pragmatics, as opposed to social skills.  While these terms may sound similar, the differences are vast when it comes to developing generalizable skills. Simply put, social skills consist of rote memorization, manners, active listening, and following a basic set of social rules. Social pragmatics focus on finding one’s own unique social style that is intrinsically motivating and fluid. It is the ability to effectively use communication in social situations while maintaining individuality and being able to respond to unpredictable circumstances.

What makes the Northeast Arc Spotlight Model different?

The Spotlight Model/SDARI uses a three-part model to create engaging groups that maximize the potential for ongoing friendships. Groups are formed by taking into account a number of factors, including personality, socialization style, common interests and, to a lesser degree, age and gender.

  1. Improvisation and dramatic training as social learning. Many of the skills necessary to be a confident social individual are the same skills necessary to become a successful actor. Goals such as Thinking of Your Feet, Body Language, Tone of Voice, and Someone Else’s Perceptive work on both improv and skills, dramatic training, and reciprocal scene work, as well as social competence and confidence. Improvisation’s one and only rule is “yes, and”; meaning that no matter what happens in a game/scene/activity, the participant must say, “yes” to accept what is happening and not block to flow, the “and” to build on that idea with a new one. Improv games allow groups to implicitly work on skills while laughing together, being creative, and forming lasting bonds. After all – laughter is the shortest distance between two people!
  2. Relational reinforcement. Counselors using the Northeast Arc Spotlight Model work to form trust and real relationships with participants. Each group has a head counselor, the individual responsible for creating the flow of the day, overseeing the group as a whole, and maintaining momentum. They are complemented by support counselors who check in with each child, create ways for everyone to be involved, and use strategies to help everyone feel like a contributing group member. Counselors use redirection, side-coaching, playful humor, inside jokes, and even passwords or codes. For example, during the opening meeting, the head counselor asks each participant the “question of the day” – a support counselor may sit next to a participant with slower processing to help them quietly prepare an answer before it is their turn to speak. During improvisation games, a support counselor may have a secret code word with a participant as a reminder to stay focused on the game they are playing. Participation looks different for everyone, and improv games and activities allow for a wide range of abilities and engagement.
  3. Strong use of age-appropriate motivators. The Northeast Arc Spotlight Model incorporates the use of video games, board games, and special interests to promote connection and interaction. During “break time” participants are encouraged to choose a preferred activity, as long as they are working together with a peer. This creates a space for independent conversation and interaction, with active facilitation from staff, and a way to share what they love. In addition, counselors often use a participant’s special interest to keep them engaged and excited. For example, someone who loves trains may play the game, Ask an Expert! to teach his peers about his favorite topic.

Many of our autistic friends and family thrive when their quirky humor is encouraged. Their unique perspective and disinhibited nature often lend itself to a unique and hilarious sense of humor. The Northeast Arc Spotlight Model creates a setting where children can be fully themselves, while simultaneously working to develop their social abilities. The facilitation of positive interactions and collaborative learning builds confidence and successful peer relationships.

Learn more and schedule an intake:

  • For more information about the Northeast Arc Spotlight Model groups being run at NESCA, please contact Rebecca Girard at rgirard@nesca-newton.com.
  • To learn more about the Northeast Arc in Danvers, MA, visit: ne-arc.org
  • To read more about the current efficacy of the SDARI model please visit lernerlab.com.

 

About the Authors: 
Girard

Rebecca Girard, LICSW, CAS is a licensed clinical social worker specializing in neurodivergent issues, sexual trauma, and international social work. She has worked primarily with children, adolescents, adults with Autism Spectrum Disorders and their families for over a decade. Ms. Girard is highly experienced in using Cognitive Behavior Therapy (CBT) as well as Socio-dramatic Affective Relational Intervention (SDARI), in addition to a number of other modalities. She provides enhanced psychotherapy to children with ASD at NESCA as well as to provide therapeutic support to youth with a range of mood, anxiety, social and behavioral challenges. Her approach is child-centered, strengths-based, creative and compassionate.

 

Sophie Bellenis, OTD, OTR/L is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team.

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Jul 16
1

Social Creativity and ASD – Challenging the assumption that autistic people are not social

By | NESCA Notes 2018

Photo from the documentary, Autism: The Musical (2007)

By: Rebecca Girard, LICSW, CAS
Licensed Clinical Social Worker

The New York Times recently published an opinion piece titled, How to Meet Autistic People Halfway, an article that challenges the common belief that people on the autism spectrum are avoidant of social interaction and do not desire social connections. The authors, Vikram K. Jaswal and Nameera Akhtar are psychologists and researchers who study the social lives of people on the autism spectrum. They assert that while core deficits of autism may make social interaction more challenging, it does not mean people on the spectrum do not desire meaningful social connection. For years, many in the ASD community and their allies in the neurodiversity rights movement have attempted to combat this anti-social stereotype, but the notion stubbornly persists. Counter-narratives of the autistic social experience often reflect autistic people as extremely emotionally sensitive, hyper-aware of the feeling states of others, and indeed motivated to experience social success in the form of friendships and social acceptance. Additionally, an increasing number of people believe those on the spectrum may actually display more creative and interesting ways to connect and choose to describe autistic individuals as “socially creative” rather than having “social deficits”.

If we then acknowledge the desire to connect is present, how can we best facilitate social learning and promote social success? First, we can acknowledge that a person on the spectrum will have a myriad of ASD-related challenges that will likely make socializing difficult. These include trouble reading and interpreting social cues (eye contact, body language, facial expressions), attending to and managing sensory challenges during interaction, and repetitive and inflexible thinking (getting “stuck”, echolalia), all of which can lead to preemptive social rejection by peers and a lack of social opportunities to practice and improve upon their social interaction skills. These challenges require multi-disciplinary supports, including (but not limited to) occupational therapy, speech therapy, and cognitive-behavioral therapy. Second, we can provide positive social learning interventions that address and ameliorate the impact of these factors, while providing opportunities to explore and understand the social world.

A popular method of intervention is that of “social knowledge”, or didactic social skills training. This entails imparting concrete social skills, in the effort to explicitly teach what a person may not know about socializing. Think – programming a social computer with many algorithms; if a person does A, you do B. While this may be great at teaching the basics, it often does not adequately prepare ASD individuals for the unpredictability and fluidity of everyday interactions. Another approach is that of “social performance”, a dynamic method of encouraging social pragmatic development by providing semi-structured socialization opportunities in small group settings with immediate, in vivo feedback on what’s working or not. Think – flexing a social muscle. Drama-based social pragmatic groups are gaining in popularity as a method for not only promoting social connections but as a fun way to create an encouraging and supportive space to finds one’s own intrinsically motivating social style.

But enhancing individual social skills and providing adequate social opportunities is admittedly a one-sided approach. Equally important is challenging the stigma and bias that plague the ASD community. We need to be allies to this community by promoting greater acceptance of a wide-range of social styles and approaches to social engagement. To honor the neurodiversity mission, which “rejects the idea that autism should be cured, advocating instead for celebrating autistic forms of communication and self-expression, and for promoting support systems that allow autistic people to live as autistic people.” (What is Neurodiversity? [Website]. (2011).  National Symposium on Neurodiversity at Syracuse University)

As a therapist who has worked with ASD individuals across the lifespan since 2004, I know firsthand that autistic people feel the same loneliness and isolation when chronically socially disconnected, and feel the same anxiety and unease when experiencing social rejection. I have also had the pleasure of witnessing individuals find their own distinctive social style and the joy of connecting with others who appreciate what is different as interesting and exceptional, rather than off-putting or strange. The autistic people in my life, both professionally and personally, have challenged me to rethink narrow and strictly defined social expectations, and have made all my relationships richer as a result. Autistic people are often credited with “out of the box” thinking and innovation, which can be applied to their social lives as well, as they are uninhibited by social convention. For example, Asperger’s are Us are the first all-autistic sketch comedy troupe, and their performances reflect their original and offbeat sense of humor, as well as their deep connection to one another as friends. A great example of what is possible.

The New York Times article said it best in its conclusion, “improving the social lives of autistic people will require putting aside assumptions about how social interest is expressed and recognizing that it can be shown in unexpected ways.” As parents, professionals, and allies, let’s commit to challenging this very basic and long-held assumption and appreciate and embrace the unique and creative ways autistic people chose to engage the world around them.

 

About the Author: 

Rebecca Girard, LICSW, CAS is a licensed clinical social worker specializing in neurodivergent issues, sexual trauma, and international social work. She has worked primarily with children, adolescents, adults with Autism Spectrum Disorders and their families for over a decade. Ms. Girard is highly experienced in using Cognitive Behavior Therapy (CBT) as well as Socio-dramatic Affective Relational Intervention (SDARI), in addition to a number of other modalities. She provides enhanced psychotherapy to children with ASD at NESCA as well as to provide therapeutic support to youth with a range of mood, anxiety, social and behavioral challenges. Her approach is child-centered, strengths-based, creative and compassionate.

Reach out if you would like to work with Rebecca: Email rgirard@nesca-newton.com or call 617-658-9825

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.