On the Move

●My prayers have been answered in such a marvelous way.  The Karate Program has been instrumental in my son's life by   increasing positive character traits. Each Wednesday, because my son knows that he will attend the Karate Program, there is an exuberant sparkle in his eyes. He has always kept his room clean, but because of his increased independence, he asks to vacuum his room and other rooms in the house on this special day!  Prior to the Program, negative characteristics existed such as anxiety, fear, nervousness, frustration, and a lack of focus.  Currently, the positive character fruit produced within my son is patience, improved body strength, courage, confidence, increased maturity, increased independence, increased responsibility, and joy. I am thankful to God for Amy, Sensei Riaan and for the Karate Program.  The love and compassion given to my son weekly is more than any parent could imagine.  This Program has exceeded my expectations.  It is a blessing. It is a gift from God.”-Mother of a 16-year-old boy diagnosed with Asperger's Syndrome

 
For over a year now, our son, who is on the autistic spectrum, has been attending a weekly karate class under the direction and tutelage of Sensei Riaan.  He has never been in a structured group setting like this, and he is thriving more and more after each session.  His confidence level has increased because he feels successful, and is able to be with and keep up with his peers.  We have noticed significant improvement in his balance, motor skills, and coordination, as well as his social and play skills.  One of the particularly commendable aspects of this program is the way it is organized with each child having an outside support person to work along with him and help and guide him, as necessary.  I highly recommend this class to everyone; especially our special people who need extra love and support! -Parent of a Karate Group Participant

My son has greatly benefited from the PT Karate group! His upper body, lower body and core strength are all improving, and his attention span as well as ability to stay on task has increased. I am so glad this class is offered and hope others will be positively impacted by it too. -Mother of a 12-year-old with autism  

What is it?

The Physical Therapy-Based Karate group is a long-time favorite at Child and Family Development.  It is led by Amy Sturkey, Physical Therapist, and Riaan Van Schalkwyck, Black Belt Instructor. 

We have seen such success with teenagers with high functioning Autism and Asperger’s Syndrome that we want to expand and offer it to young adults and adults with high functioning Autism or Asperger’s Syndrome. 

The goal is to help participants improve balance, strength, and coordination and control. There is also a focus on self defense moves.

How does it work?

Each participant is paired with a ‘shadow’ to offer verbal encouragement and instruction and simple physical redirection cues.   It is important that each participant be able to follow directions and not have aggressive tendencies towards self or others.

Groups are formed according to skill level with age and size taken into consideration, to ensure the best opportunity for success and homogeneity. Groups are limited to 4 participants. 

What can I expect?

The Karate group meets weekly at our Midtown Clinic for a minimum of 8 weeks. The group may continue passed 8 weeks if there is sufficient interest.                         

Session times will be offered on Wednesdays at 1pm and/or 12pm. 

The private cost of the groups is $50 per session. All payments are due at the time of service.  

Want to learn more?  

∙  Call Amy: 704-332-4834 ext. 114

∙  Email Amy: asturkey@childandfamilydevelopment.com

∙ Visit the C&FD website: www.childandfamilydevelopment.com

Improve Speed, Timing, Concentration, Balance, Form, Shot Accuracy and Overall Sport Performance

Are you looking for that competitive edge? Is your skill development at a plateau and need a jump start? Interactive Metronome (IM) is a tool for athletes who are good… who want to be better. This 3 day a week, 5 week long intensive intervention can give you an extra boost in your performance with 1 hour sessions. Wow the coach with your new ability to time, concentrate, and accurately move in coordination with others. 

I have done interactive Metronome for about 10 years. Over time, I have experience with a wide variety of clients with Interactive Metronome. I am excited about its applications for the elite athlete or the athlete who is good who wants that extra edge. Clinically I have seen clients improve balance, endurance, focus, timing, coordination, and the ability to work in the face of distractions. No matter the starting skill level, every client has improved dramatically comparing pre-test to post-test. I have seen clients start in the severe level and improve to the Exceptional level. The program self modifies to challenge even the strongest athlete. IM is used in sports to improve club level, high school, college or pro level sports performance. As a physical therapist, I know how to modify this program to hone your skills to meet you and your sport needs. 

For more information on Interactive Metronome, check out www.interactivemetronome.com. For more information on our practice, check out www.childandfamilydevelopment.com. My experience is that the more competitively spirited you are, the better your gains.  Even the Pro I worked with improved her skills significantly. IM can help your performance in basketball, football, lacrosse, baseball, lacrosse, soccer, cheerleading, dance, karate, gymnastics, golf, track, swimming and more. The initial evaluation will show where your skills are now and will give us some indication of what your skills might become. Give me a call, for more information: (704) 332-4834 ext. 114. 

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating an emotional world where so many things are decided by how you feel about a situation.

This week I had a mother come to my therapy room and tell me her son (my client) was down at the car with his sister and wouldn’t come up. She said she thought he was overly tired and hungry. Could I please come help? Sure, I thought. No big deal. The moment he saw me, I knew he would come right up. He loves me and requests me all week long. I got down to the car, and sure enough there he was clinging to the outside of the car crying and saying he wanted to go to McDonalds and get chicken McNuggets. When he saw me, nothing changed. I was flabbergasted. I’ve seen him for almost 10 years and he had never done anything like this. I tried to catch him, pull him, drag him, bribe him with food, and nothing worked. He was crying and wanted to go to McDonald’s and get chicken McNuggets. I wondered since he had never done this before, should we let him go to McDonald’s and just skip PT? What would be the ramifications of this if we did? His mom asked me what we should do. I said more to myself than to his mom, “As soon as I figure out what is the best thing to do, I’ll do it.”

Isn’t life a lot like this? How many times in my life, have I thought, “If I just knew the right thing to do, I’d do it.” I’ve felt this way about friendships, relationships, sibling differences, work outs, medical issues and more. Don’t you just wish life came with a little book that you could look up in the index what the answer is? More times than not, the answer comes down to emotional decisions informed of course by experience, speculation, and your gut feeling about a situation. How do you know when it is time to choose a new friend, a new décor for the living room, a new school or a new behavior management technique for your child? When is it time to let an old friend go? It comes down to advice from all your friends (or maybe despite all the advice from your friends) and your final feelings on the matter. These kinds of choices and conflicts are natural challenges for people on the spectrum.

What happened with the child in the parking lot? The mom commented that her son had been doing this recently at school, lying in the floor crying and getting out of work. That’s all I had to hear, and in my gut, I knew the answer. I “helped” him in the building, and we got to work. 

Emotional choices and challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114.  

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating a world where so many things happen in such imperfect ways.

Dr. Steve Gutstein, founder of RDI, says, “The world is imperfect. Rarely in our modern world do we complete something without interruption or finish it with 100% perfection. Most times decisions and follow through are based on “good enough” criteria. …As in all relationships, there are significant periods of getting it wrong. In fact, the importance of dealing with manageable failure is critical to the development of personal competence.” 

In my clinical experience, the idea of perfect is often related to what a person thinks is perfect. I have kids who think in a perfect world my door is closed… or who feel all the toys in my room must always be put up. If one particular child comes in my room and a toy is left out…he’ll put it up for me. I have another kid who decided that how he saw my room for the first time was the perfect example. So unfortunately a ball had casually been thrown “behind a mat”. From that point on, “behind the mat” is where that ball belonged. If he came in the room and the ball was up on the ball rack, he wasn’t happy until it was “behind the mat”. I know growing up, I didn’t want food to touch on my plate and the sauces shouldn’t run together either. But for some kids, Harris Teeter waffles are totally unacceptable but Eggo Waffles are perfect. For another child, he becomes frustrated when he doesn’t do an activity according to his standard that he hasn’t exactly specified and then refuses to try anymore. Some kids get bent out of shape if I don’t do the exact sequence of activities that I last week. 

I personally think that perfect for neurotypical people is something that would be nice, at least in the short run, or maybe less stressful. But with children with Autism, I believe that the need for “perfect” is coping related. I believe they have trouble efficiently developing/storing/retrieving/organizing a mental file of successfully coping with past situations that are less than perfect. They feel that things won’t go well/the day will be ruined unless the door is closed, the toys are put up, the ball is behind the rack, the mash potatoes and peas are not touching, and the Eggo waffles are really Eggo and they are all done in the correct order and in the correct way …so it will all be perfect. I don’t know about you but all that makes me really tired. 

Imperfect challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114.  

*Quotations are from the RDI Messier brochure.

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating a world where so many things happen in such surprising ways. 

To come up with ideas for this post, I spoke to a mother of a child who is high functioning with only aspects of his personality in common with people who are autistic. I thought he might be able to verbalize his concerns.  I spoke to him and his mother and asked them to tell me what was hard about surprises.  His mother explained that she tries not to tell her son about potential surprises that are upcoming in his schedule...unless they are definite. Then a warning could help...otherwise the potential drives him nuts. 

She said that vacations were really stressful for him.  "Stressful?  Vacations?" I asked.  Yes, she said that on vacations the family tended to make last second decisions and decide to go fun places without notice.  This unnerves him.

Another great example was the problem with the monthly fire drills at school. His mother explained that if it got toward the end of the month and the fire drill hadn't happened that he became convinced that it was going to happen at any moment.  She said, "Don't even think about concentrating on the teacher or getting any work done.  He would just sit and worry."  They finally coordinated with the school to let him know before a fire drill so he wouldn't have to worry about the potential surprise.  

His mother explained that she thinks her son feels that with surprises...that if anything changes...that anything could change....and then nothing could be trusted.  Then the world just becomes unbearable chaos...

At this point in the discussion, the son looks up and says, "Is this your way of telling me something is about to change?"  His mother reassured him, "No honey, we are just talking about surprises."  ..."Just answer the question?"  "No, no surprises honey", she answered. "Why don't you just tell me?..."  and on and on for several minutes...

Surprising challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114. 

 

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating a world where so many things happen simultaneously. 

To come up with examples of this, I problem solved with Gail Fennimore, a physical therapist. We decided that play between children has lots of simultaneous challenges. Playing sports are classic examples. Think of all the important things that happen simultaneously in a game of kickball, soccer, freeze tag or duck duck goose. Simply playing safely on a crowded playground requires know what you are doing and the children next to you are doing or hope to do. Even by yourself, processing lots of information simultaneously allows you to walk safely up and down stairs, jump rope, or ride a bike for example.

In Speech Therapy, Sadia Syed explained to me that in a conversation we take in information not only from the words that people say but also from the tone of their voice, their inflection, their gestures, and facial expressions. The rate or loudness of their words can dramatically change the meaning of what is said. She explained that people with Autism may have poor processing skills, poor eye contact, short attention span, and decreased memory skills that make processing simultaneous information yet more difficult. As Sadia flipped her braided hair, she said, “Some children become  distracted by something as simple as me flipping my hair or by my cool shiny ring, then nothing else is processed”. 

In Occupational Therapy, Lindsey Pritchard said that when we write we have to simultaneously think of the formation of the letter we are writing, its spacing, alignment, and size, all while keeping in mind the word, sentence and paragraph and the overall theme/idea of the assignment. 

In Psychology, Steve Elliott talked about how you have the simultaneous influence of multiple subsystems. A child has simultaneous relationships with his siblings, his parents, his pets, his peers, and his school, to name a few. The quality of the relationship between his parents, between a parent and his older brother, and between his siblings (or pets) has an effect on us. I think we all struggle to keep difficulties between us and our sister for example from affecting how we talk and interact with our parents or our teacher at school. 

In Education Therapy, Martha Knight spoke to me of how difficult it could be while teaching to keep the attention of her class. Students have to listen and take notes (2 different types of processing) while tuning out the cool bulletin board beside them, the kid beside them picking their nose, the blinking of the fluorescent light or the police car with its siren blaring as it goes down the road. 

Simultaneous challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114. 

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI), I see core difficulties in children with Autism as they try to manage the challenges of daily life.  One is that they have difficulty negotiating a world that is ever-changing. 

Dr. Steve Gutstein, founder of RDI, says, “Most days hold the promise of ever-changing problems and new challenges. Fresh information leads to solutions we have not previously considered.” 

I considered in my life how it is ever-changing and decided change is more of the rule than staying the same. It always seems that just when I get things figured out,…it changes. Some changes I don’t notice so much. At Trader Joes, they constantly move where the food is that I buy. They stop carrying one item and I have to pick a replacement. The check out line people constantly change. These I cope with easily. Other changes, like the death of my Mother, watching my Father age…and me age… I notice a lot.

I went down to consult in Occupational therapy, Ellen Bruce reminded me how most people don’t eat the same food every day. They may eat at different place, different restaurants, with different plates, different cups for the milk and with different people.

I went down to Speech therapy and Lisa Peterson reminded me how we seldom if ever have the exact same conversation twice. The topic changes, the people, the setting. We may change the words we say or the topics we bring up according to who is present. 

Down at Education Therapy, Dawn Keller told me how with the school year or semesters that classes and teachers change. As we get older, we change classes. Teachers may teach with different styles, different classroom rules, and different emphasis. As soon as we learn one concept in math or spelling, the teacher brings up a new one.

At Psychology, Tina Murphy explained how simple daily life routines change. We may get up earlier or later according to our plans. We may not always come straight home from school. The weekend ritual is different from school days. Some mornings you may have to rush eating your breakfast to catch the school bus. Sometimes Mom may be home for dinner and sometimes not. 

There is a lot of change in life. I remind myself that when it seems like it is changing too fast that change is what makes it exciting and worth living. But change is challenging for people with Autism. RDI helps to build the precursors to these skills. 

You can learn more about autism at www.rdiconnect.com.  If I can help your child with Autism, give me a call. Amy Sturkey 704 332 4834 ext 114. 

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI), I see core difficulties in children with Autism as they try to manage the challenges of daily life.  One is that they have difficulty negotiating a world of Multiple Demands/Roles/Goals. 

Dr. Steve Gutstein, founder of RDI, says, "We are constantly shifting our roles and relationships and do it without conscious reflection most of the time. Faced with multiple goals and daily demands, we easily find ways to prioritize".  Well, I agree with most of what he says...I'm not so sure about the "easily". 

In my life these multiple demands appear on so many different levels.  For example, last night when I get off work, I had to decide:

• Do I leave work now or stay and get some of this paperwork done?  (You've got the essentials done. It's 7 pm.  Get out of the office!)
• Do I have time to work out at the gym?  (No, don't have time.)
• Do I go home first and find out what the DELL repair people said about my fried lap top or do I go ahead and price what a new lap top will cost?   (Go ahead and price a new one, their original quote to fix the fried laptop was $500. Surely I can find a new one for almost that price.)
• How many stores should I get price quotes on?  (Let's try 2. I can hit both of those on the way home and still make it home by 9 pm when the DELL repair office closes.)
• Do I go ahead and buy the one on sale with limited numbers in stock for $429?  (No, I better wait until I hear DELL's final cost for repair and if they will consider it in warrantee.)
• My new artist housemate got paint on the floors, do I have time to go to Home Depot and find something to protect the floors tonight or risk having more paint splattered on my wood floors before buying something suitable? (Yes, take care of it tonight. I have time (and money) now that DELL says the work is under warrantee.)
• My housemate says Home Depot will have what I need, but this seems more like an Office Max kind of problem. I don't have time for both, which one should I go to?  (Call Home Depot and ask before you waste a trip.)
• Now that I am back from Home Depot with flooring cover in hand, what do I have time to eat?  I'm starved!  (A can of soup is all you have time for. Fire up the Microwave.)

You can see how I have in just one evening multiple goals, demands, and roles to juggle... and this was the list of the main choices.  Lots of smaller multiple demands were handled in between.  These are challenges our kids with Autism struggle with (and me too many days).  RDI helps build the precursors to these skills. 

If I can help your child with Autism, give me a call.  Amy Sturkey 704 332 4834 ext 114. 

As a Relationship Development Intervention (RDI) Consultant and a Pediatric Physical Therapist here in Charlotte, NC, I've had to learn a great deal about Autism Treatment.  I try to learn all the time.  I read books and attend autism chats on the RDIos (the online community available for people on the RDI path), but one of my favorites is listening to lectures on itunes or U-tube.  It is free and keeps me up to date. You might want to consider it.  I listen while on the treadmill or on long drives out of town. 

One of the concepts I've learned that I really like is an acronym for remembering the core deficits in people with Autism.  Dr. Steve Gutstein from RDIconnect.com talks about how important Dynamic intelligence is.  It "allows us to successfully solve complicated problems, prioritize multiple demands, carry on meaningful relationships, and achieve long term goals.  Jobs, friendships, marriages and most aspects of daily life are primarily 'dynamic' in nature, although each has static elements that must be mastered.  Almost all human communication and interaction occurs during dynamic encounters, they are the things that make us who we are today."* The MESSIER acronym lists the skills needed to negotiate our very complex worlds.  It is as follows:

Multiple
Ever-changing
Simultaneous
Surprising
Imperfect
Emotional
Relative

On future posts, I'll discuss each one of the above challenges in more detail. 

*Quotes and concepts taken from the Messier brochure available from RDIconnect.com

Declarative Language is another name for experience sharing communication. Emphasizing Declarative Language has really improved my skills as a pediatric Physical Therapist and as a Relationship Development Intervention (RDI) Certified Consultant.  Experience sharing communication is the use of statements and comments instead of orders and questions that you already know the answer to. 

Imperative communication is what we want to de-emphasize. It includes orders, fill in the blanks, or questions that you already know the answer to.  Examples of Imperative style communication are "Put on your shoes!" "Say 'Bye'", "He is wearing a white____".

When a person is using declarative communication, on the other hand, the goal is to share ideas, perspectives, thoughts, and predictions with another person. In declarative style communication, you comment on things or ask questions that you don't know the answer to.  Examples are, "Wow! That was fun" "What did you think about that?"  The person who uses declarative communication is inviting the other person's insights and adding them to what they already know.  Responses to declarative communication are not rote and cannot be scripted by the person who initiates. 

Research indicates that ordinary conversation between typical children shows 80% declarative communication.  Communication from high functioning autistic children shows less than 1% declarative communication.  Adults interacting with special needs or autistic spectrum children tend to question them and order them around. 

Why switch to declarative style communication with your child?

1.  Think about it.  An order carries within itself the information that tells your child directly what to do.  (i.e. Stand up!, "Look at me!")  It requires minimal cognitive activity.  Comments and statements do not tell your child exactly what to do.  They support processing information and enriching communication.  They allow any type of response. We want to encourage our children to think, ponder, wonder, and connect the dots.  Giving orders does not ask a child to think.  It just tells your child to act.  Encourage thinking. Speak Declaratively!   

2.  If you speak declaratively, you provide a model of experience sharing that is badly needed with autistic spectrum children.  How can they learn to talk declaratively if all you do is order them around? Is that what you want them to do to other people? Declarative conversation is more than means-end conversation. 

3.  I've had many families tell me that switching to declarative style conversation made their child more cooperative. Their children didn't feel they were being ordered around and were more willing to be agreeable.  If your life felt like “boot camp” 24/7 getting ordered around, you’d start to be disagreeable too! 

Contact me to learn more about RDI. 

• I had to slow down the pace of my talking to match my client's thinking and processing speed.  That might mean talking really slowly or giving pauses between directions so each one could be processed. I always think about what would happen if  I went to Mexico. I have very little Spanish. If someone spoke to me in long involved sentences, I wouldn't have a chance.  Shorter....simpler....slower sentences with pauses to let me translate would really help me.
• I had to create a less distracting environment.  Sometimes this means turning off a child's favorite music playing on CD in the background, covering the mirror, or making sure I am in front of them on eye level when I talk to them.  Sometimes I stop talking if they look away from me while I am talking and continue when they return their gaze at me.
• I had to learn to emphasize quality of  communication over quantity.  I don't want to hog a conversation.  I think about talking generally the same number of times my child talks.  (This one is really hard for me... I am a work in progress.)
• I learned to exaggerate my body language cues, sound effects, (That part is easy for me. I am a sound effect machine!  I make sound effects when no one else is around.) dramatic facial expressions, and postures. 

Relationship Development Intervention (RDI) is an innovative approach to teach Dynamic Intelligence created by Doctors Hannah and Steven Gutstein via RDI Connect.  The website, www.RDIConnect.com, is the best source of  information about all of the programs:  The Family Guided Participation Program, The Dynamic Education Program, and The Learning Support Community.  

 The website states the RDI Program for Autism Spectrum Disorder (ASD) is described as “a tailored set of objectives, extending from the Family Guided Participation Program and intended to target the core deficits of individuals with the diagnostic distinction, Autism Spectrum Disorder.  Started less than a decade ago, the RDI Program for ASD provides a remedial approach to this complex disorder. A comprehensive set of developmentally sequenced steps…is the cornerstone for neural development.  Families under the guidance of a certified consultant slowly and carefully construct opportunities for their child’s neural growth while adding complexity.  Over time, parents create a formidable impact on their child’s ability to form reciprocal friendships, mature emotional relationships, conduct successful collaborations, engage in flexible/ adaptive thought and master problem–solving abilities necessary for job attainment and success in the 21st century world.  Combining all of the tools with a unique emphasis on the needs of families with an ASD child, the RDI Program for ASD restores hope of second chance for families with an ASD child to successfully engage in this universal developmental relationship, that through no fault of their own, was not successful the first time.” 

RDI places emphasis on the Family Guided Participation Program which helps “families facing a variety of challenges, such as Reactive Attachment Disorder, ADHD, Tourette Syndrome.  Parents learn to re-think their daily lifestyle and restructure routine activities to provide safe but challenging opportunities for mental growth.”

RDI’s Learning Support Community is a web-based learning network that plays a significant role in improving quality of life for children and families.