The Conversation

This Week’s Guest

Returning guests, Jackie Bartell, retired special educator, and Colette Ryan, Infant Mental Health Specialist discuss a video conversation presented at a past ICDL Conference where a mother and son have a discussion about the son’s differences pre- and post-DIR/Floortime. Jackie and Colette are both Developmental, Individual differences, Relationship-based (DIR) Expert Training Leaders teaching certificate courses at the International Council on Development and Learning (ICDL) where they also coach parents in the DIR Home Program.

Parenting Dreams

The beginning of the video starts with the dreams the parent has for the child, but sometimes our dreams don’t match the child we have, Colette points out. The beautiful thing about Floortime, Colette says, is that a coach can support you so that you feel good about your parenting, rather than feel sad. They can support them in interacting differently. Maybe you can rock faster or slower, singing more slowly or in a whisper, or touching more firmly. It helps parents get to the 2nd part of The Conversation.

Jackie adds that in both scenarios, parents are working very hard and are trying to gain connection with their child. In the first half of The Conversation, the connection isn’t working due to the uniqueness of the child. When you change the response, you change the reaction. Jackie adds that the cue sending and reading in the first half isn’t a match, despite good intentions. In the second part of the video, Mom starts to join where the child is at and reads the child’s cues which starts the connection. 

DIR/Floortime really helps look at and determine where your child is Developmentally, determine their Individual differences and sensory processing profile, and use the Relationship to make a connection. I related so well to not knowing why my child was so fussy all the time. It’s very confusing for parents who want to connect but don’t understand why their baby is unhappy. Our child’s attachment promoting behaviour might be different than what we expect. This is where we have to attune to the child. 

Negative Feedback Loop

Jackie adds that there is a mismatch when the child needs the parent, but the parent picking them up makes the child uncomfortable. The parent’s intention is so good, but the mismatch between what the parent does and how the child experiences it, from a sensory perspective, is negative. Colette points out that it’s not rejection. It’s not their choice. My son needed to constantly be held while others might not like being held. Jackie adds that the sensory experience gives rise to the affect, which gives rise to the emotion that then gets intertwined with that sensory experience.

You are collecting experiences that feel like rejection to you as a parent. That plays into the parent’s own neurology and how they then respond back and forth. We have to give ourselves space as parents to think about that, too. Mom might be singing trying to soothe the child, but the child can’t be soothed in that way. Colette adds that the sound, “Shh” doesn’t have the meaning of being quiet to the child and could be an aversive noise to the child. The child might cringe when the mother comes close in anticipation of the aversive noise, which is a feedback loop of rejection to the parent who then can be dysregulated by the experience, themselves.

Body Awareness

The next part of The Conversation talks about the child’s body being ‘floppy’ and Colette points out that the idea of not understanding your body can be ‘out there’ for many people. A Floortime coach can help the parent understand how the body takes in the sensory information into the body and come out with a response. We also have an apparatus to help a baby sit up in any variety of settings which prevents them from being able to work on sitting up on their own. A coach can help you to understand how to give your child the movement experiences such as tummy time, etc. to help that sensory system develop.

I explained how I struggle with explaining body awareness as well and point listeners/readers/viewers to the last podcast with Occupational Therapist (OT) Maude Le Roux who described being floppy as a lack of balance between the extensor and flexor muscles in order to be able to hold your body up. Pediatricians don’t tell parents about this, and after the diagnosis you may or may not get referred to OT, and that OT may or may not be informed about Sensory Integration, and they may or may not be Floortime trained, so it’s tough for parents to navigate. 

In addition, the experts say that the more a child is using the energy to try to hold their body up, the more cognitive load they are using and thus have less for interactions with us. Jackie points out that you also have to think about the organization it takes for a child to use different muscles in different positions and how that changes as the child starts to crawl and walk. She adds that we have to think about the mother’s cognitive load, too, because her source of data is that the twin sibling can sit up, so she’s puzzled what to do about this child who can’t. 

I added that the child over time might continue to hear about all the things they cannot do that their siblings or other kids can, and will notice all the things other kids are doing that they can’t do, and that can give them a bit of a complex! Jackie points out that the parent’s intent is not negative, however, in pointing this out. They are simply at a loss for why they had success with one child but not the other and are seeking that connection. 

Not Responding to Their Name

In the next section of The Conversation, the mother wonders why the child won’t look when she calls his name. The child’s response is that they do hear the mother, but are unable to respond due to everything going on around them, and inside of them. Colette first points out that the child may not have made meaning around their name yet, and that even if you know your name, that you’re supposed to turn around and look, which is a neurotypical social norm.

Routine

In the next section of The Conversation, the mother calls the child stubborn and the child responds that having things be predictable helps. ‘Stubborn’ is the observable behaviour, and there’s a frustration with not knowing how to manage and move through it, Jackie says. The mother is having a challenge understanding who her child is, Jackie continues. Colette adds that if you don’t feel safe when you interact with someone, there goes your regulation. And you can’t engage with someone if you don’t feel safe. Colette adds that it’s about their perceived sense of safety, too. Not just the general safety that parents provide. 

Repeating What They Hear

In the next section of The Conversation, the mother describes how the child repeats everything. My son repeats everything over and over again, too, and we had a great conversation about this in ICDL’s Parent Support Meeting recently. And the child continues in the video to say that it’s hard for them to find their own words and they need help sharing their feelings and ideas. I took that to mean that since it’s hard to find their own words, it’s easier to repeat what they hear, and also that they may have seen a movie that depicts what they’re feeling, so they repeat a script that iterates what they feel. Colette brings it back to meaning making. 

Dysregulation and Negative Emotions

Colette says that it might be easy to navigate positive emotions, but when they feel negative emotions, “Calm down” never works. We have to support them in understanding these feelings in a calm way, joining them and being on the journey of that emotion. And as far as ideas are concerned, we don’t always have an easy time coming up with them so pictures or code words might be of assistance so they have less stress, their cognitive load, in expressing their feelings ideas.

Jackie adds that what the meaning the parent is understanding in that moment is not so great. They wonder why their child is finding themselves in this place of dysregulation and ask what they have done about it. They want to be able to take care of it because that’s what a parent should be able to do, she explains. Floortime is a great way to help us understand how we help parent and child find that place of calm and safety together and change the meaning of what that dysregulation means, Jackie offers.

An Adaptive Response

The last podcast with Occupational Therapist Maude Le Roux really highlighted why moving makes your body feel good and makes you happy if you’re a kid who needs to use your vestibular system to activate your other sensory systems. It is adaptive. However, parents do often compare their children to those who can sit still and stay calm. 

Playing with Other Kids

I hear parents frequently say that their child seems so interested in other kids. They look and watch, but don’t know how to join in. I think it’s indicative of the child’s sensory processing why it’s difficult for them. The other kids speak faster than they can hear and process, or move more quickly than they can register. In We chose play, I shared how Dr. Tippy pointed out in a coaching session with my husband that he was ‘very athletic’ but our son couldn’t process these quick movements. Jackie adds that Floortime helps to facilitate moving their bodies to organize in order to relate in a connected way.

Colette adds that the mother has dreams for her child that includes wanting them to be able to play with other children. Going to a playground where kids are playing and plopping your kid down would seem like a way to make that happen, but if our kids have processing challenges, it’s too difficult. That doesn’t mean it can’t happen, though, she adds. It means that we start with one child until they’re able to have a great time with one child. Then, you add another child, Colette says. As we introduce more and more stimuli, your body adapts. We build on our ability to process information. I gave an example of this process with my son.

Finding Connection

The mother then wonders about the dreams she had for her child and the child pleas that they need the parent to understand them. The video pauses in the middle with an explosion of text describing everything that bombards a caregiver after the diagnosis, then whittles all the words away until only ‘Developmental, Individual differences, Relationship-based‘ is left on the screen. Colette says the greatest gift of being a Floortime coach is that they can help you modify your dreams so the child is understood and everyone is more connected! Connection, Jackie emphasizes.

The video then replays with the child saying the same things, but the responses of the mother being different. The mother is now enlightened. What jumped out to Colette is the attunement the mother has found with her child. Someone has now coached the mother to do a little ‘wait, watch, and wonder’ to determine what the baby likes, and how they experience the world. Jackie adds ‘implementing’. Try different things to see what happens, and giving yourself the space to do that without having to know all the answers, Jackie adds. She likes the idea of watching the baby and learning from the baby about what makes them feel safe, which then allows you to attune.

I discussed how while many things intuitively come to a new parent, such as what your child likes and doesn’t like, some negative reactions are more difficult to figure out. When the mother says that hugs work best when the child needs them, not when she needs them, Colette says that hopefully she also figures out that we don’t have to hug grandma, grandpa, aunt, uncle, etc. either. I shared how I love how Dr. Neufeld suggests asking the child, “How would you like to say ‘bye’ to ___?” which gives the child control over the touch. They may want a fist bump or a high five instead!

Follow your Child’s Lead

When the child says that the mother’s voice and smells overwhelm him and she said she’ll follow his lead we talked about what that means. I mentioned my past podcasts about Floortime being child led and/or adolescent/adult led. It’s about attunement and cue reading when you look to the child for the communication cues they’re sending you. The cues tell us what they like and what they don’t like, Colette continues. Following the child’s cues is following their lead, Jackie adds. It’s about being together in a shared experience.

Next the mother responds to the child that they’ll move together, “roll, push, pull, climb” to get body awareness. Colette says it’s about exploring what your body likes and doesn’t and what it needs help with, and that I’ll be there as a parent to support you to become aware of it. Jackie stresses that it’s together. The mother won’t ask you to do it and watch. They’ll do it together. All of this movement is how you gain body awareness. When you don’t have body awareness, Colette continues, the neurodevelopmental reflexes aren’t integrated correctly.

Guiding our Children’s Attention

The mother then says that she’ll help the child figure out what is background noise to help them filter out noises that can be overwhelming. Colette says when the mother says, “Shhh…” it may or may not be about what the mother says, but that the mother said something. The child learns to pay attention to what Mom pays attention to and draws attention to. It’s again about experiencing sounds together, Jackie says, and maybe the mother is aiming to keep herself quiet by waiting, watching, and wondering how the child is experiencing the noises.

I pointed out that parents wonder how to do this. I suggested that I would use a lot of affect and guess about the child’s reaction to noises by saying, “Oh! You did NOT like that sound!” or “Oooo…what a funny noise! You thought that was funny!” Your child’s look, gestures, movement, displeasure or smiles and laughter will tell you if your guess was correct or not. Colette adds that you can say things to alert the child to important sounds such as asking, “(Gasp) Did you hear Daddy’s voice?” or alerting them to some other sound like a horn so they can make meaning of them.

Schedules

In the next section, the mother now supports the child’s need for routine by making a schedule. Colette points out that we support regulation through changes by alerting the child of changes that might come up, such as letting them know that although we were going to go swimming later, there is a thunderstorm coming, so we will have to do it tomorrow instead. Jackie stressed in the affect podcast we did some years ago that nonsense and silliness can make it more fun and less anxiety provoking, so we might say, “Oops! It’s raining today! We’ll have to swim tomorrow!“

Communication

The parent is now noticing that the child is communicating in a different way. Colette says there’s a difference between communication and language. We just have to pick up on the cues about what’s going on. You miss out a lot if you’re only focusing on the language. Jackie adds that you need to allow your child to be the director of their own drama. Dr. Greenspan would say to let the child win at least 80% of the time and only challenge about 20% of the time. This allows them to feel safe enough to explore and move forward, rather than staying anxious and dysregulated.

Colette adds that letting the child direct goes back to following the lead because sometimes parents think that they are the boss and need to take charge rather than letting their child take the lead, but we are talking about them directing in a play context. We’re not giving over control and having a free for all, Colette says. We’re supporting the child in initiating their own ideas and letting us know about them instead of us telling them what to do, what to think and where to go.

Again with Movement

When we give space for movement, that’s when the magic starts to happen, Jackie says, because the child is starting to figure out their body, their sensory systems and primary reflexes become more organized. The key though is that the parent does the movements with them, she adds. That’s where the reciprocity, connection and support comes in around the challenges around where’s my body in space and integrating the reflexes and sensory systems. 

We’re in this Together

Floortime provides a platform where the frustration is not at the forefront, Jackie says. It’s a collective process where everybody grows and moves into a shared world, she continues. Colette adds that we do so much reflection in Floortime: in the moment, on the moment after the action happen, and before the moment when we wonder about what will happen. Supporting parents in understanding the reflective piece is very powerful, Colette stresses. Jackie adds that, as parents, we add to the flow of interaction. Our own regulation impacts this and the reflective process helps us be in touch with our own feelings about what’s unfolding before us. 

Thank you to Colette and Jackie for reviewing this video and discussing development of a child on the autism spectrum. I hope that you learned something valuable and will share it on Facebook or Twitter and feel free to share relevant experiences, questions, or comments in the Comments section below.

Until next time, here’s to choosing play and experiencing joy everyday!