This Week’s Episode

ToniAnn Loftus is DIR Expert and Speech-Language Pathologist. She trained at the Rebecca School and now owns and operates Seaport Speech and Feeding, a clinic in Manhattan. Today we are discussing inclusion in schools with a specific focus on speech and language and how she can bring the Developmental, Individual differences, and Relationship (DIR) Model into the classroom to make it accommodating for all students. This is a nice follow-up to my podcast with Kim Kredich who, along with her family, was a keynote speaker at the March DIR conference in New York City.

Bringing DIR Into the Classroom to Accommodate Communication for All

by Affect Autism

Seaport Speech and Feeding

ToniAnn’s practice includes children from age 1 to 10. Depending on their needs, ToniAnn works with neurodivergent and neurotypical children at home and communicates with the school on their behalf. Sometimes does in-service work at the school where she’ll talk about what communication looks like, what development looks like, what sensory looks like, and how different communications come out, which can be through behaviour.

ToniAnn also sees children in her local community within the classroom. She’ll work with their Special Education Itinerant Teacher (SEIT 1:1 aids) and Occupational Therapists (OTs) to make sure their day is enriched with speech and language, such as joining their morning meeting or a cooking activity, and bring visuals for the classroom. She finds that the teachers will use the visuals for all of the kids in the classroom and continue to use them when her in-service is done.

Buy In from Classroom Teachers

I asked ToniAnn if she does a follow-up with the teachers. She finds that 99% of the teachers do follow-up and ask for more because maybe they have a child in their class who is on the quieter side and because of the changes they made after ToniAnn’s training, that child now feels like they have a voice using a visual aid in the classroom. She can also help the teacher take any book and help make it a Floortime experience for any class.

Many teachers and directors request learning more about sensory systems and Floortime after ToniAnn’s coaching and ask how to incorporate moving in their preschool. I commented that she must be thinking about movement so much due to her interdisciplinary work at the Rebecca School where she learned so much about the sensory system. Indeed, she says. She points out that you get a lot of buy-in from teachers when they recognize behaviours of children as sensory challenges or communication.

Movement and Meaning Making

After my DIR 202- The DIRFloortime Certificate of Proficiency Course, I had mentoring with an OT in Hawaii named Kiegan Blake who drilled that point into me about bringing what you’re playing into three dimensions. When my son was sliding down into the ‘water’, I used our blue lycra sheet as the water. It really helps with regulation at the first Functional Emotional Developmental Capacity (FEDC 1) and following the child’s interests if they like water.

Bringing the play into movement helps to solidify the concepts so the learning sinks in and motivates the child to communicate more since you’re using multiple parts of your brain, ToniAnn explains. Kids are more motivated to talk and communicate because they feel more successful, she says. They feel like they can point and gesture to communicate, even if their voice is failing them or they can’t get their words out due to apraxia of speech, for instance.

Toni Ann will ask children to show her what they want and if it’s a cup she’ll say the word ‘cup’, smiling. The child then gets to hold the cup to get the touch and feel of it and they’ll smile feeling understood. This motivates them to communicate more because they were understood.  That joy at the second  Functional Emotional Developmental Capacity (FEDC 2) makes them want to communicate more, ToniAnn explains, because you’re helping them form meaning.

Holding up a cue card of an apple doesn’t teach you about an apple as much as biting into an apple does, tasting it and feeling its weight, as Dr. Stanley Greenspan would describe. ToniAnn said that Dr. Gil Tippy explained to her when she first started working at the Rebecca School that if you haven’t heard the roar of the crowds, tasted the hotdog and felt the ketchup drip down on your chin, how can you be a Yankees fan?

When I joked that this is a very American example and that I didn’t like hotdogs nor ketchup, ToniAnn pointed out that even tasting the hotdog and not liking it is an emotional experience! ToniAnn added that many toddlers will eat something and make a yucky face while saying, “Yummy“. She will comment that it doesn’t look like it’s yummy. I shared that my son does the opposite. He says he doesn’t like it but then tastes it and wants more.

What about AAC?

Many parents in ICDL’s parent support group that I facilitate use Alternative and Augmentative Communication (AAC) devices with their non speaking children. ToniAnn said that she will introduce AAC to classrooms as many teachers are not trained to use AAC. She will often use visuals in classrooms for teachers first. It only helps communication. She will typically just observe the classroom for the first day to see how they’re phrasing what they’re saying. Are they making demands or just inviting comments?

ToniAnn tries to have them wonder how they can pay attention to everyone using AAC rather than centering out that one child who uses it. Everyone can use AAC in a functional way. I brought up how Andrew Klein brought up in our recent podcast on Reflective Practice about modelling and how this also came up in my Parent Perspectives podcast with Cass Griffin Bennett, who modelled both low and high tech AAC with her daughters.

I wondered how receptive teachers are to using AAC devices. ToniAnn explained that it’s tough on the teachers if they’re not supported. Most of the teachers have a general education background, but not working with special education needs. ToniAnn would rather they tell her that they have no knowledge about it upfront so she can support them. Getting the kids excited and involved in it helps them understand that it works for everyone, she shared. 

Many of the students feel excited that there’s opportunities to learn within the context of their classroom when they can use AAC. Teachers see ToniAnn use it during morning meeting then are excited to use it the next day themselves. It’s like learning a new motor plan, ToniAnn explains. Having someone model it for you makes it easier and as they do it more and more, it becomes a new part of their day and doesn’t feel like a daunting new task.

Speech is a Fine Motor Skill

Speech is the finest motor task there is, ToniAnn explains. When we think about learning something new for the first time, speech is like a motor plan. We have an idea in our head, we want to execute the idea, and move our mouth in a coordinated way to produce speech, she continues. If we learn the word ‘cup’, for instance, we want to be able to say ‘cup’ every time. Joleen and Lynn’s course on praxis and motor planning for speech is one ToniAnn recommends to practitioners.

ToniAnn talked about how when you start with gross motor movements so kids have to think less about their movements, their fine motor will eventually improve. Let’s teach kids how to use words while they run and jump first, ToniAnn suggests. We want to think about how you can break it down and make it easier. If you work more on gross motor, kids feel more successful, then eventually you move on to the fine motor skills, she says.

It’s not just about the sensory system and vestibular on the swing and then their sensory systems are awake you talk more, ToniAnn said. It’s about the mechanics of their mouth, how they move, and how your brain works, she explained. I shared how we had worked with Occupational Therapist Maude Le Roux going to her clinic’s intensives and my son had a phase where he started licking everything, starting with licking his dad’s face, then his friends at school.

Maude’s theory was that because he had gone through a round of Tomatis listening therapy to effect auditory processing, she believed his mouth was starting to awaken and feel new sensations to clarify how he spoke. Although I could mostly understand him, others couldn’t. Toni Ann said that it’s all interconnected. It’s all the brain processing information. His brain was trying to gain more information Licking felt good and gave him more information. Every child is different.

Development Doesn’t Skip Steps

When our kids are developing and not on a neurotypical pathway, they do things that neurotypical kids do years later, such as mouthing objects that babies do. My son did that when he was 3 or 4. Gene Christian talked about children grabbing parents’ glasses. Babies reach for their parents’ face and our kids are doing it later. My son started pointing at things about four or so years after they were asking me at appointments if he was pointing.

Development doesn’t skip steps, Toni Ann, says. Everything builds on everything else. That’s why she loves Floortime. Everyone follows a developmental plan and everyone will go at different rates. Toni Ann’s 4-year-old son burnt his tongue on hot soup and couldn’t tell her, so he looked at her and licked her hand. He was trying to get whatever was going on with his tongue off. It clued Toni Ann in to the reason and she realized he burnt his tongue and was able to tell him what happened to him.

A Focus on Communication

There are children on the autism spectrum who don’t start speaking at all sometimes until they are 6 or 7. ICDL’s board president Emile Gouws did not speak until he was 15. People didn’t think he would ever talk. There will be some autistic individuals who will never speak. They will use AAC devices to communicate. Dr. Joleen Fernald said that she’ll never make a prediction again about which children will or won’t speak after being wrong about it in the past.

I asked ToniAnn how we approach this with parents or teachers. She asks them how they feel when they are given a question in a crowd. Would it make them more or less likely to be able to respond? They maybe never thought of it as feeling like a quiz, she says. There’s talking versus communication. ToniAnn focuses on communication and how we can enhance it. After a few sessions with her, she can say, “Look how much better they are motor planning and letting us know what they want.

We are always looking to improve a little bit more, ToniAnn says. We want to think about how we can support our child to feel heard. Let’s give the child space to show us how they feel most comfortable communicating. This will be a lifelong process, ToniAnn stresses, figuring out how they want to communicate. She has met kids who are poets, but don’t use verbal speech. Let’s celebrate each child as an individual, she emphasizes again.

Things are Slowly Changing

The world is slowly starting to understand that different children communicate differently, ToniAnn believes. Now people understand that each individual is different and the way we each learn is different, which makes it harder for teachers, but it’s starting to be recognized. Ideally we want teachers to notice “That’s different. Let’s celebrate it and support it” versus saying “I can’t do that!

At the Rebecca School, ToniAnn shares, they would take the students out into the community and one time at Trader Joe’s a student started throwing apples. Her regulation plummeted along with the child’s. A worker there recognized them and introduced himself to the child and asked his name. He explained that we can’t throw the apples and asked him to help pick them up. It was so kind and supportive, letting the child have the time he needed to pick up the apples and put them back.

Process over product, ToniAnn says. That person could have been angry at Toni Ann or the child, but was instead supportive. Toni Ann taught a DIR 101 Introduction to DIR and DIRFloortime course in Heber Springs, AK where people from the entire town came to learn: the Walmart greeter, a police officer, teachers, parents, the librarian–they all came to learn how to interact with autistic kids in a way that’s productive for families versus being punitive and were there to learn how to support each other.

How do we have a sensory space in the library to support the children during storytime, for instance, was a wondering. A bunch of them then took the Basic Certificate Course, DIR 201 with ToniAnn and a few went on to the next course, DIR 202, as well, with another trainer. It was such a great experience for ToniAnn to see this community’s dedication.

Promoting Communication

Autistic self-advocates advise providing AAC as early as possible while children are learning, even if they do end up speaking. Even if they do end up speaking, some individuals will prefer texting over speaking verbally. ToniAnn says she, herself, prefers texting so she can think about her response. By asking adults how they communicate, it gives them insight into how their child might communicate.

Toni Ann shared her use of low tech AAC with her son on her Instagram account. She put pictures of the snacks that were in the cupboard. Her son would point to what he wanted, then open the cupboard and get it. It helped solidify the meaning of what each picture meant until he could speak, ToniAnn explained. If she had drilled him to say that he wanted a ‘bar’, it would have made him feel anxious. She is more interested in overall communication. The nonverbal comes before the verbal.

We talked about recognizing cues our children provide which is their way of communicating if they can’t make their body or mouth work how they want. ToniAnn shared that Dr. Gil Tippy presented a talk called, “What are you doing?” to the Rebecca School staff about how you walk into a room and read the cues of everyone to figure out how to enter the space just ‘being’ versus ‘doing’, gauging the environment before engaging in big affective communication.

ToniAnn will observe how a parent is interacting with their child and see if it’s a match. Video recording is so helpful so you can see how far a child has come, but also so you can see how you are at reading their cues. The way a child reacts might tell you that you’re giving them too much information with your face, affect, and volume, for instance, ToniAnn explains.

Too Much Communication

I asked ToniAnn about kids who talk a lot. Toni Ann says it’s serving a purpose. It could have to do with liking the auditory input. If you are in a home where the TV is always on in the background and people are talking, that input feels good to you. If the classroom is quiet, maybe they are talking to get that feeling. It ‘could’ be a reason why. How can we give that child more input to make them feel more comfortable?

Maybe you can start with every child having a chance to give a shout out to start the day, ToniAnn offers. Reframing is always helpful. You can reframe what a student is doing. They’re seeking auditory input or more movement, so think about how we can help them get that in different ways.

More Helpful Tips

Use visuals, ToniAnn stresses. Visuals are simple. You can use your mobile phone to take photos of places you go, your child’s school, and things they do around the house so they can visualize what’s happening. Having a red circle on the floor where they sit during morning meeting can support them going to morning meeting. Having a rolodex of things in their classroom that can help, ToniAnn suggests.

ToniAnn also suggests using picture boards on the back of their IDs for when they’re out in the community. It’s one thing to say we’re going to a new park today versus showing a photo of where you’re going and saying that it’s a new park. Take the time to explain and show the visuals because it is very helpful, she says.

Working with the deaf and blind community, ToniAnn has also learned about backgrounds. A black background with white print is easier to see than black type on a white background. You can label pictures with words. Think about things as a whole in the classroom that we can then use for everybody, ToniAnn suggests.

At Seaport Therapy, ToniAnn can help parents wherever they are, virtually. Sometimes it just takes a tiny little tweak to make a big difference. She learned so much at Rebecca School working with Dr. Gil Tippy, Toni Tortora, Andrew Klein and so many more. She is grateful for all of the training that lead her to where she is today.

Floortime is for Everyone

Floortime is for everyone, ToniAnn shares. It helps understand how we are learners. Getting DIR into more schools and to more teachers will open doors. Floortime is not just for kids with specific challenges and support needs. ToniAnn is excited to share that with others. They’ll start to think about things they can ask Occupational Therapists (OTs) and bring them into the classrooms. They’ll consider how to support kids on the patio and kids jumping all over each other. OTs should be in every school. If we start looking through this DIR lens, schools could be more inclusive, ToniAnn concludes.

This week’s PRACTICE TIP:

This week let’s use visuals with our child, if we don’t already, to provide alternatives to communicating and be mindful of not being too demanding with questions. 

For example: Take photos of places you go to regularly and/or items around the home that you use, and show them to your child to inform them of where you’ll go frequently before you go, and/or giving them choices between items you have in the home–whether toys, food, clothes, or something else.

Thank you to Toni Ann Loftus for taking the time to record this episode with me about promoting communication for all in the classroom. I hope you found it helpful and insightful, and will consider sharing this post on social media.

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

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