Neurodevelopment

Greater and Less Than – Lessons in learning Through Movement

Somatosensory activities and education, this is a topic close to my heart.

GREATER THAN

For a little over two years now I have been consultant and then project manager of a pilot project in Australia looking at the inclusion of patterned, repetitive somatosensory activities in primary school classes.

So often we hear teachers and educators ask about strategies for managing traumatised children and their resultant behaviours in the classroom.   All too often in my clinical practice teachers have looked at me, perplexed when I suggested they could include somatosensory activities into curriculum.  In fact I had almost got to the point that I believed this maybe wasn’t achievable and that I had to enlist an education champion to help me articulate my meaning more clearly.  The latter may still be the case, but in Charlotte NC I had the professionally heart warming experience of watching a relatively new teacher to the Alexander Youth Network (AYN) Psychiatric Residential Treatment Facility (PRTF) School do exactly what I’ve been talking about for years.

The PRTF School do what most neurodevelopmentally and “trauma” informed education programs do, by providing frequent “brain breaks” for their children.  Essentially this is where they step down from academic learning and engage in some form of somatosensory activity such as playing outside, water play, sand play, play doh, calming corners with sofas, bean bags, blankets and soft toys etc. They do this routinely, repetitively and frequently – in fact given the arousal and dysregulation of the children AYN sees in its PRTF, these breaks seemed to work best when applied every 10 or so minutes.  Having access to a staff member dedicated to leading these breaks and co-regulating the children in between them worked a treat as well.   All of this impressed me, but what really stood out was this one teacher who found a way to incorporate somatosensory activities into curriculum based learning!IMG_7140

You know maths and mathematical concepts is a difficult gig at any school, let alone a classroom of children struggling with emotional, social and behavioural difficulties.  So when this teacher came in to teach the concepts of less than and greater than I thought to myself this will be interesting.

Immediately on entry into the room, she invited the children to the front of the class and had them all stand or sit around her as they preferred. She didn’t get flustered or annoyed when children came and went from her teaching space and in doing so, actually appeared to manage keeping them around her and in the vicinity of learning for the whole exercise.  Each child was given a piece of paper containing a number, each child read their number out aloud.  The greater than symbol was drawn on the board and there was minimal question and answer time to ensure that everyone understood the concept of the greater than symbol.

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Less than & Greater than

Then engaging the students in an activity based process, moving them around she asked them two by two (based on those most engaged in the moment) to identify their number and stand either side of her – as she held the greater than symbol.  The student’s task – to put themselves in the right spot – who’s number was greater than the other.  Each student excitedly took their turn and much celebration was had as each pair got it right.  In addition to the movement which we know provides sensory and motor based regulation to the lower parts of the brain, this teacher relied on her voice to ensure up regulation and down regulation in the moment and what was most impressive was that she made the lesson punchy and brief.  In and out in no more than 15  minutes and a key mathematical concept was taught and grasped by these children.

Can somatosensory activity be incorporated into curriculum?

I think it can.  It might take a bit of creativity and planning, and maybe even a shift in basic education philosophy about how to teach children, but I still think this is very achievable.

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Alexander Youth Network

 

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In the last week of May I journeyed to beautiful Charlotte in North Carolina to spend the week with my colleagues at Alexander Youth Network (AYN).  AYN’s main campus or headquarters, and the home of it’s Psychiatric Residential Treatment Facility (PRTF) and one of their Day Treatment Programs, is located on a picturesque 60 acre property with buildings nestled in a woodland area with open grounds and recreation areas for their clients.  This campus also houses facilities including a gym, indoor swimming pool and cafeteria.

AYN is a non profit community based organisation receiving funding from fees for services (medicaid, insurance and the like) as well as contributions from individuals, corporations, foundations and government agencies.  AYN serves children ages 5 to 18, who are referred from hospitals, physicians, parents, schools and from state and county organisations such as department of social services and juvenile justice.  AYN serve over 7000 children each year.

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Surrounding woodlands

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Woodland Trail

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Deep in the woodland trail

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Alexander Youth Network Grounds

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Onsite Playgrounds

AYN provide an array of mental health treatment for serious emotional and behavioural difficulities including: diagnostic and outpatient services, community based programs, multisytemic day therapy, therapeutic foster care and an onsite, 36 bed psychiatric residential treatment facility.  The idea being that children, young people and families accessing their services can move from service to service with established working relationships of trust within the one organisation.  Added to this is the strong grounding the staff have in child development, trauma, attachment and neurodevelopment as a core component of their orientation and ongoing training.

AYN array diagrams 2012

It was a contrast to go from services that have decisively removed themselves from the medicaid system or appear to have more flexibility than is given from the public health system and as a result appear better funded and able to provide longer term intervention for their clients.  At AYN the financial resourcing struggle of service delivery was evident in comparison to the private services I had visited.  While the AYN staff were at times a bit despondent about this, I was nonetheless impressed at what they were offering and able to offer.  There is something about not having resources at your fingertips that can contribute to a creative resourcefulness and the team at AYN do this well.  In fact when it comes to neurodevelopmentally informed and respectful interventions AYN have lots to offer:

  • Individual therapy including EMDR, play therapy, sand tray and an awesome play room furnished largely by donation and financial grants
  • Art Therapy including pottery and their very own kiln
  • A ropes course for adventure therapy
  • A Labyrinth
  • Occupational Therapy with a motor and sensory furnished room including a swing and tunnels.
  • Physical Therapy
  • Reiki
  • Swimming
  • Vegetable and flower bed gardens and gardening program
  • Woodland walking trails
  • Playgrounds
  • Gym
  • Developmentally matched classrooms that afford children regular (every 10 – 15 mins) brain breaks and recreation
  • Classrooms that are highly sensory and provide calming, alerting and regulating activities including rocking chairs, bean bags, chill out areas and such
  • Bike program whereby each PRTF child has their own bike.

 

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Art Therapy room including Kiln

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Play Therapy Room

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Play Therapy equipment

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Play Therapy Room – role play and dress ups

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Play Therapy puppets

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Play Therapy sand tray and figures

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Occupational Therapy room

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Developmentally matched classrooms

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Chill out area in classroom

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Of more concern to me than their financial resourcing issues, were the systemic restrictions being placed on AYN in relation to the length of service delivery they are able to offer their clients.  The public health system funding children coming into the PRTF, those clients with the most serious of emotional and behavioural disturbances, are placing pressure on the service to treat and “repair” these children in 3 months.  The years of clinical practice, much of the theory out there, and my more recent acquisition of neurodevelopment and trauma expertise have taught me that it takes more than 3 months to form a trusting relationship with some of these kids.

 And we know that it is only in the context of such trusting relationships that these children can being to heal.

So with that knowledge I take my hat off to my colleagues at AYN and their ability to work within a public health system that places considerable restraint on their ability to really heal these kids.  The staff I met talked openly of the 30 day review process they have to undertake to retain or regain funding for ongoing work and the associated challenges. Despite this, the passion and commitment for their work and the children and families they serve sees them rise daily to these challenges and provide meaningful connections and healing opportunities for North Carolina’s more vulnerable citizens.

 

Cal Farley’s Boys Ranch: A Shirttail to Hang Onto!

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I had the absolute privilege of spending the week of 19th – 23rd of May in Amarillo Texas on Ranch at Cal Farley’s residential treatment centre.  It is hard to know where to start when describing Cal Farley’s and my experience there. One blog is not going to even remotely capture the breadth of what the service offers.  First and foremost I have to acknowledge the absolute generosity of the Cal Farley’s team from their Chief Operating Officer, Clinicians, Training team, House Parents and well basically everyone on the property. My visit was catered for most generously and my schedule was very busy – largely because there was just SO much to see and in the spirit of my Fellowship,  I didn’t want to miss a thing.

Cal Farley’s is a one of a kind service, of this I’m pretty confident.  It is one of America’s largest privately-funded child and family service providers specializing in both residential and community-based services at no cost to the families of children in their care.

Yes you read me right, NO COST!

The founder of the Ranch, Cal Farley was quite a visionary for his time and in 1961, he established the Cal Farley’s Boys Ranch Foundation. Contributions from the Ranch’s friends and supporters provide approximately 30 – 40% of the funds required to meet total annual operating expenditures. Through the foresight of Cal Farley and his Board of Directors, the remaining funds required to operate are available through the Cal Farley’s Boys Ranch Foundation.

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Cal Farley Statue

Cal Farley’s operates like a small town – in fact it’s almost big enough to be a small town.  It hosts a chapel, fire station, it’s own bank and post office services, has it’s own independent school district, complete with administration, including their own superintendent, elementary, middle, and high school.  An activity centre, gym, pool, football field, indoor horse riding arena, rodeo stadium, athletics field, stores and the communal dining hall.  Many of the staff live on site at the Ranch, which in addition to the staff homes, hosts 28 residential homes each of which caters up to 12 children and young people.  At capacity Cal Farley’s can have up to 260 children and young people at a time.  Residential homes are staffed by 2 sets of house parents, the lead house parents and relief house parents. The residential homes as you can see from the photos are all designed similarly and provide a very homely feel.

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Example of Cal Farley BR home

 

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Kitchen/Dining

 

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Living Room

 

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Bedroom

Neurodevelopmentally informed interventions/activities included (and I will probably leave some out):

  • Individual Therapy
  • Neurofeedback
  • Play Therapy
  • Art Therapy
  • AAT – largely equine based including colt and filly training and Rhythmic Riding
  • EMDR
  • Adventure Therapies – Ropes Courses, Kayaking, Trail Rides, Challenge course
  • Rocket Club
  • Computer Lab
  • Woodwork Studio
  • Robot and other electronics programs
  • Rodeo skills
  • Drumming
  • Archery
  • Gardening/Agriculture
  • Agriculture workshop – where they built a trailer for example so that they could transport their livestock to agricultural shows.
  • Mentoring of younger children by older children
  • Capacity for vocational training and part time employment

All of this is embedded in a community where relationships serve as the key to success.  As I wandered around Cal Farley’s I had to remind myself that this was a service for children and young people who had mental health, emotional and behavioural problems, because often what I saw and experienced seemed just like any ordinary community.  The importance of relationships whereby the kids were positively supported, contained and nurtured by multiple adults in their daily experiences was evident in the way the children and young people conducted themselves in the community. I’m not saying that there were no challenges, as there were, but on the whole the adults in this community do a wonderful job of creating a relationally rich environment filled with amazing activities, “interventions” and opportunities.

If you work in the child and welfare sector and you ever find yourself in Amarillo Texas – look Cal Farley’s up and see if you can visit – it’s nothing short of impressive and it’s folk are just downright good people who are absolutely and only in this for the best outcomes for kids.

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Kayaking Adventure Therapy Session

 

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Practicing capsizing and rescue and the experience thereof.

 

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Robot built in rocket/robotics/electronics/ computing lab

 

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Pre therapy jigsaw pieces – goals and wishes

 

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Therapy Closure Jigsaw Pieces – outcomes

An Excuse for New Boots!

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The Sandhill Trail Ride with Acacia Riding Adventures: San Lorenzo Canyon New Mexico.

I’m always looking for a reason to add to my collection of cowboy boots. Now there’s more to this story and while this blog is really about neurodevelopmentally informed interventions and I’ll get there in this one, just let me set the scene a little.

There I was in Denver – a little over a week of being in the States and well I hadn’t really packed for a cold snap.  In fact, despite what seemed to be seamless organisation in relation to my packing – I really didn’t consider or even think about researching the spring weather conditions for places like Denver, Banff and Calgary.  So after a 102/38 degree day in Wichita, I head to Denver – where it was a crisp 63/17 degrees and my footwear is pretty much a pair of canvas Toms and two pair of open toe summer sandals!  This coupled with a Facebook post from a dear colleague in Calgary showing their spring snowfall (looks like our winter on the ski slopes) resulted in a rapid move up the arousal continuum to a state of mild stress activation.  “Will it be like that when I get there in June ?” “I’ve only canvas and open toed shoes, hello frostbite…”  and then as I engaged some self regulation, calmed and regained access to my thinking brain, came the problem solving “…Hello Boots!” On that very same day I get an email from Cal Farley’s to let me know that I’d be doing a trail ride – on a horse.  It is meant to be and now the deal is sealed, new boots for me!

I haven’t ridden for over 23 years, so the idea of getting back on a horse caused me some apprehension, however in the last two weeks I’ve now had opportunity to do two trail rides, firstly with Sandhill in one of the most picturesque canyons, secondly at Cal Farley’s around the treatment centre campus.  I’d love to be able to tell you that it’s just like riding a bike and one of my observers suggested to me that it looked just like that – on the back of that animal although – that’s not how it felt.

The mere idea of getting back up on horseback was in and of itself anxiety provoking for me.  I’m not a lover of heights, and well I’ve put on a bit of weight since I was a kid riding and being a lover of animals was quite concerned about my horse having to bear my weight.  On both rides what was fantastic was the reassurance from experienced horse handlers that both of my horses were more than capable of carrying me and doing so safely.  The other thing that I loved about both Dacodah and David was their ability to scaffold a feeling of competence and in turn begin the process of co-regulation of my anxiety.  I couldn’t help but think about what this experience would be like for a child or young person so used to negative human interaction, to have both an animal and its handler working together in the most natural of ways and leaving you feeling nothing but important and what’s more, even with skill.

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Cal Farley’s Trail Ride

Once on the back of the horse, there was no going back on either occasion.  In fact on the first ride there may not have been any going forward either had the horse not clearly communicated to me that I was anxious and she was not enjoying that experience.  My horse kept looking at me and snorting almost with derision.  Initially this did nothing to quell my anxiety and left me thinking all sort of negative self talk about my weight and the horse’s experience of it.  Not unlike the float tank, it was interesting to notice the thought processes that emerged about myself and the importance of sorting that stuff out or at the very least challenging it, for the success of the experience.

Dacodah and David on both occasions reminded me that the horse, being a prey animal, have an overactive stress response system – not unlike the abused and traumatised kids we work with and that they are finely attuned to threat.  Sensing my anxiety both the horses had started to become a bit “on edge” really just feeding off my own anxiety.  So in order to calm them, I had to calm myself.  The horse like the frightened and traumatised child, at the heart of it, really wants a calm, regulated, nice, nurturing, rewarding rider who can take control and be respectful of them.  The more I was able to manage my anxiety and relax into the animal while at the same time retain a sense of confident control the more attuned the horse and I became, the more responsive they were to me and the more confident and skilled I felt.

I can only imagine living a life where you feel out of control all the time and then having an experience like this where you have capacity to control the success of your interaction.  Yeah sure we could argue that our kids have capacity to control the success of their interactions with us all the time, but the immediate feedback from the animal that is without judgement, mixed messages and completely non verbal is so very powerful.  If you don’t get yourself sorted and regulated then your horse is going to do what it needs to take care of itself. There’s not going to be responsivity, let alone the chance of working together.   I watched young people who got this and were able to, in the moment, do what they needed to do to have a successful and pleasant ride with their horse.  I also watched other young people struggle to manage themselves, then end up more dysregulated when their horse wouldn’t do what they wanted, making the horse even more non compliant and not interested in the process.  I could absolutely see the benefit for in the moment reflection and wondering about the experience with the kids and the power of experiential learning when observations and interactions could be reflected on and internalised.  Aside from the physical sensory experience of riding there is definitely something in this equine based work!!

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Not so new anymore

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San Lorenzo Canyon

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On the trail

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A Self Portrait on horseback

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Canyon Pictures

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More of the Canyon

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Pictures do not capture the beauty of this place

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Just like in the movies

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Views from a top San Lorenzo Canyon