NACD - The National Association for Child Development

NACD Newsletter - Volume 7, Issue 5 - November 2014

In this issue:

Beyond "Therapy"
A Tool is Just That
So You Developed a Skill (So What?)
ANNOUNCEMENT: NACD Cognition Coach - Toddler to Age 3 Now Available!
Upcoming Evaluation Dates

Beyond "Therapy"

by Bob Doman

Thoughts on factors influencing gross and fine motor development, with ramifications affecting cognitive function and language in developmentally challenged children.

I have observed a number of problems in our children whose overall development is slower than that of typically developing children, issues that are only indirectly associated with the actual neurological and physical aspects of their function.

The degree to which the brain seeks change is related to the rate of development.

For most children with developmental issues the sequence and steps of fine and gross motor development are as those of neuro-typical children, albeit often slower and impacted by structural issues. The slower developing area of function unfortunately creates some extra hurdles for our families and children.

In a typically developing child things happen fast. From birth to 3 years, every time you blink the child has started to do something new. During this time they go from being totally dependent and lacking mobility, hand use, or communication, to being able to run and jump, carry out most self-help functions, and speaking in sentences. Often in the period between just six and twelve months, the child learns to crawl on their belly, then pops up onto their hands and knees and creeps, and then are pulling to stand, cruising, and taking their first steps, all seemingly in the blink of an eye and without any specific help or intervention. Their brain is driven to do new things. Change stimulates change. Change is their norm. Slow down the rate of development of motor function or cognition, and homeostasis becomes the norm. The brain appears to learn to be happy maintaining the status quo, staying right where it is and not rocking the boat.

This tendency to stay put, stay in the same place, and not push forward often appears directly related to the rate of change. The slower the development, the less likely the child is to try new things and often to even perceive that they can or could do new things. The longer the child stays at a level, the less likely the child is going to initiate movement to the next level, all of which necessitates not only putting the neurodevelopmental and structural issues in place, but pushing, pulling, and trying to motivate the child to the next level. We can actually use Newton's First Law of Motion to help understand what is happening.

An object at rest tends to stay at rest unless an external force acts upon it, and an object in motion will tend to maintain its velocity unless an external force is applied to it as well.

I believe we can use Newton's law to help understand global development, as well as specific function. The slower the overall development, the slower the overall development tends to be without external force; and for specific functions, the longer the child goes without doing something, the more external force is required to get the child to that next step. I believe this is true whether we are trying to get a child to crawl or walk, communicate or speak, initiate self feeding or use a spoon, or process and think. For example, the longer a child goes without doing things for themselves, the harder it is and the more input required for them to even know that they can initiate the function, let alone starting to actually try and do it themselves and then incorporating it into their daily lives.

The slower the child's development, the more external force, specific input (program) and encouragement/external force is required to get the child moving. Once moving, they will tend to maintain and not increase their rate of development unless we continually provide more input and external force.

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A Tool is Just That
by Lori Riggs

You want to build a house, so you borrow a hammer. Every day you pull out your hammer and pound on something-anything-twice a day for two hours. And sometimes you just hold the hammer and look at it or set it close to a nail. Certainly at the rate of four hours of pounding per day, not to mention the extra time spent in the presence of the hammer, you should eventually end up with a house, right? After all, isn't a hammer for pounding? Don't you need a hammer to build a house? And yet, after a year of this, you see very little progress towards anything resembling your dream house.

Obviously this is just a metaphor; so let's get right to the point. You probably have some goals in mind for your child, or you would not have come to us at NACD. Some of your goals may simply be about getting to the very next step-learning to walk, to read, to chew. And some may be about the bigger picture-your child becoming an independent adult, going to college, being employed. Whatever your goals are, we are here to guide you in your quest to achieve those aspirations. We're here to give you some tools and teach you how to use them. NACD parents are the cream of the crop. You are the ones who are willing to pick up that hammer, roll up your sleeves, and get your hands dirty doing the

work. You don't have to be an actual carpenter or electrician or plumber. But you do need to know how to use your hammer effectively to do some of the things a carpenter does; and you do need to know how to use your wrench correctly when we ask you to tighten a nut. It is your job to do the work; it is our job to make sure you know how to do it well.The activities, materials, and programs that we recommend on your NACD program are just the tools you need in order to work towards your goals for your child. They don't magically produce results just by being on your program or even by getting the "done" box checked next to them. How you use them is all-important. In an effort to improve the quality and effectiveness of your implementation and use of the tools, here are a few pointers:

Educate Yourself

Men get teased for not reading manuals. As a woman, I want a manual for everything! I wish my kids had been born with their own personal manuals tied to their leg. Then I wouldn't have to figure out what to do when their own little individual needs come up. Just open the manual and see what works for them. It would be so much easier.

Your NACD program activities may sound straightforward when you read the name. But you really can't know what it is we intend for you to do unless you get the instructions. We provide links to videos and handouts right there on your program. If something has been customized specifically for your child, the note about it will be in the "comments" section just next to the name of the activity. Watch each video and re-watch them. It's very hard-if not impossible-to remember every detail of what you watched the first time. Review them again after you've started implementing the activities so that you can check yourself and make sure you are implementing things correctly. I learned a long time ago that doing something poorly over and over does not result in doing that thing well. That's why I don't like the saying, "Practice makes perfect" unless it's revised to, "Perfect practice makes perfect." Repetitively doing your program activities incorrectly will not bring about the results you desire.

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for more tips

So You Developed a Skill (So What?)
by Lori Riggs

The bottom line: Isolated skills are pretty worthless. They only have meaning if they are put into a context of functional activity.

That's the message I wanted to get across. That's it. I'm not much on elaboration, so if you "get it" already, you don't need to read on. End of article. But in the off chance you're not sure what I mean, I'll try to explain:

I learned to cook at an early age. I didn't take cooking classes or have a private tutor. I didn't even try to learn or know I was learning. I just hung out in the kitchen and watched my mom and talked with her while she cooked. Then when I was old enough, she'd let me grate the cheese or chop the onions. Then at some point--I don't know when, exactly; it was a gradual evolution--I was cooking whole meals myself. Imagine if she simply taught me to grate cheese then sent me on my way. I think the outcome would have been different. (There aren't a whole lot of dishes made from nothing but grated cheese.)

You probably already know how to cook, so I won't extol the virtues of knowing how to make the things that go under the grated cheese. Or how to toast grated cheese just right when it's on a baguette with a little basil and tomato. Instead, let's talk about your child. Typically developing kids develop skills naturally-we don't think about teaching them every isolated skill and then work on integrating those skills into life. It seems to just happen magically in the context of everyday activities and with the natural increase in expectation by the others in their environment. Typically developing babies don't sit in an OT's office, practicing their pincer grasp with therapy beads. We stick them in a high chair, scatter a few Cheerios on their tray, and let them go for it. And we expect that they will.

But it's different for our not-developing-so-typically kids. Often we have to work very hard on building the very foundation of strength and tone before we can even think about teaching an isolated skill. Then we work even harder and even longer, with hours and hours of repetition, to teach that one little skill-pincer grasp or sequencing two items or taking first steps or making the /m/ sound. And we celebrate. And we should celebrate because this is a big hurdle and a huge accomplishment. It's the culmination of your hours of work, your perseverance, your refusal to throw in the towel. But what now? What does it mean?

As isolated skills go--dare I say it after all that work you did?--so what?

Sitting in front of the full-length mirror and practicing having your child put his lips together and produce /m/ five times a day for a minute each time for six months is meaningless. It only has value if you then want him to say "mama" (to call you) and "mine" (because after all it was his toy that his sister took) and "moo" (because that's what a cow says, of course). It is in the context of his language and communication that the isolated skill of being able to say /m/ becomes valuable.

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ANNOUNCEMENT:

NACD Cognition Coach - Toddler to Age 3
Now Available for iPad!

We are proud to announce the release of the first in a series of Cognition Coach apps. The app follows the same easy to use and successful format of the NACD Home Speech Therapist -Apraxia apps. This first one is called Cognition Coach-NACD Simply Smarter Toddler to 3 years.

The NACD Simply Smarter Toddler app establishes the foundation for children who are neurodevelopmentally functioning at the level of a six-month old to a neuro-typical three year old. This app takes children through six levels, from the basics of learning how to identify pictures to sequentially processing up to three objects. Cognition Coach is designed to jump-start children by building sequential processing skills, the building blocks for developing short-term and working memory.

Cognition Coach-NACD Simply Smarter Preschool will be released shortly, followed by Elementary, Teen, and Adult apps.

To see the Simply Smarter Toddler app in the iTunes store, click here: