A productive September

With the opening of occupational therapy and the sudden increase in inquiries and clients (we’re actually considering hiring another speech therapist), September so far has been a blur and we have just realized that the month’s almost at an end. But a full schedule and the existence of a waiting list aren’t the only ways we measure productivity. September is also an eventful month for people who work with children. This is the month developmental pediatricians assembled in one teachable event, a world-renowned speech therapist came to the country to talk about her increasingly popular therapy framework, and people from different provinces and countries went to Manila’s five-day book fair. Seeing those events as opportunities to enrich our practice and our center and to better help our clients realize their potentials, we took the time to attend all three. And because sharing is caring, we will impart a few takeaways from each event.

QUINDECIM: The 8th Biennial Developmental and Behavioral Pediatricians’ Convention

On September 1 and 2, we attended the every-other-year convention held by the Developmental and Behavioral Pediatricians Society of the Philippines (DBPSP). Entitled Quindecim (meaning fifteen in Latin), the society celebrates its decade and a half of existence, having its inception in 1999 and foundation in 2000. “Reminiscing, experiencing and hoping” which was also meant “past, present and future” was a recurring theme during the discussions and lectures facilitated not only by developmental and behavioral pediatricians, but also other professionals who work with individuals with special needs.

Being at this convention helped us promote our therapy center to developmental pediatricians who, in the ideal setting refers students to us for occupational and/or speech therapy. But more importantly, we learned and relearned plenty of things from the lectures and discussions. Here are some of them:

1. “It is easier to build strong children than to repair broken men.” This is a quote by Frederick Douglass, as mentioned in Dr. Joel Lazaro’s lecture “CATCH THEM BEFORE THEY FALL: Framework for Linking Brain Plasticity and Early Intervention”. This is first on the list and aptly so because we cannot stress enough how important EARLY INTERVENTION is to a child’s overall development. It is crucial to start early as far as child development is concerned because the brain is highly plastic (moldable, open to change) the younger the child is. This plasticity peaks around ages 5 to 7 before it starts to become less and less adaptable due to the structures of the brain becoming fully formed at age seven.

2. Minimum screen time for children. Since we started practicing in 2010, we have been telling parents to avoid or at least limit exposing their children to television and gadgets. Some of them follow this recommendation while others say they will. As parents, or at least people who know how tiresome it is to take care of children, we know how giving our kids their much wanted iPad or leaving them in the couch watching Dora the Explorer for hours on end in turn gives us the peace and quiet we so need. But as therapists, we know doing this would be counterproductive to developing good work behaviors and learning language among other developmental skills. We tell parents to limit doing something that’s easy and pleasurable to both them and their kids but when they ask how much screen time is just right, we would give varying answers. We are so unsure of the figures at times that our clients do not find us confident and so they end up not following our advice. Now, thanks to the info from the same lecture by Dr. Lazaro, we now have these numbers to back up this no-screen prescription (from Aaron Ramos’ Facebook page):

3. Transition and self-advocacy

The convention also had a panel discussion about transition, and how it isn’t only about helping adolescents and adults get jobs. Transition happens anytime change in context happens. It can happen as early as toddlerhood. And it can be as simple as moving on from high school to college, which was exactly what the panelists discussed. One of them, a college student from the College of St. Benilde and an individual with ADD, talked of doing self-advocacy, how it isn’t easy, and how we can train ourselves to be self-advocates.

There were other topics at the convention and many of them were a mouthful. But we did not get to engage in continuing education in a long time, so after two weeks, we set out to a much nearer Alabang and attended…

Michelle Garcia Winner’s Social Thinking Seminar

This September 17-18 event was MGW’s (let’s call her that for the rest of this post) second seminar on social thinking in the Philippines (the first one happened in 2011). For a second-time stint, she had plenty of different but not necessarily new things to teach – some of them newer ways of teaching social thinking. The basic thoughts and principles however, stayed the same. Some of them being:

1. Social thinking happens all the time. Even when we’re not talking or being around others.

2. We must think with our eyes (though she did not expound on full body listening this time around).

3. Language and communication are highly nuanced.

We then capped our September in terms of acquiring new things by visiting the…

36th Manila International Book Fair

Held on September 16-20, this annual book fair is frequented not only by people who like to read, but also by those who work with children, as they have booths that sell educational books and toys with discounts. There are also booths of popular bookstores like National…

…and Fully Booked, which lived up to its name on the fair’s last day.

By the end of my visit, my bags were full with toys and books…

…and magazines for our center’s waiting area.

May October be as awesome as our September has been. Happy end of the month!

Speech therapy and occupational therapy services in Cavite

Now offering speech therapy and occupational therapy services in Cavite

Hurray! It’s official! We now cater to families whose children need speech and occupational therapy services. 🙂

Ignite Therapy Center – a speech and occupational therapy center in Cavite

Ignite Therapy Center is in Bahayang Pagasa Subd., Imus, Cavite

Hey guys!

This is Ignite Therapy Center, a center offering speech-language therapy and occupational therapy services in Imus, Cavite. After weeks of remodelling and renovations, we finally have a place we can call our own! This is really exciting for us and we even had a soft opening last July 4, 2015. We cater to parents and children who live nearby in Imus and Bacoor, but we also have some students from other parts of Cavite, as well. Currently, we still have slots available for both speech and occupational therapy services. 🙂

Our details 🙂

As of the moment, we are only offering speech-language therapy services but occupational therapy services will be available starting in September 2015.

Do like us on Facebook for more up-to-date information and interesting articles! 🙂

Thank you!

– D & I

Hurray! :)

Like us on Facebook as well! 🙂

– D & I

HAPPY FOURTH OF JULY!

We are now open! 🙂

We may be Filipinos but the 4th of July will also be a meaningful day for us! After weeks of construction and repairs, we will be having our first set of students this coming Saturday, July 4 for speech-language therapy. 🙂 We are truly looking forward to serve you!

Contact us at +63 925 3800 950 or ignitecenter.ph@gmail.com for more details. 🙂

– D & I

The Autism Diagnosis

You notice that your child is lagging behind in terms of speech. Come to think of it, she also has delayed motor skills. His teachers in school find it difficult to make him sit down and focus in class, as he is also prone to hand-flapping, humming, teeth grinding, and the occasional tantrums that seem to occur when the janitor passes by the corridors with his vacuum cleaner on. You notice that your child prefers to play alone, and that when he does, he turns over that monster truck toy you bought him and stares intently at the wheels as he makes them spin continuously with his fingers. She is small and thin for his age as she would only eat soft food items like eggs and pancit canton. He refuses to have his teeth brushed most of the time and this is ruining his pearly whites. You’ve heard, seen, or read about these symptoms before but you’ll have to find out for sure, so you seek medical help. After falling in line to get an appointment and then falling in line and waiting again to have your child seen by a developmental pediatrician, you were finally given an answer. “Autism spectrum disorder” as the DevPed wrote on her prescription pad, along with a referral for occupational and speech therapy. The doctor may also have written a recommendation for a school set up and a few behavior management strategies but you were too devastated to process it all. Too numb and hurt at the same time from all the shards that was your dreams and aspirations for your child as they come crashing down your feet after the diagnosis, like a baseball bat, shattered them into painful nothingness.

Except it doesn’t have to be like that.

So your child has been diagnosed with autism. The big A, as some people call it. It is big news, one that isn’t taken well by many. Some seek second opinion. Some undergo (or get stuck in one of) the stages of grief. Some, no matter how they feel about it, follow the doctor’s orders anyway and start looking for a speech therapist and an occupational therapist. If you are among the last example, consider your child lucky. Acting on the doctor’s (or teacher’s, or any qualified professional who noticed the problem) recommendations gives your child a head-start towards a more independent and meaningful life. Diagnosis or not, and as with most of life’s obstacles, actually doing something rather than moping is always better. We can tell you how we therapists see and treat a diagnosis given to our clients but before that, let us tell you where you, after finding out your child has autism, should focus instead:

1. Your child’s skills

Your child may have been diagnosed with autism but just where does he or she stand in the spectrum? How well can he or she communicate? Is he or she independent in terms of activities that are expected of him or her? How well does he or she do in terms of his or her developmental milestones?

2. Your child’s lifestyle as well as yours as a family

What kinds of activities does your child enjoy? What activities does he or she avoid? Do these avoided activities hinder his or her functioning and ability to communicate? Is he or she picky with food? Are there specific situations when a tantrum is almost sure to happen? How do all these affect the family’s lifestyle and vice versa? Are there certain things that happen or are done in the household that help or hinder the child’s performance? What lifestyle changes should be done to maximize the child’s abilities?

3. Discipline, activities and interactions with people across different contexts

How do you discipline the child? How does it differ from the way you discipline his or her siblings? How do these siblings interact with him or her? How do his or her classmates and teachers at school interact with him or her? How does the community in which he or she lives interact with him or her?

4. Your child’s strengths, preferences, and interests

You’ve noticed that your child actually has good visual skills. How can we make the most of this to teach him or her? To help him or her become independent? To get him or her to communicate more? So he or she also focuses a little too much on numbers, time and dates, but is this really so bad? How can we make it so that these interests benefit him or her?

5. Your usual child rearing, but more consistent

Going back to how your child is disciplined as compared to his or her other siblings, how different is raising this particular child from the others? Aside from the different skills, lifestyle demands and interests, how different or similar are the general principles of raising this child as compared to the others?

We all need to work hand in hand. 🙂

At the end of the day, we as therapists respect diagnoses given by doctors. They help and guide us with planning and making considerations in our therapeutic management. They provide us with a picture of the child so we will at least have an idea on what to do even before we meet them. But as much as diagnoses are acknowledged, they should not be dwelt on, especially if doing so leads to inaction. And in the case of child development, every action that we take or not has implications to our child’s future and well-being.

“The great aim of education is not knowledge but action.“

–Herbert Spencer

Home

Good day everyone! We can’t thank you enough for reading our blog and for liking and sharing our Facebook page! A hundred views and a bunch of likes may be little for some but to us, each person who reads our posts means one more individual informed and empowered. It is our hope that you stay with us as we build, as we’ve mentioned in previous posts, something great.  Speaking of building great things, a little update on the renovation of our clinic…  

We realize this is the first time that we are mentioning the therapy center we are putting up and that the only thing you know about us is that we are a speech pathologist and an occupational therapist, so along with a couple of pictures of the construction site that is our clinic currently, please allow us to shed just a little more light on our professional background.  We are graduates of BS Occupational Therapy and BS Speech Pathology of the University of the Philippines College of Allied Medical Professions (UP-CAMP). We passed the Professional Regulation Commission (PRC) licensure exam and received the Philippine Association of Speech Pathologists (PASP) certification the same year we graduated, in 2010. We practiced in the Philippines (in Cavite, Laguna, Bicol, and in different parts of Metro Manila to be more precise) for 2-3 years until we decided to improve our practice by working abroad for another 2-3 years. Now that one of us is back and the other one on the way, we are working on putting up this therapy center in Imus, Cavite.    We haven’t started handling clients yet, but right now, it feels good to be back in our own country, in our home. Ignite Therapy Center, with its ongoing renovation, already feels like home to us. And here’s hoping the children and families with whom we will work will also find our the place as such.

– D&I

On Behavior Management Techniques…

Q: The doctor recommended for my child to have occupational therapy with focus on BMTs. What exactly are these BMTs and how do you do them?

A: Behavior Modification Techniques or BMTs as they are more commonly known, are strategies used to modify or change behaviors. To explain further, modifying or changing means to increase or decrease the frequency of a certain behavior. Ideally, the behaviors one wants to increase the frequency are the good ones and the ones that need to be decreased are the maladaptive ones. There are many different kind of BMTs. Psychology books and the Internet are full of them. But before reading one of those online articles and applying the coolest sounding one the next time your child misbehaves, bear in mind that BMTs, like most if not all therapeutic interventions, should be child-specific. What works with this child might not work with that other one, and vice-versa. 

There is a saying among therapists that when it comes to behavior management, “whatever works” is the principle. This can be misleading. First, that “whatever” should of course be within professional, ethical, and legal limits. Needless to say it should always consider the child’s safety, otherwise, forget about doing it. Second, that whatever that works SHOULD ACTUALLY WORK. It should increase or decrease the frequency of a target behavior, and they have to be done efficiently. For BMTs to be efficient, keep in mind the following principles:

1. Consistency is key. You will realize as you read on that this principle is all you need in order to execute BMTs efficiently. Behaviors change when rules and consequences are applied consistently, regardless of what the child does (usually crying, throwing tantrums, bargaining, etc.). Likewise, reinforcements (praise, treats, etc.) should be given consistently following good behavior. 
2. Everyone should be involved…and be consistent. It’s a common misconception, even amongst professionals, that occupational therapists are the only ones who target behavior management (notice that I sometimes use this interchangeably with behavior modification). The truth is every adults who works with the child (parents, therapists, teachers) should know how to manage the child’s behavior. And as with number 1, everyone must be consistent with applying BMTs. 
3. They should be applied everywhere – clinic, home, school…and be consistent. To build up on 1 and 2, behavior management should be done by everyone, everywhere the child goes. It does not stop in school or in the therapy clinic. Rules need to be followed even when the child goes to the mall, the market, to church, and all other possible contexts in which the child interacts. 
4. Upgrade expectations as the behavior improves…and still be consistent. As the child gets better, standards for good behavior should be raised accordingly. We cannot just keep doing the same behavior chart with the same number of stars/stickers needed for six months. There has to be a regular setting of expectations, and once the rules are set, stick to them. And speaking of regular…
5. Consult with a professional regularly…and consistently. As said earlier, BMTs should be child-specific. It’s a good thing for families to be empowered enough to try to manage their child’s behaviors themselves, but in more specialized cases, at least a consultation with the the therapist should be in order. Good therapists will let the family do behavior management themselves, but will offer tips and tweaks specific to the child’s needs to maximize the effect of the BMTs done. 

-I

“The doctor said my child has… What do I do?”

Hello everyone! We are beginning to realize how difficult it is to work together while miles apart. Schedules have to be followed, new routines respected, and deadlines met. For today, we have compiled some of the common questions asked by parents regarding their child’s developmental problems that may or may not come with a definite diagnosis. I am sure these questions are not as comprehensive as one could expect and there will be other questions that need to be asked, and that is exactly what we encourage people to do. Our blog is still in its early stage but as we hopefully gain more followers (our thanks to those who already follow us!), we hope that you can find time to ask questions and engage in friendly and helpful discussions in the comments. For now, here go our questions:

1. What is developmental delay?

Developmental delay, as defined by the University of Michigan Health System, is an ongoing minor or major delay in the process of development. It happens when the child does not reach their developmental milestones at their expected times. It can occur in any of the following areas of development: gross and fine motor, language, socio-emotional, or cognitive skills. Delays in many or all of these areas can be considered as global developmental delay or GDD. This is especially the case when the multiple delays cannot be associated with other disorders such as autism, cerebral palsy, Down syndrome, etc.

2. Why was my child diagnosed with hyperactivity?

A few years ago, the answer would have been because the child is hyperactive for his or her age, but that age is still below 7 years – the age when ADHD was usually diagnosed. Now, sources say that ADHD can be found in as early as 3 to 6 year olds. It could also be that only hyperactivity is present instead of the ADHD triad (inattention, hyperactivity, impulsivity).

3. My child can talk. Why was he diagnosed with having a speech delay? 

It is possible that though the child can already say a few words and/or phrases, there may be a minor or major difference between what he or she can say AND what he or she is already expected to be able to say at his or her current age. Parents, teachers, therapists, and other individuals working closely with the child may also compare the child’s current skills with that of the language skills of the child’s siblings, cousins, or maybe parents themselves when they were at that age. These days, “speech delay” is sometimes used as an umbrella term for overall language difficulties (both in the understanding as well as the use of language) and it is advisable to seek professional help when in doubt.

The American Speech-Language-Hearing Association has kindly provided developmental milestones expected from birth to elementary level for monolingual children (read: American English speakers), which may give parents an idea of whether or not their children are reaching these milestones on time.

If you have been advised by your child’s doctor or would like to consult a speech-language pathologist yourself in your area, the Philippine Association of Speech Pathologists’ directory can be found here. 🙂

– D & I

“What’s speech-language therapy?”

My turn!

Speech therapy, speech-language therapy, speech-language pathology, speech pathology… it’s the same banana.

Simply put, speech-language pathologists (as they are called in the Philippines) help improve a person’s communicative and swallowing abilities.

Now, I have had my fair share of being on the receiving end of perplexed looks from people who ask me, “What do you do for a living?” or “Saan ka nagtatrabaho?”. I daresay that I might have heard most, if not all, of the common, yet amusing, reactions to my response.

“Ano ho yung speech terapi? Gumagawa po ba kayo ng speech?” (“What is speech therapy? Do you make speeches?”)

NOPE. Through careful assessment, individualized goal-setting, and age-appropriate activities, we help teach people to produce sounds, words, phrases, and/or sentences (read: speech) to express their needs and wants. We don’t teach them how to accept an Oscar.

“Speech terapi? Para ho sa mga taong hindi nagsasalita yun, diba?” (“Speech therapy? That is for people who cannot talk, right?”)

YES and NO. Just because a person can repeat words or sentences (especially from cartoons or movies), does not necessarily mean that that person’s speech is functional. In addition, speech-language pathologists also help people who have little or no means to produce speech to be able to “express themselves” through alternative or augmentative modes of communication, such as the use of pictures, tablets, keyboards, pencil and paper, etc.

“Pwede ho ba magpa speech terapi para makapag English ako na parang Amerikano?” (“Can I undergo speech therapy so I can speak English like an American?”)

Er… I have not had the chance to do this, honestly, but I do not think it’s unheard of. Perhaps it is possible… Hmmm…

“Pambata lang po yun, diba?” (“It’s just for children, right?”)

I think anyone of any age who struggles with communication or swallowing to the extent that it may be hampering his or her quality of life may be referred for speech-language therapy services.

“Eh di parang English teacher po?” (“So is it like being an English teacher?”)

As in the previous post, we have tried to establish that although the output looks similar (we “teach” people how to say this particular sound or word, construct sentences, listen to stories, etc.), teachers disseminate new information or knowledge to a class or to a student while speech-language pathologists help prepare the child to be able to receive information as well as retell it when asked.

“Speech Pathology? Four year course ba yun?” (“Speech Pathology? Is it a four year course?”)

In some universities, yes. Other universities offer it as a 5 year course. Areas of study in this field are so varied and broad even after everything, there is still so much to learn. The following schools offer the course:

• University of the Philippines – Manila (Manila)
• University of Sto. Tomas (Manila)
• De La Salle Health Sciences Institute (Dasmariñas, Cavite)
• Cebu Doctors’ University (Cebu)

I will try to recall more amusing reactions and add them to this post once I do. 🙂

– D