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					NEUROSEQUENTIAL
  ENHANCEMENT
 INTERVENTIONS
          Rick Gaskill, Ed.D.
    Sumner Mental Health Center
            Wellington, KS
            620-326-7448
   rgaskillsumnermentalhealth.org
In Simple Language This
        Means:


Development Begins in Biology and Ends
 in Experience
  CURRENT RESEARCH
      SUGGESTS
• SOCIAL-EMOTIONAL REGULATION
  PRECEDES ALL OTHER SKILLS
• REGULATION of “SELF” PRECEDES
  EMOTIONAL REGULATION or
  ACADEMIC SKILLS
• LOWER ORDER SKILLS MUST BE
  MASTERED FIRST.
• DEVELOPMENT IS HIERARCHICAL
 Recent Research Shows:
                 Perry, 2005

• Neuromuscular activities must be rehearsed 1,183
  times before the activity stops being a
  “conscious” or “deliberately cognitive act.

• To be come semi-reflexive the activity must be
  rehearsed 10X this number.

• Learning is patterned and repetitive experience.
  Keys to Interventions
• Pyscho-Social Ratio must match
  developmental age
• Interventions must activate the brain
  region disorganized
• Interventions must be patterned and
  repetitive
• Interventions should be fun
• Interventions must begin at the lowest
  disorganized brain level
                                            1


   THINGS TO REMEMBER
 ALL LEARNING IS INTERACTIVE AND
  EXPERIENTIAL

 ALL LEARNING MUST TAKE INDIVIDUAL
  DIFFERENCES AND THE CHILD’S DEVELOPMENT
  INTO ACCOUNT

 PRIORITY MUST BE GIVEN TO THE
  RELATIONSHIP, ABILITY TO ENGAGE, AND
  MAINTAIN THE INTERACTION

 INTERACTIONS MOVE FROM ADULT-CHILD TO
  INCLUSION OF ANOTHER CHILD/CHILDREN

 ADULTS MUST REMAIN VERY FLEXIBLE AND
  ADAPTIVE TO THE NEEDS OF THE CHILD

 DON’T COERCE OR FORCE A CHILD INTO AN
  ACTIVITY UNLESS SAFETY IS AT RISK

 DO NOT ALLOW NON-INTERACTIVE TIME OR
  ACTIVITIES

 AVOID OVER STIMULATION, ALLOW TIME TO
  CALM DOWN, HELP SELF-REGULATE
              Curiosity Fuels Development


Curiosity          results in      Exploration

Exploration        results in      Discovery

Discovery          results in      Pleasure

Pleasure           results in      Repetition

Repetition         results in      Mastery

Mastery            results in      New Skills

New Skills         results in      Confidence

Confidence         results in      Self Esteem

Self Esteem        results in      Sense of Security

Security           results in      More Exploration
     PRIMARY GOALS
           OF
       TREATMENT

 TO BE GENUINELY INTERACTIVE


 TO MAKE PSYCHOLOGICAL
   CONTACT


 TO MAKE PHYSICAL CONTACT


 TO ENHANCE THE SOCIAL BOND


 TO ENCOURAGE INTERACTION
   BASIC PROCESS


 BE SPONTANEOUS AND IN
  CONTACT WITH THE CHILD


 SENSORY ACTIVITIES BEFORE
  STRUCTURED ACTIVITIES


 ESTABLISH THE RELATIONSHIP
  FIRST
 Core Elements of Positive
 Developmental Experiences:

   Relevant (Developmentally Matched)
   Repetitive (Patterned)
   Relational (Safe)
   Rhythm (Resonate with Neural Patterns/Positive
    Entrainment)

(Processes are rooted in neurobiological elements)

                                       Perry, 2007
Brain Stem Enhancement
       Activities
    LIMBIC            1 to 4             Attunement/Attachment
Regulating Arousal/Attention
                 Paleomammalian                  Empathy
                      Brain                         Gaskill
                                                Affect/Mood & CTA, 2008
     SQ
                                        Complex Threat Response
                                       Short-term Memory/Learning
                                       Integration of Multiple Senses     Music/R
 DIENCEPHLON/          1 to 2              Coordination/Balance
 CEREBELLUM     Protoreptilian Brain          Large/Fine Motor              (Fin
                                                    Sleep
                                              Feeding/Appetite
                                               Metabolism                     Re
  BRAINSTEM         Utero to 1           Arousal/Self-Regulation
                                           Attention/Impulsivity
     AQ                                Cardiovascular/Physiological
                                        Flexible Stress Response          Calm/S
                                                         Psychosocial Implications
                                                                    Of
                                                        Neuro-sequential Development
                                                           On Treatment Planning

                                                                         SOCIAL
  BRAIN AREA                  FUNCTIONAL SOCIAL/                     INTERACTION            PLAY STAGE              COGNITIVE
    (Perry)                      EMOTIONAL                                RATIO                 OF                 DEVELOPMENT
                                DEVELOPMENT                        (Child/Adult/Typical    DEVELOPMENT                (Piaget)
                                  (Greenspan)                             Child)

    Brainstem                         Engagement                                              Solitary Play      Sensory Motor Stage
   (0 to 1 year)                      (0 to 9mon.)                                                                 of Development
                                                                                        Primary task of play is     (0 to 2 years)
Regulation of states   Child shows interest in the sights and                           exploration and direct
of arousal, fear       sounds around him or her.                           1 to 1       encounter.              The primary mode of
states, flexible                                                                                                experiencing the
stress response.       Develops mutual attention, and regulation         1to 1 to 1     Knowing is by direct    world is through the
                       of attention.                                                    sensory contact with    senses. Especially,
                                                                        1 to 1 to 2     the environment.        body to environment
                       Engagements and attachments by use of                                                    manipulations.
                       visual, gestural, and verbal behaviors.                          Play is often physical
                                                                   Time Requirements: exercise games of         Attention is first
                                                                    As many as 6 to 8   “chase”.                focused on the infant’s
                                                                      times per day                             body, then
                                                                   (20 to 45 min. each)                         intentionally to
                                                                                                                objects. Meaning and
                                                                                                                learning are motor
                                                                                                                activities.
  Research Has Shown:
              Gaskill & CTA, 2008



“Self-regulation is the ability to control one’s own
emotions, behaviors, and thinking processes.”

“The growth of self-regulation is the cornerstone
of early childhood development that cuts across
all domains of behaviors…..”

               Zigler,Singer,& Bishop-Josef, 2006
          Typical
Brainstem Related Problems
•   Sensory Stimuli Processing Problems
    – Importance of Stimuli
    – Identification of a Stimuli
    – Focusing Attention on a Stimuli

• Core Arousal Regulation Problems
    –   Can’t Quiet Physiological Arousal
    –   Transitioning Between Arousal States
    –   Overly Reactivity to stimuli
    –   Tantrums
    –   Does not sleep well

• Mutual Attention and Attunement Problems
    – Clingy
    – Defiant
                                      Functionally Appropriate Interventions
Functional Func     Developmental      Social Developmental Milestones                          Program Activities
 Division Age            Play

                                       Regulation/Attention/Engagement/ 1. Calm/Quiet Yourself!
                                        Engagement with Environment 2. Adults must be Safe Island
                                                                         2. Routine/Maintain Safety of Environment
                                          Eye contact
                 Rhythmic/Patterned                                      3. Predictable Environment (Things in Place)
                 Recitative Sensory       Mutual Gaze                   4. Limit Stimuli (Lights, Sound, People, Movement)
                 Input                    Smiles                        5. Transitional Objects/Security Objects
Brainstem
          0 to 1  Soothing/              Seeks Physical Contact        6. Eye Contact
 1 to 1           Pacifying              Enjoys Interactive Games      7. Extended Mutual Gaze
                  Infant Games           Sensory Play                  8. Smiles
                  Nurturing              Enjoys Humor/Teasing/Laughs   9. Positive Attention/Approval/Valuing
                    Activities            Demands Personal Attention    10. Nurturing/Grooming/Holding/Touching/
                                          Wants Approval                Soothing
                                          Performs for Audience         11.Lots of Sensory Play
                                          Solitary Play
                                                                                     Gaskill & CTA, 2008
                                    BRAINSTEM ENRICHMENT ACTIVITIES

  AGE                 CRITICAL                                               ENRICHMENT
                      FUNCTION                                                ACTIVITIES

                                                              Rhythmic and Patterned Sensory Input:
                                                          (Auditory, Visual, Olfactory, Taste, and Tactile Play)

              Primary Sensory Processing:   Sensory Stimulation: (Use items from each sensory system)
                  Determine the Value of   Touching with sand, clay, finger painting, or shaving cream play. Making
                   Incoming Sensory         cookies, banana bread for touch and scent. Smelling for fun, pleasure, and
                   Information              identification, with household smells (orange, onion, cinnamon, vanilla, lemon,
0 to 1 year                                 soap, baby lotion, talc, etc). Texture bags, gloves, blankets or bins (rough,
              Core Regulation Functions:    smooth, silky, slick, hard, sticky etc.). Sounds, songs for fun, pleasure, and
                    Arousal States         identification (natural sounds, household sounds, everyday sounds). Tastes from
                    Vigilance              the kitchen or candy store for fun, pleasure, and identification. Visual activities
                    Fight/Flight           with colors, patterns, pictures, puzzles, find the missing piece, and so on.

              Core Phys. Functions:
                    Blood Pressure         Pacification/ Soothing: (Calming using child’s preferred modality)
                    Respiration            Rocking, holding, touching, stroking, massage, grooming, brushing hair,
                                            painting nails, dressing, swinging, cuddling, singing, telling stories, feeding.
                    Heart Rate
                    Body Temperature.
                                            Infant Games: (mutual attention and attunement, face to face)
                                            Songs, nursery rhymes, touching games, family rituals, or nurturing rituals,
              Kinesthetic Information.
                                            Peek-A-Boo, This Little Piggy, The Slippery Hand Game, This is the Way the
                                            Ladies Ride, Humpty Dumpty Sat on a Wall, Baker’s Man, Three Men in a Tub,
                                            O Where or Where has my Little Dog Gone, Row Row Row Your Boat, and
                                            Other Interactive Sensory Games.
       Primary Sensory
    Enhancement Activities
•   Smell Identification Play
•   Texture Identification Bags
•   Texture Blankets
•   Rice Krispy Hands
•   Pudding Painting
•   Nature Walks
    Calming and Relaxation
•   Rocking
•   Holding
•   Holding hands
•   Eye to eye contact
•   Smiling
•   Talking softly and warmly
•   Sitting on your lap
•   Sitting close to you
•   Carrying
•   Rubbing back, neck, arm, or head
Relaxation, Guided Imagery,
     and Visualization
    Techniques for Kids
•   Laughter
•   Breathing Techniques
•   Progressive Muscle Relaxation and Stretching
•   Autogenic Phrases
•   Yoga and Slow Movement Exercises
•   Visualization and Guided Imagery
•   Music (60 to 80 Beats per Minute)
                              BE A STAR

      STOP, TAKE A DEEP BREATH, AND RELAX

      TAKE THREE DEEP BREATHS

      AFFIRM: “I FEEL CALM, I CAN HANDLE THIS.”

      SAY TO THE CHILD: “YOU’RE SAFE, BREATH
      WITH ME, YOU CAN DO IT.”

S Smile

T Take a deep breath (inhale)

A And

R Relax your eyes (exhale)

                       jaw
                       shoulders
                       belly

Adapted by Becky Bailey PhD from Mind-Body Magic by Martha Belknap
          RELAXATION ACTIVITY

BALLOONING:

YOUR ARMS STRETCH OUT AS YOU BLOW UP THE
BALLOON


     LOCK YOUR FINGERS TOGETHER
    ON TOP OF YOUR HEAD

     BREATH IN AS IF THE BALLOON
    WERE BEING BLOWN UP A BREATH
    AT A TIME

     ARMS FULLY EXTENDED
    ENCIRCLING YOUR HEAD, HOLD
    YOUR BREATH

     DEFLAT THE BALLOON BY
    LETTING THE AIR RUSH OUT
        RELAXATION ACTIVITY

DRAINING:
      YOUR ARMS ARE FAUCETS OVER THE SINK



    EXTEND ARMS OUT PARALLEL TO THE
     FLOOR

    FISTS CLOSED PALMS DOWN

    TO OPEN THE DRAIN RELAX YOUR FINGERS
     BY OPENING THEM

    MAKE A SWISHING NOISE (SSSSHHH) FOR THE
     SOUND OF THE WATER FLOWING OUT

    CLOSE THE DRAIN BY TIGHTENING YOUR
     FISTS

    TIGHTEN THEM SO YOUR ARMS, NECK AND
     FACE ARE CONSTRICTED

    OPEN THE DRAIN AND RELEASE WITH THE
     SOUND
                        SAFE PLACE
                (Adapted from Becky Bailey, 2002)

The safe place provides an opportunity for the child to remove
themselves from the group in order to become calm, regain
composure, and maintain control when upset, angry or
frustrated. Children come to the safe place in order to be
helpful not hurtful to themselves and others.

Structure:
    Space:
           A corner or small area in the classroom, away from
           distractions.

   Visuals:
         Label the center and have picture reminders to
         relax.

   Materials: Place calming things, appropriate to age
        Tape recorder with headphones
        Stuffed animals
        Blanket or beach towel
        Note pad and pencil
        Baby bottle
        Squeeze toy
        Hard plastic toy

   Safe Place Rules:

          One person in the safe place at a time
          The teacher can send a child to the safe place
          Students can elect to go to the safe place
          Friends can suggest a classmate go to the safe place
         Infant Games
•   Becky Bailey Demonstration Tape
•   Shaving Cream Play
•   Putting lotion on Boo Boos
•   Squeeze
•   Pat-a-Cake
•   This is Way the Gentlemen Ride
     The Importance of
          Rituals


• Consistency = Predictability = Security
                      Landreth, 2000
                     USE OF RITUALS

     Rituals are an important part in the creation of a sense
     of unity in relationships.

     The goal of rituals is connections.

     Rituals are the sacred spaces designated for togetherness
     and unity.

     Rituals sooth lower levels of the brain and produce a
     calming affect.

     They are the glue that holds a relationship together.


Suggested Rituals:

  Greeting Rituals

  Connecting and Appreciation Rituals

  Moving Child Rituals

  Life Change Rituals

  Closing Rituals
           MY SCHOOL FAMILY



Wave to a friend

Shake hands with a friend

Wave to a friend

Pinkie hug with friend

Shake hands with a friend

Wave to a friend

High five with a friend

Pinkie hug with a friend

Shake hands with a friend

Wave to a friend
          TWINKLE, TWINKLE, LITTLE STAR

     It is important to be at the same height as the child in this activity




TWINKLE, TWINKLE, LITTLE                Hold the child’s hands above your heads.
STAR.                                   Wiggle your fingers as the Twinkle of
                                        the stars.

WHAT A WONDERFUL CHILD                  Bring down your hands and rest them on
YOU ARE.                                the child’s shoulders. Have the child do
                                        the same

WITH BRIGHT EYES AND NICE               Touch the child with your index fingers
ROUND CHEEKS,                           close to his/her eyes. Pull them down to
                                        their cheeks.

TALENTED PERSON FROM HEAD Swing the child’s up over their head and
TO FEET.                  then down low to their feet.


TWINKLE, TWINKLE, LITTLE                Raise the child’s hands as in the
STAR,                                   beginning; wiggle your fingers for the
                                        shinning stars.

WHAT A WONDERFUL CHILD                  End with a hug
YOU ARE.
             I BOW TO MOTHER NATURE


               POEM                           STRETCHING ACTION

I BOW TO MOTHER NATURE Do a forward bend

    I LIFT TO FATHER SKY                   Reach overhead with both arms

      I OPEN TO THE SUN                    Open arms parallel with the ground

AND THE CLOUDS GOING BY Arms sway overhead

    I WELCOME THE RAIN                     Lower arms slowly, fingers moving

  THAT FLOWS TO THE SEA                    Roll shoulders forward and back

  I HONOR THE KINDNESS                     Bow to a partner

       IN YOU AND IN ME                    Point to a partner and then yourself




Adapted by Becky Bailey PhD from Mind-Body Magic by Martha Belknap
Brain Stem Enhancements for Grade
         School and Above Gaskill & CTA, 2005
•   Attunement/Relaxing/Calming:
     – Listening to music                              –   Songs, stories, musical
     – Singing                                         –   Pictures, Scent identification
     – Listening to natural sounds (wind, rain,        –   Paintings, coloring,
        crickets)
     – White noise                                •   Healing Touch
     – Reading to the child                             – Massage (hand, fingers, foot)
          • Dr Seuss                                    – Reiki Touch
          • Poetry                                      – Pressure Points
          • Rhyming                                     – Showing concern for injuries/hurts
•   Relaxation Exercises                          •   Grooming
     – Progressive Muscle Relaxation                    – Nail manicure/painting
     – Breathing Exercises                              – Hair Brushing/Braiding
     – Autogenic Phrases                          •   Rituals/Routines that say nothing has changed
     – Guided Imagery                                 in our relationship
     – Swimming                                         – Uniting;
     – Yoga                                                   • Songs, chants, activities
     – Marshal Arts                                     – Connecting
     – Drumming                                               • Nick Names
•   Sensory Stimulation                                       • Names of endearment
     – Sand, clay, play dough                                 • Hand Sakes/High Fives
     – Pottery making                                   – Commitment
     – Sculpting with clay                                    • Manners as a demonstration of
                                                                 respect
     – Finger foods
                                                              • Celebrations (birthdays, graduations)
Midbrain Enhancement
     Activities
                                                Cognitive Functions

                       2- Appetite,
                 Sleep,TEENS
                                                   Exec. Functions
   NEOCORTEX                                 Social Emotional Integration


                   Coordination
                   Neomammalian Brain                Self-Image
         IQ                                           Affiliation
                                                 Speech/Articulation


                                             Interpret Social Information
                                                   Share/Relational
                                                     Play/Pleasure
      LIMBIC                1 to 4             Attunement/Attachment
                       Paleomammalian                  Empathy
                            Brain                     Affect/Mood
        SQ
                                              Complex Threat Response
Gaskill & CTA, 2008                          Short-term Memory/Learning
                                             Integration of Multiple Senses
  DIENCEPHLON/               1 to 2              Coordination/Balance
  CEREBELLUM          Protoreptilian Brain          Large/Fine Motor
                                                          Sleep
                                                    Feeding/Appetite
                                                                                                                                             1
                                                            Psychosocial Implications


 BRAIN AREA                    FUNCTIONAL SOCIAL                       INTERACTION            PLAY STAGE               COGNITIVE
   (Perry)                        EMOTIONAL                                RATIO                  OF                  DEVELOPMENT
                                 DEVELOPMENT                         (Child/Adult/Typical    DEVELOPMENT                 (Piaget)
                                   (Greenspan)                              Child)

    Midbrain                     Two-Way Interactions                                           Solitary Play        Sensory Motor Stage
  (1 to 2 years)                    (9 to 18 mon.)                                                    to               of Development
                                                                                             Parallel Play by the       (0 to 2 years)
  Integration of       Child engages in purposeful gestures and             1 to 1            end of the stage.
 Multiple Sensory      simple problem solving, especially with            moving to                                  Intentional behavior
Inputs, Affiliation,   gestures.                                           1:1:1            Primary goal is still    continues to develop,
Regulation of Fine                                                         or more          exploration and direct   simple problem
 and Gross Motor       Child uses visual, gestural, and verbal                              knowing through          solving begins
      Skills           behaviors to communicate his or her                                  sensory contact.         (searching), or trial
                       thoughts and desires (pointing, reaching,                                                     and error.
                       making special noises, or reaching out to     Time Requirements: However now the
                       be picked up).                                3 to 6 times per day company of another         The development of
                                                                     (20 to 30 min. each) person to share and        thought and cognition
                       The child responds to people talking or                            participate in the         bring about symbolic
                       playing with him/her by sounds, faces, or                          experience is              meaning and some
                       gestures.                                                          desirable. The child       understanding of
                                                                                          will make his or her       causality between
                       By late in this period the child can show                          desires known to the       means and ends.
                       what they want by complex chains of                                person they are
                       actions, still largely gestural and motoric                        playing with.
                       (leading mom to the refrigerator, tugs on
                       the handle, and point to the soda.

                       Toddler will copy or imitate sounds,
                       words, gestures as part of playful
                       interactions.
      Typical Midbrain/
    Diencephalon Problems

•   Integration of Multiple Sensory Input
•    Problems with Behavioral Control
•   Poor Motor Control / Balance/ Planning
•   Memory
•   Affiliation, Attunement, Relational
    Flexibility
                                          Functionally Appropriate Interventions
Functional    Func     Developmental       Social Developmental Milestones                            Program Activities
Division      Age           Play
                                        Multiple Interaction Problem Solving & 1. Music with a strong beat (CD/Bernstein)
                                              Interpersonal Association        2. Rhythm/Percussion Bands/Drum Circles
                                              Purposeful Gestures to Communicate        3. Motor Games/ Play
                                                                                         4. Outdoor Exercise Equipment
                                              Communicates Feelings
                                                                                         5. Arts and Crafts/Manipulatives
                                              Strong Emotional Reactions
Diencephlon                                                                              6. Continued Sensory Play
Cerebellum           Music                    Tantrums when Frustrated                  7. Story Telling
              1 to 2 Movement/Motor           Seeks Adult’s Help in Problem Solving     8. Reading/Looking at Pictures
 1 to 1              Control                  Imitates Sounds and Gestures of           9. Be Available to assist Problem Solving
                     Simple Narrative         Others                                     10. Give Voice to child’s Non-Verbal Communication
                     Sensory Play             Solitary Play, Transitioning by End       11. Play with the Child Let Them Lead Play
                                              Pretends/Special Toys                     12. Attempt to Extend Play
                                              Plays near others, does not play on the
                                              edge of the group or avoid others
                                              Enjoys Active Games (Peek-a-Boo)                      Gaskill & CTA, 2008
                                              Short Attention Span
                                  DIENCEPHALON ENHANCEMENT ACTIVITIES

  AGE           CRITICAL FUNCTION                                     ENRICHMENT ACTIVITY
            Secondary Sensory Organization        Especially Focused on Visual, Auditory, and Kinesthetic Activities
            Processing:
                Conscious Experience of       Music: Songs, chanting, rhymes, poems, rhythm bands, marching bands: Hi
                  Senses                       Diddle Diddle, Mary Mary Quite Contrary, London Bridge is Falling Down,
                                               Twinkle Twinkle Little Star, The Alphabet Song, It’s Raining, Hickory
            Motor Regulation and Control       Dickory Dock, Clap Your Hands, Where is Thumpkin, This Old Man, Old
                                               MacDonald, Hush Little Baby, (I Love You Rituals by Becky Bailey)
1 to 2 yrs. Focusing Attention/Memory
                                               Movement/Motor Control: Activities with songs, chants, dance or
            Drive States: Survival/ Protection movement. Wave like a tree, blow like the wind, pretend your rain falling
                Appetite                      down, Ring around the Rosy, London Bridge is Falling Down, Dance, Yoga,
                Thirst                        Stretching, Jungle Gyms, Crawling Tunnels or Tubes, Card Board Box
                Fighting                      Tunnels or Mazes, Balance Beams, Swings, Teeter Tatters, Slides, Merry Go
                Fleeing                       Rounds, Tires Swings, Kick Ball, Catching Balls. Playing with Ribbons,
                Sexual Arousal                Hoops, Balls, Sheets of various sizes. Occupational Therapists and Physical
                                               Education Teachers can be helpful here. Stacking blocks, Dominos, Building
                                               with Sand, Sticks, Lincoln Logs, Legos, other materials. Games which
                                               require motor control and restraint of impulses. Mouse Trap, Rattle Me
                                               Bones, Hungry Hippo, Operation, Fish Pond, other games that are age/skill
                                               appropriate.

                                                Simple Narrative: Dramatic Story telling by adults with hand and body
                                                motions, changes in voice, tone, pitch. Natural or native story tellers about
                                                people, culture, relationship with nature. Reading books, poems, looking
                                                picture books of animals, objects, people, nature, how things work, ect.
                                                Stories that rhyme or have repeating patterns like Dr. Seuss or Nursery
                                                Rhymes, Mother Goose, Aesop’s Fables, etc .
    Rhythm, Songs, Chanting,
          Narrative
•   Poetry Rhymes, Lyrics
•   I Am a Bright Light
•   Tony Chestnut
•   Family Hugs
•   Story Telling
    – Family Stories
    – Reading and Telling Stories
        • Fables, Nursery Stories
        • Children’s Books
        • “I Love You Rituals”
            – Old Woman Lived in A Shoe
            – Story hand
                      TONY CHESTNUT

Toe Knee Chest Nut Nose Eye Love You

Toe Knee Nose, Toe Knee Nose

Toe Knee Chest Nut Nose Eye Love You

That’s What Toe Knee Nose


(Again)


Toe Knee, Toe Knee, Toe Knee, Toe Knee

And His Sister I Lean

And I Lean Loves Kneel

And Kneel Loves Pat

But Pat Still Loves Bob

And there’s Rustle and Skip

This Song Is Silly, but it’s Hip

How It Ends, Just One Man Nose

And Guess What It Is

Toe Knee Chest Nut

(Again, But Faster)
                  FAMILY HUGS

Begin by showing the child a “pinky finger hug”, by
interlocking his or her pinky finger with yours.

ADD DIFFERENT HUGS: (but repeat the entire series
beginning with the Pinky Hug.

    Elbow hugs

    Thumb hugs

    Knee hugs

ANOTHER VARIATION: (The family handshake)

    Shake hands and say, “Good Morning!”

    Touch Thumbs as you shake

    Slide apart

    High five

    Create your own
     A WONDERFUL WOMAN WHO
          LIVED IN A SHOE
 Have the child sit in your lap; wrap your arms around them.



A WONDERFUL WOMAN              Hold the child’s hands up palms
LIVED IN A SHOE.               to the child.


SHE HAD SO MANY                Touch each finger on one hand
CHILDREN,                      as you say each word.


SHE KNEW EXACTLY               Touch each finger of the other
WHAT TO DO.                    hand as you say each word.


SHE HELD THEM.                 Fold the child’s fingers into a
                               fist and cradle them in your
                               hands.

SHE ROCKED THEM.               Hold the child’s hand and rock
                               it from side to side.

AND SHE TUCKED THEM            Press the child’s fist against his
IN BED.                        chest. This makes a slight
                               hugging position.

I LOVE YOU, I LOVE YOU         Say the words lovingly and give
IS WHAT SHE SAID.              the child a hug.
                   STORY HAND

Play this game when something wonderful has happened
and you want to point out the child’s successes.

Tell the child:

          It is story time. Take their hand.

          Start with their pinky. Give it a little massage.

          “This little finger wanted to (hope/ dream).”

          “This next finger was a little afraid that (what
          might happen).

          “But this middle finger said, I can do it. I just
          know I can.

          “The pointing finger said, I’ll try and I’ll try.”

          “And the thumb said “I did it, I did it!”

          Tuck the thumb into the child’s palm and say,
          “No problem, all the fingers knew she could do
          it all the time.”
    Movement/ Sequencing

•   Going on Bear Hunt   • Outdoor Play
•   Drum Circles         • Exercise
•   Percussion Bands       Equipment
•   Clapping Games       • Physical Games
•   Ball Bouncing        • Build With Blocks
•   Bal A Vis X          • Treasure Hunt
•   Dance                • Walk A Maze
             HAND-CLAPPING RHYMES

1. Face your partner

2. Clap your hands as you sing this rhyme.

3. Clapping Pattern:
    Clap your hands together
    Clap you hands against your partner’s hands
    Clap your hands again
    Clap your partner’s right hand with your right hand
    Clap your own hands together
    Clap your partner’s left hand with your left hand


Rhyme:

My boyfriend’s name in Jello

He comes from Monticello

With three fat toes

And a dimple on his nose

And that’s the way my story goes
              BALL-Bouncing Rhymes

You are to bounce the ball in time to the rhymes and do
the stunts as you go. Turn your leg over the ball on the
last word of each line.


                Bouncie, bouncie, ballie

               My sister’s name is Paulie

                   I gave her a slap,

                   She paid me back,

                Bouncie, bouncie, ballie
         Treasure Hunt
•   Draw a Map to a Treasure
•   Give Directions
•   Give Distances
•   May Use a Compos
•   Take Turns Following the Directions
    Diencephlon Enhancements for
       Grade School and Above
•   Gentle/vigorous Movements                •   Music/Dance/Rhythm
     – Fast/Slow                                  – Drum Circles
     – Small/Large                                – Hand Clapping games
     – Hula Hoops
                                                  – Jump Rope
     – Balls/Bean Bags
     – Swimming
                                                  – Line Dances/YMCA
     – Children’s Games (Simon Says: Duck,   •   Simple Narrative
        Duck Goose                                – Recall experiences
     – Tampoline                                  – Show and Tell
     – Brain Gym                                  – Read Stories/Poetry
     – Bal-A-Vis-X                                – I Love You Rituals
•   Fine Motor
                                                  – Books/Pictures/Manipulative
     – Legos/Constucts/Dominos
     – Puzzles                               •   Games
     – Tidily Winks                               – Pick Up Sticks
     – Hop Scotch                                 – Jacks
     – Building Blocks                            – Marbles
     – Stringing macaroni/popcorn                 – Bop IT
     – Crafts/Jewelry Making                      – Jenga
     – Fingernail Paining                         – Operation
                                                  – Perfection
         Gaskill & CTA, 2008
 Limbic Intervention
Enhancement Activities
Attunement/Relational Play/Affect
           Regulation

                 Neuro-Sequential Developm
 FUNCTIONAL            DEVELOPMENTAL               FUNCTIONS
   DIVISION                 AGE

                                              Cognitive Functions
                                                 Exec. Functions
 NEOCORTEX                2- TEENS         Social Emotional Integration
                      Neomammalian Brain           Self-Image
      IQ                                            Affiliation
                                               Speech/Articulation
Gaskill & CTA, 2008
                                           Interpret Social Information
                                                 Share/Relational
                                                   Play/Pleasure
    LIMBIC                  1 to 4           Attunement/Attachment
                       Paleomammalian                Empathy
                            Brain                   Affect/Mood
     SQ
                                            Complex Threat Response
                                           Short-term Memory/Learning
                                                                          SOCIAL
  BRAIN AREA                     FUNCTIONAL                           INTERACTION            PLAY STAGE              COGNIVIVE
    (Perry)                   SOCIAL/EMOTIONAL                             RATIO                 OF                 DEVELOPMENT
                                DEVELOPMENT                         (Child/Adult/Typical    DEVELOPMENT                (Piaget)
                                  (Greenspan)                              Child)

      Limbic                      Shared Meanings                        2 to 1 to 3           Parallel Play      Preoperational Stage
   (1 to 4 years)                 (18 to 36 months)                                                                 of Development
                                                                             to                     To               (2 to 7 years)
Regulation of         During this period (24 to 36 mo.) the child
mood, empathy,        will use words/symbols to convey                  2 to 1 to 5/6     Cooperative Play by Still can not reverse
drive states,         intentions and feelings.                                            the end of the stage. thought. Understands
interpretation of                                                                                               actions as only going
social information,   Now (24 mo.) imitates familiar pretend-                            Primary goal moves to one way.
attachment, and       like actions, such as feeding or hugging a                         mastery play by the
complex movement.     teddy bear.                                                        end of this period.    Less trial and error,
                                                                    Time Requirements:   Constructive, dramatic but shows intuition
                      Uses Holographic speech (one word) for        3 to 6 times per day and socio-dramatic     and cognitive
                      some basic needs (24 mos.).                   (20 to 30 min. each) play is aimed at       learning, still very
                                                                                         recreation of          egocentric.
                      Can follow simple one step directions to                           experiences in images
                      meet needs. (The toy is over there.)                               and stores.            Develops
                                                                                                                classification skills.
                      Can engage in interactive, pretend play                            Knowing now            But, can not order
                      with an adult or child, by about 30 to 36                          requires the action of things into a series or
                      mo. (tea party)                                                    doing to assimilate    understand the
                                                                                         information.           conservation of
                      Uses Telegraphic speech (2 or 3 words)                                                    matter.
                      for communication (36 mos.).
                                                                                                                  Can not distinguish
                      Uses words or symbols to interact and                                                       fact from fiction
                      enjoy adults or peers.                                                                      easily, magical
                                                                                                                  thinking common.
                      Uses body, oral, imaging materials, and
                      dramatic play as language
    Typical Limbic Problems

•   Anger Outbursts
•   Difficulty Understanding Feelings
•   Lack of Empathy
•   Poor Attachment
•   Poor Social Skills
•   Poor Social/Emotional Interpretation
•   Does not Engage in Social, Pretend Play
                                      Functionally Appropriate Interventions
Functional Func Development     Social Developmental Milestones                   Program Activities
Divisions  Age       al
                   Play


                                    Regulation of Feeling, Complex
                                    Relationships, Use of Symbolic
                                           Communication

                                    Holographic Speech
                 Social             Follows One-Step Directions          1. Maintain Positive Relationship with Child
                 Emotional          Simple Interactive Play for 5 min.   2. Reflective Listening of Feelings
                 Experiences:       Words/ Sym to Share Excitement       3. Identify Feelings in Self/Others
Limbic    1 to 4 Teams               Labeling/Classifying Language
                                                                          4. Calming Strategies
                 Win-loss                                                 5. Play Feelings Games (Feelings Bingo)
                                    Uses Words, Pictures, Organized
2/1/6            Taking                                                   6. Make Faces in the Mirror
                                     Games to Interact with Peers
                 Turns                                                    7. Find Pictures in a Book
                 Sharing            Imitates/Pretend Play                8. Develop Friendship Skills
1 to 9
                 Narrative          Telegraphic Speech by 3              9. Take Turns
                 Nature             Shares when Asked                    10. Asking someone to Play
                 Discovery          Plays with Others, Needs Little      11. Asking for Help
                 Art/Dance           Sup                                  12. Giving Compliments
                                    Parallel Play                        13. Dealing with Other Children (Teasing)
                                    Objects Used in Make Believe         14. Read Books/ Tell Stories/ Sing Songs or
                                    Mastery Play by End Of Period            Use Puppet Plays to Illustrate Skills
                                    Avoids Aggression in Others
                                    Pretend Play (Dress Up/ Super        Conscious Discipline
                                     Hero)                                Positive Behavioral Supports
                                    Seeks Out Companionship in Play      Incredible Years
                                    Takes Turns in Games                 Dramatic Play
                                                                                                   Gaskill & CTA, 2008
                                    Shares Toys, Without Direction       Play Therapy
                                       LIMBIC ENRICHMENT ACTIVITIES

   AGE           CRITICAL FUNCTION                                 ENRICHMENT ACTIVITY

               Emotional Regulation        Complex Movement: Creative Dance, Bal-Vis-X, Gymnastics, Physical
                Of Mood                    Exercise Games with rules. Kicking a ball, making baskets, hitting a ball,
                                           catching a ball, simplified games.
               Social Language:
                      Interpretation of   Complex Narrative: Dramatic play, pretend play, playing out events from
                      Social-Emotional    past, present, and future. Emphasis on facial and nonverbal forms of
                      Communication       communication. Play therapy, more complex stories, poems, and books,
                      Emotional Memory    using many mediums of expression toys, books, gestures, verbalizations.

               Fear Reactions/Threat       Creative Arts: Art, Drawing, Painting, Crafts for Creative Expression using a
                 Response                  variety of materials.
1 To 4 Years
               Space/Time                  Nature Discovery: Walks or trips to discover the natural world with one’s
                 Orientation               senses, (sticks, stones, water, mudd, clouds, wind, animals, outdoor sounds,
                                           trees, plants, etc). Look at natural objects brought to the classroom
               Primary Sensory             (seashells, bird’s nest, baby birds, bats, worms, baby kittens, crawdads, fish,
                 Integration               soil, sand, bark, etc).

               Complex Movement            Socio-Emotional Experiences: Social Skills games, Cooperation Games,
                                           Taking Turns, Red Rover, Simon Says, Red Light Green Light, Mother May
               Drive States:               I, Candy Land, Flower Garden, other simple games of taking turns and
                    Aggression            sharing. Taking turns on the play ground equipment to be sure everyone gets
                    Escape                their turn. Visits from a dog or cat to learn about soft, gentle, safe empathic
                                           touches. A therapy dog may be helpful here.
                    Appetite/Thirst
                    Sexual Arousal
Limbic Enhancements For Grade
       School and Above
  • Creative Arts
     – Create masks of           •   Study facial cues and
                                     environmental cues and
       emotions, animals             discuss what happened and
  • Emotional learning               what will happen next
     – Build what is described   •   Create plays and dramas to
       to you with legos             express feelings and ideas
     – Make map and have         •   Create Mazes from boxes,
       someone follow it.            sheets or in a garden
                                 •   Have a scavenger hunt
     – Use terms of
       up/down/behind/under to   •   Puzzles to solve of
                                     wood/metal
       have others draw what
       you describe              •   Creative Dance, movement
                                 •   Card Tricks/Magic Tricks
     – Make a compass course
       and follow it.            •   Games: Sorry/Bingo/Ungame/
                                     Talking, Thinking, Doing
     – Make a treasure map to        Game/Attitude
       find hidden candy or          Adjustment/Life/Battle
       prize                         Ship/Trouble
                                 •   Social Skills games and
Gaskill & CTA, 2008                  activities.
        Limbic Activities
•   All The News That’s Fit to Tell
•   Game Play (Sharing, Taking Turns)
•   Puzzles, Mazes, Object Searches
•   Social Skills Stories (Berentain Bears)
•   Pretend/Dramatic Play
•   Following Directions
•   Nature Discovery
•   Creative Art Expression
Cortex Intervention
     Activities
 Cognition, Self-Awareness, Speech
   Language, Impulse Modulation




             Neuro-Sequential Developmental Chart
FUNCTIONAL     DEVELOPMENTAL              FUNCTIONS               SEQUENTIAL DEVELOPMENT OF PLAY
  DIVISION          AGE

                                      Cognitive Functions           Language/Reading Enhancements
                                         Exec. Functions                Humor/Performing Arts
NEOCORTEX        2- TEENS          Social Emotional Integration         Dramatic Symbolic Play
             Neomammalian Brain            Self-Image                            Games
   IQ                                       Affiliation                  Narrative/Story Telling
                                       Speech/Articulation                 Cultural Anchors
             Gaskill & CTA, 2008                                           CBT and Variants
                                                                           SOCIAL
  BRIAN AREA                      FUNCTIONAL                           INTERACTION            PLAY STAGE             COGNITIVE
     (Perry)                   SOCIAL/EMOTIONAL                             RATIO                 OF                DEVELOPMENT
                                 DEVELOPMENT                         (Child/Adult/Typical    DEVELOPMENT               (Piaget)
                                   (Greenspan)                              Child)

                                                                                                                   Preoperational Stage
     Neocortex            Emotional Thinking and Problem                 3 to 1 to 5/6       Cooperative Play        of Development
   (2 to 6 years)                     Solving                                                At the end of this
                                   (3 to 5 years)                                                 period.         Child uses more
Cognitive functions,                                                                                              anticipation and
abstractions,          The toddler (36 mo.) is now able to use                            Mastery continues as    forethought, less trial
creativity, and        words, pictures, or other symbols to show                          the primary task.       and error.
problem solving.       his or her likes or dislikes. (“want that”)                        Constructive and
Social/emotional                                                     Time Requirements: social dramatic play is Magical thinking
integration, self-     Can now engage in pretend play or drama       3 to 4 times per day common.                about causality
image and              that makes sense (36 mos.).                   (20 to 30 min. each)                        common. False
affiliation.                                                                              Knowing is still       learning common,
                       The toddler (36 mo.) is able to explain                            through experiences in repeats for rote.
                       wishes with some help.                                             images and stories in
                                                                                          an attempt to          Still no ability to
                       The preschooler can explain why they                               assimilate             distinguish reality
                       want something or wants to do something                            information.           from fantasy.
                       (48 mos.) (“…because I am thirsty.”)                                                      “Stretching the truth”
                                                                                          The child will         is common.
                       At 48 months can explain their feelings as                         represent these issues
                       a reason for their behavior (“…because I                           through body           Still has trouble with
                       am happy.”                                                         language, oral         views other than their
                                                                                          language, imaging      own point of view.
                       The preschooler engages in interactive                             materials (art), and
                       pretend drama with both peers and adults.                          dramatic play.         Chance and
                       The play logically fits together.                                                         probability have no
                                                                                                                 meaning.
                       Logical conversation connecting 4 or more
                       give and take sequences of communication
                       on a variety of topics.
     CORTEX PROBLEMS
•   Difficulties with Problem Solving
•   Difficulties with Planning
•   Conflicted by Rule Governed Behavior
•   Moral, Spiritual, Ethical Confusion
•   Questions of Self-Image
                        FUNCTIONALLY APPROPRIATE INTERVENTIONS
Functional Func Developmental     Social Developmental Milestones                  Program Activities
 Division Age       Play

                                Thinking, Creativity, Problem Solving
                                  Uses Words/Symbols to show
                                    likes or Dislikes
                                  Parallel Play at the Beginning
                                  Pretend Play moving to Dramatic
                                    Play that Makes Sense
                                  Explains Wishes/Wants                1. Maintain Supportive Relationship
                                                                        2. Give Positive Feedback
                                  Performs with Others
                                                                        3. Recognize the Child’s Unique Qualities
                 Humor            Gives Reasons for Wants
                                                                        4. Value Child’s Thoughts, Needs, Wishes
Cortex/   2 to 6 Language         At Times Gives Feelings to           5. Engage in pretend and dramatic play
Neocortex        Performing         Explain Behavior                    6. Play Cooperative Games
                 Arts             Cooperative Play with Many           7. Play Competitive Games
 3-1-6           Games              Elements in Play                    8. Help Recognize when a Problem Exists
                                  Logical Sequences of                 9. Help Generate Multiple Alternatives
1 to 10                             Conversation (at least 4 circles    10. Evaluate Possible Solutions
                                    chained together)
                                  Plays Outdoor Games
                                    (Tag/Catch)                         Conscious Discipline
                                  Plays Competitive Games (Races)      Positive Behavioral Supports
                                  Plays Simple Board Games             Incredible Years
                                  Takes Turns without Being Asked


                                                                                             Gaskill & CTA, 2008
              Cortex Enhancements
                      (use as age appropriate)
•   Bibliotherapy                                     •   Logical Problem Solving
                                                           –   Riddles
•   Stories with a lesson
                                                           –   Logic problems
     –   Aesop’s Fables
                                                           –   20 Questions
     –   Annie's Stories
                                                           –   Who or What am I
     –   Therapeutic Metaphors
                                                           –   I am Thinking of an animal
     –   Story telling about moral issues/character
                                                           –   Guess Who
     –   Jokes/humor
                                                           –   What’s missing
     –   Cartoons/humorous art, characters
                                                      •   Problem Solving
•   Conversations about things of interest to
    the child                                              –   Puzzles
                                                           –   Paper Mazes
•   Performing/Creative Arts                               –   Bent Nail Puzzles
     –   Musical expression
                                                           –   Toys that can be taken apart and
     –   Dance                                                 assembled
     –   Art expression                               •   Physical games and sports
     –   Writing                                           –   Teach Strategy
•   Field trips to see visual and performing               –   Teach Character
    arts, with discussion of the experience                –   Team Building
•   Role play abstract themes                              –   Team Work
     –   Love, justice, jealousy, loyalty, morality        –   Winning/Losing
•   Use puppet, animals, toy people to
    illustrate experiences

                                                                        Gaskill & CTA, 2008
          Cortex Activities
•   Art                             •   Riddles
•   Poetry                          •   Logic Games
•   Performing Arts                 •   Games of Strategy
•   Literature                      •   Problem Solving
•   Talk Therapy                    •   Anger Management
•   Activity Therapy                •   Sports
•   Moral and Ethical Discussions   •   Outdoor activities
•   Behavior Modification           •   Crafts
•   Humor                           •   Logical Problem Solving Games
•   Rational Emotive Therapy        •   Dance
•   Books                           •   Hobbies
•   Conversations                   •   Work
                                    •   Creative Arts
            Cortex Enhancements
•   Games                 •   Social Skills Training
    –   Charades               –   Boys Town Program
    –   Clue                   –   Conscious Discipline
    –   Master Mind            –   PATHS
    –   Pictionay              –   Incredible Years Programs
    –   Junior Scruples   •   Social Skills Games
    –   Guess Who              –   Angry Monster Machine
    –   Connect Four           –   Family Happenings
    –   Pick-up-Sticks         –   Control Patrol
    –   Sorry                  –   Mountaineering
    –   Aggravation            –   Self-Esteem Game
    –   Checkers               –   Social Security
    –   Chess                  –   Ungame
    –   Spades
    –   Old Maid          •   Cultural Appreciation
    –   Battle Ship            –   Books
    –   Mine Sweeper           –   Pictures
    –   Uno                    –   Museums
    –   Trouble                –   Cultural Centers
    –   Dominos                –   Speakers
    –   Memory
    –   Go Fish
    –   I Doubt It
                                                       Gaskill & CTA, 2008
     THANK YOU
   Go and Play with Children
With Sense of Renewed Purpose

				
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