Floortime is powerful play therapy. You can use it to recreate an emotionally charged event in your child’s life, and allow him to play out different roles and endings as he desires and imagines. But can you do this with a child with severe challenges in symbolic thinking and language? Yes you can! You can even go down to the sensory level if necessary to reach your child and access the event. In fact, that’s what’s often necessary to help kids with PTSD recover from their trauma.
At the recent DIR Profectum conference earlier this month, I watched a videotape of a grandmother working with her granddaughter on a the sensory level to help her recover from PTSD night terrors and agarophobia a year after a traumatic car collision. The child was swinging in a net swing and instructing her grandmother on how to push her. Her grandma was working on stopping the swing as a surprise, to try to recreate some of the sense of sudden stopping that the child had experienced, but change the associations from unpleasant to pleasant. So the key was making it fun and loving, and also to hand control over to the child. So the granddaughter got to tell grandma to swing just forward and back, not side to side, and only stop her when facing forward and not while going too fast. She gradually got grandma to increase the force of her push and stop more abruptly to make it more exciting. They worked on these “self-titration” exercises over a year, till finally, the PTSD symptoms melted away.
So I tried it with Peter. He had a hard time getting out of the car the other day to attend his brother’s track meet, as he gets anxious in crowded and noisy places. So I gave Peter a race track/ramp and car, and watched him self- titrate the how far up he’d release the car on the ramp to control the excitement. He ended up laughing in excitement when he was able to release the car from the top of the ramp. Then I had Charmander (a big stuffed animal) drive up in a toy car, and watch Peter release the car down the ramp intently. Charmander grew very interested and leaned as far as it could reaching for the car, but was too scared to come out of the car. Finally, I asked Peter, “What should Charmander do next? Sit in the car or come out?” Peter looked at me and emphatically stated, “Sit in car!” Then he gently nudged the entire track/ramp next to Charmander’s car, and handed Charmander the racecar. Charmander didn’t know how to make the car go, so Peter repeated his titration procedure of releasing the car at increasing distances up the ramp. When he let it go from the top, Charmander cheered, and said, “I see! You can go slow, and then fast. Good idea!” Peter looked at me with a huge smile, as if he really appreciated my acknowledgement of the coping strategy he’d worked out.
So when your child has either a strong emotionally positive or negative experience, think of the theme- as Dr. Greenspan puts it, competition, aggression, fear, excitement, nurturing, or whatever it is- and set up play dramas with dolls, puppets, or stuffed animals around it. Or set up a sensory experience analogous to the one that affected your child. Then let your child explore different outcomes, on his own initiative, at his own pace, with your support (such as choices- “Should Charmander sit in the car or come out?”). You’ll be surprised at what you learn, and what your child will tell you about his feelings and desires through play.
Posted in Educational Tips, Games/Activities, Dealing with Challenging Behaviors | Tagged floortime, anxiety, play therapy, posttraumatic stress disorder, Charmander | Leave a Comment »
It’s maddening to get Peter up and dressed in the morning. He keeps on asking for “one minute, please” and dives his head under the blanket. We usually end up having to tickle him out of bed, and he moves in slow motion to get dressed. After going to an outstanding DIR conference by Profectum at the Pasadena Convention Center this weekend, I thought I’d try a different approach.
So this morning when Peter peeked out of his blanket, instead of seeing me with his shorts in my left hand and “tickle monster” right hand poised to strike, Peter saw Charmander, his brother’s giant stuffed animal Pokemon character, wearing Peter’s pants. Peter snatched Charmander, took off the pants, and ducked back under the blanket, pants and all. I waited. A few seconds later, Peter’s hand reappeared from under the blanket, offering the pants. When he peeked out from under the blanket again, he saw Charmander wearing his pants on its head. Peter took off the pants, and dived under the blanket with them. Lo and behold! His hand reappeared offering the pants again! We repeated this game with the pants appearing on Charmander’s chest with the pant legs threaded through its arms, then reversed on its back but through the arms, then on one arm and one leg.
Finally, Charmander wondered if the pants might go on Peter’s legs. Charmander wiggled under the covers and got both legs of the pants threaded onto each of Peter’s feet. But when Peter tried to wiggle his pants up (still completely under the covers), he discovered to his chagrin that the mischievous Charmander had inserted one of its own legs into one of the pant legs so that it was tangled up with Peter in the pants! After Peter had struggled to right the situation and get his pants on, he threw the extricated Charmander out of his bed onto his brother’s. Then to my delight, he threw the covers off, and got up out of bed, quickly, not in slow motion, not requiring coaxing or tickles, and made his way to the bathroom to complete his dressing.
The story doesn’t end there. Peter usually takes an eternity to get dressed, lying on a long vanity seat a prior owner had converted the bathtub into. But miracles of miracles! When Peter spied Charmander sneaking up to steal his shirt, Peter snatched the shirt first and popped it on. Ta-dah! Competition won the day, and beat any timer I could have set to use classic behavioral methods to complete his dressing.
Posted in Dealing with Challenging Behaviors, Games/Activities, Uncategorized | Tagged DIR, floortime, getting dressed, inertia, self help skills | Leave a Comment »
Peter and I went skiing for the day. It was beautiful and sunny. Just getting to and from the mountain was fun for Peter because he loves long car rides. We made up songs to sing on the chair lift together. He did a great job skiing, following me carefully as we did big long turns, and trying to get his feet into parallel as we traversed the slope.
Unfortunately, at the end we had a couple of mishaps. When trying to untie my poles (I had threaded the handle loops together to make a CASS hold for Peter), I accidentally hit his fingers with the end of one pole. Peter was a good sport, just rubbing his hand, without a sound. I apologized profusely, and he said “I forgive you” with a repeat-after-me prompt. But at the very end, when Peter was seated in the car, I had just gotten his ski boots off when he reached over and slammed the car door shut. The only problem was that I was still between him and the door, leaning over to pick up his boots. Bam! I felt the car door slam against my head, and screamed in fright. Peter said he was sorry, and I had him do several do-overs, ie practices, on how to look around carefully for people before you close the car door, and then told him I forgave him too.
So at the end of the day, we made a tally.
|| Long car ride. ☺☺☺
||Singing on the chair lift. ☺
||Great job skiing! ☺☺☺☺
|Mama hit Peter’s fingers with the ski pole.
||Peter forgave Mama. ☺
|Peter hit Mama’s head with the car door.
||Mama forgave Peter. ☺☺
|3 sad faces
||11 happy faces
What was more, happy or sad faces? The forgiving made up completely for the accidents, and there was much more good than bad, so we decided we had had a very good time on our ski trip!
We reviewed the day with Papa, using the chart as a memory prompt.
Sometimes our kids can use some help with developing perspective when things don’t go completely right on a given day. Counting up happy and sad faces helps by providing a concrete visual. Reflecting on imperfectly good days are a great opportunity to develop perspective on life.
Posted in Dealing with Challenging Behaviors, Educational Tips, Personal Stories | Tagged forgiveness, graphic organizers, happy faces, perspective, reflection | Leave a Comment »
Some days, Peter’s inertia is so big that it borders upon catatonia.
Today was one of those days. My husband and I took him to Descanso Gardens to hike around and get moving. Peter moved like a patient with Parkinson’s Disease. I had to walk arm in arm with him, chanting ”Right, right, right, left right” to get his legs to move with any speed at all- otherwise, they just seemed glued to the ground. He just kept asking me for “Car ride, please.”
So I sent my husband to go on ahead about 50 feet, and said, “Peter, want to earn minutes for a car ride? If you can walk over to Papa, who’s waving over there, in one minute, I’ll give you a stick. You can trade in every stick you earn for a minute of car ride.” I had Peter push “start” on my cell phone timer, and then cheered him on to make that long walk to Papa. He started out slowly, but as he saw the seconds running down on my cell phone which I held up, he moved faster and faster. When I started the last 10 second countdown, he even ran a couple of steps! Success! He just made it, and proudly accepted a stick I picked up from the ground with a big smile. We kept this game up all the way up the hill to the Brody House museum.
After earning five sticks, Peter seemed to have warmed up. He walked at a normal pace for a while, without needing the stick incentive. When he slowed down again, we resumed the game, but needed fewer repetitions to keep moving. We made it back to the entrance after earning another three sticks only. And we even varied the game in which he got the stick after one minute of successfully matching my pace as I would walk super slowly, faster, stop dramatically, etc. (If he didn’t keep pace, I threatened to stop the timer and start all over again, but never had to carry that out.)
I suspect there’s something wrong with that basal ganglia that controls initiation and stopping. Behavioral techniques like the game we played are like the oil that Dorothy would administer to the tin man’s joints- at least it works for a while.
Posted in Dealing with Challenging Behaviors, Games/Activities, Personal Stories, Uncategorized | Tagged basal ganglia, inertia, motivation | 1 Comment »