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Category: On the Blog

Jordan meets his heroes

Joshua-Panelo-headshotWritten by Therapy Focus Occupational Therapist, Joshua Panelo.

A few weeks ago I organised for one of my clients, Jordan Jasmins, to attend a football match to watch his favourite team, the Western Bulldogs.

Jordan has Leukodystrophy, which is a rare neurological and degenerative disorder that affects the brain, spinal cord and often the peripheral nerves.

Jordan has had a difficult few months as his physical mobility continues to decline. Nevertheless he’s a very optimistic and sports mad young man with the desire to graduate high school and one day become a sports teacher.

After months of planning, the Bulldogs were generous enough to offer us change room access before and after the game for a once in a lifetime experience. In a special moment before the game, each player ran up and gave Jordan a high-five before running onto the field to face the Fremantle Dockers.

Unfortunately for Jordan, the Dockers were too strong in front of the home crowd. But in spite of the result, both Jordan and I were grinning from ear to ear as we met some of our heroes in Marcus Bontempelli and Tom Liberatore.

jordan-jasmins-and-marcus-bontempelli

Pictured: Therapy Focus Occuaptional Therapist, Josh Panelo (left) with his client Jordan (centre) and Western Bulldogs player Marcus Bontempelli.

Jordan was delighted by the experience and described the evening as “awesome”.

“It sucks that we lost, but I still had the best experience meeting the boys,” he said.

It was a special night and it was very heart-warming to see Jordan so star-struck after experiencing some tough months. He was absolutely ecstatic and couldn’t stop smiling all the way home! 

Our thanks go to the Western Bulldogs for their kindness and hospitality.

jordan-jasmins-and-joshua-panelo

Pictured: Jordan and Joshua enjoying the game. 

Karina takes her expertise to Zimbabwe

In May, Physiotherapist Karina Caldwell travelled to Zimbabwe with Cosmos HealthCare to volunteer as part of a medical team that provided care and support to people in disadvantaged communities near Bulawayo.

Karina is employed as a Continence Physiotherapist with Therapy Focus’ PEBBLES Continence Team and is based in Karratha where she delivers continence management, toilet training and bladder and bowel health services to the local community.

As part of organisational learning and development, Therapy Focus supports volunteering as an opportunity for staff  to gain an understanding of how national and international organisations make a difference, and to provide these organisations with unpaid assistance across a range of diverse activities.

Karina took up the opportunity to volunteer and has shared her experience below:

Salibonani! (Hello everyone)

I recently spent three weeks in Zimbabwe as part of a short-term medical team with Cosmos HealthCare. Our team consisted of two doctors, two nurses, our leader, a general helper, and myself – physiotherapist and co-leader.

Cosmos HealthCare supports and partners with local mobile service Sizolwethu Health and these trips provide medical care and support to people who live in disadvantaged communities near Bulawayo. 

cosmos-healthcare-short-term-medical-team

Six weeks prior to our team arriving, Cyclone Idai struck Mozambique and eastern Zimbabwe. Our itinerary was altered to send the combined Cosmos HealthCare and Sizolwethu Health team to Chimanimani.

A 3.8 magnitude earthquake had also hit near Chimanimani the day of the cyclone. As it was a mountainous landscape, the landslides from the mud and water were devastating. In the three towns we visited, 140 people were confirmed dead, but well over 400 were still missing. The stories were very hard to hear, of people trapped under buildings for hours, children being swept out of mother’s arms by the power of the water and whole buildings being swept away along with those sheltering inside.

cyclone-idai

There was much to process as we tended to people’s physical needs, as well as emotional and spiritual needs. Common presentations included hypertension, diabetes, fractures, musculoskeletal complaints, respiratory illness, pregnancy and skin conditions.

Despite the trauma, we saw great resilience and hope amongst the community. Our days consisted of setting up consultation areas utilising gazebos and tarpaulins, triaging and treating 80-120 people, then heading back to the 4×2 house that squeezed our 15 team members in.

karina-and-patient-in-gazebokarina-applies-a-cast

The second half of the trip was spent providing daily outreach clinics that were just as confronting but in different ways. One clinic, Ngozi Mine, is a rubbish tip where nearly 2000 people reside and make a living by sorting plastics that they can then sell for the recycling money.

There are high rates of HIV, hepatitis, and tuberculosis in many of the communities we visited. Elderly people continue to struggle to work in the fields and fetch their own water as family members have often passed on or moved countries to find work.

karina-leads-stretchesturned-in-child-foot

I also spent two days at a local orphanage where 19 children had significant disabilities such as microcephaly, cerebral palsy, spina bifida, anopthalmia, and autism spectrum disorder. The love the children receive in the homes is amazing, but the orphanage has minimal resources and training in how to best support them.

The highlight of my time here was being able to show the carers that, while some of the children could not speak, they could communicate. I explained the use of a very basic communication board using a whiteboard and marker and taught some key word signs. The staff are hoping to acquire a laminator so they can start to make their own charts for the children.

The contrast between the equipment and services we have access to here and what is available in Zimbabwe was very confronting. The hospital’s physiotherapy department reported not being able to remember when there were last ankle foot orthoses available for children with cerebral palsy. Cosmos HealthCare hope to be able to send an allied health team to Zimbabwe in the future.

african-orphanage-communication-board    karina-works-with-a-patient

I feel I gained so much in terms of life perspective and understanding, and appreciate the generous volunteering leave policy at Therapy Focus.

On reflection, the greatest tool we have as therapists is to listen well. The story of what someone has been through tells you so much about who they are, how they will approach things and how they can best integrate treatment into their lives.

May we all be quick to listen, slow to speak, and slow to form assumptions.

Siyabonga! (Thank you everyone)

To learn more about the opportunities and benefits Therapy Focus employees have access to visit our careers page. Alternatively, call us on 1300 135 373 or email workforce@therapyfocus.org.au

For more information about Cosmos HealthCare, visit their website

There’s no stopping Candice!

Five and a half year-old Candice Evans is not letting her disability get in the way of living life to the fullest, thanks to the use of specialised equipment and support from her dedicated therapy team.

Candice has Pitt-Hopkins Syndrome, a condition that is characterised by intellectual disability and developmental delay. The condition affects many of Candice’s body systems, including her ability to walk, talk, learn and play.

Over the past two years Therapy Focus Advanced Physiotherapist, Deborah Mitchell, has worked closely with Candice, her family and the staff at St Mary McKillop Primary School in Busselton to maximise Candice’s independence and help her participate in school activities.

“Candice is an inquisitive little girl who loves mat time, listening to music and making new friends,” Deborah said.

“Our physiotherapy sessions have focused on developing sitting, standing, balance and walking skills to allow Candice to sit on the floor with her classmates, stand for tabletop activities and navigate the playground during breaks.”

Therapy Focus Physiotherapist Deborah helps Candice with her sitting posture

Pictured: Therapy Focus Advanced Physiotherapist Deborah helps Candice with her sitting posture.

In addition to regular hands-on physiotherapy sessions, Deborah has assisted Candice’s family to access specialised equipment and assistive technology.

“In the last 12 months I’ve worked closely with the family to acquire funding for a walker, height-adjustable bed, Second Skin body suit and specialised tricycle,” Deborah said.

“Recently Candice has learnt to independently propel herself on the trike and has started enjoying regular outings with her mum, Jen. This has been a great source of pleasure for both Candice and Jen, and they are looking forward to being able to ride along the Busselton foreshore in the future.”

With access to specialised equipment and support from her broader therapy team, including her Speech Pathologist Heidi Jupp, Candice is continuing to grow and flourish as any five year-old should.

“It’s always a pleasure working with Candice and her family,” Deborah said.

“While her condition presents challenges as she grows, it hasn’t stopped her from learning to walk, ride a bike, make her own choices and follow her big brother around the house.”

To learn more about the services Therapy Focus offers for children and adults with disability living in the South West region, visit www.therapyfocus.org.au or call us on 1300 135 373.

Candice riding her trike with help from her Mum Jen

Pictured: Candice riding her trike with help from her Mum, Jen. 

Therapy Focus goes to California

A partnership between Therapy Focus and AchieveKids in California has seen staff from both organisations take part in a two week international exchange program that aims to provide invaluable learning opportunities.

Therapy Focus Advanced Occupational Therapist, Emily Greenwood, and Team Leader, Siobhan Clery, travelled to California in March 2019 where they visited AchieveKids schools and affiliated organisations, and attended the Stanford Autism Conference. Below they have shared their itinerary and experiences.

Touch down!

After a long flight we were excited to arrive in California and enjoy the state’s first warm spring weekend. We kicked off our trip by visiting Pier 39 where we said hello to the seals, crossed the Golden Gate and explored Sausalito enjoying some amazing clam chowder and sourdough. 

Emily and Siobhan standing on Pier 39

Day 1

AchieveKids CEO, Ryan Eisenberg and Director of Educational Services, Tom Drechsler hosted us on our first day at their Palo Alto campus. Following a tour of the school and introductions to staff and students, we got to meet the Executive Team over lunch. The students greeted us with “G’day mate” and shared all their knowledge about our native animals.

AchieveKids schools provide transitional and long-term school placements for their students. Their ethos is “learning for life” and promoting independence by providing successful learning opportunities at all points in a student’s day. They achieve this by their multi-disciplinary approach to education. This allows for the collaborative delivery of individualised education, mental health therapy, behaviour therapy, speech therapy, occupational therapy, vocational training and family support services for their students.

The organisation works with students aged 5 to 22 years with a range of diagnoses including Autism Spectrum Disorder (ASD), intellectual disability and foetal alcohol syndrome disorder (FASD).

Next door to AchieveKids is the Magical Bridge Playground, which has been purpose built for children of all abilities. A friendly student tour guide filled us in on all the background information about the playground, including the bridge named after a previous student as her mother helped build it.

We had an amazing first day with our heads full of new names, faces and knowledge.

Emily and Siobhan with the AchieveKids sign

Day 2

Today we attended Bridge School in Hillsborough. There is a strong link between the school and Neil Young, who for thirty years arranged bands and musicians such as Pearl Jam and Elton John to take part in concerts that raised funds for the school.

Bridge School is a transitional placement school with an outreach service that supports past students all the way across their lifespan.  Their mission is to ensure that individuals with severe speech and physical disabilities achieve full participation in their communities through their use of Augmentative Alternative Communication (AAC) and Assistive Technology (AT).

The school has a total of 14 students at one time, with all classrooms jointly run by a teacher and speech pathologist. Full-time occupational therapists and assistive technology specialists work closely together to prescribe equipment, complete adjustments and add mounts and mounting brackets etc. This ensures that the students can fully participate in all activities independently without their AAC or AT restricting their physical access for learning and exploring. For example, we were shown an electric wheelchair with controls in the headrest that were switch activated, which allowed a student to use a mouse on the computer.

Bridge School is extremely well resourced with AAC and AT. Students get to trial the school’s equipment for extended periods of time before funding is sought for their individualised AAC and AT. Eye-gaze control technology has been successfully funded for quite a few of the students at the school and it was so lovely to watch the technology being used so successfully in classroom programs for children who do not have use of all four limbs.

To finish the day we met Dr Vicki Casella, who was preparing to travel abroad and give a presentation about Cortical Visual Impairment (CVI). She was a fountain of information which she shared feely with us. Across the day it was fantastic to see the everyday adaptions for CVI inbuilt within the curriculum, supporting all the students to learn.

Emily and Siobhan with Dr Vicki Casella at The Bridge School

Day 3

We got to spend the afternoon at Laughing Giraffe Therapy, a private practice occupational therapy clinic. Sensory integration, floor time, movement and play were on the sensory menu as we marched to the beat of the drum.

That evening we went on a night tour of Alcatraz and got to experience the chilling wind and clinking sounds of the cells closing. Strangely enough it was on this day in 1963 that the cell doors clinked shut for the final time.

Emily in a body roller

Day 4

Today we visited the staff and students at AchieveKids’ San Jose campus. We met with School Director, Stephen Crook who took us around to meet staff and students. We had another great day taking part in classes, collections for Foodbank and making connections with all. 

Emily and Siobhan with Stephen Cook

Day 5

We visited the Children’s Health Council today, where we were hosted by Occupational Therapist, Vibha Pathak and colleagues. We learnt about the wonderful work they do in the area of teen mental health, support programs for parents of children with autism, diagnostic assessments and therapy service provision.

We toured their two schools; the Sand Hill School for students with dyslexia and learning differences and the Esther B .Clark School for students with emotional and behavioural issues, before sitting down together for lunch.

They shared some wonderful tourist tips and so in the late afternoon we headed off to visit one of their recommendations, The Mystery Spot. This intrigued us and we were enthralled by the gravitational anomaly… or is it?!

Emily at the Mystery Spot

Day 6

We were lucky to hear from renowned autism researchers at Stanford University’s 12th Annual Autism Update, a one-day conference for parents, educators and care providers. We really enjoyed reconnecting with many of the people we had met earlier in the week, particularly some of the teachers from AchieveKids, who were on our table.

The main take home points were development of early screening tools for potential early diagnosis of autism and the need for all paediatricians to have training in early detection. Often a ‘watch and wait model’ is used in place of early screening and referral. The whole room was in agreement that there was a need for more targeted research and evidence with the adult population, but it appears that in Western Australia we are doing all the right things in regards to transition to employment.

Our favourite speaker was Dr Bryan King, who presented on medical approaches for people with Autism Spectrum Disorder. He shared a wealth of knowledge in comprehensible and meaningful ways, using all therapy disciplines and approaches, not just medication. We will both be closely following his research.

Emily and Siobhan at the Stanford Conference

Day 7

It was time for the Golden State Warriors, who delivered a winning performance for their two biggest fans! We got to see Australia’s Andrew Bogut play, as well as number 30 – Stephen Curry! 

Emily and Siobhan in Golden State Warriors hats

Day 8

Our focus for next two days was learning about the services available to adults. Interestingly, most children with disability stay at school until they’re 22 years here in California, as opposed to in Perth where the maximum time spent is Year 13 or 19 years old.

Today we visited Gatepath, an organisation that provides services to people with disability throughout their lifespan, although we spent our time learning about their adult programs. They have three core programs that adults can access based on their goals, including the learning centre program, community access program and employment program.

The learning centre program helps adults with disability learn key skills, particularly for those who weren’t quite ready for employment. It was lovely to learn about a coffee cart the program participants had made and used to sell coffees at a fundraiser. The community access program focuses on job readiness and community integration, and the employment program linked participants with different employment agencies. The employment program participants are given opportunities to work at a number of different companies including Safeway, Marriott Hotel and McDonalds.

The key take home point today was that jobs for participants were established through strong relationships formed by committed and passionate people who believe that adults with disability should have access to paid employment.  

Emily and Siobhan with Gatepath staff

Day 9

Today we learnt the true meaning of partnership thanks to Abilities United and Community Housing. Together they built a 26 unit apartment for adults with developmental disability and all except two occupants had paid employment with support from All Abilities. It was so inspiring to see!

The day only got better as we continued to meet adults with disability well supported in paid employment positions at the Hilton Motel and Bon Appetite Café, which is within the Google complex in the Silicone Valley. We met one lady folding linen at the Hilton Motel who said it was her dream job. It was so lovely to see inclusive practices being valued by all!

Emily and Siobhan with staff from the Hilton

Day 10

Today we visited the Creekside School, which is a school for students with autism who are significantly impacted by difficulties communicating and regulating. The school started with two students in a parent’s house and has now grown to 11 students attending a school campus. Parent power is well and truly alive!

The school aims to grow to 60 students and maintain their 1:1 ratio. We got to observe the therapists and teachers supporting their students to engage in meaningful activities across their school day.

Day 11

Parents Helping Parents is an organisation that is dedicated to supporting parents as they navigate the complexities of the health, therapy, education and social systems. They also house an Itech department which is all about “tech-ploration”. They have tool kits for loan, which we got to explore and learn from. We want them for ourselves!

Emily and Siobhan with a lady at Parents Helping Parents

Day 12

Our farewell came around too quick, with Ryan, Emily and I having breakfast at Ada’s Café on our last morning. Ada’s Café was set up by the mother of a young man with disability who recognised that there was limited vocational opportunities available for her son after school. The café has grown in reputation and size since it’s initial opening and was recognised by the Silicon Valley Business Journal with a Community Impact Award in 2018.

It was wonderful to visit and support such a valued social and commercial enterprise. Following this we spent our last day with the students and staff at AchieveKids. It was with sad hearts that we said our goodbyes and closed our amazing tour.

Day 13

The early bird catches the worm – so we were up at 4.30am to spend our last day in the Bay area visiting Muir Woods, Sonoma and Napa Valley. We loved every minute of it and made some great memories. We forgot that there are luggage limits with our souvenir shopping and hastily bought extra baggage for our departing flights.

We honestly cannot thank Therapy Focus enough for this opportunity. We can’t wait to share our new-found knowledge with our colleagues, as well as the clients, families and schools we work with.

Siobhan standing next to a big tree

For more information about the benefits of working for Therapy Focus, visit our careers page.

Play, screen time and sleep for 0-5 year-olds

Daniel Prigmore Headshot Written by Therapy Focus Advanced Physiotherapist, Dan Prigmore

The period of time from birth to five years old is one of rapid physical and cognitive development and a time during which a child’s habits are formed and family lifestyle routines are evolving.

The World Health Organisation (WHO) recently released its recommended play, screen time and sleep guidelines for 0-5 year-olds. These guidelines are relevant for all children under 5 years of age, irrespective of gender, cultural background or socio-economic status of families.

However, it’s important to note that caregivers of children with a disability or those with a medical condition would be best to seek additional guidance from a health professional.

WHO’s recommendations are as follows:

Physical activity recommendations 

Infants (less than 1 year) should:

  • Be physically active several times a day in a variety of ways, particularly through interactive floor-based play (more is better)
  • For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake

Children 1-2 years of age should:

  • Spend at least 180 minutes in a variety of types of physical activities at any intensity, including moderate-to-vigorous-intensity physical activity, spread throughout the day (more is better)

Children 3-4 years of age should:

  • Spend at least 180 minutes in a variety of types of physical activities at any intensity, of which at least 60 minutes is moderate- to vigorous intensity physical activity, spread throughout the day (more is better)

Sedentary time recommendations

Infants (less than 1 year) should:

  • Not be restrained for more than 1 hour at a time (e.g. prams/strollers, high chairs, or strapped on a caregiver’s back)
  • Screen time is not recommended
  • When sedentary, engaging in reading and storytelling with a caregiver is encouraged

Children 1-2 years of age should:

  • Not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs, or strapped on a caregiver’s back) or sit for extended periods of time
  • For 1-year-olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 hour (less is better)
  • When sedentary, engaging in reading and storytelling with a caregiver is encouraged

Children 3-4 years of age should:

  • Not be restrained for more than 1 hour at a time (e.g. prams/strollers) or sit for extended periods of time
  • Sedentary screen time should be no more than 1 hour (less is better)
  • When sedentary, engaging in reading and storytelling with a caregiver is encouraged

Sleep time recommendations

Infants (less than 1 year) should:

  • Have 14-17 hours (0-3 months of age) or 12-16 hours (4-11 months of age) of good quality sleep, including naps

Children 1-2 years of age should:

  • Have 11-14 hours of good quality sleep, including naps, with regular sleep and wake-up times

Children 3-4 years of age should:

  • Have 10-13 hours of good quality sleep, which may include a nap, with regular sleep and wake-up times

You can read WHO’s full 36 page report here.

At Therapy Focus our Physiotherapists can support children and families to ensure they are getting enough exercise and meeting physical activity recommendations. Visit our movement and mobility page and our early childhood intervention page.  

The Kitchen: A Short Story by Jasmin

The following was written by 17-year-old Jasmin Pradhan, who is autistic and accesses Therapy Focus’ services.

I have always been interested in writing, but I only just started writing novels and short stories within the last three years. Mostly I am motivated by the people around me, like my family, who are always happy to read my stories and give feedback. I have entered several writing competitions and last year I placed in two competitions; The Katharine Susannah Prichard Short Fiction Competition and the Autism CRC Digital Art Celebration. I love writing because I get to share my perspectives on events and places, which helps people better understand me.

Prologue

The world is a scary place. It doesn’t make sense. It never really does. People are the most confusing. But it isn’t always so strange. There are some people that I can connect with and like trying to talk to. There are a few places that are like safe havens in my crazy world. This story is about some of those people and one of those places …

The Kitchen

My heart is racing.

I glance at my reflection in the glass window in front of me. I certainly look different. I’m wearing long pants and a long sleeved white jacket with two rows of round black buttons. My waist long hair has been wrestled into a bun and shoved underneath a hair net. I wipe my sweating hands on my striped apron. I’m trying to hide it, but I’m nervous. ‘I haven’t ever done hours in a kitchen like this before. I can’t even do one hour in a shopping centre.’ I remind myself that I won’t be spending my whole shift in The Kitchen. ‘I’m serving food in the school’s hall at 5:30pm too. That will get me out of The Kitchen, but there will still be so many people and lights. I also hope I’ll be able to do all the work okay too without dropping or spilling anything. That would be so embarrassing. Oh well, all I can do is try.’ Taking a deep breath, I turn and heave open The Kitchen doors, my feet feeling heavy and clumsy in my big, steel capped boots.

The commercial kitchen is swarming with sounds, and despite having been there before, tonight the atmosphere feels different. It still looks the same though. All along the sides of The Kitchen are workstations of spotless silver benches which reflect the artificial lights above me. There is a big dishwasher at one end and in front of that is a large rack of neatly organised cutlery and bowls and pots and pans and just about anything we could need to bake or cook with. The dishwasher is humming and a big pot is simmering and sizzling on the stove and taps are rushing water as other students wash their hands. I notice a detailed outline of the evening is scrawled on the small whiteboard in inky blue marker. It quells some of the chaos in the room that I’m starting to feel. ‘A plan. A plan is good. Things can’t go wrong when there’s a plan … Usually.’

I go to an empty sink and wash my hands. The water is hot, but not burning, although it does make my hands turn red. Then I join all the other students in a half circle around the whiteboard where the teacher, Miss Summers is standing. She has dark hair pinned back into a neat bun. Her hair is long like mine and sometimes in school I’ve seen her easily pull it into a bun like it’s nothing. I have no idea how she does that, but I wish my hair was as easy to pin back as that. Miss Summers wears a black apron tied around her regular clothes and she stands with a confident manner about her.

When everyone has arrived, Miss Summers takes charge. Standing by the whiteboard, she explains the evening step by step. ‘This is a very well thought out plan,’ I think as I listen. “We have a lot to do, so we’re splitting into groups.” She points to the board where lists of names have been written. “We have two hours now to get all the food ready. After that, you’ll all be going out in your groups to serve the food.” Miss Summers starts giving out the jobs. I am grouped with Penny, Ella and Cassie who are also my classmates. Our task is to get the platters of savoury foods ready.

Once were dismissed to start, I feel a rush of excitement. ‘The evening is starting. Here we go.’ Cassie takes the lead in our group and everyone lets her, for she is a fair leader. “Okay, we need to figure out how many quiches fit on a tray. Then we’ll know how many platters we’ll need.” Ella fetches the quiches from the massive fridge which is also called the Cool Room
since it really is like a big room that you walk into. I peel the glad wrap off the top and Cassie is silent for a moment, counting. “We’ll need three trays,” she decides and Ella goes to find some.

There is no point in plating any of the food yet because it still needs to be re-heated in the ovens and we can’t do that until it is closer to the serving time. I squint across the room at the whiteboard. ‘Five ‘o’ clock is the reheating time.’ We prepare everything else we’ll need, down it the tiniest detail. Each bench is allocated a different type of food. Ella and I find and lay out the parsley garnishes for the meatballs. Cassie locates and prepares the samosas which she takes to another part of the kitchen to get heated later. “How’s it going over here?” Miss Summers comes over to us. “Everything’s ready Miss, we just need to re-heat it and plate it up.” Cassie reports. “Excellent.” Miss Summers smiles and I feel myself relax. ‘Everything’s going okay, we’re even ahead of schedule.’

At that moment, I see something falling out of the corner of my eye and immediately tense. A second later, there’s a massive crash from a pot that someone knocked off its shelf. It sounds like an explosion. Despite having seen it, I jump and to my surprise, so does Miss Summers. I blink. ‘She jumped at a loud sound. I thought I was the only one who did that.’ It’s not nice to see anyone getting startled, but it’s nice to know I’m not the only one who finds loud noises surprising.
“Easy there, take your time,” Miss Summers says to the student who dropped the pot. Suddenly, her watch face lights up. She looks at it, taps it, then scrolls through some writing that appears. Everyone stares, including me.
“Whoa, what’s what?” Ella asks in amazement. Miss Summers looks surprised.
“It’s a smart watch. I was just checking my emails.”
“That’s so cool!” Penny exclaimed, “I wish I could do that.” My peers all start pretending that their watches are smart watches too. I grin. It’s nice to see everyone having fun. Perhaps The Kitchen isn’t always about work after all.

At quarter past four, everyone is allowed to take a break. I step outside with my classmates and sit on one of the long silver benches with a sigh of relief. It’s nice to be away from the lights and sounds of The Kitchen for a few minutes. My peers and the other students all cluster around benches in their groups. I sit on my own, like I generally do during school time which sometimes feels lonely, but today that’s how I want it. ‘No more talking or using social energy. Just for a little while.’ I watch them though and observe. I learn a lot by simply observing. It means that when I have to do group work I know something of what I’m supposed to do and how it all works because I’ve seen the other kids doing it. Sometimes at school I like practicing having conversations with some of the students or teachers who are around during break times. I know I’m going to need to be able to communicate well when I leave school.

As I sit on the bench, listening to the chatter of my peers, it feels relatively peaceful. The cool wind blows at my skin and pulls wisps of my hair out from under its hair net. The sky is a pale blue with a sprinkling of clouds. ‘It’s going to be a pretty sunset tonight, if I were outside to see it.’ I know I’ll be inside the hall serving food at sunset though. I sit back and close my eyes for a brief moment, enjoying the silence.

Twenty minutes later, all the students are back in The Kitchen and there is still time before we’re scheduled to heat the food. Everyone drifts around, trying to find something to do. I wipe down some benches, some girls start the dishes and others cluster in groups to just chat. I join Ella, Penny and Cassie when I’ve put the cloth away. I don’t really know how to join in, but that’s okay this time. I’m happy to just listen.

The girls start talking about the hospitality uniform.
“These boots are so heavy,” Cassie groans, lifting her foot up. “My dad insisted on getting the steel cap all the way up the boot.”
“That’s in case you drop something really heavy or sharp,” comes Miss Summers’ voice and she too joins our circle. “It protects your feet better.”
“But still,” Cassie protested, “they’re so heavy!” I grin. I remember my parents taking me to buy my boots and words swim around in my head, but I can’t get my words organised and out of my mouth before someone else speaks. It all goes so fast. I stay quiet.

As Miss Summers bends down to tie up her dark navy sandals that wind up her ankles, everyone notices the same thing.
“Miss, you’re not wearing your steel boots,” Ella points out.
“I know,” Miss Summers smiles and explains that she hadn’t known she was going to be helping out tonight. “At least you girls have yours.”
“Nothing’s going to get through my boots.” Cassie decides. “Hey Miss, stand on on my feet.” Miss Summers presses one foot onto one of Cassie’s boots.
“Oh wow, that’s good protection.” Miss Summers agrees, impressed. Penny starts jumping up and down on Ella’s boots and we all laugh. I feel a zing of pleasure rush up my spine. ‘I’m really starting to enjoy being here. It’s not half as exhausting as I thought it would be. I was so nervous about knowing what to say or do and trying something new, but it’s actually going okay. I’m actually having fun.’
“Alright girls,” Miss Summers instructs with a smile once we’ve calmed down. “We probably shouldn’t just be standing here. It’s nearly five, I reckon it’s time to start getting ready. Let’s get some work done.” Everyone nods and scatters to work. My heart starts to race. ‘Here we go. The second part of the evening. This is going to be interesting.

I grab an oven mitt and open the oven closest to me. Miss Summers hovers around to supervise. I peer inside the oven. Inside are all the quiches. I start to reach in to the trays which are pushed nearer the back. Then I stop. ‘If I reach all the way in now I’ll burn my arm.’ With logical thinking, I simply grab the oven rack and slide it out further so the quiches come toward me. Now I can get to them more easily.
“Good girl,” Miss Summers says, having watched, and I smile. I place the trays on the stovetop and then take them to the silver benches. Miss Summers helps me to prise the quiches out of the tray using a knife. Then I use the tongs to arrange the warm quiches along one of the platters, but my coping strength is suddenly starting to waver. It’s a lot louder than it was a few minutes ago. I can hear the ovens clattering open and closed and trays slapping the bench tops and boots clapping on the floor and words zipping around the air. It makes my head spin and my breathing feels like it gets louder and I try to keep my hands steady as I arrange the quiches. ‘Is this right? Am I doing it right? Do I put all of them on? What if they don’t all fit?’

As I start to finish, Miss Summers comes and stands next to me and helps me with the final few. “Well done, these look perfect.” Her words make me breathe an inward sigh of relief. The praise acts as water to my fiery overload. My thoughts slow and the sounds don’t seem as irritating. ‘Oh, so I was doing it right. That’s okay then.’ I smile to myself and then line the tray up with the other ones that are also ready to go. I move to help Cassie who is sticking toothpicks into the meatballs.

Finally, everything is ready and the time comes to serve the food. Everyone gathers all the platters and lays them out along the front bench. There are plates of bruschetta, meatballs, samosas and of course the quiches. All the dessert trays are put into the fridge for when we’ll need them later. “You can all take your hairnets off now,” Miss Summers instructs and she shows us how to wear our aprons differently by folding the top half down and tying it around our waist, rather than putting it over our heads. Everyone looks very professional.
“Remember to be confident when you go out,” Miss Summers advises us, “smile and walk around and even if you have no idea what to do, just pretend that you do.” There’s a ripple of laughter through the students. I take a deep breath and bite my lip. ‘I’m nervous again. I’m not sure if I can do this.’
“Alright, year elevens go first,” Miss Summers nods at us all. “We don’t need everyone going out there at once or we’ll swarm them.”

The year elevens all grab a tray and mine has bruschetta on it. With our trays, we walk out into the night air and toward the hall. The stars are twinkling above me, but I’m not looking up. I’m looking down to make sure I’m not going to trip on anything and drop my platter. I make it to the hall with the platter still whole and then I hesitate. There are so. Many. People. I feel light headed and tiny among so many people I don’t know. I swallow. Cassie, Ella, Penny and the other students go on ahead of me. I follow last. ‘Look confident and smile.’ I think, recalling Miss Miss Summers’ advice. ‘This might be really terrifying because I’ve never done this before, but I can’t let it show. Besides, how hard can it be? I just have to walk around and offer people food. Simple …’

Trying to keep calm, I step into the hall and slowly wander around the outskirts of the exhibition with the platter of bruschetta in front of me. My heart beats hard. A younger boy with a striped shirt comes bouncing up to me. ‘Come on. I can do it. Remember what Miss Summers said to do.’
“Hello,” I smile, lowering the platter to his height. “Would you like one?” “Yes please.” The little boy takes two, one in each hand and then skips off. I grin. ‘I did it! That wasn’t too hard.’ As I walk around, a lot of people come to me and I keep up my act, though I’m still nervous. I smile, say hello and offer them a piece. Some people recognise me from around school and want to chat. I try my best to think of words and try even harder to get them out of my mouth in a coherent sentence. It’s very difficult, but it does work and my sentences all match the conversations which is good because sometimes they don’t.

When the last piece of bruschetta has been taken, I walk back to The Kitchen. Despite all it’s bright lights and constant sounds, it’s a bit like walking out of a hurricane and into a shelter. It takes me a second to realise that I’m relieved to be back. It’s a place where I now know all the people and I’m happy to be around them. I might not always know what to say, but I know that these people don’t mind and that means more than I can say. It also helps that the environment within The Kitchen is predictable, especially on a night like tonight. Miss Summers smiles at me as I come back in and I smile back.
“You did well,” she says, gesturing to the empty tray.
“Yeah,” I agree with a nod. I turn and head to the dishwasher where another girl is washing up. ‘I don’t need words for this,’ I think in relief and silently start to help.
“Thanks,” the girl says and we work side by side in amiable silence. She wipes the dirty dishes and stacks them in the machine. I dry them when they come out and put them on the racks behind me to dry.

For the rest of the evening, that’s pretty much what happens. The year elevens and twelves wander from The Kitchen to the hall and when there are too many people going out, some stay behind and help to wash dishes. I get more confident in speaking to the people in the hall after a few goes and it starts to feel less scary.

Once most of the platters are empty, it’s scheduled for the people at the exhibition to be listening to speeches and getting some awards. This is our time to quickly get ready for serving the desserts. ‘I never knew just how much work went into a night like this,’ I realise as I help to get the desserts from the fridge. The trays are laid out on the benches and unwrapped and the air is filled with the sweet smell of chocolate cakes, tangy lemon slice and creamy profiteroles.

It’s much easier to serve the people this time, now that I know what I’m doing. The desserts are always so popular and tonight is no exception. Everyone is in a good mood and the atmosphere is lively and cheerful as I make my way around. I could barely take two steps before someone else came up to take a piece to eat. ‘This is great. It’s nice to see people enjoying everything that’s been made.’

The desserts go faster than the savoury foods and are very popular in most of the younger kinds. Slowly, as I walk around, I realise there are less people here than before. It’s then that I look at the clock and see that it’s past six o clock. Within the next ten to fifteen minutes the visitors start to leave and soon there’s only a few people left milling around. I smile and head back to The Kitchen. With almost no one left to serve, our main work is done.

Some of the desserts are still left over and Miss Summers allows us to eat some. I try a thin piece of lemon slice. The icing has melted slightly since it came out of the fridge a while ago, but it is still cold and delicious and tangy. Then comes the time that I find the easiest. It’s time to clean up. All the benches have to be wiped down and sanitised, the dishes all have to be cleaned and stacked away neatly and any mess has to be cleared up.

There’s a bustle as everyone gets to work, but there are so many of us that it doesn’t take too long. As I put away some of the dishes, I see Miss Summers looking around at us all.
“Hey guys,” she calls out. “Shall I bring out the Tim Tams?” I don’t answer because I already know what everyone else will say. I laugh quietly at the sudden chorus of delighted agreements and Miss Summers grins. She disappears into the storeroom and returns a moment later with a big packet of Tim Tam biscuits. There is enough for everyone to have one each. I much mine slowly to make it last longer. It tastes rich and smooth and delicious. I can hear happy chatter and see many bright smiles. I look around and realise just how nice it is to be in a group of people all working together and sharing fun moments with each other. ‘I fit here tonight. It feels nice to belong.’ The thought makes me smile.

Then Miss Summers suggests that we go and look at the art exhibition while she finishes up a few things. ‘That’s a good idea. We’ve been so busy serving I don’t think anyone had time to look at the art.’ Everyone wants to, so that’s what we do. We all troop down to the hall in our steel capped boots and aprons and walk around the exhibition. There is no one left now, they have all gone home. I wander around the big hall on my own, taking in all the beautiful masterpieces. My favourite one is done by two students in my year group. The drawing of the stars and sunset is breathtaking. There’s also paintings of flowers, little ceramic fishes and painted bowls that the younger students have done. The woodwork students have some of their work displayed too. I really like the wooden guitar. ‘That must have taken months to make.’ After everyone has seen what they want to, we all head back to The Kitchen together. Chatter and laughter rings out in the evening air and I smile.

Back in the Kitchen, there is nothing left for us to do. It is earlier than we had expected to finish. “You guys can call your parents now,” Miss Summers says, “tell them to come pick you up. There’s nothing more we can do now.” I step outside and send my mum a text and then grab my bag which has my school uniform in it. I’d had to get changed straight after school and while I’ve decided that I have enjoyed tonight’s experience, I am still looking forward to getting home.

As I wait outside with Miss Summers and the other students, I look up and smile at the hundreds of stars that decorate the inky sky. The evening breeze is cool and gentle and I feel a flicker of pride at having completed tonight successfully.

‘I did it. I really did it.’

Epilogue

That night was certainly a memorable one for me. It was a wonderful feeling to have done something that I didn’t think I would be able to do. I’d certainly learned a lot too and not just about how The Kitchen works. I’d learned how to interact with my peers and work with a group. I’d learned how to be confident around new people, a skill I am sure will be useful for university and the ‘real world.’ So to all those people who taught me something that night, thank you, because I still remember all the memories I made that night and I’m sure I’ll remember them for a very long time to come.

Student chefs cooking

Image credit: Food Service Equipment Journal.

What is Support Coordination?

Kiki Veron headshot Written by Therapy Focus Support Coordinator, Kiki Veron. 

Support Coordination is assistance to help you implement the supports you need to achieve the goals in your NDIS Plan. This includes formal, informal and mainstream supports.

Supports funded by the NDIS are known as formal supports. This includes things like therapy, assistive technology and consumables for example. They are supports offered by service providers like Therapy Focus.

Informal and mainstream supports are not funded by the NDIS. These include:

Informal supports – unpaid family, carer and community support available to a person.

Mainstream supports – education, health or other community services.

A Support Coordinator will help you understand your NDIS plan and connect you with the formal, informal and mainstream supports that suit your needs and help you achieve your goals.

Support Coordination is also about capacity building. This means helping you develop the skills and confidence needed to manage the supports in your NDIS plan.  A Support Coordinator will empower you to coordinate your services and participate in the community to the best of your ability.

It is important to note that Support Coordination services are time limited. This means that NDIS will only fund Support Coordination services for a certain amount of time, but this can change depending on your needs.

Levels of Support Coordination

There are three levels of Support Coordination that can be included in your NDIS plan. The level of Support Coordination you receive funding for in your plan depends on your individual goals, plan objectives and aspirations.

Support Connection – Links you with supports that maximise your NDIS plan and help you achieve your goals.

Support Coordination – Helps you build the skills you need to understand, implement and use your plan. A Support Coordinator will work with you to ensure a mix of supports are accessed and coordinated. They will also help you resolve points of crisis and develop resilience.

Specialist Support Coordination – This is for people whose situations are more complex and need specialist support. A Specialist Support Coordinator will assist you to manage challenges, work through barriers and ensure consistent delivery of services.

Our Support Coordination Services

At Therapy Focus, we provide Support Coordination and Specialist Support Coordination services.

Our Support Coordinators have extensive experience working with people living with disability and work as part of our therapy teams. Our Specialist Support Coordinator is a qualified Social Worker who also has extensive experience within the disability sector.

Our Support Coordinators provide one-on-one support to help you get the most out of your NDIS plan. The types of things they can help you with include:

  • Choosing service providers that meet your needs
  • Coordinating and reviewing services
  • Navigating the NDIS portal, developing service agreements and creating service bookings
  • Addressing any concerns you have with service providers
  • Managing any issues or challenges you’re facing
  • Accessing and navigating mainstream support (e.g. health, education, housing, legal and other services)
  • Building relationships and managing conflict
  • Preparing for a plan review
  • Liaising with NDIS Plan Managers

For more information about Support Coordination, visit the NDIS website.

To access our Support Coordination services, contact us today.

Two therapists reading a plan with an older man

Andrew joins the celebration

Josephine Chong could not be prouder of her son Andrew, who recently stepped outside his comfort zone to attend his cousin’s engagement party.

20 year-old Andrew is diagnosed with Autism Spectrum Disorder and whilst he loves going out into the community and being around people, he also likes routine and knowing what to expect.

So when Andrew was invited to his cousin’s engagement party, the family started preparing Andrew for a new experience with help from his therapy team.

“It was something very different for Andrew. It was a new environment with new people and lots happening,” Josephine said.

“I prepared him by using his communication device to explain that we would be going to a party the day before the event and just before we left the house.”

“Once we got there we found an area with less people so that Andrew could relax when he needed to. He would go out into the party, but then come back to the quieter area when he wanted.”

“We couldn’t stay for the whole night, but we stayed for a few hours and had a great time celebrating with our family.”

Andrew and his Mum Josephine

Pictured: Andrew with his Mum Josephine find a quiet corner at the engagement party.

Josephine said she wanted to share her son’s story to encourage families and people with disability to take part in positive experiences.

“My husband and I were so happy to be included with the whole family and Andrew had the opportunity to socialise at his cousin’s special occasion.”

“The most important part is that he was exposed to a new environment and met new people.”

Andrew’s Therapy Focus Speech Pathologist Erica Daneel was delighted to hear that the family could enjoy the special event.

“Josephine was so proud of how well Andrew coped with this new experience,” Erica said.

“She was able to support Andrew by using a range of strategies she discussed with the therapy team before the event, which helped support their success.”

“We know how important it is for our clients and their families to be included in these events and are thankful to Josephine for sharing her story and being such a strong advocate for her son.”

 

Pictured: Andrew with his family.

Share your story!

Each month we feature the story of a Therapy Focus client who has achieved a goal, been an inspiration to others, or done something amazing.

Send your story to sunny@therapyfocus.org.au and we’ll share it on our website, in our e-newsletter and via our social channels (if that’s ok with you!)

Moving from the WA NDIS to the NDIS

Are you moving from the Western Australian managed National Disability Insurance Scheme (WA NDIS) to the federally run scheme? If you are accessing services from Therapy Focus there will be some changes to your service agreement.  

Why the move? 

From 1 July 2018, the National Disability Insurance Agency (NDIA) became responsible for delivering the NDIS Australia-wide. The WA State Government no longer deliver the NDIS, which was known as the WA NDIS. Participants accessing the WA NDIS are being transferred to Australia-wide NDIS in stages as part of a planned schedule. 

What will be different? 

The service provided to you by Therapy Focus will not change. Your therapy team will continue to work with you and the people who are important to you to help you achieve your goals. 

The types of activities that you will be charged for does not change, but we will charge you an hourly rate in line with the NDIS Price Guide.  

Travel 

Travel costs are not included in the NDIS hourly rate, so your therapy team will need to charge for travel to and from appointments. We will talk with you about what is best for you in terms of where you would like to meet. This could be at your home, school, workplace or community.  

We will come to an agreement about the maximum travel amounts for each of these meeting places and write this in your service agreement. We charge up to 20 minutes of travel in metropolitan areas and 45 minutes in rural and remote areas. 

We will only charge you for the time it would take to travel directly to you from our closest office. If it takes less than our agreed time, we will charge you the smaller amount.  

We will not use more than 20% of the funds in your NDIS Plan for travel. If you live in a rural and remote area, we will not use more than 40% of the funds for travel.  

If you come to a Therapy Focus office you won’t be charged for travel. 

For more information about how we charge for travel under the NDIS, download this fact sheet 

Cancellations 

If you need to cancel or change an appointment, we ask that you tell us by 3pm on the business day before your appointment.  

If you cancel an appointment later than 3pm on the business day before, we will charge you for the appointment. The maximum we charge for short notice cancellations is 6 hours of funding. 

We understand that things happen so we will not charge you the first time you cancel with short notice.  

Reports 

The NDIA ask us to provide reports that summarise the services that you have received. This includes a Therapy Service Plan that lists your goals and therapy strategies. You will be charged up to 1 hour of funding for your therapy team to complete this report.   

At the end of your plan we will complete a Therapy Service Summary to show the outcomes you achieved and make recommendations for the next service plan. You will be charged up to 2 hours of funding for your therapy team to complete this report. 

For more information about the activities we charge for, download this fact sheet 

Have questions? 

Contact us on 1300 135 373 and a member of our friendly team will be able to help.  

Shannon soldiers on and looks to the future

Not even a near-death experience can hold 14 year-old Shannon Stobie back from doing the things he wants to do in life.  

The cheeky teenager was born with a rare, life threatening condition called asphyxiating thoracic dystrophy, also known as Jeune syndrome, which affects the way his bones and cartilage develop.  

Shannon needs 24 hour care and uses a ventilator to help him breathe, as well as a suction device to clear his airway. He also has scoliosis, which puts further pressure on his small lungs. 

But like his Mum Samantha, Shannon has fighting spirit and has never let condition get in the way.  

“He will give absolutely anything a go. He doesn’t let anything hold him back and just gets on with things,” Samantha said.  

“He still wanted to go to the school Christmas party after a terrifying incident in December that nearly took his life. He said he was fine and ended up coming along and helping me in the restaurant.” 

“All the customers loved him and said he did a great job. He even scored a $20 tip off one man and since then he’s wanted to work with me in the kitchen.” 

Getting a job is now one of the goals in Shannon’s NDIS Plan and Therapy Focus Physiotherapist, Brianna Rapson, is supporting Shannon to achieve this goal, in addition to sourcing him a new powered wheelchair.  

“Right now I’m helping Shannon develop the skills he needs to become job-ready, such as social skills, time management, money handling and budgeting,” Brianna said

“His new wheelchair has a high-low functioning, which will allow him to raise or lower himself as needed, helping him reach things and serve customers if needed.” 

The Stobie family and their friends are now raising money to purchase a modified van that is large enough to fit Shannon’s new wheelchair and room for someone to sit beside him.  

Samantha said that the proceeds from fundraising events held at The Almighty Lesmurdie Kitchen, music gigs and raffles were going towards the $47,000 modified van that Shannon needs to transport him safely.  

To find out more about future fundraising events, contact Samantha Stobie on 0403 763 460 or email simonjoker-1977@hotmail.com.

A boy in a wheelchair laughing with a girl standing beside him

Pictured: Shannon (right) with his sister Kellyanne (left).

Share your story

Each month we feature the story of a Therapy Focus client who has achieved a goal, been an inspiration to others, or done something amazing. Email your story to sunnny@therapyfocus.org.au and we’ll share it on our website, in our e-newsletter and via our social channels (if that’s ok with you!)

FAQ: School Transitions

 Therapy Focus Advanced Occupational Therapist, Alix Combe
Written by Occupational Therapists, Alix Combe and Tegan Larcombe.

Change can be daunting, especially for children with disability undertaking key life transitions such as starting kindy, going primary school or moving into high school. 

At Therapy Focus, our therapists support children with disability, their families and carers to manage these changes and transitions in their lives. While each person is different and will use strategies unique to them, we’ve put together some of the more frequently asked questions to get you started on the right path to a smooth transition.

Starting kindy

What’s the best way to prepare for kindy?

Good news! There are lots of different ways to prepare your child to start kindy.

In the lead up to your child starting it’s very important that you encourage them to feel excited about the upcoming change in their routine. Talk about the fun activities they will get to do at kindy, the children they will get to play with, and the play equipment they don’t have at home. You could even show them a picture of their teacher and take a trip to the kindy to show them what their classroom will look like. If you are worried or scared, your child is likely to pick up on these feelings and copy them.

Setting up a consistent morning routine in the weeks before they start can help your child to feel safe, in control and comfortable with all the tasks that need to be completed in order to get ready for kindy each morning. Once you’ve established what needs to be done (getting up, getting dressed, eating breakfast, cleaning teeth), try and do the tasks in the same order every morning. A visual schedule may be useful to support your child’s understanding of these tasks. This is a step by step flow chart that uses images of the tasks and the order in which they need to be completed. Visual schedules are great in supporting children with difficulty processing or understanding information verbally (when spoken to them). Visual schedules are also very useful in the classroom to help children understand what they will be doing throughout the day.

Toileting is often a big stressor for parents and their children. While it is not essential that children are toilet trained before starting kindy, it is recommended that the child is already toilet training at home. Encourage your child to indicate to you when they need the toilet and teach them to pull their pants/underwear up and down without you, attempt to wipe their own bottom and wash their hands. If your child is reliant on you to do these things then they might become anxious if they need to rely on a kindy teacher or education assistant to help, rather than their parent.

Your child may also benefit from attending a kindy-readiness playgroup. These groups focus on teaching children to sit and listen to a teacher, follow instructions, play with other peers and engage in different fine motor activities, such as cutting, gluing, painting, writing and doing puzzles. By attending a group such as this, your child will become familiar with the expectations of kindy and be exposed to opportunities to develop their social skills with other children their age. Therapy Focus often run Kindy Readiness groups for children and families accessing services. For more information speak to your Key Worker or therapy team. 

Social stories are also an excellent way to help prepare your child for kindy, as they can include specific information about your child’s kindy, what to expect on their first day, who their teacher will be, what their kindy room will look like and who they can talk to if they need help. Your therapy team will be able to help you create these social stories and discuss additional strategies to help you and your child prepare for the kindy transition.

Can parents stay at kindy to help initiate routines?

While increasing your child’s independence and adaptability are key aspects of kindy, many kindies will invite or allow parents to stay for varying periods of time during the first couple of weeks. Having a chat to the teacher before your child’s first day is a good way to make sure you’re all on the same page and know what to expect. You’ll also then be able to tell your child how long you’re staying for, so they don’t get a surprise when you leave. Having a chat to the teacher is also a great opportunity to have a discussion regarding any concerns you may have for your child and what strategies you currently use to support them in their daily activities. Having this information in advance will also help you prepare your child in the lead-up to the first day and help the teacher to better understand and prepare for your child in their classroom. Try to keep the communication lines open between the teacher and yourself so that everyone remains on the same page and you can both work together to unsure your child is well supported.

When it’s time to say goodbye on that first day of kindy remember to be calm and reassuring with your child (even though this might be really emotional for you). Children will easily pick up on feelings of anxiety or stress. 

A young boy and a Therapy Focus therapist playing with bubbles

Starting primary school

How do I choose the right school?

When choosing a school for your child there are a few different types of schools to consider. These include public schools, private schools, independent schools or more specialised education support centres. It is important that you consider your child’s needs and the type of school that will be best able to cater for these needs.

Both public and private schools have support services for children with disability. In a public school you, the school staff and your child will create an individual education plan. This is a plan written specifically for your child, taking into account their individual educational and personal needs. Your family may also be eligible for additional government funding to support your child’s education.

Children with disability in independent schools are also eligible for government funding, however it is at a lower level than their counterparts at government schools. Independent schools all operate slightly differently, and so provide a variety of pathways and strategies to support your child.

When you are considering a school, be sure to set up a meeting with the school to talk to them about the types of support they offer. If possible, also request a tour around the school to determine any possible access issues for your child such as stairs/ramps if they have mobility issues. This will also allow you to get a general feel about the atmosphere of the school, and how it fits with your family.

Some good questions to ask of any school are:

  • How many children are in each class?
  • Will my child have access to an Education Assistant and how many support hours will they get?
  • What does the support from an Education Assistant look like?
  • Will my child be able to access specialist equipment if they need it? i.e. specialist seating, a wheelchair, assistive technology like a laptop with reading/writing software on it?
  • Do you have inclusion policies in your school?
  • If my child needs a specific education plan, what is the process for this?
  • Does the school have written policies in relation to students with disability?
  • How many students with a disability (or receiving additional funding) does the school currently have?

What are education support centres and education support schools?

Some children with disability are eligible to attend an education support centre or school. Education support centres are located alongside mainstream primary and secondary schools. They deliver both individualised programs with specialist staff separate to the mainstream classrooms, but also look at supporting the child to participate in some mainstream programs with their peers. The frequency of mainstream integration is different in each education support centre, and is a really important question to ask a school.

Education support schools are separate primary and high schools with on-site access to specialist staff and facilities. These schools generally have smaller class sizes with a higher student to education assistant ratio. Some schools also have onsite therapists.

Both education support schools and centres have a strong focus on linking in with disability employment agencies and training organisations to make future transitions such as going to high school and looking into post school options easier.

A boy in a wheelchair in class with his Therapy Focus therapist

Starting high school

How do I support the transition to high school?

There are many things you can do at home to get ready for your child’s transition to high school.

Start preparing for the transition to high school as your child reaches the end of Year 5. This could include meeting with the high school to ensure they are aware of your child’s needs and organising transition visits so your child can go and spend a few days at the high school with other peers from their class or a familiar support person. Your therapists will be able to attend these introductory meetings with you, if you would like their support. Transition visits will give your child the chance to work out the layout of the school (where their lockers will be, where the canteen and lunch area is, the library and gym and where their main classrooms will be etc).

Talking about the new school and routine in advance, visiting the school and working out practicalities, such as how to get to and from school, can all be done before your child starts high school. You can also create a high school booklet that includes pictures of the school, their teachers, education assistants and friends that might also be starting high school with them. Include information such as how they are getting to and from school and what subjects they will be doing. Doing a lot of preparation in advance will help reduce your child’s anxiety or fears around the ‘unknown’. It is also important to highlight the aspects of the transition to high school that will remain the same. For example, they may still have the same friends attending high school, they will still be dropped off at school, they will still wear a uniform etc.

Organisational skills are also important for high school and you can support your child to develop these skills by helping them use a diary, showing them how a class timetable works, and helping them organise their text books. Colour coding books can often be a useful way to help your child to find the books they need easily.

Be prepared for ups and downs, especially in the first term. By continuing to communicate with the school staff and your therapy team, you’ll be able to work together to support your child through this transition.

Will my child get special conditions for tests and exams?

Students with disability who could be disadvantaged in timed assessments may be granted special conditions during exams. This could involve extra reading and working times, rest periods, special instructions, use of a computer or scribe and more.

Assessments to determine the type of special conditions your child needs can be completed by school staff and your therapy team. The school may then need to submit this to the Education Department in advance for approval prior to big exams (like ATAR). Your therapy team and school staff can work together to set up the best learning environment for your child.

A teenage looking over paperwork with his parents and Therapy Focus therapist

Need more info?

Our therapists can provide advice and support for school transitions and all key life transitions. For more information speak with your Key Worker or therapy team. 

To access Therapy Focus services, apply for services or call us on 1300 135 373

What does an occupational therapist do?

Deanne ColemanWritten by Advanced Occupational Therapist and Team Leader, Deanne Coleman.

Many people think that occupational therapists work mostly with children and adults to improve handwriting and fine motor skills. This is certainly one part of what we do – but there is also so much more!

Occupational therapists help people reach their potential and be as independent in life as they possibly can be. The work we do is as broad and as varied as everyone’s life is!

Who do occupational therapists work with?

Occupational therapists work with people of all ages and abilities to be as independent as possible in all activities of daily living. We assess and interpret where a person has difficulty completing an activity, then provide strategies to help the person carry out the task independently.

How can occupational therapists help?

Occupational therapists can support people in any area that brings meaning and purpose to their life. This could be things people need to do, want to do, or are expected to do in their daily life.

Some of the areas that occupational therapists can provide support for include:

  • Play and social skill development – learning how to play with others, share and take turns
  • Emotional and sensory regulation – learning how to regulate emotions and understand how behaviours impact on others
  • School skills – developing fine motor development such as handwriting, cutting skills, sequencing and memory
  • Self-care skills – learning how to dress, shower, go to the toilet, cook, clean and do the things you need to do to live independently
  • Feeding/eating skills – learning to use cutlery and eat independently
  • Employment – support to find a job and return to work after an injury or illness
  • Rehabilitation – learning how to do everyday activities again after a serious injury or stroke
  • Living skills – learning how to complete the daily activities required to live independently, such as cooking, cleaning and budgeting
  • Mental health – developing a sense of self-worth and confidence through counselling and group sessions

Where do occupational therapists work?

Occupational therapists work in a variety of different settings including schools, hospitals, aged-care facilities, mental health services, rehabilitation centres, employment agencies, community health centres and in private practice.

Occupational therapists often work as part of a transdisciplinary team, which means they work collaboratively with other therapists and heath professionals. At Therapy Focus, our occupational therapists work alongside speech pathologists, physiotherapists, psychologists, dietitians, behaviour support clinicians and continence nurses to help people with disability achieve their goals.

For more information about the type of support Therapy Focus occupational therapists can provide, visit our comprehensive therapy page or contact us.

An occupational therapist talking with a lady holding a handrail

Dietetics and the NDIS

Maddie ToddWritten by Therapy Focus Dietitian, Maddie Todd. 

At Therapy Focus, our team of experienced dietitians work closely with other allied health therapists to help children and adults with disabilities achieve their goals.

Dietitians can support people with disability in a range of areas. Some of the areas include:

  • Supporting diets for people who experience difficulties with chewing and swallowing
  • Fussy eating or resistant/picky eating
  • Stressful mealtimes and other mealtime challenges such as food refusal, not coming to the table, eating with distractions or avoidance to eat socially
  • Bowel issues (e.g. constipation, diarrhoea, coeliac disease, limited fluid/fibre intake)
  • Pressure injuries (e.g. poor wound healing, prevention of pressure areas)
  • Limited range of foods eaten which can lead to nutritional deficiencies and poor social or participation outcomes
  • Excessive weight gain which impacts physical or social function
  • Supporting optimal growth and development
  • Non-oral feeding (tube feeding) and tube weaning

With the National Disability Insurance Scheme (NDIS) rolling out in WA, people are asking whether dietetic services can be accessed using NDIS funding. In short, the answer yes. NDIS participants are given choice and control regarding their goals and how they receive support to achieve those goals. This means that a participant can choose to use funds from their NDIS plan to access support from a dietitian if they feel it will assist them to achieve their goals.

As with all planning under the NDIS, the needs of NDIS participants should be considered on an individual basis. What this means is that dietetics can be included in participant plans if judged as ‘reasonable and necessary’ against the criteria that applies to all funded supports.

Some other criteria that need to be met for NDIS funding to be considered include:

Functional capacity

The dietary support must relate to a person’s function. This can include building or maintaining function in the following areas:

  • Communication
  • Social interaction
  • Learning
  • Mobility
  • Self-care
  • Self-management

Dietary support links to your disability

Dietary support under the NDIS must relate to a person’s disability and must not be able to be funded by other service systems (e.g. public healthcare).

If you are interested in learning more about accessing dietetics under the NDIS you can read a joint statement published by the Dietitians Association of Australia, or contact Therapy Focus.

You can also learn more about Therapy Focus’ dietetics services here

How to support someone with communication difficulties

Glenna TanWritten by Therapy Focus Advanced Occupational Therapist, Glenna Tan

Imagine what it would be like if you were unable to speak or had difficulty getting your message across. Anyone can experience communication difficulties, but it is something that many people living with disability face. 

Communication is a basic human right and a crucial part of learning and development, but it is also something that successful communicators can take for granted. By modifying the way we interact with people who have communication difficulties, we can support them to communicate effectively and be heard. 

Tips for effective communication:

  • Respect is paramount. Always treat the person with the dignity and respect they deserve.
  • Learn about the different ways to communicate. This can include gesture, eye gaze, pointing at symbols, sign language and the use of aids like augmentative and alternative communication systems
  • Find out the person’s preferred communication method and ask how to help them communicate, including the use of aids they may need.
  • Make sure you have the person’s attention before attempting to communicate.
  • Try to avoid loud locations and any unnecessary noise, as this could distract the person and hinder their ability to communicate. Try to find a quiet place to talk.
  • Remember to use a friendly tone of voice and try not to get frustrated. This could negatively impact their willingness to communicate.
  • Make eye contact where possible to show you are listening, but be mindful of potential issues someone may have with eye contact. For example, someone with autism who feels uncomfortable with eye contact.
  • Allow enough time for a response if you ask a question. Wait patiently for the person to reply and repeat if necessary or say it in a different way.
  • If you don’t understand a person when they are communicating, it is better to tell them so you can work out a better option together.
  • Simplify your language. Maybe try asking the person simple yes or no questions if you are having trouble communicating.
  • Always listen. Listening is the key to effective communication.

When working with someone who has communication difficulties, it is vital to have discussions with the individual, their family, carers and/or therapy team to work out a plan of action and effective communication strategies.

Therapy Focus speech pathologists help children and adults with disability develop their speech, language, literacy and communication. This can include support for the use of Alternative and Augmentative Communication (AAC) systems and solutions for people whose communication needs are not met by speech or writing. Learn more here

For more information about our speech pathology services, contact us on 1300 135 373.

Speech Pathology Week runs from 19-25 August and the theme for this year is ‘Communication access is communication for all.’ For more information about Speech Pathology Week visit the Speech Pathology Australia website.

Therapists with child on the trampoline
Pictured: Speech pathologists using a symbol chart to communicate with a child.

Getting ready for the NDIS

Sam Berglin headshotWritten by Therapy Focus Business Transitions Manager, Samantha Berglin

Getting ready for your first NDIS planning meeting can be daunting and overwhelming. Our therapists can support you to make the most of your meetings and NDIS plan.

As the National Disability Insurance Scheme (NDIS) continues to roll-out in Western Australia, our advice to people with disability and their families is to prepare. So here are some practical tips to help you get ready:

1. Start today!

It’s time to start thinking about how you want to live your life and what you need to achieve your own goals or the goals of the person you support.

2. Think big

What do you want to achieve in life and how do you want to live? NDIS wants to know this and they want to help you get there.

3. Write a list or keep a diary

Think about a typical week or day and what was hard. Ask yourself, what are the things that make it hard for you to achieve what you want to do in life? A good way to remember this is to write it down, use a diary or a list to keep examples.

4. Be specific

Try to be specific about what your goals are and what you think you might need to achieve these. Think about both long term and short term goals. NDIS will help you with this, but it’s important to have examples ready.

5. Get your documents and information ready

Fill in your ‘Getting Ready for Your Planning Conversation’ workbook before you meet with NDIS. It has important questions that you can expect to come up in your planning meeting.

6. Talk to the people who are supporting you already

This will help you talk through your goals and aspirations with people that know you well. This might include family or friends or current service providers.

7. Take someone with you to your meetings

You don’t have to do this alone! Take someone along with you, who knows you well. This might be family, friends, your therapist or advocates. They’ll help you to make sure you aren’t forgetting anything.

The following are some examples of things you will be asked about in your first NDIS planning meeting:

1. Your personal details

You’ll be asked your name, age, where you live and about your primary disability. Have all your personal details and any reports or assessments in one place to help with this. You can even take them along to your meeting.

2. Your community and mainstream supports

You will be asked about what support you currently receive from the people in your life and in your local community. This can include things like health services or help at school or in sports groups, as well as friends and family who help you.
Write down if anyone is helping to support you at the moment. For example, friends or therapists.

3. How you manage everyday activities

You will be asked questions about how you manage your everyday activities. This helps NDIS understand what your abilities are, as well as what you might need, including equipment, housing or help to take care of yourself or your home.
Write down what a typical day or week looks like for you, and who is involved to help you manage.

4. Your safety

NDIS will ask questions about if there are any areas in your life where you may feel unsafe or where you might need extra help.

5. Setting your goals

You will need to talk through goals for the next 12 months and what you (or the person you support) are hoping to achieve through your first plan. You will also talk about how you are going to explore and develop your longer term goals over the next 12 months.

6. Starting and managing your plan

Think about if you would like to manage your own funds or support, if you would like someone else to, or if you are happy for the NDIS to manage the funding and you choose the supports.
Once you get your plan you can start contacting providers, including ones that you are already working with.

Download this information as printable PDF

You can also download information prepared by the NDIS for plan development here

Client, and therapist making plans

NAIDOC Week celebrates women: Geraldine’s story

NAIDOC Week is a celebration held across Australia to highlight the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. This year’s theme, ‘Because of her, we can’, celebrates Aboriginal women and the essential role these women play in their families and communities.

Geraldine Punch is a nan, mother, mentor and foster carer. She has welcomed more than 17 boys into her home over a number of years to help provide them with an education, a life free from crime and a loving family.

Geraldine and her boys share a joyful moment in the garden
Pictured: Geraldine and her boys share a joyful moment in the garden 

Geraldine is a proud Goreng Noongar and Christian woman from Gnowangerup, a small town south-east of Katanning, but has lived in Perth most of her life.

“My mum never pushed me to get an education or a job, but she inspired me to be a foster carer. I see the goodness in children, not ratbags, and the Lord put me here for a reason,” she said.

“I saw a 6-year-old boy at a skate park and he was wandering the streets. He didn’t have a good mother and I said to her I would take him in for 6 months so she could get cleaned up and get a job. I looked after him for 8 years. He has now graduated high school.”

Geraldine Punch

Geraldine currently has 6 boys in her care, with 2 receiving services from Therapy Focus. She said that all the boys had a love for sports and school.

“I want my kids to grow up to be strong, honest men. My boys are talented footballers most of them have finished year 12,” she said.

“They bring so much joy to me. I try to teach the kids about their identity and values, but it’s a bit harder when they have little problems.”

“It’s important the children accept who they are, and the things they can and can’t do, then you can encourage them to do what they can in the bigger world – disability or not.”

Geraldine Punch

Reflecting on this year’s NAIDOC week theme, Geraldine said that women are the backbone of every Aboriginal family.

“I would say to the children, ‘all I can give you is me’, and that’s the best I can do,” she said.

Geraldine and her boys
Pictured: Geraldine and her boys 

NAIDOC week is celebrated not only in Indigenous communities, but by Australians from all walks of life. The week is a great opportunity to participate in a range of activities and to support your local Aboriginal and Torres Strait Islander community. Find out about events happening in your area on the NAIDOC Week website.

Therapy Focus launched a Reconciliation Action Plan (RAP) in 2017 to better engage with Aboriginal and Torres Strait Islander customers and communities.

For more information about Aboriginal support groups and networks for people living with disability, visit Be My Koorda or First Peoples Disability Network.

NAIDOC Week celebrates women: Tania’s story

NAIDOC Week is a celebration held across Australia to highlight the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. This year’s theme, ‘Because of her, we can’, celebrates Aboriginal women and the essential role these women play in their families and communities.

Tania Harris is a proud Aboriginal woman from Queensland. She is a mother, career woman and a carer to her 18-year-old daughter Lisa, who has cerebral palsy.

Sitting in her backyard, feeling the crisp, cool air and the light rain drizzling down the patio bricks, Tania explains what disability means to her.

“Aboriginality and disability don’t generally go together. There’s no Aboriginal word for disability. We accept people, and all their differences. We accept them, just as they are.”

Tania is an Aboriginal Consumer Engagement Coordinator for the Health Consumers’ Council and she commented on how different this year’s theme had been for the community.

“It’s the recognition of how much work women put in, especially Mums. We have Nannas and Aunties who also care for the children that aren’t theirs and we’ve had this opportunity to say nice things to each other and build each other up,” she said.

“I was very glad when I saw the theme. The women I know are really strong, very caring and resilient and they are faced with a lot of challenges; but they get through it and get on with it.”

Tania Harris

Tania and Lisa have been accessing services from Therapy Focus for 14 years and in that time their needs have changed dramatically.

“We first started with Therapy Focus when Lisa was in full-time school and we had a lot of access to services,” she said.

“The therapists are really great and lovely people and we’ve found them to be quite intuitive in their work.” 

Tania said she had learnt a great deal from immersing herself in the disability community and she had developed wonderful friendships with strong women with disability.

“My friends who have disabilities were so willing to share about how things feel in their body, and it gave me such insight into Lisa’s world,” she said.

“If I could give any families struggling with disability, some practical advice, it would be to go and join the community and really be a part of it. Sit with people and ask them questions about what they think and how they feel. It will teach you all about the world your child lives in.”

“We are not encouraged as parents to step into that world, but we should.”

NAIDOC week is celebrated not only in Indigenous communities, but by Australians from all walks of life. The week is a great opportunity to participate in a range of activities and to support your local Aboriginal and Torres Strait Islander community. Find out about events happening in your area on the NAIDOC Week website.

Therapy Focus launched a Reconciliation Action Plan (RAP) in 2017 to better engage with Aboriginal and Torres Strait Islander customers and communities.

For more information about Aboriginal support groups and networks for people living with disability, visit Be My Koorda or First Peoples Disability Network.

Tania Harris with daughter Lisa
Pictured: Tania Harris with her daughter Lisa, enjoying the garden

Funding options for continence aids

Our specialist continence team, PEBBLES, often hear the question; ‘what funding is available for continence products like nappies, pull ups, modified swimwear and mattress protectors – amongst other things?’

There are a number of different funding options available, but it’s important to check that you meet eligibility criteria to see whether it’s the right option for you.

Continence Aids Payment Scheme (CAPS)

The Continence Aids Payment Scheme is a yearly payment provided by the Commonwealth Government to cover some of the cost of products required to help manage incontinence.

If you are eligible you can receive a subsidy of up to $533.50 paid in either 1 or 2 payments per year.

Eligibility criteria

To receive funding under the Continence Aids Payment Scheme (CAPS) you must:

  • be 5 years or older, and
  • have permanent and severe bladder or bowel incontinence.

You must also have either:

For more information and to apply visit the Department for Human Services website.

Incontinence Pad Scheme (IPS)

The Incontinence Pad Scheme is a product subsidy scheme specifically for children to assist with meeting the costs of continence products. The scheme is managed by Independence Australia and funded by the Department for Communities, Disability Services.

Eligibility criteria

To receive funding under the Incontinence Pad Scheme, you must meet the following criteria:

  • be between 3-16 years
  • have a disability
  • be a Permanent Resident or Citizen (or visa subclass 444 for NZ citizens)
  • be a Permanent Resident of WA
  • family must be in receipt of a carers allowance
  • family must produce a letter from a GP, continence nurse or medical specialist stating the child has incontinence, and
  • can access CAPS simultaneously.

If you qualify, you can receive a product subsidy of $490 per year. All money goes towards products rather than a cash payment. To apply, fill out an application form on the Independence Australia website.

Continence Management and Support Scheme (CMASS)

The Continence Management and Support Scheme is a product subsidy scheme specifically for adults to assist with meeting the costs of continence products. The scheme is managed by Independence Australia and funded by the Department for Communities, Disability Services.

Eligibility criteria

To receive funding under the Continence Management and Support Scheme, you must meet the following criteria:

  • be aged 16 years+
  • have a defined chronic or intractable continence condition (lasting 6 months+)
  • hold a Pensioner Concession Card or low income health care card (people over 16 years+ who have been receiving CAPS may be eligible for a subsidy from CMASS)
  • be a Permanent Resident of WA, and
  • must contact a CMASS registered continence professional or Silver Chain and arrange an assessment in order to access to funding. A prescription will then be provided to Independence Australia.

If you qualify, you can receive $490 per year from date of your first assessment. If the funding limit is reached, you can still continue to purchase the same products at the same contracted price from Independence Australia.

If you are registered participant under the National Disability Insurance Scheme (NDIS), you will need to request funding for continence products in your NDIS planning meeting and have it included in your plan. Please talk to you NDIS planner, Local Coordinator, or Therapy Focus’ PEBBLES Team to find out what funding options are available to you as an NDIS participant.

ultrasound
Pictured: A PEBBLES Nurse prepares an ultrasound procedure

Don’t put off access valuable continence products because you don’t want to have ‘that’ conversation. Continence needs to be talked about. If something doesn’t feel right, it’s important to have a conversation with a healthcare professional.

Therapy Focus offers specialist continence services for children and adults living with disability. Known as PEBBLES, the team of experienced clinicians provide assessment, advice and treatment for a range of bladder and bowel health issues, as well as toilet training.

Learn more about Therapy Focus’ specialist continence services

Alternatively, contact the PEBBLES Team on 1300 865 401 or email pebbles@therapyfocus.org.au

Taboo Topics with a Continence Clinician

Written by PEBBLES Continence Occupational Therapist, Tabitha Poole.

Of all the topics to talk about, poo and wee may not be top of the list. But for Therapy Focus’ PEBBLES Team, your bathroom business is our business. A key part of our job is removing the stigma around continence issues to help people seek support for even the most taboo topics.

Faecal incontinence

Did you know that 1-3% of children experience faecal soiling (aka pooing pants)? It is more common in boys, but still happens to girls. Faecal incontinence is not caused by naughtiness, laziness or attention seeking and punishing this behaviour can make it worse.

One major cause of faecal soiling in children is constipation, which can affect up to 25% of children. Treating constipation with timed toileting routines, fluids, dietary changes and appropriate medication can often resolve the faecal incontinence.

It’s not just children who experience faecal soiling either. In 2010, 1.3 million Australians aged 15 and older had faecal incontinence. In addition to constipation, other factors that can lead to faecal incontinence include:

  • Long term straining
  • Medications i.e. antibiotics and drugs for arthritis and diabetes
  • Lifestyle factors i.e. heavy lifting leading to weak pelvic floor muscles
  • Weak back passage muscles as a result of child birth, ageing, some surgeries and radiation therapy
  • Diabetes
  • Bowel diseases such as Coeliac disease or Crohn’s disease
  • Nerve disorders resulting from multiple sclerosis and Parkinson’s
  • Severe diarrhoea

Faecal incontinence can be treated and should not be ignored. The first step is a comprehensive continence assessment by a health professional.

Faecal smearing

Some children and adults engage in faecal smearing. This is the act of wiping faeces (poo) on themselves, clothing or other objects. Some possible reasons for faecal smearing are:

  • Boredom with daily activities
  • Seeking sensory stimulation with strong smells and messy textures
  • Seeking attention associated with soiling
  • Development of a persistent habit

Behavioural and sensory interventions can be effective in the management of faecal smearing. It is important to try to explore the reason for the smearing so that the most effective intervention is implemented.

Sexuality and incontinence

Bladder or bowel incontinence can have an enormous impact on sexuality, however this doesn’t mean that people with incontinence do not express their sexuality.

There are many ways that someone with bladder or bowel control issues can manage their symptoms and engage in sexual acts with their partner. More information about this can be found on the Continence Foundation of Australia’s website.

Therapy Focus’ specialist continence team, PEBBLES, can provide assessment, treatment and advice for all of these topics, as well as for other bladder and bowel health related issues.

Learn more about Therapy Focus’ specialist continence services.

Alternatively, contact the PEBBLES Team on 1300 865 401 or email pebbles@therapyfocus.org.au

Therapist looking and bowel chart with child

Pictured: a Therapy Focus PEBBLES Clinician showing a child a chart.

Busting continence myths

Karina SmithWritten by Therapy Focus PEBBLES Continence Nurse, Karina Smith

There are many misconceptions and myths surrounding incontinence. So to help people better understand some of the commonly misunderstood areas of incontinence, Continence Nurse Karina from Therapy Focus’ PEBBLES Team has shared the facts.

1. Laxative consumption is bad and can lead to dependence
Laxative use, even for long periods of time, is safe. If however you need to take laxatives regularly to open your bowels, you should seek medical advice to make sure there is no underlying cause for the constipation.

2. My child can’t be constipated, they are constantly pooing their pants
Faecal soiling can be a sign of constipation with overflow, and should be the first thing to be ruled out in managing faecal incontinence.

3. Urinary incontinence is inevitable with ageing and child birth
That’s far from the truth. Ageing and childbirth do increase the risk, but they aren’t always related. Urinary incontinence can be prevented, improved and/or resolved with the correct advice and assistance. It is important to seek help for urinary incontinence and not accept it as an inevitable fate. Fear of an accident and self-consciousness about odours, can inhibit the desire to leave the house, which can contribute to loneliness and depression.

4. Drinking less fluid will help to manage urinary incontinence
Wrong. In fact, urine that is more concentrated due to lack of fluid intake can irritate the bladder and cause more serious problems such as infection and dehydration. In addition, inadequate fluid intake can cause constipation, which may also make matters worse.

5. Having incontinence is a disease
Incontinence is not a disease; it is a symptom or side effect of another medical condition. That’s why it is so important to check with your doctor/ healthcare professional if you experience any type of bladder or bowel control problem.

6. Children wet the bed intentionally
Children don’t wet the bed intentionally. Like learning to walk or talk, a child’s bladder will develop at its own rate. So sometimes, no matter how hard your child might try, they might still urinate involuntarily. It’s a recognised medical condition known as nocturnal enuresis. Nocturnal enuresis is incontinence that occurs during periods of sleep at an age when a child could reasonably be expected to be dry (5 years+).

Therapy Focus offers specialist continence services for children and adults living with disability. Known as PEBBLES, the team of experienced clinicians provide assessment, advice and treatment for a range of bladder and bowel health issues, as well as toilet training.

Learn more about Therapy Focus’ specialist continence services

Alternatively, contact the PEBBLES Team on 1300 865 401 or email pebbles@therapyfocus.org.au

You can find more helpful information at:

www.bladderbowel.gov.au

www.continence.org.au

Client getting PEBBLES support
Pictured: A child having a bladder scan at the PEBBLES continence clinic

References:

https://www.webmd.com/digestive-disorders/features/chronic-constipation-facts-vs-mths#2

Philichi.,L.(2018).management of childhood constipation. Journal of Padiatric Health Care. 32.(1).pp.103-111

Tackling fussy or picky eating

Danielle CottamWritten by Therapy Focus Team Leader and Speech Pathologist, Danielle Cottam. 

Sometimes mealtimes can be the most stressful part of a parent’s day. Especially for a parent of a child with special needs. 

Fussy and picky eating can be typical in the preschool years when children are developing a sense of autonomy. They may be particularly choosy around fruits and vegetables or bitter foods. Most children go through a stage of rejecting foods and it is important to recognise that fussiness is a normal stage of development.

Many picky eaters outgrow their aversions and develop into curious eaters. However, if meal times seem a constant battle, or if you’re worried about the amount or variety of foods that your child is eating, there may be other underlying reasons for their selective eating.

Danielle teaching a client
Pictured: Danielle teaching a client and his mother new strategies

Signs to look out for include:

  • Feeling that you frequently have to bribe your child to eat
  • Refusal to eat and drink
  • Persistent anger, tears and tantrums at meal times
  • Difficulties with chewing certain foods, mouth stuffing or swallowing foods without chewing
  • Constipation
  • Meal times taking longer than 30 minutes
  • Significantly restricted range of foods
  • Frequent coughing or vomiting around meal times
  • Strong preference for packaged or highly processed foods
  • Strong preference for smooth pureed food options or liquids
  • Ongoing avoidance of fruit, vegetables and meat/alternatives

If you notice any of these signs in conjunction with fussy eating, consider having a health professional conduct an assessment to determine the root cause of the issues. Causes may be multifactorial and it is important to ensure you are working on the right things to make mealtimes safe and enjoyable for all. There may be more going on than the child just being fussy.

Danielle working out an eating plan with a client
Pictured: Danielle discussing an eating plan with a client

Helpful strategies to consider:

Talk about the food 
Focusing on what and how much the child is eating can alter the social aspect of a mealtime. Try to engage your child’s curiosity by talking about how the food looks, smells, feels and describing what you are doing with food E.g. I’m going to put some gravy on my carrots, I’m going to mash my potatoes with my fork. This can take the pressure off our children or teens and give them the room and confidence to experiment.

Create a mealtime schedule
Stick to 30 minutes maximum for mealtimes. It’s unlikely that a child will have the energy and desire to eat much more after this time period if they have already expressed dislike of the foods. Plan regular meals and snacks throughout the day 1.5-2 hours apart so that the child has the opportunity to eat more next time. Remember our appetite can change throughout the day for a variety of reasons.

Experiment with buffet style meals
Children need up to 15 exposures to new foods before we can expect them to take them. This means opportunities to see and talk about foods before we eat them. Offering some meals in a buffet style e.g. having the pasta, meat, sauce and cheese separate for a bolognese means that the child can serve themselves and take just the amount of new food that they feel comfortable with or at a minimum can get used to the smells and sight of having it near their plate.

Try an ‘all done bowl’
Give your child an extra bowl that they can use if they want to finish eating something or do not want it on their plate. This gives the child an opportunity to try a food without the pressure that they have to finish it. It also gives the opportunity for them to touch foods that they wouldn’t otherwise tolerate – even if it’s just to move it to the all done bowl.

Overall, we want to work towards a mealtime where the adult is in control of what is served, where and when and the child is in control of whether they eat or not and how much they eat.

Danielle Cottam

The strategies above are a way of reducing pressure and cajoling at mealtimes and it may take time for the child to develop a sense of comfort and confidence with them and to expand the range of foods that they will eat. Observe for changes in your child’s comfort with mealtimes and exposure to new foods as opposed to how much more they will eat.

If in doubt or if you are worried about your child’s growth and eating habits visit your GP or health professional and ask for a mealtime assessment. The best assessment considers a range of perspectives and may include observation from a range of health professionals to identify the underlying cause.

If you would like to access a comprehensive mealtime assessment from Therapy Focus please ask for more information from our MEAHLS team or by contacting the team.

Happiness and helping the community: A volunteer story

It’s National Volunteers Week from May 21-27! This year’s theme ‘Give a little. Change a lot.’ Represents the millions of volunteers in our community who make a profound impact in our communities through giving a little of their time.

Andrea Seator started as a passionate volunteer with Therapy Focus almost 3 years ago, volunteering her time at community events and opportunities including Christmas gift wrapping, the Telethon Beneficiaries Expo, Therapy Focus’ Lego Group and creating resources for the Bassendean team.

Now in her final year of Speech Pathology at Curtin University, Andrea’s hard work and enthusiasm paid off in 2017 when she was offered employment with Therapy Focus as a casual Therapy Assistant.

Andrea said that she enjoyed volunteering with Therapy Focus because she felt connected to other allied health professionals who were like-minded and shared her passion for good healthcare.

“As a student speech pathologist, volunteering for Therapy Focus is very rewarding in allowing me to experience how a disability service provider is making a difference in the community,” she said.

Being involved in many different volunteering roles, Andrea said the Lego Group had been a memorable experience.

I especially enjoy volunteering for the Lego Group as this has helped me to develop my self-confidence working with children with a range of different communication styles, whilst also educating me on the importance of a social-based, group language therapy.

Andrea Seator

Over 6 million Australians volunteer across the nation, generously donating their time and skills to make a difference in our community; often to a cause close to their heart or by simply doing something that they love.

To Andrea, volunteering with Therapy Focus was important because it was a way of acting upon the values that are at the centre of allied health work.

“Volunteering is also very rewarding in terms of providing me with a sense of happiness and from being able to help in the community,” she said.

Volunteers at community event
Pictured: Andrea and the team at a community event 

Coming full circle from beginning with Therapy Focus as a volunteer, to now being paid to do what she loves, Andrea has learned a lot about her time with the organisation.

“I have been able to further develop my experiences in working with children who have complex communication and language skills in the disability context,” she said.

“This has been very useful in furthering my clinical skills as a student speech pathologist.”

Andrea said she was grateful to be a part of a multidisciplinary team, which helped her to appreciate and understand the importance of a holistic, multidisciplinary service, such as Therapy Focus.

At Therapy Focus we are grateful to all of our amazing volunteers who support us in many different ways from our Board of Directors and Parent Reference Group, to our events, administrative tasks and therapy groups. On behalf of Therapy Focus, our staff and the families we work with, thank you for all of your support, Andrea!

Interested in volunteering? Sign up to our volunteer e-newsletter to find out about the latest opportunities or contact our Volunteer Coordinator on 1300 135 373 or email volunteer@therapyfocus.org.au.

Find out more about National Volunteer Week.

A Volunteers’ Toolkit: fun, purpose and confidence

It’s National Volunteer Week from May 21-27! This year’s theme ‘Give a little. Change a lot.’ Represents the millions of volunteers in our community who make a profound impact in our communities through giving a little of their time.

Santosha Robertson has been involved with Therapy Focus for almost 5 years and has been a regular face at many of our events and activities, including Christmas gift wrapping, Telethon Community Cinemas, dressing as our mascot Sunny the Sunflower, and supporting our PEBBLES Continence Team with resource creation and administrative assistance.

Santosha said she loved seeing the very best in people and her work at Therapy Focus has showcased exactly that.

“It’s great seeing and getting to know people that work for Therapy Focus, other people that volunteer with Therapy Focus and the community that want to donate and give to Therapy Focus,” she said.

Everyone believes in the same objective and enjoys working together to achieve the same goal. The feeling of belonging and working together as an overall group is the best part of volunteering with Therapy Focus.

Santosha Robertson

Over 6 million Australians volunteer across the nation, generously donating their time and skills to make a difference in our community, often to a cause close to their heart or by simply doing something that they love. 

To Santosha, volunteering is an important part of life as it builds relationships and empathy for others. Volunteering her time is a way of giving back and enhancing the lives of other people.

Volunteer story - Santosha

Pictured: Santosha, hard at work at Therapy Focus

“Volunteering is important to me because it makes me feel good, improves my confidence and skill set, creates fun and purpose and gives me a sense of accomplishment when I am helping others,” she said.

“I feel happy when I volunteer.”

At Therapy Focus we are grateful to all of our amazing volunteers who support us in many different ways from our Board of Directors and Parent Reference Group, to our events, administrative tasks and therapy groups. On behalf of Therapy Focus, our staff and the families we work with, thank you for all of your support, Santosha!

Interested in volunteering? Sign up to our volunteer e-newsletter to find out about the latest opportunities or contact our Volunteer Coordinator on 1300 135 373 or email volunteer@therapyfocus.org.au.

Find out more about National Volunteer Week

Mealtime tips for children with autism

Maddie ToddWritten by Therapy Focus Dietitian, Maddie Todd. 

Mealtimes can be challenging for parents of children with autism. The following are my top tips for those parents who have to pick their battles when it comes to mealtimes.

1. Offer at least one preferred food at every meal and snack time. The child must feel safe and confident that there is something that they can eat at the mealtime. Often when there is not a preferred food or a food that matches the child’s skill level or sensory preferences, the child will often refuse to eat at all.

2. Don’t give up on offering a range of foods at mealtimes! Once you find yourself catering to your child’s specific food preferences, you might find that you get to the point where you can’t offer any other foods without a meltdown. Sometimes new foods need to be offered in a very gradual way to assist a child to slowly build up their tolerance.

3. Offer exposure to a wide range of foods through grocery shopping.

4. See an Accredited Practising Dietitian (APD) to see if there are any nutritional gaps in the diet which may be impacting their range of foods eaten, food/mealtime behaviours and growth and development. Find out more about our dietetics services

5. Build structure into every mealtime. Building routines can help to support children with autism as they often prefer to know what is expected of them and what is coming next.

6. Seek some support as picky eating can be really tricky to manage. Get a thorough assessment of your child’s eating and drinking skills. Often picky eating is more than the usual ‘fussy eating’ phase that many children experience as part of their typical development. An assessment could include chewing and swallowing skills, self-feeding skills, seating and positioning and continence. All of these areas can have a big impact on a child’s diet and mealtimes.

If you would like more information about Therapy Focus’ dietetics services, or would like to see one of our Accredited Practising Dietitians, contact us today.

Learn more about what Therapy Focus dietitians do. 

Therapist helping a boy cut his toast
Pictured: Therapist helping a boy cut his toast

California Study Tour Success

Earlier this year, Therapy Focus clinicians Sulin Ng and Christine Bosch travelled to California as part of a two week study tour with Achieve Kids.

As part of the program Sulin and Christine visited disability service organisations and attended the “Autism through the Life Span” Conference held at Stanford University.

Below, Sulin shares her experience of the study program:

In March 2018, Christine and I were fortunate to be chosen to represent Therapy Focus as part of a study tour with Achieve Kids in California. As part of the study tour, we visited the main sites of Achieve Kids in Palo Alto, Sacramento and San Jose as well as their partner organisations in the Bay Area. 

Sulin and Christine outside of Achieve Kids, California

Pictured: Christine Bosch and Sulin Ng outside of the Achieve Kids office in Palo Alto.

Achieve Kids is a specialised school that accept students with significant behavioural challenges who have had difficulties attending previous schools. The students can have a diagnosis of Autism, ADD, ADHD, intellectual disabilities or have emotional difficulties, including experiencing trauma.

What really impressed us was the dedication and immense patience of staff members towards the students, while working on functional, social and academic skills. Staff encouraged problem solving skills and peer encouragement amongst students.

Pictured: Sulin and Christine with School Director Skye, serving hot chocolate to the students of Achieve Kids in San Jose.

We were also warmly welcomed by various partner organisations who showed us around their facilities where we met with the staff members, attended some therapy sessions, and exchanged information about our organisations. Like Achieve Kids, their staff were passionate and dedicated to their roles and the clients they work with. Christine and I were also impressed by the range of programs that are available, including camp programs, employment services, recreational and social programs.  

Due to the way therapy was funded in California, therapy services are fragmented. Families and service providers often have to fight for funding from government or insurance companies. Organisations also rely on fundraising so that they can provide the necessary services to their client population.

We realised how incredibly lucky we are to be living in Australia, where there is more funding for disability and therapy services. 

 

While we were in Palo Alto, we also attended the “Autism through the Life Span” Conference held at Stanford University, where we learnt about current research and programs in this area. I was particularly interested in the research presented by Dr Ami Klin on using a device for eye tracking and assessing social interactions to assist with early diagnosis of Autism in infants and toddlers, as it would enable children to access early childhood intervention earlier.

While there, we were invited to present to the Special Needs Professionals about Therapy Focus services on one of the evenings. We had positive feedback about our services, particularly around the flexibility of where services can occur, our transdisciplinary team approach such as access to physiotherapy services for people with Autism, and our specialist teams available at Therapy Focus like our PEBBLES, BeST and MEAHLS services.

The study tour was a great learning and networking opportunity, and we would like to express our thanks to Achieve Kids CEO Ryan Eisenberg for organising the itinerary and welcoming us to his wonderful organisation.

As well as the partner organisations who opened their doors to us while we were over there including Abilities United, Via Services, Via West camp, Gatepath, Laughing Giraffe Therapy, Rebekah’s Children Services, Children’s Health Council, Stanford Child and Adolescent Psychiatry and Greater Opportunities.

Pictured: Christine and Sulin with Matt Dolan, General Manager of Hilton Suites and Soheila Razban, Vice President of Abilities United. 

The story of my wheelchair

Written by Harrison Pierce and his family with support from Advanced Occupational Therapist, Kelsie Davis.

Hi I’m Harrison. I am 13 years old and I’ve just got a new wheelchair. It’s super comfy, helps me sit up straight and is a smooth ride. I love my new wheels.

It took a long time for the first assessment. We needed to get funding, wait for the seat to be made and for the chair to come all the way from Germany before we could bring it home. I had to be very patient. I got lots of pokes and prodding from my therapy team but it is all worth it now.

First of all they had to do an assessment of me to determine what I needed. My therapists chatted to my Mum and Dad, reviewed an x-ray with Princess Margaret Hospital and did a physical assessment of me – this is called the DSC Seating Assessment; it took a long time.

My family and therapy team know me very well, so they knew that in my new chair I needed to sit up a bit straighter. I tend to lean towards my right as I have scoliosis, and I am working very hard to make sure it doesn’t get any worse. One way I do this is through my bed set-up. It helps me stay nice and straight at night, and it’s my favourite colour – red!

Harrison's back with severely curved spine  An x-ray of Harrison's back   Harrison lying in his specialised bed

Pictured: Harrison’s back, an x-ray showing his scoliosis, and his specialised bedding. 

Because of how I sit, I needed a seat made especially for me. The seat is called an insert. The technology used to make this is pretty cool. I started by sitting in something similar to a beanbag. Then my therapists get me sitting in the best position and turn on a machine which sucks the air out from the bean bag. This leaves a mould of where I sit. It took a few attempts, but we got it just right. 

Special sticky dots then get stuck onto the mould so that it can be scanned into a computer program. My Dad really enjoyed seeing the technology that was used to make my insert. It’s pretty fascinating when it gets scanned into the 3D image and my mould then appears on the screen. From here, a big magic machine and a very handy man cut it out of the foam to make my insert.

Harrison having his wheelchair insert moulded   The wheelchair insert being mapped   The wheelchair insert being mapped

Pictured: Harrison having the insert moulded to his body, mould mapping and 3D image. 

After some more fiddling around, and lots of chats between my Mum and the therapists, the wheelchair was ready for me to take home to trial. It felt a bit strange at first and took a while to get used to, but it is perfect!

There was one very important step left though. My Mum took the chair back to the workshop where the upholsterer made a nice cover for my insert.

Harrison smiling in his new wheelchair

Pictured: Harrison in his new wheelchair.

Learn more about how Therapy Focus can support people with disabilities to access equipment and assistive technology. 

Top tips for early intervention

Written by Therapy Focus Advanced Physiotherapist, Lucy Simmer.

For a child with developmental delay or disability, early intervention is fundamental to growing potential for school and later years.

In the early years of life, the brain is at its greatest capacity to make new connections and change. This is why children pick up new things so quickly! For children with delays, this is the optimal time to develop their skills.

Early childhood intervention is not only for the child but the whole family. The focus of intervention is working with the family to give them the support and skills needed to maximise the child’s independence. The therapist will work with the family to set meaningful goals that will improve the child’s well-being and participation in everyday life.

Here are my top five tips I share with families who have young children with delays:

Keep it natural

Children learn best in context; they are most likely to improve their skills if they’re practised within their normal routine. Therapy will support families to embed strategies into these daily routines to work on the child’s goals. This approach gives the child lots of opportunities to practice during the day, without them even realising they’re doing therapy!

Practice makes perfect

The family can positively impact the child’s development by giving them lots of opportunities during the day to practice new skills. Refining skills takes time – just think, before walking, kids fall down hundreds of times before they master it.

Enjoy the fresh air

Being active outdoors in nature has huge benefits for a developing child. You don’t need to spend money on fancy toys when there are sticks, flowers, rocks and mud outside your door! Physical activity is extremely important for young children to learn and grow. Did you know kids under 5 should be active for at least 3 hours each day?

Play, play, play

Much of a child’s early years should be focused on play (if only this were true for adulthood too!). Children instinctively learn through play; they experiment, solve problems and cooperate with others. In doing so, they develop social, language, self-regulation and motor skills. This is important for attention, emotional well-being and school readiness. 

Have fun!

A child is motivated to learn when the activity is enjoyable. You can make a simple routine like tying shoelaces fun by using colourful laces and celebrating with a ‘high-five’ when the child tries it themselves. Praising their efforts provides positive reinforcement.

Find out about Therapy Focus’ early intervention services.

Lunchbox snacks: Fibre Energy Balls

Getting healthy and delicious snacks into your child’s lunchbox can be a challenge. 

Therapy Focus Dietitian Maddie Todd has a great alternative to sugary snacks with her Fibre Energy Balls. 

Check out the recipe – 

*Please note this may not be appropriate for children who have texture modified dietary requirements.*

Fibre energy balls

Ingredients

  • 70 g pumpkin seeds
  • 20 g puffed brown rice or puffed quinoa
  • 50 g whole almonds
  • 80 g dates
  • 1 cm piece of fresh turmeric or ½ teaspoon ground turmeric
  • ½ teaspoon ground cinnamon
  • 1 heaped teaspoon quality cocoa powder
  • 1 teaspoon vanilla extract
  • ½ tablespoon honey
  • 1 orange

Method

  1. Blitz 40g of the pumpkin seeds into a fine dust in a food processor, then decant onto a plate.
  2. Place the remaining pumpkin seeds and the puffed rice or quinoa in the processor with the almonds and dates (destone first), then blitz until finely chopped.
  3. Peel and finely grate in the turmeric, if using fresh, or add the ground turmeric, along with the cinnamon, cocoa powder and a pinch of sea salt.
  4. Blitz again until finely ground, then add the vanilla, honey and half the orange juice.
  5. Blitz for another 1 to 2 minutes, stopping to scrape down the sides a couple of times, and adding an extra squeeze of orange juice to bind, only if needed – it takes a while for the mixture to come together, so be patient and let the processor work its magic.
  6. With wet hands, divide into 24 and roll into balls, dropping them into the pumpkin seed dust as you go.
  7. Shake to coat, storing them in the excess dust until needed. They’ll keep happily for up to 2 weeks in an airtight container.

Goody Two Shoes – choosing the best school shoes

Blog author  Written by Therapy Focus Advanced Clinician, Physiotherapy, Dan Prigmore 

With children wearing their school shoes around 35 hours a week or around 1500 hours a year, choosing the right pair can sometimes seem overwhelming.

To help you out, we’ve got five tips to help with choosing the right pair, one step at a time.

  1. The right pair of shoes needs the right pair of socks

Before even looking at different pairs of shoes, ensure you are prepared for the visit by taking socks that your child is comfortable wearing. Using the socks available at the shoe store is not recommended for both hygiene and comfort reasons. If your child frequently attempts to pull off their socks, consider trying seamless socks (check online for places to purchase), as the sensation of the seam pressing against their foot inside the shoe may be uncomfortable.

  1. Try on shoes at the right time – the end of the day

Standing or sitting for long periods can result in more swollen feet at the end of the day. Therefore, it is best to try shoes on in the afternoon or evening to ensure you allow for this when determining the right fit.

  1. Be sure to choose shoes that are the right fit

Selecting shoes that your child can grow into can often mean purchasing shoes that are too big for them right now. Over-large shoes can result in discomfort and/or injury, creating a negative experience for your child when wearing their school shoes.

As a guide, your child’s foot is likely to grow around half a size every six months once they reach school age (excluding any large growth spurts). By following the below guidelines to a firm fitting shoe, your child’s shoes should be the right fit throughout the school year.

  • If your child wears foot orthotics or AFO’s, ensure you bring them along when trying on new shoes
  • One thumb width only should fit between the end of the shoe and the end of the longest toe when you check for length
  • The widest part of the shoe and the widest part of the foot should be at the same point
  • If the shoe seems too tight around their forefoot, try requesting a wider size before asking for a longer shoe
  • The laces/Velcro/buckles should be tight enough to secure the heel at the back of the shoe and prevent sliding forwards
  • Your child (if they are usually able to) should be able to wriggle their toes with the shoe on
  1. Shoes should provide enough support whilst also being lightweight

Support does not mean bulky, and lightweight does not mean flimsy. Avoid slip-on shoes as they do not have a fastening function to facilitate keeping your child’s heel in the back of the shoe, and where possible avoid hand-me-down/second hand shoes as over time shoes mould slightly to the shape of the wearer’s foot. To ensure that your child has enough support, follow the guidelines below:

  • The sole should not be able to twist or fold in half easily
  • The heel counter should not be too stiff or too tight, and hence should not cause rubbing on your child’s heel
  1. How to make the final choice

Once you have narrowed down the long list following the above recommendations, consider these final tips before making your final choice.

  • Rubber soles and double stitching around the toes are likely to ensure that your child’s new shoes pass the test of their adventurous lifestyles, until they grow out of them
  • Check the school uniform guidelines regarding whether your child’s school shoes have to be a particular colour
  • If possible, select a shoe with a wide tongue to assist with opening the shoe to promote your child being able to put their foot in independently
  • If you are still left with multiple options, allowing your child to make the final decision between those options will ensure that they choose the shoe that they like best

Finally, having your child wear their shoes for a day or two the week before they go back to school will hopefully ensure that they are comfortable and ready to kick the new year off on the right foot.

What does the Parent Reference Group do?

blog author Written by Parent Reference Group member, Elaine Bradley 

My name is Elaine Bradley and I have a 12 year-old son with autism. 

My journey of having a family member with a disability has been both challenging and rewarding.  Every day is different.  I am sure most of you have parents and/or family members to give you a helping hand during the good and difficult times.  Unfortunately, for those like myself who do not have parent’s or extended family members it can be hard to find support. 

However, I can assure you it is out there.

I would like to share with you how I am supported through my challenges and celebrations.  For me, my support is made up from three elements; my husband, our school and Therapy Focus. 

Hopefully we all have someone close to us who allows us to vent, gives us a hug when we need it, and is the truthful voice of reason when we have doubt.  They are also there for the “Yes” moments and “high five” our rewards and celebrations.  This may be your mum, dad, brother, sister, best friend, neighbour or therapist.  Mine is my husband.

I have been very fortunate that my school have been a major support.  They have met our educational needs with their outstanding knowledge and experience of working with families with children with special needs.  They helped us through the diagnosis process and reassured us all the way. This was a great comfort in what was a very lonely and highly stressful time.   The school community have also been a huge support.  I completely appreciate that not everyone has this experience.

Therapy Focus are my final link.  I receive a few services from them and our therapists have been my other voice of reason and the catchers when I fall.  They have been instrumental in my son being where he is today with respect to his independence, maturity and being the best version of himself that he can be.   Our therapists are part of the family and they embrace the challenges and celebrate the rewards with us.

The relationship I have with Therapy Focus has driven me to be more of an advocate for my son and I now have the strength and knowledge to support others. How do I do this?  I am a member of the Therapy Focus Parent Reference Group (PRG).  The group consists of family members of people who receive services, along with CEO Matt Burrows and Governance Manager Penelope Wakefield. 

I have made friends with a group of amazing and strong individuals who have their own unique journey, who listen, who are not judgemental and who are of like minds. They get what I am going through on a day-to-day basis and it is reciprocated.  We meet every other month and this gives me the opportunity to speak up and give my thoughts about services and initiatives that the organisation is currently investing in and proposing for the future. 

You may remember seeing some of the members handing out balloons at Sunflower Sunday. We are also involved in the Connecting over Coffee support group at the Goollelal office. You may recall seeing requests for nominations for the Peoples Choice Award, which was initiated by the group. 

I have been a member of this group for the past year and I can honestly say that my voice is heard. I am empowered to be an advocate for my son and I do not feel alone.  My son has all the support he needs. I too have the support I need from this great group and I am helping make a difference not just on a personal level but also for others. 

Do you want to be a voice for your family member?  Do you want to have an input into the services that you need and for the organisation to understand how you deal with everyday life and share the information?  If the answer is YES, we need you to join us. 

Come along to one of our meetings and see for yourself. No matter your background, language, gender, ethnicity or even if you are doing it tough, you can stand up and not only help your family member but be supported yourself. 

I know that, some of you are saying “I don’t have time”.  That’s okay.  If you have any feedback or comments, the PRG wants to hear from you.  You can email us at  PRG@therapyfocus.org.au.

Together we can all make a difference.

Read more about the PRG.   

 

What is anxiety?

Anxiety blog author Written by Margaret Ho, Behaviour Support Clinician 

Anxiety is a normal part of life which everyone experiences at some point.

However, when people consistently experience anxiety in large amounts, it can become a problem.  

For example, anxiety can stop both children and adults from doing things that are important to them as going to school or seeing friends.

Anxiety has three main characteristics

  1. Feelings of dread or fear;
  2. Bodily reactions  like sweating, feeling sick, shaking or increased heart rate; and
  3. Behaviours of withdrawal or avoidance

What does it look like?

Anxiety looks different on everyone.

It will largely depend on what the fear or worry causing the anxiety is about.  

For example, if a child is worried about being away from mum or dad, they may try and avoid times of separation – they might take a long time to get ready for school or refuse to attend. Many kids will also say they’re not feeling well so they have a reason not to attend.

Both children and adults can have a fear of what other people might think of them, dislike speaking in big groups or feel worried about eating in front of lots of people. Where this is the case, people will often choose to spend of their time alone.

Other times, people might be worried about making mistakes or not knowing about what is happening so they might ask lots of questions, do lots of checking or need people to assure them that everything is okay.

Some people are afraid of very specific things like dogs or spiders and will cry or scream and run away when they see them.

What can I do to help my child if I think they have anxiety?

While anxiety is most commonly spoken about in relation to teenagers and adults, it can often develop in children, especially in children living with disability.

If you think your child may have anxiety, it is important to acknowledge that there is something really bothering them and let them know that you will get them some help.

If you decide to see a psychologist, they will provide a structured way to help the child confront their fears via something called systematic desensitisation. This is a method of breaking the scary thing into small manageable steps and providing the child with calming strategies so that they don’t get overwhelmed by their fear.

The worst thing about anxiety is that when you avoid or “run away” from what you’re scared of, the relief you feel is very powerful. This means you end up wanting to avoid the scary thing all the time. Over time, this makes it harder to get over your fear.

Learn more about how Therapy Focus can help with behaviour support. 

A day in the life of an Occupational Therapist

Written by Advanced Clinician, Occupational Therapy, Emily Greenwood

Our occupational therapists work with people living with disability to support them to participate in everyday life.

To celebrate World Occupational Therapy Week and give us a glimpse into all the varied and exciting work our OT’s do, we’re sharing “a day in the life of an OT” from one of our advanced clinicians, Emily Greenwood.

8.00am: Once I arrive at the office I start getting prepared for my day and making sure I have everything I need for client visits. As I’m based at Durham Road School I’ll spend some time confirming my appointments with the classroom teachers and looking over individual treatment plans and therapy goals.

I also use this time to catch up on some admin, answer emails and check in with my colleagues and team leader.

9.00am: At 9am I have my first client for the day. Today it’s a home visit for a 2-year-old with fine motor delays and low muscle tone. We use play therapy to work on his postural strength and control, as well as his hand strength.

Using motivating play positions such as standing at a table and pushing through his hands to play with play-dough is such a great way to develop the arches in the palms of the hand and shoulder strength. This is so important for further fine motor skill- development later in life, such as doing up buttons and holding a pencil. It’s a win-win as my client is having so much fun, but I’m also getting him to engage in an age appropriate therapy activity which will help him to achieve his developmental mile-stones.

We always take the time at the beginning or end of an appointment to talk to the parents about what we’ve been covering, and how things have been tracking at home. By working with parents to let them know the strategies we’ve been using, children are able to receive support throughout the week, not just during their therapy sessions.

10.30am: Once I’m back in the office, I write up my notes from the session I‘ve just had and start planning for the next one. I see this client every week, so between appointments I look over the progress he’s making, evaluate how he’s progressing towards his goals and brainstorm what we can try next week.

11.30am: My second client today is a 19 year-old girl transitioning into employment. We work together on updating her resume with her recent volunteer work, practising her interview skills and using the Transperth journey planner. We also spend some time consolidating the skills she’ll need in her new office like organising her workload and using certain computer programs.

12.30-1.00pm: Lunch time! Back in the office I have lunch with the rest of my team. We’ve been celebrating Occupational Therapy Week and today we had a team lunch.

1:00pm- 2:00pm: As I’m based at Durham Road School (an independent public school catering to children with a disability) I have a lot of clients with physical disabilities such as Cerebral Palsy.

This client is 15 years-old and has all 4 of his limbs affected, so he mobilises in a wheelchair. Wheelchairs can be grown as people grow, but normally after 4-5 years it’s time to get a new one.

Luckily I’ve spent my free time over the last few months meeting with the family, completing the assessments and trials for different wheelchairs and comparing the quotes from the different suppliers. I use this time after lunch to sit at my desk, write the necessary reports and submit the wheelchair application to the NDIS to obtain funding for my client.

2.00pm-3pm: I’m off to do a school visit for an eight year-old girl with autism. A key part of our role with school aged kids is to provide strategies that promote inclusion in both academic and extra-curricular activities within schools. Today we’re focussing on increasing her attention span in the class room. I use some visual supports and some fun movement breaks to assist my client to stay on task.

3.30-4pm: Once I’m back in the office I finish up my admin for the day, filling out client cases, responding to emails and preparing as much as I can for tomorrow.

Occupational therapy is an exciting and varied role. I love that I get to work with a wide variety of people every day and assist them in enhancing their ability to live the life they want to live.

For more information about how Therapy Focus Occupational Therapists can help, click here.

therapist and boy using sign language

FAQs: Transitions

 Written by Advanced Occupational Therapist, Alix Combe.

Changes can be daunting, especially at key life transition points like starting kindy, primary school, high school and higher education or work.

Our team of therapists and support staff help children, adults, their families and carers to manage new environments every day. While each person is different and will use unique strategies, we’ve put together some of the more frequently asked questions to get you started on the right path to a smooth transition. 

Starting kindy

Can parents stay at kindy to help initiate routines?

While increasing your child’s independence and adaptability are key parts of starting kindy, many kindies will invite or allow parents to stay for varying periods of time during the first couple of weeks. Having a chat to the teacher before your child’s first day is a good way to make sure you’re all on the same page and know what to expect. It is also a great opportunity to have a discussion regarding any concerns you may have for your child, and what strategies you currently use to support them in their daily activities.

Having this information in advance will also help you prepare your child in the lead-up to the first day. You’ll be able to tell them how long you’re staying for, so they don’t get a surprise when you leave.

Remember to be calm and reassuring when you are with your child at kindy and saying goodbye (even though this might be really emotional for you). Children will easily pick up on feelings of anxiety or worry.

What’s the best way to prepare for the transition to kindy?

There are lots of different ways to prepare your child for kindy.

It’s very important in the lead up to starting kindy that you encourage your child to feel excited about the upcoming change in their routine. Talk about the fun activities they will get to do at kindy, the children they will get to play with and the play equipment they don’t get to play on at home. You could even show them a picture of their kindy teacher and go for a walk to school to show them what their kindy looks like. If you are worried or scared, your child will likely pick up on these feelings and copy them.

Working on a morning routine in the weeks before hand can help your child to feel safe and in control within their new environment. Once you’ve established what needs to be done in the morning (getting up, getting dressed, eating breakfast, cleaning teeth) try and do these in the same order every morning.

Toileting is often a stressor for parents and their children before going to kindy. As much as possible, start early in teaching your child to pull up and down their pants/underwear without you, wipe their bottom and wash their hands. If your child is reliant on you to do these things they might be anxious if they then need to rely on a kindy teacher or education assistant to help, rather than their parent.

Children with trouble processing verbally delivered information or trouble with focusing will often benefit from a visual schedule. This is like a step-by-step flow chart using images to show tasks, and the order they need to be completed in.

Your child may also benefit from kindy-readiness playgroups. These focus on teaching children to sit and attend to a teacher, follow instructions, play with other peers and  engage in different fine motor activities i.e. cutting & gluing, painting, writing and doing puzzles.

Social stories are often excellent tools to help prepare your child for kindy and can include specific information about your child’s own kindy such as what to expect on their first day, who their teacher will be, what their kindy room will look like and who they can talk to if they need help. Your speech pathologist or occupational therapist will be able to help you create these social stories and discuss further strategies to help best prepare you and your child for the kindy transition.

 
Therapist at table with little girl

Starting primary school

Public or private school?

Both public and private schools have support services for children with disabilities. In a public school you, the school staff and your child will create an individual education plan. This is a plan written specifically for your child, taking into account their individual educational and personal needs. Your family may also be eligible for additional government funding to support your child’s education.

Children with a disability in independent schools are also eligible for government funding, however it is at a lower level than their counterparts at government schools.

Independent schools all operate slightly differently, and so provide a variety of pathways and strategies. If you’re considering a private or independent school, be sure to set up a meeting with the school to talk to them about what sort of supports they offer. If possible, also request a tour around the school to determine any possible access issues for your child such as classrooms up stairs if they have mobility issues. This will also allow you to get a general feel about the atmosphere of the school, and how it fits with your family. Some good questions to ask are:

  • How many children are in each class?
  • Will my child have access to an Education Assistant and how many support hours will they get?
  • What does the support from an Education Assistant look like?
  • Will my child be able to access specialist equipment if they need it? i.e. specialist seating, a wheelchair, assistive technology like a laptop with reading/writing software on it?
  • Do you have inclusion policies in your school?
  • If my child needs a specific education plan, what is the process for this?
  • Does the school have written policies in relation to students with disability?
  • How many students with a disability (or receiving additional funding) does the school currently have?

What are education support centres and education support schools?

Some children with a disability will be eligible to attend an education support centre or school.

Education support centres are located alongside primary and secondary schools. They deliver individualised programs with specialist staff in addition to supporting the child to participate in programs with mainstream peers. The frequency of mainstream integration is different in each education support centre, and is a really important question to ask a school.   

Education support schools are separate primary and high schools with on-site access to specialist staff and facilities. Some schools also have onsite therapists.

Both have a strong focus on linking in with employers, training organisations and the Disability Services Commission to make future transitions (such as going to high school and onward from there) easier. 

Therapist and boy using podd book

Starting high school

How do I support the transition to high school?

There are many things you can do at home to get ready for the transition to high school.  

Start preparing for the transition to high school in year 6. This could include meeting with the school to ensure they are aware of your child’s needs and organising transition visits so your child can go and spend a few days at the high school with other peers from their class or a familiar support person. Your therapists will be able to attend these introductory meetings with you, if you would like their support. Transition visits will give your child the chance to work out the layout of the school i.e. where their lockers will be, where the canteen and lunch area is, the library and gym and where their main classrooms will be etc.

Talking about the new school and routine in advance, visiting the school and working out practicalities such as how to get to and from school can all be done before your child gets to high school. You can also create a high school booklet that includes pictures of the school, their teachers, education assistants and friends that might also be going to school with them. Include information such as how they are getting to and from school and what subjects they will be doing. Doing a lot of preparation in advance will help reduce your child’s anxiety or fears around the ‘unknown’.

Be prepared for ups and downs, especially in the first term. By continuing to communicate with the school staff and your therapy team, you’ll be able to work together to support your child through this transition.  

Will my child get special conditions for tests and exams?

Students with a disability that could disadvantage them in timed assessments may be granted special conditions during exams. This could involve extra reading and working times, rest periods, special instructions, use of a computer or scribe and many more. Assessments to determine the type of special conditions your child needs can be completed by school staff and your therapy team.

The school may then need to submit this to the Education Department in advance for approval prior to big exams i.e. WACE exams. Your therapy team and school staff can work together to set up the best learning environment for your child.

Leaving high school

What are my child’s options after high school?

Whether the next step for your child involves building on life skills, engaging in leisure activities, gaining employment or continuing their studies, there are many options and ways to go about this.

High school graduates may be able to go to university, TAFE or study online. This will give them the opportunity to earn a certificate, diploma or degree of higher learning. If your young adult would like to test the waters of higher learning, a short course or holiday course may be a good option for them.

Alternatively, if they’re seeking employment there are many options including supported employment, customised employment, starting a micro-business or working in a full time, part time or casual capacity in a local business (open employment).

Start planning for your young adult’s transition to the workforce in Year 10 so you can discuss work experience options with your high school and link into Disability Support Services in Year 12. Your therapy team can help you with information regarding this.  

Ticket to Work is a great resource for school leavers looking for employment. The program helps people with a disability as they prepare for the world of work and provides them with an open employment pathway in their transition from school.

To find out how Therapy Focus can provide support for key transitions, visit the transitions page.

How your child’s vision affects their movement

Written by Therapy Focus Physiotherapist, Jenine Davis.

It is very difficult to get along in a world where you can’t tell where you are, where other people are, where objects are, or even where your body ends and the outside world begins. This is the reality for many children with disability.

Vision involves the brain and the eyes, and so when the two aren’t able to communicate, vision is impaired. Because 80 percent of the information we receive from our environment is visual, understanding what we see is very important.

Poor vision can also result in problems such as difficulty with movement and balance or even social skills.

Vision professionals trained under the medical model mainly look at the structural problems that occur in the eye. A vision problem within the eye will impact a child’s ability to identify objects. This is called focal vision and can be impaired by cataracts and other “hardware” problems. These problems are usually treated with glasses or with surgery.

Behavioural optometrists look at focal vision as well as how we understand what we see. This includes peripheral vision, which takes in the entire visual field. This is a lower-resolution system that operates largely on a non-conscious level, and it works correctly only if the “software” of the nervous system is working properly.

If the peripheral vision system is not working properly, simple activities that you take for granted like climbing stairs, watching TV, or talking with another person can become very difficult and stressful. Objects will appear closer or farther away than they really are, causing you to be clumsy or disoriented. Other people’s body language may be hard to read, making social situations frightening. Catching a football or walking through a crowded hallway can be scary.

In response, seemingly strange behaviours may develop in order to cope. These behaviours are logical responses to sensory input that they don’t understand. Many people with autism walk on their toes, “stim” with their hands, or touch walls as they move through a room. All of these behaviours may stem from their inability to handle both themselves and space at the same time.

Because peripheral visual problems affect the “software” of the visual system, we can’t address them effectively with surgery or standard glasses. However, they can respond well to intervention in the form of vision therapy.  Vision therapy can therefore be a valuable form of therapy when treating problems with a child’s movement or behaviour patterns.

If you are concerned about your child’s sensory processing or movement skills, talk to your child’s occupational therapist or physiotherapist.

For further information on behavioural optometry and vision therapy, take a look at the Australasian College of Behavioural Optometrists, information for patients.

therapists helping child stretch

Pictured: Yoga and stretching class at Therapy Focus’ Goollelal School office

Reference:

Kaplan, Melvin, 1929. Seeing through new eyes : changing the lives of children with autism, Asperger syndrome and other developmental disabilities through vision therapy / Melvin Kaplan; foreword by Stephen Edelson.—1st American pbk. ed.

Why do kids walk on their toes?

Blog author Laura MartinWritten by Therapy Focus Physiotherapist, Laura Martin

 

Toe walking is something many children do while learning to walk. For some kids it’s a completely normal part of development and is quickly out grown, while for others it can be a sign of a bigger problem that requires the support of a multidisciplinary therapy team.

As physiotherapists, toe walking is something we are asked about all the time. While the causes and treatments will be different for everyone, knowing the basics about toe walking can help you understand whether it is a normal part of development, and when you need to speak to a therapist.

 What is toe walking?

Toe walking is exactly what it sounds like, walking up on your toes rather than having your heel make first contact with the ground in each step.

Up until the age of 2-3, toe walking is a normal part of learning to walk. If toe walking persists after this age, then it can be classified as idiopathic toe walking, or it could be related to disability. 

What causes it?

There are three main areas of the body that may cause a child or adult to toe walk. These are the musculoskeletal system (muscles), sensory system (sensory processing difficulties) or neurological system (muscle tone, reflexes or proprioception).

For children with cerebral palsy or muscular dystrophy, toe walking can be in response to tight muscles and tendons around the calf and heel. This feeling of tightness makes it very uncomfortable to place the sole of the foot on the ground. 

Some children with autism will continue to toe walk long after the usual 2-3 year-old point. This can either be a learned habit, or it may relate to sensory processing or motor coordination difficulties. For some children with autism, walking on the whole foot causes over-stimulation and toe walking is an easy way to avoid this.

Should you seek help?

If your child is over the age of 2 and toe walking regularly, it is worth flagging this with your paediatrician or a therapist. 

How is it treated?

Toe walking involves a multidisciplinary approach using input from occupational therapists, physiotherapists and speech pathologists to determine why the toe walking is occurring. This will ensure the most effective therapeutic intervention is chosen.

Treatment can include strengthening exercises, stretching, walking retraining, serial casting, botox injections and orthotic management. There’s no one size fits all treatment. Your therapist will look at your child’s individual case and make recommendations based on their findings. 

Concerned about your child’s development? Contact us today for more information about the services Therapy Focus can provide to improve movement and mobility for children with disabilities and developmental delays.

If you are already accessing Therapy Focus services, speak with your therapy team.

therapist applying casts to boy

 

Pictured: Physiotherapist Laura Martin applying casts to Michael’s legs to help develop his walking

Communicating your goals

Written by Advanced Speech Pathologist, Julie Tan 

 

Goal setting is something we should all practice. Goals give us focus and direction to achieve what’s most important to us.

As Western Australia transitions to the National Disability Insurance Scheme (NDIS), effective goal setting and being able to communicate goals is becoming increasingly important. The planning stage is centred on each NDIS participant’s statement of goals and aspirations, which provides the foundation for their selection of supports.

At Therapy Focus we often use a tool known as the Strengths for Life Profile to help people with disabilities and their families set meaningful, functional, participation-based goals. The profile focuses on what you’re already good at and interested in, and finds ways to develop these strengths and interests into more complex abilities.

By empowering you to focus on your strengths when planning new goals, the Strengths for Life profile supports a positive, upbeat journey to gaining new skills. For example, if a child identifies playing as a strength, this could be used as a building block to achieving goals like talking with others and making friends.

Our therapists developed the Strengths for Life Profile in collaboration with a local artist to create a visually accessible tool that captures a person’s experience across varied contexts. For example; home, school and community.

Once you, your family and your therapist have used the Strengths for Life Profile to identify the broader goal you’re striving for, your therapist can help you make sure your goal is SMART – specific, measurable, attainable, relevant and time-based. When your goals meet these criteria, not only will you be able to better understand what you’re working towards, but you’ll also be able to explain and communicate your goals to those around you.

Setting and achieving goals is an exciting part of life. It’s a continuous process that we’re able to regularly build upon as we grow and progress. By taking time to set the SMART goals and ensuring you’re communicating them effectively, you’ll be setting yourself up for success.

If you’re a current Therapy Focus client, talk to your therapy team about using Strengths for Life. If you’re interested in starting services with Therapy Focus, contact us for more information.

man and woman talking with therapist

The home modification collaboration

Written by Equipment Funding Team Admin Officer, Simona Gilmore

From completing everyday tasks to seeing family and friends or just relaxing; the safety and accessibility of your home can have a big impact on your daily life. For many people living with disability, home modifications can increase independence and accessibility, and help them make the most of their home.

If you’ve been thinking about a home modification, Therapy Focus’ Equipment Funding Team can help. We are a 10 person team consisting of occupational therapists, physiotherapists, speech pathologists, a home modifications project manager and administration staff. Our team can assess the accessibility of your home and provide support for modifications under the National Disability Insurance Scheme (NDIS), WA NDIS and Community Aids and Equipment Program (CAEP).

The first step in the process of a home modification is working with you, your family and carers to identify any barriers or hazards that are currently present in your home. We then discuss your goals for your living space, and what sort of home modifications could help you achieve these.

Modifications might include:

  • Modifying bathrooms to make them more accessible, usable and safe (e.g. slip resistant flooring)
  • Installing ramps to make accessing your home easier
  • Installing rails to provide you with more stability in the home
  • Widening doorways to provide easier access to the house and rooms inside the house
  • Installation of sliding doors to provide easier access
  • Modifying taps to make them easier to turn on and off
  • Adjusting lighting in the kitchen for better visibility
  • Adjusting kitchen benches/cupboards to be more functional
  • Levelling floors within the home 

Our Project Manager, Jenny Greensmith, has previously worked as an architect and brings a wealth of knowledge from the disability sector having worked as a Family Connect Worker at Therapy Focus for many years. Jenny can work with you and any builders or tradespeople to ensure your home modifications are exactly what you need.

For more information about how Therapy Focus can help with home modifications, click here.

PEBBLES celebrate World Continence Week

Written by PEBBLES Clinical Program Manager, Deborah Gordon.

This year’s World Continence Week theme, ‘incontinence- it’s no laughing matter’ is one that will resonate with many of us. Bladder and bowel health problems, including leakage (incontinence), are more common when a child or adult has a disability, and can be tricky to navigate.

The good news is, the PEBBLES Team are here to help. With a bit of detective work, we can find out what is causing the problem and we can work with you to overcome or lessen the challenges.

Constipation is a very common bowel problem in both children and adults. Constipation means that the poo is hard, dry and often lumpy. It can hurt to do a poo when it is dry so children may “hold on” and refuse to go to the toilet. This  makes the problem worse, as the poo dries out more the longer it says in the lower bowel (colon and rectum). This can result in the rectum becoming overstretched, resulting in a loss of the sensation of fullness and “the need to go” and poo can leak out.

Common causes of constipation include not drinking enough fluid, not being physically active and not eating enough fruit and vegetables.

For some, laxatives are essential to help soften the poo and assist in helping it to pass through the bowel. Laxatives are not habit forming and are an important part of improving bowel health when used under the direction of a health care professional.

My top tips for a healthy bowel are:

  • Go to the toilet when you feel the sensation of needing to do a poo
  • Eat two servings of fruit and five servings of vegetables every day
  • Be as physically active as possible
  • When sitting on the toilet make sure the feet are supported – preferably on a stool, so that the knees are up higher than the hips. Lean slightly forwards so that the elbows rest on the thighs

Having a full bowel can also stop the bladder from working properly and aggravate problems like bladder leakage and bed wetting. Our PEBBLES Team will try to resolve bowel issues first because we know that this will help the bladder too.

To keep your bladder healthy there are some easy steps you can take. Drinking plenty of water, taking the time to empty your bladder properly without straining, and going when you need to go (not “just in case”) is a good place to start.

Whilst incontinence is not a laughing matter, achieving better bladder and bowel health is definitely something to smile about.

The PEBBLES continence management service is managed by Therapy Focus in partnership with Bladder and Bowel Health Australia. The PEBBLES Team can support children and adults with disabilities who experience a range of toileting, bladder, and bowel health issues. Visit our Incontinence and Toilet Training page for more information and to download an application for services. 

Continence nurse talks with a child

The Power of a Key Worker

Blog thumbnail - Tania Muscat
Written by Therapy Focus Speech Pathologist, Tania Muscat.

 

 
At Therapy Focus we use what’s called a ‘Key Worker model’ when delivering therapy services. The model ensures that the people we work with have one main contact at Therapy Focus, but access to a team of clinicians with diverse skill sets and knowledge to achieve the best outcomes.

A Key Worker is one therapist within a team, and is responsible for coordinating a client’s therapy services. The Key Worker establishes a relationship with the client, their family and/or carer(s), and supports the development of therapy goals. They keep in regular contact to ensure needs are being met and all stakeholders (team clinicians, general practitioners, other service providers) are kept up-to-date on the progress of goals.

Key Workers empower clients and their families to engage in therapy and utilise the network of supports around them. They provide information and advice to the client, their family and/or carer(s) on behalf of the broader therapy team, and assist with implementation of strategies that promote learning and development.

The Key Worker model is vital when clients are widely spread geographically, like in the Mandurah/Peel area for example. To ensure consistent and regular therapy, the Key Worker will collaborate with clinicians in the broader therapy team before and after a visit to discuss and model potential strategies. As a client’s therapy goals change, therapy teams will explore whether the Key Worker needs to change to best support the client.

“The relationship that forms between a family and a key worker is a dynamic one, characterised by mutual acceptance, respect, trust, commitment, openness and shared responsibility” – Alexander, S., & Forster, J. (2012) The Key Worker: Resources for Early Childhood Intervention Professionals (Ed. 1st), Noah’s Ark Inc: Malvern VIC. 

Find out more about how we work.    

Key Worker

Study options after school

Celine Windsor

Written by Therapy Focus Occupational Therapist, Celine Windsor.

  
 
“What opportunities does my child have to keep learning after high school?” This is a common question parents ask. The following article by Therapy Focus Occupational Therapist Celine Windsor outlines the various options for post-school study as well as what supports may be available.

There are many ways that people with disabilities can continue to learn after high school, whether the goal is gaining life skills and/or finding employment. Your young adult may be able to go to university, TAFE or study online with a Registered Training Organisation (RTO), which could lead to a certificate, diploma or degree of higher learning. There are also many holiday or short courses on offer.

Most providers of tertiary studies are very accommodating and willing to do what they can to help people with disabilities to complete the requirements of their course.  Each learning centre will have an Abilities Coordinator or  Disability Support Officer available to provide information about:

  • Courses
  • Scholarships or grants
  • Campus tours with a focus on accessibility
  • Support services including advocacy, counselling, mentoring, AUSLAN interpreters or scribe
  • Study, exam and assignment techniques and workshops
  • Where to go for help
  • Options for support such as negotiating course loads, exam condition and liaising with teachers on the student’s behalf

Even if they are not able to finish their studies, having the opportunity to learn can still be helpful for personal growth and self-discovery.

For more information

  • Career Centre – A great starting point to find out more about pathways to different jobs or careers.

Phone: 13 64 64 or (08) 9224 6500

Phone: 6488 2423

Phone: 9370 6960            

Phone: 9360 6084

Phone: 9433 0950

Phone: 9266 7850

Phone: 1800 001 001

Phone: 9427 1314 or 9427 1250

Each training provider is required to meet standards for disability access. Check with your prospective training provider to see what they are able to offer before enrolling in a course.

For more information about how Therapy Focus can support your transition to post-school training or work opportunities visit www.therapyfocus.org.au/transitions.

What does a social worker do?

Blog thumbnail - Jo AndrewsWritten by Therapy Focus Social Worker, Jo Andrews in collaboration with Dr Brenda Clare.

 
In our experience, there are many assumptions and a lot of confusion about what social workers actually do. Often we’re seen as people who simply have a chat over a cuppa for example.

But there is so much more to our role than simply talking with others. Social workers help people manage difficult relationships, overcome challenging situations they’re unable to cope with alone, and help get lives back on track.

Building effective working relationships is at the heart of what we do. Social workers work with people to help them find solutions to problems and support them to manage things more independently. In instances of families where a member has a disability, we understand that some problems cannot be solved. In this case our goal is to assist the family to remain strong and hopeful. We believe that the situation is the problem, not the person.

Social workers also work for people by advocating on their behalf. We work to ensure their voice is heard and that they have access to the services and resources they need. We also work collaboratively with other health professionals to ensure service systems work effectively for the people we support.

In summary, social workers can provide support in the following areas:

  • Relationship building
  • Identifying support requirements
  • Linking families to useful services
  • Information and referral for:
    • Financial problems
    • Parenting
    • Relationships
    • Mental health
    • Housing

For more information about Therapy Focus’ comprehensive therapy services, including social worker support, contact us on 1300 135 373.

Social Work Day

What is Central Auditory Processing Disorder?

Written by Therapy Focus Speech Pathologist Ruyi Tong.

 

 
“Everyone, please get your homework from your bags outside, put it on my desk, then come to the front with your blue maths book. Today we will talk about fractions, which are on page 5 of your book.”

Sam takes out her maths book and looks around, confused. She can’t understand why the rest of her classmates are leaving their desks and heading outside.

Is Sam being defiant? Why isn’t she following instructions? Her hearing has been tested and there is nothing wrong with it. Perhaps Sam has heard her teacher, but finds it difficult to process or understand what was said?

As a therapist, situations such as this set off alarm bells that signal there may be central auditory processing issues.

Central auditory… what?

Central Auditory Processing Disorder (CAPD) is the inability to understand verbal language in a meaningful way, in the absence of a hearing loss. In other words, there are issues with the way the ear talks to the brain, and the brain has trouble interpreting what the ear is trying to tell it.  The disorder may also be referred to as auditory comprehension deficit, word deafness and auditory perceptual processing dysfunction. This problem is commonly experienced when complex language is used, long instructions are given, speech is too rapid, and when there is a lot of noise.

CAPD

What can be done?  

There are 2 treatment approaches for Central Auditory Processing Disorder.

The first focuses on training certain listening skills such as word discrimination (e.g. telling the difference between peas and bees), identifying where sounds are coming from (e.g. is it from the left or right side of your body), putting different letter sounds together to form words, or identifying a sound in the presence of noise (e.g. being able to focus on the ticking of a clock in a noisy room).

The downside of this approach is that some individual may not be able to use these skills in everyday environments.

Therefore the other approach focuses on modifying the environments the individual is regularly in. Examples include:

Seating arrangements

  • Sit the individual away from auditory and visual distractions. In the classroom, for example, choose a seat close to the teacher and white/blackboard and away from any windows and doors.

Setting

  • Reduce external visual distractions like busy bulletin boards
  • Place mats on the floor and walls to absorb noise
  • Ear plugs may be useful to distract from ambient noise such as the air-conditioner or a pencil sharpener
  • See an audiologist to discuss the use of an FM system. These systems work by transmitting the teacher’s voice directly to the individual’s ear, minus any background noise.

Speaking   

  • Gain the individual’s attention before speaking
  • Speak slowly and clearly
  • Break lengthy instructions into a few shorter instructions that follow a logical order
  • Emphasise key words
  • Use gestures
  • Use visual aids such as written instructions (depending on the individual’s literacy level)

Central Auditory Processing Disorder can affect reading and spelling, therefore early identification, typically by a speech pathologist or audiologist, is beneficial.

Therapy Focus offers a range of assessments to help identify difficulties in a number of developmental areas, including auditory processing. For more information visit www.therapyfocus.org.au/assessments.     

How is autism diagnosed?

Christine Bosch headshotWritten by Advanced Speech Pathologist, Christine Bosch.

Autism Spectrum Disorder (ASD), or autism, is a neurodevelopmental disorder that affects three main areas of an individual’s life: communication, social interaction and repetitive and restricted behaviours.

Approximately one in every 88 people has autism and it is more common in boys than girls. In 2017, 2.5% of the Australian population had a diagnosis of autism. At that time, the WA Department of Education reported that autism accounted for the highest number of children requiring additional support through Schools of Special Education Needs.

Although the cause of autism is unknown, genetic factors have been identified. Siblings have a 35% higher chance of developing symptoms of autism.

Who conducts the assessment?

National Guidelines for the assessment of Autism Spectrum Disorder were announced late 2018 by the Minister of Health. The ‘gold standard’ in terms of diagnosing autism includes a comprehensive assessment by a paediatrician (for children) or psychiatrist (for adults), plus assessments by a psychologist and speech pathologist with specialised training using criteria outlined in the Diagnostic Statistical Manual (DSM-5). All three professionals have to be in agreement with the findings of the assessments before the paediatrician/psychiatrist makes the final diagnosis. This is to ensure that the individual is assessed from different points of view. It also helps prevent misdiagnosis. 

What does the assessment involve?

The diagnostic process involves a detailed observation of the individual’s behaviour through a play-based assessment (for children), a language assessment, intellectual assessment, as well as a detailed parent interview. An individual with autism may also have a language impairment and/or intellectual disability. Severity and support needs are determined by how the social communication or repetitive and restrictive behaviours are impacting on the individual’s ability to function at home, school, at work or in the community.

What are the signs of autism?

Signs of autism can include:

  • Lack of communicative intent (the use of gestures, facial expressions, written or spoken words)
  • Difficulty with the flow of conversation, including reverting conversations back to self- interests, difficulty listening, frequent interruptions or lack of engagement
  • Language difficulties, or difficulty with reasoning and problem solving
  • Speech delays or non-verbal communication
  • Difficulty using and interpreting others’ body language, gestures and facial expressions
  • Problems with play, including difficulties with imaginative and pretend play, as well as engaging in play with peers
  • Difficulty making and maintaining relationships with friends or significant others
  • Difficulty with processing sensory stimuli such as an oversensitivity to noise
  • Attention difficulties
  • Behaviours that are repetitive or ritualistic (i.e. having to complete a ritual task before moving onto another task)
  • Obsessive behaviours
  • Anxiety
  • Difficulty with transitions
  • Refusing to go to school or leave the house
  • ‘Black and white’ thinking and inflexibility with rules or routines

If you are concerned that your child may be showing signs of autism, contact your paediatrician and they will make the appropriate referrals based on the findings of their initial assessment.

At Therapy Focus, we offer autism assessment services through our trained and highly experiences psychologists and speech pathologists. For more information, or to book an assessment, simply contact us.

What happens after diagnosis?

Once a diagnosis is confirmed, an individual with autism is eligible for funding for various services relating to school, therapy and assistance in the community. The level of funding they receive will depend upon their needs and the severity of the diagnosis. There is a significant body of evidence that suggests that early intervention is the best solution and leads to the best outcomes in terms of therapy. For more information, visit our autism services and support page.

A boy blowing bubbles with help from a therapist

Mealtimes can be sense-ational!

Blog - Lisa Blog - Alice

Written by Therapy Focus Speech Pathologist Lisa Hargraves and Occupational Therapist Alice Kettle.

 

Mealtimes can be very stressful for parents of children with tricky behaviours and fussy eating habits.

But an approach called ‘Sense-ational Mealtimes’ developed by Gillian Griffiths and Denise Stapleton is helping parents better understand mealtime challenges and supporting them to set realistic goals.

The approach is aimed at children who:

  • eat a small range of foods
  • avoid entire food groups
  • refuse to sit and eat with the family at mealtimes
  • react negatively when presented with new foods and/or
  • insist on the same food at each mealtime

All of which are commonly experienced by children with autism.

The Sense-ational Mealtimes approach includes strategies such as:

  • How to prepare your child’s senses for mealtimes
  • How to put a time limit on mealtimes
  • How to position your child so s/he is supported during mealtimes
  • How to talk about feelings and sensations during mealtimes
  • How to increase your child’s appetite
  • How to adapt favourite meals to suit each member of the family

Initially an information session is provided to families using the Sense-ational Mealtimes approach, which helps parents explore their child’s nutritional needs, feeding behaviours and sensory experiences at mealtimes.

One of the most useful tools to support parents to understand the process of food acceptance is a visual diagram called the ‘Sensory Whirlwind’.

Sensory Whirlwind

The Sensory Whirlwind supports parents to identify how their child is currently experiencing a particular food and how to take steps toward their child eventually eating that food.

For example, a child who dislikes carrots may have learned to accept seeing the food on their parents’ plates but is not yet ready to touch it.  In this scenario, the parents are encouraged to talk about the food and show enjoyment when eating it, without pressuring their child to touch it or try it.  Once the child is comfortable seeing it on their parents’ plates, parents may then try placing the carrot on the child’s plate. Again, there is no pressure for the child to touch it or try it. Over time, as the child becomes comfortable with the carrot on their own plate, they may take the next step of touching it and maybe even bringing it to their lips.

The time a child takes to move through each step of the Whirlwind will vary greatly. It can be a slow process, but taking it gradually can help to develop trust between the child and parents at mealtimes.

Another aspect of the approach encourages parents to reflect on their own past experiences of food when they were growing up.  It is important for parents to know and understand their own feelings and sensory preferences around food in order to help their child.

When a child feels safe and supported by their family to explore foods, there is a greater chance of success at building up the range of foods that they will accept at mealtimes.

For more information about Sense-ational Mealtimes, visit www.sense-ationalmealtimes.com.au.

To enquire about signing up for the program visit www.sense-ationalmealtimes.com.au/contact/.

For more information about how Therapy Focus can help with mealtime management issues visit www.therapyfocus.org.au/mealtime-management.  

Bibra Lake Regional Playground Review

blog-thumbnail-deanneWritten by Therapy Focus Occupational Therapist, Deanne Coleman.

As I live and work in the Cockburn area my family and I have been eagerly looking forward to visiting the new Bibra Lake Regional Playground, which opened on Saturday 12 November.

We visited on opening weekend, so it was busy! Despite the madness, we were able to find a car park relatively easily. I was also pleased to see that there were a couple of disabled car bays close to both entrances of the playground.

The first thing I noticed about the playground is that it’s able to be locked and gated! Tick! This is a must for my mother’s group, as most of us have more than one child and it’s much more relaxed when we’re at a park where the kids can roam around (relatively) safely!

The playground boasts many different activities aimed at all abilities and ages, and I have to say I was impressed. The playground is surrounded by paving, grass or soft form the whole way around. There are a lot of sensory and water play activities, which is great for children with disabilities. Also very popular with the kids was the accessible swing set and flying fox!

The playground offers plenty of amenities including ambulant toilets and a fully fitted out disabled toilet with a ceiling hoist and adjustable adult sized change table. Unfortunately this is not ready for use yet, but it will be soon.

The lush and plentiful trees provide plenty of shade in which to enjoy sitting on the grass with little ones. Another thing I love about this playground is the use of nature in the design. There are rocks to climb and saw dust to play in!

Unfortunately we ran out of time trying to look at everything this playground has to offer, but my family and I will be back soon! I am keen to try out the in-ground trampolines, water play, giant turtle splash pad and pole maze just to name a few! I am looking forward to using this playground with the clients I work with. There seem to be endless opportunities for therapy and play.

For more information about the playground visit the City of Cockburn’s website

The value of being included

Celine WindsorWritten by Therapy Focus Adult Services Coordinator, Celine Windsor.

Social inclusion is an important part of feeling happy and healthy, growing stronger and becoming the person we want to be. So what is social inclusion? And how can we achieve a healthy social life?

Social inclusion is:

  • Feeling connected to other people
  • Feeling supported when things are tough 
  • Feeling important enough to be considered by others, have a say and be listened to
  • Feeling like you are part of something bigger than you

Consider the following: Do, Be, Become, Belong:

  • What can I do, where and how can I do it? Think art, archery or acting; bike-riding, bocce or ballet-dancing; collecting, craft or canoeing. The opportunities are endless!
  • What can I be? Are you a student, friend, neighbour, employee, team member, volunteer or a citizen?
  • Who can I become? Every day the choices we make and the experiences we have help to shape who we become.
  • Where can I belong? Develop and share your interests with others. Committing to a project or group helps to build relationships with like-minded people. This helps us to feel like we connect with others and belong.

social-inclusion-blog-

If you’re looking for ways to feel included, try having a conversation with a family member, friend or your therapist. They can help identify where new opportunities might lie and what support you might need.  Below are some questions you might like to discuss:

  1. Do you think you are healthy as you can be?  If not, what might help you to improve in this area?
  2. How do you feel about yourself? What are your positives and strengths you’d like to build upon?
  3. Do you let people know when you want to do something or do you keep quiet? What might help you to improve in this area?
  4. Do you have enough help to do the things you want to do?
  5. Would you like to have more choice and be able to make more decisions about your life, what, where, when and how you do things?
  6. How are your relationships with family, friends and others? Are there people that you would like to see more of?
  7. Would you like to get out more and meet new people and build a circle of friends?
  8. If you were to go out, where would you like to go?
  9. Is there anything stopping you from going out? If yes, what can be done to make it easier to get out?
  10. Would you like to change where you live or who you live with?
  11. Are you still learning? Is there something that you would like to learn?
  12. Do you have a job that you enjoy? If not, what work would you like to do?
  13. How can you make a difference in your world and in lives of others?

Finding your ‘just right’ level of social inclusion might give you a new reason to jump out of bed in the morning with a spring in your step!

Tips for parents and carers:

  • Start early
  • Be a role model
  • Knock on doors, ask questions
  • Seek advice, ideas and support from your children’s school, service providers, other parents, employers, communities and decision makers
  • Open the door to new opportunities for your child

For more information about social inclusion visit the following websites:

World Cerebral Palsy Day: Shakira’s Story

In celebration of World Cerebral Palsy Day on 5 October 2016, we invited a family receiving services to share their story.

Cerebral palsy is the most common physical disability in childhood. It is an ‘umbrella’ term used for a group of movement and posture disorders caused by damage to the developing brain. 

Most people with cerebral palsy are healthy and can expect a normal life span, participating in meaningful studies, hobbies and employment. However, children with cerebral palsy may require extra support and encouragement, and this takes a lot of dedication from their family and others around them.

 The following is written by Jessie-Lee, who is Mum to six year-old Shakira.

Shakira was diagnosed with cerebral palsy when she was 2. She has since received physiotherapy from the wonderful team at Therapy Focus. They have been able to help Shakira reach goals that I never thought imaginable.

With her calf being constantly tight she couldn’t ride a normal bike but with support from Therapy Focus, we were able to work with Dream Fit to modify a bike for her. Shakira can now the ride the bike without the heel cups that used to hold her feet in place! She wears an Ankle Foot Orthosis (splint) daily to help stretch the calf. This can be challenging some days as she sometimes just wants to wear her special ballerina shoes, but with a lot of encouragement she agrees to wear it daily. Some of the things Shakira has used to manage her CP include daily stretches, splint, Botox, tilted foot step, hop scotch, trampoline, Dream Fit bike, squats, and swimming.

Shakira started Botox injections at the start of the year and I have seen a fantastic difference in her range of movement. Daily stretches take place at home and school and with the help of the injections Shakira has come so far in her physical activities. At last year’s sports carnival she had to stop and jump side legged over the hurdles; this year she is jumping with both legs together in a forward motion. The school captured a fantastic shot of her leaping over them with all the joy in the world.

She is a beautiful spirited little girl and will give anything a go. As a mother with a daughter with special needs you have to stay focused, happy and encouraging as I believe they feed off you a lot and if you show a slight sign of “they can’t do it” or “that might be a bit hard” then you’re instantly setting them up to fail. Stay positive and if they give it a go and it doesn’t work that’s ok, they gave it their best shot.

Shakira’s school has been an amazing support to her. In addition to assisting with her stretches, the school recently participated in ‘Steptember’, a fundraising event for the Cerebral Palsy Alliance. Calling themselves ‘Shakira’s Stepparoos’, four of her teachers took on the challenge of completing 10,000 steps a day for the entire month in order to raise vital funds. It was a big challenge but it was for a very worthy cause.

One in two people with cerebral palsy are in chronic pain due to the tightening of their muscles. Many will never be able to take a single step without assistance. If you would like to support the Wanneroo Primary School Team “Shakira’s Stepparoos” visit their fundraising page. Any amount you contribute will make a huge difference to children and adults living with cerebral palsy.

For more information about World Cerebral Palsy Day visit the website.

Shakira

Pictured: Shakira with ‘Shakira’s Stepparoos’.

Spina Bifida Awareness Week: Michael’s Story

September 1-7 marks Spina Bifida Awareness Week. To help people gain a better understanding of the birth defect, which causes varying degrees of disability, we asked 10 year-old Michael McDonald to share an insight into what it’s like living with spina bifida.

My name is Michael McDonald. I’m 10 years old and in Year 5 at Poseidon Primary School. I have lots of friends at my school and my favourite sport is soccer. My favourite soccer team is Perth Glory and I like watching them play. I also have spina bifida, which I’ve had since I was born.

Spina bifida is the incomplete formation of the spinal cord which happens during the first few months of a baby’s development in the womb. Spina bifida affects everyone differently and can cause paralysis or weakness in the legs, bowel and bladder incontinence and specific learning difficulties. I don’t like having spina bifida because I can’t run fast like my friends.

Even though I don’t like having spina bifida, I can still do lots of things. Every Saturday I play wheelchair sports. I do a different sport each week like basketball, badminton, laser tag, rugby, hand ball, tennis and volleyball.  My favourite wheelchair sport is basketball which I am the best at.

Because of my spina bifida I am also really good at using my wheelchair. I can do wheelies and turn corners really fast. I have also ridden quad bikes and horses which was fun.

At the start of the year I was super lucky to be chosen to toss the coin at the start of a Perth Glory match, which was very exciting. Every year I go on a spina bifida camp in Rockingham. While on camp I play soccer and footy with my friends. It’s really fun! Last year I got an iPad from Therapy Focus to help me with my schoolwork, but I also have some games on it that I can play. When I found out that i was getting an iPad i was happy and excited!

Even though I have spina bifida I can still go to my friend’s house on the school holidays. When I am at my friend’s house we like to play the Wii, which I am really good at. I really like going to my friend’s house to play.

Finally, even though I really don’t like having spina bifida and it means I can’t run fast, I can still do lots of fun things like tricks with my wheelchair and go to my friend’s house to play.

Perth Glory

Pictured: Michael about to toss the coin at a Perth Glory home game.

What does a speech pathologist do?

Blog thumbnail - MoniqueWritten by Therapy Focus Speech Pathologist Monique Moreno.

What does a speech pathologist actually do? This is a question I am regularly asked by members of the community.

Common perceptions of our work include correcting articulation difficulties in children (e.g. lisps) and working with people who stutter. Speech pathologists do work to support these client groups – and so much more! Speech pathologists complete a university degree to support children and adults with two fundamental life skills; communicating and eating. Speech pathologists possess the drive and passion to support people with these skills in order to engage across all aspects of daily living.

Who do speech pathologists work with?
Speech pathologists assess, diagnose and treat communication and swallowing difficulties in children and adults. Communication difficulties refer to challenges with speaking, understanding and/or using language, listening, social skills, stuttering, reading, writing and using voice. Speech pathologists also help people who have difficulties eating and drinking safely.

Where do speech pathologists work?
Speech pathologists work in many different settings including schools, hospitals, aged care homes, mental health services, rehabilitation centres, community health centres and private practice. Speech pathologists often work collaboratively with occupational therapists, physiotherapists, dietitians, audiologists, psychologists, doctors and teachers.

How can a speech pathologist help?
Speech pathologists can support people in the following areas:

  • Speech delays and disorders – articulation and producing speech sounds
  • Expressive language – using language to share thoughts, feelings and ideas
  • Receptive language – understanding language, word meanings and instructions
  • Augmentative and alternative communication for people with difficulties speaking and writing e.g. using pictures, communication boards or assistive devices to support understanding and expression of language
  • Fluency – supporting people who stutter to speak more fluently and with confidence
  • Feeding and swallowing difficulties – supporting infants, children and adults who have difficulties eating, drinking and swallowing safely
  • Pre literacy and literacy skills – learning to read, write and spell
  • Voice – disorders of the voice including pitch, quality, volume
  • Social  communication difficulties – communicating for social purposes and following the rules for conversation
  • Cognitive-communication disorders – organising thoughts, planning, reasoning, paying attention, remembering and problem solving
  • Aural rehabilitation for people who are deaf or hard of hearing
  • Accent modification

Therapy Focus’ qualified speech pathologists provide government funded and fee-for-service speech pathology to children and adults. Find out more.

Where can I find out more information about the work speech pathologists do?
Speech Pathology Australia is the professional body who represent speech pathologists across Australia. To find out more about the work speech pathologists do in the community, view this video.

For more information about Speech Pathology Week 2016 visit their website.

The importance of imaginative play

Blog thumbnail image - Rachael TanWritten by Therapy Focus Behaviour Support Team (BeST) Clinician (Clinical Psychologist) Rachael Tan.

Kids play make-believe because it’s fun, but did you know it is also a vital component of normal child development and should be encouraged?

What is imaginative play?
Imaginative play, or make believe as it is sometimes referred to, occurs when a child role plays experiences that are of interest to them, such as playing ‘school’ with their toys. Children may engage in imaginative play alone or with others. There are a number of benefits that imaginative play contributes to a child’s development.

The benefits of imaginative play:

  • It fosters creativity by providing a safe space for children to act out scenarios of their choosing, including situations that they may not be able to experience in real life. For example, a 5-year-old who is unable to go to a restaurant without her parents can, through imaginative play with her friend, create a pretend tea party they can both enjoy at home.
  • It promotes physical development in a fun way. Activities such as fitting doll’s arms through the sleeves of her jacket are great for hand-eye coordination, as is learning to move and control her hands in different ways.
  • It provides an opportunity for kids to practice and develop their language and social skills simply by being with and talking to other children.
  • It boosts development of problem solving and self-regulation skills. Imaginative play with peers can create situations in which not everyone gets what they want. For example, when more than one child wants to be King of the castle, the child who doesn’t get what he wants needs to learn how to manage unpleasant emotions in order for play to continue.
  • It gives parents a fun way to teach positive behaviour to their kids. Parents can introduce situations into play to create “incidental learning” opportunities. For example, when giving their doll a shower, the parent might ask the child questions (e.g. “what happens next?”), make comments (“the water is nice and warm”), and discuss dilemmas (“Oh no, Dolly ran out of soap!”). These teach the child important functional skills and the ability to work through tricky situations with guidance.

Tips to encourage imaginative play:
Because imaginative play is such a healthy contributor to a child’s overall development, parents should actively encourage their child when they engage in imaginative play.

  • Provide plenty of props, play partners (both similar-aged peers as well as adults) and play time.
  • Dress-up parties are also a great way to both promote imaginary play and keep children entertained!
  • Involve them in your daily chores and incorporate incidental learning into these situations. For example, while you are preparing dinner, you might invite your child to cook alongside you with their play items.

What’s the right age to introduce imaginative play to a child?
There is no set age to introduce imaginative play into a child’s world. You can start by introducing simple items that are safe for the child, such as a soft toy. Create situations to engage that item in play, like having your child’s doll give them a kiss on the cheek.

Are there any disadvantages to imaginative play?
Absolutely none! But, if a child often behaves in a way during play that causes harm either to themselves or others, or if a child develops a strong preference for solitary imaginary play at the expense of social play, it may be worth seeking the advice of a qualified child development professional.

Find this article helpful? Visit our blog for more useful tips and insights from our therapists.

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