The Koala Who Can

A great book to help children cope with change

By Michael (Speech Pathologist)

Change can pose quite a challenge for children. Jacques Lacan, a French psychiatrist, argued that feelings of anxiety often arise when we do not know what is expected of us. New and unfamiliar situations present new expectations, and often these expectations are not only ‘unwritten,’ but also ‘unspoken.’ As adults, we typically have a wealth of experience with the world behind, so when we unexpectedly find ourselves in a new situation, we can draw upon our encounters with other, more-or-less similar situations to guide how we might act in order to meet the expectations that might accompany this new set of circumstances.

For children, however, many situations they will encounter are not only ‘new,’ but ‘radically new’: they don’t have the familiar landmarks they can use to orient themselves and find their bearings in whatever new territory they are attempting to navigate. There is nothing quite like kinder until you attend kinder for the first time, and school only resembles kinder to a small degree.

So how do children cope with the great deluge of situations to which they are subjected in those early years? Pragmatic language and social-inferencing skills are key here: if you can make inferences about social situations and gauge how people around you are reacting to things that you and others do, then this means you can learn-as-you-go and figure out how you should be acting to meet the expectations of the situation. Similarly, if you are able to communicate effectively with other people, you can deftly ask others around you to fill you in on what you should be doing, or perhaps even offer the right apologies or crack the right jokes that will serve to smooth over any unintentional blunders you might make during the period of adjustment.

When children aren’t quite so well-versed in these skills as their peers, then the introduction of even minor changes to a routine, activity, or what-have-you can occasion anxiety. It can be as if a sudden gust of wind has unmoored them, and they find themselves adrift in strange waters without the necessary navigation equipment chart their way back to the dock. From an outsider’s perspective, the change is minor, but that is because past experience and the ability to ‘check in’ with others through communication allows for the recognition that expectations really haven’t shifted all that much, I just need to do or stop doing this one thing now that the situation has changed.

Children who find change—especially of the expected and/or unwelcome variety—difficult to manage need multiple resources to draw upon when such changes do inevitably occur. At the outset, it is usually helpful to help children get a firm grasp on what change means, and the distinctions between welcome/unwelcome and unexpected/expected changes. Leading on from this, helping children to understand that even when unexpected and unwelcome changes do occur, it’s okay, because a) it probably won’t be as bad as they expected, and may even bring along new and exciting things that they will enjoy, and b) they cope with such changes by using one of the strategies they have learned.

The book I want to bring to your attention today (The Koala Who Can, written by Rachel Bright and illustrated by Jim Field) is all about understanding that change is okay, and that there might even be certain disadvantages to avoiding change (like missing out on something fun). It also communicates that there are other people who will support and help you through change, and that going on that journey together can actually strengthen your bonds with those people. Replete with the most wonderful illustrations, the book provides plenty of opportunities to discuss the emotions that the main character, a Koala named Kevin, is feeling at various points in the story. I would also, depending on your child’s age and development, consider discussion the particular features of the changes that Kevin either goes through or avoids: e.g., refusing to change by coming down out of the tree vs. the tree falling over near the end of the book and forcefully reuniting him with terra firma. Most of all though, the book does a wonderful job of representing the embracing of change as a very brave and praiseworthy act—and what child doesn’t want to be brave?

Sincere apologies

By Michael (Speech Pathologist)

Sincere apologies are often a tricky thing for young children to master. For one thing, it takes time for children to be able to mentally move beyond the bounds of their own perspectives, and begin to consider how other people might think and feel about things. Second, their vocabularies are still developing, and thus they lack the words necessary to offer a full apology that contains not only the words ‘I’m sorry,’ but also some statement about why and what for; along these same lines, a relative lack (compared to older children and adults) of social experience means that they may not have a great deal of familiarity with the different forms that an apology could or should take in different situations.

Ordinarily, these gaps in a child’s awareness and knowledge will be plugged by observing, and interacting with, people within the social environments which the child moves through. For children on the autism spectrum, however, such learning through observation often only occurs to an appreciable degree when the thing that they are learning about strongly corresponds to their interests. Thus a child may readily learn the letters of the alphabet after hearing them recited a handful of times, but never tune in to social interactions closely enough to recognise the how, when, and why of offering apologies.

Apologising is a skill, then, that may need to be explicitly taught. But while it is easy enough to teach most children to offer some variation of “I’m sorry” in at least some of the situations when an apology is called for, it is another thing entirely to teach the empathic response necessary for the formulation and demonstration of a sincere apology. What follows is an outline of some of the ways in which you might help your child develop this skill:
What happened?

Before a child can experience an empathic response to a situation, they need to understand the what of the situation itself. In order to guide this understanding, you can start by gently prompting your child with questions like:

Why is Steven mad?
What happened to Chloe that made her cry?
How do you think Negin felt when Robert pushed her?

It might also be helpful to explore your child’s own emotional responses, both to the incident under consideration, and also to the emotions they recognise in those involved in the situation.
What was my role?

Once your child understand what has happened, the next step is for them to recognise what role they played in how events transpired, and what is their share of the responsibility for how people felt as a result. It is very important that your questions be phrased and delivered in as-gentle a way as possible, so that they do not sound like recriminations—rather as genuine entreaties for reflection and learning. The sorts of questions you work through with your child might include:

Do you think that it made Susanna upset when you pushed in front of her?
How would you feel if someone threw your favourite toy over the fence?

The value of an apology

Your child is more likely to be motivated by, and invested in, an apology when they perceive that it will yield some benefit for all the parties involved. It is important that children learn how an apology not only makes people feel better, but that it also benefits the one offering an apology—either by avoiding negative consequences (e.g., some form of retaliation), or reaping positive benefits (making a new friend, or repairing/strengthening existing bonds of friendship). You could prompt your child to consider statements like:

Giving someone an apology is a way to show them respect. If we treat others with respect, they’re more likely to treat us with respect too.
Apologising to someone usually cheers them up, and sometimes it may even make you better friends.

Next time, we will delve into some ways you can work with your child on what to say in an apology, as well as how to say it.

Is my child a picky eater or a problem feeder?  We get asked this question a lot.  Here is an SOS feeding checklist.   Please check in with our dietitian Kim who is running SOS workshops and sessions in Term 3 and 4 for further information.

Raising Children Bilingual or multilingual Doesn’t Cause Confusion In Children

By Pauline, Speech Pathologist, Change for Life

Often parents are told by some health professionals not to speak two languages with their child, or I will have parents say to me: “I don’t want to confuse him/her by speaking two languages”.

These are all myths. There are a lot of myths that dual-language learning causes language delay in children, would confuse the child, or that bilingual children are less intelligent than monolingual children or reducing to one language would improve a child’s chances for success. It is farther from the truth.

There is no evidence indicating that speaking to your child in more than one language causes a delay or that speaking one language will improve your child’s chance for success. Children who speak one language make a lot of errors. It is a normal part of language learning, and, it is not a sign of confusion.

On the other hand, there is evidenced-based research indicating numerous advantages that bilingual children have over monolingual children. Bilingual children can ignore distractions and focus their attention on important information. They are more creative. Bilinguals are better at planning and solving complex problems than monolingual children. The effects of aging on the brain are diminished among bilingual adults. One study found that the onset of dementia was delayed by four years in bilingual children compared to monolingual children. Bilingual children have better access to people and resources. Bilinguals have higher employment rates in some countries. For example, in Canada, people who speak both official languages, i.e., English and French have a 10% higher income rate than those who speak only English.

Reducing to one language can cause a lot of other difficulties emotionally and psychologically because parents can struggle to communicate with their child, and the child might not fit in with other family members and friends. Many parents are learning English themselves, so they are not able to model rich linguistic grammar and therefore, the children only get exposed to simpler linguistic models in English. Research suggests speaking to your child in the language that you speak best as this will provide your child with rich linguistic input. Learning more than one language is doable. Also, children with Autism can be bilingual as there is no scientific evidence that children with developmental disabilities or language impairment cannot learn more than one language. Remember half of the world is bilingual or multilingual.

The Trouble with Gender Pronouns

Michael, Speech Pathologist, Change for Life

Gender pronouns—him, her, she, & he–are types of deictic expressions. All children find deictic expressions challenging, because unlike words such as ‘tree’ or ‘cat,’ they don’t reliably label a single object or class of objects in all situations. Instead, deictic expressions require the addition of specific contexts in order to make sense of them: for example, the ‘there’ phrase “just leave it there” can reasonably be interpreted to mean ‘on the kitchen bench’ if that’s where the speaker was looking at the time, but would likely leave the listener quite confused if it was uttered during a phone conversation.

In order for a child to learn the distinction between deictic expressions such as ‘this,’ and ‘that,’ they have to intuit that ‘this’ and ‘that’ can refer to many different things, and that the only thing that remains the same is the speaker’s perspective. And when it comes to gender pronouns, there are at least two layers of complexity involved: the first, and most obvious, is that we need to use a different pronoun depending on whether we are talking about someone who is female vs. someone who is male. Even when we have figured this out, however, we are still left to choose between ‘her’ or ‘she’ in the event that it’s a female person we’re talking about.

Figuring out the ‘she’ vs ‘her’ puzzle requires the ability to take perspective into account. Is this person doing some action (“She is riding her bike”), or is she receiving an an action (“The cat jumped in her lap”)?

When children mix up gender pronouns, and refer to boys as ‘she,’ or girls as ‘he,’ it provides a startling illustration of how language and social development contribute to, and depend upon, each other. If a child is using pronouns at all, it demonstrates that they have at least begun to grasp that there is a class of words which can ‘fill in,’ for proper nouns. But if they refer to Steven as ‘she,’ then this might just be because their social development has not yet reached the point where they can use the right pronoun for the right context.

It is important to understand, then, that a child who is confusing gender pronouns is not necessarily incapable of grasping these kids of distinctions. The more likely explanation is that either their language or social development—or both—has not yet reached the level where they can mark these distinctions verbally. And given that children with Autism Spectrum Disorder can often find it harder to adopt the perspectives of other people, it is little surprise that gender-pronoun errors, and deictic errors of all kinds, show up more often in this population.

Parents can help children who make these sorts of errors by recasting their sentences. So, if Max says “he is sitting down” when referring to a boy, you would say “he is sitting down”—making sure to put emphasis on the ‘he.’ If your child is seeing a Speech Pathologist, on the other hand, they might well take a combined approach wherein they target both his or her language and social development—which includes perspective taking.

Let’s talk about feelings

By Melanie, Provisional Psychologist, Change for Life

Released in 2015, the award-winning film Inside Out won the hearts of many. Not only was the film engaging, lively and relatable, it also highlighted many lessons about our emotions and the workings of our brain and mind.

Firstly, one of the biggest take-aways from this film was the spotlight it placed on sadness. In the movie, the character Sadness was isolated and even confined to a single space. Sadness was seen by her colleagues and friends not to have a place in helping Riley. This behaviour mirrors the world that we live in today, where many do not embrace being sad. Our society tells us that we need to be happy and think positive thoughts. While somewhat true, there is also an underlying assumption that being sad or thinking negative should be overwritten, that sadness is not value-adding. However, every emotion in our body is there for a reason; it helps us to understand the situation, to troubleshoot a problem, and sometimes to protect ourselves. When we ignore the emotion we’re feeling with something more socially acceptable; we deny ourselves the process of understanding what we are going through. It is okay to feel sad! By embracing sadness, we are opening up ourselves to feel and begin the process of healing. If we deny ourselves the opportunity to be sad and grieve, we are jumping ahead and forcing ourselves to be happy. This does not necessarily solve the issue or the emotional turmoil we are going through. Instead, it leaves an area of our lives unresolved. This festers and might turn into a bigger problem in the future.

Secondly, the movie Inside Out explains to us that our memories can elicit more than one emotion. Maybe recalling a happy memory with a pet that is no longer around might make us feel sad. For a moment, we are confronted with feeling both joy and sadness. It is okay to feel multiple emotions when recalling a memory. As we grow older, we learn to understand more emotions and its complexities. In understanding what emotions each memory elicits, we know how each memory impacts us.

Lastly, our core beliefs play a part in the decisions and actions we make. Riley’s core memories in Inside Out are seen to power her each of her personality islands. When these core memories are lost in the movie, Riley’s personality islands start to fall apart. Similar to core memories, core beliefs are often formed from a childhood experience or an early life experience. When our core beliefs are challenged or threatened, we begin to respond and behave differently to situations. When Riley performed poorly at the Hockey tryouts, her core belief of being a good hockey player and enjoying hockey was threatened, and she got angry and upset. She behaved in a way that she usually would not have. Our core beliefs can be vital to the way we respond to situations.

There are many more lessons that the movie Inside Out presents. It portrays this knowledge in a manner that is easily understood and digested by many across all ages. Watch the movie (again, if you’ve already watched it before) and see if you can find more exciting lessons the producers included in their film.

The Components of Social Communication

Michael Audas, Speech Pathologist, Change for Life

For many of us, our ability to interact with other people is something that we take for granted. This is because it is easy to overlook just how many language, cognitive, and social skills are involved in even the most simple–seeming social acts. For example, here are just a few of the considerations that apply to being able to greet someone appropriately:

1. Familiarity: Am I able to judge how well I know the person I am greeting, and what my relation is to them?
2. Formality: Am I able to select an appropriately formal or informal greeting, depending on my relation to that person? Do I have a ‘bank’ of both informal and formal greetings I can select from?
3. Temporality: Do I understand that greetings often change depending on the time of day?
4. Context and history: If I greeted this same person when I saw them two hours ago, is it appropriate to greet them again? If not, should I just ignore them, or should I acknowledge them in some way? Do I understand the difference between a greeting and an acknowledgement?
5. Nonverbal communication: What, if any, gestures should accompany the greeting I have chosen to make? What should I do with my face as I greet this person? Should I look them in the eyes as I greet them; for how long?
6. Asking and answering questions: What if the person asks me “what have you been up to?” in response to my greeting? Do I know not to take this literally? How lengthy and detailed should my response be?

As you can see, there is a lot to think about when it comes to something that we rarely have to think about! In typical development, we learn all of these things so well from observing and interacting in our social environment that we don’t have to consciously think about all the different steps involved.

For some children, however, the various pieces of the puzzle that make up social communication don’t simply fall into place as if by magic. For these children, skills that seem intuitive need to be explicitly taught. Furthermore, identifying what skills need to be taught, and how, requires identifying which of the proverbial pieces are yet to be put into place.

Speech Pathologists are experts in communication, and are equipped to determine what might be contributing to breakdowns in social communication. Returning to the domain of greetings, difficulties could arise because a child does not know what sort of expression conveys a friendly attitude towards the person they are greeting, or because they lack the vocabulary to be able to appropriately vary the greetings they can produce in response to different contexts. So if your child seems to be finding it difficult to interact with others, consider seeking a referral to a Speech Pathologist from your paediatrician or general practitioner.

Tips for Fussy Eaters in Isolation

Kimberly Nelson, Dietitian, Change for LIfe

Managing this weird and stressful time can be extra challenging when you have children with feeding challenges. Forced time at home and disruptions to usual routines can increase everyone’s stress. Children are quite adept at tuning in to their parents emotions so when you are stressed, it is likely they are feeling this also. Which is a problem for our fussy eaters. When we are stressed, our body releases adrenaline – triggering fight-flight mode. This directly affects your child’s appetite by shutting off appetite signals, moving blood from your digestive system to your limbs so you can fight or run away, and shifts your child into ‘react mode’ versus ‘learning/thinking mode’. Add tantrums into the mix and the adrenalin increases even more.

1. Try to keep your child on their usual eating schedule and a have a flexible daily routine for your family. This helps to not disrupt their hunger/fullness cycles.
2. Focus on pressure free family meals and snacks (see above).
3. Create a weekly menu for meals and snacks with your child (≥ 4 years).
4. Get them in kitchen!
   Children of all ages can help you prepare and cook meals. These activities generally don’t involve pressure to eat so can be a great way to get them more comfortable with different foods.
5. Movement activities.
   This is especially important if your child is missing out on their regular movement opportunities. There are plenty of ideas online for what you can do when stuck at home – inside or out!
6. Build in some deep breathing or yoga into the routine to help balance stress hormones. Free apps for smartphones are available as well as you tube clips.
7. Remember, they are likely to be more overreactive if foods/meals aren’t up to their standards or challenge their sensory sensitivities. Try to be aware of their emotional state around meals and think about how you can help to reduce their stress e.g. movement activities, deep breathing, less food on their plate, more preferred foods with new/learning foods or deconstructing meals.
8. Above all, make food fun!

Adapted from SOS Approach to Feeding – Managing Stressful Times with a Picky Eater or Problem Feeder.

Fun time with baby talk: Age 2 to 4 years

By: Pauline and Michael, Speech Pathology Team, Change for Life

• Speak clearly to your child—model good speech and language.
• Cut out pictures of favourite or familiar things. Put them into categories, like things to ride on and things to eat.
• Help your child understand and ask questions. Play the yes-no game. Ask questions such as, “Are you Paul?” and “Can a dog fly?” Have your child makeup questions and try to fool you.
• Ask questions that include a choice. “Do you want an apple or an orange?” “Do you want to wear your red shirt or your blue shirt?”
• Help your child learn new words. Name body parts, and talk about what you do with them. “This is my nose. I can smell flowers, brownies, and soap.”
• Sing simple songs and say nursery rhymes. It helps your child learn the rhythm of speech.
• Place familiar objects in a box. Have your child take one out and tell you it’s name and how to use it. “This is my ball. I bounce it. I play with it.”