Communication and Anxiety

Transcription

1 Anxiety and Communication J s Story Presentation by Cindy Harrison, M.Sc., Reg. CASLPO Senior Faculty, Profectum Foundation Goals To explore the role of uneven processing and anxiety in communication To present J and to illustrate how a DIR focus allowed the creation of strategies to mitigate the impact of anxiety on J s communication abilities Core Functional Social and Emotional Developmental Capacities (FEDL) Level 1: Regulation and Shared Attention Level 2: Engaging and Relating/Mutual Engagement Level 3: Purposeful Emotional Interaction/Two Way Purposeful Communication Level 4: Shared Problem Solving/Sense of Self Level 5: Symbolic Thinking/Creating Ideas Level 6: Building Bridges/Emotional Thinking Climbing the "developmental ladder CASLOP,SLP 1

2 Anxiety and Communication Level 1: Regulation and Shared Attention: The child is calm and focused, able to screen out distracting internal or external stimuli; available to interact and explore their world. Level 2: Mutual Engagement: The child is able to engage with trusted caregivers, demonstrating warm connections, robust engagement, trust and intimacy; sharing attention together around a meaningful experience. Anxiety and Communication In order to communicate anxiety/fear/worry or concern you need to have an understanding of what the feeling feels like It is later that this feeling is paired with a label (scared, worried, upset) Consider the infant who is content, regulated, fed, dry, and swaddled in daddy s arms that feeling baby gets as daddy coos at him will later be paired with the symbol love The ability to stay calm and regulated to take in the panorama of sights and sounds is an important developmental building block It forms the foundation for our ability to calm ourselves, soothe ourselves The ability to be mutually engaged allows the baby to understand interactions long before the baby understands words CASLOP,SLP 2

3 Example (baby breastfeeding) Example (daddy phone) What happens in above examples if the baby cannot stay regulated for significant periods of time or if the baby is not able to engage in shared attention or mutual engagement Level 3: Intentional Two way Purposeful Communication: The child can engage in back and forth communication with their caregiver using vocalizations, facial expressions, affect, movement, gestures, or language. It is this ability to have a conversation without words that allows us to modulate stressful situations (Example of a preschooler who is negotiating for a toy) If the child is not able to do this often get a zero to sixty reaction Well before the child is able to produce language they are able to use their bodies to communicate anxiety or concern Gestures, running away, running to an adult, vocalizations Power words Level 4: Complex Problem Solving/Sense of Self: The child has emerging ideas, all his or her own. The caregiver supports the child in executing the ideas and in resolving together natural and semi structured problems that can occur. Circles of Communication are increasingly robust and sustained. The child's sense of self is strengthened. The ability to engage in these problem solving interactions helps the child to feel powerful and to have an impact on others in order to get what he/she wants and to solve a problem In situations of anxiety/stress/concern a child can call on this ability (putting the dragon in another room, opening the cupboard to turn the stereo down, using gestures to tell his/her play partner to move away CASLOP,SLP 3

4 Level 5: Symbolic Thinking and Creating ideas: The child begins to use symbols (language) to express and share ideas. In play at first, the child mimics daily life; begins moving to more original imaginary ideas and actions dramatizing a widening range of child's real life issues. Think back to earlier levels.if the child is not able to differentiate or identify affect states will they be able to label them? If you can t label them can you express them symbolically? Level 6: Building Bridges Between Ideas: A child is able to make connections between different internal representations or emotional ideas ( I m mad because you re mean. ). He or she is able to bridge ideas logically and demonstrate emotional awareness of themselves and others. He or she is able to explore the how, what, where, why of a situation. This takes into account time, spatial and causal relationships between themes. At this level the complexity of language (both production and comprehension) allows a deepening of understanding and an ability to use the symbol system to tell stories, express complex ideas etc. It also allows the child to modulate I am a little bit scared of. or I am SO scared of Meet J J was six at the time of this video Comprehension relative strength Significant challenges in production especially expressing himself using language, sequencing, language formulation etc. Pay attention to his formulation Ask yourself the question is it better for focus on form and grammar or J s intended meaning? CASLOP,SLP 4

5 Meet J J man What did you notice about J s communication? Sequencing? Word finding? Formulation? Bad Guys In this next clip J is clearly worried about something.he is NOT ready to play until he can help me figure it out Ask yourself the question: What would or could have happened if I had barged ahead with the play? Was J able to express his anxiety? CASLOP,SLP 5

6 Bad Guys He Says She Says Background J was experiencing extreme anxiety in social situations at recess Typically a calm, sweet boy he was lashing out, becoming physical, pushing etc. J was spending every day after recess in the Principal s office J s mom was eventually unable to get him to go to school and he was transferred to a new school He Says She Says J is trying to communicate something but I am not certain what CASLOP,SLP 6

7 He Says She Says No Justice The story continues.. So What to Do? Use the DIR model and the understanding of the I to create strategies Give J the tools to get away from the situation Make sure that the adults (teachers on the playground) understand his challenges and that they understand that these challenges are exacerbated under stress CASLOP,SLP 7

8 So What to Do? Give J the tools to tell his story (visual cues) especially in the face of high affect Help J to reflect on what he did, if it worked, what he could do next time Where Is He now? From a student of concern who was asked to leave his former school To. Thriving in an environment that feels safe He knows what he needs and can actually advocate for himself. Thank you To J and his family for allowing us to join them on their journey and especially for allowing us to share this journey with others. CASLOP,SLP 8