Holis­tic way

In­ter­ven­tional ther­apy should give mean­ing to the tasks pre­sented. With­out mean­ing, there is no un­der­stand­ing.

The Star Malaysia - Star2 - - PARENTING - By PANG HIN YUE

STIM­U­LAT­ING the mind of a child who has a brain dis­or­der is more than just fill­ing up the in­tel­lec­tual gaps. It is just as im­por­tant to en­sure that he is emo­tion­ally equipped, says Geneva-based ed­u­ca­tor and ther­a­pist Roland Hi­fler.

“A child’s devel­op­ment is marked by both emo­tional and in­tel­lec­tual growth. Both are mu­tu­ally de­pen­dent,” as­serts Hi­fler who has been work­ing with chil­dren with autism for the past 10 years.

Hi­fler was in Ipoh, Perak, re­cently at the in­vi­ta­tion of Autism Sup­port As­so­ci­a­tion For Par­ents (ASAP) to con­duct a work­shop on Cog­ni­tive Ther­apy For Chil­dren With Autism.

Hi­fler is in­flu­enced by the works of child psy­chi­a­trist Dr Stan­ley Greenspan. The lat­ter pi­o­neered the con­cept of “floor time” to en­gage chil­dren with learn­ing dis­abil­i­ties, em­pha­sis­ing per­sonal in­ter­ac­tion through play rather than fo­cus­ing on chang­ing the child’s be­hav­iour.

Over­com­ing de­vel­op­men­tal de­lays, Hi­fler stresses, is more than shap­ing ap­pro­pri­ate be­hav­iours.

Be­havioural mod­i­fi­ca­tion ther­apy which is widely ap­plied in Amer­ica and which is gain­ing ground else­where, has its lim­i­ta­tions, he ob­serves. For ex­am­ple, if the goal is to get the child to com­ply with the com­mand “sit down”, and he suc­ceeds in per­form­ing it, he is re­warded with food of his choice or to­kens for other ac­tiv­i­ties which he likes.

While such ap­proach en­sures com­pli­ance, to the crit­ics, it is done with­out the child un­der­stand­ing what and why he is do­ing it.

Hi­fler be­lieves ther­apy has to do more than that. He is among the grow­ing num­ber of ed­u­ca­tors who are ad­vo­cat­ing cog­ni­tive ther­apy which takes the holis­tic ap­proach, in­cor­po­rat­ing the dis­ci­plines of neu­ro­sciences, psy­chol­ogy and ed­u­ca­tion.

Chil­dren with learn­ing dis­or­ders gen­er­ally have prob­lems pro­cess­ing in­for­ma­tion to make sense of the en­vi­ron­ment they live in.

“The whole point about in­ter­ven­tional ther­apy is to give mean­ing to the tasks pre­sented. With­out mean­ing, there is no un­der­stand­ing. When a task is mean­ing­less to the child, it could lead to frus­tra­tion and worsen the very be­havioural is­sues that the ther­a­pist is try­ing to solve,” he con­tends.

Chil­dren with autism and other learn­ing dis­or­ders gen­er­ally have prob­lems pro­cess­ing, se­lect­ing, in­te­grat­ing and re­tain­ing in­for­ma­tion to make sense of the en­vi­ron­ment they live in.

Added to that, some also face sen­sory prob­lems which present them­selves as aver­sions to sights, sounds and touch.

Writ­ing be­comes an is­sue, too, for those with mo­tor skill prob­lems.All of which can be over- whelm­ing and chal­leng­ing for the af­fected chil­dren and their fam­i­lies.

This is where cog­ni­tive ther­apy comes in, by seek­ing ways and means to over­come these deficits.

Sub­scrib­ing to Dr Reu­ven Feuer­stein’s the­ory that the brain is mod­i­fi­able given the right stim­u­lus, Hil­fer says the key to cog­ni­tive ther­apy is to re-con­di­tion the brain by teach­ing and re­plac­ing faulty rep­re­sen­ta­tions.

Seek­ing ways to learn how to en­code and de­code mean­ings, re­tain me­mory, or­gan­ise in­for­ma­tion and shape thought pat­terns are in­te­gral to cog­ni­tive ther­apy.

In or­der for the child to have a good foun­da­tion for learn­ing, the ther­a­pist must be adap­tive and ex­pres­sive, shap­ing the lan­guage the child needs for emo­tions.

“The teacher/ther­a­pist must have the right at­ti­tude. You have to be calm, kind, pa­tient, ob­ser­vant, cre­ative and dis­ci­plined. When cor­rect­ing the child, the teacher must be con­sis­tent,” he adds.

“The point is to build up the cog­ni­tive struc­ture that is adap­tive in a way so that we can re­trieve what was nat­u­ral but lost in the child,” he ex­plains.

In teach­ing a child with a learn­ing dis­or­der, there is no short cut. “It is about con­sis­tency and keep­ing the child oc­cu­pied as we don’t want the child’s mind to wan­der,” he says.

That means cre­at­ing op­por­tu­ni­ties for the child to learn and so­cialise in dif­fer­ent set­tings, be it in an art class or in sports.

Ac­tiv­i­ties that in­volve hon­ing skills for plan­ning, or­gan­is­ing, solv­ing prob­lems, fol­low­ing rules and tak­ing care of one­self are part and par­cel of get­ting the child to be adap­tive to the en­vi­ron­ment.

“Cog­ni­tive ther­apy is about build­ing an adap­tive form of func­tion­ing. It starts from a lit­tle win­dow of op­por­tu­nity that can ex­pand. Most of all, never give up and as par­ents, sup­port each other,’ he con­cludes. n Hi­fler can be reached at roland. hi­fler@vtx.ch, www.ed­u­ca­tioncog­ni­tive.ch

One Voice is a monthly col­umn which serves as a plat­form for pro­fes­sion­als, par­ents and care­providers of chil­dren with learn­ing dif­fi­cul­ties. Feed­back on the col­umn can be sent to onevoice4ld@gmail. com.

For en­quiries of ser­vices and sup­port groups, call Malaysian Care (% 03-9058 2102) or Dig­nity & Ser­vices (% 03-7725 5569). E-mail: onevoice4ld@gmail.com.

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