Connecting with a Multidisciplinary Approach

By: Stephanie Magnussen

Although it may seem apparent that a child needs specific help, there usually are many layers to an individual’s needs.  For example, if a child has a speech delay, the parent may request that he sees a speech pathologist.  But why does this child have a speech delay?  Is there is a sensory need that is not being met, or are there developmental delays or behavioral issues at work?  Kids are complicated little people, and it’s important to remember that what we see is only the tip of the iceberg.  It’s really beneficial for a group of therapists to explore what lies beneath the surface to give the child the most effective strategies to thrive academically, socially, and mentally.

Perhaps the short term goals for a child with Autism Spectrum Disorder are maintaining eye contact and increased vocabulary, and the long term goals are independence and integration into a typical classroom.  The speech pathologist will develop activities that increase vocabulary, while the occupational therapist creates drills for promoting eye contact, and the psychologist may make social stories that build confidence and promote more appropriate social behavior.  Just having one therapist would not be the most advantageous for the child and family in this case.  The parents are also part of the multidisciplinary team.  They must be on board with practicing what the therapists are working on and provide a supportive environment for the child to thrive under this team approach.

At Connecting Dots, all of the therapists are registered health care professionals with Master’s level education.  They all work together and share ideas on how to set a child up for success by using each of their expertise.  If a child is exhibiting disfluent speech or a stutter, and therefore struggling socially at school, of course we want to promote smooth speech, but there may be other issues to address.  The child may have motor planning deficits which result in disfluent speech.  The speech pathologist can work on an action plan for smooth speech, while the occupational therapist develops a plan to promote increased ability for the muscles to make the correct movements for speech.  Psychologists are also a key part of this multidisciplinary approach.  Communication is not just the words that we speak, but also our ability to interact with those around us.  Any disability can be stressful for a child, and may result in anxiety and social isolation.  A psychologist can identify activities and games that will help a child excel socially.

As an aide at Connecting Dots, I have been fortunate to work with speech pathologists, occupational therapists, and psychologists and have seen the gains my clients are making by working on each piece of their puzzle.   Every child’s background and needs are so diverse, and an individualized plan with input from different types of therapists allows the team to work on gains for the child in a holistic manner.  It is truly a team approach between the therapists, aides, and family members.

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Story Cubes: A Play Based Learning Opportunity

By: Stephanie Magnussen

At Connecting Dots, the therapists are skilled at creating play based learning activities based on the individual child’s needs.  When learning is play based, the child looks forward to sessions with the therapists and this excitement makes it easier for the child to be engaged in the activity.  Based on each individual’s contract, the therapists will work with the child a few times each month.  I work as an aide, and am therefore with the clients and families multiple times a week, enacting the therapists’ and family’s goals through creative and play based approaches.  I was looking for a game for one of my clients that promoted long sentences, complex ideas, and smooth speech when I found Story Cubes.  Story Cubes are affordable and fun and have been working really well with my clients!

Story Cubes are a set of nine, six-sided dice that have an image on each side.  Each player rolls three to four dice at a time and has to create a story based on the images.  When I use it with my clients, I have a sheet of paper next to us that has the important elements of a story: Plot, Setting, Characters, Conflict, Solution, and Theme.  Based on the developmental goals of the child, theme is optional to include as it can be abstract.  In the first roll, player one must create the setting and identify the main character.  The second roll introduces more characters, and expands on the plot.  The conflict is introduced between the second to fourth roll and the solution is achieved in the fourth to eighth roll.  Of course there can be as many rolls as one likes, but I find that kids can get distracted by too many details, and the stories make more sense when there are six to eight story turns total.  After ever two turns, I refer back to the piece of paper that has the list of important story details and the child recounts what has happened so far and identifies each of the major components of our story.  If I am trying to promote smooth, clear speech with my client, I keep a tally of all of the smooth sentences that are over eight words that my client has said.  I involve the client in this, so it isn’t anxiety provoking for him or her.  I’ll say things like, “Wow!  That was a really smooth sentence!  I think you should make a tally on the smooth sentence side,” or “Take a deep breath before you start your next sentence because it is going to be a long one!”  After a few sessions, I can see the progress of smooth versus bumpy sentences during story cubes when comparing the smooth vs. bumpy tallies.  For older children and when appropriate, after the game is finished, I ask what the theme of our story was.  It is always so interesting to see how creative kids can be and it makes for more speech opportunities to give the client the chance to describe the theme.

Story Cubes have been a great tool to use with my clients because it also allows them to be creative and silly.  It promotes organized thinking because although it is a free flowing game, certain components of the story have to be identified by certain rolls.  Also, the child can’t just create a nonsensical story.  I make sure to check in with him or her after ever two turns so that they have a clear understanding of what is happening in the story and what needs to happen to reach a resolution.  I make sure to remind each client before his or her turn to take a breath and think about what they are going to say and how each story cube will relate back to the story itself.  This has been a great game for kids that are having trouble expanding on ideas, creative writing, are exhibiting non fluent speech, or need help organizing their thoughts or with memory.  I bought mine at Wal-Mart, but there are lots of options on as well!




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The Importance of Serve and Return

By Simran Saroya

We all know that a child needs nurturing relationships to help them grow but to what extent does a child need the caregiver there? The basic concept of serve and return will explain how important it is for the caregiver to be present AND engaged with the child.

What is serve and return?

Serve and return is about building relationships and strong brain foundations. During serve and return, the child’s brain is forming many connections. These connections start very early, as soon as the child “coo’s” and the adult responds to the child. The child may serve using various forms of communication such as: eye contact, touch, through games or verbal cues. This serve is an indicator that the child is interested in something or that they want to engage in an activity. Think of it as a game of tennis, where the child serves the ball and the caregiver receives the serve and then serves back.

Why it is important:

Healthy brains are built by forming healthy foundations which all start with daily human interactions. Being present physically and emotionally will benefit the child and strengthen the relationship between the parent and child. Staying attentive and responsive to the child’s needs helps the child make and build strong and solid foundations for brain development. These strong foundations will help build strong relationships as well as better the child’s learning and understandings. Always keep in mind that these interactions must be positive, meaningful and directive to help create strong brain architecture within the child’s brain. Emotion, visual, language, memory, motor skills and behavior control all depend on the neural connections the child makes while engaging with their caregiver. For example, if your child has picked up an animal book and has brought it over to you, that is their serve. The adult can then take the book and read it to the child or go through the pictures with the child, which is then returning the serve. It is as simple as paying attention to their interests. This will lead to more learning and more experiences. Being responsive and acknowledging the child’s interest in wanting to read that book will lead to recognition of letters and reading.

Negative factors:

Sometimes we forget that engagement from a parent holds so much importance especially among the young children. A parent may be exhausted from a day at work and not think twice about what their five-year-old is bringing over to them. This disrupts the relationship building, instead of avoiding the child or being passive about it, acknowledge that they have brought that story up to you and set aside a better time to read it together. Being enthusiastic and interested in what your child is interested in will help build a stronger connection. Putting the child by a computer screen or TV will hold their interest and have them engaged but will not build healthy brain development. This is called passive communication, where you may be present but not fully engaged. There may be barriers that sometimes permit the serve to be responded to such as a phone call or text but there is a difference between being responsive and distracted or just being unresponsive. Passive activities will not build healthy and strong brains. Our goal is to build healthy brains.

Children need positive interactions and positive environments around them to thrive. It is our job to ensure that the children in our life have adults who consistently engage in serve and return with them to build healthy foundations in the brain for all their learning, behavior and health in the future.

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Connecting with OT

By Tammy Cheng

“What is Occupational Therapy? Do you help people find jobs?” These are the questions I get asked the most when people ask me what I do, or they may just agree in silence pretending they know what Occupational Therapy is.

Occupation is not just about work or productivity. It is anything we do that occupies our time! Think about what you do in a day… you get out of bed, brush your teeth, make breakfast, drive to work, go to school, meet your friends, go to yoga classes, play sport, and the list goes on. These are some of the occupations that are meaningful to us, and the list looks different for everyone. Now think about a person who is wheelchair bound or has a mental illness. Getting out of bed may seem impossible; the sink or the counter may be too high and not accessible; how is he/she getting to work or school? How can he/she participate in sports? This is where Occupational Therapy comes into play.

Occupational Therapists (aka. OTs) help people of all ages to do things that they want or need to do regardless of their abilities. We help people function in their environment and address the physical, psychological, and cognitive aspects of their well-being. Some common Occupational Therapy interventions include helping children with disabilities to participate fully at home, school and social situation, helping people recover from injuries and return to work, recommending strategies at workplace to prevent injuries, and supporting seniors with physical and cognitive limitations to ensure they live life to its fullest.

What do OTs do at Connecting Dots?


OT services at Connecting Dots focus on enabling children to participate in meaningful activities through play. We help children with:

  • Cognitive skills – remembering letters, shapes and sequences
  • Fine motor skills – hand writing, finger and hand strength, wrist and forearm control
  • Gross motor skills – balance and body coordination
  • Self-care skills – dressing, toileting, feeding, sleeping, routines
  • Social skills – play, taking turns, sharing, listening, following directions
  • Sensory regulation- responding appropriately to your environment and experiences

We work closely with other team members to provide you and your child with coping strategies to deal with day-to-day challenges. Every child is different and we tailor the goals around your needs. We help you problem solve and put the FUN into functions!

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What influences my child?

By Simran Saroya

The world of a child is just as busy as the world of an adult. Sometimes we forget how many factors a child has to take into account while going about their day. It is important to understand that the child is influenced by many things outside of their immediate environment. Well, how is the child’s development effected by the people and world around them? Let’s take a look at the Ecological System’s Theory. The concept is simple. It is a model that is made up of five systems. These five systems are the microsystem, mesosystem, exosystem, macrosystem and chronosystem. They explain how everything inside the child and the child’s environment affects their development and growth.


So, in a child’s microsystem they might have immediate family, caregivers, teachers or peers in environments such as their home, daycares, schools and more. This system is the most influential on the child. These are the people and places involved in the child’s everyday life. In their everyday life, there are settings where a child may feel a sense of security, comfort, happiness and love. It is crucial to recognize that the environment that you provide or choose for your child, supports the child’s physical, emotional, social, and cognitive development. In the world of play, there is a lot more going on than what we see.


The second system is the mesosystem, it is simply two or more microsystems and their relationships. This will have indirect impact on the child. An example of as the relationships between the child and the child’s teacher. Parents may take an active role in the child’s school life by taking part in parent teacher conferences and volunteering in the classroom. This will be a positive impact in the child’s life because his/her microsystems are working together. This could also be a negative impact if the microsystems were working against one another instead of together. This is why it is important to have all supports and people in the child’s life working together to ensure all responses are positive.


The third system is the exosystem. This system looks at external factors and how they influence the child such as the parents job or neighborhood influences. A parent’s promotion or loss of a job may not directly influence the child, but will have an indirect effect. If the father of the child is very busy and tends to come home really late from work and doesn’t have time to spend time with the child, this will have a negative impact on the child. The child might start to feel sad, anxious or guilty.


The fourth system is the macrosystem, this system is a part of our “bigger picture”. This includes cultural aspects and all other influences in the child’s life. Some examples of the macrosystem are: the economy, cultural values and politics. These factors can have a positive or negative impact.


Lastly, the chronosystem talks about the time in relation to development. This could be something such as the death of a parent. Now, your two-year-old will react differently to this than a teenager would. They might not know exactly what is happening or understand it as a child but they may have an empty feeling inside. This could also be growing up in different historical events such as war. This is uncontrollable and just dependent on the time and place you are in.


All five of these systems go hand in hand in the growth and development of your child. Being aware of the external influences as well as internal will not only help benefit your child but also help benefit you.



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