Teaching the 5-W-H Questions: Part 4

By Christine Marchant

If you have read my previous posts, you’ll notice that I have a system for teaching 5-W-H questions.  Levels one through three deal with concrete who, what, where, when, why, and how questions, while level four is concerned with asking the child about what can happen in the future.  It’s quite easy to teach the first two levels.  When the child becomes more aware of their world, and isn’t easily entertained by the simple flash cards or photos, the teaching becomes more challenging.  I find that they are now more interested in the games.  I like to try plenty of new games to test the child’s interest and to see if the game will match the goal.  We play the game at least three times with no target goals.  This is how I build the interest and desire to play the game.  The goal here is to create a strong desire to play the game.  At this level, it’s the game and the interactions with the people that keep the child involved and wanting to cooperate.  It doesn’t matter what the game is, as long as you explain to the child that the reason you are doing the sessions is to help the child achieve the targets.  Hopefully, at this level, you’ve already created a relationship of trust and honesty.  This is my favorite level of the relationship with the child because they are opened enough to actually understand why you are spending the time with them.  They are usually enthusiastic about achieving their goals.  I explain to the child that we play the game with no targets and then when we really enjoy the game we add the targets.

While playing the games, I use a LOT of WE, US, OUR, and TEAM WORK language to motivate the child and let her know that we are working together.  The language you use will determine the attitude of the child.  They LOVE to take ownership of their learning.  By this level, they seldom resist doing their “work.”  The games are now a fun way to make the sessions go faster.  They may MOAN and GROAN or ROLL their eyes, and declare “you’re the meanest aide EVER!!” BUT, it’s all said in laughter and good cheer.  If you have a good relationship with them, you play along, then say, “OK! Let’s get down to business, and get it done. ” If you don’t have a relationship with the child and are just jumping in, don’t start at this level!!  If I were to start teaching the 5-W-H without knowing the child, I would ALWAYS start at a lower level and see where the child is, then move up the levels, in the same order,  at the speed that matches the child.  This level is based entirely on trust and a relationship with the child.

Teaching what happens after is the trickiest part for children because it requires abstract thinking.  It’s been proven that we can envision the past easier than the future.  The future is difficult because it can be any possibility.  The past now seems more concrete than the future because it’s easier to prove.  If you have one of those children that LOVE to argue and declare that a dragon has super powers and can possibly run for government in the future, LET IT GO!!!!  Don’t argue with the child, but try to remember the goal!  At this point, the goal is opening their minds to future possibilities, not to debate what the future actually can be (natural consequences will take care of that).  Here is my method:

1) Find books and tons of photos that show a ton of details.  I use books, flash cards, random photos, even advertisement photos.

2) Bring out their favorite game and lay the photos beside the game.

3) At this level, the child already knows the expectations.

4) Start the game.  The first player looks at the picture and describes what she sees.  This is important because this gives the story as they see it.  It’s concrete, so use concrete language like “the people are in the boat”, “the dog is in the water”, or “the waves are huge”.

5) All the players look at the picture, then agree or disagree with the player’s description.

6) The player then says what the possible future may be.  Using the language, “I think the waves will push the boat over”, “I think they will rescue the dog”, or “I think the people in the boat will be beamed up by aliens”.  It doesn’t matter what the child says.  The goal is not to correct the child’s idea of the future.  The goal is to have the child be flexible in their thinking.  If it’s dark, you can leave it, or have your version of the future when it’s your turn.  Do NOT correct the child during their turn.  It’s their turn and you can damage the relationship if you are constantly correcting the child on their turn.  Save that for another goal, at another time.

7) When the child is finished predicting, the turn is over and they take their turn playing the game. Often by this level, the interest can be more into the predicting than playing the game.  If the child wants to go on and on with their predictions, let them because the game is not the goal.  This does not go on for hours.  Whenever you choose to teach a target, you choose the system and how long it will last.  You can set the expectation as an open ended game, which is with a timer, or closed ended one, which is with the number of turns.

8) I alternate between the open and closed ended.  We seldom ever finish the game at this level, which is not a big deal.

9) Never let the game go for more than ten minutes for the very young, and fifteen for the older children.  Put on the timer, and when it goes off, you say, “Do you want the game to be over?” or “Do you want to play for another ten or fifteen minutes?”.

10) If they choose game over, you can smile and say it was a fun game.  If they choose to play, set the timer.  If they want more, you tell them that you will play it at the next session, and then keep your word.

This is the end of sharing how I teach 5-W-H questions.  In the future, I will share the different approaches I take.  The system always stays the same, but the approach and materials change.  As I said in earlier posts, I’m not a therapist or have formal education in teaching.  I am a mom for thirty-one years and have lots of experience with children from parenting and running a private day home for twenty years.  I was also a nanny in between and during doing those jobs.  I have also been a child development facilitator for five years.  I hope you enjoyed my posts, and found at least one tip to help you teach the 5-W-H questions!

 

 

Teaching the 5-W-H Questions: Part 3

By Christine Marchant

If you read my previous posts, you’d notice that I have a system to teaching the 5-W-H questions.

By the time the child has surpassed level two and is ready for level three, he is not impressed with the ‘preschool’ attempts.  The magnetic fishing and the Caribou games no longer hold his interest.  Using basic pictures will often bore him to death!  There is no right or wrong way to teach, but the best way is to match your system to the child’s learning style.  It is important to observe if the child is an active or passive learner.  The active learner loves games and action. The passive learner prefers work sheets, scrabble and card games etc.  I have watched many therapists teach the 5-W-H questions to children.  Most of them are for younger children, I have had a few older children that are a bigger challenge.  The little children are happy with ANY game you come up with, while the older ones are more tricky.  With the older children, I find just saying: “this is our target—this is what we are doing and when we are finished, then you can play your game” is the more effective.  We set up their favorite game, then we do “target” then your turn, “target” then your turn.  My rules are that we do two cycles of “target’ games, then we do one game “free style” game.  Free style is playing the game any way the child wants to.  It’s ok if the child rigs it for them to win EVERY TIME!   I don’t care!  Just get the child hooked.

Teaching before and after is often a challenge.  It’s vague and abstract thinking.  It’s been proven that we can envision the past easier than the future.  That’s why I teach “before” first.

1) Find books or photos that show a TON of details in each photo.  I use books, flash cards, and random photos saved on to my Ipad.

2) I bring out their favorite game, then the photos.

3) At this level, the child is already hooked into the program.  The first player looks at the photo, and describes what is in the photo, then says what he thinks might have happened just before this photo.

4) The other players can agree or disagree.  This opens an interesting conversation.

5) Follow the same pattern that I shared in the previous posts:

What do you suppose happened before the girl fell off her bike?

Who do you suppose she was with?

Why do you suppose she fall off the bike?

Where do you suppose she was?

When do you suppose this happened?

How did we come up with the “before” information?

6) When all players are satisfied with the answers, the player takes their turn.

7) By providing their favorite game, the child is usually motivated to do the “work”.

8) Sometimes, at this level, the child finds it difficult and tries to avoid the “work”.  If this happens, just sit quiet and say, first we do the “target” then you can play the game. The desire to play usually is enough.

I find it very rewarding to see the children go on this journey.  I love seeing the look of amazement and understanding in their eyes as they become more aware of their world.  I decided in high school that I wanted to work with children and I’ve enjoyed every year.  I have one more post on this topic, which involves teaching “after” and then I move on to teaching other aspects of language.

Teaching the 5-W-H Questions: Part 2

By Christine Marchant

I am sharing my experiences as a mom for 30 years, a Day Home Provider for 20 years, and a Child Development Facilitator for 5 years.  The first post in this series was sharing the first basic level of how to teach the 5-W-H questions, which are “who, what, where, when, why how” to a child.  If you read my earlier post, you would have read one of the ways I taught the 5-W-H questions.  There are MANY different ways to teach it.  This is only one of the ways I found to be successful.  If the child doesn’t have that basic level of understanding, trying to teach any higher level is possible, but is more difficult.  Exposing the child to “social thinking” is a tricky thing to teach…. Ok, it actually isn’t.  I was finding it complicated, until I realized that I’ve been doing it for years.  Today, I have chosen one of the many ways.  I decided to stay with the formula I wrote about previously.

Level two deals with more abstract ideas and requires a little more effort and preparing than level one.  It is important to pick one system or formula and stay with it throughout the whole journey.  Children like patterns and like to know what is expected and it’s more consistent.  When choosing what approach you will take, you need to know what type of learner the child is and what will keep their attention.  An active learner prefers games and action and a passive learner enjoys worksheets, using dry erase pens, etc.  The next important step is to assess what level the child is.  ALWAYS teach at the child’s level.  The next step is to always teach responsibly.  No one knows what someone else is feeling or thinking etc.  This is why it drives me CRAZY when I see an adult saying, “what is the boy thinking?” or “What is he feeling?” or “where is the boy?”.  The first level, you can do this.  It’s concrete, and that the level the child is.  After that, I prefer to say, “What do you suppose the person is thinking?” I try not to tell the child that a picture is a boy or girl.  I try not to label the gender, but instead follow the lead of the child.  If the child insists the child in a dress is a boy, I don’t correct him or try to convince him it is a girl.  (I gloss over it) because It’s not my place to enforce my opinion on to the children.  Keep the goal in mind!!  We are teaching 5-W-H not genders.

I found looking at simple photos and asking the 5-W-H questions gets stale FAST!  The child gets bored easily.  They are very clever.  Not all the 5-W-H questions are relevant to every photo.  I prefer photos with LOTS of details and actions.  Sometimes all questions are not applicable to every photo.  My favorite way to teach is through books.  I go to a thrift store and for $1, I buy books with a lot of expressions and emotions.  I glue blank paper over ALL of the typing.  YES!  Deface that book!  Then I look at each page and type out my own 5-W-H questions that are relevant to what the picture is showing.  This sounds like a lot of work, but it really isn’t.  I just glue on the level I’m currently teaching.  I then add more questions as the child achieves their goals.  I start one level at a time.  You can use the same book for the entire journey.  Don’t put all the levels at once.  In level 2, we are exposing the child to “what is the person thinking” and “what is the person feeling.”  You can use different books, every child has different interests.  You can put your books in your tool box and pull out different books, as long as you stay with the same system.  Keep the “thinking” questions to the left page and the “feeling” questions to the right page.  Stay consistent.  This comes in handy when you have an active learner.  I will describe the games I use for my active learners at a later date.

Here is an example of the book I made this week for my older child:

I covered the original story, and I typed “thinking” questions on the left page.

What do you suppose the Mom is thinking?

What do you suppose the child is thinking ?

Why do you suppose the Mom is thinking?

Why do you suppose the child is thinking?

Who else may be thinking ?

Where do you suppose they are?

When do you suppose this is happening ?

How can you tell Mom is thinking?

How can you tell the child is thinking?

You can talk about their expressions, or how the body is showing what they may be thinking.  Look!  The Mom’s eyes are large and round, her hands are in the air, etc.  What do you think she’s thinking about? Etc.  Then on the right page, I typed “feeling” questions.

What do you think the Mom is feeling?

What do you think the child is feeling?

Who else may be feeling?

Why do you think the Mom is feeling?

Why do you think the child is feeling?

Where do you suppose this is happening ?

When do you suppose this is happening ?

How can you tell Mom is feeling?

How can you tell the child is feeling?

There are no right or wrong answers.  I use this as a conversation starter and encourage a discussion or even debate about what the character is feeling.  As we go along the journey, this easy going approach has the child feeling good and positive about sharing ideas and debating each person’s opinions etc.  This teaches the child that other people have their own thoughts and feelings and they are sometimes different than what the child believes.

At the first glance, it looks like it isn’t teaching social thinking.  “Ask your Mom, how are you.”  “Ask your brother why he is crying,”  etc.  I found the child wasn’t able to do that in a genuine inquiry.  They ask that because they are taught to ask those questions.  You take a book, and you are ‘discovering’ these questions.  There are no right or wrong questions and answers, but a genuine conversation happens.  It is an exchange of ideas.  The child’s awareness blooms and they are genuinely interested in the people and things around them.

The next post will be sharing my experiences in teaching the 5-W-H before and after the picture we are looking at.  Exposing the child to an even deeper level of thinking about what could have happened earlier to cause this person to be thinking___ or feeling____.

Teaching the 5-W-H questions: Part 1

By Christine Marchant

Teaching the 5-W-H questions (who, what where why and how) is different for each child. At least, that’s what I thought, until one day I realized that I’ve been teaching it for several years.  I discovered that the verbal level of the child does not matter.  I have a child who is not much higher than “non verbal.”  She is very intelligent, but is unable to express herself.  Without realizing it, I actually taught her the 5-W-H questions.  I sat down and started to write down the formula I used.  I then tried it on my preschool boy, and he got it!  I then tried it on my other preschool boy and he got it!  I was amazed!  I wrote out the formula step by step, and next week, I will try it on my older boy.

I’m not a speech pathologist, but I do have decades of experience raising children, and 5 years experience as a child development facilitator.  I am on many full service teams.  I am only sharing my experience working with many therapists and children.  This is the formula that works for me.

The 5-W-H questions can be very difficult to teach because they are abstract and can be a challenge for children and their support aides.  I started with the most concrete and easy W question, and then worked up to the most abstract and difficult questions, which are WHY and HOW.  Children will move through these steps at different speeds.  The amount of time isn’t the goal.  The goal is to have the child concretely understand the question and why and when to use it.  Stay with the formula and repeat as often as needed.  If the child ‘loses their grasp’ of the knowledge, just drop back one step, do a quick review, and when it’s concrete again move to the next step.  Don’t change the order or the formula.   Just go forward and backwards.

My girl took 3 years, my preschool boys took weeks, and my older boy will most likely have it mastered in a few sessions.  Go slow and stay faithful to the formula.  Do not move to the next level until the previous levels are set, concrete, and consistent.  Once the child knows the formula, you don’t need the visual.  I use the visual for my girl because she’s still almost non verbal and LOVES to print her thoughts.  The visual helps her remember where each answer belongs.  Once the child is consistently responding correctly to each question, you can mix them up and be creative.

On a sheet of paper, create 6 columns and in each column, print the 5-W-H questions allow enough space to print at least 4-5 words.

___________________________________________________________________

WHO                       WHAT                WHERE                     WHEN                 WHY                  HOW

___________________________________________________________________

I like to use a set of 24 photos.  Use 6 at a time- 3 turns each.  I keep it to 10 to 15 minutes per activity.

I repeat the activity twice.  Then put it away, I do this twice a session.  It’s more effective to teach shorter lengths of time more often than longer times, less often.

Leave the columns blank and laminate the sheet.

Level 1

  • Only ask WHO and leave the rest of the columns blank
  • WHO is riding the bike?
  • Do this for each photo, the adult should go first to model the correct response.
  • Take turns until the 6 photos are done.
  • Stay on this level until the child is consistently responding correctly

Level 2

  • Only ask WHO-WHAT and leave the rest blank
  • Do this for each photo, and the adult should go first to model the correct response.
  • Take turns until the 6 photos are done.
  • Stay on this level until the child is consistently responding correctly.
  • WHO is riding the bike?
  • WHAT is the boy doing?

Level 3

  • Only ask WHO-WHAT-WHERE and leave the rest blank
  • Do this for each photo, yougo first to model the correct response.
  • Take turns until the 6 photos are done.
  • Stay on this level until the child is consistently responding correctly
  • WHO is riding the bike?
  • What is the boy doing?
  • WHERE are they riding the bike?
  • Follow the same steps as level 1 and 2

Level 4

  • Only ask WHO-WHAT-WHERE-WHEN
  • WHO is riding the bike?
  • WHAT is the boy doing?
  • WHERE are they riding the bike?
  • WHEN are they riding the bike?
  • Repeat the same steps.

Level 5

  • Only ask WHO-WHAT-WHERE-WHEN-WHY
  • WHO is riding the bike?
  • WHAT is the boy doing?
  • WHERE are they riding the bike?
  • WHEN are they riding the bike?
  • WHY are they riding the bike?
  • Follow the same steps

Level 6

  • Only ask WHO-WHAT-WHERE-WHEN-HOW.
  • WHO is riding the bike?
  • WHAT is the boy doing?
  • WHERE are they riding the bike?
  • WHEN are they riding the bike?
  • WHY are they riding the bike?
  • HOW are they riding the bike?
  • Repeat the same steps.

The Real Life Experience of Sensory Processing Disorder

By Alyssa Neudorf

The first question most people ask is, what is sensory processing disorder (SPD)? I would describe it simply as processing the entire world differently. A person who is partially sighted or hearing impaired will process the information coming to those senses in a different way from someone with typical vision or hearing.

What does this mean for me? As a person with SPD, it means that I process all the information coming to ALL of my senses differently, more intensely and all at the same time. Most people have the luxury of blocking out repetitive stimuli like the clock ticking, the clothes you are wearing, the smells in the air and, the chair you are sitting on while reading – this is not something I get to do. I am aware of everything all the time.

When all this intense and repetitive information becomes too much something called sensory overload is reached. Sensory overload can look and feel different for each individual person. For me, it is something that happens suddenly. I am fine until I am not. I begin to feel very warm, shaky, things start to dim around the outside of my eyes. My brain starts to try and leave my body making it very, very hard to speak or move without help. It feels like there is a tonne of bricks stacked on my vocal cords and the signals to legs are slow or blocked. Mentally I know I can speak and I can move but making that happen is very hard. It is at this point that a simple question, touch or surprise will trigger a meltdown. People will often ask “what do you need?”, or “what can I do?” The problem is at this point I don’t know and if I do I can’t always tell you. I can’t think and I feel frozen and stuck with everything spinning, flashing and pounding away around me all while becoming more intense. Then hyperventilation kicks in.

Sound exhausting and painful yet?

Having a schedule and routine helps me to plan out my sensory energy for the day. There is only such much I can do with 20 tokens and everything in your days takes different amounts. Getting dressed, eating, school, being social, going outside, tying your shoes, and taking the bus just to name a few. As a result, I can’t drive yet even though I would like to, don’t go shopping much, I wear certain clothing, most of my shoes don’t have laces (those that still do will be replaced with elastics), and I only wear specific socks. Clothes shopping is a big challenge and thus is avoided and is only done on a day when I don’t have to do anything else that day.

That is just a small window into the life of one person with SPD. It is different from person to person. Hopefully this article has helped you gain some understanding of what it is like to have SPD.

The Importance of Indoor Play

By: Simran Saroya

Sometimes we feel that it is easy to hand our children the iPad or phone to keep them occupied. Even on a snow day or a rainy day there are ways to make these situations positive interactions. Giving them a phone or tablet is easy but not the most interesting choice for your child. Indoor play can consist of more stimulating, fun and active play that will help your child’s brain develop.

When we think about indoor play, we talk about roleplaying, games and engagement opportunities. If you are baking cookies, having the child present and engaged is a form of play for them where they can use their senses and create something new. When thinking about play we should consider all five senses: look, listen, touch, smell and taste. Where can my child use these five senses with me?

Through play children are able to create healthy brain architecture which allows them to have better peer social interactions, use their imagination and creativity and engage with the world around them. Play is so important for children; it is the foundation to all the learning that is going to happen here on forward.  Play can also strengthen physical, emotional and cognitive strength within the child.

Now indoor play, how do you play inside on a rainy day or a day where the outdoors is not easily accessible? Here is a list of things you can do indoors with your child!

  1. Board games
  2. Scavenger hunt
  3. Make slime!
  4. Cook with your child (cookies, jello, rice krispies, or even prep for dinner)
  5. Read stories
  6. Visit an indoor play place (Telus Spark, Glenbow, swimming, Calgary public library)

Let your child take the lead and have them decide what they would like to do indoors with you or with a friend. This way the child feels a sense of independence in choosing an activity or game. Children create and preserve friendships through play therefore indoor and outdoor play are both essential in a child’s growth and development.

Understanding the benefits in your child’s play can be a bit confusing. Play fosters cognitive growth meaning that is essential for healthy brain development. Sometimes we believe that play must have a goal behind it, a structure to it. In reality, free play positively affects neurological connections by making those circuits in the brain stronger. Free play will allow your child to build communication skills, self-confidence and intelligence. Through play children become less anxious and more resilient to deal with real life situations. Once the adults in the child’s life understand how important it is to play, the child will benefit and the adults will benefit. Promoting play as quality time spent indoors will strengthen your relationship with your child and allow for meaning making and a world of connections to be brought to the table. It is amazing what their little minds can come up with!

Hooray for reading with your child!

By: Stephanie Magnussen

Most parents know that it is important to read to their children.  Many parents do this naturally before bed even when their children are very young.  Children crave language and pick up on so much of what parents say in conversation during the day, but book reading is another opportunity to add words and phrases that may not naturally occur in everyday speech.  This exposure to language adds variety to the input kids are getting on a daily basis and can increase their language abilities.

The more you read to your child, the more language she will potentially acquire early on.  When parents read to their child, they use more diverse vocabulary and rephrase sentences in different ways, exposing children to varied sentence structure.  We have all noticed that as we get older, it gets harder and harder to master a new language.  Children learn an entirely new language within their first few years of life without even realizing they are mastering such a complicated skill.  During these impressionable years, it is important to expose children to not only lots of vocabulary, but different ways of saying things.  Books give parents the opportunity to get out of their daily way of speaking and add some different flavor to the language they are exposing to their children.  It also gives kids the chance to directly engage with the words and phrases on the page.

There are easy principles that can be applied to the way a parent reads to this child that can promote language development.  This method of dialogic reading can be used for typically developing children as well to increase language skills!  Parents can and should start reading to their children as early as eight months to aid in their language development.

  1. Guess the plot of the book after reading the title. The first time you and your child read a book, read the cover page to your child.  Encourage her to guess what the book could be about and take your time talking about this.

 

  1. Point to the words on the page as you read. Once you have read a book to your child one time through, point to the words as you are reading them.  You can name some of the letters and identify which one is the same as the first letter in her name.

 

  1. Expand on your child’s sentence. If a child says “blue,” the parent can respond and say “Yes, the kite is blue and so is the sky!”

 

  1. Model, model model! If a child cannot answer the question, simply say “That is a kite.  Can you say kite?”  This will instill a sense of accomplishment when they can repeat or attempt the word even if they were not able to find it the first time.  Then, later on, when they have learned the word, give them praise!

 

  1. Pause reading and respond to what a child is interested in on the page. Sometimes a child will point to or name something while a parent is reading.  Pause and expand on this by giving context to what she has named.  For example, “Yes, that is a kite and we can fly kites on windy days.”  This is also a good opportunity to talk about the story.  You can ask, “Remember when he flew the kite?” or “Have you ever flown a kite?”

 

  1. Prompt your child to read with you. Leave out the last word in a sentence and encourage your child to fill it in.

 

  1. Have fun! Reading can be free flowing with pauses to talk about interesting things on the page.  Parents can engage a child by asking her to help turn the page, encourage turn taking by pointing to objects and naming them, etc.  There should not be any pressure associated with reading and children should feel encouraged.  Make reading into a game or activity that you can share with your child!

 

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.