Friday, January 29, 2010

Hear Them Out - The Star newspaper

This appeared just last week, and was very timely cos my son's in the 5-year-old class. I agree with a lot of what she says because I see it first hand!

“Do your work properly. No talking in class.”
At least in my son's class, the teacher is a bit more understanding than the other two classes. Kids are allowed to talk while doing their workbooks...quitely and for a short while anyway! My son's class would be considered chaotic compared to the two other classes! In the other classes, I hardly hear the kids and they're very often seated quitely in their chairs (a bit like robots). I'm not saying one teacher is better than another. Each have their strengths and challenges I'm sure ...and my son's class has FOUR other challenging kids excluding my son and excluding the girl I talk about below. It's just that we've passed the first decade of the new millenium and we're still using the old education model?!

"losing the Bill Gates, Picassos, Montessoris and Albert Schweitzers of the future".

There's a girl in his class who's different from others. She usually doesnt sit with the others and pay attention to the teacher, nor repeat what the teacher asks the kids to repeat. She knows her stuff. She also sees things differently. Today, she picked up a tiny piece of scrap paper (about 8cm x 1mm), showed it to me, then said something to which I didnt pay attention to (cos teacher was teaching and I didnt want to get into trouble for encouraging her to talk!). Shortly after, she showed me that piece, but twisted up, and shaped into a "toy" walking cane, and she confidently started her story about it. She seldom talks to her peers. When we were about to go home, she peeled off some paint from the door (!), twisted it a bit, and said it's the bird that she had said earlier that she wanted to give me.

I had noticed this girl back during the holiday programme, but thought that she had behavioural issues as the teachers were struggling to get her to do what they want her to do. Teachers were using a harsh tone with her a lot then. Now, I see her in a different light. She was probably really bored and hence 'acting up' cos the holiday programme was more like baby sitting. I think her potential has been overlooked by the school. I'm not blaming the school, mind you. It's just so sad to see that potential wasted! Refer to the paragraph in the article below about "losing the Bill Gates, Picassos, Montessoris and Albert Schweitzers of the future".

Wednesday, January 20, 2010

Childwise by Ruth Liew

Hear them out

Young children are active learners with unlimited potential.

LOOKING at five-year-olds and six-year-olds sitting in rows of desk writing away in their workbooks makes me wonder how little we know about their potential. If we really respect children for their ability to think and value their ideas, we would be sitting down with them and asking them what we should do instead.

Most teachers and parents consider conversations with children frivolous and a waste of time. After all, what do children really know at such a tender age? The adults should be the ones deciding what they should learn and how they learn.

It is sad to note that almost a decade into the new millennium, we still have so little trust in young children as active learners. If we focus on what they are paying attention to, we will learn that they are serious about their learning. They do have ideas that matter a great deal.

The adults in their lives – parents and teachers – want to make sure that they learn and develop the intellectual skills that they need in life. They teach children to “bark” at print rather than to enjoy reading.

During one parenting seminar, a mother asked me: “How many hours in a day should my child spend on reading before he makes the breakthrough to knowing how to read independently? Should I send him to additional reading classes after kindergarten?”

Learning to read takes more than just drill work or learning the sounds to make words. Children have to gain many experiences first before they start to master the ability to read and write.

One six-year-old boy proudly read in English, the title of the book I was holding at storytime. After reading aloud the title, he turned to me and said in Mandarin, “See, I can read.” When I asked him to speak to me in English instead of Mandarin, he turned away without saying a word.

This little boy, like many of his friends, had his head filled with information deemed important by the adults who control their lives. He learned how to read but he did not fall in love with the language.

Before they can read, children need a chance to mess around and to experiment. They need to delve in meaningful conversations with adults to share their ideas and opinions. Give them opportunities to reflect on what they know and what they think. When they realise that they can use writing to express themselves, they will happily do so without much persuasion from adults.

This kind of teaching and learning is not happening in many preschool settings.

When I saw a five-year-old child holding a pencil and drawing a line between one picture to another, I wonder what was going through his mind. He could be thinking about the cartoon character that he liked so much. Or he could have quite a bit to say about his visit to the zoo during the weekend.

The little boy turned to his friend sitting next to him, who was drawing circles instead of lines. He muttered something to him and both of them ended up laughing. The teacher walked over and reprimanded them: “Do your work properly. No talking in class.”

The mind of a child has unlimited potential. When we do not value individual differences or accept the ideas that come out of children’s interest, we lose the Bill Gates, Picassos, Montessoris and Albert Schweitzers of the future. Montessori believed that no teacher could teach a child what he can learn for himself. Our role as adults, their teachers and parents, is to support their learning.

We provide them with the right tools and opportunities to learn. We should not force them to learn when they are not ready or get them to merely follow what we set out for them. Just because children’s ideas are not part of the curriculum planned, they are far from being unimportant. Their ideas can help them build a bridge from existing strengths to new learning.

Inspire your child - The Star newspaper

This article appeared in The Star newspaper back on 12 July 2007. I had saved the article. I have a few more articles to share in my blog. You see, I'm trying to organise my newspaper clippings that I've kept all this while. By sharing them with you now, I'm also refreshing my memory. I inserted the yellow highlights as those "spoke" to me. I hope the yellow highlights do not turn out to be too distracting.

It is important that parents raise their children to be successful in life, as well as to be good people.

WHEN asked what they want for their children, most parents say that they want them to be happy. This sounds simple but, sadly, many children who are indulged by their parents are not happy. They have to live up to their parents’ expectations, with little thought for their own dreams.

Their parents want them to be independent and to stay tuned to their expectations. Most parents work hard at getting children to do what they want them to. It is not surprising; therefore, that many children find learning a chore and feel uninspired.

Having good grades and staying at the top of the class are two common objectives that children state, when asked what they want in life. While some parents and teachers believe that there is more to life than just school, children are not convinced. They dare not be different from others. They want what others want. The problem does not lie with the other children. It is their parents who groom them for the rat race – to do well in their studies and collect paper qualifications.

Inspiring children goes beyond teaching them. Learning should be a process. We only enjoy learning when it is fun. Unfortunately, many people do not have positive learning moments in school. Instead, they recall the pressure of exams and of having to answer the teacher’s questions correctly, and handing up homework on time. However, some have good memories of a particular teacher who put in the extra effort to make lessons interesting.

Does your child open his books only during exam time? Then it is time for a change. He must have passions in life, even if he is as young as eight. He ought to have a role model – someone who inspires him to contribute to society and do well. It is important that parents raise their children to be successful in life, as well as to be good people.

Parents are their children’s role models. For children to be convinced that their parents are good role models, the adults have to be genuine in their thoughts, values, feelings and actions. Children can see through feigned behavior. They become disappointed when they realize that their parents don’t do what they tell their children to do.

Instead of yelling and shouting at or scolding children for not doing what they should do, parents should inspire their children to do better by creating an environment of support in which children can develop their own ideas, take chances and express their opinions and feelings. Most of all, children should feel confident so that they develop into strong individuals. Parents need to know what their children understand and are interested in.

When conversing with a child the parent should also listen to what the child has to say. Children have ideas and opinions that are worth listening to. They need to be encouraged to listen to their hearts and trust their inner voices.

Talk to your children about your values and beliefs, and how they help you to overcome obstacles and face challenges in life. Tell them about the people who inspire you. Your children’s minds will be freed from the limitations they think they have. Once children dare to take on challenges, to be different and to go the extra mile, they will find success in all that they set their minds on.

Parents often feel it is necessary to tell children what to do and what not to do, such as not taking drugs or having pre-marital sex. Parents always remind children of how many mistakes they have made and remind them not to repeat those misdeeds. Yet, they hardly speak of things that appeal to the child’s good nature. Many children do not know they are good.

Most parents tend to fill their children’s minds with doubts. They fail to help them understand that they can be their own teachers, that they are not just learners. Children are inquisitive and not lazy. They want to try things out rather than wait to be told what to do. They listen attentively to the stories that adults tell them so that they can look forward to the future, having understood what happened in the past.

If children’s minds are packed with positive ideas and inspiring stories, they will be able to do their own problem-solving. Adults forget that the human mind is more versatile than anything else in the world. With an inspired mind, the child will grow confidently, knowing that “the sky’s the limit” and anything is possible.

- Ruth Liew, 2007

Thursday, January 28, 2010

Be still

Be still...

Just be still...

There is a time and place for everything, so just be still

I need to learn to be still

Infant CPR Programme

KPJ Damansara Specialist Hospital started running a course for parents and childcare providers - Infant CPR Programe. I wish I had known about this course when he was born. Still, I think it's a very important skill to learn even now for me. They said that it's still relevant for young children (4yrs old) and not just for "infants".

Accidents can happen to anyone, at anytime. I've read newspaper reports of young kids who choked on a fishball, of kids who drowned or nearly drowned. Although none of that happened to my son, it does hit a raw nerve in me, and I've to hold back my tears.

Although our mothers never attended such courses in their time, it doesnt mean we do not need to. It's always better to be well equipped with vital skills such as this...just in case. Such accidents happen more often than we're aware of.

The same goes for learning CPR for adults. I've been looking out for such a course (free or for nominal fee) for a few years now, but it's usually reported in the newspaper after the event. I had left my contact with St John's Ambulance who conducts such courses but they never got back to me. Heart disease and strokes are far more common and affecting a younger and younger age group, so I believe that's a useful skill too.

Details of the Infant CPR course are below:

It covers:
- anatomy and physiology of the heart and lung
- proper feeding technique
- video presentation
- CPR demonstration and practice
- how to handle choking/drowning
- hands on session
- Question and answer

It's held every 3rd Saturday of the month at the hospital, with two available time slots. Group A: 9-10.30am while Group B is 11-12.30pm. Cost RM60 per couple.

Call customer service at 03-77222692 ext 1301 to register.

Wednesday, January 27, 2010

Montessori's Sensitive Period

I'm finally putting in a post on Montessori's sensitive period. It's not in my own words. I simply do not know enough to write about it! Unfortunately I forgot which website I copied it from as it was a while ago. The highlight in red, is one of the driving reasons for me to push on, for my son.

For almost one hundred years, Montessori educators have observed a set of motivations shared by young children around the world. What Dr. Maria Montessori discovered in the St. Lorenz Quarter in 1907 was that children are self-motivated to learn from their environment.

Borrowing a term from biology, she called these stages the sensitive periods, after similar developmental stages in animals. The idea seemed revolutionary at the time, and took many years, following Piaget's extensions of Montessori's initial explanation, to become generally accepted in child psychology. Today, whether we use Montessori's terminology or not, the description of child development she first presented at the turn of the century rings true.

Each sensitive period is:
- A period of special sensibility and psychological attitudes.
- An overpowering force, interest, or impetus directing children to particular qualities and elements in the environment.
- A period of time during which children center their attention on specific aspects of the environment, to the exclusion of all else.
- A passion and a commitment.
- Derived from the unconscious and leads children to conscious and creative activities.
- Intense and prolonged activity which does not lead to fatigue or boredom, but instead leads to persistent energy and interest.
- A transitory state once realized, the sensitive period disappears. Sensitive periods are never regained, once they have passed.

Dr. Montessori identified eleven different sensitive periods occurring from birth through age six. Each refers to a predisposition compelling children to acquire specific characteristics as described below. When Montessori teachers speak about children being "inner directed," they are referring to an inner compulsion or sensitive period. A Montessori teacher would say, for example, "This child is in her sensitive period for order." These phrases point to each child's predisposition to follow her own daily classroom routine in which she chooses the same materials and in the same sequence. Ages of the onset and conclusion of each sensitive period are approximate and are indicated after the general description.

Movement Random movements become coordinated and controlled: grasping, touching, turning, balancing, crawling, walking. (birth — one)

Language Use of words to communicate: a progression from babble to words to phrases to sentences, with a continuously expanding vocabulary and comprehension. (birth — six)

Small Objects A fixation on small objects and tiny details. (one — four)

Order Characterized by a desire for consistency and repetition and a passionate love for established routines. Children can become deeply disturbed by disorder. The environment must be carefully ordered with a place for everything and with carefully established ground rules. (two — four)

Music Spontaneous interest in and the development of pitch, rhythm, and melody. (two — six)

Grace & Courtesy Imitation of polite and considerate behavior leading to an internalization of these qualities into the personality. (two — six)

Refinement of the Senses Fascination with sensorial experiences (taste, sound, touch, weight, smell) resulting with children learning to observe and with making increasingly refined sensorial discriminations. (two — six)

Writing Fascination with the attempt to reproduce letters and numbers with pencil or pen and paper. Montessori discovered that writing precedes reading. (three — four)

Reading Spontaneous interest in the symbolic representations of the sounds of each letter and in the formation of words. (three — five)

Spatial Relationships Forming cognitive impressions about relationships in space, including the layout of familiar places. Children become more able to find their way around their neighborhoods, and they are increasingly able to work complex puzzles. (four — six)

Mathematics Formation of the concepts of quantity and operations from the uses of concrete material aids. (four — six)

Note: This list does not include the sensitive periods found in the development of older children and adolescents. However, it does suggest to the early childhood educator some of the things that young children absorb, or will if they are given exposure and opportunity.

Keep in mind that the child's learning during these early stages is not complete, nor has it reached the internalized abstraction stage that will develop as she grows older. It is, however, the foundation upon which much that follows will be built. Wherever this solid foundation is lacking, children will experience difficulty in learning and operating later on.


Just as a rubber band has its limits in being stretched, I now realise that I was stretching myself beyond my limit recently. That resulted in me falling ill.

I think it was a combination of factors, starting from a few weeks ago. It was initially the mental tiredness caused by the issues relating to my helper and to my son's schooling. I shall not delve into detail over those issues as it'll no doubt tire me out by writing about it!

Then came the physical tiredness. When I'm worried over matters that which are unresolved, I end up more frustrated, have poor quality of sleep, and I'd keep myself busy to distract myself from actively thinking about it.

I was also pushing myself to get things done (before my helper leaves) by stealing a few minutes here and there. I generally do not like to have work done half way as it keeps bugging me at the back of my mind (like I dont already have enough on my mind), and it leaves the place messy too. I get even more frustrated when things get lost in the mess and I also get blamed for it.

Added to that, my son kept on falling ill and had restless sleep, was very sticky, and cranky.

It was hard to slow down. Perhaps I kept on going, to block out the various things bugging me because I had no solution to make everything better? Perhaps it's a form of self punishment, to prove to others that I'm not capable of juggling it all? Or perhaps it was to speed up the inevitable (falling sick) so that I can justify my need to get some rest? Or perhaps it was the fear of how much harder things would be when my helper leaves, driving me to get things in order now before she leaves? Or a combination of the above!

Looking back, I know that I've not had "me-time" for a long while now. I used to have facials or massages once a month. That all stopped around middle of last year as I wanted to minimise the risk of catching H1N1.

The rubber band had snapped. The last two days, I finally slowed down. I slept the entire mornings. I did very few activities with my son. I watched TV with my son! I think I watched a total of 3-4 hours over the two days. Putting that in perspective, that 3-4 hours is probably more or equal to the total TV time the whole of last year. Yesterday, I was relaxed enough to put up Chinese New Year decorations together.

I keep pushing myself because it's a race against time. It's already the end of the first month in the new year. He's got to get ready for big boy school in two years time, and preferably without needing a shadow aide.

I push myself because I see that my son wants to learn. He likes it when we do activities together. He likes it when I explain things that are happening on TV. He likes me to read books to him (latest favourite book is about trains, which I bought for RM3 from the warehouse sale last Sun).

I push myself because I know that it's between the years 0-7 that a child learns the most. I've read an article about the Sensitive Period (as expounded by Montessori) and I'll probably do a post on it later.

I push myself because sometime this year, I want to do a new therapy (HBOT) that'll take up a lot of time and I'm unlikely to have time for other activities. So, I want to get in more of those other activities before I start HBOT.

When I want to do so many things, I need the right support.

I'm not getting the right support from his school. His school is just for socialising, to build his confidence in speaking and to identify the 'school skills' needed. I'm still his main teacher and I'm not qualified.

At home, I had great support from my helper but that's a lot lesser, and more unpredictable nowadays.

Financially, I've been very blessed to have the support of my husband. Therapies, diapers, his high-end milk, materials for activities all add up. I do not take that forgranted and save where I can - make my own things, get his 'toys' from kedai runcits/hypermarkets/Cash Converters/knick knack shops etc, borrow (thanks so much my dear friends!), and buy books from warehouse sales.

Knowledge wise, I have supportive therapists (thanks to Fe and his speech therapist), teachers (not his school ones, but his music teacher and Yvonne), and the internet (glad to be in this age of the internet!).

But perhaps I did not lock on to my biggest source - God, without whom, nothing would be possible. And with whom, nothing is impossible.

It's hard to continuously swim against the current, so I might just go with the flow. I think I'll take it easy for the rest of the week! I need to fully charge up my batteries in order to properly plan for the departure of my helper...or I might throw caution to the wind and let the bombs go by (unlikely).

Tuesday, January 26, 2010

My homemade version of (montessori) large rods

I've finally completed making my homemade version of the large number rods.

I could only find a large enough sheet of corrugated board in yellow and green, but not red or blue. I wanted a large single sheet to make the longest rod so that I wouldnt need to tape two rods together to make a single long one. Shorter coloured boards are easily bought at Tesco, whilst the large sheet (more than 1m in length) was bought at Jasema Stationery shop at Rahim Kajai side of Tmn Tun.

I obtained the dimensions of the rods from websites selling the large number rods commercially. The first rod measures 2.5cm (width) x 10cm (length)  x 2.5cm (thick). The second rod's length increases by 10cm. Each subsequent rod's length increases by 10cm.

In my version, the difference is that I didnt follow the thickness. To make it less flimsy (especially the longest rod at 1meter) I stuck two layers together, with double sided sticky tape. The bottom layer is a single piece, whilst the top layer is made up of alternating coloured short pieces. To make it stronger, the "veins" of the top and bottom layer are horizontal and vertical respectively.

My sticky tape was available in 1.8cm width so that was perfect for me. That's also easily available at Tesco, Jusco, large stationery shops.

As the child picks up the rods from one to ten, they learn sensorially through visual (1=shortest to 10=longest) and weight (1=lightest to 10=heaviest). They are meant to carry the rods at opposite ends to further enhance the difference (1=arms are near, to 10=arms stretched far).

Although my son already knows his numbers from 1 to 20 (now I'm teaching him the tens 20,30,40 etc), I wasn't sure if he understood which number was "bigger" than or "smaller" than another number. So I made this activity (as well as the spindle box) to teach him that.

Here's a video from YouTube illustrating how it's used.

This is another video on it. This lady uploaded a lot of Montessori videos, which were very helpful to me. In her version of the large rods, it's all in red (not alternating colour). I tried doing it with him in a single colour (yellow) with and without lines demarkating the sections, but he wasnt interested.

Monday, January 25, 2010

My turn to be sick!

I'm definitely sick. I think it's the gastric flu. Rested the whole morning. Called the school to say we wont be going for 2 days.

My son isn't fully recovered yet. On Sunday, his stuffy nose started again. Nebulised him once yesterday. Very hard to get him to sleep yesterday. He napped for less than an hour, yet he slept really late last night. He kept saying he wanted to go to hospital last night. He wanted the nebuliser again. I didnt think he needed it cos the first dose would not have worn off yet, and he didnt have a cough.

Thankfully, my maid is still reliable enough to care for him while I rested this morning. They did some colouring together, and cycled in the car porch, and he pushed his "toyota vios" around.

I dont have enough energy for much else (or at least, I've had enough of pushing myself so hard) so I'm going to end here. Please do pray for a speedy and complete recovery for both of us. Thanks!

Saturday, January 23, 2010

He's recovering

He slept well last night, without any coughing. His afternoon nap was a good hour and a half, without coughing too.

His runny nose stopped during the day. But it started a little again tonight probably because this evening, we were seated under the fan in the TV area (cos we were enjoying the company of an aunt from Australia who's with us for holiday).

We went for nebuliser only once today, just before bedtime, which means he is getting better. He needed the nebuliser twice yesterday.

Hoping he sleeps just as well tonight so that he continues his recovery...and so that I get to rest more too.

I've got a sore throat today from all the running around today and yesterday. Slightly dehydrated and heaty, I think.

Stayed up late-ish last night waiting for my aunt to arrive. This morning, my husband and I went to the maid agency to select a new helper. We were there for 2 solid hours which was far longer than I expected.

Thankfully the timing of my aunt's arrival was good cos we left our son at home with my helper and my aunt to keep an eye. After lunch, I had a good nap for an hour together with my son, but still felt tired. I snuck out while he was still sleeping, to a book warehouse sale...and got lost on the way! I think driving (and getting lost) in the hot afternoon sun was the 'last straw' cos I felt really ill at the sale.

Thankfully I had my helper cook a simple dinner at home, cos it allowed me to spend some time with my son. It was the only 'activity' time I had with him today. At the other times, I was either about to head out or just got home, or was caring for him (in the toilet etc).

After dinner, I headed out to a supermarket nearby to get his fruits (he has a smoothie everyday) and then it was off to the hospital.

I am worried about how we'll cope without my current helper. Even though I will have a new helper when she leaves, there'll be a steep learning curve for her, and a big language barrier (doesn't know English or Malay). A lot of time would be spent on training her, instead of on my son. I always feel that I should be spending time with my son as it's a race against time in terms of helping the development of special needs kids.

I'm trying to "stock up" on things before my current helper leaves cos I wont be able to shop when the new helper arrives (too busy training new helper). Since middle of last year, I have also been slowly (key word here being "slowly"! LOL) clearing things out, reorganising things, making new activities for my son, in preparation for the time I'll have to invest in training a new helper.

At times like this, I wish I didnt have to be his shadow aide. I also wish he had much better teachers who could teach him (surely he deserves that?), rather than rely on an incompetent teacher (ie. me, his mom). Instead of just wishing, I'll pray. God loves him. God loves us. Thank you for being with me on my journey. Thank you for your prayer support.

Friday, January 22, 2010

Nebuliser again

He didnt sleep well last night as he was woken up by his own coughing. It sounded different, chesty, this time and it was not a good sign.

When he woke in the morning, he tried so hard to clear the phlegm stuck, that he vomitted. Since his tummy was still empty (before breakfast), it wasn't messy.

So, off we went to see his paed again, to check on his lungs. He did say to come back if he starts coughing. I want to be more careful this round and catch it early on.

We were there even before the clinic opened. We got the number one slot for walk in patients. Unfortunately, all the doctors at the hospital, inc his, were at a conference upstairs. So, we were in for a long wait. Luckily, we had brought his milk along and fed him while he watched the cars pull up to the lobby. My helper fed him while I had my breakfast at the canteen. His assistant informed us that the conference was likely to end at 10am, so I had a bit of time for an errand.

Finally got to see the doctor at 11.30am, after he saw to several patients who had previously made appointments. I'm a walk in patient, so had to wait to clear the others first. I'm glad to have a brought along my helper.

Thank goodness that his lungs are still clear. Dr explained that his cough was probably because his airways close a little when he sleeps, and that's why it was a night cough. So he advised to have him nebulised at night before bed.

The other good news is that for the entire morning, he didnt urinate in his diapers. He did it in the toilet. We were so happy that he went 3 times in the morning. My helper got him to drink lots of water which explains why he went so many times. Luckily it was a nicely renovated and clean toilet!

In fact, for the entire day, he did it in the toilet, and not his diapers. That's a first for him! We were so proud of him, and he was too! I'm so glad to see it progressing so well...finally after trying for over a year (on and off)!

He didnt have a bowel movement today so didnt have a chance to invite him to the toilet for that. Getting him to poo poo in the toilet is a whole different story. Need a breakthrough for that. He's totally scared of poo pooing on his potty...or on the WC with a kiddie seat.

My story of hospital visits hasnt ended. Less than an hour into his afternoon nap, he called out to me. I ran in to his room, shocked to see half his face (and parts of his hair) covered in vomit! There was another pool of it on the blanket, and another on the bed sheet. He's vomitted often since he was tiny, and it really reminded be of the old days. That was his entire lunch gone! The unusual thing though, was that he wasnt crying. So we could calmly get him and the linen cleaned up. Of course, I decided that a trip to the hospital for a nebuliser treatment was due, even though dr had said to do it at night. He was better after that. No more vomitting and less of a runny nose.

We went again once more at night before his bedtime. Even though the hospital isnt too far from our home, a lot of time was spent on the roads, and in the hospital! A lot of time was wasted, which I could have spent more productively with him. It wasn't 100% wasted though, as I did some simple activities (sticker book, reading the newspaper with him, singing) with him while waiting at the clinic, and he did well with toileting.

Thursday, January 21, 2010

Paediatric Lokomat

A few weeks ago while viewing a video (on stem cells), posted by a mother whose daughter has CP, I was intrigued by a machine that a boy was using. The machine appeared for only 1-2 seconds and I had no idea what it was called.

I was disappointed then that I couldnt find it on the net. It seemed very interesting and something that might help my son in improving his gait (specifically the heel toe movement). But a few weeks later, I chanced upon it on the net while looking for something else. The internet and YouTube can be such great resources!

Here's a video of it:

There are more videos on Lokomat on YouTube. If you're interested, just key in "Lokomat" in the search tool in YouTube.

Here are some bits of info from other websites on the Lokomat machine.

The Lokomat is a robotic gait orthosis with electromechanical drives that supports walking on a treadmill with body weight support. Because the movements are performed according to a predefined trajectory, there is no visible cue to the amount the patient is contributing. However, the forces measured within the drives can deliver an estimation of this contribution. Based on these measurements, biofeedback on the patient's gait performance was added as a new feature. The visual display will allow the patient to get direct feedback on his/her efforts, and will allow the therapist to instruct the patient better.

A recent article from Reuters touts a Swiss rehab system, with robot-assisted lower extremities controls. Research, reported by the German team in the February issue of Stroke, found that the system by Hocoma AG was beneficial to patients status post stroke by making their leg muscles stronger, and by letting them gain more muscle mass than a control group.

The company has two devices, called Lokomat, for adults and peds. Here's how the company explains the basics of its system:

The basic version of the Lokomat System consists of the Lokomat (robotic gait orthosis) and the Lokobasis (body weight support system). It is used in combination with a Woodway treadmill. The orthosis is position controlled. The patient's legs are guided according to a pre-programmed physiological gait pattern. The computer controlled guidance allows individual adjustments of different gait parameters.

The Lokomat System utilizes high quality computer controlled motors (drives) which are integrated in the gait orthosis at each hip and knee joint. Force transducers at the joints accurately measure the interaction between the patient and the Lokomat. The drives are precisely synchronized with the speed of the treadmill. This sensitive system assures a precise match between the speed of the gait orthosis and the treadmill.

The extract in green text above was copied from the following website. You can click on the link below for more info:

I talked to the person in charge in the company that distributes the Lokomat in Malaysia. He says that the first ever unit of the Paediatric Lokomat in Malaysia will be available at a rehab centre in Puchong, after Chinese New Year. I dont know how much they'll charge for a therapy session on it. Likely to be expensive tho, cos it's a very expensive machine.

He said the next unit will be in Cheras (HUKM?) around middle of this year. I'm hoping it's HUKM so that the therapy charges on it will be cheaper. I'm jumping the gun cos I dont even know if it's suitable for my son! But it may be useful for some of the readers of this blog.
If you're interested, here's the contact details (I got it off the net):
Mr. Shamsurillah Bin Shafei
Omega Sientific (M) Sdn. Bhd
Suite E6-2, 2nd Floor, Jalan Selaman ½
Dataran Palma
68000 Ampang
Selangor Danul Ehsan
Tel. +03-42701372
Fax +03-42701375

Progress in Fine Motor

My son's asleep, and it was not as tiring today as we didnt go to school, so I'm able to write an additional post today. There are actually several I want to write, but I'll see how it son is likely to wake up soon and many times tonight cos of a stuffy nose/cold.

In the photo above, you'll see the first row of stickers not so nicely stuck into the numbered boxes. He started that row several weeks ago, if not 1-2 months ago. He's not so interested in sticking these anymore. Perhaps he's done too many of it in the past cos even if the stickers from Giant and Cold Storage are differently coloured from the Guardian stickers, it's still the same shape, and same card.

Now, note the sticker in box 25. That's the most recent one he did. I think he stuck it a week ago. See how well he placed it in the box. I've been doing a lot more fine motor with him especially since he was sick for a week in Dec and a week in Jan. The time I normally use for gross motor was used for fine motor instead.

I teach him to use both hands when sticking. Left hand helps right hand by fixing the position before right hand releases the rest of the sticker onto the card. His left hand is very weak, so I'm glad to see the progress made.

Also, he has difficulty in adjusting/turning his wrist or arm for fine motor work. This too has improved. You'll see more evidence of it improving in the photos below.

Those are given to him when he is able to tell us he wants to urinate at home, and goes with us, and does it in the toilet (his toileting has improved a lot the last week or so). Note how a lot of the cars are not horizontal. There's even one that's vertical! The nicely horizontal ones are the most recent.

These stickers are 'special stickers' which I started to give him just yesterday. The police car sticker was for urinating in the school toilet for the first time ever yesterday. The double decker bus sticker was for telling us he wanted to urinate while we were in the hospital this morning.

These stickers are smaller than the racing car stickers but are "bulging" (foam inside). The racing car ones are flat. I bought these stickers at Jusco 1 Utama, stationery dept.

I'm very thankful that God has blessed the effort put in...and for various Montessori blogs that gave me the inspiration to create fine motor activities for my son. If I have the time, I'd love to take photos and share.

He's sick

We spent the entire morning (9-12) at the hospital. His paediatrician sure is a busy doctor.

It's the common cold this time round. We've to get his nose dried up with anti-histamines orally and a nose drip, or else we risk it moving down to his throat and infecting his lungs again (like the previous round).

Doctor said that it's common for kids to get sick a lot when starting school. Yes, I know that. I just didnt expect him to get sick again so soon. Sigh.

Please pray for speedy and complete recovery this time around; for good sleep at nights; for good appetite; for less discomfort and crankiness.

Saturday, January 16, 2010

Kiddie Stress - The Star newspaper

The article on stress faced by children appeared in The Star a few days ago. I'm reproducing it below as I think it's useful.

I think kids nowadays encounter a lot more stress compared to our time when we were kids. So I'm not keen on pushing my son too much, academically.

In terms of academics, I just want him to learn the basic 3 Rs - reading, writing, arthmetic. I'm putting in the effort now, in the hope that the foundation is set right for the long term.

Other than that, I want him to be independent - self care skills, social skills, resilience. Frankly, that's already a huge target for me.

I've been worried about my son since he started school. I'm worried about how he's coping. Thankfully I'm there as his shadow aide, so I get to observe him. I suspect that he's experiencing adjustment difficulties (stress?) which I think is showing through his screaming, his running around the class, being extremely clingy to me even at home (insecurity?). At home, he displayed defiance, wanting his own way, crying, whining etc.

Could it be that particular school that's causing him to react that way? Would his behaviour be better at a different school? A parent said that some kids just react a certain way to certain schools, but are very different in a different school.

I've been trying to be firm with him when he shows defiance, so I've raised my voice or, I've shown a stern face, but no spanking. It's slowly working, I think. A few days ago, when I showed my stern face and told him I'm angry with his behaviour, he stopped. He looked at me, to see how serious I was. Then said sorry, hugged me and kissed me. I didnt soften up immediately but did tell him not to do it again. The past 2 or so days, he's far more settled, behaviour wise. We've not been to school the whole week, so I'm not sure if that's a factor too.

To be fair, there have been changes to his routine since about November. That was the time I was getting very busy completing errands before he started his December holiday programme (being his shadow aide meant I would have a lot less time for errands). So I'm sure that contributed to changes in his behaviour too.

Anyway, it's a very interesting article below. I have tried to do those things in the past, for example, breaking down an activity to suit his abilities/level, or to make learning fun, or to be positive wtih him.

I agree with many of the things he says, but we live in an imperfect world. Therein lies the challenge for parents.

One point I was surprised to note was that he said kids up to age 12 or so still need a lot of playtime. I didnt realise that and will keep that in mind.


The Star

Wednesday, 13/01/2010

Kiddie stress


Children face a lot of stress daily and need encouragement from their parents.

Daniel, eight, tries his best to work out the math problem in his textbook but, with his father brething down his neck, he can hardly concentrate. His father, with a scowl on his face, says angrily: "How to solve this problem? You've already learned it in school, right? How?"

Daniel feels tremendous pressure not to let his father down, and fears that his father may get angrier if he does not solve the problem. After a while, his father does get angrier, and bellows: "You're lazy! You never do your homework! You're doing this just to make me angry, aren't you?

Imagine, for a moment, a different scenario. Let's say Daniel father wasn't angry but shows a lot of patience with him. When Daniel isn't able to solve the math problem, his father shows him how, and then lets him solve the next one all by himself. When Daniel is able to, his father rewards him with a "well done, son!"

Naturally, Daniel wouldn't feel pressured or stressed, or even fearful. He would be motivated by his father's praise to do even better.

Adults sometimes do not realise that children also face tremendous stress in their everyday lives. Think about it. They wake up early to go to school, sometimes having to face tough teachers or bullying schoolmates, then they come home for tuition classes, music or ballet lessons, which take up the rest of their day. At night, they have homework to do, after which they go to bed, and wake up early the next day for school again.

"Adults have eight-to-six jobs, after which they go out to have drinks and relax," says clinical psychologist Dr. Alvin Ng of Universiti Kebangsaan Malaysia's Healthy Psychology Unit. "Kids don't have that. Play is a very essential activity for children, especially for the younger ones, because they haven't developed the cognitive capacityto converse and entertain each other by having conversations. From the time they are born till they're 12 or 13, they need a lot of play-time.

But Dr. Ng emphasises that everyone experiences stress, and it is only when stress reaches a level where children can no longer cope, that it becomes a problem. The sign to look out for to determine whether your child is stressed, are changes in their sleep and eating patterns.

"If you see any drastic changes in these two, chances are they're going through some adjusment problems," says Dr. Ng. "Do they sleep more or less than usual? Are they waking up more often? Are they having disturbed sleep? It's not whether they sleep too much or to little, but whether it is a changed in their normal pattern."

In term of behaviour, some children may show more emotions, throw tantrums, cry, or become more rebellious, negating everything that their parents tell them. They may also lose interest in certain thing or become more fearful, anxious or paranoid that somthing bad is going to happen.

This can lead to behavioural problems, especially in school. When their self-esteem is at its lowest, children often compensate by doing the wrong things. Then they are also the children with learning disabilities that are not serius enough to warrant special education classes, but they have difficulty coping with normal classes.

"They tend to fall behind and, for children like these, the teachers would usually notice it in Year One and Two, but there's not much they can do," says Dr. Ng. "If nothing is done, then by Year Three, there would be behavioural problems. They would cope by using all sorts of methods other than academic ones.

"They would try their best to avoid doing what you ask of them. And if they start to be a clown, then the teacher would label them as naughty instead of not being able to do the work. It would then be ingrained in them that "I'm not able to do this and I'm good as a clown. So I might as well be a clown."

Dr. Ng sees the school system as one that punishes the bad but rarely rewards the good, and that contributes to the overall problem.

"Lazy and naughty. Don't want to do work. The way we are brought up to think is that if someone doesn't do something, it means they are lazy or have no desire to do it," says Dr. Ng.

"We never really consider whether the person is able to do it. Most of the time, when a child doesn't want to do something, it is because firstly, it is too boring. And secondly, it is too difficult."

With children, you have to break it down to size. Dr. Ng uses what he calls the PlayStation Rule.

"If I ask you to start at Level 10, would you be able to play the game? It would be too hard. So you start with Level 1, which entices you to play more because it's so easy. So you go on to Level 2," he explains.

Dr. Ng relates how he once tried to interest a boy in cleaning up a room after playing. The child's mother said it usually takes him half an hour to clear all his toys.

Dr. Ng then used a stopwatch to play a game in which the boy would try to clear away all his toys as fast as he could. Because the child saw it as a fun game, he did it in 23 seconds flat, and there was not a toy left on the floor. The mother, of course, was surprised.

"I believe if all schools were like this, children won't play truant," says Dr. Ng. "Children play truant because school is no fun."

Dr. Ng then illustrates how we usually become nervous when we see a traffic policeman, because we associate the police with negative things like sum­monses. But if the policeman stops you and rewards you for keeping to the speed limit, and if this keeps happening, you would be happy to see a cop.

"And you would even try to get the policeman's attention!" he says. "If you're a reward-giver, you would be seen as something positive. So if schools and parents were more positive, learning becomes easier because it's less stressful.

"The main purpose of punishment is to reduce bad behaviour, which I agree with because it works very well," says Dr. Ng. "But punishment comes with side-effects - anger, resentment, fear. If you want to punish, make sure you know how to manage these three side-effects. My rule is, if you were to punish once, make sure you reward three times more. The punishment must seem less than the reward."

In the case of Daniel, illustrated above, the boy would be happy to see something good come out of what he has done.

"The idea of stress management is not just about teaching a child how to relax. As they are doing something and you encourage them with positivity, the stress level automatically goes down," says Dr. Ng.

He's almost fully recovered

We went for what should be his last nebuliser treatment for this bronchitis episode. Thank you for your prayers.

This round, he didnt need the nebuliser as often - just twice a day - compared to previous episodes where he needed 3 to 4 times daily. He has gotten so used to the nebuliser (fortunately and unfortunately!) that we dont need to bring along his toy cars to distract him. He sat there, watching events around him, or we'd talk to him. It was so much easier this round.

Strangely though, he hated having the nebuliser done in the doctor's clinic. He kicked up such a huge fuss on Monday afternoon when he had his first dose of nebuliser. We both ended up on the floor with him arching his back almost horizontal, leaning into me, screaming, crying, while I struggled trying to hold the mask on his face. Sigh. He was the one who chose to have the nebuliser done there instead of at A&E.

I noticed that his nose was a lot more blocked compared to previous episodes which saw more coughing. His appetite was also better than previous episodes. He had less vomitting too. I think the low points during this episode were not as low as before, and didnt last as long as before, which is really good.

Lessons learnt -
(1) I've to be a lot more careful where he sleeps at night, and still be careful on the temperature of the room.
(2) I've to give him a lot more water while at school. He used to take just a few sips during 1st week of school. I'll just have to help him by pouring from the tumbler into his mouth.
(3) While in school, I'll have to change his shirt the moment it's wet cos the fans are on full speed. That may mean bringing 4-5 shirts!
(4) I've to pray that he's not sick in the event I'm without a helper for several months (quite likely seeing how things are going)!

Monday, January 11, 2010

Wheezy Bronchitis

He was getting better on Sunday. His runny nose had stopped. He was active around the house. Then at night, he woke up, coughing so hard that he vomitted everything. He had a restless sleep the rest of the night, with intermittent coughing.

We didnt go to school today. This morning, his runny nose resumed but wasnt as much as on Saturday. My helper took care of him most of the morning while I rested for an extra 2 hours (I hardly slept last night). So far he's been able to eat well, thank goodness. It's just that when he tries to clear the phlegm especially at night, he vomits.

He woke from his afternoon nap coughing hard again. He vomitted, but only a little bit. The sound of his coughing was different this time. It turned chesty. We immediately took him to the hospital, to see his paeditrician. After listening to his chest, looking at his nose and throat, he said that it's inflammed. Dr gave a letter to be used at the A&E, and marked the box "wheezy bronchitis". As expected, he's been put on the nebuliser, but also given antibiotics. I hate giving him antibiotics as he's tummy is very sensitive to several types of antibiotics. He gets bad bad diarrhoea with several types. It's so bad that he excreates a little every hour but it's enough to cause his anus to be so sore. It just adds to the overall discomfort already felt from having a cold, having to be nebulised, having a cough, not having enough rest etc.

So, it begins my twice a day runs to the hospital for nebuliser. I guess he wont be attending school for a few more days. I just hope he sleeps a whole lot better, very soon. I was feeling very light headed/faint today even with the extra sleep this morning.

Sunday, January 10, 2010

He's mildly sick

My son is sick again, but thankfully it's a mild one this time. It's only a week into school and he'll be on MC tomorrow! Sigh.

I think he caught a cold a few days ago when he kicked off the blanket and rolled over to sleep under the air cond.

On top of that, the weather turned so cold on Friday. Friday's blustery wind and rain during school might have made things worse for him. We could feel tiny mists of rain water coming into the classroom and had to shut all four doors.

Last night it was very hard for him to fall asleep. He kept on breathing through his mouth despite having done a suction. My arms were very tired from carrying him to help him fall asleep. He did eventually fall asleep (by himself), only to wake up an hour later! Funny thing is that when he was asleep, he was breathing through his nose, not his mouth, which was good. Then it was another 20minutes of trying to help him fall asleep again. I couldnt continue beyond 20min, so we got into the car. I drove around and around...for an hour and a half only to find him finally dozing off when we were arriving home. When I switched off the engine, his eyes opened wide! Sigh. Well, after that it was another 2 times of waking but it was easy to put him back to sleep those 2 times. Needless to say, I was very tired this morning, but did get an extra hour of rest when my helper took over. An appointment at the hairdresser's this morning also helped as I got 2 hours of chilling out time (two hours cos I brought my sis for a haircut too).

Well, I dont mind so much when he's mildly sick, so long as he doesnt get worse and recovers fast. I can do more fine motor activities and toilet training with him when he's sick cos I stop going to the parks for gross motor activities. Going to the park for gross motor activities eat up 2-3 hours and gets me more tired than if that 2-3 hours were spent on fine motor work.

No fever, so that's good. Just pray for speedy recovery (from mucus and sore throat) for him and for good sleep for him and myself.

Tuesday, January 5, 2010

New shoes

My husband is putting my son to sleep...what a treat to have a "bonus hour" to catch up on bits of admin and a quick write up.

That's his pair of new shoes in the photo above. We got it about 2 weeks ago, so it's not that new anymore - it's just that I didnt have time to write about it.

Cost wise, it's a fraction of the Schein shoes, at RM170 and RM20 more for sewing on the tape. The tape is used for Neurosuit purposes. Note that charges depend on the size and design. It's genuine leather and it really is customised for his wide feet, his insole, his needs so it's a reasonable price. It took about 3-4 weeks for them to make it.

I removed the insole (on the left of the photo) to show you what it looks like. Not a normal looking insole as it's a proprioceptive insole. The material that it's made of and the design cant be found locally. It's imported from Germany. Bought it from Schein at RM499. It definitely makes a difference in the way he runs.

With the new shoes, I requested for the part around the ankles to be higher to give him better ankle support and stability.

I noted that when he wore that while pushing the trolley at Tesco, he had beautiful heel-toe movement! That's when he's walking. It's a different story when he runs.

Anyway, here's the contact details of the shop where you can custom make shoes for your special needs child:

Choi Hoong Shoe Enterprise
No 371, Jalan Tuanku Abdul Rahman
50100 Kuala Lumpur
Tel: 03-2697 9082

Monday, January 4, 2010

Reflections on 2009, hopes for 2010

I'm not a fan of making New Year resolutions. Life lessons occur throughout the year, so 'resolutions' to change for the better should occur throughout the year. I will instead reflect on his progress in 2009, and my hopes for 2010.

Reflections on 2009
My husband commented today that our son has progressed so much. That comment caught me off guard because I had not yet reflected on how much he has changed over the year. For me I try to take one small step at a time, in my journey to help him. It overwhelms me if I project too far in the future (even a year ahead is too far ahead!).

Feeding and oral motor
He's now able to eat the same home cooked food we eat and that's a huge improvement. If we eat out, we still have to very mindful of where we go as he still has feeding issues. The quantity he eats is still very small compared to his peers. He still relies on Pediasure to supplement his nutritional needs but we've been able to cut down the quantity consumed as he's made progress in eating solids.

He still gags and that's not just during feeding. He gags when colouring. He gags when he talks a bit too much. He used to gag when he ran a bit too much or exerted himself a bit too much. His threshold of "a bit too much" has improved though.

He still drools but that's reduced too. He used to constantly wear a bib, but is far lesser now.

The incidence of vomitting has slowly reduced too. I'm really relieved because the velocity of his vomit is akin to turning on a fireman's hose. It's not just the smell and mess, but its the discomfort that he has to experience and my heartaches each time. Now that the occurence has reduced, the worry that he's ill arises whenever he vomits two feeds in a row. Just this afternoon, he vomitted his entire lunch but thankfully, there was no further vomitting.

He's a bit less sensitive in the oral motor/facial region. It used to be that we could not wipe his mouth as he'd vomit (yes, he was a messy looking boy!). Now, we can, but just not immediately after eating. He still occasionally screams when I brush his teeth but at least now, he seldom gags when I brush them.

The strength of his blowing has improved compared to the start of the year. In the last month or so, I did less blowing activities (and more of other activites) which I think unfortunately resulted in reduced blowing strength. It's like a juggling act and I honestly find it hard to get the right balance for his various activities.

The development of his speech has been very good. It seems to progress in spurts and the last few weeks saw another speech developmental spurt. In the last few weeks, he's talking a lot more, asking lots of questions (mostly to which he already knows the answer), and surprising us on a daily basis with the things he's saying. That might be due to his exposure to the holiday programme or starting him on Effalex, a DHA supplement (both of which were around the same time).

With the good progress noted, the frequency of his speech therapy sessions has reduced. His previous session was in October, and the next one would be in a few week's time.

Clarity of speech is still a big issue, as is his lack of confidence in talking to others outside the household.

Music class
He started music class earlier in the year. I've written about his music classes, so you already know what's happening on that front. Overall, I think of late, he's getting the sense of rhythm, and loves playing with the boys in his class.

He started Neurosuit therapy around the middle of the year. It's a lot of hard work on both his part and our part (he hates it and him hating it makes it much harder), but we saw improvements quite quickly. Overall, his walking is now near normal in appearance, the volume of his speech has increased, his drool is lesser, his upper body is stronger, his balance is better, and his stamina has improved.

Cranial sacral therapy
CST sessions were increased to twice weekly, which I believe contributed to improvements in his oral motor, gross motor, sensory issues, and improved sleeping habit.

Gross motor
He's so much more flexible in his gross motor movements. I love it! He can squat easily. His walking stride is longer and narrower. He can climb a ladder (if rungs are not too high). He walks and runs on his tip toes a lot less. He can throw a ball further. He's more adventurous at KizSports. He can walk up the stairs alternating his feet (but still needs to hold onto the wall or banister) - it's only happened lately and not often, but the fact is that he can do it. He can pedal (with both trainer wheels on) - again it's only happened lately and I still have to help him most of the time, but he finally can!

He still can't jump. He still cant get into the car by himself (or climb onto a platform that's more than say, 10cm high). He's still scared when there's someone walking or running behind him. His upper body strength still needs working on. His hip stability still needs to be improved. His running gait still needs work. He's not achieved "toe-heel".

Fine motor
There're improvements but no where near that seen for the areas of speech, oral motor, gross motor and cognition.

Cognitive development
I'm so thankful that his CP has not affected his intelligence. He's learnt to read decodeable consonant-vowel-consonant words. However, from around November, he lost interest in my homemade books (*sigh*) so I dont force him to move on to the 'blue series'. Although, it might be that I've not been creative or knowledgeable enough to keep the up the progress. Instead, nowadays I read aloud to him so as not to lose the interest (but I still risk him forgetting most of the sight words he's learnt).

Hopes for 2010
Obviously, I hope for greater improvements in all areas of his development. I hope to maintain or increase my motivation level because I think "therapy-fatigue" (if there's such a word) has set in in 2009.

Hyperbaric Oxygen Therapy (HBOT)
I hope to start HBOT. I've not yet decided when to start as I'd like him to settle into kindergarten first. I've also yet to figure out how to fit it into his schedule (school in the morning, gross motor exercises in the evening, min 2 hours after food). The recommendation is for 40 sessions, an hour a day at the centre, on consecutive days (if possible) with breaks for illness, and weekends.

Schooling (kindergarten)
Tomorrow will be his first day at kindergarten. He went for their holiday programme in Dec, so he's familiar with the place and I will continue to be his shadow aide.

But he's not met his class teacher yet, and the holiday programme had very little teaching content. He's a lot more playful lately (loves to get up and about) so I hope he can sit and pay attention when he's supposed to.

I hope his speech improves greatly such that the teacher and his friends are able to understand him most of the time. I hope he makes friends. I hope he is able to learn. I hope he can cope with the demands of being in kindergarten (it is a lot for him). I hope he improves so much that he doesn't need a shadow aide.

Self care skills/independence
One major aspect of self care skills/independence I hope to see great improvement is in the area of toileting. It's been slow progress in getting him to go to toilet to urinate. There's been no progress in getting him to poo in the toilet or potty.

Apart from toileting, there are lots more self care skills he needs to learn from the smallest things like carrying his bag, zipping and unzipping, opening the cover of his snack container, self-feeding and drinking, to bigger ones like standing up for himself, communicating with the teacher and classmates, obeying instructions.

My helper's employment contract expires in just a couple of months' time. She had very helpful in getting us to where we are right now. I've been so reliant on her. I'm hoping she'll extend until middle of the year so that my son and I get settled down into kindergarten and hopefully have completed one round of 40 HBOT sessions by then. I'm hoping that the new helper is quick to learn, obedient, trustworthy, loves my son, and can cook!

I hope his immune system continues to strengthen. I hope for minimal sick days especially now that he's starting kindergarten.

I've to stop here as it's getting very late and tomorrow's the first day of kindergarten. I'd very much appreciate you praying along with me in my journey. Thank you! Prayer changes things!

Saturday, January 2, 2010

Teaching him addition

Today I introduced him to the maths concept of addition. The series of photos below illustrate some of the steps I used. It's based on Montessori principles but I improvised heavily on the presentation of it.

I used magnetic numbers, a magnetic board, and paper stars as the physical counters.

I laid out all the numbers (for easy selection). I introduced the symbols 'add/plus' and 'equals/is'.

For the first set of sums, I showed him how to 'play the game' as he calls. I chose two numbers placing it in the equation. I then verbalised what "2+5=" sounds like in words.

Then counted out the correct number of stars and placed them below the numbers.

Then showed that when I add them, I move them all to after the 'equals' sign.

Then counted the number of stars and placed the right numeral after the 'equals' sign. Then read out the equation.

We did 2 more sums, with a lot of guidance from me. I'm glad that he took an interest and was paying attention.

In one of the sums, the total was 11. I'm not sure if it's ok to introduce addition which total is more than 9 at this early point in time. I think I should hold off on such addition until I've taught him the decimal system.

That's the problem I'm facing right now. I've read bits and pieces, watched very very short videos on presenting the various equipments used in Montessori maths. But I am missing a lot more. I do not know which I should introduce first before other things.

Ending on a happier note, as I chose the final set of numbers for the 3rd sum, papa walked past and gave him encouragement. I then engaged in a brief conversation with my husband. Before I could count out the stars for the equation 4 + 4, my son was already telling my husband the answer. "Eight. Eight. eight!" (my son repeats his words cos of his dysarthria)

Before you think my son is a genius (he's not), I'll have you know that in playgroup which he attended in 2008, one of the songs they sang was on addition. It goes something like this:

One and one, two
Two and two, four
Three and three are six to me
Four and four, eight
Five and five, ten
little fingers on my hand.

I had sung that many times back in 2008 but not since then. I guess it got registered in his memory! Is that rote learning? Did he understand the song was about addition? I did use my fingers to physically show him that one finger plus one finger equals two fingers. Perhaps he was already picking up the concept? Perhaps it was blind memorisation? Who knows!

Friday, January 1, 2010

Well being of carers of cerebral palsy kids

The post below is another one sitting in my "draft folder" for months. So as part of cleaning up my blog for year end, I'm posting it now. (I reckon it's the 'teh tarik' I had that's keeping me up til the wee hours and fuelling this tidying up of my blog!)

It's an extract from a study, and whilst the extract below states the obvious when I read it, it may help parents of non-disabled kids to have a better (high-level) understanding of the dynamics involved in raising a CP child. I say 'obvious' simply because I can easily relate to it as my son has CP.

In a way, for me, the article also 'validates' how daunting the journey is and of the strong psychological impact too.$=relatedarticles&logdbfrom=pubmed

Most children enjoy healthy childhoods with little need for specialized health care services. However, some children experience difficulties in early childhood and require access to and utilization of considerable health care resources over time. Although impaired motor function is the hallmark of the cerebral palsy (CP) syndromes, many children with this development disorder also experience sensory, communicative, and intellectual impairments and may have complex limitations in self-care functions. Although caregiving is a normal part of being the parent of a young child, this role takes on an entirely different significance when a child experiences functional limitations and possible long-term dependence. One of the main challenges for parents is to manage their child's chronic health problems effectively and juggle this role with the requirements of everyday living. Consequently, the task of caring for a child with complex disabilities at home might be somewhat daunting for caregivers. The provision of such care may prove detrimental to both the physical health and the psychological well-being of parents of children with chronic disabilities. It is not fully understood why some caregivers cope well and others do not.

The psychological and physical health of caregivers, who in this study were primarily mothers, was strongly influenced by child behavior and caregiving demands. Child behavior problems were an important predictor of caregiver psychological well-being, both directly and indirectly, through their effect on self-perception and family function. Caregiving demands contributed directly to both the psychological and the physical health of the caregivers. The practical day-to-day needs of the child created challenges for parents. The influence of social support provided by extended family, friends, and neighbors on health outcomes was secondary to that of the immediate family working closely together. Family function affected health directly and also mediated the effects of self-perception, social support, and stress management. In families of children with CP, strategies for optimizing caregiver physical and psychological health include supports for behavioral management and daily functional activities as well as stress management and self-efficacy techniques. These data support clinical pathways that require biopsychosocial frameworks that are family centered, not simply technical and short-term rehabilitation interventions that are focused primarily on the child. In terms of prevention, providing parents with cognitive and behavioral strategies to manage their child's behaviors may have the potential to change caregiver health outcomes. This model also needs to be examined with caregivers of children with other disabilities.

Lacing activity

That's a photo of the set of the Garden Stringing Beads, by Imaginarium.

Mid of last year, I eventually found version of lacing beads that was attractive, chunky enough, and the hard-plastic-wrapped-up-end of the lace seemed sufficiently long enough. It was sold at Toys R Us.

He struggled to insert the lace through the wooden pieces and while I did bring that toy out once in a while, I didnt force it upon him to play with it the way it was intended. It was obvious he didnt have an interest in that activity even though the toy was attractive. I now think that that's because his fine motor skills weren't ready for it back then.

I've another silly story to share on how I got him interested in lacing the Garden Stringing beads.

He attended a Sports Day earlier in the day, so I got the idea to turn it into a race. I took 3 animal pieces out of the set - snail, turtle, butterfly - and laced them up on a piece of their own lace. I laced - he didnt even bother to watch me lace it up. 

I roped my sister in to help since there were 3 animals. I used the doorway as an imaginery starting line, and chose an end point. Did the count down, and blew the 'whistle'. We each pulled an animal along towards the finish line, while creating excitement by giving a running commentary on who's leading, who's about to overtake, who tipped over and had an accident, etc.

He loved the game so much that we played it many, many times. To keep the interest going, I'd occasionally change the race route. He was quite hyper towards the end!

My original intention was to get him to lace the pieces but it turned out differently! Anyhow, it wasn't wasted cos I managed to teach him some stuff whilst having loads of fun.

Some of the bits of learning I sneaked in:
- reinforced the vocabulary of 1st, 2nd, 3rd.
- showed him that he doesn't always finish first, and that's ok
- race rules/concepts (starting line, finishing line, listen for the whistle)

It did though, renew his interest in using that toy as it was intended to be used. The next few times I brought out that toy, he did manage to lace a few pieces, with assistance. Make no mistake, I still had to create the interest with new games or scenarios to get him to try to lace the pieces, but at least, I had broken the negative perception/mental block he had on that toy.

I guess for him, it is a longer route towards learning to lace...longer, but at least we're on it now and we'll get there eventually.

He seems to like games that are made up on the spot, which challenges my creativity (cos I usually operate with a brain fog!). So I just spend time playing with him to spot opportunities to build in objectives I'd like to achieve, whether it's vocabulary, a math concept, living skills, gross or fine motor skills. It's tiring for me, but fun for both of us, whilst getting some "learning" done! It's all by God's grace!

(I must have forgotten to post this after I wrote it a few months back! So as part of 'housekeeping' of my blog, I'm posting it now - better late than never!)

Photos of oral motor, fine motor activities etc - part 1

I took many photos of his activities to write about and upload into my blog, but due to time constrains, many never quite made it into a posting on my blog.

As part of 'housekeeping' and somewhat timely as it is the year end, I thought I'd do a post of those photos.

That's for colour matching and pincer grip practice

An oral motor activity - blowing cotton/cotton balls, with and without using a straw. The carton is an improvised 'track'. He chose those stickers. The stickers not only make it interesting, but also serves as targets for him to aim when blowing.

Various crazy straws for oral motor work. There's a hierachy in using those differently shaped straws. Hard to find them locally. These were brought by a good friend from UK (thanks Ren!).

Various blowing instruments for oral motor work. Again, there's a hierachy to it. He cant as yet blow on some of them.

For oral motor purposes. Got the idea from speech therapy. I had merely wanted him to blow (cos he had couldnt blow most of the whistles back then). To encourage him, I made up a game, where he had to help the dragonflies reach home etc, by blowing. I'd be manually 'flying' the dragonfly. The dragonflies on the right are wooden pegs which I use for pincer grip practice too.

For hand eye coordination practice. It's homemade as you can see. It's one of his earliest toys. Back then I could not find a commercially sold fishing toy that he could use. Those fishing rods had strings which are too hard for him to control. My version uses a solid rod (old chopstick) with a magnet glued to the end of it.

Wipe clean book for hand eye coordination, pencil grip practice.

His box of stuff for fine motor practice (sorry for the blurry photo) - colourful pegs with cartoon characters, silly putty, Fisher Price cubes of manipulatives, seashells inside the white box, a small wooden top (partially hidden), battery operated bubble blower (to practice finger isolation when he presses the red button). Many of those are still of a challenge for him. I've also added new things as I go along.

My internet connection has gotten incredibly slow, so I'll upload the remaining photos in separate posts.