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Episode 13: Understanding Stimming: An Occupational Therapist's Insight | FREE ABA CEU — Transcript

by Blossoming Together · 10,669 words · 1,471 segments · language en · Watch on YouTube

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0:00welcome back to the blossoming together
0:01podcast as you guys can tell my voice
0:04I'm losing it I lost it in Bali swinging
0:06on the swings but today we're going to
0:09be talking about stemming we have a
0:11guest speaker on but before we introduce
0:13her let's go over our objectives
0:15objective one participants will be able
0:17to identify the purpose of stemming for
0:19individuals with higher sensory
0:21processing needs and objective two
0:24participants will be able to discuss and
0:26apply ethical considerations in
0:27addressing stemming behaviors and
0:29understand when it is appropriate to
0:31Target or not Target stemming behaviors
0:34all right Amy
0:35welcome so Amy you're a lead right like
0:38a lead OT yes I'm the lead OT here at
0:41Blossom Novi wow and how long have you
0:43been in that role um a little bit over a
0:45year now um I started at Blossom this is
0:48my first position out of OT school so
0:50actually today is exactly 3 and a half
0:52years since I started congrats thank you
0:56that's amazing do you have any questions
0:58for Amy yeah can you tell us about like
1:01where you got your education for your OT
1:03program so I actually did my
1:05undergraduate at Michigan State
1:07University in kinesiology and then I
1:09went to Grand Valley State University
1:11for my masters in occupational therapy
1:13wait I went there for my undergrad Grand
1:15Val so really I didn't know that I don't
1:17know why I didn't know
1:19went but what really introduced you to
1:23the OT world and how did you decide that
1:25that's what you wanted to pursue yeah so
1:27I always knew I wanted to work with
1:28children and I was going more like the
1:30elementary education route and then I
1:33took a few classes in undergrad I'm like
1:35I cannot do a full classroom of students
1:38overwhelming but then through some
1:39personal experiences some family members
1:41went through occupational therapy and I
1:44just thought it was just so amazing to
1:46see how individuals can help others
1:49regain their functional Independence
1:51yeah so I just thought why not combine
1:53the two and work with children as an
1:54occupational therapist I love it it's
1:56amazing well I'm glad you found the
1:58field cuz you've helped so many indiv
1:59idual and so many kids and you've taught
2:01us so much so we're excited to dive into
2:04this topic so we're going to be talking
2:05about stemming something I know about
2:08stemming is it's a self stimulat
2:10stimulatory behavior that refers to
2:12repetitive movements or sounds that
2:14individuals use to engage in to really
2:18like regulate themselves or their
2:19sensory experiences do you have anything
2:21to add to that cuz I bet you got a
2:23better definition than me yeah can you
2:24tell us a little bit about like what
2:25stemming is in general yeah so just like
2:27as you mentioned um stemming is
2:29competitive actions or sounds that
2:31individuals engage in to regulate their
2:33sensory and emotional experiences so
2:36stemming can be part of any of the
2:38sensory system so vestibular you might
2:41think of like children who like to
2:42rockot um proception like even some head
2:46hitting tactile stems feeling different
2:48surfaces or having to feel hair thr hair
2:52um even visual just watching objects or
2:55rearranging objects um old factory so
2:58our sense of smell some KS or
3:01individuals have to keep smelling
3:03specific things like they stem on that
3:05SC of it um and then gustatory so our
3:08sense of taste so if we see individuals
3:11who have to keep tasting the same thing
3:12or licking objects ah so stems can
3:15Encompass a single sensory system or a
3:18bunch of sensory systems together at the
3:20same time okay so that kind of leads
3:22into like my next question so we kind of
3:26talk about like stemming in ABA it kind
3:28of was formerly thought of as like
3:29steming was just a behavior or something
3:31to correct but can you actually tell us
3:34why individuals engage in stemming yes
3:37so there are a lot of underlying factors
3:39why individuals may stem but the first
3:42thing I want to mention is not only
3:44autistic individuals or neurode diverg
3:47individuals engage in stemming everyone
3:49stems to some capacity so just for
3:51examples to bring it into context so I
3:54know I like to pce around when I'm
3:56talking on the phone um I do that too
3:59people who like to nail bite that's a
4:00form of stemming if you listen to the
4:02same song over and over so me when I
4:04listen to Taylor Swift That's stemming
4:07because it's the repetitive action oh my
4:10gosh that's why I listen to the same
4:11song like five times in a row on my
4:13drive in to work yes that makes so much
4:15sense so that's like the first thing we
4:17want to make sure that we understand
4:18that everyone stems and it just might
4:20look different for different individuals
4:22yeah but some underlying purposes
4:24sensory processing so individuals who
4:27have sensory processing differences they
4:30may engage in stemming to modulate your
4:32sensory experiences so just think about
4:35if we're in an over stimulate
4:36environment and sensory overload yeah we
4:39might stem to help regulate ourselves to
4:41bring us down to an optimal learning
4:43State can you talk a little bit about
4:45like sensory overload and what that
4:46would look like with a learner
4:48especially for like some of our bcbas
4:49who don't have a chance to work with OTS
4:51or necessarily like know to look for
4:52that kind of like Behavior yeah so it
4:55all comes down to sensory modulation so
4:57I like to use an example called like the
4:59sensory cup so just think you have like
5:01a regular plastic cup and there's a line
5:04in the middle of the cup and that's
5:05what's called the optimal learning line
5:07so everyone takes an sensory input
5:09through their daily activities so all
5:11the sites we see smells um we smell
5:15everything we hear and then also sensory
5:17input is in form of like changes in
5:19routines small demands small upsets
5:22through our day so all those sensory
5:24inputs fill up our sensory cup okay and
5:27we have to be kind of we're would assume
5:30we're at that line right in the middle
5:31our ideal that's our ideal state so for
5:34a lot of our Learners they keep getting
5:36all the sensory input in and they cop
5:38fills up to the point where they don't
5:40know how to regulate themselves so like
5:42you and I may know like oh if I'm
5:43overwhelmed I need to leave this room or
5:45take a break okay then we can um empty
5:48out the cup to some capacity to help us
5:50reach that state but for some of our
5:52Learners who have more um more robust
5:55sensory preferences we need help to
5:58support them to bring them down because
6:00then we might have our cups spill over
6:02essentially and that could lead to
6:03sensory meltdowns so I like to think
6:06especially in the environment here you
6:08know if you're in a big noisy
6:09environment there's lots of kids running
6:11around um making lots of sounds there's
6:14so much visual input it can be so hard
6:17for an individual to focus on things
6:19within that over stimulating environment
6:21yeah so that's when they may stem so
6:23then they can help them Focus to
6:25whatever they're doing and to work
6:27through the deregulating environment I
6:29really like that example and I feel like
6:31even for our like you said ourselves our
6:33cup gets full all the time and depending
6:35on the day you know we might not we
6:38might not need it right but then some
6:39days we've had like different
6:41experiences like you were late getting
6:43out of the door and then maybe in the
6:45car like you spilled everything on
6:46yourself and then somebody cut me off
6:49and I thought I was going to get into an
6:50accident so now just adding and adding
6:52onto my cup the same with our Learners
6:54we don't know what kind of day they had
6:55before they got to us sometimes too
6:57that's the underlying component don't
6:59know what goes on at home before we get
7:01to work with them and I know we were
7:03talking before we're talking about how
7:05traffic has been so terrible so I know
7:07that throws out my day when I'm stuck in
7:08traffic absolutely and that overfills my
7:11cup at some points too but on the other
7:13hand sometimes if children are in an
7:16environment where there's not a lot of
7:17stimulation going on they need to
7:20upregulate themselves so that they can
7:22reach optimal learning line and
7:24effectively participate in their day so
7:26that's when you might also see simming
7:28so they can provide the up regulating
7:30response this is something that I never
7:32took into consideration I always like I
7:34always looked at the overlo yeah the
7:36over stimulation and like the almost
7:38like the disregulation in that sense and
7:40it was hard for me to understand it with
7:41some of those kids who um like
7:43considered more mellow or just like
7:45chill like I didn't realize that they
7:47might need more sensory input to like
7:49upregulate them right so sensory
7:53processing is definitely one of the
7:54biggest components underlying simy but
7:56there are so many other things I'll
7:57touch on too so so for example um
8:01emotional regulation and also
8:03self-expression and communication so um
8:07when children exper or adults experience
8:09intense emotions so like excitement or
8:12if they're feeling anxious or stressed
8:15we might see an increase in stemming to
8:17help regulate those emotions okay can
8:20you give maybe an example of this one
8:22yeah so I'm just trying to think I have
8:24one learner that I work with right now
8:27um if we watch the marble run the visual
8:29stimul of watching the Marvel go around
8:31and round we get a lot of flapping we
8:34getting excited because it's something
8:36that's so meaningful to them to watch it
8:38and excites them that we're just so
8:40excited and I'll join in this stem and
8:41just to share that Joy with them so
8:43that's something you might see um help
8:46with the emotional piece with that you
8:48feel like you see it sometimes when
8:49someone is like sad or upset or
8:51frustrated as well yes I feel like that
8:54was really hard for me to understand too
8:55cuz I I always heard like happy hands
8:58but never like the opposite right so
9:01really any intense emotion and we know
9:04neurode Divergent individuals as well as
9:06neurotypical individuals can experience
9:09emotions on so many different levels
9:11yeah so whenever we're just trying to
9:13help regulate those emotions or express
9:15it that's when we may see some more
9:16stemming okay yeah thank you for like
9:19breaking that down with the emotions and
9:21then you also said the communication and
9:23self expression self- expression so
9:26especially for um autistic individuals
9:29where it might be a little bit harder to
9:30express themselves verbally or
9:32non-verbally they can express themselves
9:34through stems it helps um communicate
9:37with others and also to indicate what
9:39their interests are so we see how they
9:41stem like oh this is something that's
9:44like important to you and you're trying
9:45to show something to me so it just helps
9:47with that communication piece right and
9:49I like to think of it like you know we
9:51say like all behavior is a form of
9:53communication so we need to look at like
9:55the stems and what they're trying to
9:57communicate to us I feel like that's
9:59very important right absolutely could
10:02like an example of a learner trying to
10:05communicate through stem be like when
10:07they're repeatedly covering their ears
10:08and tapping their ears like maybe
10:10they're trying to communicate that
10:11something's too loud or like the
10:12environment is too loud for them it
10:15could be part of that too and it could
10:16also just be a general auditory so when
10:18kids cover and uncover the ears because
10:21like trying to modulate or see if like
10:22the environment sounds different for
10:24them but that could definitely be part
10:26of communicating like oh maybe I need to
10:28go find another environment get some
10:30headphones yeah that makes sense I want
10:32to take a quick pause for our first code
10:34word today code word one for your cus is
10:38hair twirling nice all right and then
10:40getting right back into it I know when
10:42we were talking we also discussed
10:43another reason individuals might stem is
10:46for that cognitive focus and the
10:47engagement could you share a little bit
10:49more about that yes so um research has
10:51found that engaging and repetitive
10:53actions promotes a regulating and
10:56organizing response in the brain so when
10:58our brain is nice and organized it's
11:00easier to learn and process information
11:03and it just helps us with that overall
11:04regulation and able to actively problem
11:06solve through different situations in
11:08our day I was just thinking about like
11:11the um like self soothing and stress
11:13relief portion that I think you and I
11:14have talked about in the past could you
11:15talk a little bit about that yes so it
11:18also goes down to the sensory modulation
11:21piece yeah but with self soothing
11:23stemming just provides a sense of safety
11:26comfortability and predictability and
11:28allow our neurode Divergent Learners
11:30they need that predictability and
11:32routine yeah so it just provides that
11:35soothing comfort for them so if you're
11:36dealing with stressful situations or
11:39challenging or new unfamiliar situations
11:41it just helps them cope with it oh okay
11:44that makes a lot of sense really good to
11:45know we kind of discussed like what
11:47stemming is what function the function
11:51it serves I to kind of talk about and
11:53get your Insight onto why it is harmful
11:55to stop stemming Behavior yes so there
11:59are are many um components to this as
12:01well but the first thing I want to touch
12:03on is blocking or stopping siming
12:07Behavior really just takes away a source
12:10of autonomy for individuals and it can
12:12cause increased stress um increased
12:15anxiety and can impact their ability to
12:18focus throughout the day because we
12:20talked about like how stemi helps with
12:23regulation emotional expression and
12:26overall cognitive processing mhh well
12:28I'm thinking like you were talking about
12:30the cups say like our cups really filled
12:31up and we want to get back down we're
12:34trying really hard we're engaging our
12:36stems try to get down there but imagine
12:38like someone's there and like stopping
12:40you that's like if I was trying to leave
12:42the room cuz like like say like curon
12:45smelled really bad today like she didn't
12:46have any deodorant on and like she
12:48smells bad and I'm like okay like I
12:50can't stand it anymore I'm going to
12:51throw up and I'm trying to leave the
12:52room and you were like no right so
12:55that's why I wanted to touch too so to
12:58go off of that so let's say an
12:59individual sensory cup is spilling up
13:02but they're able to identify oh I'm
13:04about to spill over so I need to
13:06regulate myself you the stemming so if
13:09someone were to say like no you can't do
13:10that or we're blocking that stem they
13:13don't know how else to regulate
13:14themselves so that increases the um cup
13:17and that's when they're going to spill
13:18over and the frustrating part about it
13:21is like we a lot of us focus a lot on
13:24like building those self self-regulation
13:26te like techniques for our kids and like
13:28promoting that and we're when we block
13:30it we're stopping them from that
13:32self-regulation technique that they then
13:34even trying to remember like this is
13:36like you said this is something they
13:38have developed and we can let them
13:40engage in this it's yeah so for example
13:44that blocking the stemming so their cup
13:46is spilling over then they're seeking
13:49out we have to understand that there's a
13:51reason behind every time that we're
13:53stemming so they're seeking out some
13:54kind of input they're trying to
13:55communicate with us so blocking it we
13:59get disregulated and then they don't
14:02know what else to do we might see an
14:03increase in harmful stemming or we might
14:05see they're looking for something to
14:07replace it with looking for something to
14:09replace it and then you might see some
14:10self-injurious behaviors because then we
14:13in the sensory overload we don't know
14:14how to regulate ourselves when our
14:16source of Regulation is taken away from
14:19us yeah now of course there are times
14:22that we do have to redirect stemming so
14:25this is if the stemming is going to hurt
14:27the individual themselves or someone
14:29else in the environment but like I said
14:31we have to respect and honor that there
14:33is a reason and we need to help support
14:35them with the input yeah you feel like
14:37if you were say like you had to you know
14:40block a stem say it was like headbanging
14:42on something really hard you like would
14:44also replace it with something else
14:46right that would give them the same kind
14:47of input yes so that's a great example
14:50so if you have your learner banging
14:52their head against the wall for the stem
14:54of course you want to dve away from them
14:55wall but an alternative is to provide
14:57them with a pillow so they still give
14:59them the opportunity to hit their head
15:01but just in a much more safer context
15:03and I feel like that the example with a
15:05pillow like you're not moving them
15:07either to like a different Spa like you
15:08are still allowing them to be where
15:10they're at respecting them in that way
15:12as well yes and then talking about this
15:15kind of reminds me there was this one
15:17time like you were there as well we had
15:19a learner that I was was Tech on at that
15:22point and he used to Pace back and forth
15:24all the time and it was to a point where
15:27like you know we understand yet but the
15:30BCB on the case was like oh like we need
15:32to redirect it so that we can provide
15:34like these different opportunities for
15:35him and you really put your foot down
15:37you were like no this is a stem and you
15:39explained it to us but even then like we
15:41took some data like be if we stopped it
15:44versus if we didn't stop it and we saw
15:46that all of the other behaviors during
15:48the day went down once we allowed him to
15:51Pace back and forth yeah right that was
15:54a
15:55wonderful just to see how everything
15:57decreased but it's a wonderful
15:59opportunity for all of us of how we're
16:00working as a multidisiplinary team to
16:03help support our client right and I
16:04appreciate like you were also like okay
16:06how can I show you so like that's when
16:09we were like okay let's take data cuz
16:10you know bcb's love data like take the
16:13data and see that it does work yeah how
16:16helpful it is for the kid yeah and um I
16:19do have some other points quickly about
16:22the um effects of blacking stiming yes
16:24so there's such a significant impact on
16:27self-esteem and it's so wonderful now
16:29that we have so many autistic adults who
16:31are sharing their lip experiences and
16:33insight of their experiences of having
16:36their Sims blocked and how it impacted
16:38them yeah but something that's really
16:40coming out is with blocking a Sim
16:43there's increased masking going yes and
16:45as we know when we're we're masking
16:47we're trying to fit in with what's like
16:49expected the societal standards yes
16:52there's some significant impacts on
16:54increased anxiety um depression later on
16:59and just a decreased self awareness and
17:02individuals are coming out saying I
17:03didn't know who I was until I was in my
17:05later adulthood because I was told I
17:07should not be doing this they were
17:09expected to change who they were you
17:11know and what they what they knew to be
17:13like their self-
17:15expression and with the masking it just
17:17takes so much energy and it can lead to
17:19autistic
17:20burnout and that's just not being their
17:23authentic selves yeah what is autistic
17:26burnout I've heard that a little bit
17:28like I've seen it on social media I
17:29haven't heard it a lot like in our field
17:31yet so artistic burnout I'll just touch
17:33on it quickly because like also
17:34something for another episode on it um
17:38but it's just essentially a state of
17:40burnout and decreased motivation to
17:43engage in daily activities because
17:45there's so much pressure so think of
17:47like kids who are in therapy for so long
17:49trying to um engage your daily Tas or
17:52just like so many demands and we might
17:54see more connection seeking behaviors um
17:59they have decreased motivation to do
18:01things they just want time and space
18:03it's different than occupational burnout
18:05but it's also the same in the terms that
18:08like we just need to have time to be
18:10ourselves and regulate and not have so
18:12many demands day kind of like I'm I'm
18:16done taking the mask off because I need
18:19time to be my true self yeah I like that
18:22thank you for sharing that yeah of
18:23course were there any other harmful like
18:25effects of blocking stre me that you
18:27wanted to touch on yes I just wanted to
18:29um emphasize the fact that stemming
18:31provides opportunities for individuals
18:33to be their true authentic selves and
18:35feel safe so trying to force steming or
18:38taking away from them takes away their
18:40autonomy
18:42self-expression and the ability to self-
18:44regulate themselves that's why it's so
18:47so important to be able to respect
18:50individual choices regarding stain and
18:52that promotes the self advocacy and
18:54autonomy for the
18:56individual yeah thank you for sharing
18:58that and kind of bringing awareness we
19:01come from a field that I was trained
19:04before I came um to work at Blossom like
19:06I was trained on blocking stemming and I
19:09wasn't really aware of I didn't think
19:11about it from an OT standpoint I really
19:12had no OT knowledge at all so I I've
19:15just learned like it's a behavior and we
19:16have to block it so that we can teach
19:18them other things um so it's it just
19:21makes me happy it sucks yeah but I feel
19:23like I wasn't necessarily trained to
19:24block it but if like say like at when I
19:28was a te technician a lot of times like
19:29it wasn't at Blossom but lot of times
19:31when someone was engaging in a stem say
19:33like once we brought them to the table
19:34to do some work we're like okay now we
19:36have to block cuz now we need to get
19:37their attention get them working which
19:40sucks because ABA has so like I feel
19:43like historically ABA has focus on
19:45eliminating stiming behaviors like you
19:46talked about a little bit but because
19:49they were viewed as disruptive and some
19:51strategies or things people did were
19:54like I wanted to kind of talk to you
19:55about that and you kind of give us your
19:57input on I probably
19:59sucks no and we want to talk to like our
20:01field as well you know our audience is
20:03primarily bcbas right now and just like
20:06if maybe they're education LED them this
20:07way these are some of the strategies you
20:09might be using um and like here are some
20:11Alternatives that we want to provide
20:13yeah so the first one was Extinction so
20:16what a lot of people were doing or some
20:18people are continuing to do are if say
20:21someone was engaging in a stem say like
20:23an example was like hand flapping so if
20:26someone was engaging hand flapping what
20:28they would do is they would put it on
20:29extinction that means they would block
20:30every single attempt and like really the
20:33unless it was specified to give
20:35redirection to something else that's all
20:37it would be just blocking it making sure
20:39they got no reinforcement for so yeah I
20:40was going to explain to Amy like
20:41Extinction is no longer providing
20:43reinforcement to a behavior that was
20:45once reinforced so and the thought was
20:48that the stem was um like it was
20:51self-reinforcing which it is now that we
20:54like hear about it so blocking it like
20:56not allowing them to do it prevented the
20:58reinforcement So It ultimately should
21:01extinguish the behavior but as you kind
21:03of shared as well once we were doing
21:05there you know maybe replacing it with
21:07other stems that might not have been as
21:10safe or were you know causing it was
21:12causing more anxiety more stress to
21:14their lives and leading to that masking
21:16that you were talking about yeah yeah um
21:19do you have any questions on it no I
21:21just kind of wanted to bring up another
21:23topic that has to do with all this um so
21:26this could be another conversation too
21:28but I know if you guys have heard of the
21:29monot tropism no no so monot tropism is
21:33a thinking and processing pattern that a
21:35lot of individuals not only neurod
21:37Divergent but neurotypical as well um
21:40how they interpret and process and
21:42engage in their daily routines so that's
21:45when we might see they have like a deep
21:46focus on one activity at hand and it can
21:49be very disregulated to try to redirect
21:53them so there's something called The
21:54Flow State which goes with this mot
21:56tropism and the flow is the complete
21:59immersion in the task and activity okay
22:02so we might think of it I used to think
22:03of it until I learned about this is like
22:05they're hyperfocus on something but it's
22:08really they're all their sensory systems
22:11are working to engage in something
22:13that's regulating for them and they're
22:15in this state of flow where we may think
22:17they're not attending to us and in a
22:20sense it might be true because they're
22:21so completely focused on the task you're
22:23engaging with and it promotes self um
22:26self-awareness well-being and it also
22:29just makes them happy and part of
22:32repetitive actions helps achieve that
22:34flow state so steming a lot of times
22:36when our kids are stemming they're in
22:38that flow State and it's like they're
22:40just feeling very themselves and
22:42authentic so to hear about like the
22:44extinction of it when we're trying to
22:46take that away we're not giving the kids
22:47opportunity to reach their Flow State
22:49for regulation and to complete and focus
22:51on tasks yeah it's sad and I have used
22:56like Extinction in the past and I've had
22:57you know when I was under like the
22:59practice of other bcbas so it's like I'm
23:01glad we're trying to make changes
23:02towards other strategies that's really
23:04like what we wanted to use as platform
23:06was like you know as a field we are
23:08moving towards like accepting
23:11individuals and respecting their
23:12autonomy so we wanted to neur firming
23:15when provide everyone to knowled with
23:17the knowledge to understand why it's
23:19important not to block these things yeah
23:22exactly and that leads me into there's
23:24another strategy it's called Rd or
23:26response Interruption and Direction um
23:30so this is very similar to Extinction
23:31where we like block the um behavior in
23:34the moment so it's like if they were to
23:36engage in like you said hand flapping we
23:37would immediately block it and some
23:39people would say like safe hands or show
23:40me quiet hands um but then replace it
23:43and redirect it too and this is like
23:45where I like the research shows it's
23:47like a more acceptable behavior um so
23:51for those listening Kristen what oh air
23:53quot air
23:54quot sorry yes um and that's kind of
23:58what the thought was was to like
23:59redirect it so it could be more
24:00acceptable and give them an alternative
24:02Behavior to engage in which it sounds
24:04like in ABA we kind of thought of it it
24:05was like in theory it was kind of we
24:08were leaning towards the right thing but
24:09it's they were well intentioned maybe
24:12but but it's still blocking the learner
24:14from getting access to what they were
24:16needing in that moment another strategy
24:18people have used in the past or people
24:20continue to use is differential
24:22reinforcement so meaning providing
24:24reinforcement for the Alternatives that
24:27are happening so anytime they aren't
24:29maybe engaging in that stemming Behavior
24:31providing reinforcement and then the
24:33last one is functional communication
24:35training if you want to touch on that
24:36real quick yeah um I think this was used
24:38a lot for um like Vocal Stems and it's
24:41even used like to help the learner like
24:43meet their needs that's what I feel like
24:45I hear the most with so yeah like
24:47advocate for their own needs so say like
24:48it's really loud in a room and we see
24:50them like engaging within the covering
24:52yours like having them request for like
24:54headphones is something I've seen a lot
24:57and this is something that think I still
24:59incorporate into my practice now because
25:01it's like I'm trying to help them
25:03provide me like with what they need like
25:06as um like a vocal and like man what do
25:10you like what do you think about that do
25:11you feel like that's acceptable or would
25:13you do the
25:15same um a lot of times from the sensory
25:18and OT perspective if I do see that I
25:20may just offer the sensory supports of
25:24necessarily like manding or requesting
25:26it especially if we are in over
25:28stimulating environment it might be hard
25:30to access that Language Center in our
25:31brain my just provide the model that's
25:34what I was thinking yeah like I tend to
25:35like model for the like oh it's loud or
25:38um need some headphones need some help
25:40yeah no yeah I agree with that as well
25:43but I just know sometimes it's harder
25:44when we are in like that state or even
25:46to like follow the model might be
25:47sometimes difficult when we are
25:49disregulated so I think there's
25:51different ways we can help support the
25:52Learners there and I think about this
25:54like um I think you and I had worked on
25:55a learner where they had um some
25:57behaviors in they were in like not quite
25:59an opal learning State they might be
26:00like tantruming laying on the floor and
26:03um you had mentioned you're like oh you
26:05guys are kind of talking a lot during
26:06the behavior like we were trying to
26:08model and help communicate for them and
26:09I was like oh but I'm just trying to
26:11help and you're like yeah but it might
26:12be best right now to hold space and
26:14allow them the time to like feel their
26:17feelings and then model in when they're
26:18in a learning State absolutely I think
26:21of it like say like I had a really bad
26:23day and I get home and I'm crying and
26:25then like my husband's like what's wrong
26:28what can I do for you you need help like
26:31my husband does the fix it he like
26:33provides me all these stres like I don't
26:35want to hear it right now that's not
26:36what I want right now like just I want
26:37to sit here and just like raw on the
26:41couch be mad yeah I want to be upset
26:44about it like this is my time but then
26:46like maybe when I'm feeling a little
26:47better I might want like okay like can I
26:50have a hug yes and that's a great
26:53example to apply it to your own lives to
26:55put this into practice like cuz I'm the
26:57same way too like I'm over WS it's been
26:58a long day I just need my me time I need
27:01my space and then after I have some time
27:03then I'll socialize with others or like
27:05connect with others maybe maybe if
27:08you're ready maybe if I'm ready but yeah
27:11that's such a great perspective to take
27:13on it because we need to apply it to our
27:15own lives to understand how it can help
27:17support our Learners I think as like
27:19therapists or people in these positions
27:21where we're like you know we're actively
27:23trying to help someone it feels like
27:25sometimes when we're telling someone to
27:26like hold space like if feels like I've
27:28hear a lot of tech like it feels like
27:29I'm doing nothing but like remembering
27:32that it's not doing nothing that like it
27:35is very beneficial yeah so beneficial
27:37and holding space yes it sometimes it
27:39feels like I'm just sitting here
27:41lowering my AFF just being with them but
27:44that's a connection that so many people
27:46need during dysregulating times yeah so
27:49that's therapeutic in itself can you
27:51talk about like what our body
27:52positioning might look like while
27:53holding space cuz I don't want people
27:55who might be listening to think that
27:56we're just standing there with our arms
27:57crossed and like just not looking at the
27:59learner like what does holding space
28:00really look like so holding space it
28:02really just depends on the situation at
28:04hand but a lot of times in my practice I
28:07will actually get down to the floor a
28:09lot of times there kids are on the floor
28:10so I'm just saying that um I will get
28:12down to the individual's level provide
28:14some increased space um but then I'll
28:17just model using like I can't really put
28:20this auditorily but um model just having
28:22a calm effect and just presenting myself
28:25like understanding a lot of times I'm
28:27not talking it's just my and every so
28:30often I'll say okay I'm here for you or
28:33like I'll just model some deep breathing
28:35just to kind of help pass on like that
28:37calming sensation to the individual not
28:40putting any demands on them you know I
28:43remembering that even to like you know
28:44sometimes I feel like if someone's upset
28:46like trying to put my hand on them that
28:48might be too much at that moment too
28:50just if they want it like I I'll put my
28:53hand out like if you're ready like you
28:55can show me I think lately something
28:57I've been doing is holding my hands open
28:59and out towards the learner but while
29:00still providing them like quite a few
29:02feet of space if they need it like so an
29:04open position right open position and
29:06then it puts it on aarn to reach out
29:09when they're ready yeah because yes if
29:11we like reach out or try to provide hugs
29:13or compression at that time that might
29:15be enough to spell our cup back over
29:17again when we're trying to deescalate
29:19ourselves yeah I think so too so we
29:21talked a little bit about like that abas
29:24um like we're really shifting towards
29:26accepting like um and person centered
29:28approach and just really neuro affirming
29:30for our Learners um I think that
29:32stimming is often it's really
29:34misinterpreted as a socially in
29:36appropriate behavior um especially in
29:38ABA like from kind of the education that
29:39I received on it but like Amy said
29:41everybody engages in stemming so I just
29:44wanted to talk a little bit about like
29:45youer and like user what do you do as
29:47like some of your stems some of my stems
29:49is like I'll bite things like I'll bite
29:51like pens my
29:54nails even like I haven't I haven't done
29:56it in a while but like I used to like
29:58chew on like my clothes like the my
30:00clothing that was some of my stems yeah
30:03I tap my foot a lot or like when I'm
30:05really thinking like my husband would
30:06always ask like my foot would be like
30:07moving on the bed like back and forth
30:10and he's like okaying the foot swinging
30:12a lot too but I feel like my feet don't
30:14touch the floor cuz I'm very short and I
30:16feel like like then I'm like oh like
30:17swinging back s but it makes me feel
30:19better you know um and then I um like
30:22pick my lip sometimes like if I'm
30:24overwhelmed like I like if I'm anxious I
30:26pick my lip some of your stems so I
30:29definitely I cannot like sit down when
30:31I'm having a FaceTime or a phone call I
30:33have to be moving walking around yeah um
30:36I tend to listen to the same songs onat
30:39I we talked about that a little bit big
30:41Swifty I'm a big Swifty so shout out to
30:43Taylor Swift I hope you listen to
30:45this but yeah those are like some of my
30:48major Sims but I know a lot of times too
30:51I also like if I'm anxious or
30:53overwhelmed like I'll just start like
30:54tapping my shoulders really yeah it's I
30:57never really thought of as system before
30:58until like I really got into this world
31:00of learning about um stems and sensory
31:03processing I'm like oh I do that all the
31:05time there's nothing wrong with it it's
31:07regulating for yeah it's just what you
31:08do and exactly and so I think like the
31:11point that we're trying to get across
31:13for like our ABA field is really just
31:16promoting acceptance and inclusivity in
31:17our field and then I wanted to kind of
31:19talk about like how we can do this like
31:21we've talked about why it's harmful
31:24really like what's we what people have
31:26done in the past like histor
31:28like what we can do moving forward as
31:30well so one thing is like as like
31:32especially if you're a bcba in a center
31:34or in a clinic or in home and you don't
31:37have access to an OT you can still
31:39advocate for your learner to receive
31:42like the supports they might need to
31:44like help them with their sensory needs
31:46in that moment so I know like here we
31:48are lucky we have like dim lights and
31:50stuff like that what are some other
31:52things you feel like people can advocate
31:54for um just free access to stemy and I
31:58think the biggest piece there is that
31:59education of why it is
32:02important um and also just really
32:04touching on the mental health impacts of
32:07trying to Blain I think it's so
32:10important just that General awareness
32:12and really allow it just remembering
32:14it's a natural behavior it's a natural
32:16it's a natural something that need to be
32:18fixed yes nothing that needs to be fixed
32:20it's a natural expression of an
32:22individual's neurology and you know we
32:25need to celebrate and encourage stemming
32:27MH to be their authentic selves yeah you
32:30have anything to add to that yeah I
32:32think that it's just um there as a field
32:36and many different people even parents I
32:38hear like want to that's a hard one that
32:40we might talk about a little bit more
32:41yeah we'll go into it a little bit later
32:43but I think that it's because we're
32:45unaware and like none of us are ever
32:47trying to harm the children we're
32:48working with we're all in this field
32:50because we like love the population we
32:52work with we want to help them so
32:53nobody's doing this like with like in
32:56Bad Intentions um so bringing awareness
32:58to it I think is such a good point all
33:00right let's yes I wanted to talk and we
33:02talk you mentioned about it briefly um
33:05but as bcbas there might be times when
33:07we do need to Target stemming um some
33:10things that I think of like you said are
33:11like when there's harmful behaviors
33:13towards self or others um and then
33:15another thing that we'll touch on a
33:16little bit too um is like when it in
33:19interferes with learning opportunities
33:22so especially like in the education
33:23setting or like when they're um like
33:25maybe in school and things like that and
33:27then another one is like the functional
33:29impairment if it's like the stemming
33:31behaviors interfering with their daily
33:32living tasks yeah right um so something
33:36that we want to note before we get into
33:38is like rather than attempting to
33:39extinguish the stemming alog together we
33:41can explore alternative strategies for
33:43like kind of you noted like alternative
33:45things that they can do to engage in to
33:47meet that same sensory need that they
33:49might be attempting to get at all right
33:51so let's kind of start with the safety
33:53concerns so if the stemming Behavior
33:55poses a safety risk to an individual or
33:57others such as self-injures Behavior
34:00like severe headbanging some other do
34:02you have any other ones that are coming
34:04to your mind um or hurting others so
34:07like even like kicking um like your feet
34:09I know some Learners like kick or like
34:12bite and head biting is a big one I feel
34:14like I've had a lot of Learners that
34:16bite themselves very hard or will
34:18attempt to bite someone else very hard
34:20when they are stemming but this might be
34:22an instance where it's necessary to
34:25address stemming you have any
34:26suggestions on like what you would
34:28replace it with or strategies to use in
34:31those moments yeah so it really just
34:33depends on the stem but thinking about
34:36like kicking um provide like I If
34:39there's like therapy balls available or
34:41provide like a safer thing for someone
34:43to kick into um for biting there are
34:46like chewy options you can present so
34:49for biting could be like oral sensory
34:52seeking or could also be they looking
34:53for that's so important to collaborate
34:56like if you like like you don't have it
34:59tell like recommend like the learner
35:01receives OT Services get on a weight
35:04list and that's like what's super
35:06important too and even if you don't have
35:07OT at your clinic listening to this um
35:12you can do a simple Google search just
35:13to learn about the sensory system so we
35:16have eight sensory systems but when
35:18working if you do have an OT clinic or
35:20someone you collaborate with it's
35:21important to collaborate to learn about
35:23why like why you're saying different T
35:25systems that are impacted with with the
35:28Sims or like what they're trying to seek
35:29out at that time so it just provides a
35:32better understanding of like okay these
35:34are these are the child's sensory needs
35:37then we can collaborate on ways to help
35:38support the needs right that makes sense
35:41I like that yeah I agree I want to take
35:43a quick pause for our second code word
35:45today for our cus is nail
35:48biting is there anything else you wanted
35:50to touch on with that no I think we're
35:52good to go in with the interfering with
35:54learning yes so I wanted to talk a
35:55little bit about like the interfering
35:56with learning opportunities and when it
35:59might be um necessary to um provide
36:01those Alternatives that we were talking
36:03about um so if the stem Behavior
36:05significantly interferes with the
36:07individual's ability to engage in
36:08learning activities I know you and I
36:10worked with a shared client um who they
36:14engaged in they like had a tube like
36:16what I don't know what they're called a
36:18pop tube and he really loved it and he
36:20shook it in front of his um face
36:22visually and really enjoyed the like
36:24visual component of it um but he really
36:26would engage in all day and it would
36:28really um it regulated him and he
36:30enjoyed it a lot but we struggled to
36:33find times to do work like any time that
36:36we would sit to do work he wouldn't um
36:38be able to focus on like anything that
36:40we asked him or communicated to him so
36:42you and I worked together on like we had
36:45to like remove it just during that like
36:47learning opportunity but instead of
36:48completely removing it from them and
36:50like taking it from them almost like
36:52aggressively like having to like have a
36:53power struggle we like removed it and we
36:55put it on the table in front of him so
36:56that he knows it's still his access we
36:59were just um like removing it for the
37:01task and he still had free access to it
37:03at any other point during the day yes so
37:06that's important if they are steming on
37:07an object instead of completely taking
37:10away like you mentioned Kiren you still
37:12want to keep it in their visual field
37:14yeah and why do we do this to help
37:16alleviate anxiety because stemming is so
37:20self-regulating and self soothing that
37:22if that object is taken away the child
37:25may have no idea where they can find it
37:26if
37:28it because it's so caling for them so we
37:30want to be able to provide them the
37:32access to it so even if we're doing a
37:34task and they do like 30 seconds of a
37:36task and then I need to S on it again by
37:38all means please do that we need to give
37:40them like those small breaks breaks yes
37:42sensory breaks especially if we're
37:44having them do seated work and it's not
37:46necessarily something that's
37:47intrinsically motivating or engaging
37:49yeah then we're going need extra support
37:51to regulate ourselves so it might take
37:54longer to complete task which is totally
37:56fine because we're still supporting the
37:58learner's best entrance
37:59ands and this is something to consider
38:01too when like you guys are like still
38:03working towards um building that skill
38:06like if it's outside of their skill set
38:07to sit at a table for imagine how hard
38:10it is to learn a new skill like you
38:11might need that regulation it's so hard
38:15yeah so yeah really taking that into
38:17consideration um and it's also with like
38:19if it's impacting um social
38:21opportunities as well like if they are
38:23unable to really interact with peers
38:25because they're stemming con stantly um
38:28help helping them find like alternative
38:30ways to engage in that what do you re
38:32like that one's a hard one how you what
38:35do what you do in that situation oh that
38:37is a hard question I'm going to need to
38:39think about
38:40that um but I think it's also important
38:44just to like even if they don't want to
38:47if they don't want to respect that of
38:49course we want to promote pure
38:51socialization that's such an important
38:52part of our well-beings but that also
38:55increase anxiety for IND especially if
38:57they're monotropic thinkers and
38:59processors and they need to focus on one
39:01thing at a time M that we just need to
39:04respect that but also like if we are
39:06Stan like encourage other peers to like
39:09join them in their s and enter their
39:12world especially if you have like a peer
39:13that would be like is able to like you
39:16know I know we would say like if you're
39:17working on conversations or like
39:19greetings you want to do it with a peer
39:21that would reciprocate back trying to
39:23find a peer that would also reciprocate
39:25back when we're introducing those social
39:26opportun for them yes very important I
39:29feel like and I think this kind of goes
39:31back to what you're were saying like I
39:32think you were talking about a learner
39:34who is engaging in happy hands when very
39:36excited so you joined them um to like
39:39share that Joy yes and I think that when
39:41we model it especially with other
39:42Learners in the environment like
39:44expressing to the other Learners that no
39:47our friend is so happy this is how
39:48they're showing they're happy and like
39:51if they want to join sometimes they will
39:53it's a good time to do that and just to
39:55note on that too so sometimes like we
39:57may think they're happy but we don't
39:59actually know how they're truly thinking
40:01so I like to label body cues like oh
40:03their hands are flapping there's a smile
40:04on their face they may be feeling happy
40:08because I don't want to assume that I
40:09know how they're truly feeling on the
40:10inside that's a good point I really like
40:12that thank you all right and then the
40:13next one we're talking about kind of was
40:15the functional impairment so if the
40:17stemming behavior is causing functional
40:19impairment or limiting the individual's
40:21ability to participate in daily living
40:23activities pursue personal goals or
40:25maintain relationships was kind of where
40:28I was going with this do you have any
40:29thoughts about like what we would do in
40:31this situation or have you guys ever had
40:33the situation come up I feel like this
40:35comes up a lot with like our older I
40:37think about this a lot with like eating
40:39um like if they're struggling to eat or
40:42like they can't brush their teeth
40:43because they enjoy like stemming with
40:45the toothbrush and like helping parents
40:47navigate those situations of like their
40:48daily living skills can I just give a
40:50second toothbrush and then like no that
40:53is a that's a strategy I recommend
40:55before give them one to hold on to and
40:56stem want to engage in that task um but
41:00what I also find to be encouraging too
41:02and kind of helps at times is just to
41:05label what you're about to do so you're
41:07going to say okay we're going to you
41:09know have free access we're going to
41:10play with our toothbrush
41:12for however many minutes or seconds and
41:15then we're going to take a small break
41:16we're going to brush our teeth so give
41:18me preparation because I think a lot of
41:21times we underestimate our individuals
41:25receptive language so giving that
41:27prepared time simple first then first
41:30we're going to do this but still like
41:32okay I see that we're you're engaging in
41:34this and it looks like it's fun for you
41:37we're going to take a small break so
41:38would you give like a countdown do you
41:40feel like like okay three or even 10
41:42like if it's something like 10 8 then
41:44take it away yeah um a countdown or
41:47sometimes I use like a timer on my phone
41:49and then like sometimes like that timer
41:51the sound like um divides their
41:53attention like oh something's happening
41:55like our timer went off now I know can
41:58complete this task and I know I would
41:59give this toothbrush right back to them
42:01yeah it becomes Bast and I feel like
42:03something after talking about it is like
42:05maybe trying to have them put their own
42:08like instead of blocking like okay like
42:10can you like show me like hands to your
42:12side really quick and then we'll go do
42:14or whatever rather than like removing
42:16the from them like set it let's set it
42:18down yeah I would definitely say like
42:19let's set it down like I want to resp
42:21their aony I don't want to take things
42:23away from and I feel like people even
42:25like P like as a mom like let me just do
42:26it for you right like you know like
42:29respecting like okay like even if it
42:31takes a little bit longer let our
42:33learner do it yeah and that's important
42:35too with everything that we're talking
42:37about too our Learners need increased
42:39processing time and time to complete
42:42tasks so that's like another part of
42:43like holding space or just preparing
42:45ourselves that we might not do things
42:47quickly we just need to regulate and
42:49give them that time to process yeah MH I
42:52think so too like going with that like
42:55with the um increased time
42:58um a lot of families like really really
43:00struggle with some of the stemming and
43:03they ask us like a lot of times like
43:04that's one of the main goals is like oh
43:05can you eliminate this um and it's
43:08because a lot of times they might not
43:09like have the time to navigate it or
43:11there's just barriers so when we are um
43:14like working with parents how would you
43:17go about that like if you were if I were
43:19to ask you to join a parent meeting with
43:20me um to help address like their learner
43:23engages in a lot of stemming and they
43:25really want to like eliminate it
43:27how would you start that conversation
43:29with the
43:30family yes so I think it' be very
43:33similar to this podcast today just um
43:36explaining the underlying reasons for
43:38stemming and that we need it to support
43:40our engagement in daily life we need it
43:42for
43:43regulation and just talk about how
43:46harmful it can be to block that simming
43:49and I know that may not be they really
43:51receptive may not be what parents want
43:52to hear but it's so important to provide
43:54that education and if we need to provide
43:57research like to support that to help
43:59them understand this is how your child
44:02perceives life how they go through their
44:03daily life there's nothing wrong with it
44:05we need to embrace it and enjoy it with
44:07them and I think that's one of the other
44:09things like as like people in this field
44:12like we should be like talking to
44:15parents and not like I feel like before
44:17a lot of parents I have had this sorry
44:20rep I had a lot of I've had a lot of
44:22parents come to me and they say like
44:23they think like therapy's going to like
44:26fix yes all of like these autistic
44:28traits but telling like this is not what
44:30therapy is for it's really to help them
44:33Reach different Milestones learn new
44:35skills we're not here to change the
44:37individuals like autistic traits and
44:40like being firm in that being very firm
44:43you know recognizing the individuals
44:45perfect the way that they are we're not
44:47trying to change them there's nothing to
44:49change it's more how can we support them
44:52to engage in their daily life while
44:54meeting their sensory needs and
44:55preferences I feel like once you have
44:57that like behind you and you're ready to
45:00like you can face it a lot easier yeah
45:02you know yeah yeah like the
45:04understanding and the other thing too
45:06like that you mentioned was just like
45:09really emphasizing excuse me the
45:12importance of like their emotional
45:14well-being through their stem and like I
45:16know parents they just want the best for
45:18their child they want them to be happy
45:20like with my daughter I'm like oh my God
45:21I'll do anything to make her happy and
45:24so just really emphasizing the
45:26importance like that the stem has on
45:28their mental health even reminding them
45:30like okay if we maybe like we like we
45:32stop it every time they're just going to
45:33replace it something we may not want or
45:36something that's self- inous as well and
45:39reminding them like if we take this away
45:41like this is what's going to might
45:43happen something we can do as well right
45:46I think so too and then also like if
45:48you're just a BCB like you're a bcba
45:51like trying to get an OT in because
45:53they're able to explain that a lot
45:55better they can share what like each
45:57stem what the purpose of each stem is on
46:00a deeper level and if you don't you can
46:03even share like the functions like well
46:05we see like once this happens like like
46:09behaviors go down or something like that
46:11yeah and even like I think you mentioned
46:13it before thinking about these stems um
46:15from a data perspective like looking at
46:18the data when you're blocking the stems
46:19versus when you're not like there are
46:21ways to address it behaviorally that
46:23don't include blocking or eliminating
46:25the stem um we are so lucky we have the
46:28opportunity to work alongside OTS and
46:30like I talk to OTS multiple times a day
46:33some bcbas don't have that opportunity
46:35so a strategy that Amy mentioned earlier
46:37was to um just like Google what did you
46:40suggest Googling I forgot um sensor
46:42integration sensory processing sensory
46:45systems and you know there are like
46:47simple ceu courses for all professionals
46:50just to learn more about sensory but um
46:52like this one a re a website I really
46:55recommend it's the star instit for
46:57sensory processing there's so much
47:00knowledge on there so many different
47:02resources and it's very digestible so
47:04heing sensory terminology can be
47:06overwhelming but they really break it
47:08down
47:11into term L terms yes thank you I feel
47:14like that's important too when like
47:15talking to parents or talking to
47:17caregivers is like explaining it on that
47:20kind of level like yeah the easy way
47:22easy to digest way yeah and I wanted to
47:25touch on like when like yes we can
47:27Google and like learn a lot about the um
47:30OT needs but be cautious don't Implement
47:34strategies without consultation of an OT
47:37does you can gain more knowledge on like
47:38the sensory needs that your child may be
47:41having but before implementing anything
47:43always consult with an OT because
47:45because we don't have the answer to
47:46everything yeah we have the best
47:47interest at heart but we we might not be
47:48doing it correctly right right are there
47:51any other points you wanted to make with
47:54collaboration I think we touched on them
47:56all
47:57just being very open and receptive to
47:59learning about other
48:00people's disciplines what our knowledge
48:03based and what we're trained in and just
48:05really working together to make the
48:07experience as beneficial for the child
48:09as we can yeah and of course that also
48:12includes parents as well so just having
48:14those open conversations and the
48:16education piece yeah all right so one
48:19other question I had I know we're
48:21talking about like a little bit of like
48:22the collaboration do you feel like
48:24you've ever had a bad experience like
48:27collaborating with a bcba that's like
48:29say maybe like doesn't want to implement
48:32like any of the strategies youest a
48:34resistance to it so I wouldn't say I had
48:37a bad experience but I would say I was
48:39met with initial hesitation of why would
48:42we freely allow the kid to STM all day
48:45so that's when I had to like pull out my
48:47resources and research and just educate
48:50on the importance of swimming and then
48:53the bcba was actively willing to try it
48:55out like hey like we're trying to help
48:57this kid in any way we can let's try
48:58anything and see if it helps and then we
49:01did see some success and it's just the
49:02client that you were talking about
49:03earlier um he wanted to like run back
49:05and forth MH and I feel like that that
49:08like that situation actually the time we
49:10took the data it lasted like one or two
49:12weeks it wasn't like something we agreed
49:14upon like within a day or two days even
49:17took a little while right yes and then I
49:20think once the client was understanding
49:23oh like I'm allowed to keep doing this
49:25no one's going to stop me then we see
49:27like the decrease and the other
49:28behaviors may not necessarily want to
49:30see that increase in yeah so it does
49:32take a while for the child to like adapt
49:34to it as well just being able to do what
49:36they need to yeah I think something with
49:38collaboration like when I first I think
49:40I've noted before um I wasn't always a
49:42bcba here and I came from a clinic where
49:44I um was never really taught to
49:46collaborate so when I initially came um
49:48to Blossom something that really
49:49benefited me when working with other
49:51disciplines was I would ask to join OT
49:54sessions I'm like okay I hear what
49:55you're saying but I can't understand how
49:57to implement it when working on the stem
49:59or especially even just imitating the
50:01stem I'm like wait how are you doing
50:02that what does it look like in your
50:03sessions so I would just join um and
50:06just really observe and kind of figure
50:07out what you guys were doing and try and
50:09replicate it in our sessions to see if
50:10it would work with my technicians as
50:12well another this was like another shirt
50:14CLI I had with Amy but we talked about
50:16his stem was like moving like dropping
50:19things in front of his eye and we talked
50:21about like other play sequences we could
50:23do that in so we could find a way to
50:25like pair with them like see those
50:27engaged Smiles cuz it was really hard to
50:30motivate him to do a lot of tasks so
50:33once we kind of like even figured that
50:35out we came up with so many play
50:36strategies for him and then we were able
50:38to see like that engagement with him as
50:40well I think that's a good point to note
50:42it's like incorporating the stem into
50:43play especially visual stems and things
50:46like that like there are ways to
50:48replicate it to help them enjoy other
50:50activities you compare it as we talk
50:51about in ABA like the visual tactile the
50:55PO receptive those are all so easily
50:58able to be incorporated into play and
51:00like you mentioned once the client sees
51:02that we're joining them it's like wow
51:04they understand me get they want to
51:06engage with me and then we see so much
51:08more increased joyful engagement and
51:11just that General understanding of like
51:12their resp me for who I am and who I
51:14need to be and also sometimes the visual
51:16sys once I see it I'm like this is like
51:18I can see what they see
51:21like say like it's like a ball like
51:23moving down like up and down their face
51:24but if you do it you see like it's weird
51:28to say but once you see it from their
51:30perspective it really does open up a lot
51:33cuz you're like well we can do this in
51:34so many ways like let's get like balls
51:36and out in front of us or like the sand
51:38in front of our faces the same exact
51:40thing yeah I had a professor and when we
51:42were like discussing stems and in school
51:44they were like just replicate the stem
51:46that your learner is engaging in just so
51:48you can kind of see and get a sense of
51:49what they're understanding from it and
51:51feeling with it so like I remember when
51:54I was a student my one one of my
51:55Learners they did like side eye so they
51:57would the corner but then they would
51:59look at a toy through it and I'm like oh
52:01wow that is kind of cool like look it's
52:02like there's double now it's just like
52:05really see what they're enjoying from it
52:07and help them enjoy it more well thank
52:09you so much for like your Insight on
52:11collaboration it's a big component that
52:13like user and I like to harp on it's our
52:15number one topic I feel like um quick
52:18break for our third code word is tapping
52:22all right and then on that note like
52:24that's all the info we had for today
52:26we'd love to have Amy on again she
52:28mentioned a few things that she'd love
52:30to talk about a little bit more but
52:31until next time we'll talk to you later
52:34see you
52:36bye all right guys thank you so much for
52:38listening please don't forget to like
52:40And subscribe and if you want your ceu
52:42credits go to our website at Blossom
52:43children.com talk to you later see you

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