I know it can be rare sometimes, but this is a real feel-good story! I had the pleasure of working with a family recently about their son, Joe*. Joe was referred to Kindred Kids Early Intervention (KKEI) by Rachel Birthsel, Occupational Therapist at Collaborative Partnerships, due to the comprehensive small group treatment based on the Group-Early Start Denver Model (G-ESDM) format that KKEI provides. Joe is and was an incredibly bright, young boy, however, Amelia*, Joe's mum, identified at intake that Joe's behaviours of concern were difficult and that they had been engaging in therapy for a long time to assist Joe's growth for school transition. Joe had trialled day-cares in the past, and these were not suitable. Joe had few friendships due to his behaviours of concern or the interactions would end abruptly if he did engage in a behaviour of concern so as not to escalate the situation. Amelia had been given a number of strategies by Rachael to reduce behaviours of concern, however now was time for the missing step of developing Joe's skills amongst his peers.
The first therapy cycle that Joe engaged in was typical to what most KKEI clients utilise - 1 Group and 1 Individual session per week. Throughout the first therapy cycle, Practitioners are always focused on regulation whether in the group or individual, and Joe developed a trusting relationship with his practitioner that mostly involved play to start. Specific transition plans around leaving therapy were developed to assist Joe.
The second therapy cycle focused on the specific supports that Joe needed in Group while increasing demands within the individual while reducing their frequency. While in Group sessions, the team was able to develop a number of strategies specific to Joe to help him reduce behaviours of concern occurring and identifying replacement skills. Throughout this therapy cycle, parents and practitioners hypothesised anxiety as a potential trigger and complicating factor for behaviours of concern and made adjustments. At the cycle review, eating and toileting were identified as difficulties for Joe at Kindy which were limiting his ability to stay for the full day, and plans were made to address them. Joe's individual sessions were reduced to fortnightly.
Throughout his 3rd and final therapy cycle, Joe flourished. The practitioners witnessed replacement skills increasing, and it also became very rare for Joe to use behaviours of concern. The toileting plan began working across environments, and Joe's participation with friends became more evident. Working Memory became a priority and recalling sessions to Amelia became a point of pride to re-tell all the work that Joe completed in the sessions. Towards the end of the cycle, Amelia let the practitioners know that Joe was ready to go to Kindy for full days in preparation for school.
Over the course of the last year, Joe has grown in many ways. Not only has he gotten taller, Joe is now able to identify his feelings and replacement strategies for when he may display behaviours of concern. Towards the end of his treatment, he has been utilising replacement behaviours. Joe eats and uses the toilet while in various places such as kindy, therapy, and Nan's house. Joe experiences the range of emotions, but now relies on his mother or himself to work through difficult emotions, Overall, Joe appears happier and more engaged than ever.
Supports will be altered and will continue for Joe, but he is now capable of many beautiful strategies that were not previously observed. He no longer requires such intensive support, and his family has a great impact on continuing to address emotional regulation difficulties. Although not every client will have the same year or success as Joe, we hope each child can reach their full capacity just like Joe and live a happier, more fulfilled life.
*Name changed due to confidentiality.
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