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Sting of social rejection partly physical














Brain regions that light up in response to physical pain are similar to those processed during social rejection, according to a new paper that suggests that feeling ‘broken-hearted’ is not just a metaphor.

In this month’s Current Directions in Psychological Science, Naomi Eisenberger, co-director of the Social Cognitive Neuroscience Lab at UCLA, surveys recent research that shows that social pain triggers neural regions associated with the distressing emotional experience – and sometimes even the sensory experience – of physical pain.

“It suggests that there is something real about this experience of pain that we have following rejection and exclusion,” Eisenberger says.

She also found that people with a gene that makes them more sensitive to physical pain are also more susceptible to the sting of social rejection. According to studies Eisenberger references, medication like Tylenol designed to relieve physical pain can also kill emotional pain, and emotional support – such as holding a loved one’s hand – reduces physical pain.

I thought this overlap between social and physical pain had interesting implications given that children with disabilities are at greater risk of experiencing both. Thoughts?

Should kids be asked to care for a disabled sib?


This is the author's note to Pillow: A sibling story, which was written by Sophia Isako Wong. Sophia has a 40-year-old brother with Down syndrome. She is an associate professor of philosophy at Long Island University in Brooklyn, New York. She writes about political and educational inclusion for people with cognitive disabilities and justice within family relationships.

I wrote this story to illustrate how typical siblings may feel when they provide “respite care” for their parents. Research shows that parents often believe that their children are emotionally mature enough to recognize their own developmental needs and to speak up for themselves. One parent said, “I know if it’s too much for her she’ll tell me.”

Let me tell you a secret: we sibs don’t tell our parents how we truly feel. Our motto is “Never mind me; you have enough to deal with. I’ll figure it out by myself.” If our behaviour seems untroubled and serene, that’s because we are experts at hiding our worries, resentment, envy and nightmares.

In families untouched by disabilities, sisters and brothers fight, argue, sulk and express the whole spectrum of feelings toward each other. In our families, we never get that opportunity. With our sibs, it is never a fair fight. Even if we have a just cause, the disabled child usually gets the lion’s share of our parents’ attention and sympathy.

We’ve learned through experience that we are rewarded with positive attention from parents for being the easy child, and sometimes reproached for making more trouble for you. So we often help you without complaining.

We watch you every day. We see that parents have far too much to do, resources are lacking, and there aren’t enough hours in the day.

When we notice how exhausted you are, we fear that you won’t be able to take care of us adequately, or you might have to quit your jobs, and where would we be then? So we volunteer to give you a break, thinking this will help the whole family survive. “Parentification” is what happens when children perform the role of parent at the expense of their own developmentally appropriate needs and pursuits. When children take on responsibilities performed more appropriately by an adult, they feel torn between looking after the vulnerable sibling and taking care of their own needs.

If a child or teenager (mistakenly) perceives that his needs are less important than the needs of others in the family, he may volunteer to sacrifice time and energy he would otherwise devote to school, friendships and typical childhood activities.

Research shows increased risk of psychological and social problems in some siblings who are burdened by excessive caregiving roles and who, in effect, become ‘little parents.’

Here’s the good news: the whole family benefits when parents take breaks from the exhausting work of caring for a child with disabilities. Parents need to take care of their own health by asking support staff, neighbours, friends and family members to help out. Doing so gives them precious time to rest and recover from the stresses of parenting a child with disabilities.

Even if your typical child is eager to babysit, and is supremely confident she can handle it, please make sure an adult is supervising her at all times. That way, she doesn’t have to function as an adult before she is ready. By helping but not being in charge, typical children can continue to focus on what they need to be healthy and safe.

Trust me, we siblings of kids with disabilities feel intensely guilty whenever we play with other kids, master skills that the disabled sib will never learn, or pass for normal in a crowd. We’re acutely aware that we are very lucky to be non-disabled, and that we might have been born in the disabled sib’s shoes.

Some of us are forever trying to make it up by being on our best behaviour, concealing our negative feelings and accepting more than our fair share of household chores. Many of us see ourselves as Super Sibs: born to babysit. You may even believe that we are more high-functioning and more emotionally mature than other kids our age. Don’t be fooled: we are kids with the same concerns and complex emotions as other young people.

So if your child volunteers to babysit before she has become a competent adult mature enough to have her own children, I hope you’ll think of Pillow and Sister and say: “No, honey, go ahead and play. We’ll hire a babysitter, use respite, or ask other adults to help us when we need a break.”

Pillow: A sibling's story















This is a short story written by an adult sibling about the emotional bind siblings feel when they're burdened by excessive caregiving of a brother or sister with disability. We will follow the story this weekend with a note from the author about her personal experience and research. I hope this will spark a lively discussion.

Pillow: A sibling's story

Every time Sister packs for a trip, she takes along Pillow, a battered cushion in a rectangular cotton cover. Mysteriously stained, once-white, with a print pattern in faded primary colours, Pillow looks suspiciously childish for a trilingual woman in her 20s fearlessly travelling the world.

Sister recalls the day she got Pillow. It was a spring afternoon, and her parents wanted to visit the new IKEA store. They usually went everywhere as a family, but Brother was so slow and clumsy. He touched everything, spoke loudly and often made everyone stare in public places.

Sister felt embarrassed just imagining what could happen if they all went together. She knew they couldn’t afford a babysitter. Her parents were eager to go out for a change of pace, so she said she’d rather stay home alone with Brother. Easier for everyone that way.

Mom and Dad are back, their arms full of new things. After describing the taste of the Swedish meatballs, Mom holds out a small white pillow. “We got something for you, Sister. This is your reward for being such a good sister while we were out shopping.”

Surprised, Sister wonders: What about Brother? He’s been home alone as well.

Looking closely, she notices bright red teddy bears, pink-faced dolls and yellow trucks all over the pillow. Do her parents think she’s still a baby?

Just this morning they said, “You’re very mature for your age. We know you’ll be fine looking after your brother until we get back. Thanks for offering to do this.” Sister panics. Wait. Have I missed something?

She runs through her checklist: I made sandwiches for lunch, cleaned up the kitchen, told friends I can’t play today, helped him in the bathroom, played in the yard, then sang softly to calm him down after he got scared by a neighbour’s dog. She inspects his face and hands. They look clean enough.

Holding her breath, Sister wonders if they will detect that Brother tripped and scraped his knee while running in the yard. Parents and teachers seem to have a way of knowing when something bad has happened, even when kids don’t tell them right away. What if they notice the scrape later? They’ll be so angry at me for letting him hurt himself. Selfish me, I was the one who wanted to play outside since it’s so nice out. I knew I should have kept him inside all day. I’ll never forgive myself if his leg gets infected now.

Sister decides to volunteer to help with bath time. That way nobody else will see the scrape. I guess it’s okay I didn’t call the doctor. It wasn’t an emergency. She puts on three drops of iodine to disinfect the scrape before sticking on the band-aid, just as she’s seen her parents do a million times.

As she takes the pillow, Brother hugs her. “Thanks for taking care of me. I’m so happy you’re my sister.” What a relief. Brother’s already forgotten about his scrape.

Sister isn’t sure whether she deserves this unexpected gift. She’s anxious to get to the math homework she hasn’t even started. She presses the pillow to her chest and says the magic words that make them smile. “Thanks, Mom and Dad. You can go to IKEA anytime you want.”

Friendship part 2

A week ago a blog of mine was picked up by the Huffington Post. It was about the lack of friends in my son Ben's life -- and research showing that isolation is a significant problem for our children, particularly in the teen years, when their social world shrinks instead of expanding.

It's not a topic that anyone likes to talk about. Who wants to admit that their child has no friends?

It really hit me a couple of years ago when I was programming a voice device for Ben and couldn't think of a single authentic friend to include on the friends' page. And this for a boy who has always expressed his desire for friends, and was capable of having some as a younger child.

Over 750 people commented on the post, which tells me that friendship is something we value, that many people struggle with it -- disability or not -- and that this is a big issue.

There were many suggestions: build your child's interests because friendship is based on common interest; join with other parents of kids with disabilities to promote friendships or reach out to programs for kids with disabilities – especially overnight camps – where your child may be better understood; get a service dog; seek out people with alternative lifestyles; use the internet to break barriers, either by setting up a blog or Facebook page.

A number of people were adamant that typical children can never have authentic relationships with our kids, and that they shouldn't be 'forced' to. Even some seasoned parents of kids with disabilities agree: “No matter how kind the typical child or family, the only reliable peers are from the world of disabilities too.” I’m not quite sure what to make of this. It doesn’t sit right with me, but I'm well aware of how complex the issue is.

That's why this piece today by a blogger with spina bifida in the Huff Po bothered me. She argues that if only parents would toughen up and send their kids into the real world, all would be well. "In an effort to protect their children, some parents will only seek out other disabled children for potential friendships," she writes.

I find her tone self-congratulatory ("My family always taught me how to do for myself") and blaming of kids who are more complex and need more support. "I had to make friends with the 'normal' kids because they were the only kids around," she writes.

The comments on my Huff Po piece tell me that many youth -- with and without disabilities -- are unable to 'make friends with the normal kids' despite best efforts. Struggling to find good friends seems to cross every line, and certainly the disability one.

I heard from some organizations that are promoting inclusion or access for people with disabilities. Game Accessibility from the Able Gamers Foundation advocates for accessibility in video games and has great resources. Unified Theatre brings together kids with and without disabilities to develop and perform plays. The concept is simple, reads its website: let teens lead, let creativity rule and treat people with disabilities as complete and entire equals. Together Including Every Student is a peer-matching program that brings students with developmental disabilities together with student volunteers to participate in community activities. Side by Side is a parent’s blog post about a boy’s successful inclusion in a regular school program.

There were parents of kids, with and without disabilities, high school and college students, disabled adults and a businessman who contacted me, wanting to know how they could make a difference. A counselor who also has hearing loss wants to adapt fairy tales to include our children – her first is about a princess who is deaf/hard of hearing. Given Ben’s tiny size, she thought he might be a candidate for inclusion in Jack and the Beanstalk! A breeder offered to donate a pup as a service dog.

The response from my Huff Po piece leaves me hopeful.

Ben and I set up a Facebook page.

What are your thoughts?

The upside of going downhill










 





















The upside of going downhill
By Ijeoma Ross

We happened upon skiing almost by accident. Four years ago we had a bad case of cabin fever. Canadian winters are hard with a child in a wheelchair. Going down south or on a cruise was too expensive. Cruising online we happened across Maine Handicapped Skiing (now Maine Adaptive Sports and Recreation) based at Sunday River Ski Resort.

We couldn’t believe that our son Deane could go skiing at Maine Adaptive for free (the group offers free lessons to children and adults with physical disabilities). Deane, who has cerebral palsy and uses a wheelchair, would be taught to ski by volunteers. And we could ski with him. We booked five afternoons and over March Break drove to Sunday River.

The team at Maine Adaptive was amazing. They have an occupation therapist and equipment “doctor” on site who assessed Deane’s strengths and abilities and adjusted and adapted equipment for him. Their building is slopeside so the skiers can get fitted and go right on to the hill.

It is a busy place with volunteers and skiers of all abilities coming and going. Deane and his “team” made up primarily of his father (Mark) and a good friend (Ali), who is a keen skier, were immediately welcomed. Because of their experience, expertise and friendliness, we will be going back for our fourth year in March.

For the first two years, Deane skied in a slider – the front of a walker on skis with arm rests for him to help support his weight while on his own skis. A volunteer would control his speed and direction from behind using straps attached to the slider.

The volunteers were more than willing to teach Mark and Ali how to control the slider. By the end of the second year, the volunteers were there primarily in a teaching role.

Other family members and friends could ski down the hill with Deane - as long as we stayed out of the way!

This past year we switched to a sit ski because Deane had the beginnings of hip dysplagia. Deane was more than happy with the move. Because the sit ski is more stable it can go faster and Deane loves speed. Now I’m working to keep up with him.

For the past two winters, we have also been skiing with the Canadian Association of Disabled Skiing (CADS) at Brimacomb Ski Hill outside of Oshawa.

There are provincial branches of CADS across the country with different ski hills running programs. In total CADS has 1,130 skiers assisted by 1,900 volunteers to participate in recreational and competitive snow skiing and snowboarding.

At Brimacomb, a team of dedicated volunteers take 30 skiers out on the hills for one of three 1.5 hour lessons each Sunday for eight weeks during January and February. All equipment is provided by CADS.

It is a tight-knit group of instructors, volunteers, family members all there to help the skiers get the most out of their time on the hill.

All of the instructors and volunteers must be trained on all of the equipment from sit skis to harnesses for blind skiers and three-track outriggers for leg amputees. Family members are encouraged to take the training so they understand the process. The cost is $110 for participants and $35 for volunteers to cover the insurance.

It was at Brimacomb that Deane first moved into a sit ski. Mark and Ali were trained to drive (holding on to the back bar on the sit ski) and tether (holding a strap while skiing behind as an anchor). In our first year, I found it difficult to keep up with the speed of sit ski.

This year, I have learned to tether and have loved being a crucial part of Deane’s skiing.

There are not many activities that both Deane and his sister Rayne, who is not disabled, can do together. Skiing is one of them. It has become an integral part of our family’s recreation.

On the iPad Deane uses to communicate, he will readily tell you that he likes the chair lifts, the sit ski and going fast. What we thought was just a rash idea to cure cabin fever has become a way of life for all of us.

CHOP apologizes to Rivera family














The Children's Hospital of Philadelphia apologized yesterday for the way it communicated with the Riveras, who said they were told daughter Amelia (above) was not eligible for a kidney transplant because of intellectual disability.
Children's hospital apologizes to family of disabled girl for insensitive statement

A change of mind






















This quote from No Ordinary Boy author Jennifer Johannesen (above with son Owen) sums up what I got last night from her BLOOM talk at Holland Bloorview.

“Your own experience of your child can improve and blossom and grow in a way that is not attached to achieving anything.”

Jennifer spoke about a shift in how she looked at Owen's disabilities: from that of high-achieving new mom who undertook her complex son's care like a 'project,' to one who realized after he died that she had stopped seeing his deafness as a disability. When she was asked to speak recently at an agency that serves children who are deaf, she at first didn't make the connection.

Jennifer -- you inspire me! Louise

No Ordinary Boy author launches BLOOM speaker series

No Ordinary Boy author Jennifer Johannesen launches the BLOOM speaker series tonight in the Family Resource Centre at Holland Bloorview!

Tonight Jennifer talks about society’s expectations for constant improvement, how this plays into therapy for children with disabilities, and how families can be left shouldering more burden than they want or can handle.

In the BLOOM clip above, she talks about her book as a whole. Thank you Jennifer!

What to do when your child is upset

I was in the car with my girlfriend and she was late picking up her 13 year old son from school. She had phoned him to say she was going to be late, and he was already anxious about being the only one left outside the school.

When she arrived he was angry and upset. She immediately launched into an explanation about why she was late, and he got more angry and upset. I intervened and said, "Think of his feelings rather than your own." I then coached her to do a skill we call Reflective Listening. I explained that he doesn't want to hear your reasons or excuses--that he is upset and wants you to listen to his feelings. She then said to him, "I'm usually on time, and maybe you were worried about being left alone." He replied, "What kind of mother would be late for her child?" Instead of getting into another round of explanations and reasoning, she said, "I am sorry I was late; that must have been really upsetting." He then replied, "I don't like this, I am used to getting my mum all riled up and having an argument."

In the Calmer, Easier, Happier parenting approach, Reflective Listening is one of the five core strategies we teach parents. This skill teaches parents how to stay calm and deal with their child or teenagers uncomfortable feelings without getting upset, angry, denying, reasoning, justifying or explaining. With Reflective Listening parents learn an effective way to communicate that all feelings are valid no matter how unpleasant, although some actions are not allowed no matter how they feel. This strategy also gives us a way to stay calm!

Reflective Listening steps:

1. Listen to your child or teen, nod and make encouraging comments like "Mmmm, I see, Oh, Ahh"

2. Temporarily put your own feelings on the shelf (when our kids get upset, it often make us upset!). 
    Resist the urge to justify, reason or explain.

3. Step inside your child or teen's shoes and try and guess how he may be feeling

4. Reflect back in words what you think he may be feeling--be tentative. Use phrases like "Maybe you're angry that..." or "You might wish our rule were different about...", etc.

You will see that once your child or teen feels heard and understood, he'll be able to get over strong feelings more quickly and will be in a better position to listen to what you have to say or to problem solve for himself.

Suzanne Ferera (view profile below)
Vancouver, BC

My Child's Dream: To Have Friends

The Huffington Post is running this BLOOM post from last week:

My Child's Dream: To Have Friends

There is growing research showing kids with disabilities are largely friendless and that the older the kids get, the worse their isolation. The numbers are stark and I think would be cause for concern (from a health perspective) if they pertained to any other population of children.

This blog has had close to 800 pageviews at BLOOM and seems to have struck a chord with parents.

Please visit Huff Post and leave a comment if you feel inclined, or link to their story to raise awareness.

Thanks! Louise



The kid writes


















Ben was never able to write because of fine-motor problems. In the summer he began Kumon and now he can even sign cards!

All students deserve high standards, choice

It was a treat when Ben came home Tuesday night with a course catalogue for choosing his courses for Grade 10.

He has to take math and science and history and English – what you’d expect as part of any education – but he also has some choice in non-academic courses like construction technology and drama. The courses are part of a well-thought out high-school curriculum designed by the Ontario Ministry of Education.

The reason this was a treat was that for three years we have lived in the world of ‘alternative expectations’ – read no expectations – at the segregated school Ben attended.

Alternative expectations are courses that are not tied to the Ontario curriculum and tend to focus on life skills. They include speech, social skills, personal care and transit training. At the high-school level, they are non-credit courses.

"For the vast majority of students, these programs would be given in addition to modified or regular grade-level expectations,” reads The IEP – A Resource Guide from the Ministry. “A very small number of students who are unable to demonstrate even the most basic literacy or numeracy skills may receive only an alternative report."

Although Ben does read, and is now writing, for three years he received only alternative courses and an alternative report. In his last year the courses were things like art appreciation, gym, social skills (which was a cooking class) and ‘math’ – which involved tasks like putting flashlights together.

Four courses were offered per semester. They didn’t follow the general Ontario curriculum and my understanding is that they didn’t follow any Ministry-mandated content. It was up to the school to decide what it would offer.

The value of having a province-wide curriculum, I imagine, is that if students are taught the same material across schools, to meet one set of standards, you have a way of measuring progress and ensuring accountability.

I’m not sure why the same approach wouldn’t be taken with students with disabilities in segregated schools. Why would the same thought and energy not be put into developing a standard curriculum – ideally that draws on the general curriculum all students receive?

Why is it okay for students in these segregated high schools to have no Ontario-directed course content and no choice of courses and for students and parents to simply accept whatever learning is put forward in a particular class and school?

Last night I got to go through the standard credit high-school courses with Ben, in a document (above) aptly called: Life is the sum of all your choices.

Doesn’t it seem like there’s a double standard here?

Homework: How much is too much?

Recently my little sister contacted me for some big sisterly (and professional) advice. My nephew, a bright and active nine year old was battling homework every night. It wasn’t that he didn’t want to do it, but the volume and variance of tasks was overwhelming to manage. A worksheet in math, a project in science, a list of spelling words, and a paragraph to write seem simple to prioritize, but so does getting the kids off to school, getting the groceries, paying the bills, delivering dinner, and supervising homework. The reality of doing is more difficult than drafting the list.

My sister wanted to know how much was too much. Are her instincts correct that the homework load is too much to expect, or is she off the norm and is not demanding enough from her child? Her first stop was the teacher and then the school. Both were willing to discuss but neither appeared willing or able to reduce the homework demand. To my sister, this appeared to be a sacred cow issue despite the two hours it took for the family to accomplish the task. She had to make a decision, continue with the culture’s current demand or stand alone at risk.

My sister chose to adopt the recommendations given by the Department of Education, National Education Association and National Parent Teacher Association of ten minutes of homework per grade level. http://www.nea.org/tools/16938.htm She felt, as the Calmer, Easier, Happier Parenting program promotes, that the time limit would be a strong motivator for her son and not make homework a punishment. She and her husband decided to shift their efforts from pressuring him to get the work done to: focusing on positive feedback and goals, reinforcing he do his best, increasing personal meaning and a sense of autonomy by providing choices, and reinforcing the feeling of accomplishment and responsibility.

My sister is making a brave move stepping outside the cultural norm of pressuring her child to achieve at school no matter the cost. I believe her risk will be rewarded in her son and her family’s mental health. The moving film, The Race to Nowhere, http://www.racetonowhere.com/, documents the increase in risk of suicide, depression, and stress related illness in young children today that is directly related to the pressure to achieve. Additionally, not a focus of a film, but a poignant experience in my counseling experience, is the life crisis of the students who have mastered the pressure but do not know where to go once they are out of school. They do not know where to go in life or how to create opportunity despite their exceptional skills. There has to be a better way to achieve growth and success. Setting a time limit on homework is one concrete measure to keep parents and their children from being pulled into the never ending, accelerating competition in the race to nowhere.

Amanda Deverich (view profile below) 
Williamsburg, VA