Category Archives: Filomena’s Corner

Review: Nov 16, 2019: Advanced Treatment Strategies for Youth with Complex Behavior

On November 16, John Pagano, PhD, OTR/L presented his Therapro Saturday Seminar, Advanced Treatment Strategies for Youth with Complex Behavioral Challenges, to a captivated audience. The energy in the room was palpable throughout the two hour talk. Dr. Pagano ‘s passion was evident as he discussed assessing and treating children and adolescents who have complex behavioral disorders. He shared clinical examples and anecdotes to highlight his talk, peppered with humor. Leading the audience through many experiential activities provided them with examples of practical tools to use with individuals and groups.

John is an occupational therapist who practices at an adolescent psychiatric hospital and school. He is a certified instructor of Positive Behavioral Support and Movement Based Learning Strategies. His years of experience include working in various settings including adolescent juvenile detention, psychiatric hospital, adolescent group home, and in special needs, regular education and preschool classrooms. He is the author of the recently published book, FAB: Functionally Alert Behavior Strategies: Integrated Behavioral, Developmental, Sensory, Mindfulness & Massage Treatment.

John discussed the importance of setting functional behavioral goals when providing OT, PT, and Speech/Language therapies for students with complex behavioral disorders. He frequently reiterated the value of a team approach, including ABA specialists, to working with this population.

FAB Strategies® are Dr. Pagano’s evidence-based, practical strategies that use “clinical reasoning based on current clinical research and neurology to develop the individualized strategies needed to address complex behavioral challenges.” John reviewed Sensory Processing Disorders, how they interact, and how to treat them using sensory based interventions. In his discussion of Sensory Modulation Disorders, John stated that his research and experience have shown that the olfactory sense is a powerful teaching tool for those with ASD and for those who have experienced trauma. He has found that pairing a scent is very effective for achieving the desired Quiet Alert state of arousal. He advocated using materials like Scented Clay and scented markers as treatment materials.

John disclosed that research supports that mindfulness strategies are an effective and powerful treatment methodology for improving special needs students’ behavior and executive functioning. John led the group in breathing and movement activities that he uses with his students that also increase body awareness. John taught the group a number of quick, easy, and practical strategies to circumvent problem behaviors. For example, his FAB Turtle Strategy involves 4 steps: 1) Notice environmental & body triggers – STOP 2) Go to the sensory coping area 3) Do your individual coping strategy 4) Later problem solve with help. Fidgets like Loopeez, Boinks, Panic Pete, and Theraband were mentioned as some of John’s favorites for calming.

Dr. Pagano is a dynamic presenter who generously shared resources and evidence-based, practical treatment strategies for working with children and adolescents who have complex behavioral challenges. He integrates all that he has learned in his years of experience with current research so adeptly!! Attendees left this seminar with ideas they could put to use immediately in their practice.

Take a look at some of the overwhelmingly positive comments from those who attended John’s seminar:

“I left full of simple/functional strategies to try with my students, all ages. John is simply AMAZING!!!” – Christie H, Speech/Language Pathologist

“John is an excellent speaker who was very helpful, evidence based, and offered suggestions for treatment.” – Renee S., Physical Therapist

“Offered many resources & activities that can be used immediately in my practice & therapy.” – Rose O, Occupational Therapist

“John’s sense of humor made this important topic fun. Many teachers & therapists are struggling in the classroom. These are strategies that can be implemented Monday. In addition, his strategies come from evidence based research of strategies/techniques that help our students make progress.” – Jennifer H, Occupational Therapist

Thank you, John!

Filomena Connor, OT, MS, OTR
November 16, 2019

Review: Oct 26, 2019: Armed and Ready for Monday Morning!

October’s Saturday Seminar speaker, Lisa Mitchell, M.S., CCC-SLP is an expert in Childhood Apraxia of Speech (CAS). She is a pediatric speech language pathologist, Clinical Director and co-owner of Clearly Speaking, a private practice in Hampton Falls, Dover and Londonderry, NH. Lisa has been recognized for extensive training and expertise in CAS by Apraxia-Kids.

On October 26th, Lisa shared her passion with attendees who are speech language pathologists, occupational therapists, OT students, and teachers, with her presentation entitled Armed and Ready for Monday Morning! 26+ Valuable Clinical Tools for Treating CAS (Childhood Apraxia of Speech) from A-Z. She organized her talk in a unique way that highlighted “Tips and Strategies for Treating CAS” in an A through Z format. She discussed some of her favorite publications including those by Pam Marshalla, such as Successful R Therapy, and Apraxia Uncovered.

Lisa explained that CAS is typically part of a broader diagnosis and is a challenging diagnosis to treat. She discussed the importance of collaboration with others on the team, i.e. OTs, who are working with the student on motor issues. Difficulty with motor planning can lead to errors in speech production. With a motor speech disorder, the student has difficulty achieving smooth movement from one sound to another. So, as the complexity and length of words increase, the student has more difficulty. As we can imagine, the child’s level of frustration increases when they are trying to talk.
Wind-Up Toys for reinforcers. Lisa touched on a controversial area for speech/language pathologists’ treatment – oral motor exercises. She discussed how using exercises not attached to speech for children with CAS, such as blowing whistles, bubbles, etc. will not help a child talk. However, using a whistle to help position the lips for speech is useful if the whistle is removed and the student is then given a syllable to produce using lip rounding.

Lisa is a gifted presenter and her passion for her CAS work is evident! She offered a hefty toolbox of ideas and strategies for treating CAS. With such a varied audience today, her tip that was very powerful and resonated with us all was that team collaboration, including parents, strongly benefits a child with Childhood Apraxia of Speech.

Here are some of the appreciative comments from those who attended Lisa’s seminar:

“Very insightful and great ideas for therapy. Enjoyed the insights on co-treating.” – Beth M., COTA/L

“I would recommend this seminar to a colleague. I would like to learn more about collaboration of OT/PT/SLP – how to work together.” – Maria L., Speech/Language Pathologist

“Easily explained and well thought out.” – Tai M., Occupational Therapy Grad student

“Learned a lot and was easy to understand.” – Anonymous, Occupational Therapy Grad student

Thank you, Lisa!

Filomena Connor, OT, MS, OTR
October 26, 2019

Review: Sep 14, 2019: Making Sensory Connection Through a Mock Sense-ability

On September 14th, Therapro’s Saturday Seminar Series featured Karen Moore, OTR/L, author of the Sensory Connection Program. Karen’s passion is mental health practice, where she has had extensive experience in acute psychiatric care and in various residential settings with adult and adolescent psychiatric patients. Her career-long commitment to the study and use of sensory modalities for treatment in psychiatric care culminated in the writing of her book, The Sensory Connection Program: Activities for Mental Health Treatment. Her subsequent publications include: The Sensory Connection Program: Self Regulation Workbook and The Sensory Connection Program: Curriculum for Self Regulation. Karen has presented workshops on sensory related treatment to programs and facilities throughout the country, including presentations for “at risk” youths, special needs students, and behavioral programs for adolescent treatment.

Karen’s seminar involved active participation by all the attendees in a simulated Sense-ability Group while sitting in a circle and being challenged motorically, socially, cognitively, and with sensory activities. Karen demonstrated how to adapt the group to target certain behaviors and skills of individuals in the group with the goal of each participant feeling competent and positive. Karen’s style was encouraging, supportive, and at the same time fluid in targeting the needs of each participant. Her anecdotes from her practice were enlightening. Karen described the Sense-ability Group Stages 1-6 along with activities the facilitator might use in each. These stages include the Awareness Stage, Moving and Breathing Stage, Conversing Stage, Active/Interacting Stage, and Learning Stage. Attendees tried out many novelty as well as familiar games in the group such a Hot Potato, to spark interest and energize a sluggish group; ball play with Spider Ball or Koosh Ball, parachute games for movement and interaction; Brain Gym based movement for calming; Theraband rowing for strengthening and reciprocal movement; Thumball to help express emotion, and many many more! Karen referred all to her website for full instruction and details for every stage of the Sense-ability Group.

Karen is a Therapro author, and all of her publications are available through the Therapro website. She recommends both the manual and handbook of The Sensory Connection Program: Activities for Mental Health Treatment. These activities can be adapted and interchanged easily for a wide range of purposes, ages, and settings. All of Karen’s books use a person-centered treatment approach that begins with self-awareness and then moves on to self-regulation and eventually to self-care.

In summary, a Sense-ability Group is a highly adaptable, supportive group for those who experience a variety of symptoms that might include, depression, anxiety, psychosis, disorganization, poor self regulation, sensory problems, difficulty with social skills, physical challenges, and much more. The facilitator designs the group to ensure that the participants have a successful, enjoyable experience. Every group is different and is modified by the facilitator depending on the environment, the mood of the group, the participants, etc. Activities might include movement, sensory, physical, cognitive, and social experiences. The goal of the group is that each participant feels competent and improves function.

Thank you, Karen, for sharing your knowledge, expertise, and dedication to mental health treatment by modeling how a Sense-ability group can be a highly effective occupational therapy treatment modality… and lots of FUN!

Take a look at just a few of the glowing comments from those who attended Karen’s seminar:

“It accentuated how incorporating sensory games can enhance engagement, self-regulation & learning all at once.” – Christine C.B., Occupational Therapist

“Awesome ideas for sensory based social skills learning. Great intro & walk through of the materials.” – I.D., Occupational Therapist

“Very hands on and applies to so many different levels of abilities and ages!!” – Beth M., Occupational Therapist

“Hands on. Lots of group ideas. Real life examples. Very comprehensive. Holistic approaches. Many recommended activities & resources.” – Joann W., Occupational Therapist

Thank you, Karen!

Filomena Connor, OT, MS, OTR
September 14, 2019