Early childhood case studies
Early Childhood Case Studies
Educators can feel overwhelmed with all of the information that they receive from training workshops, meetings, and therapy recommendations, to the point that they struggle putting their knowledge into practice.
I give hands on mentoring that leaves educators feeling empowered not flustered.
Identifying the red flags
My first session in a kindergarten classroom always involves at least one hour of me observing every fine detail of children's motor development, focus, play skills, and behaviour in the classroom.
What I typically look for includes:
- Children who are struggling to sit still and maintain focus for more than 2 minutes
- Children who are easily distracted by the sensory input of the classroom
- Children who are finding it difficult to follow 3 step instructions
- Children who get stuck in the transition process and either become distracted during transitions, or need additional support from educators during the transitions
- Children who are hypervigilant and stressed in the classroom (eg. children from trauma who are watching my every move, or are so focused on the movements of their peers and their teachers that they're finding it difficult to focus and learn)
- Children who are disconnected from the classroom and are not engaged in learning activities or play
- Children who are struggling to complete gross motor and fine motor activities
- Children who are finding it challenging to regulate their emotions
With my Exercise Physiology hat on, I am looking at how the children are moving their body. For example, can their sit up tall without leaning on their lap or their peer sitting next to them; can they stand up from the floor without needing to use their hands (core strength); can they open their own lunch box and unzip their own jacket; can they climb across all components of the obstacle course without showing fear or poor coordination; can they copy simple body movements during music and movement sessions.
With my Developmental Educator hat on, I am looking at whether children can communicate their needs to their teachers, educators, and peers. For example, can children ask for help; ask to join in play activities; invite a friend to join them in play. I am also looking at children's emotional and social development, including the ability to choose a play activity independently; follow the flow of the classroom (transitions, routines) independently; maintain focus on an activity for more than 4 - 5 minutes; complete non-preferred and preferred activities.
Supporting children with developmental delay
Currently our research in Australia is showing that 4 to 5 children in each classroom do not have their physical development that they need to be 'school ready'. 4 to 5 children in each classroom are struggling with skills such as:
- Difficulty getting dressed and undressed independently
- Difficulty climbing and playing on play equipment
- Poor energy levels and fitness (lethargic and tired at kinder)
- Difficulty maintaining a strong sitting posture during mat time and for fine motor tasks
- Difficulty opening and closing their own bag, lunch box, etc.
- Difficulty copying body movements of teacher during music and movement activities (poor spatial awareness and body awareness)
When I see children with poor coordination and motor development delays in my observations, I firstly point out what I am seeing to the educators and teachers. This helps them to view the child's movement and behaviour from a new perspective.
I then provide educators and teachers with morning routine and obstacle course strategies to help provide more opportunities for all children to practice and develop important gross motor and fine motor skills for school and life.
Seeing children through a trauma lens
One part of my role in early childhood includes my expertise for children who have a traumatic background.
When I first started working with children I thought that I was just going to apply my Exercise Physiology knowledge and encourage children to improve their motor development and increase their physical activity levels. But what I found was life changing. I was connecting with children from trauma, who were typically not engaging well with other educators and teachers in their classroom. I was doing this innately because I too am from a traumatic background.
My own trauma lens was helping me to identify other children with trauma in the classroom, and over the last 10 years I have advanced my skills and knowledge in trauma informed practice to support children with trauma with their physical health, as well as their social and emotional health.
Lucy's trauma may have gone unnoticed
The first example of how I have worked with children from trauma was when I identified the trauma needs of a little girl called Lucy (her name has been changed for privacy reasons).
Lucy was struggling to connect with other children in her kindergarten classroom. Lucy was often playing alone and when moving throughout the classroom, Lucy appeared to be nervous, to the point that her nervousness was hindering Lucy from being able to explore, play, and create.
Lucy would engage with her kindergarten teacher, but was very hesitant to communicate with other adults in the room who she hadn't formed a strong connection with. Lucy was very wary of me as I entered the classroom for the first time. I feel that Lucy studied my body language, my gestures, even to the detail of my yellow flower scrunchie (which Lucy remembered the 3rd session that we worked together).
Due to Lucy's disengagement in class and nervousness, Lucy's teachers asked for Lucy to see a paediatrician and maternal health nurse to assess why Lucy may have been finding it difficult to play, explore, and settle into kindergarten.
Lucy went to see her paediatrician and no further information about Lucy's challenges at kindergarten were discovered.
The next step involved Lucy's mum coming to sit with me during one of my kindergarten sessions, to observe how I was engaging with Lucy and what strategies we were putting in place to build up Lucy's confidence and play skills. The conversation that I had with Lucy's mum helped all of us put the pieces of the puzzle together.
My first question to mum was, "I can see that Lucy moves throughout the classroom tentatively, as if she's nervous or unsure of where to go and what to do, is Lucy like this at home?"
Lucy's mum replied, "Lucy is completely different at home. Lucy is always chatting and playing at home."
My next question was, "Could there be any reason why Lucy may feel nervous around lots of people, particularly new adults like me."
Lucy's mum's answer changed the way we all started interacting with Lucy... "Lucy spent a large part of her childhood in hospital due to kidney failure."
My trauma informed skills started being kicked into gear at this point, because it made so much sense. Lucy was nervous of adults because she had been treated by so many nurses and doctors during her childhood. She had spent time in ICU where her little body would have been pushed and prodded so that doctors and nurses could save her life. Lucy could possibly be nervous, anxious, and wary of her classroom environment, because Lucy's possible trauma from her hospital admissions have never been addressed until now.
We sometimes assume that only children who have experienced violence or sexual assault in the home, have experienced trauma. But trauma can impact children from a range of different scenarios - for example, hospital admissions, car accidents, family home burning down, loss of a loved one, etc.
What I see when I observe a child with trauma is the child's hypervigilance, their extreme attention to every detail of their environment and the people in their environment. Even for me, I can remember what people are wearing, whether people talk with their hands rapidly near me, or whether people stand with their hands in their pockets. Children from trauma spend so much time studying the people around them (to protect themselves) that their minds are exhausted by the time it's circle time or outdoor play time.
Helping Lucy's teachers and family to see why Lucy was disengaging, and simple strategies to help Lucy feel safe and connected, changed not only my life, but the life of those who are close to Lucy.
Is it autism?
A large part of my role in early childhood is mentoring educators and teachers about autism identification, as families are often nervous about whether their child has autism, and in my opinion sometimes we are quick to try and label children's behaviour rather than develop strategies to support children's learning and behaviour.
I would like to introduce you to a little man called Ben (name has been changed for privacy reasons).
During an observation session at an early learning centre, Ben was brought to my attention by an educator who was concerned about Ben's reservations with playing with other children. Ben also tippy toe walked, which was another concern for the educator.
When observing Ben during his morning session I could see that Ben:
- Found it difficult to sit up straight on the floor
- Found it difficult to stand up from the floor without using his hands to push against his knees on the way up
- Found it difficult completing fine motor activities (his hand movements were delayed and awkward)
- Was hesitant to run around and climb on the play equipment
- Spoke quietly when asked a question during circle time
- Spoke quietly to me when I engaged with him playing trains
From a motor development perspective, Ben was showing signs of poor gross motor and fine motor development, including poor core strength, poor spatial awareness, poor balance, and a nervousness to run near a busy playground (implying that Ben may have fallen over or been knocked over accidentally in a playground before).
Ben's poor gross motor development, particularly his poor core strength and balance may have been causing Ben's tippy toe walking. Not necessarily an autistic trait.
When I was observing how Ben played with his peers, Ben often stood around talking to teachers and educators more than children, or playing by himself on the floor until other children came to join in. What I am looking for in these play moments is Ben's ability to cope when other children enter his space to play with the same toys that he has been playing with; Ben's ability to cope when I deliberately move on of his toys, or place a toy out of place; Ben's ability to talk with his peers when his peers ask him a question; Ben's ability to assert himself if he would like a turn or need a piece that his peer has. Ben showed an ability to cope well when others were in his play space, and Ben was responding to his peers when they asked him for a turn or asked for his help.
For children with autism who are in this situation, they may find it difficult to cope when others enter their play space and touch the toys that they have been playing with. Children with autism may also find it difficult engaging in conversation with peers and answering their peers questions in context.
In my personal opinion, for Ben, he was a reserved character who enjoyed his own space, and was playing on the floor rather than playing outdoors because he may have felt nervous to keep up with his peers running around when he was finding his gross motor development challenging.
Of course I also referred Ben's family to their maternal health nurse to continue to monitor and review his gross motor and fine motor development, and I highlighted the importance of encouraging Ben to find common interests with other children in his class.
A large part of my role is mentoring educators and teachers about how autism can appear in preschool aged children, and the importance of viewing all of the child's development, personality, and life situation, rather than just looking at two symptoms - tippy toe walking and playing alone.
It's a balancing act
Sometimes we take the ability to balance for granted. Most of us can easily stand on one foot, climb a ladder, and hop along a masking tape line. However, 25% of children in Australia are struggling with this important skill.
To be able to keep up without our friends who are playing tiggy we need balance. To be able to follow our friends up the ladder and down the slide we need balance. To be able to walk from the mat to our locker without bumping into our friends we need balance. Yet 4 to 5 children per classroom are struggling with their balance.
One preschooler that comes to mind when I think about balance is my own son Hugh. When Hugh was 4 he was struggling with his developmental delays and one of his delays was his dynamic balance. Hugh avoided the play equipment as much as he could and he often sat at the craft or puzzle table because he didn't need to challenge his balance while sitting. Hugh was also very good at spatial puzzles so he felt confident in his comfort zone.
When I used to take Hugh to the park, Hugh would often stand around chatting to adults instead of practising climbing, running, swinging, and jumping. To this day I still need to give Hugh a gross motor challenge at the park because he would prefer to avoid than challenge his balance.
We often see children preferring to sit in the sand pit, than climb the a-frame. My concern here is that children who are avoiding playground equipment, are not practising the skills that they need to be able to run, weave, and play in the yard at school, and they're also increasing their nervousness around taking risks and climbing. The sand pit or puzzle table is their comfort zone, and by providing children with support through a daily obstacle course, we are building up their confidence, self-esteem, and gross motor skills that they need for school and life.