Listen to the children

national | health / disability issues | news report Thursday October 20, 2005 13:19 by Miriam Cotton miriamcotton at eircom dot net

How playtherapy is working wonders for children with learning difficulties

‘Children can bring out the best and worst in adults’ says Ann Healey, a Playtherapist who lives in Courtmacsherry, Co Cork. ‘Depending on how we listen and respond to them, their interaction with us will be affected. I read a book many years ago called ‘Dibs in Search of Self’ by Virginia Axiline and it changed my whole approach to working with children. It caused me to realise that verbally instructing children is not an effective way of relating to them - especially children with learning disabilities.”

This realisation was for Ann the beginning of a career during which she has had extensive training and most recently completed an MA in Playtherapy from the University of York. She now has a thriving practice in West Cork and is also involved in providing training for parents and professionals who are caring for children with social and behavioural difficulties. “For all the training and studying I’ve done” Ann says “I can say with conviction that it is the children themselves who have taught me almost all of what I know. That is not an exaggeration.”

The many parents and children who have seen significant, life-enhancing results from Ann's therapy are testimony to the success of this approach - so much so that Ann has had to close her books for the time being. The therapy itself is centred around non-directive play which Ann says is a very effective means of communicating with the child. It involves working at the child’s own pace and allowing them to lead the activities. Children are more communicative and receptive to the adult’s input when we respect their perspective rather than requiring them to accept what we tell them. Most communication between adults and children unfortunately falls into the latter category. As a nation, Ireland is not particularly child-friendly and certainly we lag well behind many other countries where child-centred policies form a central plank of child care work. Despite reams of books and mountains of research, the essential commitment that is needed to put these methodologies into practice doesn’t seem to exist at professional or administrative levels in Ireland.

Where this therapy comes into its own is when it is applied to children with learning difficulties and conditions such as ADHD or other autistic spectrum disorders. Clearly, such children are not able to make sense of the world we present them with and to a greater or lesser extent are locked in their own perspective. The one time children are completely in charge of their own world is when they are playing – when they explore possibilities and express themselves in any way they choose. By following the child in his or her excursions around their world, a sensitive therapist can begin to identify how the child comprehends what he or she is experiencing and gently suggest strategies for coping with things they find difficult. A pattern of communicating more expressively and openly with others can be built but the key principle to be observed is that where the child leads, the therapist follows.

‘Very often children do not know how to handle or even to express emotions and this is particularly the case where ASDs are concerned' Ann continues 'and a common problem is ‘inappropriate’ response. A child might laugh when something happens which is not funny. When you communicate with a child from within his or her own perspective it’s much easier to offer explanations about these responses.’

Children with special educational needs process information in a different way, whether or not they show difficult behaviour. They need plenty of time in which to respond and understand what is happening. They also need concrete examples with which to work and the physical space in which to act. In these conditions the adult establishes a much clearer sense of the child themselves and is much more closely attuned to them. Most educational practice requires the opposite approach to children and while most of them cope, the SEN child cannot.

Healy says ‘When you establish a connection with the child like this, that is the point when they truly ‘join us’ and stop being so lonely. The child begins to open up like a flower and to find communication rewarding instead of threatening and incomprehensible. They begin to understand, slowly but surely, how to read facial cues, for example, and how their own actions effect the responses of others. The standard method of ‘telling’ them what to do simply doesn’t work. The ‘telling’ approach invariably ends up in a pointless and very counterproductive power struggle between the adult and the child. What most people don’t realise is that most SEN children are actually hugely stressed by what is to them a largely incomprehensible world. It's therefore vital for parents and teachers to work together where a child has learning difficulties. The principles applied in this therapy are similar to the ‘Bion’ concept of containment. This is a theory of how mothers usually learn to read their babies’ signals. The child soon realises that the mother is able to interpret the feelings they are expressing and to give them back constructively or appropriately in the form of food, reassurance, a change of nappy or whatever. A powerful bond of trust is established because the baby knows that it is understood. When autistic children throw out lonely, angry feelings, the adults in their world really need to do something similar – to take those feelings in and give them back as something constructive and helpful. Playtherapy is an essential release from those feelings of isolation and fear – a safe way of addressing the child’s inner world and of really understanding what the child needs.’

Healey’s therapy room is a plain room with bare walls, to minimise distracting stimuli. The activities are all at ground level and the tallest thing in the room is the table. The child can investigate the various toys and activities as they wish and the therapist gradually introduces themselves into the play either by making slightly exaggerated, relevant play noises to encourage the child to include them. Gradually eye contact is established and the dialogue begins. The children love this interaction with the therapist and quickly understand that their own choices and interests, their ideas and observations are what are important. As the therapy progresses different sorts of play can be used as a form of discussion - experessive games or tea-parties with scripts for example. ‘Children have a fabulous sense of the ridiculous’ Ann says ‘and the experience of working with them is unbelievably rewarding. It saddens me to think how much of every child is lost to the world because of our traditional methods of working with and teaching them. There is so much about children that we don’t generally understand and we are the poorer for it. I firmly believe that play like this should be on the school curriculum for every child but of course it is particularly relevant where there are ‘behavioural’ or socialising difficulties. What I can’t understand is that the world is full of information about all of this. We need to be continually refining our understanding of what is best practice. The internet is stuffed with it – why aren’t we learning from it and applying it?’ It’s a very good question.

Good news for parents and teachers is that they will have an opportunity to find out more next spring. On the 13th March Ann Healy will be running a course in conjunction with the University of York. Dr Virginia Ryan from UOY who has vast experience in this field will be facilitating the course which will be on the subject of ‘Using Clay and Helping Children on the Autistic Spectrum’. For more information ring 087 2486421.