Mentoring Culture - Confidence & Competence - OTA 2019 Presentation

In this recorded seminar from the 2019 Occupational Therapy Australia conference, team leader and owner Jacky Peile shares about how the mentoring culture at Early Links serves as a powerful tool to promote clinical excellence within OT practice.

Additional reading
https://onlinelibrary.wiley.com/toc/14401630/2019/66/S1

Affective Neuroscience in Trauma recovery & Emotional Regulation - OTA Presentation 2019

Clinical team leader and owner Jacky Peile shares in this presentation, recorded at the 2019 Occupational Therapy Australia Conference, how principles of affective neuroscience are utilised by Occupational therapists at Early Links.

Additional Reading
https://onlinelibrary.wiley.com/toc/14401630/2019/66/S1

More BLOG Posts

From the pages of our previous site are these classics - 

Check back in another few weeks as these gems are republished

1. A REVIEW - Occupational Therapy National Conference 2015
2. ANZAC Day Traditions - Are they being remembered?
3. Music to Change the Brain - Vital Links Information
4. iPad Generation - The impact on School Readiness
5. BOOK LAUNCH - 2015 is the Year for Action
6. Understanding Core Stability vs Core Strength
7. Helping your Baby to Development Movement
8. HSC Handwriting
9. PROGRAM LAUNCH - Love Real Food Group
10. NEW PROGRAM - Sensory Playgroup
11. Core Activation

My Story...A craving for silence

The response to the last BLOG in the My Story series was overwhelming. Thank-you to everyone who read the blog post and comment or shared my story. I must say it was a liberating feeling to know that other people could reflect on their own vulnerability and resilience too. It was powerful to know that my experiences resonated with people in my life.

This BLOG is an opportunity to share more of my story. This BLOG is about explaining the current research on Sensory Processing Difficulties and sharing more of my daily experiences from living with sensory defensiveness. I hope to give you an insight into the complexity of daily life when your sensory system is sending mixed up signals to your brain.

My Story - In 2012, I was sitting in a lecture theatre learning about Sensory Processing and Defensiveness. At this point I had no idea, I would actually learn more about myself in this weekend than I thought possible. Patricia Willbargar and Tracey Stackhouse has spoken about neuroscience and their research into behavour and the sensory system, and I was sitting there thinking “wow, I’ve learnt more about neuroscience in 1 day than I did in 2 semesters in Uni”. But the best (and worst) was yet to come. I remember it so clearly. I still have the piece of paper I wrote my list on. It was a list of all the flight/fight triggers I experienced each day. The still remember sitting there trying to hold back the tears welling in my eyes. Not sad tears. Not happy tears, But tears of relief. There was a name for it, there was a reason why and there was something I could do about it. I’d written over 50 things on this list; everything from the demanding to be first student bell-ringer in primary school (normally the office lady did it), to becoming frustrated at a clock ticking or having these wild emotional outbursts that really only my family had seen. The hardest part came when we had to demonstrate the therapy techniques on each other. We had been told that these techniques would have dramatic and rapid effects on our clients. We were told they may become emotional because we were calming a sensory system which had been in high alert for years… nothing could have prepared me for that feeling, that rush of emotions, that overwhelming feeling of relief or the elation that comes from understand. I did cry, I did feel overwhelmed and I did nearly whack the colleague who didn’t do the technique correctly. Not on purpose, but as a reaction... as when these techniques are not done properly they have the opposite effect, and that’s not pleasant.

My Story is a journal, filled with personal experiences and education to help you understand the actions and reaction within my story.    

So, what is Sensory Processing?

Sensory Processing is the mechanism the human brain uses to identify, organise and react to sensory information. This information is collected through the sensory organ, transferred to the brain by the nerves and sent to different areas of the brain which plan the required responses.

A sensory processing disorder is different to having injured or damaged the organs for sensation, as in blindness or deafness. Rather, it is an error in how this information is treated once it passes from the sensory organs. Dr Jean Aryes, first wrote about sensory integration and processing in the 1960’s. Dr Ayres defined sensory integration as, “the neurological process that organizes sensations from one’s own body and from the environment and makes it possible to use the body effectively within the environment” (1). She proposed several types of errors in the sensory processing system. which remain accepted theories today. Her theories relate to -

• Sensory Modulation Disorder - The inability or inaccuracy of automatic neurological responses to sensory information with accurate referencing for intensity, significance and risk for each situation.
  Under-responsiveness
  Over-responsiveness
  Sensory Seeking

• Sensory Discrimination Disorder - The inability to accurately apply meaning or organise sensory information to assist in understanding the sensory information within each situation.

• Sensory-based Motor Disorders - The inability to create ideas, design movement plans or perform coordinated activities for each situation.

So why am I giving you all these definitions? In every aspect of my life, I have worked hard to understand why something happens the way it does; why I experience the world the way I do. I’m sharing this information with you as a way to begin to explain the power of the sensory system to change, for the better, the way you explore your environment and your ability to be highly productive in each situation.

What is Self-regulation?

Self-regulation is our way to participate in the activities we choose to each day. Activities like getting dressed, performing at work or school and even maintaining friendships. There are three important stages within self-regulation -

1. The ability to perceive the required level of alertness of the situation/activity

2. The ability to recognise your own internal level of alertness in that moment

3. The ability to shift your level of internal alertness to match the situation/activity

A self-regulation disorder occurs when one or more of these stages is not functioning accurately, automatically or effortlessly. Overall it’s the inability to change/adapt the brain’s internal filters to match the different levels of sensory information from the environment required for each situation.

The ALERT Program, developed by Williams and Shellinburger, applies a model of thinking to self-regulation which allows children and adults to find a common language to discuss self-regulation and make the necessary changes in learning to overcome self-regulation difficulties.

• Too high – over active and disruptive

• Just Right – focused and learning

• Too Low – inattentive and distracted

What is the research saying about Sensory Processing Disorders? (SPD)

Sensory processing, and the disorders/difficulties associated with SPD, have been researched and published widely by Dr Jean Aryes, Dr Lucy Miller and Winnie Dunn over the last 50 years. In 2014, the DSM-V listed sensory under-responsivity and over-responsivity as criteria in Autism Spectrum Disorders, however SPD was not included as a stand-alone neurological disorder, despite significant advocacy from Dr Lucy Miller and her colleagues.

Research from 2013, completed by Pratik Mukherjee and seven colleagues (2) found biological similarities between people with behavioural symptoms of SPD. Previously, there had only been behaviour and physiological observation studies. The 2013 study suggests there is a link between SPD and reduced conductivity in brain white matter, mostly in posterior tracts which carries specific sensory information.

To better understand how a sensory processing disorder presents , we need to understand the organising mechanisms that take sensory information from the organs to the brain. When these mechanisms are dysfunctional they distort the perception of sensory information, and it is the disorganisation which can prompt the 'fear / danger' aspect in the  Flight | Fight | Fright. The disorganisation of sensory information in the brain puts the body/brain into a state of high-alert and this will disrupt the person's ability to perform their normal movements / learning / thinking. (3)

Inhibition: The mechanism which acts to block out unnecessary sensory information.
EG. Blocking out the other conversations on the train to read your book.
When this mechanism is dysfunctional behaviours may include: distractibility or poor judgement/ problem solving skills in situations with varying sensory inputs.

Habituation: The mechanism which automatically switches off awareness of sensory information.
EG. When first you put on your socks, you notice the seam at the toes, once your shoe is on, you don't. When this mechanism is dysfunctional behaviours may include: fidgeting with clothing, repeated attention to noises or sights to reassure their origins.

Facilitation: The mechanism responsible for storing patterns of sensory information / practiced actions. EG. A particular food tastes bitter, next time you see the food you recall it's bitterness and you don't eat
When this mechanism is dysfunctional behaviours may include: needing to think about the action required before acting, ie. Hearing a school bell, thinking what it means then packing up rather then an automatic response to pack up.

What is Sensory Defensiveness?

Sensory Defensiveness is described as a tendency to react negatively or with alarm to sensory input which is generally considered harmless or non-irritating by a neurologically normal system. Sensory Defensiveness is a neurological condition with sensory symptoms.

While it is common to have sensory preferences of 'dislike' towards some sensory information such as loud noise, or bitter taste characterised by distinct behavioural responses, people with sensory defensiveness will elicit the Flight|Fight|Fright response automatically on a neurological level to these same ‘disliked’ sensory information. (4). The body will initiate the Flight | Fight | Fright response in situations of perceived fear/danger. This primal response ensures the body is ready to act. The neurological features of this response include: raised adrenaline levels, increased blood flow to the limbs and sustained endurance/alertness. If this system is placed under repeated stress/activation, it will fatigue and become less effective. This over-active state can result in sickness, depression, anxiety and an inability to react appropriately when the Flight | Fight | Fright system is called upon. (5)

Secondary issues associated with Sensory Defensiveness

• Anxiety, stress, distractibility

• Sensory overload / shut-down

• Sleep difficulties

• Postural and Physiological problems

• Social and Emotional disruptions

Coping strategies often used to manage daily life

• Avoidance

• Controlling

• Cognitive strategies

• Sensory seeking behaviours

How do we treat Sensory Defensiveness?

There are three stages to treating Sensory Defensiveness.  All three are key to managing this disorder and maintaining a high level of happiness in life, when life feels complicated enough already. The first, enhances the existing coping strategies. The second, minimises the secondary symptoms for that next reaction. While the third, begins to change the neurological structures which trigger the sensory defensiveness.

1. Awareness, Planning and Recovery - Knowing what triggers sensory defensiveness, which is different for each person, helps to minimise the stress in anticipation and increases the ability to remain in challenging (important everyday) situations longer.    

2. Sensory Diet - Initially developed by Patricia Willbargar, a collection of powerful activities to assist the nervous system to process sensory information correctly by providing recurring positive and calming sensory input. This Sensory Diet, not only assists in recovery (Valance shifts) but also to minimise the size of future reactions (Phasic shifts).  

3. Intensive Protocols - The amygdala is a small part of the brain responsible to deciding if sensory information adds up to ‘dangerous’ or ‘positive’ situations. This brain-switch should be mostly applying positive meaning to information, however in sensory defensiveness, it applies mostly negative coding, which raises the baseline level of alertness (Tonic levels). Intensive Protocols, such as Willbargar Therapressure Brushing or Therapeutic Listening from Vital Sounds have a targeted neurological approach which is closely monitored by Occupational Therapists for both behavioural and neurological changes in response to challenging sensation.

Over the last 2 weeks, I have been completing my own Sensory Defensiveness Intensive Protocol and I’m almost ready to start scaling back this program. As with most treatment programs or sensory defensiveness, there is a certain level of maintanence that needs to become part of everyday life in order to reduce the elevation of baseline alertness and limit the impact of secondary symptoms. You wouldn’t expect to exercise a couple of times and be fit for life so the same is true with sensory processing/defensiveness program

My sensory diet has included -

• Two (2) hours of intense exercise each morning

• Stretching

• Showering twice a day

• Core Activation

• Avoiding noisy situations

• Twice daily Therapuetic Listening - Grape Jamz and Collective Focus Q.S.

• Mediation before bed

It’s certainly boosted my productivity levels and this BLOG post is tribute to that boost in attention and concentration. I was planning to have it completed weeks ago, before I started my Intensive Treatment but each time I sat down to write, or work, or focus… there were too many distractions. The clock ticking, the dogs barking, the glare from the windows, the slight hunger I felt, the tag on my clothing. I realise that reading this list may sound familiar to you, when you’re procrastinating over beginning work or study, the thing is, that list is about 10% of the things that grab and hold my attention. The main difference I believe between this feeling of anxiety/discomfort/fear and ADHD, is that I am not distracted by the sensation, my brain is asking me to focus on +100 things at once to make sure I’m safe. These last two weeks have been wonderfully challenging to maintain the social connections around me, when all I wanted to do was hide away because my nervous system was changing so fast that it felt new, weird and different each moment, so unpredictable. Then, today, 10 days into the program, I’ve needed that space. Today, my brain finally switched over and has allowed that tonic level to begin to down-shift towards normal levels of alertness. It’s a strange feeling, not having the buzz, not feeling the random sensations or being pulled in many directions all at once. Tomorrow, there will be a calm focus and from there, an opportunity to maintain these changes for another 6-9 months through daily habits.

Adult Experience

Children diagnosed with Defensive SPD have the opportunity to access early intervetion. They receive the support and interventions to enable them to overcome their Defensiveness and properly manage their sensory processing disorder so they don't miss out on vital opportunities to develop and experience everything the world has to offer. These children often had marked behavioral challenges as a younger child that were disruptive or challenging for their parents or teachers on a regular basis. Adults with Defensive SPD have been those children who, through intelligence or conditioning from an early age have controlled their symptoms, hid their discomfort from those closest to them and found a solution to any challenge presented to them, even if that meant missing out! These were the kids who bottled up their emotion until they overflowed, melted down or throw a tantrum. These were the kids who couldn't explain why they reacted so strongly to a tap on the shoulder...except to know that it was much more than the tap on the shoulder they were reacting to at the time. It was in fact every piece of sensory information their body was presented with that day, it was the 20 time every hours they were bombarded with sensory information their brain could not organise, it was the regret and shame they felt when they made an excuse for avoiding participation. It was everything about the world that scared them exploding in one magnificent moment of relief that was so quickly followed by a feeling of embarrassment and remorse.

My Story - A Personal Experience

Back in 2014, I wrote this text on my phone as a way to focus myself, rather than going into a full melt-down.

“While walking across the Harbour Bridge in Sydney my logical brain said "Slow down, stop, look at the beauty Sydney harbour has to offer, enjoy the moment, you have earnt after working so hard." BUT my protective brain, the part affected by Defensive SPD said "Get me out of here! The breeze stings my skin, the flashing lights of the car headlights is grabbing my attention with each flash, the sound of my shoes on the footpath is ringing in my ears and if I slow down I will feel more overwhelmed because movement is about the only thing that makes sense in my body. My eyes are welling up with tears but I feel the need to push away the fears and ask myself to be calm, it’s not working and the tears are flowing, making it difficult to type, I’m not sad, I’m not unhappy, I’m just not happy.” Reading this text back to myself now, brings back the memory of that evening and the sensations that were so intense I really just wanted to scream out loud, but at the same time I remember just wanting to get out of that situation without falling apart. It is this conflict that adults with Defensive SPD live with nearly every second of every day.

Part of the reason why I am writing this BLOG is to draw attention to the need for more conversation about sensory defensiveness and sensory processing disorders amongst the health professionals who treat adults with anxiety and depression. Also to highlight the need to open up the conversation with more adults who may feel that many of the explanations I have given above in this BLOG apply to their life experience too. Here’s the place to have that discussion, to open that conversation…

Child experience

Many of the children who are referred to Occupational Therapy or Child Psychology for behavioural difficulties have some form of sensory processing disorder or sensory defensiveness. The most common difficulty parents and teachers report is “uncontrollable tantrums”, I’d suggest that in most cases, these are actually sensory melt-downs. Children (and adults) with Sensory Defensiveness develop coping strategies to assist them to manage day-to-day activities that pose significant sensory challenges. With prolonged exposure to challenging situations coping strategies may become ineffective, this is known as a 'melt-down'. Children are remarkably clever and some will recognise that when they are at school there are certain expectations and social requirements, whilst at home they feel free to relax and allow their parents to help with managing melt-downs. This is often frustrating for parents who do not yet understand why their child “chooses” to be “better behaved” at school. Behaviours exhibited during a 'melt-down' are a result of a 'threatened nervous system' and do not reflect the individual's true nature. Signs of a 'melt-down' may include -

• Strong emotional responses

• Aggression

• Retreat to a 'safe' location

• Atypical behaviours

• Regret or remorse following a period of self-regulation to calm the nervous system and regain control over thought processing and behaviour

Sensory Processing Disorders affect children and adults. Most children are referred for behavioural issues surrounding skill development or learning difficulties. While most adults are referred for high stress levels or as part of the search for better social skills. Often, these adults have extremely good coping strategies in place and have come to view these strategies as 'personality traits'. It is not until we consider childhood behaviours and current likes/dislikes that sensory processing disorders are diagnosed and baseline levels of alertness can be addressed which lowers the overall need to consciously control each situation with coping strategies.

My story is a craving for silence, silence within my own brain, to smooth out the ups & downs, Most importantly, this story is about finding the pockets of silence that surround sensory processing disorder to breaking it down, break down the lack of knowledge about treatment and identification of coping strategies which often hide the effort required to maintain abilities in daily skills and social situations.

Remember that each person has their own sensory preferences and a ‘dislike’ is vastly different to ‘defensiveness’. Myself and our Team of Occupational Therapists are always standing by for a “Quick Chat” with you about any gut-instinct this BLOG post may have triggered for you. Reach out and ask that question… either below in the comments, on Facebook or with me at 1300 933 552. You can always request a time by visiting http://earlylinks.youcanbook.me  

1. Ayres; 1989,  Sensory Integration and Learning Disorders, p11

2. Mukherjee. P, et al. Abnormal white matter microstructures in children with sensory processing disorders. NeuroImage: Clinical. 2013 (2) 844-853.

3. Williams, Mary Sue and Sherry Shellenberger. "How Does Your Engine Run?" A Leader's Guide to The Alert Program for Self-Regulation. Albuquerque, NM: TherapyWorks, Inc., 1996.

4. Wilbarger, Patricia and Wilbarger, Julia. (1991). Sensory Defensiveness in Children Aged 2-12: An Intervention Guide for Parents and Other Caretakers. Presented in Penrith, Sydney – August 2011

5. http://psychcentral.com/lib/2006/fight-or-flight/

Learning from International Students

As with any learning experience, there comes a point when things begin to make sense. You begin to identify what you don’t know and where you can go to find the help you need.

The reflection of two international student studying in Australia, explores an interesting perspective to learning in a multi-pressure situation...

We catch up with the International Masters Occupational Therapy students who are currently five (5) weeks into their final placement. Catherine wrote a piece after just 2 weeks of her placement, which explored how Being Brave was so important to making the most of learning opportunities.

Now, Catherine and Ash team up to write a piece which shares the important hints & tips that have helped them make the most of new learning.

Time goes by so fast when you put yourself into something. We can’t believe we’ve already been at Early Links for five weeks. Compared with the first few weeks, we have started to play a more active role in therapy sessions with children and practicing using our knowledge and reasoning skills. To be honest, every day we have encountered a new personal challenge. We can’t wait to share more about our placement experience with you. However, in this blog, we would like to pause and talk about some tips and hints which may help other international students adjust to their life in Australia as soon as possible. This is important because the more we practice, the more we realise that if we want to be Australian Occupational Therapists. We have had to explore the Australian culture and be a part of it, which is an important foundation for interacting with clients and co-workers.

While this Blog has hints & tips for international students, I believe much of this information also speaks to the families and clients we work with at Early Links. The new learning we ask our clients to explore to better understand their challenges and be a part of finding the solution that is right for them. Being able to explore the learning mindset required.  

From Catherine...

As I mentioned in my last blog, coming to a new country alone is not an easy journey and so I’ve developed my own strategies to deal with the stress and loneliness. For example, at campus, I tend to spend more time with my Chinese friends who are also international students. I don’t have any local friends and have few interactions with local classmates unless we are in the same group for tutorials or assignments. Off campus, I live in a suburb where Chinese elements are all over the place. There are many Chinese restaurants and shops in this area and it’s okay to live without speaking a word of English. Even my flatmates and landlord are Chinese as well. As a result, I’m living in my comfort-zone where I’m isolated from the English environment and Australian culture. Sometimes I have a feeling that I’m still in my home country, and I’m just attending a university that uses a foreign language. However, I have to admit that although setting up my life in Australia with all these strategies has helped me to limit my stress, it’s not really helping me to be ready to live and work in Australia. Therefore, I hope other international students can learn a lesson from my experience and take any opportunities to practice English (if English is their second language) and explore all the wonderful differences between Australia and their home country.

The recent changes we have decided to make in order to be ready to live in Australia include tips that we’ve collected from our placement supervisors and mentors from the university -

1. Live with local family or flatmates in an area where you have few opportunities to speak your mother tongue.

2. Build a social network with native English speakers (at school or in the community).

3. Join at least one or two interests groups or clubs, and attend some volunteer activities if you can.

4. Watch or listen to local news, get familiar with local popular people and events.

5. Change the language of your electronic devices (e.g. phone, laptop, ipad) from your language to English.

If you have particular interest in improving your English:

1. Find language exchange partners (e.g. meetup.com).

2. Use phone apps (search for “learn English”).

3. Visit English learning website (e.g. breakingnewsenglish.com).

4. Search “occupational therapy” on YouTube, listen and write down what they say on the videos, speak and record your voice to compare and practice your tone and pronunciation.

5. Find a fun activity to practice English (e.g. read an English novel or watch English TV shows).

6. Find help from the university (e.g. free weekly English classes from learning centre).

From Ash...

I first came to Australia six years ago when I was 18 years old. I was born and lived in South Africa up until 2009, before things began to change. Around 2007 my father was motivated to explore other ‘options’ for places to live where we could be safer, feel more secure, and invest in an internationally recognised tertiary education for my younger sister and myself. I worked very hard in my final year at school and in January 2010, I had a monumental choice to make - study in a familiar place, surrounded by people I know and love, or pick up my whole life and move to a new country and start all over again. Option B it was.

From receiving my offer to study at The University of Sydney in 2010, I had six days to pack my bags and say my goodbyes. I didn’t know anyone and didn’t know much about Australia at all. I found it both exciting and daunting to begin this next chapter of my life in a completely new environment with different cultures, social norms and expectations that what I am used to. English is my first language so I didn’t have a language barrier, however, the Australian slang and some words were rather new to me and took time for me to get used to. I knew that it was important to get to know people and to try to get comfortable with small things like walking down the street. Where I come from, walking anywhere was not an option for safety reasons. An encounter I will never forget was with a lecturer for my degree program during my two-week international student orientation class. I was the only international student to turn up for this information session and I was fortunate to have met someone with whom I have built a lasting professional relationship with, as well as a wonderful friendship.

One of the hardest things for me during my first year in Sydney was being separated from my family. By the end of the first year, I was lucky enough to have my mother, father and sister also in the country. Not having them around in the early days motivated me to try to get to know people and make some friends. Initially it was tricky because my background is a bit different and I found that many people here didn’t have an accurate understanding of what South Africa and Africa in general is like and so finding things in common with my peers was hard. I was asked the strangest questions about having wild animals living in my backyard and whether or not I rode an elephant to school each day. I had to continually describe my home country to people which did help in forming friendships but also made me miss my home. In tutorials I tried to get to know people and showed interest in working with them on assignments. I met people from other different backgrounds too which helped me to not feel alone a lot of the time. I knew I was not the only one to start fresh in a new place.

I believe that Ash’s experience highlights the isolation that is often felt but not often seen. We all, at some stage feel it, that feeling of not belonging to the group of people we surround ourselves with on a daily basis. The people who we would love to connect with, love for them to understand your inner most fears, share a respect  for your deepest most desires and relate to the life you imagine you could be living. Does that sound familiar?  Have you ever wished that you understood the world of doctor, appointments and school meetings, all with their own unique language and customs?

During the international orientation before classes started, there was an academic writing workshop and where we learned what referencing at university level meant and how to use the university’s library facilities to find journal articles and books. This workshop was very helpful and gave us an idea of what to expect in our classes. The university website was also particularly helpful at the time - we found the faculty’s page with the assignment cover sheets and other relevant forms that we would need as well as a structured breakdown of the Occupational Therapy degree and what subjects that would be covered during year. This was a helpful starting point and we have suggested to our Australian peers, in particular first year students, that the website is a great place to start when looking for information.

From Ash...

It took me quite some time to gather up the courage to ask my lecturers questions. I found this very daunting to begin with. I preferred to ask questions after class or over email and my lecturers were very receptive to that. I also found that the university’s LMS site and MyUni were invaluable websites to visit at least every day. Once I knew where all the information was, it was much easier to navigate my way through my studies. I also met and got to know my faculty administrator who has been very kind and helpful over the last six years in answering questions and pointing me in the right direction.

Here are some pieces of advice I can offer based on my experience as an international student (for one year) and over the last six years:

1. Make the most of every opportunity - attend the orientation sessions on offer, library tutorials, campus tours, computer lab orientation, writing workshops… the list goes on. You never know who you’ll meet and how valuable that meeting could be.
    

2. Make an effort to get to know your teachers and class peers - there will be many group assignments to come and you’ll need referees for your resume. I found that making friends with people from different ethnic backgrounds and countries helped me to become for familiar with different cultures as well.
    

3. Find out about the university’s information systems - e.g. LMS, MyUni, the website etc and what information is on what site. LMS was used for the units of study (subjects) and the MyUni was used for timetables, finances, etc.
    

4. If in doubt, ask. Be it a peer, a teacher, a library staff member - anyone. One of the biggest things I learned was to ask when I wasn’t sure because otherwise I wouldn’t find something out. The student centre is also a good place to start if you have questions.
    

5. Join a peer mentoring program to learn from students who have done similar subjects.
    

6. For second-language English students - find out about workshops for English language skills on offer from the Learning Centre and practice with peers as much as you can.

The advice I would offer to families, who have found themselves in a similar situation, where they feel isolated and confused by the environment and the expectations that surround them in the healthcare system is this…

1. Talk to someone about your experiences - your family, your friends
    

2. Read what you can from sources that are reviewed regularly by healthcare professionals
    

3. Find other people in a similar situation

I’d like to offer you several opportunities to access that type of support - The Team at Early Links offers a complimentary “quick chat” for anyone looking for a new perspective on the challenges they face in their daily life. We also have a Sip&Share catch-up and a Community SHOUT-out which I would invite you to explore further.

Students in Occupational Therapy may also be interested in our Personal Mentoring Program which runs year-round for all students and professionals looking to give more value to others by investing in their own learning.

My Story - What it really takes to uncover the real you

“I'm right where I belong”... I've never really felt this way or associated myself with these song lyrics by Good Charlotte. Until now.

I'm sitting on a flight to Melbourne, it's a Friday night and the sense of sheer happiness is unbelievable, it's infectious, it’s pulsing inside me and spilling out in fits of silent laughter, mixed with happy tears and a smile that keeps creeping out across my face to change the way I see the world around me.

If not for the four (4) sleeping businessmen sitting in the rows surrounding me, I'd be very keen to chat with someone right now.. But it seems that I was meant to spend this time talking with you. It's time I told my story from beginning to end and some of the in between. I've been writing an autobiography in spurts and pieces for the last 10 years or so and I finally know what the tone of the words will sound like. The story is far from over but I feel like I finally know myself well enough to know the tone of the story and the main message I need to tell you, for you to know "my story"...the key pieces that make me, me and finally, proud of it.

To start at the end seems logical at this point. To tell you who I am and why I feel it's important to share this information with you, now. The realisation that I am now "living a life on purpose" as Jack Delosa would say, has allowed me to truly be grateful for both the support and inspiration I receive from those around me. Jack Delosa, founder of The Entourage, has been a major influence in my Entrepreneurial journey over the last 5 years and even more so in the last year. His personal growth and willingness to share his journey inspires me. His ability to bring out the best in the people around him encourages me to do the same, and his passion for life is what's prompted me to jump on a plane and fly to Melbourne to volunteer at the UNconvention. My purpose - Live the Life you Imagine...

To me, having purpose is about enjoying the path I take, the challenges I need to work through and the support I receive along the way. My purpose is to "live the life I imagine" so my skills and abilities (whatever they may be today) can be shared with others. Listening to many speakers talk about Entrepreneurship over the years; from Branson, to Opera, to my colleagues and the media... I've always felt uneasy saying "I'm an entrepreneur". But, that's what I am. "I'm an Entrepreneur!" Now I realise, it's not a job title reserved for tech-startups that go from $0 to $1m overnight, or a jealously spoken term for people who sit on a beach blogging about travel... It's a way of thinking, a way of acting, a spiritual understanding of the world we live in, the world we effect with each of our interactions and the world we will gift to future generations.

...

After a wonderfully exhausting day at the UNconvention in Melbourne, "enabling greatness", I am once again on a flight back to Sydney. Sitting next to two lovely ladies who are on a trip to Sydney to visit their sister in hospital. They are funny, well-spoken and open about themselves. Our conversation has been real, it's been about the current moment and most of all, there's no mask, it feels genuine. I also had a similarly open conversation with the cab driver on the way to the airport this evening. He's a cabby on Friday & Saturday nights, works as a mechanic on Monday through Wednesday and he's passionate about his family. He loves the technical challenge of being a mechanic and working in a small business. The cab helps him earn extra money for his family. So why am I including their stories within a BLOG about my story?? Because without telling their story, I cannot begin to tell you just how humbling it is to realise that we all have a story that is worth sharing once we drop the mask, allow people to share in our fears, our desires, our innermost self. The true version of ourselves we would love the world to see, and support, and love.

It's been interesting to listen to all the stories I was told today about where people were at in business and what their aspirations are. It's been interesting to observe where people were at in their "entrepreneurial quest" and how many ONION layers they will uncover before they can let the inner voice speak-out. One such story I heard throughout today made me realise that sometimes, these ONION layers need to be played out, need to be experienced and lived before they are ready to be peeled back, to uncover a truer version of that person...and that's something I'm willing to wait for, when I can see that below their outer layer is a story that I'd love to get to know, and to share.

So, back to my story. I've worked with coaches since I was very young; gymnastics, debating, school sports, elite rowing, and now business. The support from the business advisors at The Entourage has been amazing. It's made me think deeper about the decisions I make within my business and have helped scaffold the growth Early Links has achieved over the last 2 years. The S&S community is a wonderful place to "test-out" each new version of myself as I uncovered them. It's a "safe-fail" environment that encourages a mentality of 'test-iterate-reiterate' and for that I'm thankful. In January this year, I sat down in a coffee shop with Barry Magliarditi and he challenged me to consider what the best version of me would do/think/feel/have achieved in just one year. It was confronting, it was challenging, it was scary, but without that moment of sheer terror, I would not have the opportunity to say today, "I am so grateful"... Looking within yourself, learning to listen to your inner voice and act upon it, has allowed me to peel back more layers in the last 9 months than in my whole life.

I believe the life of an Entrepreneur is about resilience. Having the resilience to know that you're not perfect but yet, to take your own fears and frustrations, to acknowledge they are what make you great, what make your purpose real...and turn them into actions to change the lives of future generations. Being an entrepreneur is about vulnerability. Being ok, with being vulnerable and letting people know that you're not perfect. Because without that moment of vulnerability, you cannot share your story, you cannot connect with the people who can help you most, the people who have been there and experienced your fears and frustrations, problem solved, and continued to grow. And it doesn't matter if that growth is upwards, outwards or refining the structures within, both personally and in business.

Keeping these two key values in mind; resilience & vulnerability - I am ready to share the beginning of my story. This part of my story begins in 2011 when I attended the Sensory Defensiveness course with international speakers and Occupational Therapists Patricia Willbaragar and Tracey Stackhouse. I remember the specific moment when the "penny dropped", like it was yesterday. Sitting in the middle of the lecture hall listening to Tracey talk about the errors in neurological processing involved with sensory defensiveness, the neurophysiological symptoms and the anxiety often associated with compensatory strategies. I frantically made a list, re-read it and knew...this explained me, it all made sense now, there was a name for it (Moderate Sensory Defensiveness) and more importantly, a solution. I had gone to this course with the viewpoint of learning something to help my clients, and had left there knowing how to help myself.

I will admit, I have indulged myself in quiet moments (over the years) where I wondered what would have been different in my life if I did not have this condition or if I had not found a way to cope with the symptoms, to achieve the success in school and sports that I had. I wondered what if, this condition had been diagnosed and treated when I was younger, I wondered why it was not noticed, not treated. To be brutally honest, I looked in envy at the children I treated in my clinic, who were receiving early intervention.

What I now realise is that the resilience my parents taught me from an extremely young age had actually prepared me for anything life had to throw at me... including Sensory Defensiveness. It was the greatest gift they could have given me, because my personal experience of coping and compensating and getting on with the daily activities of life, now gives me a unique story to tell. A unique perspective to share with you about how I have found my passion and my purpose for helping others to Live the Life you Imagine, regardless of the challenges you face.

I am truly grateful that my parents showed me how to be independent, to be a problem solver, to take a moment to reflect before making decisions. Because when I was growing up there was nothing spoken about Sensory Processing Disorders, or Sensory Defensiveness. And most certainly, nothing was ever mentioned to my parents about me ‘not coping’ each day, each aspect of my life - infact, I found a way to excel at school and become a leader in every activity, because it was easier, more predictable and I could be in control of what happened and what to expect. It was my way of coping with the world and the symptoms of Sensory Defensiveness. It was just that, “my way” of coping - and, I’m sure there are many other ways, that you choose to  “cope” with the challenges you face in your own life, as do many other children and adults.

Growing up, the phrases "toughen up" and "get over it" we're always surrounded by love and the mindset that if you are able to simply acknowledge your initial 'reaction' to panic in a challenging situation, then you will be in the right mindset to overcome any challenge life has to throw at you. And that’s what resilience is all about.

Speaking about vulnerability and the role it has played in allowing me to feel so entirely comfortable with who I am and where I’m heading, is key to explaining my story. I’ve never been someone to share my thoughts and feeling with anyone, and that’s probably why I have never been on a date, and there are only a few people I would say are close friends. Being vulnerable is more than being able to scream out that you need help or sharing your inner voice with others… it’s about recognising just how much you have to share with others and believing that you already have people in your life who are there to support you, who love you and who can see through the layers of protection we all surround ourselves with.

There are many more elements in my story, and I’m sure your story is just as colourful and complex. I will be sharing information and learnings, and hopefully you will gain some insight into the importance of your own story from these messages. While this BLOG post has been many years in the thought-process and even longer in the making, it’s actually been the easiest 2000 words I have ever written.

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Remember “Live the Life you Imagine” and you will be “Changing Lives of Future Generations”

...

As with each one of my BLOG posts, I now throw a challenge out to you… This time, it’s a two part challenge - first, visit our Facebook page and share a small part of your story - it can be anything, anything you feel comfortable sharing. Second, reflect on the story you shared and think about how you could uncover the ONION layer surrounding your shared story, think about the people who will be there to support you and the new outlook on life you would have. What situation would be easier to approach if this ONION layer was gone…

If you’d like to share the second part of the challenge with me - call me - 0430 935 016

If you feel ready to be vulnerable - share the second part of this challenge on our Facebook page, including what you recognised as a “learning” that would help other people too

Halfway around the world - Being Brave

The learning experiences of an Occupational Therapy Student during their fieldwork placements are some of the most intense times of their life so far.

...and this can be said for supervisors too. As a supervisor, it is my role to maintain the high standard of service provided to my clients while also teaching critical OT theories and finding opportunities for students to practice their emerging skills. I love the challenge and believe irt makes me a better Occupational Therapist because I need to justify and evaluate each decision I make for every minute of my day so that I can explain myself and my actions so the students can learn how to think and apply their knowledge to a situation. 

I asked Katherine to write a blog post each fortnight during placement to capture the essence of the educational journal of fieldwork placement... this is what she had to say after Week One

I’m an international student from China. I came to Australia two years ago to pursue my Master of Occupational Therapy degree at the University of Sydney. Just like many of my friends, I have left my family and everything I am familiar with, and have come to a strange country alone, which is the bravest decision I have made in my life. This is not an easy journey and I have overcome so many challenges to keep going. Now I’ve just started my last 8 week placement at Early Links before graduation. I’m so grateful that I could have this opportunity to share my experience with other international students who are about to practice in this setting, because I believe I’m not the only one who is struggling during their journey. I hope that through reading my blogs, students who have similar problems or concerns will feel more confident to enjoy their placement.

When I first heard that I would practice in a pediatric setting, I could not stop worrying about the difficulties I may face. How can I communicate with kids? What topics or activities can I use to build trust and rapport with kids? What if kids cannot understand me or what if they don’t like me? What if I cannot explain theories or reasons well to parents? I have no confidence to deal with those problems as I have both language and culture barriers which keep me from communicating effectively with clients. For instance, although I still remember some games that I used to enjoy when I was a little girl, I have no idea how to translate them and fit them into Australian culture. Not to mention that I know nothing about what kind of games or activities Australian kids would like. During my third placement, I got an opportunity to play with a lovely local kid. He was so eager to play his favorite game with me. He told me the name of that game several times and even demonstrated how to play it, but I could not get it as I had never heard or seen it before. I could see the disappointment in his eyes although he didn’t say anything. I felt so awful and this feeling has stayed with me till now. I have a fear that it will happen again during my current placement. In addition, the way we communicate with kids in Australia is quite different to the way in China. In Chinese culture, discipline is a concept that would be taught to children throughout their whole childhood. It is very common to hear a parent or a teacher say “don’t do this” or “you must do that” to a child, and the child’s compliance is very high. Whereas it is definitely inappropriate to use this way to communicate with kids in Australia. But without experience, how can I know the appropriate way to approach kids? There are so many things I need to learn and adapt during this placement, which stresses me out.

Stress is a normal part of any learning experience and it actually helps to lay down new memories. The strategies we use to cope with stress and ensure we have opportunities to step away from it, relax, reset, re-energize...are what will allow our stress to be a positive during our placement.

On the other hand, along with initial fears, I have some excitements as well. I love kids, but I need to find out my way to interact with them. I believe this placement is my best opportunity to achieve it. I also love the feeling of helping people, which inspires me to be an OT. It would be one of the most wonderful things in my journey as an OT student if I could help my little clients to achieve their goals. During my third placement, I developed some sensory playgroup sessions for preschoolers and I enjoyed the process of finding and creating interesting activities. However, I did not have a chance to run them in person. This time, practicing at Early Links, I’m looking forward to having more opportunities to develop and run sessions. Furthermore, unlike my last long-term placement, I have another OT student as my partner. I enjoy working within a team at the university as we could come up with more ideas and complete tasks more efficiently. So I feel excited to work with her during this placement. Last but not the least, I really appreciate that I can have a supervisor to instruct me when I practice to make sure I’m on the right track. I can’t wait to pass this final placement and become a real OT.

After a week of practice, I have a better understanding of what I am going to do during the placement. When I look back to my initial fears and excitements, I have found several changes. The biggest one is I feel more confident to deal with my problems. Although I still feel a bit overwhelmed by a large amount of information and caseload, well-organised working environment, clear structured working process of this placement and supportive supervisors help me to take the edge off stress. For example, my weekly tasks throughout the placement were explained on the first day, and I knew that I would have time and opportunities to observe supervisor’s practice before actually taking part in a clinical session. This is exactly what I did during the first week. I observed how my supervisor interacted with kids and their parents, which was really inspiring. She used engine analogy to explain the concept of self-regulation to little kids and parents, which made the theory much easier to understand. I would never know how to explain something like that to clients if I have not seen it. Besides, she encouraged kids to improve their performance by asking about their feelings and their wishes, and making them feel better after participation. As a results, kids would be motivated to continue the therapeutic sessions and complete their homework. It was amazing to see the change of some kids, from unwilling to happy. After each session, my supervisor would ask for my observations with clinical reasoning and answer my questions, which helps me to develop my thinking process. With those observations and help from my supervisor, I’m able to find a starting point to learn clinical knowledge and solve my language and culture problems. Now I’m about to start my second week of placement. With more confidence, I definitely feel more excited to practice at Early Links.

I certainly wouldn't say that coming from a different culture is a problem, in fact it's a point of difference that kids will often be curious about. Kids are great like that, they just want to be allowed to play and ask questions, they want to explore and challenge, they need to feel acknowledged and supported with boundaries. Overall, fieldwork placements are an opportunity to grow, change and share your experiences both past and present with others. To be open and honest, to be vulnerable and resilience. And isn't that what being human is all about?

My Story - Being Busy

Want to fit more into your life but believe that you need to sacrifice something before you can have success?
You don't have to do that...

Don't have time for all the things you want to do because there are too many things you need to get done?   
You can do it all...

Last weekend, my life was a prime example. I have always resented the comment people would say to me about my life... "you're so busy, I don't know how you do it..."

But I've now come to acknowledge it, respect it, and be thankful that I have found a way to live a life where I love every minute. I'm still learning how to utilise this attitude to help get everything done each day, but I'm getting there!  

In just 60 hours; I have been to 18 locations, connected with 63 people, and completed 27 different activities, each with multiple tasks that I was able to check off my to-do list. I feel more alive than ever and more ready to grow the level of "busy" to a whole new level in the coming weeks. First, I'd love to share my weekend with you.

Starting on Friday morning -

• 6am - Communication with the world - 30mins for Email x4, Facebook, Twitter, LinkedIn.

• 6:30am - Preparing for client sessions today

• 8am - Exercise... a 10km run from home to Cronulla Point and back

• 9am - Self care and preparing for the weekend ahead, plus a load of washing

• 10am - filmed a "how to" video for my Girl Guide unit on "building a bedroll for under-the-stars sleeping"

• 10:30am - Returning calls/emails from clients and partners

• 1pm - family & children client session, home visit

• 3pm - driving to Taronga Zoo early to miss the traffic

• 4pm - content and marketing material creation sitting in the car overlooking the harbour

• 6pm - arrive at Taronga Zoo ready to look after eight 10-13 year old girls among 1200 other girl guides who collectively raised $25,000 for environment conservation and preservation of the Bilby.

• 7pm - had the girls settled into our patch of grass with the other leaders before doing a media interview promoting Girl Guides to future generations of young women and girls

• 8pm - Phone calls to team members to complete “Feel Good Friday” culture

• Dinner, Disco, Movie, catching up with old friends from other units, Bedrolls, SLEEP by 10:30pm...

Saturday morning,

• 6am - breakfast, doing up bedrolls, entertaining the girls until activities began

• 8am - FREE BEING ME activities to teach young girls they can be proud of their thoughts, opinions and decisions.

• 9:30am - the Zoo opens and "counting to eight" becomes my new favourite activity...we managed to keep eight girls safe and entertained -

  • Promise ceremony for one of our newest members

  • Lemur show

  • Animals

  • Bird show

  • Lunch

  • Cable car ride

  • Seal show

  • Redoing bedrolls before trekking up the hill

• 3pm - Rushing to the top gates to meet the parents who will drive the girls back home. Really, this was more about motivating tired 10 years to carry their bedrolls and backpacks up the 3km steep hill inside the zoo.

• 4pm - Finally got out for a Row in my single scull on Iron Cove. After a few weeks, it was the best feeling to be out on the water, putting my body through a few fast laps.

• 5:30pm - Driving to Gladesville to see a sports client

• 6:15pm - Core activation and postural stability training session, helping 2 athletes to improve their coordination, body awareness and concentration.

• 7:30pm - Driving home

• 8:30pm - Dinner while watching a movie with my parents

• Conversation with a friend who was visiting Sydney

• 9pm - walk to Nan's house to help her take off her Compression Stockings

• 10pm - bedtime!

Sunday morning,

• 6am - Woke up without an alarm clock!

• 6:30am - arrived at the Georges River for a rowing race

• 7am - On the water as a coxswain/coach for my 70+ year old men's crew. These guys are amazing, they train hard, appreciate their health and the are prime examples of how teamwork can get help achieve results.

• 8:30am - Racing is underway...for 40mins, over 9.3km the guys pushed themselves both physically and mentally. My part was to steer, motivate and provide the tactics to navigate the turning tides and river corners.

• 9:30am - driving to the city

• 10:30am - blog post writing for the Early Links website

• 12pm - meeting number one with Fiona - while sitting in the powerhouse cafe

• 1:30pm - meeting number two with Liz - while sitting in another cafe

• 4pm - catch up with friends at The Entourage, Entrepreneur Development Centre

• 4:30pm - CAaPS Breathing reset session with Fiona in the park

• 4:30pm - meeting number three with Fiona - while driving home from the city

• 5:30pm - home for family dinner for my brother's birthday

• 8pm - phone call with a friend who's business is growing rapidly

• 9pm - complete content writing from earlier this weekend

• 10pm - bedtime

Now to share my learnings with you -

1. Being "busy" is an observation not an attitude

Previously, I thought that being busy was a bad thing. I believed that "being busy" was the same as "being too busy" which was an excuse for not getting the important and meaningful things done within the day. Or it was the phrase we all used when we were expected to do something we didn't really want to get done and therefore procrastination had set in.

Having shifted my thinking, being busy is an observation. It's about recognising that life is hectic and it can be a challenge to fit everything into one day. For everyone, this observation of being busy will look different, feel different and sound different. Be aware of this. But don't judge others on your observation of their level of "busy". This is when the attitude of being "too busy" can turn around and bite you, slow you down, make you feel unable to match other and ultimately, doubt yourself. Don't get caught up in this attitude... Completing a time-audit over a short period of time will help your to clearly see just how busy you are choosing to see yourself. I like being "busy" therefore my time-audit from the weekend is fairly detailed, but you might group your activities more broadly...and that's perfectly ok!!

Everyone is "busy", even you... This exercise is all about recognising and observing what "busy" looks like for you and breaking away from the attitude of comparing yourself to others. This is the first step in being able to add more productivity into your day without adding more "busy" into your life.

CLICK HERE - simple audit tool

2. Living with your "values" in thought does help

From the minute I (finally) realised my personal values and how they applied to each area of my life, my capacity to be productive has skyrocketed. My ability to make clear decisions has jumped and my willingness to get the important, yet not overly exciting things done, has taken a leap forward.

So, my personal values - Mentoring, Teaching, Inspired, Exploring

• Mentoring - asking the right question, at the right time, to help the right person find the right answer to their question

• Teaching - learning knowledge that's worth sharing

• Inspired - recognising the past and present experiences that help me grow

• Exploring - challenging my limits physically, mentally and emotionally to find myself

Putting these values into practice, testing them one by one has allowed me to grow parts of my business more organically, return to competitive rowing training with a more simple plan, and strengthen personal relationships. I started this process in December 2014 on a trip to Thailand, listening to the influential Jack Delosa talk about vision and finding life purpose and it will continue to evolve for years to come as I refine the way I implement the values into my day to day and the circles of influence I choose to live in.

Ok, so the way I got to realise my personal values was through a lot of journaling, a lot of thinking and by giving myself time to put these values to the test. But...all this has allowed me to reflect on the shortcut, which I can share with you!    

CLICK HERE - Get to know your personal values.

3. Regretting your choices only slows you down

There is a difference between a "fail-safe system" and "safe-fail support".

The first, is a way to avoid failure, avoid getting it wrong, and save yourself the experience of challenging the way you think. The second, provides you with the tools you need to feel safe within an experience of failure. It's my opinion that making mistakes is a vital part of learning and without this experience, we coast through life without truly knowing what it means to expand our thinking and develop more productivity in our day. One quote that I have loved and live by since reading it is “...be big enough to admit mistakes, smart enough to profit from them, and strong enough to correct them.” John C Maxwell.

I often think that it would be so easy to plan to do less each day and spend longer planning how to complete each action. But each time I do this, I end up feeling less productive and achieving far less in the day. I have spent time over the years developing a mind-set where experiencing “failure” is just another reflection on ways to improve for the next attempt. This mind-set is the ‘safety’ aspect of making mistakes and it comes from having wonderful people surround me and a method of debriefing/reflecting which helps to turn “failure” into “learning”. It’s not that I don’t care if I get something wrong (in fact, the opposite is true if you talk to my colleagues/friends), but it just doesn’t play on my mind, doesn’t make me sad, doesn’t take my energy for the other activities I know I have planned for the day.  

CLICK HERE - “How-To... build safe-fail supports”

4. Reflect on the changes you make each day

This section has been influenced by Stewart Cook and Andrew Morello, two men who I have had the pleasure of meeting and in my opinion, represent what it is to be an entrepreneur. Andrew Morello takes well over 100 flights per year and mixes charity work with multiple business endeavours. Stewart has been the CEO of Zambrano's over the last 4 years and was instrumental in taking this company global. Both very "busy" men who, when talking to them, I believe, know their personal values, embrace "safe-fail" supports and both speak actively about the benefits of self-reflection in building yourself and the life you want to live.

I have been more active in the reflection process this year. It's been a confronting, challenging, eye-opening, worthwhile experience without a doubt. I have reflected on different aspects of my life; both personal growth and business development. Some nightly, or weekly, others more formally each month. The things I reflect in each night, help me to "pause" the entrepreneurial-thinking so I can actually fall asleep. The weekly reflections help me to appreciate and celebrate the changes I have made happen in the last 7-days, while also preparing myself for upcoming challenges. The other reflections each month are an hour long, dedicated to "brain-dumping" on whatever my thinking sticks on, it’s essentially a ramble of thought that eventually finds an ah-ha moment of clarity. Then there is the business related reflections each week/month/quarter that help acknowledge the successes, changes and challenges.

The questions I ask myself at each of these reflections are critical to helping draw out the knowledge that ultimately strengthens my productivity within my "busy" life.

CLICK HERE - make your own "my busy week" calendar.

The real learning I have come to understand about “Being Busy” throughout the process of writing this Blog post, is that TIME is the only thing on Earth we cannot replace once used. There is no more TIME to “find”, but rather we must “find” what is most important to us in each moment of each day... and do that.

The challenge that I am setting you today is to; complete each of the four (4) worksheets in the "Being Busy is Easy" package, send me the results then, book a FREE 30min catch up slot to really get the most out of your Busy-Life!!

It only takes one click to get started...

Click on the link and download your FREE  "Being Busy is Easy" starter pack

• Simple time-audit tool

• Get to know your personal values

• How-To build safe-fail supports

• "My busy week calendar"

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