Parenting Balance Podcast
Parenting Balance Podcast
020 Sensory Integration Therapy with Lilibel Bernhardt
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Did you know that sensory integration problems may manifest as distraction, impulsivity, lashing out or melting down? It can also manifest through hyperactivity, resisting hugs and putting things in their mouth. There are many theories to the cause of this behavior: it can be sensory processing disorder, ADHD or autism.
One popular approach to treatment is called Sensory Integration therapy (SI). SI uses fun activities in a controlled, stimulating environment. This way, kids experiencing sensory integration problems can experience stimuli without feeling overwhelmed. Over time, they will develop coping skills for being exposed to stimuli. Occupational Therapists are the specialists who work with kids who have sensory issues.
In this episode, we have Lilibel Bernhardt who shared her valuable insights on how SI addresses sensory processing deficits among children. Lilibel Bernhardt is an Occupational Therapy assistant and a PhD candidate in Organizational Psychology with a focus on sensory integration in the workplace. She is a co-founder of Re-connections Education center in New Port Richey, Florida. Her biggest interests are sensory integration techniques and emotional regulation techniques for children within a wide range of ages and diagnosis.
You can reach Lilibel Bernhardt through this website: https://reconnectionseducationcenter.org/
Alternatively, you may reach her through the following social media pages:
Facebook: https://www.facebook.com/REConnectionsEducationCenter
Instagram: https://www.instagram.com/reconnectionseducation/
Twitter: https://twitter.com/reconnectionsc
Here at the Parenting Balance Podcast, you'll find simple, science-based tools and tricks for parenting kids with ADHD or anxiety. Although we are both family therapists, this podcast is for informational purposes only and should not replace the guidance of a qualified professional. Join us as we debate and discuss our own experiences as parents of kids diagnosed with ADHD and anxiety and breakdown the latest research into easily digestible portions. We created this podcast to educate, inspire hope, explore new ideas and discover together what we know to be true: you are not alone, and finding a community of support can make all the difference. Please join our Parenting Balance Podcast Community here and sign up here to be the first in line for our new Modern Guide to Understanding Kids With ADHD mini-course.
Hi, everyone, welcome to the Parenting Balance podcast. My name is Kelly Williams. I'm a licensed Clinical Social Worker and an ADHD parenting expert by experience. I'm here with my partner.
Teresa Vanpelt :Hi, I'm Teresa Vanpelt. I'm a licensed Mental Health Counselor and anxiety parenting expert by experience and for the past 10 years, Kelly and I have had a family practice in Florida. This podcast is for parents who want to really understand what's going on with ADHD and anxiety so you can ditch the chaos and feel confident and happy again. Lilibel Bernhardt s an Occupational Therapy Assistant and a PhD candidate in Organizational Psychology with a focus on sensory integration in the workplace. She is the co founder of Reconnections Education Center in New Port Richey, Florida. Her biggest interests are sensory integration techniques and emotional regulation techniques for children within a wide range of ages and diagnosis, as we know a lot of our kids struggle on these areas.
Kelly Williams :Hi, Lilibel and thank you so much for taking the time to be here with us today.
Lilibel Bernhardt :Thank you so much for having me.
Kelly Williams :I'm so excited to talk to you about sensory integration and how it relates to emotion regulation. And but before we get into that, I know that you are trained in Occupational Therapy, but you're also working on your doctorate in Organizational Psychology. And that's kind of like a big shift. You know, to my mind, maybe, maybe it isn't, I'm not exactly sure but, um, but how are these two areas related and why. Can you tell us a little bit about why you decided to pursue your doctorate in Organizational Psych?
Lilibel Bernhardt :Absolutely. So, my dream was always to open a school. Once I, you know, realized that Pediatrics was the area that I was going to focus on. That was that's where I was at. I wanted to open up a school for, you know, special needs children, children that learn differently and process information differently. So originally, when I started going to school, I did my quota program, which is occupational therapy assistant. And the plan was always, you know, to go right back and get my AR, which would then make me an occupational therapist, but I just wanted to work as a coder while I was doing that. So when I started working in the field with the children, I soon realized that I needed more of a psychology background to really understand these kids. And so it was a really special decision because I was trying to find the best degree that would prepare me to be able to do all of these things and help me to run a school and organize a school. The plan will be eventually I will step back from being the active therapist in the school. And I will be training, you know, other therapists to show them, you know, what we're doing and how we're being successful with our children at the school. So Organizational Psychology is all about, you know, running organizations and, and it teaches you about training in the workplace and an education in the workplace. And so, that's why I ended up going that route because, you know, I knew there was an end game to all of this where I wanted to end up so I just kind of thought ahead and, you know, that's, that's why I took that route.
Kelly Williams :Yeah, it's so it's so interesting that you, you know Like, well, first of all in the area that we're working right, with kids who learn differently? I don't know, you know, there are so many different degrees and fields and avenues through which you can kind of get into this work, you know, even already on on this podcasts, we've interviewed all kinds of different people from different educational backgrounds. Yeah. So but I love it that you figured out that you really wanted to connect with the emotional piece of it is what I heard you saying, Do I have it, right?
Lilibel Bernhardt :Absolutely, yes. Just trying to understand the kids.
Teresa Vanpelt :And I think that that's something that you're really good at is kind of looking at the whole picture. And, you know, not, you know, like seeing the whole picture of the family dynamics and everything like that when you do your work. And I'm curious, you know, When we when we start talking about occupational therapy. I'm curious how that approach fits in with everything. Absolutely.
Lilibel Bernhardt :Absolutely. And one of the things that, you know, when you see a degree on paper, you don't really see all that, that goes into it in the background. One of the cool things about my degree is the school, they worked really close with me to kind of allow me the freedom to focus on classes that I really wanted to take. So I took every counseling class that was available, you know, I really focused on even the Clinical Psychology aspect of it, and I so I got to get a little bit of everything. So even though my degree is Organizational Psychology, I got to really learn about all different aspects of psychology and focused a lot on the Clinical Psychology and the counseling piece because obviously, knowing that I'm working with children that have, you know, emotional regulation, deficits, that have self regulation deficits, that was an important part for me.
Kelly Williams :It's so interesting too, because, you know, organization is one of the areas of executive function, right? Absolutely. So, um, you know, learn understanding organization, and I realized organizational psych is more about systems, but as humans, we are systems ourselves, aren't we? Absolutely. Yeah. So tell us a little bit about how you use. Okay, so I'm going to switch over to the occupational therapy now because that's what you're doing in your school, right? And you use occupational therapy to help kids regulate sensory stimuli. Is that Is that how it works?
Lilibel Bernhardt :Well, you know, that is one of the things that occupational therapy does. Occupational therapy, you know, it allows us to help children with their emotional, social, physical needs. So it's not just the sensory needs they, it's kind of like a whole, looking at the whole body, you really have to work on everything to work on one thing, you really can't just work on one thing.
Kelly Williams :Yeah, cuz it's all connected, right?
Lilibel Bernhardt :Absolutely. Absolutely.
Kelly Williams :What kind of things does an Occupational Therapist do with a child in order to help them work on those things?
Lilibel Bernhardt :There are so many things, you know, in the sensory gym, we organize obstacle courses for them, that focus on different skills, you know, you might be working on your appropriate receptive skills, you know, crawling, jumping balance, core strengthening, a lot of times when fine motor skills, you know, it's all encompassing, we, you know, you, you, we try to try to keep it fun. So I'm not really sit down and do some handwriting kind of therapists like, I want to work on handwriting with a child, what I do first is work on their core strength because they don't have any core strength, their handwriting is probably not going to be great. So, I, you know, we do so many things, you know, you play you, you learn your environment, and you you help them with these skills through play, and you make it fun.
Kelly Williams :That's so interesting. Because it's, it's almost like when you understand the psychological piece, you know, because I know like, as a therapist, that doing the talking part of it is always happening along with play. You know, like, if possible, do it that way, right? So you can kind of do both at the same time while you're doing the obstacle course be you know, talking about things or pointing out or learning.
Lilibel Bernhardt :Well, I always when I do when I play in the gym with my kids, and this is something I always try to teach this, like my fieldwork, students, you always want there to be like something motivating to be your in game, you might have a child who, you know, loves Disney. So, you know, pick out a puzzle throughout the obstacle course use the puzzle and the obstacle course and have them pick out pieces from different areas of the room to put together you know, a Disney puzzle, or different things like that. You just, you have to make it motivating for them, they have to have a reason to want to do it because a lot of times these children have a hard time playing, which is one of the main reasons why they're not integrating all of these skills. You know, we take that for granted. We don't realize that when we were younger, we were doing all this play. We were always playing outside we you know, we learned our empire. Through playing because that's a child's job. So you have to kind of try to simulate that so that they can then try to learn their environment and integrate those skills that they're missing.
Teresa Vanpelt :Yeah. It's super interesting for them that way.
Kelly Williams :Yes.
Unknown Speaker :Yeah, it's super interesting, you know that our system of education, at least in the United States, you know, is, is moving toward structured activity at a younger and younger and a younger age. Yet we know from the science that what kids really need when they're young is unstructured activity and play time.
Lilibel Bernhardt :Absolutely. It's, it's imperative to integrating many skills that you know, we use throughout our life.
Kelly Williams :So interesting. So does occupational therapy, can that help with impulsivity that you know, is related to having a nine neurotypical brain or ADHD, are there things that you can do through occupational therapy to help impulsivity?
Lilibel Bernhardt :Absolutely. Absolutely. So, when you think, you know, OT, it doesn't treat a diagnosis, a focus on the symptoms of the diagnosis, and many different diagnosis have impulsivity as a symptom. So, again, working on those organizational skills, working on time management skills, having them do obstacle courses where they have to take different steps to get to the end, you know, all of this slows the brain down and allows throughout time, the child to you know, slowly come down from that impulsive behavior. I mean, I'm not saying it just takes it away completely. But you notice the difference if you continue and consistently work on that. So you know, absolutely OT, is impulsivity is a huge piece of OT. You see it in many of the children, I mean, you see it and even typical children. So it's a very big piece of what we do.
Kelly Williams :Wow, that's so interesting. So is and I don't know if you've ever practiced outside of your school fit. But in his occupational therapy like if we listeners were their children go to public school is occupational therapy, a service that's available to them in a in a public school.
Lilibel Bernhardt :Absolutely. Dchools offer occupational therapy, mostly focusing on educational needs. So handwriting, scissor skills, academic outcomes, math, reading, participation, at recess, participation in sports or lunchtime. Most often times, when you know, a child needs occupational therapy, the teachers are with them all day. They, you know, your teachers are able to notice is these things that the child is struggling in? And oftentimes they reach out to the families about, you know, the services and starting the services. So yeah, OT at school, that's, that's, that's very common. Often when I worked in private practice before I worked for here at, you know, my school, the children who received OT, at school, you know, the the, since the OT school focus so much on the educational needs would still come to private practice to focus on the sensory needs, you know, with us, so they, they would get both. So that's the way that I have most often seen, seen it work and kind of work better.
Kelly Williams :Yeah, and this is a service that's typically covered by health insurance?
Lilibel Bernhardt :So yes, it is covered by health insurance. You if you speak like so. If you and your doctor notice that your child is having difficulties with you know, certain developmental milestones, then you can definitely go about seeking OT services. So, you know, the doctor will refer you and then you contact the insurance company, you know, and and then you get your occupational therapists that you're going to go to to do your evaluation. And that once they do the evaluation, then they will determine how many times they feel your child needs therapy that is submitted into the insurance company and then, you know, it's it's about what the insurance company whether they approve or they deny it, but a lot of great therapists have gotten very creative at you know, helping kids and, and helping for insurance to cover these things. And then there's also private. You know, a lot of families just decide to go the private route. If they feel like you know, they don't want to go through the insurance companies, but It absolutely can be covered through insurance.
Kelly Williams :Yeah. So I can't help but think we're still in the middle of this COVID disaster here in Florida. And I know certainly at my house that unstructured play time has basically gone away, right? You know, like, we can't go outside and run around with the neighbors and do a pickup game or do kind of the things that we used to do. And I, I don't know, do you have any suggestions? Right, like creative suggestions, being an occupational therapist who, you know, like, plans activities to build these skills, what are there things that we can do at home, even just to support normal development in this unusual time of the COVID crisis?
Lilibel Bernhardt :Well, absolutely. And and of course, everything, everything requires, you know, sacrificing time from us as parents as well. I mean, unstructured play in the home, you know, playing board games with your child playing memory games, you know, are just getting down on the ground and pretend playing, you know, with with toys that they like and creating obstacle courses inside of the home, doing crafts, painting, all those things are tools that we use in occupational therapy to create sessions for these children to work on their goals.
Kelly Williams :Yeah, I'm thinking of the the fort building. Like I know at the beginning of the crisis, I was I was so dialed in on that. I mean, we had a we turned our house Into the Wild West and set up these Nerf gun, you know, obstacle courses, but like, you can't live like that forever. I mean, there was there was stuff everywhere.
Lilibel Bernhardt :Absolutely. I mean, it's unrealistic to think that You would have to do that every day. But you know, there are other things like, you know, crafting, we've, I feel like we've gotten away from that when we were younger, you know, crafts and painting and cutting and making things was a huge part of our childhood. And they're, you know, that's that's a great for these kids to work on fine motor skills, you know, I mean, those things definitely need to be integrated back into our homes for the children because they work on many skills.
Kelly Williams :I'm feeling like you know, maybe even a way to think about the screen time right because I know again, I'll speak for myself but like the amount of screen time my kids are getting right now is making me it makes my eyes twitch, you know, like I'm just sort of I don't like it, but maybe if I were to balance try to balance it out with like for every hour of screen we do a half an hour of crafting. You know, I could be like figure something out like that.
Lilibel Bernhardt :Absolutely. And I mean, I I'm guilty as well, you know, I'm really busy sometimes and, and that there might be a day where I don't do those things with my son. But as soon as I check in to the fact that, you know, screen time is too much, you know, I just let's play a board game, you know, let's make something like, I want the TV off right now there just has to be that you know, expectation because the kids, they don't want to do it, you know, because they're not used to it, it's not being done, you know. So they're, they're not motivated to do it so
Kelly Williams :It's hard to shift your thinking. And the other thing is, is that there's in a board game, there's more of a delay in the reward of the game. So it like when we compare a board game to a video game, it's kind of like slower to start up and feel that reward and that in and of itself is something I think that we really need to keep doing with our kids so that they can tolerate that. That delay, you know?
Lilibel Bernhardt :Absolutely. And if you think about it, like, let's just say, okay, we picked out a board game today, if you think about all of the different things that you have to the skills that you have, you're working on playing a board game, you might have a child who, you know, has no patience, is impulsive, doesn't like to share. You know, those things are difficult for some kiddos. Playing a board game within itself is addressing all of those skills and you don't even realize it, you know, you have to wait for your turn. You're not always going to when you teach them so many things through something so simple as a board game, which is why we use things like that in occupational therapy.
Teresa Vanpelt :I use board games too in therapy. I mean, I sometimes I have to kind of pull back a little bit and it really depends on who I'm working with and what the goals are. But that is that thing that I found very helpful for me, emotion regulation, it gives you a opportunity for them to be upset to work on practice skills.
Lilibel Bernhardt :And I know we live in a world right now where video games are huge, but it doesn't have to be like a bad thing. You know, if you think about the video games, again, when we were younger, you know, Donkey Kong, Zelda, Mario, there was always problem solving skills, there was always something that you had to get there, you know, you could do two players, somebody wins, somebody loses. I mean, some of these, you know, I'm not going to name the names of some of the newer video games that don't really have those components to them. You know, if you're going to let the kids play video games, then at least allow those video games to work on some skills, not just mindless, you know, building and there's no end. There's no problem solving. I don't really have to work at something, you know, make them workout it.
Kelly Williams :Yeah, it's always tricky. It's always that's kind of the, the balance. You know, that's why we call this podcast the Parenting Balance, right? It's we're always trying to balance the, you know what they want with our need to be building frustration tolerance and having having our kids do things that are hard for them. You able to tolerate that, because that's how we keep moving forward.
Lilibel Bernhardt :You know, yeah, but you have to work through those things. And if, you know, it is a hard thing to work through for everyone. But if you're not, you know, focusing on working through those problem solving skills, and focusing on those skills that you have trouble with, then it just becomes frustrating all the time, you know? Mm hmm.
Teresa Vanpelt :Well, it's good to know that there's things that parents can do at home to supplement and to help their kiddos even if they don't need occupational therapy, but how would a parent and know, if the teacher doesn't contact them or the daycare or preschool teacher doesn't let them know that there's some delays? How would a parent know that their kid might need occupational therapy?
Lilibel Bernhardt :Well, I think focusing on the developmental, you know, appropriate developmental milestones, but not hyper focusing on them. Because sometimes we tend to do that as human beings. You know, just when you you see that there's difficulty with, with fine motor skills with you know, picking things up off the ground, with holding on to things like you know, grasping things, all of those things are supposed to be integrated, you know, at the beginning when your kids are, you know, walking and running and playing with toys and, you know, when you start noticing that they're not able to do those things, then you can always voice your concerns to the doctor, of course to your you know, your medical provider and kind of go through that but, you know, fine motor wise, if they're struggling with dexterity, have difficult difficulty drawing, which is a huge one, you know, stringing beads because again, crafts is, you know, we're supposed to be doing crafts with with toddlers, you know, scissor skills, or even using utensils to eat when you start noticing, you know, there's, there's, there's difficulty with those things then there might be a fine motor delay, or maybe gross motor wise difficulty with like, balance and strength once the kids you know, once they're walking and then running, you know, there's supposed to be a time where it kind of then becomes fluid. It's, it's not like at the beginning, if you don't see that going away, and you see that, you know, they're struggling with balance and they don't have any endurance, they're, they're struggling with coordination. They're not able to maybe hop and run fast and, you know, are unable to catch balls and and things of that nature, then, you know, then you can start speaking to your medical professional about, you know, what can we do? How delayed are they like, do you think we should? You know, do you think we should start occupational therapy because starting young is great. Sometimes you have kids that, that they just have a developmental delay, it might not be, you know, another diagnosis per se. And if you catch that early and put them in therapy, you know, they catch up and, and then, you know, you've you did your part and they don't have to be in therapy for, you know, five years. So catching it early is really, it really makes a huge difference in in the in the ultimate, you know, the progress and, and the end,
Teresa Vanpelt :The end prognosis?
Lilibel Bernhardt :Yes. And obviously, sensory wise, which is a huge one. Now, you know, when they're overreacting to touch and feel, tastes and sounds and smells are they're very under sensitive, or showing seeking behaviors like with children that have, you know, a lot of impulsivity, ADHD is a huge one, they have a lot of seeking behaviors, they don't stay still, they're touching everything. It's, you know, it's more than just, he's just a toddler, you know, you can tell that it's just more they're coming out of their body, they can't stay still. And, you know, sometimes a parents that really they don't understand, which is fine, because you're not, you didn't go to school for this. And, you know, sometimes they don't understand, like, why is my kid, why can't sit still for one second, you know, if you if you're saying that to yourself every day, constantly, all the time, and it's just more than, you know, what you observe other toddlers doing? Then you you know, you may want to talk to the doctor about, you know, getting an occupational therapy, you know, referral evaluation.
Kelly Williams :Yeah, and you know, that I've told on this podcast before the story about my own son, and he's my firstborn. You know, I had no frame of reference, you know, I didn't know that he was far more active than most kids. And, and then finally, when somebody pointed it out to me, oh, man, what a sense of relief, right? But sometimes parents don't know. So that's why we're excited that you're here and talking to us about it on this podcast and kind of just putting the information out there for, you know, telling parents what kinds of things they can be looking for, you know, that's wonderful. So it's about time for us to kind of wind down here, Lilibel, and I wanted to offer our listeners a way to get in touch with you or to check out your school that you co founded, and I wanted to give you an opportunity to talk a little bit about your school before we go ahead and give out the email address or the sorry, the website.
Lilibel Bernhardt :Absolutely. So the school was started with with my colleague, it wouldn't exist if it wasn't for her. She's an amazing, amazing therapist and human being. She specializes in the DIR Floortime model, which is it utilizes developmental individual differences, and it's a relationship based model. And so it's all about like meeting the kids, where they're at. So, you know, engaging with them in order to get the communication, you know, helping them to regulate in order to get the engagement. So, the DIR Floortime model is wonderful. I'm currently training and the model so, you know, I know a lot about it because she's taught me so much I just try I'm trying to get certified, like she is, since this is the basis for what our school is about. So, basically, through play, and sensory based activities, we use that model to, you know, create these educational curriculums for our children that are individual for each child. So, you know, when we have our kids come in, we usually do a lot of observation, you know, between both therapies, speech and occupational therapy, and then, you know, with the teachers in the different classes, so we do a lot of observation to assess the skills that the children have, and the skills that they are lacking, so that we can, you know, build off of that to use their strengths to, you know, focus and work on their individual differences. So that's what our model is all about. And this is our second year, we just actually started classes on on Monday and the first year to see where our kids started and where they ended. Like, it was like a dream come true. It was like a really like an outer body experience because you have all these amazing ideas, and you know what you have to offer, you know, these children, but you know that every day consistent, you know, working with them to see the outcomes from beginning to end like it's, it's just amazing. You know, we we couldn't be happier. So we're really excited to grow and just help as many children and families as we possibly can. And most of our children that come to us have been, have tried public schools, have tried homeschooling, and have just been unsuccessful and need something more you know. And that's where we we come in.
Kelly Williams :Wow, it's amazing. It sounds like an amazing school. So let me tell our listeners that the name of your school is called Reconnections Education Center. It's located in New Port Richey, Florida. And your website is reconnectionseducationcenter.org where listeners can see about the model the DIR Floortime model, the ratio of students to teacher which is a main thing like 1-3. Yeah, so that means for every one teacher there is only three students and what ages does or what grades does your school cover? Is it a, an elementary, middle or high school? What kind of a age range are we talking about?
Lilibel Bernhardt :So we are actually a K through 12. We made the decision last year to grow with our oldest child who is in seventh grade this year. So We are, technically we're not accepting, you know, higher than seventh grade. So K through seventh. And then we, we will continue to grow every year until we get to, you know, 12th grade.
Kelly Williams :Amazing, amazing. It's wonderful and congratulations.
Lilibel Bernhardt :Thank you so much.
Kelly Williams :Yeah, thank you for like bringing this awesome service to our community too. And thank you for being here and sharing your valuable time with us today.
Lilibel Bernhardt :Thank you for letting me I love to talk about you know, all of this and, and I love to teach I love to educate parents and, and families on you know, sometimes it just takes for somebody to really explain what's happening for you to understand like, wow, you know, that makes sense. I didn't think about it that way. So and I think that helps a lot of our moms to just understand it from, you know, a different point of view, taking yourself out of the situation every day and kind of seeing, you know what, what others have to say.
Kelly Williams :Right? Absolutely. Absolutely. Well, that's all for our episode today. Please join us next week on the Parenting Balance podcast.
Teresa Vanpelt :Thank you for listening to the Parenting Balance podcast. To join our mailing list, go to parenting balanced.com/podcast. When you join, you will be notified of upcoming live Q and A's. You can help us plan future episodes. We'd love to hear comments and questions. You can reach us by email hello@ parentingbalance.com.
Kelly Williams :And if you found this information helpful, please share it with anyone else who can benefit and subscribe and give us a rating on your podcast platform. And until then, remember different isn't wrong.