2019

〔英文〕
Full Inclusion Holidays

The holiday season hits me just right － the scents of pine and cinnamon, the twinkling lights (the more the better), the candles, the ever-present music. I love the extended family coming into town, the enthusiastic and off-key school concerts and plays, and the special projects and winter-themed events in the classroom and home.

（ア）For me, the holidays are like a sparkly ornament: Whether you like it or not, you will find yourself covered in glitter.

But this isn't the case for a lot of our students and clients who struggle with interpersonal communication, transitions, foods with different textures, and sensory stimulation. For them and their parents, the holiday season can be fraught with increased anxiety and harder-to-manage behavior.
So how do we assist our students who do best with consistent routines and expectations and who have little tolerance for unending adult chatter and high sensory stimulation? These are children who don't easily manage the metaphorical holiday "glitter." What strategies can families use to accommodate children working on pragmatic skills and behavioral management－and to sensitize other family members to these children's unique needs?

Get ready
For starters, parents and caregivers can't expect holiday miracles from children with these challenges. They need to manage their expectations because changes in the environment can contribute to the children feeling overwhelmed. As a result, you are likely to see more behavior problems or shutting down.

It's important to realize that progress at this time of year might look like a step back. But parents, extended family members and clinicians can take steps to help ease the stress on the child-and themselves.

（イ）Prepare students in advance. Use a well-placed calendar at school and home to show the sequence of holiday events including classroom parties, decorating, concerts, visiting relatives and so forth. Use picture symbols for non-readers. A calendar is a fun way to count down to the holidays and allows children to independently check "how many days?" as often as they need to.
You can use sweets, small toys or pictures to mark the days.

Be proactive. Help older children plan for holiday challenges they may encounter by, for example, rehearsing events. Once they've identified likely rough spots or changes they may encounter－like becoming overwhelmed or angry－have them choose potential coping strategies such as self-talk or deep breathing. And although a reminder of the chosen strategies is appropriate, trying to identify one in the middle of a heightened state is nearly impossible.

Provide a role model. Adults, too, can find themselves overwhelmed by holiday-related schedule changes and sensory overload. Parents can be forthcoming about sharing that anxiety and how they respond to it with flexibility. For instance, if travel plans prevent guests from arriving for dinner, explain, "I'm disappointed that Grandma won't be here for dinner. Let's eat while we're hungry. We can have dessert together once she arrives."

Establish routines through traditions. Help ease into once-a-year events while building family traditions by encouraging parents to make a picture book about the holidays. They can take several pictures of each annual event and make a simple picture story.

The holiday picture book can be reviewed each year before and during the holidays to help the child navigate through the changes during the season. Including seldom-seen relatives in the photos will also give children a chance for reacquainting before their actual arrival. Teachers might consider creating these books for the classroom as well, showing traditional classroom activities and events like field trips, performances and projects related to the changing seasons.

Pick and choose events. Adults avoid burnout by politely declining some holiday events, and parents can extend the same courtesy to children. Perhaps greeting grandma and grandpa upon arrival is enough excitement, and staying home with a familiar sitter rather than joining the family for dinner out is an option. If special events during the school day are becoming overwhelming, perhaps an option to sit one out in a quieter area of the school is an alternative.

Trust your instincts! Encourage parents, when attending social events, that it's OK to remind family and friends not to hug or pressure a child to speak or look at them. Gauge how much activity a child can tolerate before needing a break and plan a place to go to regroup (another room, the car, a walk) or prepare to leave the event early, In the school setting, this may mean strategizing seating at a performance near an exit, or arriving before others file in or after everyone else has settled in their seat.

Social teachable moment
The holidays also provide a unique opportunity for clinicians and parents to help a child target pragmatic goals in a natural context. Consider the following:

Strengthen conversational skills. Often students with pragmatic challenges don't give their listener enough context to easily follow the conversation. （ウ）This is another opportunity to create small photo books of current "hot" topics for the child­­­ － it may be a holiday "wish list" of hoped-for gifts or perhaps a quick summary of a beloved story － whatever topic the child is revisiting frequently. This book can be used for rehearsal­ － reminding the child to include background information for the listener－ ­or can be shared with an interested adult who now has a better idea of the topic and an easier way to formulate questions.

Books have the added benefit of allowing joint attention without the pressure of eye contact. And because there tends to be a larger assortment of "new" listeners during the holidays, a child that tends to repeat stories will have an appropriate reason to do so in addition to the extra conversation practice.

Rein in perseveration. The excitement of gifts often results in a child "stuck" on talking about a specific desire. Parents can set parameters on the amount of time this is discussed by using tokens (such as poker chips or pennies). The child receives five tokens in the morning (or divide the tokens-two in the morning and another three in the afternoon) and can trade in a chip to talk about the desired item for five minutes. Using the timer on a phone or oven helps everyone know when the five minutes are up. This technique can be used at home or in school.

Promote friendships. Customs of exchanging gifts or small tokens during holidays is a prime occasion for perspective-taking. Guide young ones in understanding that their desire for everything superhero isn't shared by a sports enthusiast friend or a princess-crazed younger sister. A simple card craft, in which the child cuts pictures from a catalog, can be a heartfelt gift for a teacher, friend or family member.

Develop empathy. The awareness that everyone requires help from time to time is part of our humanity and the holidays abound with chances to pitch in for someone in need. These opportunities may include shopping or passing on lightly used gifts for a toy drive or packing canned goods for a food drive. Other ideas might be delivering meals to those in need, reading to younger children, or stuffing/stamping envelopes for a nonprofit. Be sure to research and discuss how the child's contribution makes an impact and provide verbal－rather than tangible－rewards for a job well done.

When you're in the midst of day-to-day work, it's easy to miss the progress of the big picture. Clinicians and parents can take a moment to journal or simply write a short description of how a holiday event went on your calendar. The following year you'll not only have a better idea of which traditions work and which are better skipped, but you'll also have a record of how far you've come.

[出典]
Kim Swon Lewis: Full Inclusion Holidays. The ASHA Leader, December 2016, Vol. 21, 52-56. より一部抜粋、改変

註

glitter      きらきら輝く

interpersonal         対人関係の

texture    食感

sensory stimulation               感覚刺激fraught  （危険などを）伴って

consistent               首尾一貫した

metaphorical          隠喩的な

caregiver                                  介助者

overwhelmed         （精神的に）圧倒する

burnout  燃えつきる

clinician 臨床医

proactive                 前向き

forthcoming           手近に用意されて

reacquaint              再び分からせる

gauge      測定する，評価する

strategize                戦略化する

instinct   直感

pragmatic challenges            語用的課題

formulate                明確に述べる

assortment             雑多な人の集まり

rein          制御

perseveration         固執

token       トークン（硬貨の代わりに用いる代用貨幣）

enthusiast               熱狂者

empathy 共感

toy drive 各家庭で余った玩具を持ち寄り，それを必要とする人々に寄付をする活動

food drive               各家庭で余った食品を持ち寄り，それを必要とする人々に寄付する活動

nonprofit                非営利的な

tangible  有形の