Practice Updates
We have recently relocated to specialist rooms at St George Private Hospital.
We have availabilities for assessments and a small number of therapy appointments are available. Assessments will only be taking place on Mondays and Tuesdays.
If you are interested in an assessment or therapy appointment, please email reception@lizettecampbellandassociates.com.au, or complete the online intake form and we will get back to you as soon as possible as to whether we can assist.
We have recently re-opened our booking system, however, only a limited number of appointments are available. The psychologists work both remotely and face-to-face. Katie is currently on maternity leave. Michaela has returned from maternity leave and is planning to work three days this year. Lenore is continuing to enjoy part-time work, and Lizette is currently on sabbatical.
Similar to our update in March, we have had to close the booking system again. All the psychologists continue to work remotely, including our secretary Bernie. Katie is currently on maternity leave and is yet to finalise her return date. When she does return she will be working via telehealth only. Michaela is continuing to work three days this year, however, will be on maternity leave from November. Lenore is continuing to enjoy part-time work, and Lizette will be taking sabbatical from August.
As you may be aware, we have had a few occasions when we have briefly re-opened for new referrals, however, we quickly find we are full and have to close the booking system again. We realise this is very disappointing and frustrating, and find it very frustrating and stressful ourselves.
All the psychologists are working remotely, as is our secretary, Bernie. This brings quite a few challenges and slows down our communication. Katie has just begun her maternity leave and Michaela has been able to arrange childcare to increase to 3 days this year. After a full-time career, Lenore is enjoying part- time work . I aspire to some time off.
Given the huge amount of time required to score, analyse, interpret and write our detailed reports and recommendations, (10 to 15 hours at the end of the half day assessment), there is very little time left for counselling and feedback sessions and liaising with other professionals in a part time week. It does not take long for new referrals to have to wait too long to get in, and we close our books and the cycle starts again.
Sarah, our part-time receptionist, enjoys access to lots of interesting resources and articles. She found this small publication very practical and has written this review. Sarah worked as a high-school teacher before becoming a mother of two boys. She hopes to complete her studies at SMBC this year and enjoys working in the clinic reception on Wednesdays.
Sarah, our part-time receptionist, enjoys access to lots of interesting resources and articles. She found this small publication very practical and has written this review. Sarah worked as a high-school teacher before becoming a mother of two boys. She hopes to complete her studies at SMBC this year and enjoys working in the clinic reception on Wednesdays.
“Socks, Shoes, bags, let’s go” I repeat for what feels like the fiftieth time this morning. We have made it out the door in good time today and our uniforms are on and clean (thank goodness, because it’s school photo day for Mr 6), tummies are full, teeth brushed and we’re now safely buckled in the car. It’s a good day today, but not every day looks like this in our house. Sometimes we sleep in and can’t get moving, sometimes Mr 8 takes an eternity to eat breakfast. Sometimes we faff around half-naked looking for shoes, books, lego or the whatever (which is probably still in the car anyway), sometimes our emotions explode and we ride the wave until they resolve, even if it means we’re late for school, again. Sure, everyone has their off days, but the variability of my two scrumptious neuro-diverse boys is tough; some days we can, some days we can’t and that’s ok. Our morning and evening routines have been hard won. My husband and I have spent countless hours building, teaching, reinforcing these routines, not just so we can get out the door without driving each other crazy, but because our kids struggle with those hidden skills that have a massive impact on so many areas of life; their executive functioning skills.
Of course, we are not alone and the LDC (Learning Difficulties Coalition of NSW Inc.) has just released their Hot Tips for Parents and Professionals on executive functions, as part of their “Tool Kit Series”. Bringing together suggestions from professionals like Emily Bull, Sue Larkey and Amanda Hicks, the booklet helpfully explains the basics and challenges of executive function particularly in relation to ADHD and Autism. Their suggestions are practical and it makes a great resource for home and school (I’m already making plans to get them to our teachers ASAP!).
But if you haven’t got time to read it, I thought I’d help you out with-
There are plenty of things you cannot control in your child’s life but most parents and care-givers can make a big difference by paying attention to the child’s surroundings. If something is worth doing (like listening and following instructions or performing a task) support the child in making it happen and minimise the chance of failure. Have they got everything they need at the point of performance and can they see it clearly or will they wander off looking for something else they need and never return? Can they have two copies of textbooks or worksheets for school and home? If they need to organise their room, locker, or desk better, a photo of what these should like is a great idea! Schedules and expectations should be clear, consistent, and displayed visually, the aim is to avoid tiring the working memory so the child doesn’t feel overwhelmed and get stuck on unimportant things. Frequent sensory and movement breaks are also important to help the body and brain stay regulated: consider using a fidget or sitting on a gym ball to work. Short rest breaks can also help the brain to reset when fatigue sets in.
It’s worth remembering the importance of good physical health and well-being for supporting behaviour, emotional regulation, learning and executive function. A good night’s sleep (with time to wind down before bed and get up slowly in the morning) is crucial. A healthy diet and exercise also play their parts, but muscle strength is something you may not have considered. How can they sit up at their desk, write, read, or run if the muscles they need are weak? A Physiotherapist, Occupational Therapist or Optometrist may be helpful here. Mental and emotional health are also vitally important. People who struggle with executive function often forget the successes they’ve had in the past. Tell them specifically why YOU think they can do this task, remind them of how they have had successes in similar tasks or obstacles they’ve already overcome, and of all the people who love them no matter what. Positive self-belief is a wonderful motivator, but in the meantime pull out your pom-poms on their behalf.
I like to think of the neurodiverse brain as a theme park, but let’s imagine for a second, it’s a computer. As the person learns the documents are written and saved. As the information comes in and more documents are generated, we create folders to store similar documents together and so on. When you ask a computer to retrieve a document (let’s say it’s the one called “How to Brush My Teeth”) up comes the document, sitting in the folder containing all the required information and related content. The brain with executive dysfunction stores its documents all over the place, forgets to label them, makes three accidently but can’t work out which ones to delete- you get the idea. This means that both storage and retrieval of information is more challenging when the child is faced with a task, and very little is automatic. Repetition is key to learning new things and moving towards doing things with ease. Performing routines out loud; literally saying the steps, is often helpful. Using acronyms and checklists reduce the load on the working memory. Skills should be broken down and taught backwards from what the finished task looks like. Mini-deadlines that allow frequent success are helpful and new skills must be practised repeatedly in the same way.
Supporting your child with their homework will involve writing it in the same spot every time, keeping a daily schedule posted, supporting them in understanding what the finished result should look like, breaking the task into achievable steps and staying on track until it’s done. As the child improves, the parent can gradually withdraw their help. Celebrate effort not just achievement and remember that teachers and educational psychologists are specifically trained to help adults and kids in this area.
Executive Function skills impact the way children listen, understand, and respond to instructions (Why don’t you pause for a second and think about how many instructions there are in your kid’s day?) The best tip I can offer is to allow additional time for them to receive the information, process it correctly, and act on it. As parents, it is easy to shout five things in ten different directions and expect them all to be done yesterday, but this rarely results in anything but frustration and stress for everyone. Instead, try giving instructions as simply, directly, and sequentially as possible. For example, it’s much easier for your child to process “Please eat your dinner before you watch TV”, rather than “before you watch TV, you need to eat dinner, please”. This is why many people adopt the “First, then” approach. For example; “FIRST eat your dinner please, THEN watch TV”. When you need to repeat yourself, you can try reducing the instruction even further to “First dinner, then TV” or even “Dinner. TV.” In order to respond appropriately to an instruction, children need to hear and comprehend the meaning of the words in context, decipher the verbal and non-verbal cues that accompany the instructions and decide on an appropriate reaction. Sometimes this may take a fraction longer than we are used to, but your patience will most likely be rewarded when you choose to communicate in a way that is helpful for your child.
Of course, everyone learns better when verbal instructions are supported by visual aids, but this is especially helpful for supporting children with executive function. Routines, daily tasks, schedules, and checklists (as well as instructions, information, procedures, and expectations) can all be presented visually. This helps with comprehension and memory, and allows the person to feel a sense of control over their lives. Visual schedules can be made a thousand different ways but they can work wonders with providing consistency, predictability, and a sense of personal safety. Similarly, it can be hard for some people with executive function challenges to correctly perceive of time. Visual timers (time timers, sand timers, digital timer apps, stop watches, traffic light timers, bubble, or oil drip timers- you name it I’ve bought it!) can all be helpful in tracking time and using it more effectively. Hopefully the child will start to see what that amount of time “feels like” and can modify their actions to sit within a given time frame. Gentle warnings before a change of activity occurs can also help with what our family calls “reeling your tentacles back in” and being ready for the next thing.
So, there you have it. Just a few idea puddles for you to splash around in. Throw some mud and see what sticks. If you would like a copy of the “Executive Function Hot Tips for Parents and Professionals” compiled by the Learning Difficulties Coalition, please visit their website at www.ldc.org.au .
We are very pleased to announce that Michaela Hayes has returned part time from maternity leave. She has resumed telehealth appointments and we are all hoping to be able to soon resume working in the office and being able to offer face to face appointments.
The office will be temporarily closed from Monday September 27th October to Monday 11th October 2021. Messages and emails will not be accessed until Monday 11th October. A limited number of ongoing telehealth appointments will be held during this time. if you need to cancel or defer these appointments, please email the individual psychologist.
We are working towards being able to resume face to face assessments that have been deferred by the lockdown. There are many steps needed to be put in place in order to provide a safe work environment for everyone, particularly given we work with a predominantly paediatric population.
At the moment, we are unable to accept new referrals for assessment until we can complete our existing list of deferred assessments. Limited counselling and parent consultations will be available as we prioritise the assessments.
Lizette
As we start a new financial year, we are in varying stages of stages of Stay At Home/ Lockdown across the nation, watching for the latest news and information.
At the moment, we are mostly working remotely, with Bernie coming in for shorter hours to check messages and keep the admin ticking along, while one psychologist at a time works in the rooms to acccess files, check test manuals as part of report writing and provide telehealth appointments.
We are also using this “difficult to plan time” to do additional reading, study and professional development. As a group, Lenore, Katie and I have been spending time together discussing and deepening our knowledge of some of the new, specialised test batteries we have purchased and reviewing our report writing skills and style. I am updating my knowledge and skills by doing a course entitled “Expert Strategies for Working with Traumatic Memory”.
We hope you are keeping well, and those who are eligible are part way through their vaccinations.
LIZETTE 30-6-21
Work and life are "Busy as usual” it seems. Things have changed a little, with Michaela on Maternity leave and Lenore joining us part-time. We are still working remotely at least part of the time, but looking forward to a time in the near future when we can have everyone together. At the moment, we try to make a regular time to all get together so we can look at new tests, or discuss complex results, as Zoom practice meetings aren’t quite the same as being together and bouncing ideas off each other.
Changes due to Covid-19 are still impacting our ability to accept as many referrals as we did in the past. There are a fewer options for both counselling and assessments. Over the years, we have found that a Parent Planning appointment or a Second Opinion consultation can be very helpful in “starting the ball rolling” or providing some direction and these are proving very valuable at the moment. We are able to offer these as a Tele-health or Face to Face appointment relatively quickly, even if there is a long wait for an assessment date. We gather and read all the information needed for a comprehensive assessment, including past reports, teacher comments and samples of current work, and can summarize our findings and make some recommendations for the school or referrals if appropriate. At the end of the consultation, at times we find that there is not a need to proceed to an assessment after all
Lizette 27-4-2021.
We are continuing to provide a mixture of Face to Face and Telehealth appointments and maintaining low numbers of people on site. We believe this is the safest approach to continuing to practice for us and for you. It does mean our waiting list is longer and it does mean we are working on ways to address this.
There are no more available assessment dates in 2020. We are not accepting referrals for the next few weeks as we work to try to clear our backlog of reports and Zoom planning meetings.
Please check back in mid December, when we expect to be taking bookings for 2021.
Lizette 16/11/2020
We feel very fortunate to be well and healthy and able to continue to do the work we love.
We have been working remotely for several months now, and although we miss the camaraderie of the office, we find the telehealth options have been working well. Like everyone, we have had to adjust to a different way of working and a need for some different resources. We have done some research and training regarding remote cognitive assessments and have come to the decision that we feel it preferable to conduct this face to face. We have, however, been pleased with the increased options for some standardised questionnaires and checklists to be administered via telehealth. We are now also able to remotely administer a number of tests of academic skills as well as attention and memory.
Counselling appointments will continue to be offered via telehealth, and we are now opening up a small number of face to face appointments. We continue to restrict the number of people attending the office and in the waiting room and follow best practice guidelines to ensure a safe working environment. This has reduced the number of concurrent face to face appointments we can offer. Pre Covid-19, we had the ability to have three psychologists conducting appointments in the office at the same time; we are now restricting it to one individual or family at a time.
Once again, our assessment waiting list has become unwieldy. At present, we are unable to offer further assessment dates in 2020. It is not practical to continue to offer appointments into 2021 when we are uncertain if there will be further interruptions such as increased restrictions. We have therefore made the decision to stop accepting new referrals for assessment at the moment. We will work through our current list of assessments booked and deferred from March before opening up new assessment bookings. Please watch the website for details.
We strive to offer a thorough and thoughtful approach to referrals. Lizette, Katie and Michaela continue to discuss and collaborate on cases and conduct some joint assessments, feedbacks and parent planning appointments.
Although we are not able to accept all the requests for assessments we receive, we are still able to offer an extended appointment (with parents only) to review documentation, provide a further opinion, make recommendations for further assessment or intervention and help plan priorities and consider alternatives. It is our experience that parents find these type of appointments very practical and helpful.
Lizette, Katie, Michaela and Bernie.
Photography by Peter Campbell
