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Noooo!!! It is going to be Forever!!! I am Never going to be able to do what I want to do!!! Part 2

Time is an elusive skill for Kayla as she struggles with developing her executive functioning skills. As a baby she had to learn to understand different cycles of sleep and wake as well as night and day. She struggles with impulsivity and finds it difficult to wait for someone to finish their thought before she jumps in with her own contribution. She frequently struggles with the ability to bring in the past experience into the present, as she remains in the moment, instead of fully employing past, present, and future, another building block in the understanding of time.

Our own internal sense of timing lies within these concepts, as well as our own body’s ability to anticipate timing. After we develop body timing, the intricate process of integrative timing starts to build. Our ability to look at the teacher, while listening to him at the same time, the ability to listen to kids in the background play, yet still to continue focusing on a task at the same time, relies on the integration of our different senses and their ability to work together. Yet another layer to consider would be reading decoding. Dr. Keith Raynor’s research stated that a good reader would scan lexicon on paper for about 11 to 18 character letters at a time in one saccadic eye movement before fixation takes place. During this visual fixation, phonics kicks in within 5 to 20 milliseconds, and this enables us to decode unfamiliar words in a fairly even way. The timing between the visual and auditory system is important for decoding to become rapid and automatic. Frequently programs focus on one or the other skill, but it is timing them together that makes the difference to reading fluency.

When Kayla has to write an essay, she has to think a thought, plan the sequence of events as well as her sentence construction with language pragmatic skill, while she also has to negotiate her penmanship and grammatical rules in constructing her thought. All the while she has to keep her main idea in mind, while she also pays attention to the detail of her writing. Written expression is likely the most intricate of all in timing different systems to work together in an efficient manner. Therapy that targets integration as a goal, is not complete until this process of timing have also been included and addressed.

Our own internal sense of timing lies within these concepts, as well as our own body’s ability to anticipate timing. After we develop body timing, the intricate process of integrative timing starts to build.

Timing and Rhythm goes together in assisting Kayla to keep pace with her peers. It is that innate sense that transpires into a timely production of task in the time allotted for it. She develops her own sense of pace by the understanding her own body has reached in terms of working with a certain rhythm, while keeping track of time. It simply does not help to ask her to work at a faster pace, because even though she understands your words, she does not have the ability in her body to create an adaptive response to the command. It leaves her feeling frustrated that her mind is willing, but her nervous system cannot comply.

Kayla will frequently be found to ask the same questions over and over. The question with “when” is especially frequent, because the common words we use such as “in a moment” or “in 5 minutes” or “after dinner” does not make sense to her. For her, all of those answers in the space of time could be “now” and the insecurity of this loss of sense of time leaves her feeling vulnerable and exposed as she cannot affect closure and anxiety reigns. For her it is as if she has been left in mid-air. Difficult for us to understand as we rely on this system so much, we take it for granted in ourselves.

One more aspect to cover with regards to time is how difficult it would be for Kayla to be interrupted. Her parents and teachers frequently struggle with transitioning her from one activity to another, especially if the first activity was the preferred activity. If her parent tells her that it will be quick and she will be right back to her video game, two major areas are going to come into play. Number one would be that since she has a limited concept of time, taking her from her preferred activity would be “forever!” and the word “quick” was not attuned to. The number 2 aspect of this is that Kayla may be in the middle of a plot that she is focusing on and knows that when she is interrupted, for however small amount of time, she would have to renegotiate much of what she had already gone through to pick up the thread where she has left off. Even though timing is not the only aspect involved in this (more to come), it certainly is part of the equation. Kayla has to develop the ability to be busy with a task that she have allotted a certain amount of time for, being interrupted by the teacher or another student, and being able to make a quick calculation in her mind with regards to how and when she will be able to make up the time lost.

Understanding time is complex, but this skill can be addressed through targeted therapy that considers the building blocks first and then focuses on timing it all together. Without this skill Kayla would always carry the burden of being late for everything, frequently being last to finish, needing extended time for tests, and frequent power struggles between herself and authority figures that require her to respond at a certain pace within a certain amount of time.

In my next blog we will discuss the important skill of paying and sustaining attention.

Stay tuned!


AUTHOR: Maude Leroux, Clinical Director, A Total Approach, Glen Mills, PA


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