From the Confines of the MSTE to the Outside World - Transference in Practice
Picture a child with multiple and complex difficulties as standing at the bottom of a steep mountain looking up at a lofty and seemingly unattainable peak. The child knows that in order to function in a way that is considered “normal” in this complex world, there are so many things they must learn; so many skills they must work hard to acquire. Many of these skills have been grasped and learned intuitively by their ‘typically developing’ peers, without the pain of repeated failure they have experienced. For children with disabilities, even seemingly basic skills such as making eye-contact with a caretaker or expressing a desire can take hours of intervention to master. Part of the multisensory therapeutic environment’s (MSTE) benefit is that it provides a safe haven in which to work on skills by breaking them down into tiny steps. Because we can control the environment within the MSTE in such a regulated way, we can cut out all sensory stimuli bar the one we want to focus on and make the challenge of learning new skills less complex and exhausting for those with sensory and cognitive issues.
But of course, working in the controlled environment of an MSTE is not the same as functioning in the real world, so does it really have any value when trying to prepare a child for real life? The answer is a resounding “yes” – primarily because of transference. The term, coined by D.N. Perkins and G. Salomon, was applied to educational settings where it was observed that “learning in one context or with one set of materials impacts on performance in another context or with other related materials.” In our experience with Issie Senses, we have found that transference from the MSTE to the outside world is a powerful tool for equipping clients with complex disabilities for life in the “real” world.
Transference from an MSTE to the outside can happen on many levels, from the very basic to the more profound. The best way to discuss this effect is through examples observed by our own therapists in working with children using the Issie Senses Methodology.
E. was a nervous child who was better able to relax whenever he was in close proximity to the bubble tube in the MSTE. His therapist noticed that, with the soothing effect of the bubbles at close hand, it was easier to get E. to react and to try new things. Eventually, in conjunction with his educational team, it was decided to purchase a small bubble tube for his classroom. E. always sat next to the tube during lessons and this helped him feel safer and thus perform better in class.
A similar case was the one of B. – written about in our previous article. B’s team experienced something similar when they noticed how much she loved to put her mouth against the bubble tube and feel the vibrations. They translated this knowledge into a practical suggestion by telling her parents that perhaps she would respond better to an electric toothbrush than a regular one. In this way, the pervasive problem of B’s fear of tooth-brushing was solved.
These above examples show how very basic observations gleaned from working therapeutically in the MSTE using the Issie Senses Methodology, can be used to effect highly impactful changes in the lives of those with difficulties when applied to life outside the confines of the MSTE. But there are also deeper applications as the following examples show:
Y. was a seemingly unresponsive child. Whenever anyone tried to interact with her, ask a question or suggest an activity, Y. seemed totally disinterested and was not in the least bit responsive. The therapist who was working with her in the MSTE however, observed that after each interaction, if she held space for 15 seconds, Y. would respond. This occurred repeatedly in the MSTE. Each time the therapist waited a full 15 seconds after an interaction, there would be some response from Y. A child that everyone believed to be unreachable, proved during non-pressurized sessions in the MSTE, to simply be a child who needed a 15 seconds’ space in which to process information and prepare her response. As soon as this knowledge was tested and verified, Y’s team conveyed the information to her classroom teachers, who then applied the same principle in an educational setting. When asking a question or trying to engage Y. in a task, they gave her 15 seconds to process the information and were rewarded by seeing her progress in leaps and bounds in every area of development.
The impact of transference is particularly powerful in the case of children who have become deflated by repeated failures. In our experience working with such children, we have found that any success with the Issie Senses Methodology, however tiny that achievement may be, can restore faith and completely alter the outlook for that child. Many children have effectively given up by the time we get to work with them and it can be so hard to encourage them to try anything new or challenging. But in the supportive structure of the MSTE, even a small degree of progress can open a window of hope. Once a child has tasted success, however minimal, the feeling of triumph translates to life outside and we see more resolve and determination in other areas of their life too.
It is not just the child that can transfer skills learned in the MSTE to the outside world. Anyone who works with the child can benefit from lessons learned therein too. Consider this example:
M. was a one-on-one caregiver who assisted a child T. in school. Like many children in his situation, T. was constantly being asked to “do” things in his daily life, especially in the classroom. The MSTE was to be a place of relief, where T. was allowed to just “be.” This behavior could then be taken outside the classroom and used wherever T. felt overwhelmed. M. was guided by the Issie Senses therapist to allow T. to make his own decisions about what activities he wanted to do. M. was told that her role was to follow T’s lead and facilitate whatever activity he chose – something she found was hard to comply with. Her intentions were good as she wanted to push T. to achieve more but the stress this behavior caused was counteractive.
The Issie Senses therapist tried to model how to let T. just “be” but it was hard to persuade M. that this was a good approach and the training had to be repeated many times. A year later, M. reported a “light-bulb” moment. She had been serving lunch at school and was about to push T. to say thank you when she “heard” the therapist’s voice in her ears and decided to wait. After a few minutes, T. initiated and asked for more food. This breakthrough was extremely emotional for T’s entire team as it was the first time T. had ever initiated a communication.
Here again, experience gleaned inside the MSTE had prepared the caregiver to apply a new technique in her interactions with a child outside the room – one that made a massive impact in the child’s life. Because tasks in the MSTE can be broken down so minutely, it often seems that they have no application to the world outside but the opposite is true. So much of what takes place inside the soothing space of the MSTE can be used to inform new interventions and ways of relating to those with difficulties. Similarly, joy taken in achievements that happen within the room are taken outside and can transform the entire emotional landscape for a child, particularly one who has never tasted success. When working within the MSTE it is important that therapists remain on the lookout for ways in which experiences that take place within the room can be used to enrich life outside the room.
Thank you for reading this series. We would love to help you build your MSTE, train your staff in Issie Senses, and help support its implementation in your framework. For more information, please contact firstname.lastname@example.org.