Barbara Kalmanson: Upstream disturbances and downstream behavior

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Recently Barbara Kalmanson was a speaker at Parents Education Network in San Francisco.  Barbara is a clinical psychologist and special educator who has worked with infants, children and their families for over 30 years. She is also a founder of the Oak Hill School, a developmental, relationship-based school for children and adolescents with Autism Spectrum and related neurodevelopmental disorders.

Her two-hour lecture on the topic “Why does he do that?” – Identifying and empathizing with the social-emotional side of learning differences  – was so full of information, it was almost overwhelming.  I am reporting on a just a few of the highlights.

Ms. Kalmanson used a metaphor: down stream and up stream. By this she means some upstream activities are throwing children downstream into the river because they can’t find a solution upstream.   The challenge for parents, teachers and psychologists is to see what is causing the child to go downstream.  For example:

  • Children who seem cautions and fearful may have low tone in their muscles, or have visual and spatial issues which make them moody and anxious.
  • Some children have issues of sequencing and memory, perhaps from an insurmountable set of activities, or disorder in their environment.
  • Some children don’t seem to have flexibility.  They can think of Plan A but if that’s not possible don’t know how to develop Plan B.
  • Some kids are controlling and demanding:  could be an auditory process issues. He or she can’t figure out the sounds coming at them.
  • Some kids try to control the topic. They could be doing it because the discussion is going beyond what they can understand.

The challenge for parents, teachers and therapists is to put themselves into the shoes of their child or student to know what the child or student is feeling inside themselves.  The goal is to discover  the cause of the disturbance. Its affect predicts the future.  In other words, the upstream experience predicts the downstream behavior.

Ms. Kalmanson commented that temperament is the “how” of behavior and described nine dimensions:

  1. Activity:  how physical motion is going on
  2. Rhythmic:  regularity of movement and psychological functions.   If a child needs and doesn’t have a predictable routine there’s an emotional sequel to that.
  3. Approach/withdrawal:  reaction of a child to new stimulus e.g.: are they happy when they first go to school?
  4. Ease in modifying reactions.
  5. Intensity energy level of responses.
  6. Mood:  how much does the child feel life is pleasant?
  7. Persistence/attention space.
  8. Distractibility:  effect of extraneous stimuli to ongoing behavior.   Do they notice when a fire truck goes by?
  9. Sensory threshold:  how much stimulation does it take to get a response?

In tandem with these dimensions are Risk Factors that are associated with school performance.

  1. Low task orientation
  2. Low flexibility:  negative approach and social difficulty
  3. High reactivity which could mean low sensory input.

Principles of assessment look at upstream issues:  Usually it’s advisable to look for a specific symptom, e.g. poor eye contact.  That symptom provides information that it is a functional limitation.  Then, look at the larger functional capacity.  Is there an intimacy connection?  Is the child thinking: how does someone know what I am feeling?  Most important, can the teacher,  parent or therapist empathize with the child/student?

The above highlights some areas Ms. Kalmanson encouraged parents, teachers and therapists to observe in their child or student.  The more the child’s behavior is understood the less opportunity for upstream disturbances and downstream behavior.