WEBVTT 00:05:50.000 --> 00:05:55.000 Liz McNeillie: Hi everybody, so I think you'll just be joining the call now. 00:05:56.000 --> 00:05:57.000 Liz McNeillie: Hello. 00:05:59.000 --> 00:06:00.000 Liz McNeillie: Hi. 00:06:00.000 --> 00:06:04.000 Liz McNeillie: So my name is Susanna Vosper. 00:06:04.000 --> 00:06:19.000 Liz McNeillie: And I'll be facilitating the session today with my colleague, Liz McNeillie. I'm a speech and language therapist by profession, and I've been working delivering PACT for about 13, 14 years now, and I base this for about seven or eight. 00:06:19.000 --> 00:06:37.000 Liz McNeillie: supporting families and professionals to use the approach. I'm also an IBASIS and PACT trainer, so I train professionals and supervise them as they work towards accreditation. And I'm really passionate about helping infants and their families, young children and their families. 00:06:37.000 --> 00:06:52.000 Liz McNeillie: find their voice and feel heard. So, uh, welcome to our webinar, um, about a therapeutic journey for neurodivergent children. Um, like I said, I'm joined by my colleague Liz, so I'm just going to hand over now so Liz can introduce herself. 00:06:52.000 --> 00:06:57.000 Liz McNeillie: Hi, I'm Elizabeth McNeillie. I'm also a speech and language therapist working with Sue at Impact. 00:06:57.000 --> 00:07:06.000 Liz McNeillie: I'm a trainer and practitioner in the IBASIS and PACT programmes, which we'll talk a little bit about today in the webinar. 00:07:06.000 --> 00:07:22.000 Liz McNeillie: Thanks, Liz. And I hope the rain's not too loud. It sounds quite loud in our room. So I hope that's not distracting. So welcome to you. I know it's a mixture of professionals and parents or carers who are here today. You're all very welcome. 00:07:59.000 --> 00:08:04.000 Liz McNeillie: And we'll come to those at the end of the presentation. 00:08:04.000 --> 00:08:09.000 Liz McNeillie: And we'll aim, obviously, to answer as many questions as possible in the time we have. 00:08:09.000 --> 00:08:28.000 Liz McNeillie: Really pleased to have you here today as part of this webinar series. The next session in the series, um, will be around delivering PACT at home and school on June the 25th, and that will be presented by Sharon Sargent, so hopefully, um, for those of you who are interested, you'll be able to join for that too. 00:08:30.000 --> 00:08:32.000 Liz McNeillie: So let's move us on. 00:08:33.000 --> 00:08:49.000 Liz McNeillie: to DAISY. So, I mentioned that myself and Liz deliver two therapeutic programs called IBASIS and PACT for neurodivergent children. And so, for today's webinar, we really wanted to share. 00:08:49.000 --> 00:09:01.000 Liz McNeillie: the story of a little girl, Daisy, to give a family perspective of her therapeutic journey. And Daisy took part in the IBASIS programme, which we'll tell you more about in a moment. 00:09:02.000 --> 00:09:19.000 Liz McNeillie: So introducing Daisy. She's two years old. She lives with her mum, Rachel and brother Harry. We've changed all the names for this presentation. Daisy can't use any words yet and finds it quite difficult to understand language. 00:09:19.000 --> 00:09:34.000 Liz McNeillie: Um, so she was an ideal, um, child to work on the IBASIS program. Luckily, um, her mum is really tuned into her. Her mum knows her the best and makes sure that she has everything that she needs. 00:09:34.000 --> 00:09:43.000 Liz McNeillie: Um, and tunes into all her communication, so, you know, she loves cuddles, um, and is a really responsive little girl. 00:09:45.000 --> 00:10:05.000 Liz McNeillie: So, Daisy took part in an early neurodevelopmental pathway, and this pathway aimed to support children showing early signs of neurodiversity. And you can see the pathway here, it's quite small, but the starting point of the pathway involves health visitors completing a play-based assessment called the SACSAR with the child. 00:10:05.000 --> 00:10:11.000 Liz McNeillie: And this is triggered when parents or professionals notice developmental differences. 00:10:13.000 --> 00:10:29.000 Liz McNeillie: So as part of this pathway, the family's health visitor, Gemma, came to see them and explained to Rachel that she would be completing the play-based assessment with Daisy using the SACSAR tool. This identifies early differences in social communication. 00:10:29.000 --> 00:10:40.000 Liz McNeillie: So in this assessment, Gemma was considering Daisy's use of gestures, eye gaze, response to her name, and ability to share attention during play. 00:10:40.000 --> 00:10:45.000 Liz McNeillie: Gemma explained to Rachel that the IBASIS programme would be really beneficial for Daisy. 00:10:48.000 --> 00:11:03.000 Liz McNeillie: So Jenna told Rachel a bit more about iBASIS. She explained that it's a communication therapy programme using video feedback and asked for consent for filming these videos of Rachel and Daisy playing together, which would form the basis of the discussions in each session. 00:11:03.000 --> 00:11:10.000 Liz McNeillie: She explained that IBASIS is really helpful for children like Daisy, who are showing early developmental differences. 00:11:10.000 --> 00:11:19.000 Liz McNeillie: Rachel was really excited to get started with Ibasis, as she wanted to help Daisy to find communicating a little earlier. 00:11:15.000 --> 00:11:17.000 Katy Willis: Thank you. Who's this? 00:11:19.000 --> 00:11:25.000 Liz McNeillie: a little easier, and to be able to pick up on Daisy's more subtle ways of communicating. 00:11:28.000 --> 00:11:43.000 Liz McNeillie: So here's just a little bit about IBASIS. IBASIS uses videos of the caregiver and baby playing together as the basis for discussion. So videos of Rachel and Daisy for this family. In each session, Rachel and her health visitor Gemma watched a video back. 00:11:43.000 --> 00:11:59.000 Liz McNeillie: of Daisy and Rachel playing together and noticed how Daisy liked to explore and connect with Rachel and all the helpful things that Rachel was already doing to support Daisy. So really noticing what Daisy really liked and what she was responding well to. 00:12:47.000 --> 00:13:01.000 Liz McNeillie: And Daisy loves sensory exploration, so being at home meant she had access to her trampoline, to her sensory tent, and lots of other sensory toys, um, that her mum and grandad bought for her. 00:13:01.000 --> 00:13:19.000 Liz McNeillie: So, Daisy loved playing with Rachel, as her mum gave her lots of attention, which helped her to concentrate and stay engaged in her play. Like we said, Daisy's quite an active little girl, she likes to be moving or jumping around, so actually developing shared attention with her mum. 00:13:19.000 --> 00:13:24.000 Liz McNeillie: The ability to share her focus with her mum was a really big thing for her. 00:13:28.000 --> 00:13:39.000 Liz McNeillie: This is Daisy playing with bubbles. It's one of her favourite games to play with and it helps her to focus and share her attention with her mum alongside other activities. 00:13:39.000 --> 00:13:54.000 Liz McNeillie: So through IBASIS, Daisy's mum and Gemma discussed lots of different topics and explored different types of play and interactions. In total, Gemma filmed Daisy and her mum for seven sessions and had lots of chats and discussion. 00:13:54.000 --> 00:14:09.000 Liz McNeillie: with Rachel about, um, understanding how Daisy liked to communicate, connect, and explore with her. Supporting interaction in play with and without toys. So, in iBASIS, we're interested in what. 00:14:09.000 --> 00:14:26.000 Liz McNeillie: makes it easier for children to play, so we were interested in what was going to help Daisy play most easily, and Gemma found that it was a mixture of bubbles, of songs and rhymes, as well as. 00:14:57.000 --> 00:15:15.000 Liz McNeillie: um, our gestures. So sharing feelings was also, um, a really big part of the program, and looking for signs of Daisy being interested, being excited, being puzzled, how she shared her different emotional experience, and how Rachel picked up on those signals. 00:15:15.000 --> 00:15:26.000 Liz McNeillie: and could respond to them. And I think that's a really nice part of the programme, that we, um, work with parents, so that not only are they able to interpret. 00:15:26.000 --> 00:15:42.000 Liz McNeillie: their child's feelings, but with Rachel and Daisy, Rachel was able to really think about, um, how she responded to Daisy's emotions through her tone of voice, um, through what she said, through her own facial expressions. 00:15:42.000 --> 00:15:51.000 Liz McNeillie: sometimes mirroring back Daisy's emotions, or responding really empathetically if Daisy was finding something a little bit harder. 00:15:51.000 --> 00:16:08.000 Liz McNeillie: And the IBASIS sessions also involve how you can support sounds and early words. So the sessions explored how Rachel could provide words that were linked to Daisy's interests and provide early words. 00:16:08.000 --> 00:16:23.000 Liz McNeillie: That would be easy for Daisy to process, but also if Daisy was vocalizing, so she wasn't yet using words, but if she was using her voice, how she could feel really powerful through her mum's responses to her. 00:16:24.000 --> 00:16:39.000 Liz McNeillie: And we've talked, haven't we, about bubbles. Um, this is a great context for Daisy to connect and share with her mum, so bubbles were used, as well as other activities throughout the program, to really engage her, um, and motivate her. 00:16:39.000 --> 00:16:46.000 Liz McNeillie: Um, to… to want to play and share her feelings with her mum, her communication with her mum. 00:16:48.000 --> 00:17:04.000 Liz McNeillie: So, the program went on for 5 to 6 months. Gemma saw Rachel and Daisy on a fortnightly basis, and before iBASIS, Daisy didn't make any sounds and wasn't sure how to use her body to communicate. 00:16:55.000 --> 00:16:56.000 Zoom user: I'm pulling up. 00:17:04.000 --> 00:17:21.000 Liz McNeillie: But now, at the end of iBasis, she's interacting much more with her mum, um, she's able to initiate and start communication much more easily, and, um, she's starting to find her voice and use more gesture. So even if that's initially through vocalizations. 00:17:21.000 --> 00:17:39.000 Liz McNeillie: We know that this will help to build and hopefully turn into words over time, as well as all her non-verbal communication, her gestures, and her feeling powerful that she knows how to start communication with Rachel. 00:17:40.000 --> 00:17:52.000 Liz McNeillie: Daisy also looks at Rachel much more often now, and this helps her understand how and what her mum is also communicating, and helps them share feelings together and ideas. 00:17:55.000 --> 00:18:14.000 Liz McNeillie: Daisy's mum fed back her experience of the iBasis program by saying, iBasis was a blessing for me and Daisy. She's come on leaps and bounds. Over our time doing iBasis, Daisy has been able to come out of her shell. She gives me cuddles, she engages with eye contact a lot more, and she's more vocal. 00:18:14.000 --> 00:18:19.000 Liz McNeillie: Daisy's been able to go at her own pace more comfortably. 00:18:19.000 --> 00:18:29.000 Liz McNeillie: As a mum, I cannot thank Gemma enough for bringing me and Daisy closer together in terms of her communication and relationship with more understanding. 00:18:29.000 --> 00:18:49.000 Liz McNeillie: To be able to look back at footage and see how Daisy is developing, and be able to think and do in Daisy's own little world has been amazing. And I think that really sums up the power of the programme, that how using video clips of them playing together was really helpful as a way of looking at. 00:18:49.000 --> 00:18:56.000 Liz McNeillie: but what was working really well, and what Rachel could build on to be able to really tune in to Daisy. 00:19:00.000 --> 00:19:16.000 Liz McNeillie: So, we just wanted to share a short clip of an IBASIS session. So, this first clip shows a little bit of play between baby Francis and his mum, and then we'll go on to look at a clip of some discussion with the therapist and Francis's mum. 00:19:16.000 --> 00:19:18.000 Liz McNeillie: about this. 00:19:19.000 --> 00:19:25.000 Liz McNeillie: So yeah, just to give you an idea of how IBASIS actually works in practice. 00:19:28.000 --> 00:19:31.000 Susanna Vosper: Oh, where's Max? 00:19:31.000 --> 00:19:34.000 Susanna Vosper: Where's Francis gone? Where's he gone? 00:19:35.000 --> 00:19:45.000 Susanna Vosper: Where is he? We've lost him. We've lost Francis. There he is. Yeah, there he is. Yeah. 00:19:46.000 --> 00:19:50.000 Susanna Vosper: Oh, where's Francis? Oh no! 00:19:50.000 --> 00:19:52.000 Susanna Vosper: There he is! 00:19:52.000 --> 00:19:53.000 Susanna Vosper: But yes. 00:19:56.000 --> 00:20:15.000 Liz McNeillie: So that was a lovely clip showing Francis interacting and engaging with his mum, and he was clearly really enjoying that, and interacting and connecting with her in lots of different ways, and she was also responding and connecting back with him. So in this second clip, we'll look at how the… you can see how the therapist uses the video. 00:20:15.000 --> 00:20:22.000 Liz McNeillie: to support a discussion with Mum, and to really notice all these different ways that Frances is communicating and connecting with her. 00:20:26.000 --> 00:20:28.000 Susanna Vosper: Oh, what's this? 00:20:28.000 --> 00:20:31.000 Susanna Vosper: Where's Francis gone? Where's he gone? 00:20:30.000 --> 00:20:33.000 Liz McNeillie: We need the next slide. 00:20:32.000 --> 00:20:33.000 Susanna Vosper: Hey! 00:20:36.000 --> 00:20:39.000 Liz McNeillie: Sorry, here we go. 00:20:38.000 --> 00:20:48.000 Susanna Vosper: So there's his first turn, like we said. He cheekily looks up, holds up the cloth, and how did you so sensitively respond to him there, Verity? 00:20:50.000 --> 00:20:52.000 Susanna Vosper: I mean, I lifted up the cloth… 00:20:52.000 --> 00:20:56.000 Susanna Vosper: Yeah? And what do you do with your face and eyes? 00:20:56.000 --> 00:21:13.000 Susanna Vosper: Oh yeah, I look enthusiastic. Yeah, when we're excited, we go a bit wide-eyed and you look quite wide-eyed in again matching his excitement. So you're helping be a bit of a mirror to him of like, this is fun, this is play, we're excited. 00:21:14.000 --> 00:21:30.000 Liz McNeillie: So we could see there how Sue, the therapist, asked a few questions and just looked at that clip with Mum and asked, how's Frances communicating here? What are you doing to connect? And then also discussed with Mum her responses, the things that she was doing. 00:21:30.000 --> 00:21:45.000 Liz McNeillie: without even realising unconsciously with him to connect. So the way she was using her voice and her face, and how that was actually really supporting him to feel understood, to feel heard, and to learn about how to use his face and his voice to communicate as well. 00:21:45.000 --> 00:21:49.000 Liz McNeillie: And we'll have a look at another clip now. 00:21:53.000 --> 00:22:03.000 Liz McNeillie: So, this next clip, um, shares another family's perspective of Ibasis, um, and this is a parent from Stockport, Ontario. 00:22:03.000 --> 00:22:05.000 Susanna Vosper: And. 00:22:05.000 --> 00:22:15.000 Susanna Vosper: To me, it was the best thing that I could have got involved in with Hallett. Um, when I first had my speech and language, when we got referred to it, I felt like… 00:22:16.000 --> 00:22:23.000 Susanna Vosper: With Halle being the third baby, she was the one who I could communicate with least, so I felt like I made this. 00:22:23.000 --> 00:22:31.000 Susanna Vosper: Just showed me a new way of learning Halley's communication. It was the best thing that I could have ever got involved in. 00:22:31.000 --> 00:22:38.000 Susanna Vosper: So we use it in our everyday life really, throughout the whole day, 24 hours a day, 7 days a week. 00:22:40.000 --> 00:22:52.000 Liz McNeillie: That was really nice to hear that perspective from a different parent. So we've seen here a few different families' experience of IBASIS and kind of journey through IBASIS. 00:22:52.000 --> 00:22:55.000 Liz McNeillie: So next slide please. 00:22:54.000 --> 00:22:56.000 Susanna Vosper: And. 00:23:00.000 --> 00:23:15.000 Liz McNeillie: And so this is, um, this is PACT. So IBASIS, which we've talked about so far, is suitable for children, sort of, under 20 months. And for children over 2, the new, uh, the new Early Years Neurodevelopmental Pathway also includes PACT. 00:23:15.000 --> 00:23:33.000 Liz McNeillie: which is a… another video feedback-based program. And like iBASIS, it really focuses on supporting parent-child interaction and support… in order to support the child to really develop and flourish. And what we find with both of these approaches is by really supporting. 00:23:33.000 --> 00:23:51.000 Liz McNeillie: the parent to be able to support the child and notice all of the child's subtle signs, ways of communicating and communication preferences. That really allows the child to kind of flourish within those interactions and to develop their communication skills. 00:23:51.000 --> 00:24:07.000 Liz McNeillie: And then we see the child over time taking the skills that they've developed within those one-to-one interactions with their parent and caregiver and then using that in other settings and other places. So how this pathway works is it starts with the SACSAR. 00:24:07.000 --> 00:24:22.000 Liz McNeillie: And when those early developmental differences are noticed in maybe the standard health check or when a parent might notice something or the professional notices something, then we have the SACSAR, the play-based assessment tool is used. 00:24:22.000 --> 00:24:43.000 Liz McNeillie: And if developmental differences are noticed within that, then the child would be either offered IBASIS if they're under two or PACT if they're over two. And then at the end of the programme, the practitioner working with them has had a really good opportunity to get to know the family, to get to know the child and to be able to advise them on the best next step. 00:24:44.000 --> 00:24:54.000 Liz McNeillie: And whether there's some other kind of support that might be needed for the family, or whether there might be kind of ongoing differences in sort of social communication that needs some further support and assessment. 00:24:54.000 --> 00:25:12.000 Liz McNeillie: Thanks, Liz. So, um, you've heard today the story of Daisy and Rachel. We've also shared with you a clip of the little baby Francis, and how, um, iBasis works in practice, and we've shared some feedback from a parent about how. 00:25:12.000 --> 00:25:28.000 Liz McNeillie: They've used iBASIS and generalised it within their day-to-day lives. So just to conclude really, both iBASIS and PACT are relationship-based approaches. So they really both focus on the interactional process. 00:25:28.000 --> 00:25:43.000 Liz McNeillie: And we know that this process is really robust and evidence-based because what we're promoting are the inherent developmental capacities of the baby and the child. So we are… 00:25:43.000 --> 00:26:04.000 Liz McNeillie: Waiting and looking out for signs from the baby that they are signaling, they're initiating, and then we're looking at how the parent responds to that. So any moments where the baby's showing or the child's showing their own ideas is really encouraged and responded to by the parent. 00:26:04.000 --> 00:26:14.000 Liz McNeillie: So there's no masking involved, because this is all about what comes from the baby and child. Um, and it encourages emotional thinking and family involvement. 00:26:14.000 --> 00:26:26.000 Liz McNeillie: So, I really love iBasis Impact because they honour the family and, um, parental psychology, and we know that parents are the expert of their own child or children. 00:26:26.000 --> 00:26:38.000 Liz McNeillie: But we're also following the child's intention, so it's a very child-centred approach, individualised, um, to each child and family who takes part. 00:27:08.000 --> 00:27:11.000 Liz McNeillie: and their family going forward. 00:27:11.000 --> 00:27:17.000 Liz McNeillie: So thank you so much for listening to our webinar and joining us today. 00:27:17.000 --> 00:27:36.000 Liz McNeillie: Um, we're now, um, at the stage where we can take some questions. Um, we'll do our best to answer as many of your questions as we can. Um, just to remind you that this is being recorded, um, so if you want to revisit the webinar, you can do, and share it with colleagues. 00:27:36.000 --> 00:27:39.000 Liz McNeillie: And, uh… 00:27:39.000 --> 00:27:54.000 Liz McNeillie: We're also sharing the webinar series. There are other webinars going forward, so we hope that you might be able to join the other webinars in the series, the next one, like we said, being on the 25th of June. 00:27:54.000 --> 00:28:10.000 Liz McNeillie: So we will move on now to questions and I'll stop sharing the slideshow so that we can see all your faces. So please do feel free to either ask questions or we'll have a look in the chat to see people's comments. 00:28:11.000 --> 00:28:27.000 Liz McNeillie: So, I know that there's already been a few questions in the chat. So, there was a question about the minimum age for IBASIS, which I have answered in the chat, but for anyone who's not seen it, so IBASIS can be used from the age of 6 months. Within this pathway, we… 00:28:26.000 --> 00:28:31.000 Susanna Vosper: It's half a week with children from 11 months, I'm sorry. 00:28:32.000 --> 00:28:43.000 Liz McNeillie: And we work with children from 11 months, which is because that's when the SACSAR tool is valid from and can be used from. But it is possible to support children younger than that with the IBASIS approach. 00:28:43.000 --> 00:28:59.000 Liz McNeillie: There's also a couple of questions, Sue, about the key differences between PACT and iBasis as well in the chat. Yeah, that's a really good question. So there are a few key differences. So there are some similarities and differences. 00:28:59.000 --> 00:29:16.000 Liz McNeillie: We mentioned the similarities, that they are both relationship-based approaches, so we're really interested in the dyad, um, the connections between the parent and the caregiver and the child. Um, and we're also… another similarity is that both the approaches use video feedback. 00:29:16.000 --> 00:29:33.000 Liz McNeillie: So they're parent mediated, so the therapist or practitioner works with the parent and through the parent if you like. So it's the parent interacting with their baby and using those play clips as a focus for discussion. 00:29:33.000 --> 00:29:53.000 Liz McNeillie: In terms of the differences, the main difference are the video feedback tools that are used. So the discussion in iBASIS includes a number of different video feedback tools. In other words, the practitioner is using a range of different things to help. 00:29:53.000 --> 00:30:16.000 Liz McNeillie: The parent reflect on what they're seeing in the video, so for example, we use something called reading the baby, which is really encouraging the parent to understand what the baby's experience is in that moment. We also look at something that we call a sensitivity chain, which is a back-forth moment, so there are certain things that are kind of woven into the sessions. 00:30:16.000 --> 00:30:34.000 Liz McNeillie: And each session in iBasis is a particular theme. So in iBasis, the first couple of sessions are really focused just on the baby and how the baby explores and connects. But from session three onwards, we're starting to look at the dyad, we're looking at the relationship between the baby and the parent. 00:30:34.000 --> 00:30:50.000 Liz McNeillie: And then thinking about feelings, about how to generalise. So there are sort of set session themes. In fact, the way that the practitioner feeds back with the parent is a little bit different. 00:30:50.000 --> 00:31:06.000 Liz McNeillie: So it's much more through non-directive, a non-directive approach through questioning, asking the parents what they notice in the video. 00:31:06.000 --> 00:31:21.000 Liz McNeillie: So that can be a really, really good way to help parents to reflect. So the slightly different video feedback styles. PACT is also for twos and above. So it's for children aged two to 11. 00:32:06.000 --> 00:32:24.000 Liz McNeillie: So something we really think about is, what are the moments where we're really noticing those moments of connection and togetherness, and what might the reasons for that be? What is it that the child is really enjoying or really experiencing in those moments that's really allowing them to connect with their parent and to really enjoy that moment and that interaction? 00:32:24.000 --> 00:32:35.000 Liz McNeillie: And also thinking about what are the things that the caregiver is doing that they might not even realize that they're doing in those moments that's really supporting that kind of connection and that shared attention. 00:32:37.000 --> 00:32:39.000 Liz McNeillie: Thanks, Liz. 00:32:48.000 --> 00:33:03.000 Liz McNeillie: Ist. 00:33:18.000 --> 00:33:20.000 Liz McNeillie: We hope to see you at the next webinar. 00:33:21.000 --> 00:33:23.000 Liz McNeillie: Thanks. Thank you.