VOLUME 25 NO 1 2015
Sensory
Processing
Profiles of our 100 Acre Wood friends
ADDRESS TEL WORK TEL HOME FAX EMAIL
EDITOR
Rosa-Marié Olivier P.O. Box 17369 (011) 867 0015 (011) 867 0015 (011) 867 0015 [email protected]
Randhart 1457
EXCO
CHAIRPERSON
Ray Anne Cook
9 Wonderboom St
(021) 976 2258
(021) 976 2258
(021) 976 2258
[email protected]
Eversdal Heights
Durbanville 7550
VICE CHAIRPERSON Riëtte Smit
P.O. Box 668
083 3000 951
083 3000 951
riette.smit@kznatal
Bethlehem, 9700
SECRETARY
Ninette Visser
P.O. Box 461
(011) 475 1449
086 697 6697
[email protected]
Strubensvalley 1735
TREASURER
Marica Botha
P.O. Box 10536
082 335 6386
082 335 6386
[email protected]
Aston Manor 1630
HEAD OF EDCOM
Janine van der Linde
P.O. Box 2559
(011) 717 3272 (011) 615 6900
[email protected]
Potchefstroom 2520
HEAD OF LIAISONS
Magdaleen Stadler
P.O. Box 7131
(041) 379 3318
083 328 1715
[email protected]
Newton Park
Port Elizabeth 6055
BOARD MEMBERS
Stefanie Kruger
P.O. Box 60750
(012) 667 3998
[email protected]
Pierre v Ryneveld
0045
Sally Mackenzie
51 Wilson Street
(044) 384 1536
(044) 384 1536
(044) 384 1536
[email protected]
Hunters Home
Knysna 6571
Annamarie van Jaarsveld P.O. Box 43218
(051) 401 2829
(051) 451 1782
(051) 401 3288
[email protected]
Heuwelsig 9332
Corina Botha
P.O. Box 32472
051 404 8942
(051) 522 5506
086 729 1476
[email protected]
Fichardtpark 9317
Marié Greyling
P.O.Box 25346
082 854 3382
(012) 460 2029
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Monument Park
Pretoria 0105
Magdaleen Stadler
P.O. Box 7131
(041) 379 3318
083 328 1715
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Newton Park
Port Elizabeth 6055
Dana Katz
P.O. Box 321
082 491 0314
082 491 0314
(021) 686 4264
[email protected]
Bergvliet 7856
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24 Dawn Close
(021) 975 0286
(021) 975 0286
[email protected]
Eversdal 7550
Gina Rencken
3 Sanderstead
(031) 260 7052 (031) 705 4784
[email protected]
97 Sander Rd, New
Germany, KZN 3610
Anneke Kruger
P.O. Box 12637 083 447 5477
[email protected]
Die Hoewes
Pretoria 0163
Elze Pelser
3 Rietjie St
(051) 432 4024
(051) 422 4197
[email protected]
Pellissier,
Bloemfontein 9301
Amy Rode
21 Rokewood Ave
082 562 4147
(021) 887 9935
[email protected]
Die Boord
Stellenbosch 7600
Nika Oberholster
P.O. Box 539 082 372 7689
[email protected]
Jeffreys Bay 6330
CO-OPTED MEMBER
Elna Jooste
P.O. Box 349
(011) 954 3626
(011) 954 3626
086 689 7747
[email protected]
Paardekraal 1752
SAISI OFFICE
Aletta Kietzman
P.O. Box 14510
(012) 362 5457
086 651 5438
[email protected]
Hatfield 0028
ADVISORY BOARD
Prof André Venter
P.O. Box 29864
(051) 405 3181
[email protected]
Danhof 9310
Dr Lorna Jacklin
P.O. Box 269
(011) 481 5192
Glenvista 2058
Dr Jackie Visser
P.O. Box 29962
(051) 410 4000
083 263 7199
[email protected]
Danhof 9310
Marguerite Monvoisin
33 Saffraan St
082 870 7213
[email protected]
Loevenstein
Bellville 7530
Suzanne Smith-Roley 15 Songbird Lane
(949) 581-1380 (949) 581-1384
[email protected]
Aliso Viejo
California 92656
Rosalind Urwin
27a High St. Theale [email protected]
Reading, Berkshire
RG7 5AH, UK
Sensory
Processing
Profiles of our
100 Acre Wood
friends
CONTENTS
SAISI NEWSLETTER VOLUME 25 NO 1 2015
PORTFOLIO
MANAGERS
SAISI BOARD
EXCO
Ray Anne Cook
Riëtte Smit
Ninette Visser
Marica Botha
Janine van der Linde
Magdaleen Stadler
Chairperson
Vice Chairperson
Secretary
Treasurer
Head of Edcom
Head of Liaisons
LIAISONS
Anneke Kruger
Elze Pelser
Celette Crafford
Magdaleen Stadler
Sally Mackenzie
Gina Rencken
Annamarie van Jaarsveld
Gauteng
Free State & Northern Cape
Western Cape
Eastern Cape
Southern Cape
KwaZulu Natal
International Liaison
EDCOM
Emmerentia Aldrich
Stefanie Kruger
Rosa-Marié Olivier
Riëtte Smit
Janine van der Linde
Marié Greyling
Corina Botha
Course Facilitator
Theory & Allied Health
SIPT & Clinical Observations
Interpretation
Protocols
Treatment &
Additional Core Courses
Diverse Populations
OTHER
Dana Katz
Sally Mackenzie
Corina Botha
Annamarie van Jaarsveld
Ninette Visser
Rosa-Marié Olivier Amy Rode
Nika Oberholster
Riëtte Smit
CO-OPTED MEMBER
Elna Jooste
Ethics & SAQA Support
Marketing
Website
Universities, Research & SAQA
CPD
Newsletter
Website Public Domain &
Newsletter Support
Standing Orders, Job Descriptions
& Newsletter Support
Policies
4
Editor’s Letter
5Letters
7Competition
8
Winnie the Pooh and The Characters in The
Hundred Acre Wood as a Tool for Self-reflection
18 An Occupational Therapist’s visit to
The Hundred Acre Forest
21 Activity Ideas
28 Book Reviews
30 CPD Programme Questionnaire
ADVERTISING
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SAISI MEMBERS
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CLOSING DATE
Closing date for contributions to
Newsletter vol 25 no 2 2015 is 1 June 2015.
SAISI WEBSITE: www.instsi.co.za
Views contained in articles appearing in this newsletter
do not necessarily reflect the opinion of the South African
Institute for Sensory Integration.
Editor’s Letter
WINNIE THE POOH SAID, “SOMETIMES THE
SMALLEST THINGS TAKE UP THE MOST
ROOM IN YOUR HEART.”
I believe that the SAISI Newsletter took up a considerable
amount of space in the hearts of many OT’s for the past
34 years. To me, there is nothing like a printed book or
magazine. To read a book is a multisensory experience
– you can smell it, feel it, see it… but, life goes on and
things change. Considering high printing costs and postal
and other challenges, the decision was made to go online.
Therefore, this Winnie the Pooh issue will be our last
printed version of the SAISI Newsletter.
Although saying good-bye to the printed version of the
Newsletter is hard, we are looking forward to exciting new
things ahead.
“HOW LUCKY I AM TO HAVE SOMETHING
We are now in that moment just before the exciting new
electronic version of the newsletter starts. We look forward
to the new journey, just like Pooh Bear and Christopher
Robin on their journey to the top of the forest:
“Wherever they go, and whatever happens to them on the
way, in that enchanted place on the top of the forest, a little
boy and his Bear will always be playing.”
As from June / July, the Newsletter will be accessible
through the SAISI website: www.instsi.co.za. Just click
on the Newsletter cover page on the home page of the
website and start paging digitally!
I wish you all happy reading with Pooh Bear and friends!
Thank you to the Western Cape group for your fun and
inspiring articles!
THAT MAKES SAYING GOODBYE SO HARD.”
“WELL,” SAID POOH, “WHAT I LIKE BEST,”
AND THEN HE HAD TO STOP AND THINK.
BECAUSE ALTHOUGH EATING HONEY WAS
A VERY GOOD THING TO DO, THERE WAS
A MOMENT JUST BEFORE YOU BEGAN TO
I CONCLUDE THIS FINAL PRINTED
EAT IT WHICH WAS BETTER THAN WHEN
NEWSLETTER WITH MY FAVOURITE WINNIE
YOU WERE, BUT HE DIDN’T KNOW WHAT IT
THE POOH QUOTE:
WAS CALLED.”
PIGLET: “HOW DO YOU SPELL LOVE?”
POOH: “YOU DON’T SPELL IT, YOU FEEL IT!”
Rosa Marié
-
4
Volume 25 | No 1 | 2015
Letters
On a personal note…
A mom’s
experience
Lurika Munnik
This morning I am sitting amazed at how God has blessed
me again. Again a turmoil of thoughts spinning through
my head and a giggling itch bubbling inside of me. Right
now, in the midst of a staff meeting, I had to stop myself
from making funny noises. I am feeling out of control and
I’m loving it! Actually I got these words early this morning
already and I know it is God busy igniting the flame again.
Something’s up!
My name is Lurika and I have been doing mentoring for
many years. I stand in amazement in how God is showing
me early on in the year already: Something’s up. That
“something” which I have been carrying for soooo many
years and which have been stealing from me bit by bit.
But God had to reveal it to heal it. I have been asked to
share a creative snippet of a huge oxen yoke which has
tumbled from my shoulders.
KAPOETE KAPOETE KAPAT
DIE ESELTJIE RY NA DIE STAD
HY SUKKEL MET OOMPIE
EN PLUK AAN SY TOOMPIE
EN TREK SY TWEE LANG ORE PLAT
KAPOETE KAPOETE ...
That was me. Sturdy and strong with mule-courage on my
way to the city. My city of plans which God has for me.
Little did I know that along the way I was going to assume
the “abused mule” identity. And somewhere, somewhere
the kapoete kapat, which was suppose to be like worship
in my ears, became the whip with which the enemy was
flicking me. Flicking me! Not on your life! No ... it was a
good lashing! I tried ... pulling and tugging on my bridle,
shrinking away, but “oompie” stayed put.
What a relief! I heard God’s voice again echoing in
between the whip lashes on my way to His city.
And between the shwiep shwap lashes I could hear,
inside of me, the horseshoe beat of His heart (clop, clop,
clop). How, God, did this become so heavy? How did it
happen that every time I am looking up to the road ahead
and excitedly start skipping downhill, my head gets pulled
down so that the only thing I see through my blurry eyes
is the black tar in front of my feet ... this spiritlessness that
could extinguish the wonder of a moment ago with a swish!
Somewhere, somewhere hidden away ...
Thank you God for the mules-hard headedness which
allows me to every time, day after day to lift my head!
Again and again, despite “oompie’s” weight and sharp
“now-do-you-see” and “I-told-you-so” – here in my loins!
Thank you God that you have now decided – enough is
enough!
Thank you God for the flowers you have placed all the way
along this city road which allowed me to EVENTUALLY
pull down my ears and kick up on my hinds to let
“oompievyand” fall on his back! I really had to get on my
hinds and hie-ha ... but now I am free! “Oompie” is lying
kapoete kapat flat on his back. And around me, my flower
friends who decorates me with flowers of love, grace and
tons of TLC! With ointment of words for my soul’s bruises.
Kapoete, kapoe ...
Oh no man! Somehow this mule-thing does not gel with
my free flowing emotions anymore. I’m a stallion! I’m royalty
and I am favoured!
NOW
I might not be there yet, BUT I’m going strong!
I reckon this mule-thing has (out)served its purpose.
Volume 25 | No 1 | 2015
5
Letters
Dear SAISI
Thank You!
AviRabinowitz
I just wanted to take this opportunity to say that I am
beyond grateful to have been granted a bursary by your
prestigious organization to attend this year’s SAISI
course. I am truly thankful and honoured by your profound
generosity and kindness. Your act of giving has really made
a big difference!
It was such a privilege and an honour to join a group of
passionate and dedicated therapists and I am sincerely
grateful to once again be a part of such a vibrant body
of people, who care enough to give. Thank you for the
blessing, it will go a long way. I know that my words can
never express my sincere gratitude, but I hope that I can
give back to others what you have helped instil in me.
Saisi is truly supportive, influential and a body that has
gone above and beyond what was expected. Thank you for
caring SAISI! What we do truly does matter and I promise
to carry what you continue to impart wherever I go.
Avi Rabinowitz
Occupational Therapist
0712055432
[email protected]
SOME PEOPLE
CARE TOO MUCH.
I THINK IT’S
CALLED LOVE.
Winnie the Pooh
6
Volume 25 | No 1 | 2015
SAISI Competition No.1
R1000
prize money for YOU!
We will be starting a competition
in each of our newsletters throughout the year. Results and winners
will be published in the following
magazine. Your deadline for sending in
entries for this competition will be 1 June ‘15.
Please send your entries to Sally Fraser-Mackenzie at
[email protected] with your name and cell number.
We are looking for the top 10 Sensory Integration
Activities in a community setting. Please describe
them. You may send in more than one entry/activity.
The top ten activities will be in line for R100 prizes EACH.
Happy thinking! SAISI
Volume 25 | No 1 | 2015
7
Article
WINNIE THE POOH & THE CHARACTERS IN THE HUNDRED ACRE WOOD
as a tool for self-reflection
Ray AnneCook
M.OT (US)
INTRODUCTION
I decided to use the story as a way to reflect on oneself
as a therapist. By using fictional characters and a story it
would be fun and not so threatening to oneself.
The characters in the story also provide a visual picture
which we can relate to easier. In this way we can maybe
laugh, empathize and even at times sympathize with the
character that may actually reflect who we are. In our
study groups we spent wonderful sessions discussing
Winnie the Pooh. Being fictional we could get lost in the
characters and imaginary world, allowing our thoughts
and opinions to flow freely. At times laughing and many
times learning more about ourselves, our colleagues and
our clients relating it to our OT practice. I have always
been known as a Tigger, but interestingly I would look
at the negative aspects of Tigger and what that causes
me to do in therapy, yet the members in the study group
looked at the positives of Tigger. A big thank you to all the
therapists in my study groups who participated and gave
8
Volume 25 | No 1 | 2015
their thoughts especially on the strengths to embrace; and
hazards to manage for each character. Our wish is that
you may enjoy reading the article as much as we enjoyed
discussing each character.
OT- SI is a relationship based intervention and we need
to understand our own personal story and how that
affects our therapy as well as interactions with the child,
family and team members. Many therapists come to
work with personal experiences that may reflect some
of the same stressors and injuries being faced by the
families with whom they work. This could be our own
sensory processing challenges or other challenges such
as having a family member or friend with difficulties, a
disability, ADHD, traumatic school experiences, or social
or parenting issues. Such experiences can be the source
of both great empathy, as well as great difficulty in our
work. You need to find your strengths to harness them
and weakness to avoid or adapt to them. We also need to
consider how these challenges of the clients we see have
Article
an effect on our own lives.
how you relate to the character
Our feelings help us: organize and interpret information,
give meaning to situation, energize (or deplete) us, connect
or divide with others and may engage us in promoting
learning and development. (Gerard Costa, 2009)
• Which character do you identify with and why?
Two critical questions for reflection are:
1.Who is this child to this family?
This refers to the importance of understanding the nature
of the parental relationship.
2.What is going on inside of you, or what is being stirred
up in you, the OT/helper?
• How does this match your sensory system as well as
other characteristics, traits or psychological issues?
• Think how this character lives in Hundred Acre Wood
and link that to your practice being the Hundred Acre
Wood.
THE OCCUPATIONAL THERAPY PRACTICE AS
HUNDRED ACRE WOOD:
This refers to the essential requirement that all who form
helping relationships with families must pay attention to
the feelings, personal “narratives,” and elements of his/
her own life that naturally gets activated by every child and
family he works with. (Gerard Costa, 2009)
Each person/character has their own individual profile and
this could include the OT, child and their family, teacher,
tutor and other people involved in this child’s life. Together
we all live in the Hundred Acre Wood. It is a beautiful, safe
place just like your practice should offer a safe environment
for the residents of Hundred Acre Wood (parent and child)
despite each one’s difficulties.
Setting The Scene:
A TOOLBOX OF
REFLECTIVE THINKING IN
WINNIE THE POOH
It has a few natural hazards, just like typical life has
hazards. In OT-SI we need to set obstacles or the therapy
activity to challenge various skills such postural control,
ocular control, oral control and bilateral motor control.
Further you have to challenge praxis and organization of
behaviour by setting the just right challenge.
Imagine your OT practice as being the Hundred Acre
Wood. We need to do some self-reflection to see what
we bring into the story of the child and the family we
treat. May you enjoy this journey in self-reflection and
development.
REFLECT ON THE WINNIE THE POOH STORIES:
• What do you visualize or what memories does the
story recall?
• Which character do you identify with, feel sorry for,
like, look down on etc.
• Consider the characters and their weaknesses
and strengths.
Reflect on the characters as being in your practice
• Assess each character from a sensory integration
perspective - as an occupational therapist we need to
think holistically and make a diagnosis.
• Form a visual picture of the child or therapist and
It has a warm community spirit with the residents doing
their best to help one another (James, 2008). It is a loving
environment which is non-judgemental and this should be
the therapeutic relationship. We all want to and try to help
one another. The parents could belong to a support group
or we could have talks for them. As therapists we need to
have a support system or group and this is often done by
belonging to groups like OTASA, SAISI and other interest
groups. Even when attending workshops you often find
that we are there to support one another.
There are housing problems as we find in the running of a
practice. In therapy the glider swing may break or someone
is using the equipment you need. In communicating with
the parents you miss the SMS or email. Accounts do not
always go smoothly. The report is not out on time and many
such things. Consider where you tend to have too many
housing problems and try to resolve these.
All the characters live alone and often the child or family
feel alone and isolated with their problem, so like the
Volume 25 | No 1 | 2015
9
Article
Hundred Acre Wood we need to care for one another
like the characters do and provide support and develop
support groups. Just as Piglet moved in with Pooh
when Owl squatted in his house. If you are working in
a solo practice consider whether you have support and
interaction with other occupational therapists.
INDIVIDUAL DIFFERENCES
OF THE HUNDRED ACRE WOOD CHARACTERS
The following section can be used to look at your own
individual differences as well as when assessing a child/
parent to plan intervention and then look at how this could
influence your own Hundred Acre Wood OT practice.
Each character will consist of a description of the character
with presenting problems, possible sensory processing
deficits, differential diagnosis, behaviour in Hundred Acre
Wood and the OT in the character. This highlights the
strengths to embrace and hazards to manage and how
it could affect you as a therapist if you identify with a
character or parts of a character.
TIGGER
Description:
He loves to bounce, especially bouncing on others.
He rarely sits still and is always running, climbing,
bouncing and fidgeting. He is full of energy, outgoing
and likes to have fun. Tigger is tough, fearless, optimistic
and resourceful. He is so overconfident that he thinks
that any task is “what tiggers do best”. He commonly
mispronounces words, like ‘ridickerus’ (ridiculous) or
‘vill-i-an’ (villain) and often causes chaos rather than good.
His main catchphrase is “Hoo Hoo Hoo Hoo!” when he is
happy. (Unknown, 2015) (A.A.Milne, 1994)
Sensory processing:
Sensory Modulation Difficulty (Sensory Craver) - he seeks
sensory input especially proprioception and vestibular
input of gravity to increase his level of arousal; or he may
be using it to regulate if he is sensory defensive. However,
we have nothing to indicate to the latter. He could be
bouncing on his tail as the tactile defensive person often
walks on their toes.
Ideational or somatodyspraxia might be considered,
because he jumps on his tale so he may have difficulty
10
Volume 25 | No 1 | 2015
planning activities and does the same activity (jumping)
repetitively. Oral praxis may be considered as he has
difficulty in pronouncing words correctly.
Differential diagnosis:
Attention Deficit Hyperactivity Disorder: Hyperactive/
impulsive subtype. He has difficulty in controlling his
hyperactivity. Also, he is extremely impulsive, which in
turn could potentially make him a bad role model like with
Roo. He is also a social magnet but those drawn into him
run the risk of getting themselves into trouble because of
his questionable behaviour. On a more serious note he is
prepared to try any substance no matter what comes along
his path, which could indicate a substance abuse problem.
(James, 2008) (Canadian, 2012)
Hypomanic personality – overly happy chappy,
overenthusiastic and all is good in Hundred Acre Wood.
He misreads all the clues that there may be problems.
Behaviour in Hundred Acre Wood:
He becomes Roo’s best friend as a happy, less-thanresponsible and sometimes trouble-making tiger friend
(Unknown, 2015). Do the children with similar difficulties
influence and urge one another to be over active and
impulsive? He is Pooh’s bouncy, exuberant and fun-loving
other best friend and he can be used to alert some children
when seen in a group. He often bounces and he comes
close, even if his friends don’t want it and he may thus
irritate others and dysregulate them. He will benefit from a
session on personal space like using hoola hoop to feel his
personal space. He has a friendly rivalry with Rabbit.
He is very social and his friends include Pooh, Piglet,
Rabbit, Eeyore, Owl, Christopher Robin and Kanga, but his
best friend might be Roo.
WINNIE THE POOH & THE CHARACTERS IN THE HUNDRED ACRE WOOD
AS A TOOL FOR SELF-REFLECTION
TIGGER THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
Enthusiastic, fun, energetic.
May over stimulate or dysregulate the child/parent
especially those who are sensory defensive.
May connect easier with the child to play with in therapy.
Child centred and can follow child easier.
Attractive to child to see adult being playful.
Can do more in therapy and stamina lasts longer.
Children energize and not drain the therapist.
Can handle more than one person at a time such as
doing therapy in a room with other therapists, have
parents/siblings or friends in the session.
Can work with the whole family at the same time
in a session.
Pace of activity may be too fast for the slow processor or
child with praxis difficulties.
Needs to develop the skill to wait, watch and wonder when
working with the child and not just rush in and take over.
Learn to follow through with impulsive ideas and complete
the task.
Be aware that activity or session needs to have a
beginning, middle and end.
Be aware that some children can dysregulate the OT to
become over stimulated (high engine).
Is positive nothing is too much to do.
Often sees the positive in things.
Your practice will not remain static – develop things.
Often liked by others as she is an extrovert.
WINNIE THE POOH
Description:
Despite being naïve and slow-witted, he is a friendly,
thoughtful and sometimes insightful character who is
always willing to help his friends and try his best. Often
appears vague. A prime motivation is his love for honey,
which quite often leads to troubling overweight. He is a
talented poet and his stories are punctuated by his poems
and “hums.” He is humble about his slow-wittedness, but
comfortable with his creative gifts. Pooh’s catchphrases
are “Oh, Bother!” and “Think, think, think”. (Unknown,
2015). In the Tao of Pooh he is referred to as the uncarved
block inferring that he is wise in his head (Hoff, 1994).
Sensory processing:
High threshold: He takes long to register that he is full and
thus is overweight.
Sensory modulation (low registration) as he is known for
his slow wittedness and is often not alert enough to focus.
Poor sensory discrimination as he may have poor
discrimination of intero-receptors. Because discrimination
is poor he may take long to process the sensory
information, as well as process it incorrectly. Because he
appears to be slow to process information, or process
differently to others he may have somatodyspraxia. He lives
in his head and may thus have poor body schema. One
questions if he is slightly low toned with poor vestibularproprioception when one looks at his posture. This may
lead to bilateral and integration and sequencing difficulties
as he often confuses left and right. He may be more of a
right-brained person.
He does not appear to have a distinctive sensory
integration disorder but needs further diagnostic therapy to
make a conclusion. This could help us understand his love
for honey. Is he using the honey to regulate himself on an
emotional or a sensory level?
Volume 25 | No 1 | 2015
11
WINNIE THE POOH & THE CHARACTERS IN THE HUNDRED ACRE WOOD
AS A TOOL FOR SELF-REFLECTION
However he is often referred to as his engine being “just
right” in the Alert Programme® and this then makes us
have to clinically reason his character again or is this more
because the children can relate to Pooh better or because
he is the main character and compared to Eeyore and
Tigger he is “just right”? (Williams & Shellenberger, 2001)
Differential diagnosis:
Attention Deficit Hyperactivity Disorder: Inattentive
subtype: He often appears vague and cannot finish tasks
he begins, such as counting pots of honey. He does not
think carefully before doing anything and is often distracted
like building the trap to catch a Heffalump or deciding to
build a house for Eeyore without consulting Eeyore.
He then writes notes to remind him but then the notes
make little sense. Like many people with ADHD, he will
remain focused if he is interested; like when making up
songs which he completes in the end. (James, 2008)
Impulsivity with obsessive fixation: He is obsessed with
honey and may even be addicted to honey. He grabs it
everywhere he can and is even prepared to take risks in
order to acquire it, this resulted in him being overweight
(Canadian, 2012). Or is he eating for comfort?
Behaviour in Hundred Acre Wood:
His best friends are Christopher Robin and Piglet. He loves
to help his friends. However his singing causes a noise and
is distressing the others who may be auditory defensive.
This could lead to a mismatch if a parent or therapist does
not like noise.
EEYORE
Description:
His posture is slumped and he fidgets with his tail which
he has difficulty in keeping attached to his bottom. His
eyes are downcast and he appears ever-glum, sarcastic
and pessimistic. Eeyore’s voice is low and monotonous
and he is slow-talking which makes him difficult to hear.
He is more cautious than some of the other animals, and
WINNIE THE POOH THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
Will accept people and situations for what they are –
“things are as they are”.
May find it hard to scaffold on physical level for child as he
is not in tune with his body.
More in the moment, so will be there and make it work –
goes with the flow.
Low tone so may not move as fast and have enough
stamina with the child and spikes with sugar which drops
again.
Will be good with wait, watch and wonder to give child
time to process the sensory information.
Won’t easily over stimulate a child.
Can be very zoned in with child – like honey.
The therapist could use singing in therapy which may be
rhythmical and calming.
Preoccupied with your own needs e.g. honey so not in tune
with child.
Does not finish tasks – so does not get administration
tasks done.
May appear too simple and not get the recognition from
other therapist/parents that he deserves.
The therapist may sing in therapy without realizing and
cause distress for the auditory defensive child so she
needs to sing in a frequency acceptable for the child or not
sing at all.
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Article
is often reluctant to go along with their actions Eeyore
has a house made of sticks, which falls apart and has to
be rebuilt. His catchphrase is “Thanks for noticing” as
indicated to himself (Unknown, 2015).
Sensory processing
Sensory Modulation – under responsive to sensory input
and his temperament is passive to his sensory system.
He misses the salient information and may appear lazy,
withdrawn and uninterested.
He has poor vestibular-proprioceptive functioning that has
led to poor postural control not knowing where his body is
in space. He can’t even keep his tail attached to his body.
Low tone in his face which then makes him look depressive
and has difficulty in showing a variety of facial expressions
and affect. This may affect his speech also then. Eeyore
has no routine which may suggest that he has a poor
sense of time and sequencing difficulties. This is also seen
in him explaining situations in a roundabout manner.
General sensory integration dysfunction: He will require
a SIPT assessment as his problems seem so great and
life is difficult. He has limited affect and is slow in talking
Differential diagnosis:
Dysphoria/depressive disorder as he is has difficulty in
experiencing emotions like joy and excitement and he is
always downcast and has a negative outlook on life. His
voice is monotonous and he is always fidgeting with his
tail. (Canadian, 2012) (James, 2008)
Behaviour in Hundred Acre Wood:
Pooh’s friend. He lives on the edge of the small community
both geographically and emotionally and finds it hard to
form significant relationships and have a fulfilling role in life.
If another colleague understands them and walks the extra
mile with them, like Pooh, they will blossom. He does not
bother trying to oppose anyone because he believes it to
be futile to try. This child is often not sent to therapy so will
not come into your Hundred Acre Wood. However if you
could treat him in an Alert group to teach him the sensory
strategies to alert himself (Williams & Shellenberg, 1996)
and the therapist could facilitate the child to stand up for
himself in the group context, he will believe more in himself
and become more assertive in society.
and doing things and nothing works that he tries to do. He
lacks self-confidence.
EEYORE THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
Don’t easily get upset by children and parents and will have
perseverance and patience
Won’t stand up for himself
They are not irritated by the Tigger’s
Focus more specific on a task
If too much sensory input they can go into shutdown
If it is depression they can’t handle too many pressures in
their work
Will have understanding for the child that is like them and be May appear too simple and not get the recognition from
other therapist/parents that they deserves
able empathize with them.
Open to abuse by parents and colleagues as they may trod
on them
Set in ways and find it difficult to think out the box and
solve a problem
Volume 25 | No 1 | 2015
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Article
PIGLET
Description:
Nervous, fidgety, ill at ease, squeaky voice and small
animal. He hesitates before speaking and appears
permanently worried about potential disaster. Increasingly
through the stories he shows himself to be very
brave when faced with a crisis and given sufficient
encouragement (usually by Pooh). He is fond of
“haycorns“. In the Disney series he is a kind, gentle and
ordinarily quite shy. Lives in a beech tree that he likes to
keep neat and tidy, can sing very well and his catchphrase
is “Oh, D-D-Dear!”. (Unknown, 2015)
Sensory processing:
Sensory modulation - sensory sensitive and his
temperament may be passive to his sensory system. Even
Pooh thinks that he will not take kindly to Tigger bouncing
so much (intolerance to visual or vestibular input). He may
thus be worried all the time that something will not feel
well. He needs tidiness in his house to keep order.
Differential diagnosis:
Generalized anxiety disorder and he is permanently worried
about mishaps. He is prone to stuttering. His anxiety levels
are increased in the presence of disorder (Canadian,
2012) (James, 2008).
Behaviour in hundred acre wood:
Piglet is Pooh’s best friend and who often takes his lead
from Pooh unless overcome by fear (Unknown, 2015).
The other residents are sensitive to Piglet’s issue (James,
2008) and one often finds that the sensory sensitive
person has everyone around them being sensitive to
their needs. At times the siblings in a family may become
irritated by this and we need to be aware of it and teach
the child strategies to overcome the sensory defensiveness
and become more confident to solve their own problems
RABBIT
Description:
Despite showing great friendship and compassion with
the others he is often irritable, angry and easily frustrated.
He is over organized and insists on doing things his
way. He becomes obsessed with rules, planning and
order. He often loses his temper to others and bosses
them around, but deep down, he cares a lot about his
friends. (Unknown, 2015) (Canadian, 2012) Maybe all
occupational therapists have a bit of Rabbit in themselves
as we have compassion and are friendly but still need
order in our work and like to do things our way.
PIGLET THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
Can organize and plan well – will be structured and keep
the therapy room and practice tidy and neat.
Low self-esteem not recognized for what he can do.
Could be the administration person in the practice.
Will always consider the safety of the child.
Is small so he can go on the equipment and do everything
with the children.
Tend to use less words and
more demonstration.
Does not believe that he is good so child/parent /
colleagues can walk over him.
May struggle in a big sensory integration room with other
therapists and children and fear mishaps all the time.
Hesitant on sensory integration equipment in case child
get hurt.
Does not always explain in free flowing words to parents or
child due to stuttering.
Worry excessively about life’s circumstances such as
the practice’s finances, job responsibilities, enough CPD
points, money to attend courses etc.
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WINNIE THE POOH & THE CHARACTERS IN THE HUNDRED ACRE WOOD
AS A TOOL FOR SELF-REFLECTION
Sensory processing:
Sensory modulation: He is sensory avoiding and needs
things to be done his way to avoid the sensory input.
However there is not enough to support this and possibly
further diagnostic therapy is required.
Differential diagnosis:
Obsessive compulsive disorder as he is obsessed with
order and is over-organized (Canadian, 2012).
Behaviour in hundred Acre Wood:
He fancies himself the smartest animal in the Hundred
Acre Wood films, he takes pride in his garden and hates
when anyone (mainly Tigger, but also Gopher) messes it
up. He also has compassion and cares about the others
KANGA
Description:
Doting mother who appears to be fierce initially as she
protects Roo. Once the others becomes friends they see
she is kind-hearted, calm, patient and docile. She likes
to keep things clean and organized, and offers motherly
advice and food to anyone who asks her. She has a sense
of humour. (Unknown, 2015) (Canadian, 2012).
Sensory processing:
Typical sensory processing so possibly she should be
depicted as just right, however the children may not be
able to relate to her character but the mothers may.
Differential diagnosis:
Social anxiety disorder - as she is an overprotective
mothering and obsessed with controlling her young and
then prevents them from making their own decisions, make
mistakes and allow them to do their own thing (Canadian,
2012).
Behaviour in Hundred Acre Wood:
She welcomes Tigger into her home, attempts to find
him food he likes and allows him to live with her and Roo.
After this, Kanga treats him much the way she does her
own son. She is protective over Roo, almost obsessively,
and treats him with kind words and gentle discipline.
Kanga pretends not to notice that Piglet is not Roo and
proceeds to give him Roo’s usual bath, much to Piglet’s
dismay. Considering our practice many of us therapists
as well as the mother of children with problems become
overprotective and we need to always be aware that we do
not overprotect but allow the child to develop and grow in
themselves. Maybe SAISI strives
to be KANGA as we fiercely try
to protect the work of
Jean Ayres and our mission, whilst
deep down we are kind hearted and
caring with a splash of humour.
RABBIT THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
The practice will be organized and run efficiently
Will want child to fit into a box for a diagnosis.
Can mask irritation and be friendly as often needed
in therapy.
May be friendly but not always considerate of others.
May rub others up the wrong way.
Parents will appreciate the structure, routine and business
side of this practice.
Potentially a poor team player.
The business should be sustainable.
May not be tolerant to others especially the Tiggers
in the practice.
Have self confidence in knowledge and therapy.
Takes pride in her work and the look of the practice.
Children may irritate her and child may sense the irritation.
Blame others for the problem and not take ownership of
the problem.
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WINNIE THE POOH & THE CHARACTERS IN THE HUNDRED ACRE WOOD
AS A TOOL FOR SELF-REFLECTION
OWL
CHRISTOPHER ROBIN
Description:
Very wise and bright but often believes and even falls for
less-than-bright ideas, often those of Pooh. He has a good
grasp of the written word but has trouble with spelling and
often confuses the meaning of words. He is scatterbrain
and often forgets things (Canadian, 2012) (James, 2008).
Description:
The imagination of Robin often manifests itself through
auditory hallucinations - characters are formed in his mind.
It is very likely that these characters represent feelings he
experiences in his internal world.
Sensory processing:
Bilateral Integration and sequencing disorder: He may
have dyslexia. If one looks at the fact that he often fall for
Pooh’s not so bright ideas, one could consider that he may
be bright but not so practical and possibly have a higher
verbal performance than non-verbal.
Differential diagnosis:
Dyslexia (Canadian, 2012), ADHD combined subtype
as he is a scatterbrain and may thus have poor working
memory.
Behaviour in Hundred Acre Wood:
He is the wisest and most literate and others come to him
for advice.
Sensory processing:
Unsure, this is the child who comes at a young age living in
his own world as the world out there is too harsh. Further
diagnostic therapy is needed to see if it is emotional or
sensory based or both.
Differential diagnosis:
Schizophrenia due to auditory hallucinations.
Behaviour in Hundred Acre Wood
As therapist we often get the Christopher Robin in the
practice and we need to learn how to meet him on his
level and not judge him for living in his imaginary world.
This is the child that is still learning how to function
socially and interact with the external world. He is not
fully understanding himself and the therapist needs to go
into his world to find him and bring him out so that he can
learn to deal with the present world. Each character could
represent a different reaction or feeling within himself as
he learns to cope and deal with that extra world out there.
KANGA THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
The care for the child and parents is genuine.
Do too much for the child and overprotect them from
developing their own sense of self.
Will protect and fight for the child against the harsh
realities of life.
Welcoming to all who come into the practice and create a
safe and nurturing environment.
Be kind yet discipline gently.
Has a sense of humour which is often
needed in various situations in therapy.
Play / act / pretend in a manner so
that child feel they are good at
something and even better than
the therapist.
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Might find it hard to discharge the child as she will want to
continue looking after them.
Not give child enough freedom to explore and learn from
the therapy equipment.
May not be able to let go and trust others to do the work.
Will struggle with child directed therapy and freedom to
explore.
Article
As we follow the ASI principles of treatment as found in
the fidelity measure we will allow the child to follow the
process that they need to develop and grow. They will then
be able to cope with the present time and the realities of
the environments they find themselves in.
BIBLIOGRAPHY:
A.A.Milne, 1994. The Complete Tales of Winnie the Pooh. New York:
Dutton Children’s Books.
Canadian, M. A., 2012. Hall of Fame: The-mental-disorders-of-winnie-thepooh-characters/. [Online]
Available at: https://knowledgeguild.wordpress.com/2012/10/13/themental-disorders-of-winnie-the-pooh-characters/
[Accessed 28 February 2015].
CONCLUSION
In the world of a child’s imagination we can go on and on
forever. Continue to reflect on your work and yourself as
a therapist. Enjoy working in Hundred Acre Wood! May
your clients have a meaningful sensory experience in your
Hundred Acre Wood as our KANGA, Jean Ayres, would
have wanted.
Gerard Costa, L. S., 2009. What staff development activities can be used
to build reflective capacity. In: L. G. Sheryl Scott Heller, ed. A Practical
Guide to Reflective Supervision. Washington: Zero to Three, pp. 149 155.
Hoff, B., 1994. The Tao of Pooh and the Te of Piglet. london: methuem
childrens books.
James, L., 2008. Tigger on the Couch. London: HarperCollins UK.
Unknown, 2015. Wikepedia. [Online]
Available at: http://en.wikipedia.org/wiki/List_of_Winnie-the-Pooh_
characters
[Accessed 28 February 2015].
Williams, M. & Shellenberger, S., 2001. Take Five! Staying Alert at Home
and School. 1 ed. Albuquerque: TherapyWorks Inc..
Williams, M. & Shellenberg, S., 1996. How does your Engine Run?
A Leaders Guide to the Alert Programme for Self Regulation.. 1 ed.
Alburqueque: Therapy Works Incorporation.
OWL THE OCCUPATIONAL THERAPIST
Strengths to embrace
Hazards to manage
Wise and good at clinical reasoning.
Taking down telephone numbers and spelling in reports
will be poor.
Very good advice for parents with good verbal skills.
Mentor and teacher to other OT’s.
Understand the child with dyslexia.
Struggle to write their protocol and read books on
sensory integration.
Too longwinded when talking.
Use too many verbal instructions in therapy and then
loose the child.
Volume 25 | No 1 | 2015
17
Article
AN OCCUPATIONAL THERAPIST’S VISIT TO
The Hundred Acre Forest
NitaLombard
M.Sc.OT (UCT)
Alan Alexander Milne (1882-1956) was much more than a
children’s writer. He wrote many novels, plays, poems and
essays, but it is the Winnie-the-Pooh stories for which he is
remembered.
Ever since A.A.Milne first created the character Winnie-thePooh, Pooh-Bear stories have become favourites amongst
children and adults alike.
Milne created these stories for his son Christopher
Robin Milne. He used his son’s stuffed animals as the
characters. Christopher’s teddy bear, Edward, appeared
as a character, Teddy Bear, in a poem (November 1924)
published in the children’s book of verse When We Were
Very Young, although his first actual appearance was
earlier that year (February 1924) in Punch Magazine.
The stories are set in The Hundred Acre Wood which is
based on the Ashdown Forest, Sussex, England, which is
actually a five hundred acre expanse where the Milne family
had a holiday home.
Christopher Milne later wrote in his biography: “Pooh’s
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Volume 25 | No 1 | 2015
forest and Ashdown Forest are identical”.
Christopher named his toy bear after a Canadian black
bear, named Winnie, after Winnipeg where his owner came
from. Christopher often saw this black bear at the London
Zoo, where the bear was a much loved attraction. In
December 1925 Winnie-the-Pooh appeared in a Christmas
story in a London newspaper, The Evening News. This
story appeared as the first chapter of the book Winnie-thePooh (1926).
Christopher Robin Milne is the only human figure in the
stories as Christopher Robin. The other characters include
Pooh (a bear), Tigger (a tiger), Eeyore (a donkey), Piglet
(a very small pig), Owl, Kanga and Roo (a Kangaroo and
her baby) and Rabbit. Rabbit and Owl are the only two real
animals featured in the stories. Heffalump, who doesn’t
feature very much and had not been given structure by
Milne, became a more important character in the Disney
production. Gopher was not a character created by Milne,
but became a character of Walt Disney’s in his rendition of
Article
the stories. Disney felt that the existing characters weren’t
American enough for his audience. Subsequently he also
dropped the hyphens in the name and it became Winnie
the Pooh.
FASCINATION WITH
WINNIE THE POOH
power that is easily spoiled and lost when that simplicity
is changed. This applies not only to things, but people as
well.
Pooh Bear is accepting of his slow-wittedness “a bear of
little brain”, but comfortable with his creativity, i.e. poetry
and song. Despite his so-called lack of intelligence, many,
wise and insightful comments can be found in the stories,
i.e.
Since the first stories about Pooh-Bear saw the light, many
authors used the characters analogous in writings about
philosophy, psychology, psychiatry, management, self-help,
life-skills, eastern religion and many more. Three books
have been particularly helpful in the application of Sensory
Integration and general Occupational Therapy principles,
especially the older clients, i.e. 5yrs +. These are The Tao
of Pooh, The Te of Piglet and Tigger on the Couch.
“YOU CAN’T STAY IN YOUR CORNER OF THE
FOREST WAITING FOR OTHERS TO COME
TO YOU. YOU HAVE TO GO TO GET THEM
SOMETIMES”. “SOME PEOPLE CARE TOO
MUCH. I THINK IT IS CALLED LOVE.”
Walt Disney popularized Winnie the Pooh in the United
States of America and it has become a well-known trade
mark with many products evolving from it.
He has a great capacity for friendship, love and
compassion. His best friends are Christopher Robin and
Piglet, although he also regards all of the other animals in
the forest as his friends. About Tigger he says:
This can be found in films, toys, clothing, tableware, books,
music, video games, etc.
Pooh-Bear is alive and well and living worldwide!
THE CHARACTERS
WHO LIVE IN THE HUNDRED ACRE FOREST
WINNIE THE POOH
Pooh Bear is an anthromorphic (with human qualities)
bear that lives in The Hundred Acre Forest with his animal
friends and one human friend Christopher Robin. He values
and loves his friends and has become the main character
in these stories.
Pooh Bear has been described in many ways, but often
as naïve and slow-witted. Despite this slow-wittedness
he is described as friendly, thoughtful and often insightful.
He is always ready to help his friends and try his best. He
displays immense caring for his friends and insight into
their needs, i.e. finding Eeyore’s tail and helping him build
a house.
On the other hand he is seen by Benjamin Hoff in The
Tao of Pooh as the epitome of the “uncarved block”. In
Taoism the essence of the uncarved block is that things
in their original simplicity contain their own natural power,
“JUST BECAUSE AN ANIMAL IS LARGE,
IT DOESN’T MEAN HE DOESN’T NEED
KINDNESS”.
Pooh Bear has also been described as ADHD, inattentive
subtype, with careless and indifferent behaviour. His
obsessive search for honey is seen as possible addictive
behaviour or an eating disturbance leading to his obesity
TIGGER
Tigger is the bouncy, hyperactive, fun-loving tiger in these
stories. He is impulsive, overestimates his own abilities,
(“..that is what Tiggers do best”) and is often a threat to
his own and others’ safety. He bounces all over things and
his friends without regard of whether they like it or not.
He is overconfident, but often irresponsible. His best friend
is Roo, a baby kangaroo who lives with his mother Kanga.
Kanga mothers Tigger together with Roo as she is kind,
calm and employs gentle discipline.
Volume 25 | No 1 | 2015
19
Article
OWL
Owl is not a stuffed animal, but appears in MiIne’s stories
as a real-life animal, the only other one being Rabbit. Owl is
dyslexic, but very proud of his intelligence. He can’t read or
spell and often bluffs his way through. Despite his dyslexia
he is very bright as is often seen in very talented people,
i.e. Albert Einstein, Thomas Edison, Alexander Graham
Bell, Leonardo da Vinci, John Lennon and many more. Owl
has a superior attitude, but is very kind.
PIGLET
He has a general downcast and negative outlook on life
which renders him incapable of experiencing emotions
like joy and excitement. He often complains and expects
doom around every corner: “at least we haven’t had an
earthquake yet.”
In 2008, The Canadian Medical Association published
an article where the Winnie the Pooh Characters were
attributed with mental disorders:
POOH BEAR:
• ADHD, inattentive subtype
• Impulsivity with obsessive fixations
• Obsessive-compulsive disorder
Piglet is a small animal and probably the youngest in the
Forest, except for Roo who is still a baby. Piglet is small,
timid, very fearful, but has the biggest heart of all. He is
Pooh’s best friend and can overcome his fears with the
support of Pooh. Pooh appreciates Piglet’s strengths:
PIGLET
• General anxiety disorder
“…YOU’RE BRAVER THAN YOU BELIEVE,
AND STRONGER THAN YOU SEEM, AND
SMARTER THAN YOU THINK.”
KANGA
• Social anxiety disorder
Benjamin Hoff sees in Piglet, the virtue of the small.
In Taoism, the ideal is to live in simplicity. The Taoist
mind is the mind of a child, responding directly, simply
and honestly to the world and embracing it with joyous
abandon. This promotes the development of sensitivity.
However this attitude to life may pose danger to the
individual when faced with other individuals’ sophisticated
attitudes. The virtue of the small and the weak is often
ignored or looked down upon in our culture. Hoff regards
it as a quality of special character, spiritual strength, or
hidden potential unique to the individual. People who
possess this quality, may be quite unaware of it as in the
case of Piglet. Luckily Pooh appreciated Piglet’s value
RABBIT
• Obsessive-compulsive disorder
EEYORE
Eeyore is ever glum, pessimistic and often sarcastic. He is
irresponsible (forever losing his tail), depressed and sad.
He has great compassion and his friends respond to him in
a caring way.
OWL
•Dyslexia
TIGGER
•ADHD
EEYORE
• Depressive disorder
All of the above opinions, from various authors, contribute
to the occupational therapist’s ability to look at their clients
in a novel, playful way. This is particularly helpful when
working in the paediatric field of OT where children enjoy
fantasy play and can easily identify with the characters.
Since 2001 an annual therapeutic camp, KWELA Camp
which has its foundation in OT and in particular, Sensory
Integration principles, was founded. These camps have
been run by Occupational Therapists in the Western
Cape for special needs children, ages 6 -10 yrs. This is a
therapeutic, recreational camp. (visit https://sites.google.
com/site/kwelacamp). Children are assessed prior to the
camp by way of information from their regular occupational
therapy reports, history, parents’ expectations as well as
the child’s expectations. The completion of the Sensory
Profile (Dunn) is a prerequisite.
Every year there is a theme from which the team/group
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AN OCCUPATIONAL THERAPIST’S VISIT TO
THE HUNDRED ACRE FOREST
names are derived. These themes are well known to
children and are drawn from children’s fiction or recent
films. In 2008 Winnie The Pooh was the theme. At first
the children thought it was too “babyish”, especially the
older boys. However they soon embraced the idea when
characteristics of some animals were used in conjunction
with the Alert Programme (AP).
The AP is a valuable used tool at KWELA and is
implemented at every camp. Many of the children are
familiar with the concept as they have been exposed to
the AP in their regular treatment sessions. For them it is
always a novel idea, easy to grasp, attractive, child friendly
and a great help in facilitating children to self-reflect. It is
interesting how the parents also latch onto the idea, once
the children tell them about their “engines”, after the camp.
The AP is introduced during the daily Life Skills sessions
where the children are mostly involved with sedentary
activities, i.e. talking, listening and fine motor tasks. Many
of our clients, due to their diagnoses, find this extremely
difficult in everyday life, i.e. home, school, play, social
setting and extra-mural activities This is also a constraint in
the Life Skills groups as well as the rest of the day where
it is ideal to have a child in the “calm-alert” state in order to
benefit optimally from their experiences.
An “Alert Box” is made available to each group and the
concept explained. The Alert Box contains articles for
tactile stimulation, deep pressure, movement against
resistance, oral stimulation, visual inputs (mostly protective,
peaked caps) and auditory inputs (ear muffs).This concept
then becomes a frequently used frame of reference
throughout the duration of the camp and is often referred
to by the therapists and children themselves.
Children are encouraged to self-reflect on their arousal
states when incidences occur that indicate that they have
become disregulated. They are supported to problem
solve around their predicament and to make a plan, using
the five strategies as taught in the AP, i.e. Touch, Move,
Look, Listen and Putting something in Mouth
Only three characters from Winnie the Pooh were used
to depict the three regulatory states of the engine, Too
Low, Too High and Too High. Pooh Bear was placed in the
centre, green zone – JUST RIGHT, Eeyore in the blue zone
to the left – TOO LOW and Tigger in the red zone to the
right TOO HIGH.
As the inhabitants of The Hundred Acre Forest are well
known to almost all children, they could easily identify
with these characters in a playful and whimsical way.
Throughout these exercises the KWELA Kids were able to
manage their arousal levels better without any blaming or
shaming coming into the play.
They were encouraged to identify with one of the
characters by learning how to get Eeyore more alert and
attentive, assisting Tigger to bounce less and consider
how others experience being bounced upon and
appreciating the value of Pooh Bear’s calm state despite
him being a “bear of little brain”.
ON A PERSONAL NOTE
Occupational Therapists are continuous learners and
constantly add extra knowledge and skills to their toolbox.
Through doing this, they gain extra knowledge about and
insights in human behaviour and the many manifestations
of behaviour that are presented to them on a daily basis.
Through gathering an ever greater deal of knowledge it
still remains one of the most exciting experiences to have
an A-Ha! moment. Apart from the enrichment it affords,
these experiences are the ones that we love to share with
colleagues.
In this regard Winnie the Pooh and friends became a
much enjoyed topic in the Advanced SI Study Group in
the Western Cape. During this exercise many possibilities
were pondered upon:
What if we could provide every Tigger with a Kanga that
nurtures him with her kind, calm demeanor and gentle,
Volume 25 | No 1 | 2015
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AN OCCUPATIONAL THERAPIST’S VISIT TO
THE HUNDRED ACRE FOREST
yet firm discipline?
What if the Eeyores around us could all have a sensory
diet included in their daily lives?
What if Owl could have access to a computer where he
could truly reach his potential?
Maybe Pooh Bear could find a job in the food industry
where his love for food and creativity would be more
appreciated?
What if all the Piglets out there could have a mentor like
Pooh Bear?
REFERENCES
1. Williams, Mary Sue and Sherry Shellenberger. “How Does Your
Engine Run” A Leaders Guide to The Alert Program for Self-Regulation,
Albequerque, Therapy Works, Inc. 1996
2. Hoff, Benjamin, The Tao of Pooh and The Te of Piglet. London,
Methuen Children’s Books. 1994
3. James, Laura. Tigger on the Couch, London, Collins, 2007.
4. Dunn, Winnie. Sensory Profile, San Antonio, Psychological
Corporation. 1999.
OTHER INTERESTING READS
1. Pooh’s Little Instruction Book. 1915
2. Positively Pooh – Timeless Wisdom from Pooh.2008
3. Pooh and the Philosophers, 1995
4. Pooh and the Psychologists, 2001
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Activity ideas
BECOMING ALERT WITH
Pooh Bear & Friends
Nadia Fourie
B.OT (US)
The alert program is a unique “tool” that allows children,
caregivers and therapists to select appropriate strategies
to maintain or alter the child’s state of alertness.
All parties involved are all taught how to interpret the
reaction of the nervous system to sensory input, causing
the child to be in a low-, just right- or high-alert state.
This program also provides the knowledge basis and skills
needed to facilitate the optimal level of arousal for the
specific situation the child is in. According to Wilbarger &
Wilbarger (1991) the Alert program was initially intended
for children with attention and learning difficulties, ages
8 – 12. The program has however been amended for
preschool through to adulthood, as well as children
suffering from a variety of disabilities. In children younger
than eight or in the case of intellectual disability, this
program can be used by the caregiver/staff to develop a
sensory diet, in order to enhance their learning ability.
“Self-regulation is the ability to attain, change or maintain
an appropriate level of alertness for a task or situation”
(Williams & Shellenberger, 1996). This search for the
optimal level of arousal, is at the core of most of the goals
set by occupational therapists, caregivers and teachers
alike. To enable children, therapists and caregivers to
discuss “levels of arousal” a common language needed
to be found, that was clear for all to understand, but also
descriptive enough to encompass the complexity of all
entails.
THE TRIED AND TESTED:
The engine analogy was the original “language” used as
most children and adults can relate very accurately to
this imagery. An engine can easily go high, to indicate a
heightened state of alertness or over-activity. Alternatively
it can run low, indicating a low state of alertness or a
lethargic state. It can also reach the optimal level of
arousal, when the right gears are chosen.
The traffic light analogy, using different colours to describe
the different levels of arousal is often used. Different
animals or specific child centered interest can also be
used to form the descriptive “language” basis for the Alert
Program. Another very good option is to use our Disney
friends living in the Hundred Acre Wood, to form another
analogy, which is often very descriptive and easy to use
with the youngsters.
Volume 25 | No 1 | 2015
23
BECOMING ALERT WITH
POOH BEAR & FRIENDS
THE HUNDRED ACRE VERSION:
Winnie the Pooh and his friends all live in the Hundred
Acre Wood. They share adventures, play games, search
for lost treasures, go camping and best of all… they learn
what friendship and sharing really means.
THE CHARACTERS:
TIGGER is …
A HIGH ALERT child could be …
• A very active animal
• Always on the go
• Full of energy
• Bouncy, he loves to bounce, especially on others
• Likely to act impulsively, causing mishaps, or utter mayhem
• Fun loving
•Exuberant
•Happy
•Competitive
• Over confidant
• Less than responsible
• Sometimes a trouble maker
•Tough
•Fearless
• Optimistic and resourceful
• Overly active and on the go
• Energetic and struggle to sit still
•Talkative
• Busy, busy, busy
•Exited
• Willing to try anything new
• Disregarding of consequences
•Optimistic
•Fearless
•Impulsive
•Reckless
• Focused on immediate gratification
• Focused on enjoyment rather than task oriented
• Unable to focus
•Distractible
His favorite saying: “That’s what Tiggers do best!”
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Volume 25 | No 1 | 2015
Activity ideas
PEOPLE SAY NOTHING IS
IMPOSSIBLE, BUT I DO
NOTHING EVERY DAY.”
Winnie the Pooh
EEYORE is …
A LOW ALERT child could be …
•Ever-glum
•Sarcastic
•Pessimistic
•Quiet
• Slow talking
• More cautious than most
• Reluctant to play along
• A loner and he keeps to himself
• Always depressed
• Reluctant to oppose anyone
• Not fond of swimming
• Not at all willing to bounce
•Lethargic
•Unmotivated
• Slow to get started
• Slow to complete a task
• Reluctant to try
• Overly cautious
• Inclined to think they will fail
• Unwilling to expand their repertoire
• Opposed to changes in their routine
•Glum
•Fearful
•Controlling
His favorite saying: “Oh bother”
Volume 25 | No 1 | 2015
25
Activity ideas
WINNIE THE POOH is …
JUST RIGHT …
•Thoughtful
•Insightful
• Willing to try his best
• Motivated to perform
• Always willing to lend a helping hand
•Friendly
• Comfortable with his abilities / talents
•Humble
• Task oriented
•Focused
• Able to plan before acting
•Motivated
• Able to solve problems
• Able to think logically
•Knowledgeable
• In tune with themselves and their abilities
•Confident
•Positive
His favorite saying: “think, think, think”
PRACTICAL ADAPTATION:
Now that we know our Hundred Acre friends, how do we
go about introducing this to the children and caregivers
who have to use it?
Firstly everyone should get acquainted with our three
friends. Looking at pictures from a magazine or a
children’s book works well. Cutting the pictures from gift
wrap and sticking them on a page to make a new story is
also a good alternative. The older friends can even watch
movie clips on a cellphone or iPad and do a “know your
character” quiz. Gross motor games that can be used here
include movement games e.g. jump like Tigger, walk slowly
with droopy ears like Eeyore or do a treasure hunt for Pooh
Bear’s Honey.
Secondly, an obstacle course can be set up, with different
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Volume 25 | No 1 | 2015
stations, each eliciting a specific type of sensory input.
The aim here will be for the child to experience the input
and determine the impact on the arousal level. At the
end, the experiences can be charted, in order to combine
the activity with the effect it has had on the level of arousal.
The most practical idea here, is to laminate pictures of all
the activities used in the obstacle course and then to stick
them on a page, with three columns labelled “low”, “just
right” and “high”.
Then it is time to create a device, to enable the child to
measure the level of arousal they are experiencing at
different times during the day. Cut a paper plate (small) in
half. Draw lines to divide it in 3 equal parts. Name the first
section “low”, the middle section “just right” and the last
section “high”. Now create a cardboard arrow that can be
fastened to the paper plate. Stick a picture of Eeyore in
BECOMING ALERT WITH
POOH BEAR & FRIENDS
I THINK WE DREAM SO WE DON’T
HAVE TO BE APART FOR SO LONG.
IF WE’RE IN EACH OTHER’S DREAMS,
WE CAN BE TOGETHER ALL THE
TIME.”
Winnie the Pooh
the “low” section. Stick a picture of Pooh Bear in the “just
right” section and Tigger in the “high” section.
Lastly the “change over tools” need to be identified
and labelled. Take a laminated piece of paper. The first
heading can read: I feel like… and then pictures of our
three friends can be added. The second header can read:
I need… and then pictures of all the different sensory
activities or pieces of equipment can be stuck on there
with velcro or prestik. This is a great tool to use when the
little one needs to get ready for bed or get ready to do
homework or a test at school. This enables them to be
in touch with their arousal level, but also to be able to be
knowledgeable about what they need, to attain the correct
level of arousal for the task ahead.
muster the courage to get started with an insurmountable
task, like Eeyore, I hope these tools will enable you, to
guide them to that just right place, to learn, play, develop,
interact and be a friend to the other characters in the
Hundred Acre Wood.
Whether your friend is bouncing off the walls like Tigger,
looking for honey like Pooh Bear or trying his best to
Volume 25 | No 1 | 2015
27
Book Review
Tigger
on the Couch
By Laura James, Published: Collins, 2007
Submitted by
NitaLombard
In this book by Laura James, she uses the analogy of
favourite childhood fictional characters to demystify and
demstigmatise common mental disorders and maladies.
She uses the stories of Alice in Wonderland, The Hundred
Acre Wood (Winnie the Pooh), Neverland (Peter Pan),
Wizard Oz, Cinderella, Willy Wonka, Bluebeard, Snow
White, Peter Rabbit, Beauty and The Beast, Goldilocks,
101 Dalmatians, the Big Bad Wolf, Pollyanna and Pippi
Longstocking.
James presents each character as a case study. She
discusses their diagnosis, physical presentation, diet,
family background, patient notes, descriptions of the
condition, prognosis and treatment.
She lists her resources, classified into different mental
disorders. These books appear to be mostly pop
psychology and self-help scripts. She also includes a list of
support groups and organizations in the UK.
Here is a sample of what you can expect. Her views on the
characters in The Hundred Acre Forest are:
Pooh-Bear is given more than one diagnosis i.e. ADHD,
inattentive subtype as he doesn’t think things through, has
left/right confusion and some problems with cognition and
he is over-weight with the suggestion of an eating disorder
and a possible addiction to honey.
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Volume 25 | No 1 | 2015
Tigger is also given the diagnosis ADHD, hyperactive and
impulsive subtype.
For both characters mentioned above, the treatment
suggestions are similar, being a combination of medication,
diet, family therapy, psycho- and behaviour therapy.
Suggestion on community involvement and education are
also made.
Eeyore is diagnosed with Dysthemic Disorder as he is
dysphoric, depressed and downtrodden. A combination of
anti-depressants and psychotherapy is prescribed. Family
therapy and group therapy are also suggested.
Piglet is diagnosed with a General Anxiety Disorder as
his capacity to enjoy life is hampered by his perpetual
timidity and innate nervousness. As hid diet is limited, a
more varied and nutritious is recommended. Furthermore,
treatment on an outpatient basis is suggested. Sedatives
or antidepressants may be considered, but cognitive
behaviour therapy is strongly recommended.
This book is recommended for lighter reading and can
certainly demystify and destigmatise the grave issue of
mental disorders.
Book Review
The Tao of
Pooh and the
Te of Piglet
By Benjamin Hoff
Submitted by
Ann Watkyns
This is a 2-book compendium. In the first book, the Tao of
Pooh, the author sets out to explain the ancient principles
of Chinese Taoist Philosophy using the stories of Winnie
the Pooh and his friends.
Similarly, in the second book, The Te of Piglet, he uses
Piglet to demonstrate one aspect of this philosophy – the
virtue of the small – the “Te” in Chinese. This word is used
to refer to the “small” in society – women, children and the
poor. Taoist philosophy is biased in favour of the humble,
the weak, the small.
“That it’s a nice day” said Pooh.
If you are not a fan of Winnie the Pooh, or are not
interested in finding out more about eastern philosophy,
I think you will find the book very heavy going. But if you
enjoy Winnie the Pooh, you will find the book very similar,
with the same quaint, old-fashioned style and the same
slightly offbeat logic and humour.
The books are written in the same style as A.A. Milne’s
books, with many sections quoted verbatim from Winnie
the Pooh and The House at Pooh Corner. The illustrations
are by E.H. Shepard, who drew the original famous
drawings. Having grown up, and brought my children up on
Winnie the Pooh, it was most enjoyable and very nostalgic
to read these familiar sections, which the author uses to
illustrate a point he is making.
An excerpt – on the virtue of “being rather than “doing” –
“I say Pooh, why aren’t you busy?” I said. “Because it’s a
mice day” said Pooh. “Yes, but – “. “Why ruin it?” he said.
“But you could be doing something important” I said.
“I am” said Pooh. “O, doing what?” “Listening”, he said.
“Listening to what?” “To the birds. And that squirrel over
there.” “What are they saying?” I asked.
Volume 25 | No 1 | 2015
29
CPD Programme Questionnaire
CPD Programme
Questionnaire
If you have not used CPD Solutions before, go to
www.cpdsolutions.co.za and click on ‘Help’ to download
the CPD Solutions SMS guide for instructions on how
to register with your cell phone and answer multiple
choice tests with an SMS.
ANSWER ALL QUESTIONS TRUE (A) OR FALSE (B)
QUESTIONNAIRE 37.1 (a36488)
Winnie the Pooh and the characters in the
Hundred Acre Wood as a tool for self-reflection
by Ray Anne Cook
1.
According to Costa our feelings can organize and interpret
information, give meaning to a situation, energize (or
deplete) us, connect or divide with others and may engage us
in promoting learning and development.
QUESTIONNAIRE 37.2 (a26723)
An Occupational Therapist’s Visit to the
Hundred Acre Forest
by Nita Lombard
1.
The characters of the Hundred Acre Wood has been used
analogous in writings about philosophy, psychology,
psychiatry, economy, geriatrics, cooking skills, western
religion and many more.
2.
Books that have been particularly helpful in the application of
Sensory Integration and general Occupational Therapy
principles, include: The Tao of Pooh, The Te of Piglet and
Tigger on the Couch.
2. There are two critical questions for self-reflection: Who is the
family to the child and what is stirred up in you with regards to
the child.
3. Pooh Bear is described in naïve and slow-witted, careless and
with lack of intelligence and common sense.
3. In the analogy of your practice being the Hundred Acre Wood
each person presents with their own sensory profile.
4. Winnie the Pooh is described as being ADD and possibly
shows addictive behaviour or has an eating disturbance
leading to his obesity.
4. Tigger is definitely representing a sensory sensitive person
avoiding input by bouncing on his tail.
5. Tigger is ever glum, pessimistic and often sarcastic.
5. Tigger’s poor pronunciation is an indication of low tone in his
mouth.
6. Pooh bear could possibly have ADHD (inattentive type) as a
differential diagnosis.
6. Owl is very bright, despite his dyslexia.
7. Piglet is small, timid, very fearful, but has the biggest heart
of all.
7. Eeyore has an under responsive sensory system and is
passive towards his system.
8. This story is particularly helpful when working in the paediatric
field of OT where children enjoy fantasy play and can easily
identify with the characters.
8. Piglet could possibly have an obsessive compulsive
differential diagnosis.
9. Tigger, Rabbit and Christopher Robin can be used to depict
the three regulatory states of the Alert Programme.
9. Rabbit is sensory sensitive and as a result needs things done
his way as to avoid sensory input.
10.The KWELA Kids were able to manage their arousal levels
better with the help of the characters of the Hundred Acre
Forest without any blaming or shaming coming into play,
because the children could easily identify with these
characters in a playful and whimsical way.
10.Owl may have dyslexia with bilateral integration and
sequencing difficulties.
30
Volume 25 | No 1 | 2015
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