Heads Up Now! » sensory

Cooking and Sensory Processing

melinda — Tue, 14 Jun 2011 00:36:29 +0000

My son Josh is not a picky eater. He’s always been good about trying new foods. If Josh resists eating something the problem he has is not usually with the taste or texture of something, but the smell.

As a young adult Josh now manages most of his sensory problems with ease. He has discovered that he enjoys cooking and decided he needed to expand the number of recipes he knows how to make. I’ve taught him the basics of meal preparation, and I compiled a list of easy-to-prepare recipes that I thought Josh would enjoy making and eating. One such recipe was “Easy Lemon Chicken”. Josh would gladly consume the final, baked version of this dish. Unfortunately, and I didn’t know this about Josh, he can’t stand the smell of lemon juice.

He’s fine with lemonade, lemon-scented soaps, cleaning wipes, and lemon jello. In fact, I can’t think of anything lemony that Josh reacted negatively to as a child. This experience revealed that there is something different and acrid for him about lemon juice and it was so hard for him to smell that concentrated lemon scent that he had difficulty just measuring it out to make the recipe.

Adding to the challenge was Josh’s tendency to be impulsive, which of course is consistent with his ADHD diagnosis. With all the ingredients, even very common and frequently used ones, Josh automatically gives them a sniff before adding them to a recipe. He tells me he needs to check to make sure the smell is consistent over time and that things should smell exactly the same way each time or something seems wrong and he feels suspicious about that ingredient. In any case, sniffing food items is a well-developed habit by now, though thankfully not in public anymore.

Josh gave the lemon juice a whiff, and had an immediate nose-wrinkling response followed by thrusting his arm as far from his nose as he could extend it. Blinking incredulously, Josh proceeded to…take another whiff from the bottle of lemon juice. Why? Partly due to impulsivity and partly due to his sensory system demanding consistency over time. He had to check again just to make sure it smelled as noxious to him as it had the first time. Yep! It still smelled awful to him, but at least he knew what to expect the second time.

Predictability is comforting to the sensory-challenged. It helps to know what to expect, even if it is still an unpleasant sensation. Better the bad sensory experience you know than the unexpected sensory experience which could prove very unsettling merely by the unpredictability factor. Josh powered through the olfactory assault as he prepared the recipe, although it wasn’t as “easy” for him as the recipe name implied.

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Easy Materials You Make Yourself

melinda — Fri, 10 Sep 2010 22:36:16 +0000

I like to give my children a lot of different ways to learn. My two kids with AD/HD are strong visual learners, and their sensory processing challenges lead them to seek out hands-on experiences. So, besides offering them fidget items when the lesson doesn’t have manipulatives, I try to find ways that they can see and touch objects as they learn. I also know that my children are externally motivated (not unusual for those who have weak executive functions) and they need frequent reinforcement or reminders to stick with a task. In case I haven’t mentioned it before (though I think maybe I have either here or during my workshops) I am also reluctant to spend a lot of money on things I can make myself. Of course I always think I will go to craft shows and then make whatever has grabbed my fancy once I get back home, but I never seem to do that. But with school materials, I sometimes manage to get inspiration from my recycling bin. The picture above shows a simple set of materials that are readily available and can be used for a number of things. It took me about 15 minutes from start to finish to make it.
First, get a cardboard egg carton. Make sure it’s clean and no eggs have cracked and leaked in it. I spray mine with Clorox Anywhere Spray to kill any germs. (Disclaimer: Melinda cannot be held responsible for any icky things you pick up from your egg carton. I am not a doctor…blah, blah…) My egg carton had a little circle indented on the bottom of each cup, and I cut around them to make the holes in the middle of each cup. If your carton does not include these handy, preformed circles, you can just cut your own. The circles need to be large enough for a clothespin to fit through but small enough to hold the clothespin in place. Leave the lid on the carton so you can store small materials inside and to provide a base for the clothespin to stand on. There are many ways you can use your newly recycled materials, so I’ll just get you started with a few ideas. I’m sure you will be able to come up with more ideas, and I’d love to hear about them.

Use the clothespins to practice counting.
Practice fine motor skills by having the child place and remove the clothespins
Use as reinforcement by putting one clothespin in place for each completed task
Use as a motivator by placing clothespins in the carton for each task that needs completed. Remove a clothespin as the work gets done, visually depicting for your child that progress is being made.
Paint the clothespins (or use colored popsicle sticks or tongue depressors) to match colors

Making this is easy to make, easy on the budget, and easy on the environment. A winner all around!

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Dressing Up A Sensory Guy

melinda — Sat, 31 Jul 2010 02:31:16 +0000

People with sensory issues often have strong clothing preferences. I don’t know if this is generally true, but in my experience most men do not enjoy dressing up. The men I know prefer comfortable clothing. They call their attractive dressier outfits “monkey suits” and yank their ties loose at the first opportunity as if their oxygen has been reduced and they need to gasp for air. Now add together “man who prefers comfortable clothes” with “sensory guy” and you’ll see the issues faced by my son. A few weeks ago we were getting ready to attend a wedding reception. I informed Josh that he would need to dress up for the event. To Josh, “dress nicely” means wearing jeans without holes. Josh doesn’t own a lot of dress clothes for the obvious reasons that he doesn’t typically need them and he doesn’t like to wear them. I asked my husband, Scott, to help Josh find something nice to wear. They are close to the same size, so sometimes they can share clothing in a pinch. This was a pinch, all right. Scott, who like Josh has AD/HD, didn’t spend a lot of time selecting an outfit. He found something that matched and tossed it to Josh to put on. Then Scott was off to do something else. A few minutes later, I found a distressed Josh in my room. He looked truly miserable, although quite handsome. When asked what the problem was, he started describing how uncomfortable his clothes were. The shirt needed to be tucked in, but then wasn’t comfortable. The cuffs around the wrist felt odd, but were tolerable. The shirt material was a little scratchy. I tried to tell Josh that it was necessary to dress up for special occasions and he quickly explained that it wasn’t dressing up that bothered him. It was being dressed up by someone else. His Dad has made the choices for him, and because Dad doesn’t have sensory issues he selected what would work for most men. Josh is the only one who knows how his body feels and responds to clothing, though, so we needed to make some adjustments. A change of pants for a looser fit made tucking in the shirt more comfortable. A belt held things comfortably in place – not too tight, not too loose, but just right. A plain cotton, tagless t-shirt under the dress shirt made Josh much more comfortable. Having the tie a wee bit looser but barely noticeable rounded out the outfit. Josh didn’t own any dress shoes and his feet are bigger than Scott’s, so he wore his nicest boots and it didn’t look too bad. Tomorrow we are going to a wedding, and sensory guy Josh will be dressing himself up again. We bought a pair of dressier shoes (Rockports) that are slip-ons, with a little elastic around the tongue of the shoe for flexibility and comfort. Josh tried on several slip-on style shoes and found that some of the styles bothered him because they did not come up high enough on the back of his heel and he could feel them slipping around. The shoes Josh picked were high enough on his heel and comfortable, so hopefully the sensory guy will be able to relax and enjoy his time at the wedding and reception even though he is in a “monkey suit”.

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Sniffing Tennis Balls?

melinda — Sat, 03 Jul 2010 03:27:59 +0000

My son, Josh, has a well developed sense of smell. His sensory processing issues are sometimes a strength but more often than not when he was younger they interfered with his ability to function and participate fully in activities. When I homeschooled Josh and his sisters, two out of three of my students had AD/HD (attention deficit hyperactivity disorder) along with sensory and auditory processing difficulties. Not only did they have more energy than I did, I had to repeat myself a lot and keep their sensory challenges in mind. Leaning over to help Josh with an assignment, I can remember Josh informing me that I had coffee breath. Unwilling to forgo coffee, I instead tried to angle my head so that when I spoke the air flow would be directed away from Josh’s nose. Picture the way a bird cocks its head, and that’s probably about what I looked like as I taught my little fledglings. Although I wasn’t right in his face, his overly sensitive nose could pick up the smell of a peanut butter sandwich from several feet away. As with many of his sensory integration challenges, Josh was both sensory seeking and sensory avoiding at times. When I prepared his meals, Josh always had to sniff the food before eating it. Always. Even if it was his favorite meal, very familiar to him, he smelled it prior to eating as if this time I might have slipped something nasty in his food for unknown reasons. Josh wasn’t a picky eater, but he sure appeared to be a suspicious one. Over time, I was able to get him to sniff more surreptitiously at least when he was a guest in someone’s home or out in public. Josh still occasionally gives an unfamiliar food item a sniff prior to tasting it, but I think that’s o.k. because we all tend to notice the smells of new and previously untried foods. Josh’s tendency to sniff things wasn’t limited to food or drink items. One time Josh was playing with our dog, having him fetch a tennis ball. This is when impulsivity collided with sensory processing and Josh took the tennis ball from the dog’s mouth and gave it a sniff. “Ewww! This smells terrible!” he proclaimed, practically gagging before lifting it to his nose for another whiff. “Ugh! That’s awful! Plus, it’s slimy!” Now his whole system was on red alert since he experienced an aversive smell and an aversive tactile feeling together. I could practically see him shudder. We had to laugh, though, because even after he knew the tennis ball had a bad odor, he went ahead and smelled it again before he could stop himself. When I asked him why, he said something in his brain told him to check again to see if it was as bad as he thought it was. His own second opinion was confirmation enough. Josh still has an acute sense of smell, but over the years has learned to control both his impulsivity and his reactions to smells – even though as his mom I can still tell when he is cringing inside.

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The Answer is Yes!

melinda — Tue, 15 Jun 2010 00:47:47 +0000

Yesterday was a big day for my daughter. She graduated with honors with a B.S. in Education from The Ohio State University. She hand embroidered Jeremiah 29:11 on the top of her cap, and I am very proud of her accomplishments and her perspective about her future. Since I homeschooled Beth all the way through high school, I have been asked by many people through the years if homeschooled students can go to college. Fortunately, with the growth in homeschooling we are not considered to be such a fringe element of society anymore. Many homeschool students have found success in a variety of venues. Beth’s graduation from college answers that question with a definitive “yes”. College is not for everyone, homeschooled or otherwise schooled. But for those who wish to seek that additional education, homeschoolers can hold their own in any setting. What a joy to celebrate Beth’s success!

Of course, it seems nothing goes without a hitch when there’s a big event and multiple people involved. Beth’s graduation was held outside in the stadium at OSU, and the heat and humidity were both high. Both of Beth’s grandparents came to see Beth graduate, but grandma doesn’t do so well in the heat. Just after I got a text from Beth saying that she wasn’t feeling well and felt dehydrated, grandma passed out in the bleachers. We were able to eventually find the first aid station and she is fine, but we were shook up and spent time in the first aid station while waiting for Beth’s turn to get her diploma. With a graduating class of over 8,600 students, it took a long time. We did leave grandma with the medics, at her insistence, and popped back into the stadium to see Beth officially graduate. Because there were so many students, instead of calling their names they tolled a bell that sounded like a funeral dirge the entire time students were receiving the diplomas. My two sensory/auditory processing children were beginning to twitch from the relentless ringing.
Next we drove to a restaurant of Beth’s choice, The Cheesecake Factory, but they didn’t take reservations and there was a 2 1/2 hour wait. We hunted around for other restaurants in the area, but all had long waits so we headed back home. I had potato salad, a fruit and yogurt parfait, and graduation cap cookies on hand, but that hardly made a meal for eight. So we got carryout to go along with it.

My son, Josh, is an author and he broke out of his usual sci-fi writing mode to pen this “Ode to Beth’s Graduation”:
Ahem.

Rush so we will be on time.
Walk a mile and then we climb.

Hungry since we walked so far.
Left the food back in the car?

Seated up so very high.
Great view of that cloudy sky.

Now the band begins to play.
Half an hour til the parade.

8,600 tassels tall.
Did you have to name them all?

Graduates who have done your best!
Survive this day and pass the test!

Moving speeches, people sing.
Can anybody hear a thing?

Think it’s time to go inside
Before this turns to suicide.

People get their PHD’s.
Hangin’ out with EMT’s.

Additional speeches get carried away.
What? You mean we’re just halfway?

More interesting show to watch:
Grandma versus the Red Cross!

Sunburn in the first degree.
People leaving. Wait for me!

Diploma time’s a living hell.
Someone kill that funeral bell!

Over? Really? Now we’re free!
To the Cheesecake Factory!

Two and a half hour’s wait?
Fifty bucks for a piece of cake?

Everything else is crazy as well.
Ten miles around the Hilton Hotel.

Home at last. What a day.
Now we get to eat parfait.

All is over, and I’m glad.
…just what year is Beckie’s grad?

Collapse.

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Crossing Midline

melinda — Thu, 15 Apr 2010 21:06:40 +0000

If you’ve had a child in speech, occupational, or physical therapy you may have heard about the importance of “crossing midline”. When my children were younger, I heard from therapists that it was very important for babies to spend time on their tummies. In addition to helping the brain make connections as the child views things from different perspectives, changes in positioning provides different proprioceptive and vestibular input. Being on the tummy encourages a child to push up with her arms, which strengthens the upper body muscles. This is important for a growing child so she can develop the muscle tone and strength needed to reach over her head or move the arms outward and across the body with a good range of motion. Without such development, the child will have difficulty sustaining a physical posture or repeating motions without rapidly fatiguing. Therapists also work on helping a child to “cross midline” in a number of ways. When a child can reach her right hand across to the left side of her body and vice versa, she is crossing her midline with her arms. In addition to these large movements, a child crosses midline when reading as her eyes move from one side of the page to another without moving her entire head as she reads. The tongue crosses midline as it moves food from side to side to position the food onto the molars for chewing. When any of these activities occur, information is transferred from one brain hemisphere across the corpus callosum to the other brain hemisphere. The corpus callosum is a fibrous band between the two hemispheres and allows for the exchange of information between the right and left hemispheres of the brain. This side-to-side sharing of information is important for fluency in processing and acting on information received. When information is not readily crossing from one side of the brain to the other, there is usually a learning glitch or struggle. In the picture above, you can see that this child tended to paint in the same area, primarily on the right side of the paper. This same child, when the paint utensil was placed in his left hand, painted primarily on the left side of the page. This was just one indication that he was not readily crossing midline and might need some help to develop in that area. One of my favorite resources for addressing this and other brain processing issues is the book Brain Gym. It provides descriptions and illustrations of simple exercises that promote crossing midline, increasing alertness, improving handwriting, readiness for reading, and more. The exercises can be done by both children and adults in just a few minutes prior to a specific task. I have used the “brain buttons” and other exercises from Brain Gym to increase my alertness when feeling the fatiguing effects of a long car trip. With my AD/HD children, I had them do some exercises between school assignments to ready their brains and bodies for focused attention to the task at hand. Such simple exercises are easily implemented and help the brain develop pathways across the midline of the brain, resulting in more efficient processing and learning.

Tickle My Back, Mom!

melinda — Thu, 11 Mar 2010 23:00:45 +0000

My youngest child, Beckie, has always been cuddly and affectionate. As a newborn, she quieted as soon as I picked her up and held her cheek next to mine. I thought she recognized my voice, but it was the skin-to skin contact at least as much as my words to her that seemed to calm her. As she grew, I noticed that when others picked her up her little hands immediately started fingering the material of the holder’s clothing. She gently explored the feel of earrings, necklaces, scarves, and even daddy’s whiskers. At age three, I took her with me to a craft show. Knowing how she loved to touch different textures, before we went in to the show I reminded her to look with her eyes and not her hands. She looked both sad and surprised as she protested, “But Mommy, to look IS to touch.” Those were her exact words, and it confirmed that I had a very tactile learner and that I needed to allow her to touch some of the items that caught her interest. I ended up telling her that if she saw something she wanted to feel, she could ask me first and I would find out from the vendor if Beckie could touch the objects to see how they felt in her hand. As she grew older still, I heard the same request every day during our homeschool time when I was reading to the children: “Tickle my back, Mom!” If you are familiar with sensory integration (AKA sensory processing), you know that tickling can be aversive and irritating to some children. In Beckie’s case, she was sensory seeking and had lower registration for tactile input so the tickling was alerting to her. When she is just listening and not actively moving, it is hard for her to focus. Her AD/HD leads her into daydreaming and distractions. She recognized this about herself, and one strategy she found that seemed to help was to have her back tickled. The light touch was enough to help her stay alert and focus on listening to what I was reading. I became adept at one-hand holding or propping a book, depending on the size of the book, and using my other hand to trace lightly over Beckie’s back. I tried using a wooden backscratcher once, but that didn’t have the same effect for Beckie. I tried a backscratcher with metal scratchers, but that was also not acceptable to Beckie. When I became too absorbed by what I was reading or needed a drink of water and would thus cease the tickling, Beckie noticed immediately and either wiggled against me to prompt me back to task or grabbed my hand and placed it where it clearly belonged – on her back again! Sensory input can be calming or alerting, and each individual’s response to input varies. Often, as in Beckie’s case, our children show us over and over what they need and what works for them. Be observant and sensitive to individual differences, and take advantage of the strategies that work.

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Sensory Issue: He’s sniffing EVERYTHING!

melinda — Fri, 05 Feb 2010 03:30:25 +0000

A friend contacted me recently to ask for some suggestions for helping her son. He is on the autism spectrum and recently has started sniffing all kinds of things, even dropping to all fours to sniff the floor at Wal-Mart and stopping to sniff at light poles. This behavior is especially embarrassing to his siblings. My friend asked her son to stop sniffing things and he told her he can’t. She came to me to see if I could suggest something inexpensive to try with her son. Here is an excerpt from my reply to her:
You are both right – he needs to stop the gross/embarrassing behavior, and…he can’t. I always try to think about how every behavior, no matter how quirky, is meeting some kind of need. We do things that are somehow rewarding to us. With that in mind, you can’t just tell a child to stop smelling objects because something in his brain is telling him to do those things. But in your family, in our society, those things will never be acceptable. So you have to try to come up with something that meets those sensory needs and is also an acceptable behavior. Some of the solutions might still be considered “quirky”, but there are degrees of quirky and some are easier to take than others. For the sniffing, try soaking a cotton ball in something with a distinct smell and keep it in a snack-size ziploc bag for portability and easy access. You might want to have several separate bags with different smells, and when your son feels the urge to smell something you can redirect him to one of the cotton balls. (Ideas include: cologne, coffee, air freshener, extracts – peppermint, lemon, cinnamon.) You know what smells your child can handle and what ones might set him off, so you choose what works for you. If you discover a favorite scent, you could apply it to a handkerchief or piece of material that he can keep in a pocket and pull out to sniff as needed.
My friend decided to try various aromas on cotton balls and used a large pill case to house each scent separately. The pictures above show her solution, and here’s what she says about it.

I bought a pill holder and put cottonballs scented with different things inside each of the seven compartments.
Now, whenever my son has the urge to sniff, he can grab that, open one, and smell away. I used vanilla flavoring, coconut, perfume, lotion….anything that had a strong smell and I tried to find some different from each other. Still quirky, yes….especially in public…but way less quirky than dropping to all fours and smelling a floor in public.

Wipe! Wipe!

melinda — Sat, 09 Jan 2010 21:03:21 +0000

Some of you probably thought this post would be about potty training, but no. This is for all of you with children who don’t like to get their hands dirty. Some children are oblivious to messes and don’t mind having a dirty hand or face. Other kids become distressed if even one finger has come into contact with a substance they don’t like to feel. I have worked with children who remind me of Monk, the obsessive compulsive detective who calls for his assistant to hand him a wipe whenever he shakes hands or touches something he deems undesirable. Recently I was sitting with a young boy who was eating a snack, and he got some frosting on his hand. In a near panic, he turned to me saying, “Wipe! Wipe!” and held out his hand for help in removing the frosting as quickly as possible. Right next to him was another child totally indifferent to the feel of frosting covering her face and hands, happily licking the frosting from each finger. My son Josh was in the “Wipe!” camp when he was young, and my daughter Beckie was such a sensory seeker that she deliberately smeared food on her face and hands and loved messy art projects. Both of them needed to work on sensory processing and awareness, but today I am going to suggest a strategy for the sensory avoidant, “Wipe!” children. I didn’t want to overwhelm or traumatize my avoidant son, making future attempts to increase his tolerance even more challenging. But I did want to expand Josh’s acceptance of various textures, smells, and sensations. I knew I couldn’t just put materials out for him to explore and expect a different response from him. Josh was already doing what came naturally to him, and that was to limit or avoid his exposure to certain materials. So I put finger paints, pudding, hair gel, etc. into Ziploc bags. For some of the bags I added in small objects such as decorative erasers for added input as the materials were investigated and experienced through touch. Sometimes I double bagged to prevent leakage, and in addition to sealing the bag I added a layer or two of packing tape along the seal. Then I modeled tracing a finger over the bag, poking it with my finger, smashing it with my palm, etc. and encouraged my son to do likewise. Touching substances through a bag felt safer to him, and the limited boundaries of a Ziploc bag appeared more manageable to his young mind. Since Josh was also sensitive to smells, the bags eliminated or at least minimized odors. As Josh became comfortable with the materials in the bags, I would gradually introduce a small amount of the material without a bag. With repeated exposure over time, Josh learned to process all the sensory input and no longer avoided touching materials directly. I found, with Josh and other children I have worked with, that many children are more willing to touch a substance that I present to them on my own hand instead of on a table or piece of paper. I’m not sure if that’s because seeing it on me implies that it is safe to touch, or if it’s the skin to skin contact that is reassuring, but in any case it’s worth trying with your kids to see if it helps them as you expose them to a greater variety of sensory input

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To Tell, or Not to Tell?

Melinda — Sat, 19 Sep 2009 15:43:17 +0000

I’ve met many parents who are pretty sure their child has AD/HD or some other learning challenge but they are hesitant to make it official by having their child evaluated and diagnosed. The fear that a label may limit their child, be inaccurate, or be used in discriminatory ways is valid. When my son, Josh, was approaching school age I thought about the advantages of private schools with smaller class sizes. Several people suggested that I go ahead and enroll him without telling the school personnel about his AD/HD diagnosis so they couldn’t turn him down. That was before we knew he also had an auditory processing disorder. I was assured that once he was enrolled in the school, they couldn’t kick him out just because he had a diagnosis and they would be forced to work with him. Wow! For one thing, Josh was pretty easy to pick out of a group as being different than his peers. I’d give it 5 minutes tops before things became unavoidably noticeable. So basically I would have had to keep him out of sight until school had officially started. Then there was the whole idea of the people he would be spending hours with each day being tricked into having a student that they weren’t prepared for and apparently didn’t feel equipped to deal with in their classroom. That made me feel sorry for Josh and for the teachers, since having someone who was “forced” to work with my child because I had hidden some vital information from them just didn’t sit well with me. I loved that boy, and the thought of sending him somewhere that he might not be wanted didn’t make sense to me. I had the same dilemma when it came time for Sunday School at church. I didn’t want to bias the teachers against Josh by telling them all his struggles, so I coached him on the way there and dropped him off like all the other parents with their children. The Sunday School teachers, bless them all, are volunteers in the church and most don’t have training as educators – and for most kids that’s just fine. But to do the “drop and run” with a special needs or challenging child is not a good idea, as I came to realize. Every week, the other parents would pick up their children and happily leave. When I came to pick up Josh, I inevitably got pulled to the side and told, “I need to talk to you about Josh.” Then I heard, week after week, a full litany of complaints from frustrated and bewildered teachers who were describing things that were not unusual for Josh but were not typical for most children. For example, Josh was not adept at sitting still for long. He was not deliberately disruptive and was never disrespectful, but his need to stand at the table while coloring his page instead of sitting in a chair like everyone else was considered problematic. His sensory issues led him to sit at the back of the group on his carpet square, and everyone else was huddled together and bumping into each other which Josh was carefully trying to avoid. But that meant he wasn’t “with” the group because he had made a row of one – just himself! And the list would go on and on until I was finally allowed to leave with my miserable son who knew that somehow just by being who he was he had screwed up again and people were unhappy with him. Those experiences led me to advocate more and be preemptive with anyone I left Josh with for any length of time. When there was a sub or a new Sunday School teacher, I made a point of telling them a bit about Josh and strategies that would help them, and I was careful not to dwell on the negatives. I shared Josh’s strengths, too, for I found that if I became negative about my son others felt free to share every little thing they saw as being wrong or weird about him. I was well aware of Josh’s struggles and it served no purpose other than to discourage me when others felt the need to complain about him. All this, and he wasn’t even doing anything “bad” on purpose! When someone was going on and on about all the things Josh did or did not do, I learned to quietly point out something that he had done right, or I’d share something that Josh had enjoyed learning in their class previously. This seemed to derail some of the negativity some of the time. Just as with our kids, nothing works all of the time but something will work some of the time. We need strategies for working with those who are in a position to care for our children, and hope that something will work some of the time. Whether you are a natural advocate or a reluctant one, if you have a child with a learning difference or special challenges, you must be an advocate unless and until your child one day develops the skills to advocate for himself. In my experience, being deliberate in my advocacy was hard but preferable to what happened when I just waited and hoped things would work out for the best.

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