Tantrum vs Meltdown: What to Do When Your Child Loses It

[0:00] Meltdowns differ a little bit because they might last an extra amount of time. How important is it for parents to be regulated? We're our children's safe person and so if we're not regulated and our child, our child does feel that from us. What do you most want parents to stop feeling guilty about?

[0:23] Health and wellness is confusing. There's a new trend every week. Everyone's got an opinion, and half the time, you can't tell what's legit and what's just good marketing. And we get it. We're in it too. Welcome to Dialed In Health. I'm Melissa Goodwin. Every episode, we bring in the people who actually do this work, providers, practitioners, the experts who see clients and patients every day. We ask the questions you'd ask if you were sitting across from them so you can find the right people, make better decisions, and feel confident about what's out there, whether it's peptides, gut health, water quality, ADHD, biohacking, or something you've never heard of, we're covering it. So let's get into it. Let's get Dialed In.

[1:00] Kristin, welcome to the show. I'm so excited to be here. You're an occupational therapist. So tell us a little bit about your background and what brought you to Move U.

[1:12] So I'm a pediatric occupational therapist with 20 years of experience. All throughout my career, I've just known that sensory processing and integration challenges have sort of been my passion area. So developing Move U, which is now four years old, has been a huge passion project of mine. And I'm so grateful for the opportunity just to start a program like Move U and bring on other disciplines of speech therapy and physical therapy as well, but to impact the lives of children in the community of Sioux Falls.

[1:48] So you guys do a lot of different things here. Give us kind of the flyover, what there's trampoline looking things and tire swings and ball pits, like super fun. Tell us a little bit about the work that you do here. What is Move U?

[2:01] So Move U is a place of wellness and growth development for children. So truly, there's no problem too big or too small for us to kind of assist families and children with, from wellness community events based for children, infancy through elementary to high school age, all the way to those that maybe have a specific diagnosis by a physician requiring or recommending that they receive intervention to those that are maybe just struggling a little to keep up with peers or feel a little awkward and clumsy. So all of the materials that you see here are really sensory-based materials. And sensory drives motor function. So from the feel of our chairs that we're sitting on right now and probably the wiggling that I'm doing because more attentive and I can keep myself regulated with a bit of movement or some muscle work, all of the materials in this gym provide sensory information and provoke motor action as well as behavioral and emotional components as well.

[3:13] I'm just going to ask some simple questions because I don't know enough about this space. My mom used to do play therapy and stuff many, many years ago. So I know that there's dexterity things, like trying to pick something up or kids struggling with dexterity or maybe they're struggling with maybe a certain kind of movement. Give me some examples of some reasons a mom might give you a call.

[3:38] Regard to manual dexterity, there's-- well, a lot of shoes right now don't even have ties on them. But if your child's struggling to learn tying shoes, that's kind of a typical thing occupational therapists may help with. Or how are they holding their pencil or grasping their fork or their spoon? But Move U really goes beyond all of those things to look at what's underlying beneath that. So a lot of times when we have challenges in our motor coordination, it's not just a practice thing. Kids practice eating all of the time. Or they practice handwriting all of the time at school. And so when there are difficulties with some of those motor-based functioning, we can look beneath the surface to wonder, are they able to adequately feel how much force they're using on that or feel the positioning of their hands or where the pencil is in their hand? And so we're able to assess and look deeper than just at that motor skill.

[4:42] Let's say a mom calls Move U for the first time. What has been happening at her house? What has she been experiencing before they give you a call?

[4:50] A lot of times for families, parents blame themselves initially, it seems like. Maybe if I just discipline different or if I'm more consistent with this or that. But with sensory-based challenges, no matter how you parent or what you implement, there's difficulty completing the current task, whether it's getting dressed in the morning or the child's too low, slow, takes a long time to get going in the morning, to get revved up to eat breakfast, change clothes, brush teeth. Or perhaps the child can be easily overwhelmed by noises or how their clothes feel or brother touched them or whatever those challenges are. And so when there's a challenge that becomes kind of unpredictable, maybe quick shifts or no matter the reinforcement sticker chart that you've created, it's just not getting better. There's really no problem too small. You know, something that's impacting your family unit, you're avoiding going to community places or birthday parties or to the store, those kinds of things, those would be a reason for a phone call.

[6:15] What about if they're not eating a lot of certain things? Like they'll only eat one thing or they've got like a fixation or those kinds of things. Can you help with that?

[6:22] Absolutely. So there would be a couple of things that we look at in that realm. Our speech therapist is very skilled in oral motor training. And so sometimes it can be the child might gag due to not being able to move the food to the side of their mouth well or chew it well enough to then be able to swallow it. Or from a sensory perspective, it could be how does the food look? My chicken nugget is an oval today, not the dino nugget that like I prefer or the brand is different or the box looks different. You might see a stress reaction of finger splay or our hands are like this, or gagging or turning our head away from food. Those would all be stress reactions that do limit food variety intake.

[7:11] Why did you feel like, you know, maybe this place needed to exist in Sioux Falls? There's, you know, tell us what was missing when you looked at this space as an occupational therapist and said like, there really isn't anything that's doing X. What was that thing?

[7:25] First and foremost, for myself as a professional, I've just always been driven to learn more and do better and really want to continue evolving. And in previous locations where I have been as a professional, I just didn't feel like quality of my work or continuing to learn was of value that maybe having just clients come and having a schedule be full was the most important thing. Personally, that was pretty draining because I want to continue to evolve and do better. And so Move U was sort of built on the conversation with Tyler, one of our owners of, you know, a lot of therapists are created differently and some are OK with just being OK. And that's fine. But for me, I was just feeling burnt out of the system and had this vision of a place where children and their families could come and kind of feel the sense of safety and security or a place of belonging instead of, you know, I'm coming here because something's wrong with me or there's something wrong with my child, but instead I get to come here. And even for siblings coming in being observing a session, but later joining into a session, you know, they want to be here as well. And when everybody's on board and we're having fun and joyful, sensory rich experiences, that's when we can see changes happen so much faster for children, because again, it's not a practice thing. We don't need to practice going up and down steps. But what we do need to do is work on two sides of the body coordination or posture control or visual skills and we get to do that in fun and playful ways here and stretching and expanding that to all disciplines as well.

[9:23] What about when parents see their kids struggling with any of the things that you just talked about earlier and they think, well, it's just a phase. You know, how do you know if it's just a phase versus something that you need to address?

[9:35] Sometimes it can be a phase, right? Like I only like to eat this food right now and then I eat something different. It totally can be a phase, but when it keeps coming around or change of season keeps coming around and it's like, oh my gosh, we're struggling with putting on socks again after the summer or even just this morning, I completed an assessment for a child whose mom I had spoken to three years ago and it wasn't the right time for them then, but now they did come today and similar challenges were persisting across different developmental stages and transitions into kindergarten and elementary school and things. And so it's not always the right time right away. You don't know, but what I would say is just even in a single appointment or an assessment, we can learn about a child, we can provide some recommendations or we can even just assure a parent like the child's doing well.

[10:36] You have people that come in or you have kids that come in here that might have autism, I'd imagine ADHD, some have eating issues. Give me a kind of a broad spectrum and I know you also treat kids that are or work with kids that are perfectly healthy and maybe need to move a little bit more. So tell me the spectrum of people that come in here. Give me some ideas so that the listeners can understand it's a good fit.

[11:02] So it could be something like maybe there's only a challenge with being able to tolerate how our underwear feel and so not wearing underwear, that could be a touch sensitivity kind of thing for a child to struggling with transitions or like start of school year, we're just kind of in that right now and we could imagine that first day of school could be stressful for kids, second day we're getting into the routine but now that we're a couple of weeks into school, if that's not getting better and we're not adjusting to that routine and we're still having big emotional things, then it may be time for an assessment. It might also be a child who you're watching your child play soccer or at a ninja class and just noticing it's hard for them to follow the directions or imitate body positions that the instructor is doing like in a dance class being able to follow the routine or wait in line, struggling to put our letters in the right spot on a piece of paper or gallops instead of runs. There's such a range of what we can see, what we can treat. Speech therapy wise, maybe it's articulation or not saying certain words or phrases, you know, how they should or maybe saying one word instead of a full sentence when other children their age are talking in sentences.

[12:37] Yeah. So what would be some things that if you're a parent and you see this kind of behavior that you should absolutely call Move U?

[12:45] That's a pretty loaded question. I mean, anything from daily performance, just things are hard for your child. They're working extra, extra hard to keep up and you can see them getting frustrated potentially or losing interest in activities because it's just too hard.

[13:09] Definitely call us because confidence that impacts confidence and anxiety, like sense of self, like I can do it kind of things. You see a lot of positive affirmations on our wall behind us. And when kids don't believe that in themselves, it really impacts their participation just throughout childhood, but also that continues into adulthood. Yeah.

[13:34] Well, I appreciate that because you're right. Like you don't want someone to think like there's something wrong with you, right? Like you're going to this thing because there's something wrong. But instead of I like the way that you're flipping it and saying like, this is a place I get to go to. And it's fun. And I get to play and learn things. It's a completely different mindset and approach. Yes. Yeah. It's connection over compliance and within DIR Floortime, which is one of our uniques, that Move U offers within all treatment sessions. We don't just need a child to like follow the rules or, you know, walk in the building and say hi because we told them they need to say hi. But instead we want them to feel that in intrinsically be motivated to want to do and be able to do what it is they're interested in.

[14:24] Yeah. So tell me about the DIR Floortime. What is that? DIR Floortime is a developmental individual difference and relationships based approach. It's a specific treatment strategy that all therapists here at Move U are certified in, at least to a basic level. So our speech therapist or physical therapist and our occupational therapists are all certified in this. What it is is a child led and strengths based approach that truly we need to build connection rapport with the child. So it's more fun for us to do it together versus the child doing on their own or it's fine. You go over there and play that and I'm just going to line these toys up or I'm just going to do it this way or control the activity this way. But instead, when we're working on togetherness and fostering our relationship, now we can stretch play even further because maybe I'm stuck in the ball pit. And now the child thinks it's so silly or I'm pretending I'm thinking and they're trying to pull me out. Now I'm working two sides of the body. I'm working strength for the child, getting variation in touch, stretching ideas and imagination and putting this motor action to it. And the child has no idea they're actually working out essentially in all of those areas. Fostering that relationship and finding joy in what we do.

[15:57] Why did you choose that specific framework for this clinic?

[16:02] DIR Floortime is a treatment. It's a treatment approach I was trained in. Gosh, it's probably been 10, 12 years ago now when I did my initial coursework in that. And it just seems so natural and a lot of it seemed like common sense to me. And so I feel like as a provider, I was maybe just naturally doing it. But then DIR Floortime gave me the framework to put what I was doing into, you know, more into practice readily and finding that it doesn't just have to be a me thing, a me treatment style. But there's a whole herd of therapists out there that are interested in impacting children in the way that DIR Floortime does.

[16:49] So you have a, tell me about the neurodiversity affirming aspect of that. Can you talk, can you speak to that a little bit more?

[16:57] Yes. So some children with autism and even those without a diagnosis of autism, maybe they just have sensory processing challenges.

[17:08] We might have limited play variety. Perhaps, you know, a stereotypical play approach that a child with autism may engage in is merely, you know, instead of like crashing my cars together and they're going under a bridge and I've made a bridge for them to like go over or under, maybe I'm just lining them up. And so within DIR Floortime as a therapist, I would join the child in doing that and allow them to notice that I'm doing what they're doing. And then, you know, gradually be able to insert myself or allow for what's called playful obstruction. Like maybe, you know, one of the cars crashed and flipped over and you know, like we see this big affect happen. And now that child's like taking notice, like, okay, something's going on with that lady. You know, I don't know what it is, but then it starts to happen again.

[18:09] And that child's taking notice instead of being in their own world.

[18:15] It's pretty remarkable, actually, the impact that it makes on a child to feel that connection. And then them be able to want to stretch out of lining the cars up into, you know, other ideas and stretching the play, imagining things, but wanting to do it together instead of are separate.

[18:37] Why is it so important? So if a child likes to line things up and you come in and you crash the car, right, for instance, why is that so important for that child to see that or experience that or imagine something different?

[18:51] Those aspects work on what's called motor planning, which is a subtype of sensory processing challenge. So motor planning requires that I have the idea of what to do. I can plan out what to do. And then I execute the motor action of that motor planning happens throughout adulthood, like childhood through adulthood. So you're driving to work and the roads closed. Like do we just we can't go to work now because the roads closed or can we problem solve and think about like, oh, I could take this road to get to that road to do something else. And so we don't get stuck or in that stress reaction of like, ah, like now I'm stuck and I'm just stuck forever, you know. And instead we can we can problem solve. But also relationships are what drive our interactions even into adulthood. Like we want to do things socially together because we find a lot of joy in it just as being a human. And so, people who may struggle with motor planning may become a little more isolated, may struggle with depression or anxiety and things. Not to say everybody, you know, with motor planning challenges will experience that. But it really does impact just life and our feeling of connectedness in life.

[20:18] Well, that makes sense. What else about DIR Floortime do you think that people should know about? Like what specifically is child led? It's helping to promote neurodiversity. It's affirming. Anything else you think would be important that people maybe don't know about it?

[20:35] DIR Floortime is essentially like the exact opposite of ABA programming, which is applied behavioral analysis programming. There's a lot of research that supports ABA programming. And within the last 10, 12 years, there's been a lot more research on DIR Floortime on reducing the levels of stress that parents of children with autism feel of cost effectiveness. Because instead of 20 to 30 hours of intervention in a week, that ABA might require we might be doing two or three hours in a week of DIR Floortime and passing those skills and interaction styles off to parents so they feel connected with their child at home as well. So you're lessening the amount of interaction or weekly interventions and it's more effective? Correct. Okay. So why are more people not doing that around here?

[21:43] That's an interesting question. Even a lot of providers locally here in South Dakota are not familiar with DIR Floortime. ABA research has a lot of, there's a lot of funds that are filtered into research and studying that and DIR Floortime being a bit newer. Newer meaning like 20 years, it's been around a long time, but not as long as ABA programming. So the funding for research isn't quite there, but there have been randomized control studies as well as systematic reviews throughout the last 12 years that do support its effectiveness. Okay.

[22:27] Tell me a little bit about behavior communication. Tell me, what does that mean when you hear the word behavior? Behavior is communication.

[22:36] Behaviors can be positive or negative, like me brushing my teeth this morning when I got up, that's obviously a positive behavior. And it's something that in a daily routine you don't really think about, but behaviors can be adaptive or they can be maladaptive. So depending on what's going on in the environment or the stimulus that you take in, starting to get a little uncomfortable on my chair, my body's wanting to shift positions a little bit more, I'm feeling that my body's doing something. So behavior is the act of doing something, whether it be positive or negative. One thing that I like to do is a lot of education for teachers and school districts, just because behaviors in a classroom can be so overwhelming. One teacher and potentially 25, 30 children.

[23:32] Hats off to all the teachers out there.

[23:34] Yeah, absolutely. Because I'm generally seeing one child at a time. I can't even imagine the load of 25 to 30 at a time. But when you're having those behaviors in classroom, like the child's struggling to sit in their chair, they're moving around, now that's causing a distraction to other children. But perhaps we could wonder about that child, maybe their posture control is delayed or not. They're not accurately engaging their posture system. And so now it's taking a lot of effort to stay in their desk or they're leaning, laying, lounging in their seat or circle time, they're now log rolling around or leaning on somebody else for support. So helping teachers understand and even parents understand like their child wants to do well. But there might be these underlying things that are occurring in their sensory system, in their nervous system, that's impacting the output or the behavior that we see.

[24:38] Well, and you think little kids, they're sitting in a class all day and they're like little kids, you know, and you're meant to move, our bodies are meant to move. So how much of that, like fidgeting and moving around and tapping your neighbor, how much of that do you help teachers or help us understand what's normal? And at what point do you say like maybe we need some intervention?

[25:04] Definitely. There is some normalcy and typical development like getting in people's space or stealing a toy from somebody. But that challenge is not getting better after the routine is established or when the sticker chart's not working, like the child's really motivated, wants the toy, but no matter how hard they try, they get derailed and they're just not, yeah, you know, we're not able to accomplish like mastering the ability to stay in our specified space or whatever the behavior might be, then definitely it's time for intervention or just assessment just to learn more about that child.

[25:47] Okay. All right. Let's talk about something most of us parents have seen or experienced, the Target meltdown. So tell us like the tantrum versus meltdown, is there a difference? And yeah, explain to us like what are we, you know, most of the time, especially young parents, you're like embarrassed, you're like trying to cover it up. What are we doing that's that's that we shouldn't be doing?

[26:10] That, I mean, it's a really great question because there is normalcy to, you know, like you have the two year old, the three year old, you know, they really want the candy or whatnot. And you're like, no, you, we got to eat supper, you know, whatever it is. And you see the meltdown happen or the tantrum happen. Meltdowns differ a little bit because they might last an extra amount of time. Bartering doesn't work like, well, if you do this, then we can get this. You know, there's a difference. Like, is it kind of that behavioral piece or is it truly like my nervous system so overwhelmed with all the lights and all the things I'm seeing and all the noises in this environment that like you can't even reason with the child. There's a difference within that. And then I would also say like age wise, you know, two year old, under two, three year old, sometimes like pretty typical that something like that could happen. But, you know, when we're five, six, you know, and that's still occurring, definitely intervention and support for that could be needed. I'd say the best thing anybody can do in that situation is provide compassion for the parent because it is like so overwhelming. And you're like, I've just like totally lost control of my child. What do I do? I mean, it's just kind of part of having, having a child of that age. And so knowing you're not alone and you are a good parent is important in that. But yeah, definitely if it's happening across lots of environments, it's pretty typical. Now you're avoiding taking your child anywhere. Those would be signs like, let's do an assessment and see what's happening.

[28:03] Yeah. What are the things that parents do that make it worse?

[28:08] I would say the thing I see most is even, even here in Move U is kind of the empty threat kind of thing. So like, if you do this, you're not going to get your juice or we're not going to go out to lunch or whatnot. And then when they leave, they're like, okay, let's go out to lunch. And it's like, no, no, you need to like follow through and be consistent with that. But unfortunately the child that does have sensory processing challenge, like no matter how hard they try, they're just going to get derailed more frequently than their peers.

[28:45] Yeah. So what do you do in that moment? If you're a parent, your child's having a complete meltdown, what's the best thing you can do?

[28:53] This is really tricky to do, but truly the best thing you can do is, you know, get to their level, not talk because we always want to fix it right away. And you always want to just like tell them things. But when our nervous systems overloaded and, and we're in this sympathetic nervous system state of fight or flight for children, their thinking part of their brain is no longer present. And so, you know, we have like our reptilian brainstem, we have our smart part of our brain on top of it. We flipped our lid now and we're, we're literally in our reptilian brainstem. So providing space, assuring safety, getting to their level and providing time are really the best things that you can do. Of course, depending on the environment, sometimes we just need to scoop them up and leave all the Target goodies in the cart at home. Yeah. Yep. All right. So is there anything you should be doing like later that night or, you know, if it happens again, like what, what are some things that you, what tips or tricks you would give to parents? So if it's, if it's a behavioral thing, the child should respond well to like that sticker chart or whatever, or actual follow through of, okay, we're going to go in the store. And if XYZ, then when we get back out, we get this, you know, or if it's a sticker chart, like, you know, we, we've made it like two days without one of those. And so then we get a reward and we gradually increase that, you know, what I have to accomplish to get a reward that's motivating for me for the child with sensory based challenges. Preparing the child first would be a benefit. So we're going somewhere new and different. Maybe you check out some photos like online, like, you know, what it might look like, what it might feel like there, what sounds we might hear, will it be loud or quiet? Will there be a lot of people there or, you know, will it just be us? So that preparation can be really great. Providing a schedule of events can reduce stress on a child who might have a hard time visualizing to the future, you know, like we're going to go here, then here, then here, and then to the park, you know, providing a visual schedule where they can see and you're reviewing that schedule will allow for them to know what to expect instead of this, like, all of a sudden it's there kind of thing. So preparedness, I would say, is like real key for those who, who do have sensory processing challenges. And these are things you help kind of parents and kids work through when they come here. Yeah, so Yeah, so some of these I would consider like band-aid strategies. Band-aid strategies meaning like they help in the moment, but they don't really solve the underlying challenge. Sensory processing challenges are an impact of, you know, I'm taking in the information from the world and either my nervous system decides not respond to it because it's not important, just like, you know, air conditioner comes on, I hear it, and after I've heard it a lot of times, I'm just like, oh, I don't need to pay attention to that. And so there's, there's truly like a nervous system challenge of misinterpreting the stimuli and that's causing behaviors or the emotional pieces or poor performance motor wise. And so we are able to actually address the underlying nervous system challenge and sensory based challenge, which then will just improve our outcomes and our participation versus always needing to do XYZ when it's going to a new place or, you know, those band-aid strategies. Right.

[33:02] So tell me what does a regulated child look like? A regulated child is, you know, we sometimes talk in like engine speed. So we might have like a too slow engine and too slow engine is not optimal for, for learning, for participating with our friends. Like it's real low, slow, sort of like Eeyore, you know, everything takes like so much effort or we might have a too fast engine where we're now we're sort of like, Tigger, like, you know, bouncing off the walls and also not great for learning. Pretty distracting might not be safe. But then we have an area in the middle called just right, or maybe even like a fun fast where we can follow the rules.

[33:48] We're able to listen to directions. We are keeping our body in our space and not maybe bulldozing peers. I can sit in my desk, you know, like regulated is being able to do sort of the expectation of that activity. How in a moment. Yeah.

[34:08] How important is it for parents to be regulated? Oh gosh. Yeah. Take, take us back to that like Target scenario, right? Like our child's freaking out like with this tantrum and now our engine systems also like our alertness is heightened and we're like sort of in this fight or flight too, because oh my gosh, we just tried to run in here really quick to do that. And it's so important because we're our children's safe person. And so if we're not regulated in our child, our child does feel that from us, then it's really tricky for them to also be regulated or feel safe and secure internally when we're not that. So it's really important as a parent and, and even as a provider, you know, sometimes in a session, not going how you expect. And it's really important to, you know, for yourself, like take your big deep breath or like pause or put some distance in between the activity and return like when we're better regulated.

[35:15] And that's not easy to do. I mean, you have to, as parents, kind of have to give them a little bit of a break because you think about like if your child is struggling and you're, it's, it's, that's stress for you, right? So if you're not taking care of yourself and able to be present and calm, it's not helpful for them to move through this or get, you know, you know, help help them, you know, navigate it well. Yes. Yeah. All right. I have a few statements I'm going to read to you. You can tell me what you think about these. Okay. Okay.

[35:45] All right. He's a boy. Boys talk late.

[35:48] Gosh, for fast responses, I'm not responding very fast to that. You know, sometimes there is a difference between boys and girls related to that. Some people develop their motor skills first, you know, and, and be really active. And maybe that comes a little later, but there is a range of in general, what's typical, you know, it's a pretty big range. Sometimes maybe the second child is a little delayed speech wise as compared to the first child, you know, cause now the first child's talking for the second child and like, no, she doesn't want that or whatever it is. But I would say if you're questioning it and if there's other children in, in your son's age group that are doing quite a bit more than doing the assessment and just learning and ways, ways that you might be able to impact speech at home would be really beneficial.

[36:51] All right. So therapy is only for kids with a diagnosis.

[36:56] Not true. We with Move U, we love to do a lot of community events. And even within our regular sessions, sometimes it's more like a wellness visit. Like a parent's not sure if their child's developmentally on track, like motor wise, you know, child's not crawling, but others are crawling already, you know, like just wondering like, what's the next step? What can I help my child with, with next? And so we don't even need a diagnosis and we don't even need to have like a current big challenge. We could just be curious, like, how do I support the development of my child? And that's, that's enough. That's enough to show up and make an appointment. So what about this one? A tantrum is manipulation. We're not talking adults here. Sometimes that can't be. What do you mean I can't have the shoes?

[37:52] Right? Yeah.

[37:54] I mean, that's, that's false. We just talked about tantrums quite a bit. It's communication. Sometimes it can be a pure behavioral kind of developmental appropriate thing that happens because I really want something and you just told me no, but other times that can occur out of stress or, you know, it's not a compliance thing. Really, it's more about, like, I don't know what else to do or I'm so overwhelmed in my nervous system. And the child can't think that, of course. And even as adults, we don't think like, oh my gosh, I'm so overwhelmed with my nervous system right now. But, you know, us finding things that do help with regulation. Like if I don't get my workout in in the morning, then my engine is like low and slow. And I feel like I don't show up well for my family or for my children. So we all have things that support our behavior and reduce the probability of a tantrum happening sensory wise.

[38:59] If you let a child lead the play, they won't get to what needs to get taught.

[39:05] Also, also false son on that. So child-led play doesn't mean that they just get to do everything exactly how they want to do it. But child-led play, if you notice behind this, there's just a lot of equipment out in the room and there's a lot of swing hooks all around this environment. And that's really meant to be sort of a canvas for for play to just happen. Things can be moved. Or if the child wants one of these swings behind me, you know, we can hang that up. And it becomes they want to do. Maybe they came in with a Mario shirt on and they love Mario. Well, let's play Mario World. Mario jumps to hit boxes or he might go in tunnels or he might, you know, throw turtle shells at people and we can use things in here to become that new symbolic play and thinking. But because the child's so motivated by, like, oh, yeah, I love Mario and I play Mario and we're in it together. Now we're stretching and I'm inserting things in play with artful vigilance to make it what their nervous system needs.

[40:16] So let's talk a little bit more about Move U the parents that should be calling you.

[40:22] What do you what do you most want parents to stop feeling guilty about?

[40:29] That the thing that I would say to not feel guilty about is blaming yourself, you know, like that it's a parenting thing because it's it's not sure there's things as a parent. I can improve on impatient all day long and you can bet when I go home with my own child. I'm not as patient with her as I am with the children I see. I see here. We as parents, we just blame ourselves a lot or maybe grandma comes in. It's like, well, if you did it this way, you know, it would work different. And I just want parents to know that oftentimes it's not how you're parenting. It's merely how our child is currently wired and responding to sensory information in the environment.

[41:21] So for those for those parents that are interested and want to do you guys take insurance? What is what does that look like in terms of a visit? Is it? Yeah, tell us a little bit about that. Move U is a hybrid clinic, meaning that we are a cash based practice, but also we're in network with Wellmark Blue Cross Blue Shield. And so if you if you have a Blue Cross Blue Shield insurance, chances are insurance will cover us in network depending on, you know, your insurance companies, your plan, if it's a high deductible copay plan, we also accept, you know, you can use HSA or flex flex spending. You can use those funds here. But also we offer cash based prices as well and packages that provide discounts for families that maybe have a high deductible insurance plan or are not in network with Blue Cross. I would say in previous environments, you know, taking lots of different insurances, sometimes places have to sort of inflate the cost per session in order to receive max reimbursement, or they might shorten how long your sessions are because the business gets more reimbursement for shorter sessions. Here at Move U, we have full one hour sessions as appropriate for for children. Maybe an infant might not be able to have an hour long session, but all of our sessions are generally one hour long, regardless of what is reimbursed for that because that is in our programming, what's most beneficial for kids. The other piece of it is because we're highly skilled, we're certified in sensory processing and integration and we're certified in DIR Floortime. A lot of times kids don't need to keep coming year after year after year to intervention, we can actually make a ton of headway in a short amount of time.

[43:27] So tell me what what does a typical interaction look like? They come in and get an assessment. You've mentioned the assessment a few times. How often would somebody tend to come here? You mentioned some are come multiple years or it might be months. Can you talk to about that a little bit? There bit? There there really is such a range of frequency for children that come to Move U, depending on perhaps underlying diagnoses, but also that assessment that we've talked about. Some children may come three times in a week, but maybe three times a week across like six to eight to 10 weeks, instead of one time per week for like the next year. And with that, when we can do increased frequency like that, we're giving the nervous system repetition and we're able to find those adaptive responses much, much quicker.

[44:24] So tell us where do people find you? Where are you located? How do they get in touch with you if they're interested and want to connect with you, Kristin? So Move U is we are our physical location is close to 57th and Louise here in Sioux Falls, 5020 South Tennis Lane. But also we we do provide therapy services at Sioux Falls Christian currently. And we also have a partnership with Primrose Preschool and Daycare as well. That's amazing. Well, thank you so much for talking us through all of the amazing things that you do through the DIR style therapy that you provide and all the good work that you're doing here at Move U for kids in this region and across Sioux Falls. Thank you. Thank you so much. Great to have you on the show.

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