At inclusive nursery school, 'the child is the star'
Photo of Jacqui and Roger at Play and Learn
By Louise Kinross
For Jacqui Zender, coming to work at Holland Bloorview's Play and Learn Nursery School during the pandemic shutdown felt like an oasis. "Once I got used to wearing a mask and glasses and goggles that fog up, the kids are still smiling and laughing and it's still all about the kids. The lightness in here, the lightness in their eyes, really does translate to us." Jacqui is a physiotherapist who came to Holland Bloorview 21 years ago and works at one of our two nursery schools in the community. We spoke about the joys and challenges of her work and what makes Play and Learn—which includes children with and without disabilities—unique.
BLOOM: How did you get into this field?
Jacqui Zender: When I was about five years old I had a neighbour who had a special school bus and special equipment and I was fascinated by him. I started to hang out at his house and play with him. I was mesmerized by all his unique needs. He was very smart and we became friends. I remember his mom saying 'You ask so many questions, I bet you'd be interested in being a physiotherapist.' I had no idea what a physiotherapist was then.
In Grade 6 a good friend of mine suddenly was unwell and at the hospital. I was in Montreal and she was at Montreal Children's and for the first time, I'd take public transport by myself downtown to visit her and accompany her to her physio sessions. I was so excited by the parallel bars and the walker and the orthotics. I could see how these assistive devices help people in their recovery or skill development. The therapy enthralled me.
A couple of years after that a mentor at summer camp who really understood me told me she was in physiotherapy school. I thought 'This is full circle. I need to be a physiotherapist.' At one time I wanted to be a pediatrician because I loved babies and children but I decided no, I want the hands-on creativity and continuity of care of physiotherapy. I don't want to just give clients an answer, I want to do it with them.
BLOOM: What is a typical day like?
Jacqui Zender: Generally I help with drop off and accompany a child to their classroom and then I go in and join in their play. If I'm working with a particular child on moving from sitting to standing, or learning how to move their body in space, I would join their play to try to enhance the skill that they need to practice.
I do functional assessments and a treatment plan and set goals with the family and team.
BLOOM: So what might be a way you help a child through play?
Jacqui Zender: Let's say a child is very distractible and as a result, they don't look where they're going and trip over their feet or fall into their peers. Before the child leaves the class to go to the gym, the occupational therapist and I might get their body warmed up by having them practise pushing and pulling, so they have more sensory awareness of their body in space.
Or maybe we'd practise squatting or little jumps on the floor, so the body knows where the floor is and can orient itself better in space. Maybe I would walk with the child. Or perhaps I'd suggest the child be at the front of the line with the early childhood educator. Or maybe we'd have the entire class walk down the hall and everyone touches the wall.
Let's say a child had trouble with balance or was very stiff in how they walk. Perhaps I'd suggest doing some animal walks on the way to the gym. 'Let's pretend we're elephants and take big, long, strong steps.' We'd get the whole group to do it, not just isolate one child.
Based on my assessments, I prescribe therapeutic interventions, which could be exercises or positioning or gross-motor skills, and the early childhood educators integrate this into the classroom programming. I collaborate with the rest of the team so that these activities happen organically in the classroom.
BLOOM: What is the biggest challenge?
Jacqui Zender: It's always time. That can be frustrating. You want to give the most time to all of the kids, and I never feel like I have enough time. I prioritize what's the most important thing for a particular child to succeed at school.
BLOOM: What's the greatest joy?
Jacqui Zender: Seeing the kids enjoy themselves and their happiness and comfort in the nursery school. The environment is so nurturing and so low-pressure on the kids that they feel like they're part of it: 'This is my school and I belong here.' Seeing the joy in their own successes is so rewarding for me.
BLOOM: What emotions come with the job?
Jacqui Zender: There's pride when I see the kids develop. Pride when they show little changes. There's pride in my team when the parents say 'Wow, my child is only here for 2 1/4 hours, but things can change so easily in this environment.' It's not effortless, but it looks effortless.
Everything here is done with a purpose. The classroom is set up so it's accessible to everybody. Staff understands how early childhood development works and how to make a goal gradually just a little bit harder so a child can achieve it. We know which children like which toys, so we may put a toy just out of reach, so they have to practise reaching or balancing on their tiptoes, or maybe they have to request the toy to practise their communication skills. Then we would reset the goal and make it just a little bit harder. It's about baby steps.
BLOOM: Do you do anything to manage stress?
Jacqui Zender: Yes. I do yoga. I exercise regularly and I talk to my team and my peers so that we all understand how hard this job is, especially during the pandemic, and we can support each other.
BLOOM: What qualities do you need to be good in your job?
Jacqui Zender: You need to have a sense of humour. You need to be very flexible and adaptable to whatever gets thrown at you. You have to have good therapy skills. Let's say I planned to do something with one little guy based on the last time I worked with him, but today is a difficult day for him and it's not a good day to see him. So I'll see someone else. You might look like you're flying by the seat of your pants, but you have your toolbox and you dig in and you find something else that's appropriate and relevant for another child. It needs to fit into the schedule of the classroom, without interfering or interrupting. I have to augment what's already happening in the room. That's a skill that I'm still working on and I learn from nursery school staff every single day.
BLOOM: What have you learned from the families?
Jacqui Zender: They really are the experts of their children.
BLOOM: If you could change one thing about children's rehab, what would it be?
Jacqui Zender: Sometimes for parents there are so many different specialists they have to keep in touch with and so many different medical terms to learn. I wish we could make it less overwhelming for parents and I'm not sure how that would work. I feel our nursery school is a start because we're one-stop shopping. Parents will say to me 'You mean my child gets occupational therapy, speech therapy and physiotherapy in one spot, and there's no extra charge?' It reduces that sense of being overwhelmed.
BLOOM: Is there anything I didn't ask that you wanted to speak about?
Jacqui Zender: I feel that this is such a unique place on the planet. The focus is on the child. The child is the star, and in our place, the child feels like the star. We're trying to build confidence, build skills. We all do that together and changes happen because children feel so good about themselves.
To give you an example. I'm a parent, and I know parents tell their kids 'No, don't touch that.' Here at Play and Learn we use affirmational language. We don't say 'Keep your hands off Johnny's bowl.' We say 'Please hold your own bowl, it's blue. Johnny's is red.' It's positive language.
You see the kids grow. They look much more confident when they leave us compared to when they come in. We instill in them this 'You can do it' and 'I'll help you' and 'Let's try together.' It's a little slice of paradise for these kids' lives.
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