Monthly Archives: December 2017

New Baby? Exhausted? Try The 5 S’s To Pull Things Together

 

 

annie-spratt-178364New parents are often shocked at how tired they are.  After all, newborns don’t DO much.  They eat, sleep, pee and poop, and that is about it.  But they do it around the clock and they aren’t very experienced with any of it.  Dr. Karp’s 5 S’s can help all of you learn more and get some sleep.

Not because the 5 s’s give babies exactly what they had in the womb.  They do, but what swaddling, swinging, sucking, etc provide is a roadmap for how baby nervous systems work.  Once you know that babies need this, not that, you feel more in control of the situation and you can relax.  And babies that have been calmed down faster and more effectively feel that you get them, you really get them.  They sense that their parents can help them better than their aunties and neighbors.  Feeing understood starts here.

 

colin-maynard-231363

When babies stop crying faster sleep an hour or so longer (yes, doing the 5 S’s can do that!) and eat/nurse more easily, life is less exhausting.  Not completely a day at the beach, but not as tough as it was before.  For more information, take a look at Help Your Newborn Adjust to Daycare By Using Happiest Baby on the Block Strategies and Why Some Newborns Look Like They Hate To Be Swaddled.

Wishing all you new parents a wonderful first year!!!

Advertisements

Stop The Whining With The Fast Food Rule

conner-baker-480775

Whining is a “fingernails on a chalkboard” experience for most adults.  We often give in to a whining child, just to avoid hearing that noise.  Or we explode and scare them (and ourselves) with the anger that whining can trigger.  What can you do?

What would you say if I told you that I use a technique that works more than 50% of the time, and it can work in mere seconds to halt a child in mid-whine? Well, read on and let me tell you the secrets that I learned from Dr. Harvey Karp and his Happiest Toddler on the Block book!

I spend more than 75% of my treatment day as an occupational therapist with children under the age of 6.  That can add up to a lot of whining!  Why?  Not because I am inexperienced, or because I am a pushover.  Anyone that knows me knows that neither statement is true.  It’s because young children may be able to talk, but they aren’t very good communicators.  Being able to express their feelings effectively and negotiate their desires is just beyond their pay grade at this age.  Their default is whining.

Dr. Karp’s Fast Food Rule has made my job so much easier. It makes young children see me as a friend, not just another adult telling them what to do.  This one simple strategy lets kids know that I care about how they feel, but doesn’t suggest that they will get their way with me every time.  In fact, they often find themselves following my directions without fully knowing why they have stopped crying, begging, or pleading with me.

Here is what the FFR entails:

Part 1:  Repeating what you believe is your child’s complaint or desire, using simple words, short phrases and more emotional tone and gestures/facial expression than usual.  You may not know for sure what a very young child wants, but take your best guess.  If you are wrong, you can always give it another try.  The more upset or younger the child, the simpler the wording and the more expressive the tone and gestures.  Why?  Because emotional people don’t hear you well, but they will pick up on your non-verbal cues effectively.  You are trying to convey a simple message:  I understand you.

Part 2:  Only after you see that your child has calmed a bit with the knowledge that they are understood can you then begin to comfort, negotiate, or solve their problem.  Not before. We jump in very early in the interaction to tell them “It’s OK, honey” or “I can’t hear you when you speak to me like that”.  It’s only when they know you have heard THEM that they can listen to YOU.

The importance of being understood by another when you are upset cannot be overstated.  Children need this from us more than we know.  Even young toddlers are aware that they won’t always get what they want, but they need to know that we understand their point of view.  If you do not convey this message, a child will whine, wail or scream to make it clearer to you that they are upset.  That is why telling them that things are fine seems to throw oil on the fire.  They think you don’t get it.

So, help them pull it together by stating their situation (as you perceive it) out loud and using some non-verbal messaging:  I got it.  You want more cookies.  You don’t want to leave the park.  You want Logan’s truck.  Whatever it is, tell them that you understand before you offer a solution, an alternative, or explain why they aren’t getting what they want.  I promise you, it will work more often than it does not, and sometimes it will work so well that you almost cannot believe how simple it was to calm things down.

There is a secret benefit from using the FFR:  your child will gradually become less likely to break out in a whine even when things have gone badly.  After repeated experiences of being understood and treated with respect and firmness, a child will expect that you are the source of solutions instead of a dumping ground for agitation and anger.

 

janko-ferlic-153521

 

Hypermobile Kids, Sleep, And The Hidden Problem With Blankets

 

annie-spratt-467871

Everyone knows that sleep is important.  Research in sleep science (yes, that is a thing) tells us that our brains are working to digest the day’s learning, the immune system is active during sleep, and our bodies are repairing and renewing tissues and organs while we slumber.  As much as we need sleep, kids need it more.  They are building the brains and bodies they will carry into their future.  Children need good quality sleep as much as they need healthy food.

Helping children to sleep well is usually a combination of creating good and consistent bedtime routines, giving them a full day of physical action and warm social interaction, and developing a healthy sleep environment.  This means providing a sleep-positive environment and removing any barriers to sleeping well.  But giving kids the chance to get a good night’s sleep can be harder when a child has hypermobility.

Some of the challenges to sleep are sensory-based, and some are orthopedic.  Here are a few things that make sleep more challenging for these kids:

  • Children with limited proprioception and kinesthesia due to low tone or excessive joint mobility can have difficulty shifting down into a quiet state for sleep.  They spend their day seeking sensory input;  not moving reduces the sensory information that makes them feel calm and organized.  To understand more about the sensory concerns of hypermobility, take a look at Hypermobility and Proprioception: Why Loose Joints Create Sensory Processing Problems for Children.
  • Some hypermobile kids have joint or muscle pain that keeps them up or wakes them up.
  • Hypermobile kids can get arms and legs caught in their bedclothes or between crib slats and mattresses.  Any layer can be a potential problem, from the top sheet to the decorative afghan that Granny sent for his birthday.
  • Limbs can slide off the mattress during deep sleep and create strain on ligaments and tendons.   You and I depend on our brain to perceive an awkward position and take corrective action.  The same child who “w” sits and slides off a chair without noticing is not going to wake up when her arm is hanging off the bed during sleep, even though the tissues are stretching beyond their typical range of motion.

Here are some simple strategies that may improve your child’s sleep:

  • Try a duvet or a flannel sheet set to minimize the number of layers of bedclothes.
  • Use a rashguard suit instead of pajamas.  I am particularly fond of the zip-front style so that less force is needed to get arms in and out while dressing.  You can peel it off more easily.  The lycra creates sensory feedback that can support body awareness while keeping them cozy.  An all-in-one suit also gives a bit of support so that limbs don’t easily overstretch.  A little bit of proprioceptive input in a breathable fabric that can also generate a bit of neutral warmth (from body heat) to keep tissues from getting too stiff.
  • Avoid footie sleepers that are too short.  Too-small footie sleepers create compressive forces on joints and could even encourage spinal torque.  Hypermobile kids will be the last ones to complain since they often don’t feel discomfort right away.  My preference is not to use these sleepers at all with hypermobile kids or kids with low tone.  See the next suggestion for another reason why I feel this way.
  • Make them take off those footie sleepers when they wake up and walk around.  As fabric twists and children stand/walk on the fabric, not the soles, it creates a safety risk underfoot.  Less sensory feedback and slippery soles!!  Get them dressed once they wake up.
  • Carefully consider weighted blankets.  Originally sold for kids on the autistic spectrum and for kids with sensory processing disorders without muscle or orthopedic issues, these blankets have become popular with other groups.  The biggest concern is that placing weight (meaning force) on an unstable joint over time without conscious awareness or adult control is a safety issue.  It is possible to create ligament injury or even subluxation of a joint, depending on limb position and the amount of force placed on a joint.  Talk this one over with your OTR or PT before you order one of these blankets.
  • Consider aromatherapy, gentle massage, white noise machines, and other gentler sleep strategies to help your child sleep well.  For kids who sleep well but wake up stiff, learn how to use gentle massage and possibly heat to help them get going.
  • Try K-Taping or Hip Helpers for stability.  Kineseotape stays on for days and gives joint support and sensory input while your child sleeps.  Hip Helpers are snug lycra bike shorts that limit extreme hip abduction for the littlest kids  (legs rotate out to the sides excessively).  They gently help your child align hip joints correctly.  As with weighted blankets, I strongly recommend consulting with your therapists to learn about how to use both of these strategies.  When used incorrectly, both can create more problems for your child.

 

sean-wells-471209

Potty Training Boys: Do You Teach Standing Up Or Sitting Down?

 

darran-shen-477150.jpgTraining children for bladder control before bowel control is often easier for quite a few reasons:  More frequent bathroom trips = more opportunities for success, digestion and diet issues don’t stall success,  and urination is usually a painless, phobia-free, and quick experience.  In general, families that hire me as a consultant are encouraged to consider bladder training to be the first mountain to conquer.

But should little boys sit or stand to do the deal?  After a child has been sitting on the potty, understands it’s use, and has consistent success, I will encourage parents to have their sons stand to urinate.  But it isn’t as simple as that.  There are pros and cons.

First, the pros of standing to urinate:

  • little boys have probably seen their brothers, cousins and dad use the toilet, and most children want to copy their same-gender parent.  This is often more motivation to become independent in the bathroom.
  • young children may be a little more mindful of why they are standing in front of the toilet.  Children that are sitting have a harder time seeing what is happening and can get distracted. I know, I know, even the “big boys” can have terrible aim.  But children need all the help they can get to stay focused.
  • improving aim is motivation to use the toilet.  I wrote a blog post on using targets to teach boys to improve their accuracy and build interest in toileting.Piddlers Make Potty Training Fun!  These really work!

And now the cons:

  • See the item about distractibility under “pros”.  Some boys are so distracted that sitting on an toilet seat insert with a splash guard is the only way to prevent spraying the bathroom and any supervising adult.
  • Some children will start out urinating and begin to have a bowel movement concurrently.  Oops!  These children often have issues with low tone or digestive problems, and cannot “hold it” long enough to finish urinating and then sit on the toilet to have a bowel movement.  If they have an accident, it could be very upsetting to them and make them less eager to be fully trained.
  • Children with low muscle tone or postural stability issues may need to sit to achieve a safe and stable position.  No one can eliminate when they are unsteady or fearful.

Some children are vocal and clearly tell you what they want to do and why.  Some cannot or will not communicate, but you can figure out what they are thinking.  Some need to be encouraged to give standing a try.  If your son was initially interested and now has lost some of his enthusiasm and is still sitting to urinate, try telling him that it is time to stand like the big guys and see if you can regain some of your momentum in toilet training!

For more information on toilet training children with low muscle tone, check out my other posts such as   Low Tone and Toilet Training: The 4 Types of Training Readiness   as well as my useful e-book.  Here is a post that explains why this unique book will help you move forward with training right away! The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

chris-benson-459919

How To Stop Your Baby From Throwing Things (Most of the Time!)

donna-410624

 

After the adorable infant period of dropping objects from the high chair to see you scoop them up, most children devolve into a throwing stage.  Commonly seen at the 11-16 month developmental level, this is different behavior but it can be just as maddening.  Maybe more.  Today, I am going to give you both an explanation and a possible solution.

Instead of learning about physics (gee, things always go straight down to the floor!) or social communication (I can get Mommy to do what I want!), this phase isn’t experimental or interactive.  Your baby is releasing something they don’t want any longer and probably reaching for something else that they see.  So they throw the object in their hand off to the side.  They don’t watch it roll and they don’t expect you to go get it.  They look like a crazed shopper, searching through a bin to find the correct size and color before someone else gets it!  Telling them to place it nicely on the floor in front of them doesn’t usually work, and telling them that they are making a mess doesn’t either.

My solution?  Give them a container.  

Container play is a developmental milestone, and they are likely approaching or fully in that stage of cognitive and motor learning.  Younger kids need bigger containers, older ones will like smaller containers.  Novelty could work for you, as could sound.  I had a family empty their Tinkertoy container because it was a tall cylinder with a metal base.  When a plastic object fell in, it made a satisfying noise.  Their baby was entranced.  She couldn’t wait to put things inside to hear the sound!  Show your child how to place things inside, and cheer even the sloppiest attempts.

If your child is clearly throwing things to get your attention, or throwing in anger, this isn’t the solution to those behaviors.  You might want to read Address A Child’s Defiance Without Crushing Their Spirit  or Discipline and Toddlers: What Do You Say if You Don’t Want to Constantly Say “No”?.

In my work as a pediatric OT and doing consultations with families of young children, I know that much of the puzzling and frustrating behavior at this age is simply a disconnect between exploration and expectations.  When you can see life through a child’s eyes, often a solution becomes evident.  Good luck turning tossing toys into container play!

janko-ferlic-484122

Automoblox: For the Discriminating Preschool Gearhead

t171_44e77fcc242838b4c438161d632a9637.jpg

 

 

t171_eddc75ca17a517cbfe590a5a47e090e9.jpg

These cars and trucks are so well crafted and have such sophisticated styling that they even impress adults.  They certainly have made me a big fan!

Automoblox are small vehicles that your 3-6 year-old child assembles by themselves or with some initial help.  They have small pieces, so they are not for children that casually put objects in their mouths.  They are harder than Duplo LEGOs to assemble, but easier than those standard and tiny LEGO pieces, and require far fewer parts to complete a vehicle.  So many younger kids want to be able to make a LEGO set by themselves, but get discouraged when they need so much help. They are in tears when their car falls apart because they didn’t have the ability to hold and manipulate the delicate LEGO vehicle with the necessary control.  Enter automoblox!

As a pediatric OT, I am often asked for advice on toys for holidays and birthdays.  These beautiful cars and trucks make terrific (if somewhat pricey) gifts for kids that may not be into arts-and-crafts but need to spend some time building visual-motor integration.  To assemble each vehicle, a child is required to use both hands in a skilled manner and use a refined grasp pattern.  Children don’t need significant strength for assembly, and most will learn the basic construction sequence quickly.

The pieces are mostly interchangeable between vehicles, meaning that although some wheels will only fit the car bases in their specific collection,  they do allow creative builders to experiment with new designs.

Parents who want to minimize the amount of plastic in their homes will be happy to know that the chassis are wood and some of the components are metal as well.  These cars roll very smoothly, and they stick together even after being crashed into walls, furniture and each other.  They can handle the rough play the average preschooler will dish out.

Take a look at automoblox this holiday season.  Your little gearhead (and probably dads and older siblings) will be thrilled to play with them!