Category Archives: behavior issues

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.

 

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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!!!

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Stop The Whining With The Fast Food Rule

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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.

 

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

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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!

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Holidays Hints For Sensitive Kids

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The stores are full, your inbox is too, and you are wondering how to handle your sensitive child’s reactions to family and school events.  You are not alone.

Everyone knows about the “holiday blues”, where our dreams and expectations come up against real life:  awkward family relationships, conflicting demands on our time and finances, etc.  But for kids with sensory and emotional sensitivity (I don’t see these as always separate issues, by the way), surviving the holiday season can be very difficult indeed.  The excitement and the novelty of the holidays affect them more intensely and are not always welcome additions to their days.   Here are some suggestions to make things better:

  • Think about an event before you commit to it.  The hour of the day, the size and the activity, the duration of the event are all considerations.  You know your child, so you can identify what factors will be the most challenging and what will be easier to handle.  In general, sensitive kids do best with smaller, shorter, quieter and earlier events.
  • Create your own event around your child, and invite others to join in.  When you get to design it, you have more control over how things play out.  Some suggestions would be cookie decorating, visiting a nursery or outdoor holiday display, making wrapping paper with crayons and stickers, and watching a holiday video party.
  • Get your sensory diet activities all set up for an event that you can’t or won’t cancel. Your OT should be able to help you craft a plan to reduce your child’s overall sensitivity with input such as deep pressure, breath control, tactile input, etc.  Just ask.  Most of us would be happy to help you.
  • Do not forget the basics of keeping any child calm at an event:  enough sleep, enough to eat and drink, and being healthy enough to participate.  If your child is ill, tired, or hungry, you need to think carefully about how well he will manage, and make the decision to cancel or alter your plans.   Sometimes the situation isn’t going to be fixed with a few bounces on a therapy ball and some joint compression.  In these situations, your child isn’t any different from any other child.

 

If you are looking for ideas about how to decrease sensitivity, take a look at How to Help Sensitive Kids Handle Greeting People (Including Their Own Parents!) and Sensory Sensitivity In Toddlers: Why Responding Differently to “Yucky!” Will Help Your Child

Holidays can be fun for everyone, including sensitive children.  Plan well, be flexible, and make thoughtful choices that work for your family!

OT and Non-Disabled Gifted Children

I was asked to write another guest post for Therapro, the fantastic OT equipment and materials company that I have been using for clinic and home items for years.  This time the subject is gifted children:  Do Gifted But Non-Disabled Children Need Occupational Therapy?.

The first time you encounter a young gifted child, you may not know that their advanced skills could be contributing to their behavior.  Giftedness is more than advanced intellectual ability, it is a whole-brain difference.  The fMRI studies done in the last decades have proved that to be true.  Gifted kids can have sensory and behavioral responses that suggest they have ADHD, oppositional disorder, or sensory processing disorder.  Some are conclusively “twice-exceptional” , but many are just responding to a brain that is wired for intense and complex interactions.  Schools are geared to routines and benchmarks.  Let the problems commence!

Occupational therapy has always been focused on helping people achieve their best lives.  Having abilities that are on the far sides of any bell curve can make life harder, so my take is that occupational therapists can be helpful to kids that are struggling because of their talents and gifts, not just due to delays and deficits.

Read my post, then tell me about your gifted child, or the gifted children that you have seen as a therapist or teacher.  They really are interesting kids in so many ways!

Gifted Or Disordered? The Unrecognized Behavioral Traits of Young Gifted Children

 

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Here is a short list of many common behavioral characteristics of gifted children:

  1. Spontaneous. 
  2. Boundless enthusiasm.
  3. Intense focus on passions.  
  4. Highly energetic.  This is the child who doesn’t seem to need as much sleep or downtime as peers.
  5. Constantly asking questions.  Constantly.
  6. Insatiably curious.  Everything is interesting, all the time.
  7. Impulsive, eager and spirited.  Novelty is a total turn-on, not to be feared.
  8. Persistent and goal-directed in areas that are important to them.
  9. Very easily frustrated, especially when they are unable to meet their own standards.
  10. Volatile temper when perceiving that they have failed.
  11. Chatty; absolutely a non-stop talker.

So…now are you excited to parent a gifted child, or to have one in your class or in your therapy clinic?  Or are you thinking “This sounds more like a child with learning problems, not gifts, and it sounds even be more like a child with autism”.    Or even “Children like these could be really annoying”.  Well, you aren’t alone.  Many of these characteristics exhaust adults, and create difficulties when gifted children try to navigate the world of typical kids and adults.  They may be 5-10% of the population, but they can be the source of 80% of the excitement in your home, class or clinic.  And they are often misdiagnosed as troubled rather than talented, just based on their behavior.

Welcome to the world of the gifted and those who interact with them.  It isn’t all sparkling conversation and shining rows of chess/debate medals.  Gifted children that have many or most of these characteristics may also be amazingly sensitive to others, the world around them, and to their own inner experiences.  That combination of behavior and sensitivity makes for some intense and often exhausting interactions that others find irritating or worse.   It really is the gift that keeps on giving.  And we aren’t even talking about the twice exceptional children. These children have diagnosable difficulties with learning, behavior, movement and sensory processing in addition to their gifted qualities.  They often wait years before clinicians parse out which is which.

So how could you know if the child in front of you is actually gifted, other than a psychologist’s tests?  And even if you know you have a certified smartypants, how can you determine whether their behavior is typical for gifted people or a sign of a disorder?  The answer could be to assess the quality of their behavior while looking at the level of cognition, the complexity of the conversation and the emotional depth and intensity of the interaction when compared to their age.

A three-year old that can eagerly exchange ideas regarding how tornados differ from hurricanes in their potential for damage and their source of power for 10 minutes is exhibiting a level of comprehension, intensity, curiosity, persistence and enthusiasm that you don’t typically see in this age group.   His ability to string together concepts, retain and analyze information,  respond to your own perspective and tune into your emotional tone during the discussion gives you clues that this is a gifted child, not a child with attention issues or autism.

A five year-old that paints and re-paints a picture until the colors and shapes express exactly how happy she was at the zoo may also be showing you some of these characteristics.   Her frustrated insistence on a complete representation of form and emotion, as well as her unique use of media are telling you a lot about her talents.  If you are amazed that all this focus doesn’t tire her out but energizes her more; there’s another clue.  The depth of her joy she has while creating or when opening a box of new pastels, like Christmas has come again, is another hint that she may be gifted.

When a child’s asynchronous development gets in the way, a gifted child can struggle.  Most gifted children aren’t gifted in every area of development, so a gifted artist may not be able to physically draw what she sees in her mind, a gifted writer may not be able to write his book legibly at 6, and a gifted athlete may not be able to handle her team losing.  That is where wise adults can provide strong support and education in managing their talents and explaining their struggles to gifted children.

I am frequently asked as an OT for ideas on how to manage gifted toddlers in class and at home, and I wrote a short post earlier this year in response Gifted at Preschool: How to Support The Young Gifted Child In Class.  For suggestions on how to make life easier at home, my suggestions focus more on building sensory and emotional tolerance for kids, and teaching self-awareness and self-calming skills.

If your child receives OT for any reason, this may be a place to start.  Check out this post for more information:  How Occupational Therapy Can Help Gifted Children (And Their Exhausted Parents!)  Occupational therapists that can see the difference between gifted traits and symptoms of an attentional or learning disorder can help parents on this amazing journey of discovery with their gifted child.

Halloween Fun When Kids Don’t or Can’t Trick-Or-Treat

 

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Kids big and little are anticipating Halloween, but this holiday isn’t always enjoyable for children with ASD, SPD, anxiety or motor issues.  Putting on a costume can be difficult for some kids to tolerate and nearly impossible for kids that have mobility issues.  Kids with endurance and mobility issues struggle to walk up to a front door and ring the bell, but they don’t want to be carried “like a baby”.  Even seeing other children in costume or decorations in their own home can be difficult for children that are very sensitive.

What begins as a celebration and an adventure becomes a minefield.  And yet, your child may be invited to participate in many Halloween events.  You may want to have a party in your own home.  Your child may even beg to be involved in things you know they will end up hating, not realizing the challenges ahead.  Inclusion is a murky pond for some kids.

Perhaps it doesn’t have to be so difficult.  Here are a few ideas that could make this holiday less stressful and more inclusive:

  • Costumes can be anything you want them to be.  Purchased costumes can be adapted or altered for comfort and tolerance.  If you have a child with tactile sensitivity, choosing the fabric that is less irritating is worth a trip to a brick-and-mortar store, or ordering multiple sets online with easy returns.  Instead of an eye patch for a pirate, you can use makeup to create one.  Princess skirts and Batman pants can be shortened to prevent tripping.  They can be bought larger and altered to allow for braces and for sitting in a wheelchair.  Hats and headpieces are optional, and can also be switched out for more wearable choices.  They can be purchased separately or by combining two costumes.  A comfortable costume is fun; an awkward costume will cost you in time, pain and struggle much more than you can imagine.
  • Trick-or-treat is over-rated.  Choose people your child knows, a neighborhood that has flat, accessible front steps, or even an apartment building with an elevator.  The experience of trick-or-treat doesn’t have to be a marathon to be fun: in fact, “fun” is the opposite of dragging stressed children around from house to house.  Remember that children with sensory modulation issues will start out excited and happy and become overwhelmed quickly.  Monitoring and planning for this helps both of you have fun that doesn’t end badly.
  • Many children with sensitivities need to practice wearing their costume until it becomes familiar.  They may protest and initially refuse, but some practice can really help them.  Make the run-through more fun by pairing it with something like watching a halloween movie at home or putting up decorations.  The child that refuses to wear a costume can become the child who doesn’t want to take it off!
  • Choose your home decorations with your child’s tolerance in mind.  It isn’t always about whether they are scary or not, it can be the brightness, the amount of movement or the sounds that overwhelm children.  You won’t always know what will be too much, so prepare yourself and the rest of the family that you may have to substitute/remove/repurpose things that don’t work out.
  • Do fun events that your child can handle.  Bake cookies, including the buy-and-bake-off cookies that don’t require a lot of effort or time.  The end product can be given to friends and family proudly.  Decorate a Halloween cookie house.  Put up cling-on decorations in windows and storm doors that are easy to remove if they become an issue.  Watch a fun movie at home and invite friends to dress up and come over for the show.

Holidays for kids with special needs take more thought, but they don’t have to be less fun, just a bit different.  The important concept is to consider your child’s needs and aim for the essential feelings of the holiday:  fun, and sharing the fun with others!