Category Archives: behavior issues

Toilet Training For Preschool And Stuck in Neutral? Here’s Why…..

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Many of my clients are in a rush to get their kid trained in the next few weeks for school. They have been making some headway over the summer, but things can stall out half-way through.  Here are some common reasons (but probably not all of them) why kids hit a plateau:

  1. They lose that initial boost of excitement in achieving a “big kid” milestone.  Using the potty isn’t an accomplishment now, it is just a chore.
  2. Parents and caregivers aren’t able to keep up the emotional rewards they need.  It is hard to be as excited about the 10th poop in the potty as the first time.
  3. The rewards used aren’t rewarding anymore.  A sticker or a candy might not be enough to pull someone away from Paw Patrol.
  4. An episode of constipation or any other negative physical experience has them worried.  Even a little bit of difficulty can discourage a toddler.
  5. Too many accidents or not enough of a result when they are really trying can also discourage a child.
  6. Using the potty is now a power play.  Some kids need to feel in control, and foiling a parent’s goal of toileting gives them the feeling that they are the ones running the show.  “I won’t” feels so much better than “I did it” for these kids.
  7. Their clothes are a barrier.  When some families start training, it is in the buff or with just underwear.  Easy to make it to the potty in time.  With clothes on, especially with button-top pants or long shirts, it can be a race to get undressed before things “happen”.
  8. They haven’t been taught the whole process.  “Making” is so much more than eliminating.  Check out How To Teach Your Child To Wipe “Back There” and The Ten Most Common Mistakes Parents Make During Toilet Training for some ideas on how to teach the whole enchilada.

Should you pause training? The answer is not always to take a break.  I know it sounds appealing to both adults and kids, but saying that this isn’t important any longer has a serious downside.  If your child has had some success, you can keep going but change some of your approaches so that they don’t get discouraged or disinterested.  If your child really wasn’t physically or cognitively ready, those are good reasons to regroup.  But most typically-developing kids over 2 are neurologically OK for training.  They may need to develop some other skills to deal with the bumps in the road that come along for just about every child.

Sometimes addressing each one of these issues will move training to the next level quickly!  Take a look at this list and see if you can pick out a few that look like the biggest barriers, and hack away at them today!

For kids with low muscle tone, including kids with ASD and SPD, take a look at my e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone.  Read Why Low Muscle Tone Creates More Toilet Training Struggles for Toddlers (and Parents!) to understand why I wrote this book just for you!   

I give parents clear readiness guidelines and tips on everything from the best equipment, the best way to handle fading rewards, to using the potty outside of your home.  It also includes an entire chapter on overcoming these bumps in the road! To learn more about what my e-book can do for you, read The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

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Calm Your Toddler By Using “Tummy Time” for Emotional Modulation

 

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You don’t have to offer your child a tablet.  Try a book or a sticker activity instead!

Yes, tummy time.  It isn’t just for babies anymore.

Why?  Because occupational therapists know that the physical effects of working against gravity to push one’s head and shoulders up, and the firmness and warmth of contact with the floor are also sensory-based modulation strategies.  What helps babies build core control can also calm upset or disorganized toddlers and older kids.

The decrease in visual input can improve calmness and attention for those kids whose eyes dart everywhere.  Not everyone can handle a visual stimulating room.  Some children need more vestibular input to reorganize, but some do better with the stillness of “tummy time”.

How long do they need to be on their stomachs for this to work?  It depends.  Probably more than a few minutes, but if you haven’t seen signs of better modulation (better eye contact, slower breathing, more communication, less agitation) then you might need to layer on another technique  Help Your Child Develop Self-Regulation With Happiest Toddler On The Block or the Wilbarger Protocol Can You Use The Wilbarger Protocol With Kids That Have Ehlers-Danlos Syndrome?.

Having trouble convincing your child to lie on their belly?  Join them, or get a sibling to model it.  Make a special new book collection for tummy time, and only have it available at that time.  Get a tent, and add the effects of an enclosed space to tummy time to make it more deeply calming.

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Is Your Gifted Child A “Troublemaker”?

 

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When you hear hoofbeats, maybe you SHOULD think zebras and not horses!

Gifted and talented children are frequently leaders in their schools and communities.  They often have advanced language skills and display an early and intense sense of humor. Gifted children can be the funny, outgoing, energetic kids who have deep empathy and abundant warmth.  Wondering if your young child might be gifted?  Read How To Spot A Gifted Child In Your Preschool Class (Or Your Living Room!).

But being gifted isn’t all rainbows and first place ribbons.  Some aspects of being gifted contribute to styles of interaction with authorities and peers that are not a cause for celebration. Gifted kids can be perceived as causing trouble, creating conflict and disrupting things wherever they go.  Super-bright children might end up with this label for the following common behaviors and characteristics:

  • They resist many rules as limiting and irrelevant.  “Because that’s the way it’s done” is not accepted when a gifted child sees the rule as useless or worse: illogical.
  • Boredom with class material they have already mastered gets expressed as anger or  criticism.
  • Their unique interests mean that they may reject their peer’s play schemes and try to convince their friends to play games their way or else.
  • They talk.  A lot.  At times, they may take over a discussion or attempt to alter a teacher’s presentation to address related issues or get more in-depth about a topic.  They may not be able to let a topic go until they have asked every question and made every point that they find important.
  • The frequent sensitivity of gifted children might make a normal level of noise, light or interaction too stimulating, and younger children especially will react in frustration or even tantrums.
  • Your gifted child may be having difficulty with an area of development that has been masked by their talents.  Gifted and Struggling? Meet the Twice Exceptional Student and How OT Can Help A common example would be the gifted child who is struggling with dyslexia, but has been able to use powerful memory and logic to fill in the blanks in a story.  They may not have read the book, but they are able to recall enough of the teacher’s description or the cover’s blurb to “fake it”.  The resulting failure and frustration, even with high overall test scores, builds their resentment and avoidance.

What can you do to transform a gifted troublemaker into your family’s champion or star?

  • The first step is to recognize where the ‘trouble” is coming from.  Your child’s early developmental skills and rapid acquisition of new information could be fueling their behavior.  Seen through this lens, many of the frustrating reactions and interactions with gifted children become understandable.
  • Explore ways to create a more enriched environment for your child.  It doesn’t have to be classes and microscope sets.  It could be more trips to the library or more craft materials to allow all that creativity to be expressed.  Children that are fulfilled are less crabby, less demanding and less resistant.
  • Be willing to take the time to answer questions and discuss the origins of rules.  A rule that is in place for safety can be accepted if it is explained.  A rule about social behavior, such as allowing everyone to have a turn in order, is an important lesson in navigating a world in which the kids with the fastest brains aren’t always the ones who get the first turn.
  • Consider the possibility that your gifted troublemaker is “twice exceptional”.  There may be issues like dyslexia or sensory processing disorder that need to be addressed.  Other issues don’t have to be cognitive.  Your child may be struggling with anxiety or coordination.  Giftedness doesn’t discriminate or remove all challenges to learning.  But remember that these do not minimize their profound gifts in other areas.  They complicate them.
  • Share your awareness of their gifts with them.  Kids who know that their frustrations and responses have a source other than being a difficult person have higher self esteem.  A gifted kid who thinks badly about themselves?  Yes, it does happen.  Feeling different from their friends, knowing that their ideas aren’t always welcomed, being told to be quiet and go along with the flow.  All of these can make a gifted child question themselves.  When you explain that their brain works differently, and that you will help them navigate situations successfully, your support can make a tremendous difference!

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Is Compulsive Gaming A Disorder…Or A Symptom?

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The WHO has recently classified compulsive gaming a mental illness.  I am not so sure.  What I do believe is that doing anything compulsively is a big problem for developing brains.  Is your child heading in the direction of using gaming or web surfing to deal with issues such as social anxiety or poor executive function skills?  Here is what you should be thinking about when you see your young child screaming because you have unplugged them from their tablet (or your phone, or your tablet):

  1. Have you (unintentionally) modeled this behavior for them?  I  don’t know any adult that isn’t tethered to their phone.  Whether for business or to keep track of where their spouse or children are/what they are doing, most of us have a phone that we look at repeatedly all day long.  When you are with your family, think carefully about how important it is to model the opposite and put it down as quickly as possible.  In effect, you are saying “You are more important to me than this device”.
  2. Be clear about what you are doing when you put down the phone in their presence and why.  In the spirit of The Happiest Toddler on the Block, which my readers know I adore, young children need to hear and see you explaining why you are doing what you do.  They don’t assume things the way we do.  Really.  The older they get, the more it appears that they are ignoring you, but don’t you believe it.  Parents are and always will be the most powerful models in a child’s life.  Forever.  Your teen may roll her eyes, but they are still open, and she is watching you.  So tell your child that you want to focus on them, and your phone is a distraction and you can always look at it later.  You want to be with them and pay attention to them.  I know this sounds a bit weird, even awkward and preach-y.  It isn’t if you do it with warmth and confidence.  Find your own wording, but the message is the same: I care more about you than I do about data.
  3. Look around.  Are your child’s activities, toys and games unsatisfying?  Don’t count the toys, look at them and what they offer your unique child.  An artsy child may need new paints, clay, yarn, etc.  A reader may need to go to the library or get a new book series.  Not a digital copy.  A young scientist might need a kit or a microscope.  A social kid may need more playdates or a creative class like cooking.  Their interests and needs may have changed since the last birthday or holiday.  If you want them to play instead of look at a screen, they need things that excite and inspire them, or the digital world will fill in the blanks.
  4. Does your child need help in building skills?  Shy kids, kids with ASD, or kids that don’t make friends easily can find the less-demanding digital world much easier to navigate.  Siblings sit quietly side-by-side, not fighting but also not learning how to solve interpersonal issues.  This isn’t preparing them to go out there and succeed.  The earlier you realize that your child is struggling, the faster you can stop bad habits and prevent rigid behaviors.
  5. I read a challenging piece this week on the origins of addiction to porn that might change your mind on dealing with gaming and digital devices.  The author’s suggestion was that early experiences have impressive power to wire the brain, to the diminishment of alternative methods of engagement and interaction.  I know, not exactly what you would expect me to discuss on my site.  But the problems of finding easy satisfaction through a non-challenging (and solitary) source of excitement fits this post.  Once a behavior is hard-wired into the brain’s system, it is going to be really difficult to change.   Not impossible, but really, really difficult.
  6. Should you ban all media?  You could, but you would be denying the reality that the world they live in is heavily digital.  I tell parents of the kids I treat that I use my tablet in sessions to teach kids that this is just one activity or toy, in the same way that I will eat cookies but not to the exclusion of everything else.  Putting the phone or the tablet away isn’t the end of the world, and using it is not a fabulous reward.

Looking for more on using technology with intent?  Read Want A Stronger Pencil Grasp? Use a Tablet Stylus .  To help kids engage and learn social and emotional skills, read Stop The Whining With The Fast Food Rule.  Yes, it really works!

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Why Pediatric Occupational Therapists Need The Happiest Toddler Techniques: Neurobiological Regulation

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Pediatric occupational therapists are usually all-in when it comes to using physical methods to help children achieve affective modulation.  We use the Wilbarger Protocol, Astronaut Training, Therapeutic Listening, and more.  But are we using Dr. Harvey Karp’s Happiest Toddler on the Block techniques?  Not so much.  All that talking seems like something a teacher or psychologist should do.  Folks, it’s time to climb off that platform swing and look at all of the ways children develop state regulation.  Early development is the time when children experience attunement with caregivers and create secure attachment.  But this is a learning process that grows over time and can be damaged by events and by brain-based issues such as ASD.  The Happiest Toddler on the Block techniques aren’t billed as such, but they are the best methods to create attunement and attachment while teaching self-regulation skills that I have found.  Combined with sensory-based treatment, progress can be amazing!

Research has told us that the way we interact with children and the way they feel has direct effects on neurotransmitters and the development of autonomic reactivity.  If you don’t believe me, check out Stephen Porges’ work on the ventral vagal component of the autonomic nervous system.

When we use The Fast Food Rule, Toddler-Ese and Patience Stretching ( Use The Fast Food Rule to Help ASD Toddlers Handle Change and Stretch Your Toddler’s Patience, Starting Today! ) to get a child focused, calm, listening, and recognizing that we “get them” even if we don’t agree with their toddler demands, we shift more than behavior.  We shift their neurophysiological responses that can become learned pathways of responding to stressors of all kinds.  We are using our social interactions to create neurobiological regulation.  I believe that the use of Happiest Toddler techniques can make a significant neurophysical change in a young child even before we put them on a swing.  I am going to go out (further) on a limb and say that if our interactions aren’t informed by understanding attunement and engagement, our sensory-based treatment might be seriously impaired.

Long story short:  if you aren’t using effective methods of developing social-emotional attunement and engagement with young children, your treatment isn’t taking advantage of what we now know about how all children learn self-regulation.  And if the child you treat has ASD, SPD, trauma from medical treatment, etc…..you know how important it is to use every method available to build the brain’s ability to respond and self-regulate.

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Help Your Child Develop Self-Regulation With Happiest Toddler On The Block

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Children start learning self-regulation early.  Most kids eventually become reasonably skilled at it, given some help from loving adults.  The problem is they don’t learn it quickly.  Self-regulation takes a long time to become established in the slowly-developing brain of a young child.  While you are scooping up the puddle of Jell-O that used to be your toddler before she dropped her ice cream cone, think about how you can use this moment to build her ability to come back to a calm state:

  1.   Reflect her emotions without denying them or taking them on.  After all, you know that it isn’t the end of the world.  But at that moment, she can’t see it.  She is sad and maybe even angry.  Use the Fast Food Rule Use The Fast Food Rule For Better Attunement With Your Child to state what happened and how you think she feels.  Remember to use lots of gestures and alter your vocal tone to convey empathy.  Don’t be placid; after all, she needs to know that you get how unhappy this has made her.  Kids tune into your expressions much more than your words at this age.  You may think you should be soothingly quiet, but she is thinking ” You don’t see my pain!!”
  2. Make sure she knows that you care about what happened, and use this moment to identify what she is feeling.  Even if you intend to get her another cone, allowed her to be upset for a very brief period, and let her know that we call that feeling “sad”.  Kids depend on us to explain what happened to the dinosaurs, how to eat with a fork, and also how to identify and manage emotions.  Take that moment to explain that there is a name for what she is feeling, and that it is normal and understandable, even if you intend to fix it with another ice cream.
  3. Ask her if she wants another ice cream cone, but not too soon.  Sometimes children aren’t ready for our solutions, even if they do want them, and presenting one too early gives a message that we never intended:  I can’t handle your pain, you can’t either, and I need to fix it right away.  Look for that shift in body language, eye contact or verbal connection that tells you she is starting to pull herself together before you jump in with a solution.

 

If you find yourself more upset than your child, their pain ripping through you, take a moment to look inside and see what experiences in your past are contributing to this feeling.  You may have been taught the same lesson early in your own childhood.  If you received the message that pain is unbearable and should be avoided at all costs, you are not alone.  Well, I am going to tell you that an important part of your life, and a part of your child’s life is all about learning to feel feelings without fear and come back to a good place after a difficult experience.

Bad things happen to us all, and the most important lesson you can teach your child at this moment is that she can handle this feeling and come through it.  With your support, and with the support of other people who love her, she will get through the loss of her ice cream and other losses in life as well.

And it can start with how to handle the loss of an ice cream cone….!

 

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Use The Fast Food Rule For Better Attunement With Your Child

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What’s attunement?  The physical and emotional connection that a healthy parent makes with their upset child that brings them both back into a calm and balanced state.  Why is it important?  Because without attunement you don’t have healthy attachment, and attachment is the foundation for a healthy emotional and interpersonal life.  Attunement and attachment are some of the biggest issues in psychology today.  Everyone is talking about it, but once those early years are over, it takes a lot of therapy to repair rifts in this foundation.  So reinforce your emotional connection with your toddler, and know that the effort you make today will help them recognize healthy relationships for the rest of their life.

How does The Fast Food Rule help parents develop attunement?  By reflecting back the child’s perceived complaint with enough gesture, facial expression and vocal intensity to register in the mind of a child, your child will feel that you “get” them, just as they are, regardless of whether you agree that a broken cookie is the end of the world.  Knowing that a parent understand where you are coming from is essential.  For more details, read Stop The Whining With The Fast Food Rule.

Again, later in life, realizing that a partner isn’t “getting them” is important when deciding whether to develop or stay in a relationship.  From there, your child will be able to consciously decide to communicate more effectively, invest more time and effort in the relationship, or move on to another person who can connect more successfully with them.

Does this mean that you give in to every howl from a young child?  Of course not.  Even toddlers know that they won’t get everything they demand.  They may be unhappy to hear that they can’t have cookies for dinner, but they don’t actually think they will be having them for dinner.  What matters is that they know that you understand them, understand their feelings, and aren’t rushing to squash their anger, sadness or frustration.

Once you see those little shoulders drop, hear the scream become a wail or a whine, and get more eye contact, you will have been given the green light to offer a solution.  Wait for it.  And look for that moment when the two of you are calm and moving forward together.  That, my friends, it attunement at work.

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