Category Archives: preschoolers

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!

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Go Back To School With Target’s Sensory-Friendly Clothing Line

 

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A boy’s tee from the Cat and Jack collection at Target

Here in the US, kids are getting ready to start the school year.  A mom mentioned to me that Target is now carrying sensory-friendly clothing by Cat and Jack; attractive and functional clothes for kids who find tags, seams and textured clothing uncomfortable.  I went to check them out online.  Here is what I learned:

The selection is limited but sufficient for kids who don’t have to wear a uniform for school.  It includes clothes for toddlers up through grade school.  I saw leggings and tees, both long and short-sleeved.  There aren’t any tags and the seams are sewn flat.  The garments have been pre-washed for softness, which saves parents some work.  I know that there are kids who insist their new clothing be repeatedly laundered to get out the stiffening agents that have been applied to fabrics.

I know that this limited line doesn’t solve the problem of getting your child into formal clothing for a big wedding, and it may not have every color under the sun, but it is nice to see affordable clothing options for kids who struggle with this issue.

In my experience as a pediatric OT, children could still have issues with tolerating sleeves and pant legs.  Some kids find the movement of fabric on skin irritating, regardless of the level of softness.  I suggest that you ask your OT about desensitization techniques that can help you and your child have better experiences when dressing, regardless of the type of garment.

Happy Back-To-School shopping!

 

 

Address A Child’s Defiance Without Crushing Their Spirit

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Kids that defy adult instructions, even instructions that are ultimately for their benefit, often get begged or threatened into compliance.  Pleading with your child to pick up their mess, or threatening your child that those toys on the floor will be given to a charity shop isn’t always going to work.

Why? Probably because your child is waiting you out.  Children are wise observers of what works and what doesn’t, so they know you will eventually clean things up and they are fully aware that toys never disappear after a threat.

If you are tired of pleading and threatening, I have a strategy that could make you less aggravated and even ultimately boost your child’s self-esteem.  It works best with children that have at least a 30-month cognitive and language level.  This means that if you have an older developmentally delayed child that is unable to comprehend a request with a reward attached (“If you give me the shoe, I will get your milk”) then you should try a less complex strategy until they can understand this concept.

The idea is simple:  you make a request and if no response is elicited, you explain that they have a choice.  Not complying will result in a consequence they can see.  After the consequence is imposed, you offer the child another chance to make things right by following a slightly different direction or offering a “re-do”.  There is no “1-2-3” counting, because if you are certain that your child has understood your initial request and the explanation of the consequence, those were already the “one” and the two” of the countdown.  Your execution of the consequence is the “three”.  Good enough for me!

The trickiest parts of this strategy are the maintenance of a warm tone while your beloved child is defying you, and your quick thinking to identify a later task that allows them to save face while complying with your second request.  Do not think I haven’t had to act warm and friendly when inviting a difficult child to give participation another try.  I remind myself that I am the adult in the situation, and my job is to model calmness and teach skills, not get the upper hand on a 4 year-old.

I have also made up some pointless tasks such as rearranging boxes on a shelf, just to have an easy and successful task to offer them after the first consequence is delivered.  The younger the child, the less they will realize that Job #2 was only a chance for them to know that I am not rejecting them in any way.   I could say it, but actions speak louder than words.

Here is what this strategy looks like with a young child:

Adult:  “Please pick up all the cars, and then we can go have our yummy lunch.”

Child:   Looks at you, shakes her head and runs to the fridge. 

Adult:  ” Here is your choice:  pick up your cars and put them in the bin, or they will sit in their bin on top of the fridge until after dinner.”  Adult points to the fridge and/or taps the top to clarify what that means.

Child:   Gets a spoon from a drawer and stands by the fridge, no acknowledgment of your  directions.

Adult:  Uses The Happiest Toddler Kind Ignoring strategy and turns away from the child and waits next to the car pile for about 15 seconds for a positive response.  If the child doesn’t return, the adult puts the cars into the bin without more discussion, and places the bin on top of the fridge.

Child:  Cries, recognizing that a consequence has been delivered.

Adult:  Uses a disappointed but calm tone :  “I am sad too, because now we have to wait to play cars.” Adult’s body language and tone brightens. “Would you like to try listening again?  Please give me the blocks and I will stack them.”  Adult begins to stack very slowly to allow the child to consider her choice, and warmly welcomes the child’s help.

Child:   Begins to hand blocks to the adult.

Adult:  “You did a great job helping me!  Thank you!  Let’s go have our lunch!”

This can go south with strong-willed children, tired children and even some hungry children. I don’t recommend letting kids get super-tired or starving and then setting them up to lose.   Some kids are feeling great, but they draw a line in the sand and decide that they aren’t budging.  They won’t back down.  I express my disappointment in the outcome (no car play) but not in the child.  I don’t tell them I am disappointed in their behavior, because for a young child, they may not always be able to distinguish themselves from their behavior.  They will always be able to see the result: no cars.

I keep calm and impose consequences unless things go from defiance to aggression.  Then I consider a time-out strategy.  Aggression should never be ignored, because that is as good as approving of aggression.  In this age of zero-tolerance in schools, no one is doing any favors to a child by inadvertently teaching them that aggressive behavior is inconsequential.  They will find out soon enough that other people feel very differently about it.

Young kids will defy you.  I guarantee it.  Responding to defiance with limit setting doesn’t have to damage them or your connection with them.   Addressing defiance in this way can build a more positive relationship while making it very clear that there are consequences to not listening to you.

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How To Teach Your Toddler To Wipe “Back There”

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Potty training is a process.  For most kids, the final frontier is managing bowel movements.  Compared to learning to pee into the toilet, little kids are often more stressed by bowel movements and have less opportunities to practice.  Constipation or just the discomfort of normal elimination can make them wary, sometimes enough to convince some children that this is a process better done in a diaper.  In comparison, urination isn’t an uncomfortable experience for healthy children.  Bowel movements sometimes happen only a few times a week, instead of the multiple times a child needs to urinate per day.  Less practice and fewer opportunities for rewards (even if your reward is warm praise) make bowel training harder.

So when they finally make the leap and manage to do #2 in the toilet, a lot of parents decide to delay teaching their child how to wipe themselves.  After all, wiping can be messy and it has to be done well enough for good hygiene.  Here are my top suggestions to make “making” a complete success:

  1. Teaching should still be part of your narrative while you are the one doing the wiping.  In my book, The Practical Guide To Toilet Training Your Child With Low Tone, I teach parents how to transform daily diapering into pre-teaching.  While you are wiping, and even while you are waiting for them to finish on the toilet, your positive narrative about learning this skill doesn’t end.  You are telling your child how it’s done, in detail, as you are doing it. You convey with your words, your tone and your body language that this is a learn-able skill.
  2. Don’t forget the power of the “dry run”.  Practice with your child when he is in the bathroom, whether it is before bath time, before dressing, or during a special trip to the bathroom to practice.  Dry runs take away the mess but teach your child’s brain the motor planning needed to lean back, reach back and move that hand in the correct pattern.
  3. Will you have to reward him for this practice? Possibly.  It doesn’t have to be food or toys.  It could be the ability to choose tonight’s dessert for the family, or reading an extra two books at bedtime.  You decide on the reward based on your values and your child’s desires.
  4. Use good tools.  The adult-sized wet wipe is your friend.  The extra sensory information of a wet wipe versus a wad of dry paper is helpful when vision isn’t an option.  They are less likely to be dropped accidentally when clean, but having a good hold is especially important after it has been used. “Yucky”stuff  makes kids not want to hold on!  Wet wipes are more likely to wipe that little tush cleanly.  Don’t cut corners.  Allow your child to use more than one.
  5. Take turns.  Who wipes first and who bats “clean-up” (couldn’t resist that one!) is your decision.  Some children want you to make sure they are clean before they try, and some are insistent that they go first with anything.  This can change depending on mood and even time of day.  Be flexible, but don’t stand there like a foreman, ordering work but not willing to help out.  One of my favorite strategies is to always offer help, but be rather slow and inefficient.  This gives children the chance to rise to the occasion but still feel like you are always willing to support them.

 

Looking for more information on toilet training?  Take a look at my e-book, The Practical Guide To Toilet Training Your child With Low Muscle Tone to get a clear understanding of how to prepare for and execute your plan without tears on both sides.  Will it help you even if your child doesn’t have low muscle tone?  Of course!  Most of my techniques simply speed up the learning process for typically-developing children.  And who doesn’t want to make potty independence happen faster?

This e-book is available on my website tranquil babies, at Your Therapy Source (a great site for parents and therapists), and at Amazon.  Read more about my book with Amazon’s “look inside” section, or by reading The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

Negotiating With Toddlers? Why 90/10 Is A Good Deal To Them

 

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Toddlers can make you doubt your sanity.  They really can.  How can a crushed cookie be the end of the universe as they know it?  Why do they think you can make more cookies appear on demand?  And how to explain to this person that thinks you hung the moon that you simply cannot erase crayon marks?

This post is an effort to explain how to successfully negotiate (most of the time) with children 18 months to 5 years old.  It is based on The Happiest Toddler on the Block strategies by Dr. Harvey Karp.  Once I learned his techniques, I never looked back and became a toddler whisperer.  Really.  You need to embrace his two most important ideas and then you are ready to hit the negotiating table with your toddler.

Dr. Karp’s most basic concept is that you need to understand that the toddler brain isn’t capable of much logical thinking due to immaturity.  This means that they cannot negotiate well, even when calm.  It gets better as they get older, so a 4 year-old will have flashes of rational negotiation, and an 18 month-old may never get it.  She can’t.  Her brain simply doesn’t “do” rational well at all until that frontal cortex is mature.  The other concept is true for negotiation with anyone, including your partner and your boss.  You have to see their side of the story and communicate to them that you are aware of their feelings….whether or not you agree with them!

Agreeing that they get 2 more bedtime stories but not a snack as well, agreeing that they get the giraffe cup but can’t spill half of it on the new carpet to make a pattern, agreeing that they can wear pajamas to the park but only with shoes are all successes.  Tell them that you understand that wearing Spiderman jammies is indeed cooler with Spiderman sneakers helps them negotiate the deal.  Honestly saying that you are too tired to read 6 more books using an exaggerated yawn and a sad look helps.  You need to go night-night too.  They may be able to see your perspective since they are tired as well (but may never admit it to you).

So here is where your paradigm shift happens.  You have to be OK with deals that seem unfair to you.   Adults want a 50/50 split at the very least.  But you aren’t negotiating with another adult.  Be prepared to leave your ego at the door.  If you are the kind of person that needs to be right, you are going to fail at toddler negotiation.  Toddlers negotiate from the heart and with heart.  A mature sense of fairness isn’t going to be helpful with an irrational mind.  Hint:  if you have ever had a totally irrational boss that you actually liked when things weren’t exploding all over the office, you will have had some experience with the toddler mind.

Successful initial negotiations with a toddler often yield a 90/10 split.  90% for them, and 10% for you.  If they walk away happy,  you should too.  This is why this is not only a good deal for you, it is the only way to teach fairness in negotiation: toddlers start out expecting 100%.  A 90% deal is, in their mind, having given in big-time. But if they feel OK about it and life goes on, you won.  If you can manage that, the next negotiation could be 80/20.

Many toddlers cannot manage this when tired, overwhelmed, hungry, etc.  So negotiations can start over something simple, something that doesn’t matter very much to either party, and when things are calm.  You are teaching a skill, not making a business deal.  But the results could make everyone’s life a lot calmer in the end!

How to Help Sensitive Kids Handle Greeting People (Including Their Own Parents!)

 

Many kids with ASD and SPD struggle with agitation and even tantrums when people enter their homes.  It can happen when their parent returns home from work, eager to scoop them up.  These kids become shy, run away, even hit!

Many, even most parents, believe that this is “bad behavior”, being defiant, or expressing anger at having people entering their space.  As an OT, I think about it differently.  Here is what I think is happening, and how to help your child handle this experience more effectively.

Sensitive children, which includes but isn’t limited to kids with sensory processing disorders, experience transitions as big charges of energy.  We all register a charge when events end or we switch locations, and when people come into our space, but those of us with less sensitivity do not charge up so high and we return to our baseline level of arousal very quickly.  So quickly that it isn’t even on our radar.  You would have to hook us up to a device like a lie-detector set to see the burst of neurological charge.

Not the sensitive person.  They are super-charged, and with little kids, it often is expressed as outsized and inappropriate aversion or agitation.  Thus, the scream, the withdrawal, the running away.  This response is often followed with agitation as the adult walks away and the child is now sad to lose the connection.  It can all seem a bit strange.

The long-term answer?  A good treatment plan that reduces overall, everyday arousal levels.  The short-term answer?  Here is my protocol that helps kids avoid getting so out-of-sorts with greetings, and builds social skills.  The nicest thing about this protocol is that it looks normal, not clinical, and it does indeed lower the brain’s level of arousal.  Keeping calm, but staying in the game socially, trains the brain to handle more interaction, not to flee.

  1. Greet the child from a distance.  This may be 5-15 feet.  Use a warm but not over the top tone.  Keep it short but friendly.  Don’t linger on eye contact.
  2. The child has been provided with an object to handoff to the greeting adult.  It doesn’t have to be meaningful, especially if the child is under 2.  Anything will do.  The idea is that it is a meaningful interaction that the child controls.  They release it to the adult.  You may have to repeat it with two objects.  The adult’s grateful response is also warm but not effusive.
  3. Now is the time to offer a hug or a kiss.  Sometimes it works, sometimes not.  With older kids that have language, I use “Handshake, hug or high-five?”.  I offer the child a choice of contact, and this alone can get them from feeling imposed upon to empowered.
  4. If the child is still protesting, the adult sits near the child, engaged in something that could be fun for the child.  A book, scribbling, something appealing.  No offer or invite; the position and the activity are the invitation.  The child may come over and begin to engage.  Connection accomplished!

Grandparents and others can think that this is coddling, or too much work.  After all, why doesn’t she greet me warmly like other children?  It is hard to parent a child with sensitivities, but your primary focus is on helping the child feel calm and comforted.  Explain that this is helpful and that the child really does love them.  He just needs a bit of help to express it.

We should be able to get out of the way emotionally for the sake of little people.  If a family member cannot wrap their head around the need to support instead of impose themselves on a clearly agitated child, then they need more help to understand sensitivity.

 

 

Is is Sensory Or Is It Behavior? Before 3, The Answer Is Usually “Yes!”

If I had a dollar for every parent that asked me if head banging when frustrated means their child has a sensory processing disorder...well, I would be writing this post from a suite in Tahiti.  Modulation of arousal is the most common sensory processing concern for the parents that I see as a pediatric occupational therapist.  Their children struggle to transition, don’t handle change well, and can’t shift gears easily.  But hold on.  A lot of this behavior in children  under 3 is developmental in nature.  Not all, but a lot.  Parsing it out and addressing it takes a paradigm shift.  Not every annoying or difficult behavior is atypical for age and temperament.

Everyone knows that you can’t expect your infant to self-regulate.  Nobody tells their baby “Just wait a little; why can’t you be like your brother and sit quietly for a minute?”  But why do adults assume that once a child can speak and walk a bit that they can handle frustration, wait patiently, and calm down quickly?

I know parents WANT that to be the case.  Toddlers are a handful on a good day.  Adorable silliness can melt your heart, but getting smacked by an angry child that was just given a consequence for trying to put your cell phone in the toilet to see if it would float?  Nah, that isn’t going to put a smile on your face.  Parents tell me “If they could only understand that when I say “wait”, I mean that you will get what you want, just not immediately.”  But no.  The toddler brain grows very slowly, and even the super-bright children who read at 3 cannot make their emotional brain grow any faster.  Sorry.  Really.   This brain thing means years of developing communication and regulation skills.

Here is the good news:  Even young children with clear sensory-based behaviors do better when your responses to their behaviors help them self-calm.  The recipe is simple to describe.  You give limits based on age, use familiar routines, teach emotional language and responses by modeling, and communicate effectively.  The Happiest Toddler strategies have transformed my work because children feel listened to but I don’t give in to toddler terrorists.  Everybody wins.

Here is the bad news:  You have to change your behavior in order to help them.  And you have to do it consistently and with loving acceptance of their limitations.  “Behavior” isn’t just their problem.  It is both of yours.  Take a look at my posts on Happiest Toddler techniques that really work for the little ones, and see if your suspicions of a sensory processing disorder wane or even evaporate as you and your child learn some valuable communication and self-calming skills.  The posts that can alter things today might be Nip Toddler Biting in the BudToddlers Too Young For Time Out Can Get Simple Consequences and Kind Ignoring, and How To Get Your Toddler To Wait For Anything (Hint: They hear “Wait” as “No”)

Good luck, and let me know what works for you!