Category Archives: toddlers

How To Stop Your Toddler From Hitting You

 

patrick-fore-557736When your sweet little baby turns into a toddler that smacks you, you may be so shocked that you don’t know how to react.  The second time you get hit, or pinched, or even bitten in anger, you might feel a level of rage come up that is both surprising and horrifying.  Well, I am not going to shame you for any of that.  I want to help you get this under control and help your child handle what is (probably) a normal level of aggression.

Yes, this is likely a normal response for toddlers.  They have really limited language, hardly any understanding of their own feelings, and they live in the moment.  You probably have one of the 85% of kids who are not placidly calm most of the time.  If you have a very young child with a strongly spirited temperament (15-20% of the population) then you probably see this behavior at least a few times a week, if not daily.  It’s still normal. And you have to deal with it or you will have a bigger, stronger, and more aggressive child next year.

Here are my suggestions to deal with aggression:

  1. You are going to have to use Dr. Karp’s Fast Food Rule.  The first simple step is to state what you think your child is thinking, such as ” You say “No go inside”, in as short and simple a phrase as you can, based on age and level of emotion.  The younger and more angry your child is, the simpler the message.  Match your expression and gestures to the emotion you are stating.
  2. Wait for a shift in body language or level of screaming.  Repeat the phrase if needed, may be more than once.  Then state “No (biting, hitting, throwing)” and you say  “I don’t like it” or a “We don’t hit” if your child isn’t totally out of control.  If they are out of control, you have to wait until they can hear you.
  3. You must make it clear that YOU don’t like this behavior, not simply that it isn’t “nice”.  Why?  Because a personal message is more powerful to a toddler than stating that they broke the rules.  I even throw in “That scared me and I don’t like it” to slightly older toddlers, to come down to their level.  They might be a little surprised, but they know all about being scared.  You aren’t admitting weakness, you are telling them how they crossed a line.  As long as you are using body language that tells them you are still the adult in control, this helps them understand the seriousness of what they did.  But the 12-18 month olds don’t get that, so wait until they are older to add that one in.
  4. If you were holding your child when this happened, put him down. Nothing says confuse me like saying these phrases while cuddling.  If you were sitting next to them, move away a bit.  The message is that they have crossed a line, because they have.  They may cry about this, but that is OK.  For now.  Once they shift out of aggression, you can be more welcoming.  Get it?  Good behavior we welcome, aggression we do not.  Simple.
  5. If you see the clouds building and you can anticipate your child will hit, bit, kick or throw, you are allowed to intervene.  Pull your arm away, put them down, reach for the toy you think she will throw, or move away.  You could say “I don’t want you to kick” and then offer a solution.  This solution could be what you think your child needs, like a nap or a snack, or it could be something amusing, like looking in your purse for your keys.  Young toddlers can switch things easily.  Older toddlers sometimes commit to aggression and they won’t take the bait.  But sometimes they will.
  6. Don’t be afraid to issue consequences.  I don’t believe in physical punishment, but I have no problem with removing toys that got thrown or issuing kind time-outs.  Losing the opportunity to go do something fun because you tossed your boots at my head is just fine for me.  I never reward bad behavior.  Ever.  I have too much to lose if a child thinks that aggression will work to avoid something or receive something.  Kids can hurt themselves in the process of being aggressive, and that is always going to be my fault.  Not a chance.
  7. I always give children a chance to come back into the fold.  Maybe not to get the same thing they were being aggressive about, but a new fun thing.  You have to wait until they are calm to do this.  This isn’t coddling.  This is teaching them how I want them to behave, and that there is always a chance to do things better.
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Is Your Hypermobile Child Frequently In An Awkward Position? No, She Really DOESN’T Feel Any Pain From Sitting That Way

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I don’t have a good photo to illustrate this point, but if you or your child are hypermobile, you know exactly what I am talking about.  It can be any part of the body; shoulders that allow an arm to fold under the body and the child lies on top of the arm, crawling on the backs of the hands instead of the palms, standing on the sides of the feet, not the soles.

The mom of a child I currently treat told me that this topic is frequently appearing on her online parent’s group.  Mostly innocent questions of “Does your child do this too?”  and responses like “At least she is finally moving on her own”  When I met her child, she was rolling her head backward to such a degree that it was clearly a risk to her cervical (neck) spine.  We gradually decreased, and have almost eliminated, this behavior.  This child is now using it to get attention when she is frustrated, not to explore movement or propel herself around the room.

Because of their extreme flexibility and the additional gradual stretching effects of these positions, most children will not register or report pain in these positions.  Those of us with typical levels of flexibility can’t quite imagine that they aren’t in pain.  Unfortunately, because of their decreased proprioception Hypermobility and Proprioception: Why Loose Joints Create Sensory Processing Problems for Children and decreased sense of stability, many hypermobile kids will intentionally get into these awkward postures as they seek more sensory input.  It can actually feel good to them to feel something!

The fact that your child isn’t in pain at the moment doesn’t mean that there isn’t damage occurring as you watch them contort their bodies, but the underlying inflammation and injury may only be perceived later, and sometimes not for years.  Possibly not until tissue is seriously damaged, or a joint structure is injured.  Nobody wants that to happen. If you think that there is a chance that your child is more than just loose-limbed, ask your therapist to read Could Your Pediatric Therapy Patient Have a Heritable Disorder of Connective Tissue? and get their opinion on whether to pursue more evaluations.  Some causes of hypermobility have effects on other parts of the body.  An informed parent is the best defense.

Here is what you can do about all those awkward postures:

  • Discuss this behavior with your OT or PT, or with both of them.  If they haven’t seen a particular behavior, take a photo or video on your phone.
  • Your professional team should be able to explain the risks, and help you come up with a plan.  For the child I mentioned above, we placed her on a cushion in a position where she could not initiate this extreme cervical hyperextension.  Then we used Dr. Harvey Karp’s “kind ignoring” strategy.  We turned away from her for a few seconds, and as soon as she stopped fussing, we offered a smile and a fun activity.  After a few tries, she got the message and the fussing was only seconds.  And it happens very infrequently now, not multiple times per day.
  • Inform everyone that cares for your child about your plan to respond to these behaviors, to ensure consistency.  Even nonverbal children learn routines and read body language.  Just one adult who ignores the behavior will make getting rid of a behavior much, much harder.
  • Find out as much as you can about safe positioning and movement.  Your therapists are experts in this area.  Their ideas may not be complicated, and they will have practical suggestions for you.  I will admit that not all therapists will approach you on this subject.  You may have to initiate this discussion and request their help.  There are posts on this blog that could help you start a conversation.  Read Three Ways To Reduce W-Sitting (And Why It Matters) and Kids With Low Muscle Tone: The Hidden Problems With Strollers .  Educate yourself so that you know how to respond when your child develops a new movement pattern that creates a new risk.  Kids are creative, but proactive parents can respond effectively!!joshua-coleman-655076-unsplash

The Best Ride-On Toy For Younger (or Petite) Toddlers

 

61-g+QMVAYL._SL1000_.jpgAs an occupational therapist, I have always found it difficult to recommend a toddler ride-on toy for younger or smaller kids with low muscle tone and hypermobility.  Most of these toys have such a wide seat that children must propel themselves with their knees rotated out and pushing forward on their toes.  Exactly the pattern of movement we DON’T want to see.

And then I saw the Fly Bike.  This little fold-up bike has a seat that is about 9.5 inches high and has a very narrow seat.  This allows a child’s feet to be aligned with their hips, facilitating the development of hip and trunk control, not substituting bending forward and back to propel the toy.

The textured seat helps grip a child’s clothing for a little extra stability, and the small handlebars mean children aren’t draping their chest over the front of the toy; they are holding onto the handlebars with their hands.  Brilliant.  The rubber wheels are kind to indoor floors, but can handle pavement easily.

Are there children that don’t fit this toy?  Absolutely.  If your child is too tall for this toy, they shouldn’t use it.  If your child cannot maintain adequate sitting balance independently on this toy, they may need more support from another style of ride-on toy, perhaps with a larger seat and a backplate.

I finally have a great ride-on toy that I can recommend for smaller kids.  An early Xmas present to me and my little clients!

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Construction Site on Christmas Night: A New Classic Is Born!

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Anyone that knows the board book Goodnight, Goodnight, Construction Site should run right out and get this one for next week.  OK, maybe you won’t be able to wait that long.   Read it when you get it home!  An absolutely read it before your young child goes to bed on Christmas Eve!  Santa will wait a little longer for his cookies and milk.

The graphics are just detailed enough, but not so complex that most 2 year-olds can’t figure out what is going on.  There is some repetition so they can keep up with the story, but older kids can follow the concepts of kindness and caring in relationships.  The rhyming text is terrific for kids learning phonics.   Rhyming has been working out well for audiences of all ages, even before Shakespeare’s iambic pentameter.  Works for me, too!  This is a fun book for parents to read out loud, which is good because you will be reading it over and over, night after night, long after the decorations are packed away.

The construction vehicles in the story end up building a new fire house for the fire engines, but they get some treats for themselves as well.  It is a happy story with a lot of warmth and a wonderful chance to talk about how good it feels to give.

Enjoy this fun little book during the holiday season!

Deluxe Water Wow Pads Offer More Challenge And More Fun To Preschoolers and Kindergarteners

 

91Wl4b-x3nL._SX425_.jpgMy clients and colleagues know how much I love the original Water Wow books.  They are reusable and mess-free fun for kids at home, at the doctor’s office, the restaurant and the plane ride.  These bigger books are going to be even more fun for preschool kids and kindergarteners!

Here are some great reasons why I love these books:

  • They have more pages, and more pages means they keep kids busy (and happy) longer.
  • They offer more detail and more challenge.  The graphics inspire critical thought (Is this a silly thing to find in the supermarket or not?) and the red lens that looks like a magnifying glass makes kids feel like Sherlock Holmes as they search for secret items.
  • There are mazes, hidden items and pages where kids can compare two almost-identical pictures and find the anomalies.  It is more than just wiping water on a picture.
  • Like the originals, the pages dry quickly and can be used over and over.  It seems like kids would get bored after the first run-through, but children can enjoy the “reveal” and the sensory play of water on a page for a long time after they have solved all the puzzles.  If you are at 30K feet and your kid is getting restless, this could buy you a bit of time without having to resort to screens that they will insist on for the rest of the (expensive) trip.  Genius.
  • Oh, and the pen is easy to grasp, and it develops a mature pencil grasp with repeated use.  Yeah!

I think these would be terrific holiday gifts.  If you are looking for more gift ideas, read Automoblox: For the Discriminating Preschool Gearhead and Melissa And Doug Tape Activity Book Is Reusable Fun for some other good toys that build skills while having fun!

Playing With Toy Food That Connects With Velcro Builds Children’s Hand Skills Faster!

81OGGQRPz8L._SL1500_This set is one of my favorite choices for toddlers of all ages and interests.  Why?  It is a safe, fun, clean-able toy that doesn’t require a USB connection or a battery.  That isn’t a complete oddity, but it getting more rare every year.  This toy is a great choice for kids with ASD, SPD, low muscle tone and hypermobility.  And children will play with it for years.  I like recommending toys that have the possibility of wearing out before they are thrown out.

In this age of edible pouches and pre-cut meal packages, your child might not realize that corn comes on a cob, or that there is a purple food; eggplant.  Learning about food through play is a wonderful way to introduce food preparation and an interest in healthy food choices.

Let’s unpack the benefits of this great set:

  • The theme is food; familiar and fun for most kids.  It encourages imaginative play and can be used by more than one child at a time.
  • The materials are lightweight and easy to clean.  The food toys made of wood sound so great, so holistic …until your toddler has chucked one into the flat screen TV in your family room!  Or at his sister’s head!  And for kids who lick or suck on toys, well, I don’t think most kids should be consuming paint.  I’d prefer it if kids didn’t lick toys, but lots of them do from time to time.  Plastic is a better choice for kids with a weak grasp as well.  Some children will revert to an immature or atypical grasp on a heavy object but can sustain a mature grasp on a lightweight item.
  • Different ages can enjoy this toy.  Very young toddlers simply connect and disconnect the velcro pieces.  Slightly older kids can practice color matching, and preschool kids can practice cutting with the super-safe knife in the set.  Even older kids can create elaborate pretend play.  I have had three and four year-olds preparing a pretend Shabbos meal, using a Kleenex to cover the bread.  Adorable!
  • The shapes are primarily cylinders and spheres.  Why is that good for motor development?  The arches in the hand are developed by hand use, and grasping these shapes encourages the use of the intrinsic muscles, deep in the palm of the hand.  Along with the thumb muscles and some of the hand muscles that originate in the forearm, these are the muscles needed to achieve the support necessary for skilled hand use.

A hint for use with the smallest kids;  don’t match the shapes.  Match contrasting colors and shapes so that it is easier for children to figure out where to place their fingers to assemble and separate the pieces.

A hint for kids with a weak grasp of sensory discrimination issues:  Offer them the most textured shapes.  The irregular textures will help them maintain their grasp as they pull or push.

Looking for more ideas for hand skill development?  Check out The Hypermobile Hand: More Than A Strength Problem and For Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance.

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This is my favorite set: Slice-a-Riffic!  The larger size and the textured pepper and corn are easy for even the weakest grip to manipulate.

For Kids Who Don’t Know They Need to “Go”? Tell Them to Stand Up

 

photo-1453342664588-b702c83fc822For children with either low muscle tone or spasticity, toilet training can be a real challenge.  If it isn’t clothing management or making it to the potty on time, they can have a hard time perceiving that NOW is the time to start heading to the toilet.

Why?  Often, their interoception isn’t terrific.  What is interoception?  Think of it like proprioception, but internal.  It’s the ability to identify and interpret sensory information coming from organs and internal tissues.  Among them, the pressure of a full bladder or a full colon.  If you can’t feel and interpret sensation correctly, your only clue that you need the potty is when your pants are soiled.  Uh-oh.  A child with muscle tone issues is almost certainly going to have sensory issues.  Tone will affect the amount and quality of sensory feedback from their body.

What can you do to help kids?  The simplest, and the fastest solution I have found, is to tell them to stand up and see if they have changed their mind.  Why?  Because in a sitting position, the force of a full bladder or colon on the abdominal wall and the pelvic floor isn’t as intense.  Gravity and intra-abdominal pressure increase those sensations in standing.  More sensation can lead to more awareness.

So the next time your child tells you they don’t have to “go”, ask them to stand up and reconsider their opinion.  Now, if they are trying to watch a show or play a game, you aren’t going to get very far.  So make sure that they don’t have any competition for their attention!

Looking for more information on toilet training?  Well, I wrote the (e) book!  The Practical Guide To Toilet Training Your Child With Low Muscle Tone gives you readiness checklists and ways to make readiness actually happen.  It has strategies you can use today to start making progress, regardless of your child’s level of communication and mobility.  Learn what occupational therapists know about how to teach this essential skill!  It is available on my website tranquil babies, on Amazon and on a terrific site for therapists and parents Your Therapy Source.  Read more about my unique book:The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

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