Category Archives: toddlers

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.

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Make Wiping Your Child’s Nose Easier With Boogie Wipes

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It is cold and flu season here in the states, and I have already seen my share of snot-caked little faces.  Little children get more colds than older kids and adults, and they can turn into an agitated mess when you say “Honey, I need to wipe your nose”.  These wipes are going to make your job as chief booger-wiper a lot easier!

When I first saw Boogie Wipes, I will confess that I thought it was another expensive product to separate first-world parents from their money.  After all, I grew up on dry tissues and I survived.

I was wrong.  These really work.

At first, I thought that the use of moisture was the key to their success.  Not so.  Parents told me that using a regular baby wipe didn’t “do the deal” the way a Boogie Wipe took care of the snot problem and made kids calm down about nose-wiping.  I had to find out what really made this product better.

  1. Boogie Wipes have a few important ingredients that separate them from the standard baby wipes.  The first ingredient is water.  The second ingredient is sodium chloride; good old salt.  Saline is a combo of these two ingredients, and saline softens the gluey crud that is dried-on snot.  It also thins the still-wet snot so you can wipe it away without pressing so hard on tender skin.  Yeah!
  2. The next four ingredients are aloe leaf juice, chamomile flower extract, vitamin E and glycerin.  All gentle and (to most children) non-irritating skin conditioners.  I am a huge fan of Puffs Plus tissues, but these wipes are gentler than my fave tissues.  Children’s skin is so much more delicate than ours, and the ingredients in snot are so irritating.  That is even before it becomes a dried-on coating.  Boogie Wipes leave a thin coating of skin conditioners after you wipe your child’s face.  This coating acts as a slight skin barrier for the next drip of snot.  Brilliant!

The remaining ingredients are preservatives that prevent your open container of Boogie Wipes from becoming a source of germs instead of a source of relief.  I am sure that there are children who react to these preservatives, but I haven’t yet met any families that report problems over the years that this product has been available in NY.

Unless you know your child will react to these specific preservatives, I recommend trying the unscented version first (they come in fresh and lavender scents too) and using them before your child gets a cold.  It is kinder to find out that they are sensitive to any ingredients before their skin is already irritated by all that snot from an illness.  Kids whose skin is going to react will likely do so when well, but their skin can recover from any irritation more quickly when their immune system is not also fighting a bad cold.

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The Boogie folks do sell a saline spray as well as wipes, and I am all for using saline spray to loosen up internal nose crud.  The problem with sprays isn’t that they don’t work.  They do, and they work well.

The problem is that children are naturally avoidant of us sticking things up their noses, and they are really bad at controlling the “sniff” in order to efficiently suck the spray up into their sinuses.  I teach children how to blow their noses and how to handle sprays.  It is part of my job as an OTR.  Not the best part, but nevertheless, a part of teaching ADLs.  I haven’t had much success teaching children under 3 to use nose sprays.  They just get more frightened and upset.  If you have an older child or a child that seems less afraid of nose examinations at the pediatrician, then go ahead and give sprays a try.  It can really loosen up a clogged nose.

Good luck trying Boogie Wipes, or try the generic versions that I am starting to see on store shelves.  Imitation is the sincerest form of flattery, so manufacturers are telling us that they also know that these products really work!

A Simple Strategy To Improve Your Child’s Posture In A Tripp Trapp or Special Tomato Chair

 

Therapists often recommend these well-designed seats for kids that need solid foot support, but even the best hip and chest strapping doesn’t always mean that a child is actively using their feet for postural control.

As a young therapist, I used tape, foam, and towel rolls everywhere, as if I was creating a modern sculpture.  For the most part, all I got for my effort was frustration.  Food and force tend to make short work of the most ingenious wedges and supports on a chair used for feeding.  Then I got smarter and decided to make this a lot easier on everyone.

I wanted to share my easiest strategy for helping children place their feet on a foot plate and keep them there:  shoes!

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The little guy in the “before” photo has generalized low tone and hypermobility.  His pelvis is reasonably stable using the existing straps on the chair, and he is able to reach forward to finger-feed, partially activating his trunk and hips.  But those feet just tapped away, and his legs extended at the knee through most of the meal.  He is too little to respond to any verbal prompts for posture but not addicted to gaining sensory input though his feet.  He is there for the food!

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Non-skid soles, and totally stylish, too!

Just putting on his tiny boat shoes gives him some “grip” on the foot plate, and he stayed in this position for the rest of the meal with our repositioning!  He still has to develop some hip control so his knees don’t move laterally as he reaches forward.  This is an easy hack to help him get some distal stability without constantly touching and repositioning him.  Kids really start to hate all our manhandling after a while.

Hope this gives parents and therapists an idea that requires very little effort and can  deliver results immediately!

Help Your Special Needs Toddler Make The Transition To School Routines

 

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Many developmentally delayed toddlers move their therapeutic and educational services to a toddler developmental group, A.K.A. special needs program, when they are between 18 and 30 months old.  Not all of them slide into the routine easily.  There can be a few tears and a lot of complaining about fitting into a schedule /leaving a fun activity because it is time for circle or therapy.

After speaking with a handful of clients and doing a few consultations, I thought it might help to provide some strategies to help parents make their child’s first school experience easier:

  1. Learn how teachers mark activity transitions, and commit to using them at home.  Some teachers sing the  “clean-up song”, some ring a bell or turn lights on and off.  Find out exactly how the staff help children, especially non-verbal children, anticipate and adjust to changes.
  2.  You don’t need to copy the exact transition strategy, but make it very similar and use it for activities at home that are the easy transitions.  Examples of easy transitions at home are getting into a bubbly tub, leaving the table once full and satisfied, putting on a coat to go outside and play, etc.  The transitions that are easiest are going to be the calmest, and children learn best when calm.  This positive spin makes the school’s routine more acceptable when a child isn’t completely on board with new situations.
  3. Find out how snack is served, and offer snacks in the same way at home.  If small cups are used for water or juice, practice cup drinking at home with the same sized cup.   If there are specific foods offered, then stock up.   Model your enjoyment of these snacks so that the food is familiar and has your seal of approval.

Good luck this year to all the toddlers that have made the leap to school!!

 

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 Child 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.  The people that invented the Kandoo line of wipes have an amusing way to practice posted on their site:  spread peanut or sunflower butter on a smooth plate, and give your child some wipes or TP.  Tell him to clean the plate completely.  This is a visual and motor experience that teaches how much work it is to clean his tush well.  After this practice, your child will make a real effort, not just wave the paper around.  Brilliant!
  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 on 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!