Tag Archives: Dr. Harvey Karp

How To Get Your Kid To Share (Hint: The Fast Food Rule Will Be Used)

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Not a week goes by that a parent or nanny asks me how to get a young child, usually under 3, to share.  I get it; it is embarrassing when a toddler rips a toy away from another child, or has a death grip on a toy car while growling at their playdate friend.

Sharing isn’t something that comes naturally to most kids.  The rare child that hands over a toy when asked isn’t the average child.  You have to teach this behavior, and you have a couple of choices.  Only one is going to give you any peace:

  1. Threats:  Telling your child that if he doesn’t share that he will lose his valued toy.  This may work in the short run, but like spanking, you teach a child that violence or the threat of violence is the way to power.  We have too much of that already.
  2. Shame:  Telling a child that they are not nice people because they don’t want to share isn’t any better.  It doesn’t make it much kinder to say “You aren’t being nice right now”  because you still haven’t acknowledged the child’s feelings. Don’t we all carry around more shame than we can handle?  I know no one thinks they are shaming their child by saying this.  Stop now.  Make a better choice.
  3. Empathy followed by reality:  Using the Fast Food Rule, you tell the child what you think they are thinking “You don’t want to share; you want that car only for you” or an even simpler version “You say NO SHARE”.  When the child nods or in some physical or verbal way indicates that they understand you and agree that this is their opinion, you add sympathy to your voice and say something like “I am SO sorry, but it is XXX’s turn now.  You will get another turn later”.  Many times the child will hand over the car.  Sometimes you will have to take it, but they might not flip out.  Your empathy and their intelligence (if they are over 18 months old, they have had experience with sharing) will help them accept the reality.  Read Stop The Whining With The Fast Food Rule for more details on Dr. Harvey Karp’s excellent strategy.

Of course, if your child is exhausted, hungry, ill, or going through a change in routine, home, caregivers, new sibling, etc. all bets are off.  They are living on the edge, and thing could fall apart.  What do you do then?  You feed, give a nap, a hug, and remember that asking a stressed child to share isn’t going to go very well.  But you also use all Dr. Karp’s positive strategies, the ones he calls Time-Ins.  Things like Patience Stretching Stretch Your Toddler’s Patience, Starting Today! and Gossiping Let Your Toddler Hear You Gossiping (About Him!).

The altruism that gives birth to sharing should not be expected in children under 2.  We ask them to follow our sharing rules, and have to help them grow to an age and a place in which they can comprehend what sharing is really about.  You may have to wait until 4 or 5 to see your child really understand how the other child is feeling and why sharing with them works better than being selfish.  At a very young age, it is enough that they know we understand where they are coming from and we will help them follow this important social rule.

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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. Read   Safety Awareness With Your Hypermobile Child? Its Not a Big Thing, Its the Biggest Thing.  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  and How To Reposition Your Child’s Legs When They “W-Sit”.  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

Parents With Disabilities Need The Happiest Toddler on the Block Techniques

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I usually write about children with disabilities, but today’s post is about parents with challenges.  As an occupational therapist that sees children in their homes through the Early Intervention program, I meet all kinds of parents.  This includes parents with disabilities of their own.  Some parents have vision or hearing issues, some have orthopedic issues (try lifting a toddler all day with a bad back!}), and some have emotional or cognitive issues.  I have worked with parents with addictions and parents that were intellectually challenged.  I may have seen it all, with the exception of parents in wheelchairs and parents that are deaf.  But my career isn’t over yet; there is still time.

They all have had one thing in common:  parenting small children is even harder when you have a disability.  Not impossible, and no reason to think that they cannot do a good or even a great job.  But it is definitely harder to raise children when you have a disability.  Small children are demanding, in a 24/7, self-centered manner.  That is normal, that is the natural state of a young child.  It doesn’t make it any easier.  There are no coffee breaks, there is no weekend off.  Not unless you have willing relatives or friends that will come over or take care of them in their own homes.

The Happiest Toddler on the Block techniques are methods to teach children self-regulating skills and strategies to help children learn to communicate their needs and feelings without aggression or defiance.  They don’t require an advanced degree, and they could save you from going to a therapist yourself, just to complete a sentence that doesn’t start with “For goodness sake,….!”

Parents with disabilities often think that what they need most are the skills or the capacity that they lack.  And I am not going to tell you that being able to see well, hear well, move easily or have boundless energy wouldn’t be a good thing.  But if a child is able to calm down, wait for a snack or a toy, follow directions and even assist the parent in accomplishing something, life gets so, so much better.  Just the removal of stress from tantrums and whining makes everyone’s life better.  You are able to focus and work out how to get things done and feel good about yourself as a parent.  Children that can self-regulate are better able to handle the frustrations of life, and better able to empathize with others.

If you are a parent with a disability, or you know such a parent, please share this post with them.  Tell them to read Why Telling Your Child “It’s OK” Doesn’t Calm Him Down (And What To Do Instead) , Stretch Your Toddler’s Patience, Starting Today! and Use The Fast Food Rule For Better Attunement With Your Child for some useful strategies that start turning things around right away.

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Why You Still Need the 5S’s, Even If You Bought a SNOO

 

 

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Want peace?  Of course you do!

OK, I won’t make you wait to get the answer to this question:  your newborn won’t spend all day, every day, in the SNOO!  Don’t know what the SNOO is?  The SNOO smart sleeper was designed by pediatrician Dr. Harvey Karp as a bassinet that uses many of his fabulous Happiest Baby on the Block techniques to soothe your newborn for sleep.  It effectively quiets and calms newborns with the touch of a button (almost).

After seeing what the SNOO can do, you may WANT to leave her there all day, peacefully dozing away.  That isn’t a reality for most parents.  After the first few weeks, and sometimes earlier than that, you will want or need to take your little bundle out of the SNOO and out of your home.  You may visit your parents, go shopping, go to the park with older children, etc.  Uh-oh!  The SNOO can’t come with you!  Oh, and by the way, leaving your little one in any device with her head against a surface for too many hours of the day places her at risk for “positional plagiocephaly”.  Yes, giving your child a flattened skull.  The same cranial bones that are malleable enough to slide through the birth canal can be deformed by letting a child lie in one position too long.  So no, you cannot leaver her in the SNOO all day long!

We know that the agitated screaming that is called colic starts on average at 2 weeks after the due date, and peaks around 6-7 weeks of age.  For the great majority of babies, serious digestive problems and other medical issues aren’t the reason for all that crying.  Babies are often just too little to be able to handle the complexity of post-uterine life in those first few months.  Combine individual temperament, limited brain development, and the big shift to the external world’s demands, and their tiny nervous systems get overwhelmed and they end up screaming.  Loudly, and often for a long, long time.  Parents get exhausted and discouraged.  The SNOO does provide the neuro-developmental needs these tiny babies have so they can calm down.    But asking the SNOO to solve your baby’s problems all day long is going to mean that you will have to be tethered to it for months!

Thank goodness you don’t have to!  Before he developed the SNOO, Dr. Karp created the 5 S’s  New Baby? Exhausted? Try The 5 S’s To Pull Things Together.  Dr. Karp’s 5 S’s are what will save your sanity when you pop him out of the SNOO and take your show on the road.  Knowing how to swaddle, shush, swing, use sucking and the side/stomach positioning (for calming, not sleep) will make your whole day better and more flexible.  I teach the Happiest Baby concepts in classes and in individual consultations, and I think that every parent should learn the 5S’s and buy the SNOO.

If the SNOO’s steep price tag has you hesitating, then you definitely need to learn the 5 S’s.  Get the video or go to a class.  But don’t think that you are a bad parent or that your baby is in trouble because of all that crying.  Most newborns are just fine; they just need your help to pull themselves together until they are old enough and skilled enough to do it themselves.  Learn to give your baby what she needs, and you all can sleep a little bit better this week!

 

Looking for more information on the 5 S’s and helping your baby calm for sleep and feeding?  Take a look at Successful Swaddling May Take More Layers of Calmness and Why Some Newborns Look Like They Hate To Be Swaddled.  As a nationally certified Happiest Baby educator, I love to help parents learn what their little one needs to settle down and make that “fourth trimester” transition!

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Sensory Sensitivity In Toddlers: Why Responding Differently to “Yucky!” Will Help Your Child

Sensory sensitivity and aversive behaviors are among the most common reasons families seek occupational therapy in Early Intervention.  Their kids are crying and clinging through meals, dressing, bathing and more.  What parents often don’t see is that they can help their child by being both empathic and educating them throughout the course of the day.

My clinical approach has matured over the years from the standard OT treatments to a whole-child and whole-family strategy.  One important part of my approach is to alter how adults react to their children.  It isn’t complex, but it is a shift away from thinking about the problem as being exclusively “my child’s issues with sensory processing”.  Once adults understand the experience a child is having from the child’s point of view, they can learn to respond more effectively to a child, and get results right away.

I recently did a therapy session with a toddler and her mom.  When the child became overwhelmed by her dog barking and rushed to her mom to be picked up, I warmly and clearly said “You want up?” twice while using explicit body language to convey calmness, while the mom looked at her child but didn’t scoop her up right away.  The child turned to look at me, stopped whining and dropped her shoulders.   She relaxed at least 50%, stuck her thumb in her mouth for about 30 seconds, then started to play quite happily.  What I know is that this short interaction affected her body’s level of neuro-hormonal arousal, her thinking about how adults handle sensory events, and her memory of how she feels when she is overstimulated changed. I believe that those differences physically change the wiring of her brain in a small but meaningful way.

I cannot take full credit for this strategy; I used the Fast Food Rule from Dr. Harvey Karp  Use The Fast Food Rule to Help ASD Toddlers Handle Change.  I am using it for therapeutic means, but it the same tantrum-defusing method he developed.   I responded with loving calmness to her over-the-top reaction, acknowledging her request while not granting it. She was “heard” and accepted.   I gave her a moment to come up with an alternate response (quick thumb-suck and then search for fun a fun toy).

This little girl has a habitual reaction to sensory input that puts her into a fear-flight pattern on a regular basis.  Cuddling her works for the short-term, but it leaves her seeking adult assistance for any fears, and it doesn’t give her any skills to handle things or suggest that she could handle situations differently.  Shifting her habitual reactions to  these benign events is essential to make progress, and telling her that it was “just the dog barking” doesn’t work.

Why?  Because Dr. Karp will tell you himself that toddlers hear you saying”just” as if you were telling them “you are wrong”.   They protest more to make you exactly see how upset they are.  Explaining things rationally doesn’t help a little person in the throes of emotion.  Modeling calmness while acknowledging their feelings is what helps them learn and grow.

Your child is wiring his brain every moment of every day. Your sensitive child is assessing all of your reactions to learn about what is a danger and what is not.  His brain, not his hands, are interpreting the world as irritating or frightening.  Your reactions to events and to his responses will help to hardwire his brain to believe something is scary, or challenge him to adapt and change that automatic pattern of response.  It isn’t all psychological, it is neurobiological as well.  Most researchers don’t differentiate between the two any longer.  They know that biology drives thought and that thought can alter biology.  The rubber meets the road right here, right now, in your own home!

OTs working with sensory processing disorders generally believe that an aversive response to a benign stimulus (hysteria when touching lotion or oatmeal) is not a skin issue or a mental health issue, but a brain interpretation gone wrong.  There are many reasons why this would happen, but most of us believe that experience and exposure, done well, can change the brain.  Some exposure is done with programs like the Wilbarger Protocol, the use of weighted or pressure garments, and many other great therapeutic techniques.  Changing adults’ responses hasn’t been researched nearly as much, but my clinical experience tells me it probably should be.  I know that teaching parents how to shift their behavior has made a difference for my clients almost immediately.

Good therapy can diminish a child’s aversions substantially, and even create exploration and excitement.  It is wonderful to see a formerly anxious child move through her day exploring and enjoying the world around her!

Does your sensitive toddler struggle with toilet training?

 The Practical Guide to Toilet Training Your Child With Low Muscle Tone is my new e-book (hard copies can be obtained by contacting me directly) that may help you tonight!  Sensory-based strategies can really help children with sensitivity, and good instruction minimizes all the multi-sensory mess that training can become when you don’t know what to do.  Your child doesn’t need to have severe issues with low tone.  Many children have both sensory sensitivity and low muscle tone.

Visit my website tranquil babies, and click “e-book” on the top ribbon to learn more about this unique book!

Overwhelmed With Your Toddler’s Demands? How To Cut Tantrums in Half!

 

Do I have your attention?  Good, because to achieve this amazing feat you will need to learn some new techniques, and understand your toddler’s perspective more clearly.  Take a look at two of my popular posts on toddler behavior, then practice a bit until your new communication skills shine.  The posts that will teach you some new ways of responding are Stretch Your Toddler’s Patience, Starting Today!  and  Taming Toddler Tantrums Using Sympathetic Reframing.  They give you easy strategies to use two of the best Happiest Toddler on the Block techniques.  These moves build listening skills and enhance cooperation in little people who are prone to big reactions.  Tantrums happen less often when toddlers feel heard and feel powerful.  You still are the parent.  Set limits and create consequences, but start here to get your toddler calm first.

Why change yourself in order to change your toddler?  Because they are waiting for you to show them how to behave, and waiting for you to reward them for their great progress.  You are teaching them skills, and so you have to model them.  Trust me, this isn’t that hard to learn.  Once you see a potential tantrum dissipate into the air, you will want to practice these techniques all the time!

You need to know a few things about the toddler mind.  It isn’t the same as the kindergartner mind, and certainly not the elementary school mind.  It’s an immature brain, running on very little frontal lobe power and a lot of amygdala and hippocampus use, all in a frenzy.  Add sugar, some taunting from an older brother, shake gently, and watch the “fun” erupt!  But that is life, so accept that your toddler is who he is, and teach him some skills to manage his reactions.

I will mention that these techniques will come in handy in about 10 years, when you have an emotional teen standing in front of you!

Here are some highlights that you should know about the toddler mind while you practice:

  • They haven’t mastered language, so talking more isn’t helpful.  Pare down the amount of words you use, and use more expressions/ gestures to express yourself.
  • They always react emotionally, not logically.  Your responses have to acknowledge their feelings, rational or not, or you are going to increase tantrums, not stop them.
  • Brains grow slowly, like trees.  Don’t expect that success once or twice means you can stop using these techniques.

Yes, I am really promising you an actual 50% reduction in tantrums .  Maybe not today, since it does take some time to become really good at the Fast Food Rule and Patience Stretching.  And maybe not when you are in the nightmare trifecta of a very tired child who is also feeling ill and is changing schools or caregivers.  That is a super-stressed child!  All bets are off then, but I think you will be able to diminish even these tantrums.  But all those other tantrums over broken cookies and not being allowed to stand on the table?  The Happiest Toddler methods can help you stop those before they even start.

The other great Happiest Toddler on the Block techniques such as Gossiping and Playing the Boob ( Dr. Karp, I wish you would rename that one!) support a warm and loving relationship with your toddler, and they will give you another 10-15% reduction in tantrum severity, depending on how much your toddler needs a more positive connection with you right now.  But just these two techniques from Dr. Harvey Karp will give you more smiles and less whining, all day long!

Low Tone and Toilet Training: Parents And Children Need To Work Together

This one is simple to explain, but not so easy to achieve with some kids.  Children whose interactional pattern is defiance or whining are going to be much harder to train, regardless of whether or not they have significant issues with low muscle tone.  In fact,  I would rather coach a very physically unstable but cooperative child than a toddler with mildly low tone but a firm commitment to resist any adult request.   If both parties aren’t able to work together, things may not go well.  At all.

Toddlers and preschoolers are known for their tendency to love the word “no”.  Did you know that, developmentally, the high-water mark for hysteria and the reflexive “no” is between 18 and 24 months?  Yup, that’s when language skills haven’t emerged to support expressing feelings and comprehending adult reasons. It is when emotional fuses are neurologically short, as in that forebrain is still sooo immature.   They really can’t handle their emotions at all on a brain level.  They have just left that sweet-baby phase where they want to please you more than anything, and they can’t be quite as easily distracted from bad behavior now.  This is a generalization, and there are some parents reading this that are thinking “We never got that lovely baby phase.  He went from crabby infant to bossy toddler!”  Well, I sympathize,  and I still invite you to read on.  All is not lost.  As language, emotional and reasoning skills slowly grow, a child who still falls apart easily and rages constantly isn’t always at the mercy of neurology as much as not having some basic coping skills.  It’s time to work on them before you jump into potty training.

Toddlerhood is long, all the way up to 5 years-old, and I won’t minimize the tantrums and agitation that can emerge.  This extended path to greater maturity is why I bought, devoured and constantly use The Happiest Toddler on the Block, Dr. Harvey Karp’s great book on building toddler coping skills. Half of the benefit is learning to both listen to and talk to toddlers in a way that calms things down.  I could not do my work as a pediatric occupational therapist with as much joy and enthusiasm as I have without these strategies.  Thanks, Dr. Karp!

For parents of children with language, communication or cognitive issues that result in developmental delays, your child may be 4 years-old but their other skills that are closer to 18 months old.  You can still toilet train.  Has your child been diagnosed on the autistic spectrum?  You can still train them.  Really.  The process may take longer and you may have to be both very creative and very consistent, but it can be done.  Job #1 is still the same: building a cooperative and warm relationship.

If your days are defined by defiance and whining, you need to learn all of the Happiest Toddler techniques that reduce frustration, including Patience Stretching and the Fast Food Rule.  Stretch Your Toddler’s Patience, Starting Today! You need to use “time-ins” for shared fun and warmth without a goal in mind.  You could try some of the more language-based techniques such as Give It In Fantasy and Gossiping.  And of course, you need to look at your approach to setting limits. All that love is great, but if your child knows that there are no consequences to breaking family rules or aggression,  your plan is in trouble.  Dr. Karp’s techniques aren’t intended to be a toilet training plan, but they set the stage for learning and independence.  Those are the ultimate goals of toilet training!

If you would like a more detailed or more personal level of support, visit my website tranquil babies  and purchase a consultation (in the NY metro area) or a phone/video consult!