Thursday, August 1, 2013

Hot spot management



There is no situation more frustrating than a child whining, screaming, lying on the floor, throwing arms and legs around. It is heart-breaking. It is mind-blowing, quite literally.
The usual response of a parent in such situations is full of desperation, exasperation, irritation, anger, embarrassment, pity, and all that is enough to make us take an immediate step in an attempt to put a stop to it. At that point of time, we are willing to do all that we haven’t learnt in our parenting books, as the sight is too unbearable.
Some of the usual steps we take when the child is throwing a tantrum are:
    1.     Punishing the child: most of us scream, hit, or lock up the child who is questioning our parenting gyaan by doing the opposite of a desired behavior. The feeling of helplessness evokes tremendous anger in us and we end up punishing a child, who is already feeling devastated for some other reason. Punishing may sort out the issue at that point of time, as the child gives in, out of fear, but it has tremendous side effects in the long run. The child may become very meek, submissive or defiant, aggressive. The feeling of not being understood by parents is also carried heavily for life.
    2.     Rationalizing the issue: many of us have a habit of start giving explanations when faced with a problem. We end up doing the same when we see an undesirable behavior in the only heir of our values and goodness. He screams, we preach. The louder he cries, the harder we try to teach. After a while, we leave the child alone with a note in his mind that he ‘shouldn’t be doing like this’. Not effective. Because the child knows that he shouldn’t be doing like this. He knows all that we are teaching at that point of time. In fact, he is totally closed to a good-behavior lesson at that point of time. This often makes parents feel very helpless to see the child not listening to them.
    3.     Giving in: many indulgent parents, who don’t believe in punishing, and who don’t have the time and patience to impart the wisdom, often follow what the child crying on the floor is demanding for, no matter how inconvenient or unhealthy. They believe in giving, and giving in, without thinking of the consequences. The child gets things done his ways, so he is happy. He feels victorious. The child is happy, so the parents feel they have won the battle. No one wins here actually. Both lose, without realizing. The only thing that the child gains is one dangerous idea; things should happen in the way he wants. This one lesson learnt brings more monstrous moments and experiences in life of these parents later.
    4.     Giving up: sometimes, we don’t know what to do. So we just give up. We give up not without telling the child how disappointed we are in him, and how ashamed we are feeling about ourselves that we are not parenting enough. We leave the cranky child on the floor, lock up ourselves in a room, cry it over. The child, who was crying for something else few moments ago, starts crying for a new reason, i.e. upset parents. The cry continues, without telling the parents that the reason has changed, so the parents continue to feel wretched. The child feels a tremendous pressure of 3 things together- the problem which unsettled him to begin with, the feeling of not being supported by the parents and the feelings of the upset parents. 
If our usual ways are doing more harm than good, then how do we handle a tantrum?
Answer lies in few simple steps. It’s called hot-spot management.
    1.     Remove the child from the hot-spot and take him gently to another room for a private conversation
    2.     Seat him in your lap and stroke his back
    3.     Let him say first
    4.     Don’t interrupt. Don’t defend yourself or offend him. Just keep saying hmmms, ohhhs
    5.     Acknowledge how upset he is. Reframe his feelings into an appropriate sentence. (“oh, you are  angry because you want to watch your favorite cartoon and your T.V time is up”)
    6.     Wait for his response. Do not rationalize, defend or offend.
    7.     When he has released his feelings, stroke his back and comfort him (“ I know it can be very frustrating when you are not able to do what you really want to do. The point is that we all need to learn to express our anger without getting angry. Only then we can think of a solution. Right now, I am very upset with this behavior. I love you a lot and I would want to talk to you nicely about this. I am sure we can sort it out”)
    8.     Discuss the solutions with him. Do not cut his points, do not put your points over his.

At the end of the talk, your child should be able to:
    1.     Feel loved and accepted by you
    2.     Feel that he is good, but the behavior he did was bad

The steps mentioned above are quite simple to follow. There are 3 tricky points to keep in mind, though
    1.     Expressing your anger without getting angry yourself
    2.     Showing love and acceptance
    3.     Consistence



When the going gets tough, the love gets going!!

Thursday, July 4, 2013

Elder sibling- without rivalry


Sibling rivalry can be any parent’s worst nightmare. They feel like being in a tug of war 24*7. While some degree of sibling rivalry is absolutely normal and developmentally healthy, in some cases it takes a very ugly shape and makes everyone’s life a mess. 
When the parents are expecting a new baby, the elder one goes through a lot of turmoil. "Will my parents love me? Were they not happy with me?" are some of the heart-breaking thoughts that haunt and torment them. 
Here are some pointers that parents can take note of, to manage (read: not erase) the negative feelings and behavior in the elder child better:
  • Tell the elder one things about his infancy, i.e. how cute he was, how much you enjoyed with him being first-time parents, and how he would eat-poop-sleep-repeat (just the way the younger one does now). Do this by showing him snaps, and clothes. The aim is to reassure him that he as an infant was given his due and what the younger one is getting is not unreasonable
  • Tell him how the younger one will grow up the same way he has and that then the younger one will also do things that he is doing now, like going to school, playing on his own, and watching T.V. The aim is to reassure him that the present situation that threatens him so much will change in some time and both the kids will then get equal attention and treatment.
  • Never burden him with ‘being the elder one’. Do not expect him to be the more responsible one, the more sensible one, and the more sacrificing one. Show him that your expectations from him will depend on his age and not on his birth order.
  • Do not ridicule the younger one to over-assure the elder one, like “He is so demanding, oh God! You are so nice!” This may backfire and make him angrier at the younger child for troubling his parents.
  • Show him graphically how your love has multiplied after the second child has come. Make cutouts of hearts and show how you had 1 love when only one child was there, and now 2, since the younger one has come. You can make a collage of two photos- one snap in which he is there with both parents (near this photo stick 2 hearts) and another snap in which all 4 of you are there (near this one stick 4 hearts). Place this collage at his eye level on a wall/ almirah where he can see it every day. The aim is to reassure him that your love multiplied and didn’t get divided.
  • When you see a problem behavior, try to say something reassuring and soothing to him. Like if he is crying for his meals when the younger one is being breastfed, the father can say something like this, “I know this upsets you a great deal when you see that mumma and papa are not attending to you the moment you want us to. Maybe you feel ignored and sad about it. Let’s count till 10 and see if mumma comes.” This will not only reassure him that you understand his feelings instead of dismissing them but also teach him the correct behaviour (i.e. not wanting immediate gratifications, waiting for his turn). Thus you taught him the right behaviour without sounding like a teacher of do’s and don’ts
  • No matter what, do not give in to a regressed behaviour. Be firm and soothing, that you do understand how much he wants to do something but it’s not ok. He may not agree to your terms in the first attempt, but if you continue to be reasonably understanding, he will eventually stop being aggressively demanding.
  • Do not express your anxiety regarding his behaviour in front of him. The more he perceives your concerns/worries the worse he will feel and it can become a vicious cycle.

Remember:
  • All children face sibling rivalry. It’s a part and parcel of growing up. Some behavioral symptoms when a new sibling arrives, are normal and not to be worried about clinically.
  • They feel tender towards the newcomer, to begin with. It’s only the bad experiences (real or imagined) with parents that make them dislike the younger one

Thursday, June 27, 2013

Understanding extreme shyness in children- Part 1


Some children are social butterflies. They enter a party and do everything to amuse others and instantly become the center of attention. In the other category, are those children who feel very shy in social situations and prefer to cling to their parents. These children act like wallpaper in the room and may as well go unnoticed by others. They hide behind their parents' legs when someone, familiar or unfamiliar, approaches them. These children may be very assertive and playful at home in the presence of everyday people, like parents and grandparents. But the moment they step out of their house or someone steps into their house, they kind of ‘freeze up’. Sometimes they ‘thaw out’ soon, and sometimes they take very long or even refuse to ‘defrost’.

Many parents feel confused and annoyed with this behavior of their child. They get embarrassed when their friend is asking the child something and the child fixes his gaze on the floor, puts his fingers into his mouth, and doesn’t respond at all. It’s very important to first understand that such kind of shyness is not a problem in itself. It is rather a reflection of something else that’s going on in the child’s mind. So first, let’s look at the possible reasons that could be there behind such terminal shyness:

  1. Fear of strangers: some children are simply too scared of unfamiliar people. Their stranger anxiety is highly marked and influences their behavior significantly. Such children find it extremely difficult to interact with those who are either completely stranger or occasional visitors.
  2. Analysis of situation: ‘’look before you leap’’ is the motto of some children. It’s as natural as other kids’ spontaneous urge to befriend others and experience the thrill of socializing. Children who are very sensitive to their own and others’ feelings generally find it difficult to be impulsive and prefer to look at things from a distance, analyze the details and then cautiously inch forward. Unfortunately, by the time they feel comfortable going ahead, the push from people fades. Then they have no choice but to stay back.
  3. Fear of uncertainty: some children like to be sure what’s happening next. They prefer a routine to an unstructured day. They throw fewer tantrums if they are told things that are going to happen. When they meet someone, they are fine. But when they meet with someone, they retreat because they are not mentally prepared for that meeting. When they go to a party, they respond well to expected things like cake cutting and giving gifts for which they were mentally prepared by parents in advance. But they fail to respond well to those things that they were not prepared for such as a new party game, unfamiliar guests, etc.
  4. Fear of blame: children who have a ‘blame-ridden environment’ at home hesitate in interacting with the outside world fearing similar blames for ‘silly mistakes’. So if a child who cannot make a mistake without receiving sarcasm ( why are you so clumsy?) or rebukes ( see how you broke it) or punishments (you won't get another toffee for 1 week as you were so careless with your pencil), he develops an idea that he is being judged all the time. That he is not simply a child, but either a good one or a bad one, depending on his last action or behavior. Such a child will have problems in having social interactions fearing similar judgments for anything silly he might end up doing.
  5. Lack of self-confidence: a child who thinks he is not good enough will want to hide it from others. When a child feels that his friends or siblings are better dancers, singers, or gymnasts, he doesn’t want to let others know how bad he dances or sings by performing in front of others. If a child doesn’t have the confidence of winning a competitive game, he will stay back when others are playing ‘musical chair’ at a birthday party. If a child feels his voice is very shaky, will prefer to keep quiet when someone approaches him with a hello. Poor self-image plays a very detrimental role in social development.
  6. Bad experience in the past: certain bad experiences in past can put a block in a child’s mind about interacting, mingling up, or performing. For example, if a child sat on a cake at a party and received teasing from other kids for the dirtied pants, will take a long time to nurse that wound of embarrassment. He will not want to attend any party in the first place. And even if he goes, he will sit down in one place and will not move, fearing similar accidents.

As mentioned earlier, some children are just not wired to be social butterflies. So you need to accept a little bit of shyness in your kid. Some shyness here and there could be coming from the small influence of each of the reasons mentioned above. That’s something not to be worried about. But yes, if the shyness goes up to an extent of reflecting extreme skepticism or timidity, a proper approach is required.

Managing extreme shyness in children- Part 2




A deeper understanding of the behavior is the first step to managing it better. Once you feel you have understood the reason, the next step is to adopt some strategies to take care of it. In part 1, we discussed the reason behind extreme shyness in children. Here are some of the strategies you need to keep in mind to handle your child’s shy behavior:

  1. Accept your child’s shyness: it’s important to accept that your child could be born with a shy temperament. It’s not a good idea to fiddle too much with his natural personality. Even if it is acquired and not innate, you need to accept it first, in order to try and change it for the better. Forcing him to participate in social situations will not only make him more rigid about his stance, but he will also feel bad to know that you are not at ease with his natural self and that he needs to behave in a certain way to make you happy.
  2. Appreciate when the child does interact: if you consider talking to people and being friendly a normal and standard form of behavior, then chances are that the absence of that behavior will annoy you, but the seldom presence of it won't fetch any appreciation from you. When the child does interact, parents might refrain from appreciating, thinking, “what’s the big deal in that? Why pay compliments to something that should have been there since the beginning?”. Wrong theory. Appreciating later, in privacy,  in a small way, does motivate the child to repeat being friendly again in the future. The absence of appreciation might make him feel, “why bother!”
  3. Role play at home: if your child is facing problems in interacting with other adults, switch roles with him at home. He can become the ‘friendly adult’ and you can become the ‘child’. This will have two benefits. First, he will come to know from the ‘child-you’ how to behave with adults. Second, you will come to know from him how he perceives those adults when he meets them. Similarly, before going to a birthday party, have a mock party at home, where he can be the host, all his toys can be guests and you can be the child. How you go up to the ‘guests’, and how the ‘guests’ treat you, will all teach him lots about socializing, as well as give him a chance to practice things at home.
  4. Social interactions at home: most parents make sure to teach their children as many things as possible, like music, dance, karate, swimming, and much more. But what sometimes gets neglected as a part of conscious teaching and learning is socialization. When the child makes a mistake, you correct him and later coach him on what he should do and shouldn’t do. But that is like passing or failing the child in an exam without teaching him the course. Like you use various methods to teach alphabets to your child, you should use various methods to teach socialization too. You can have interactions at home where you can play doctor-patient with him, tell him about your childhood experiences, read him family-story books, or show him good-manners charts.
  5. Do not humiliate or label: although your child’s shyness might embarrass you in front of your friends, especially when their children are happily playing with everyone around, you should keep your embarrassment covered. Do not scold your child for being ‘so timid’. Your sarcasm will do more harm than good. Your child is already anxious. Don’t become yet another source of his anxieties. If you keep calling your child shy and timid, he will think that this is what you think of him and that he has to live up to this prophecy of yours and will not want to change his behavior in the future.
  6. Don’t plead and threaten:  when your child hides behind your legs, do not beg and plead, “Please say hello to aunty”. It sends a wrong message to him. He feels that he needs to learn social interactions, not for his sake, but for your sake, since you look so desperate to hear that ‘hello aunty, how are you?” from his mouth. Don’t threaten him to be nice to the aunty, else he won’t be called a good boy. Later, never ever fall prey to punishing your child, physically or emotionally, for embarrassing you in public. He will feel that by not talking to the aunty, he hurt 'the aunty's" feelings, and her feelings are more important to you than his feelings.
  7. Butt in, if required: without interrupting his attempts, you may intervene, if you feel that your little one could use some guidance to open up further. Be careful to maintain the line between interference and intervention. For example, when your friend greets him a hello and your child doesn’t respond, that’s not a good point to push him to say hello. But when your friend asks him what he played in the playground, the silence from your child’s side may not mean shyness. Your child could, at that point, be recalling what all he did. And it may happen that by the time he is done recalling, he realizes that no one is any more interested in knowing the answer. With your gentle intervention here, “we had so much fun with our ball, bat, and park’s squirrels, didn’t we?” your child is more likely to add on to it. So some children require the help of an opening line as a cue to start. But be careful, not to start answering on his behalf to all the questions asked. A sensible friend of yours won’t ask too many questions seeing an uninterested child.

A sensitive and sensible approach of yours will surely take care of your child’s shyness. Keep your expectations real. Changes won’t happen overnight. Also, during times of stress, your child is more likely to slip back into his shell of shyness. So you need to keep up with your patience and hope.

Why is ADHD being overdiagnosed these days?



ADHD (attention deficit hyperactivity disorder), according to DSM IV (TR) means display of inattention, hyperactivity and impulsivity consistently for 6 or more months. These symptoms are more globally present and are not limited to selective activities like eating, learning, travelling etc. It is a serious disorder and often requires appropriate method of remediation depending upon the intensity, duration and impact of the problem on the child and people around him. It affects overall growth and development of the child.

Due to such threatening impacts of ADHD on a child, it is a term that parents fear a lot. Surprisingly, many kids have been found to be diagnosed with ADHD these days. Why should there be increase in ADHD cases? Is it because of our awareness about it and the fact that people are more psycho-educated? Or is it because of malpractice in doctors to get easy money by diagnosing and providing unnecessary remediation? Or is there yet another reason?

ADHD is a serious condition and requires medical and psychotherapeutic intervention. It is not same is general over enthusiasm and aggression in kids. Many people know about the term ADHD and fear its presence in their kids. Since little knowledge can be very misleading, any child who is found running around, giggling and not sitting down for food or studies, is readily tagged with ADHD. Such lose diagnoses brings parents’ world upside down, cornering the child with behavioural remedies, medication, counselling and everything else that is not really required.

What seems like ADHD could be simply restlessness. 

Reasons behind restless and edge :
1)    Inadequate options for physical activities: when children are not provided with enough options to play physically and vent out their surplus energy, they find it difficult to sit down at one place. In apartment cultures, there is not much space to run around, jump or cycle safely. Children go down in the society sand areas to play, but that’s for a very limited time. Rest of the time, they are physically inhibited in their houses. In the absence of adequate discharge of energy, they become fidgety.
2)    Too much television: TV is being used in many households to bind children for enough minutes to feed them without defiance. It is also used by many parents as a babysitter to get some free time for themselves. While some amount of TV watching is not bad, neither for the eyes nor for the overall development, too much of TV is making children couch potatoes. Whatever little play time they have is being consumed by TV. They also learn about violence from ‘cute’ shows like Tom and Jerry where the two of them are constantly fighting. Research shows that too much of TV just plays havoc with the brain cells. The whole wiring goes kaput. It has a bad effect on children’s appetite, physical growth, ability to focus, eyesight and psyche.
3)    High levels of empty calories and caffeine: children today have a free hand in buying and consuming chocolates, candies, aerated drinks, packaged fruit drinks, wafers etc. They whine for a chocolate, they get it. The high level of sugar and cocoa in the chocolates affect their neurological connections, by making them too charged up. This extra volatile energy, when non-discharged, makes them more impulsive and whining. It creates a vicious cycle, which many parents find difficult to break. Frequent intake of fast foods, lowers down intake of healthy food, resulting into malnutrition, which is often a big cause of irritability and restlessness in many kids.
4)    Lack of structured routine: kids find it easy to eat and sleep well when they follow a routine. In the absence of a routine, many kids feel lost, not knowing what to expect next. Lack of routine mainly affects two areas- sleep and appetite. They sleep at odd hours, when others in the house are awake and active. The constant noise level results into poor sleep thus making them cranky. They eat at odd hours, when others are doing something else, which mostly results into forced eating or distracted eating. Such poor eating and sleeping habits disrupt the routine further. On the other hand, kids who follow a routine at least on weekdays, show less restlessness as they find it easy to sleep, eat, play on time.
5)    Intestinal worms: Worms are bad ! Especially for kids, whose growth, appetite, sleep all get affected by worms they harbor in their intestines. Tape worms often cause the kids to eat a lot but hijack the nutrition from the food eaten, leading to malnutrition. Small worms often result into loss of appetite and extreme crankiness in kids. 
6)    Emotional factor: Anxiety, fear, excitement, shame can all make a child feel too restless from inside. When a child is too excited about going to park in the evening, he may find it difficult to sit down for coloring before the outing. While excitement is an overt feeling, many other covert feelings play important role in a child’s activity level. If a child is too scared of being judged for his coloring skills, he is not likely to sit down patiently with coloring books and crayons.

Recommendations for parents:
1)    Give your child enough opportunity to play rough. Opt for parks instead of malls on weekends. Buy him small trampoline before you get him Thomas engine set.
2)    Control quantity and quality of TV watching. Do not allow TV after 6 p.m. to help the child calm down by bedtime.
3)    Control sugar and caffeine intake. Do not give sweets, toffees, cold drinks after 6 p.m. to help the child sleep nicely.
4)    Make a routine on a chart paper with lots of pictorial details to help the child relate to his day-to-day activities without much fuss
5)    Increase his intake of omega 3 fatty acids. Give him walnuts, fish, flax seeds, pumpkin seeds, eggs in whichever form he likes.
6)    Deworm him regularly. Inculcate good hygiene habits to minimize the chances of harboring too many worms.
7)    Encourage pretend-play, role-play, relating of experiences in your child. The more he is able to cathart his emotions, the less he will be affected by them.  Children love personal and sensitive discussions with their parents. Use this tool to know more how and what he feels about things and people around.
8)    Don’t tag your child ‘hyper’. Tagging always acts as prophecy for kids
9)    Play quiet games with your child or listen to soft peaceful music with him. Show him again and again how you are sitting and enjoying it.
10) Teach your child some relaxation techniques