Child Development Network

Question

I have a very emotional five year old, who has trouble with NLD. As a parent when I pick him up from school care, we both tired and worn out. My child is anxious, whining, cranky, and tired etc. What skills as a parent can I learn to cope with this time of the day?

• It’s important to try and establish a familiar routine, and set yourself and your child up for success by breaking the behaviour chain – by redirecting the conversation to fun or pleasant topics, ignoring low level behaviours (whining, sulking, complaining) and setting aside time each day (later when you are both rested and calm) to debrief about the day.

• Try to release some of the built-up emotion with exercise or other activities.
• Do not attempt, if possible, activities that require effort, and are likely to be confrontational (e.g. Homework)
• Make it explicit (e.g actually say 'this is calming down time)
  

Question

As Advisory Visiting Teachers, when we speak to parents who are describing the same ‘child histories’ as Geordie’s parents, for example

    “It’s been going on since he was two years old, no one can tell me what’s wrong with him."

Where can we refer these families to for medical support? Maybe CDN, but many of these families cannot afford to pay for the likes of Pathways for example – even after the Medicare rebate.”

• There are no easy answers to this, the health systems in Queensland are divided into public and private – each with their own sets of drawbacks in terms of waiting time, costs, and expertise of the individuals who provide the service. Where costs are prohibitive for a parent it may be worthwhile investigating the possibility of financial assistance from community groups, other government agencies (Disability Services Queensland, Family Services, Child Safety) or the Department of Education, Training and the Arts. It may also be important to recognise that sometimes the diagnostic profile of a child is not clear and that the reason that a suitable explanation has not been reached is because the medical specialists are continuing to gather information and test hypotheses.

• Our experiences in private practice is that cost is relative. Some very poor people who value their children's wellbeing find the money, whereas some wealthy people resent having to pay at all for help. Money is important, but so also are values and what is important.

Question

I have a child mostly incapable of accepting blame or responsibility in any given situation: What does this mean? How can I help him? I worry how it will affect him in the workplace.

• One trick is to use the 'video umpire'. This means identifying what a video would see (and hear) to get the objective truth out first. Objective truth is what is seen and heard without any human interpretation, and without any discussion about 'why'. When the truth is agreed upon, then the child is better able to accept that they actually did (or said) what they did.Then you can look at the question of whether it was justified or not.
•  Without meeting and assessing your child it is difficult to give you responsible feedback on what the causes for the problem behaviour may be, and match the best intervention and management strategies for you and your family. I would suggest that you consider requesting a meeting with the school guidance officer or school psychologist for specific assistance, or seek a referral to a private psychologist through a referral from your local GP under the Mental Health Care Plan introduced by the Federal Government in November 2006. For more information on this service please visit http://www.psychology.org.au/medicare/psych_medicare_items/

Question

What language should you use with a student reaching the ‘red zone’, that is hitting, pushing, and becoming physical? How can I ensure a student isn’t over compensating at school? (He’s well behaved at school, has become extremely challenging at home).

• Stay calm yourself.

• You do need 'boundary' management of behaviours so that they do not cross the line and become unsafe.

• Once a child has reached the ‘red zone’ it is highly unlikely that they are capable of comprehending complex or long strings of verbal information. Limit your language to simple, one step directions that provide a clear description of what you would like them to do, i.e. “Sit down”, “Move here”, “Put the book on the table” etc. Keep your voice low and calm, and limit additional physical gestures.

• In terms of the over compensation at school, it is not uncommon for some children to ‘hold’ themselves together (despite high levels of stress and anxiety) and then unfold once they reach the safety of their home and family. Having a structured program at school where an adult regularly makes contact with the child during the day and monitors their emotion state is a critical preventative strategy.

• Use verbal labels for what is going on - "You are angry, and in the red zone. You need to calm down".

• It is good to practice when the child is calm - what you are going to say, and how they are going to respond in a way that does not further humiliate them, and retains some dignity.  They need to know that when they are calming down, they are not in trouble.

Question

If they don’t have a choice of emotions, how do you manage them/teach them to have the ‘accepted’ response to everyday situations?

• It is difficult for everyone, not just children with emotional dysregulation problems, to control their emotional response to different situations – however it is possible for everyone to learn new behaviours to express those emotions. Feelings and behaviour are separate, and in a supportive and direct teaching approach alternative and more appropriate behaviours can be taught. They need lots of practice in safe environments, and support during periods of potential conflict or anxiety.

• You can't teach them. You need to allow them to feel what they feel, and help them understand what they feel. If their emotions are inappropriate, it may be that there are more complex problems going on (e.g. you see anger and agression, but deep down they are afraid, vulnerable and feeling 'hurt'). In these cases you may need professional assistance.
  

Question

Given the 3 zones, is it possible for children to take what they’ve learned regarding behaviour while in the green zone and ever be able to apply it once they enter their ‘red zone’? If saying “Do your work or go to the office” is a threat and not a choice then when do you inform the child of the consequence for the behaviour (in this case – not completing set work that is realistic – ‘doable’ for that child.)

• In response to the first question, yes. It is possible for children to learn new behaviours to use when they are highly anxious or distressed, but they will require explicit and supportive teaching, lots of practice and reinforcement for making changes in their behaviour.

• It is always better to negotiate, develop understanding and practice behaviours in the green zone. If you do this, it is much more successful to remind children when they are in the red zone, and they are more likely to follow what they have practiced.

• In terms of informing the child of the applied consequences for behaviour, those should be explicit to the entire class as part of the classroom rules. In an effective classroom children do not complete work because they are afraid of being sent to the office, they complete the work because they are interested in the work, confident that they have a reasonable chance of completing the task successfully and are looking forward to the acknowledgement for following instructions. In situations where a child isn’t completing the set work it is important to examine why this is occurring and intervene prior to the next task rather than relying on punishment along to change behaviour.

Question

Do you think emotionally dysregulated children benefit from a small school setting over a larger one?

• It depends very much on the child, each school needs to be assessed for the ‘best fit’ for your child – for some children a large school enables them to be relatively anonymous and avoid gaining a difficult reputation, and for others a smaller school gives them the specific attention and security they require to feel comfortable to learn.

• Often the staff and school 'culture' are more important than the school size.
  

Question

Can you ever close the gap (social delay)?

• It depends on the child and the difficulty with which they have been assessed. It is possible, with a child who is smart enough to look and learn, and mature enough to have 'ownership' of their social immaturities.
  

Question

As a parent, how do you talk to your child about self-harm? (Which happens at school).

• This is an area that should be guided by someone with specific expertise in the area, such as a psychologist or guidance officer. In general the approach should be focussed on what people around the child can do to help alleviate the stress or discomfort they are feeling.

• Sometimes expressing self harm is a way of saying the child is sad, or struggling in some way. In these cases children need to learn to express how they feel more effectively. Again, this usually requires some professional assistance.

Question

How do I manage anxiety related to being left for two weeks at three years of age with grandparents? Outworked through sleep disorders, shyness at ten years of age.

• This is a difficult question to respond to without additional information. I would recommend seeking specialist support to guide management of the anxiety and separation trauma (see above question re GP Mental Health Care Plan).

• It is possible that the presumed cause is not as important as you think, and there are other factors that perpetuate the child's anxiety.

Question

I am looking forward to hearing the strategies! Year Nine boy (he has Asperger’s). Teachers do not have the same behaviour expectation of him as others. He is egocentric, immature, inappropriate behaviour, lacks motivation in everything, angry and disrespectful. What do we do with him?

He is almost/nearly/going to be expelled? He doesn’t acknowledge that he has ASD.

• He sounds socially immature (developmentally delayed). If this is the case you need to think about his behaviour, and manage him at the developmental age of his thinking and behaviour rather than his intellectual and chronological age.

• He needs to learn to see his behaviours as others see them (see Video Umpire above). 

• Avocate for the development a support team to be set up around the child, which includes specialists that can advise the teachers and work with the parents. It is impossible for one person to carry all of the intervention responsibilities and have the solutions for a child who is experiencing such severe difficulties. It isn’t necessarily always relevant or useful for a child to know what others may have diagnosed him with as such knowledge won’t bring about a sudden change in behaviour – and in some situations it may actually contribute to additional mental health concerns. The focus should be on what the immediate goals are for the child, and assigning tasks/responsibilities to a team.

Question

How can we prevent schools labelling and blaming individual children? I overheard the principal say to my son “What did you do now?!” when he arrived after a situation in front of kids and parents.

• It’s difficult to get society as a whole to change this type of practice as its very much part of how our community operates. Principals are perhaps expected to demonstrate a higher level of understanding in appreciating the complexities of child development, but in their busy work lives it is often a poor habit that develops in response to the bureaucratic demands of their positions. Be strategic about seeking the change by modelling the behaviour you expect them to have, and drawing their attention to the behaviour you object to – by letting them know that you would prefer them to use other descriptors or comments you are putting them on notice that you will be watching.

• It may be worthwhile discussion with the principal whether the legal concept of 'innocent until proven guilty' applies in his/her school. For these discussions, we recommend both parents be present if possible.
  

Question

Social skill are usually picked up in day to day life, and not necessarily taught e.g. Teasing Sensitive Sam. Should it be taught? e.g. How to be nice/forgive/not tease. How? The ME generation vs. Love your neighbour

• Social skills should be taught, in much the same way that academic skills are taught. There are thousands of resources available to schools and parents through local libraries, specialist booksellers, and internet sites.

• The most powerful teaching is example. What do the children see at school, and at home?
  

Question

Lack of sleep and lack of healthy food – how can these issues be helped. Vitamins, powder? Should parents insist on child being in own room not parent’s bed? 

• Structure and routine in day to day life is more important for the emotional child than for other children. It is something that should be structured at a whole-of-family level, rather than expecting a child to behave differently from the rest of the family. Children need their bodies to be working well if they are to best manage their emotional brains.

• From a school perspective, those are very much home based issues that school staff have a limited responsibility or right in which to involve themselves. Healthy food can be guided at school through the Healthy Eating programs, but other aspects are issues that parents have sole responsibility for managing.

Question

Consequences – are suspensions and playground withdrawal suitable? They are frequent and don’t seem to work.

• Suspensions and playground withdrawals alone will not change the behaviour of a child (in terms of teaching them new, appropriate behaviours and social skills). They work as a strategy for managing staff workload and student safety, but unless paired with teaching alternative behaviours the same problems will continue.

Question

A lot of this is talk about classroom management. What about the playground, surely there’s more provocation among kids there with less teacher supervision?

• The playground is part of the school and classroom instructional environment and should be treated in the same way – that is, children need structure and support to ensure they are learning appropriate skills. There is less adult supervision during playground sessions, which increases the need for programs to meet the needs of a range of children who have difficulty regulating their behaviour and engaging in appropriate activities.

Question

What is a simple way to explain ‘emotional dysfunction’ to the child’s teacher? When we were explaining it to the teacher they commented “Well what is it?” they wanted a diagnosis! Why do so many boys have this problem?

• Use simple description rather than anything complex: 'Andrew is a passionate and sensitive boy who responds to situations with stronger emotions than other children. He can't help this. We are trying to help him learn about his emotions, and better manage the behaviours associated with these'.

• Teachers cannot be expected to know every disorder and the impact that it will have for them on their teaching – the best way of sharing information about your child with a school is to give the teacher and the principal a one page A4 sheet with dot points describing the situation.

Question

Is there a connection between emotional dysregulation and childhood depression?

• Yes. Emotional dysregulation puts individuals at higher risk of emotionally-based problems in later life. But if managed well during early childhood (before puberty), children can learn to emotionally regulate and avoid mental health problems in later life.

Question

Is it appropriate for the school to ‘debrief’ an emotionally incompetent six year old – five days after the event following a suspension when he was also read the ‘drill’? Do you believe suspension is an appropriate form of discipline for a six year old?

• If any debriefing is to occur, it should be once a child has calmed down - no sooner, but also no later. If it is a day or more later, the opportunity has essentially been lost.

• No, it is not appropriate for a school to attempt to debrief a child five days after the event. Suspension maybe a strategy that is useful in terms of giving all adults a break, but it rarely produces a positive behavioural change in a child.