B-DI News


A Newsletter About Caring for the High Maintenance Child by Kate Andersen, M.Ed.

Issue Theme: Activity, Attention Span and Persistence
Volume # 21, Issue 10
July, 2019.
http://b-di.com/newsletter.html



Letter to Kate

Dear Kate:

Here is my situation. I have a 9 month old who sleeps fairly well (10 hours a night usually). Not a problem until lately, she wakes up and can't go back to sleep. I don't believe it's teething, and she's definitely not hungry. But, the serious issue is that she refuses to take naps during the day. She definitely needs them; after being awake for about 2.5 hours she becomes very fussy, rubbing her eyes, dropping things, falling (she started walking a couple weeks ago), etc. So I put her down for a nap, which she refuses to cooperate with.

She has always hated taking naps but would eventually have to give in because she wasn't strong enough to keep fighting. But as she becomes stronger, she fights longer. Before she would sleep for 30 min. on the dot, after crying for 20/25 minutes. Now she cries for an hour and sleeps for 30 min. sitting up holding on to the rails of her crib, with her forehead resting against it. Not to mention the slightest noise starts the whole process over again.

If I try to lay her down after she falls asleep sitting up, it starts all over again. I try to be as consistent as possible, but nothing seems to work. It may not seem like a serious problem, but it is. I've tried to stay in the room and comfort her, but she just keeps trying to stand up, and I'm sure it would drag on for as long as I'm in there. I've tried putting her down at the first hint of being tired; I've tried keeping her awake for hours. It all ends up the same way.

Another insight to her personality is that she never sits down! She has to play with her toys standing up with them elevated on something. She skipped crawling because she hates laying down.

There is a lot more detail I could give, but I don't want to waste anymore of your time if you are unable to consider this problem. I've taken advice from many people, but nothing works. Usually it is a mystery to anyone I talk to.

I talked to her pediatrician, and he doesn't seem to be concerned. If I let this carry on like this, she will be spending 50% of each day in a dysfunctional state of mind. Thank you for your consideration..

Sincerely,

Heather

Kate's Answer

Dear Heather,
You sound pretty concerned so I sure hope my comments will be helpful. Your story reminds me so much of my own first daughter when a few months younger, only she had not yet learned to walk. She had just learned to pull herself to stand. She seemed to be so over-stimulated by this new learning that she literally stood up in her crib while asleep. When she did this she woke herself up and was in a frenzy. We panicked, too, because she was, as you say, "in a dysfunctional state". My guess is it is a type of over-stimulation from new learning. We tried all the things you did, but eventually had to close the door and let her cry. It stopped in a couple of days. I am pretty sure she fell asleep standing up and then eventually keeled over..

Nine months is very young to start walking. Another child I know who did this was so excited by his new mobility (which in a sense he really wasn't ready for) that he walked constantly, wearing himself and everyone else out. Of course, you need to check with a pediatrician that there is nothing else going on. My feeling is that some youngsters are very driven to achieve tasks like walking early, perhaps because they are bright and see what other children can do. I must admit that both families were rather achievement-oriented with these babies and tended to make a big fuss over new milestones. We became more laid back with our later-born children and had fewer of these problems. The two children I have described (my own daughter and the other little boy) are now 20 and 18 respectively. They are still prone to getting over-stimulated, still push themselves to achieve things beyond their year sand are wonderful, bright and well-adjusted young people. I hope you find that reassuring.

Good luck. I hope your little girl settles down soon. Then get ready for the next achievement.

I hope this helps.
 
Sincerely,

Kate


COPING WITH TEMPERAMENT: High Activity Level, Short Attention Span, Low and High Persistence


Although they are truly different traits, there is considerable overlap with these dimensions. Methods that help with a short attention span can often help with low persistence, and many very active children have short attention spans and low persistence. Both inattentive and energetic highly active children find it difficult to sit still for a long time. Very active children need to move their bodies; inattentive children may need novelty and specific ways to occupy themselves. Of course, there are many children with several types of temperament-based 'attentional' difficulty and they are restless indeed. Those highly active youngsters who truly do have boundless energy may have a quite different profile from those the constant activity that reflects difficulty focussing and sustaining attention. In the latter case, often steering the child towards the playground is less successful. Even so, the following ideas have proven helpful with many restless youngsters.

Each of these clues leads to a different solution. Once again, parents are often the experts and have been very creative in finding solutions for their children. "We made a rule of only one sleep over a month and it had to be on a Friday on a long weekend so seven-year old Kim had the rest of the weekend to catch up on her sleep. Her friends' parents went along with this rule, thankfully". "When I am expecting my PMS, I warn the family and make plans for some relief from parenting". "When my husband goes out of town, we have different routines that ensure I can give our son the extra attention he needs. Dad phones regularly to make sure Randy realizes that he is okay, and did not, as five-year old Randy feared, go up in the sky to heaven to be with Grandpa (which is what we finally realized Randy thought an airplane ride 'up in the sky' was all about)". "Solutions to sibling rivalry? Get real! Oh well, I guess we have to hear the messages and do what we can to make sure each child feels valued. Wish us luck!" "We found that our nine-year old son would open up more about his life - and therefore sometimes discover the reasons for his bad mood - if we went swimming with him and then took him out for a one-on-one treat afterwards. For some reason, this combination seemed to loosen him up and open the doors to communication".





ADJUST YOUR EXPECTATIONS

Long drives, waiting for appointments, sitting through religious ceremonies and participating in adults' events such as dinner-parties are common problem areas with active and inattentive youngsters, and indeed with most young children. Families and teachers need to adjust their expectations to developmental level and to temperament. Although there are ways to help children cope in these situations, at times the best solution is not to expect them to manage such long periods of inactivity. This can be difficult for some families to do when it comes to very highly-valued activities such as going to church, temple or synagogue, especially if they have previous children who did not give them any problems in these situations or if they cannot remember causing trouble in this way when they were children.

Maria was very devout and her four oldest children had always behaved so well in church. Her youngest son, Miguel, aged three, was causing her deep unhappiness with his restless behavior during Mass. When she first worked with a professional who was not from her own culture, she was very offended when told to adjust her expectations. She felt her devotion and her church were not being respected. After all, in her view, there were so many problem children who would benefit from religious training. When she worked with a new counsellor who was from the same culture and religion, she acknowledged that at times she felt that Miguel was truly sinful for behaving this way. When the counsellor distinguished between sin and innocent childhood behavior in religious terms that were acceptable to Maria, Maria agreed to place her son in the church child care program and to try bringing him back when he was older and more able to truly benefit from the service.

BE CREATIVE
When active children must sit for long periods, they may be given permission to move their legs, play with a squishy ball (or two) in the hands, play with a hand-held game, listen to an audio-tape through headphones. On long (to the child) car trips, some children will cope better with a parent in the back seat talking to them or reading a story. There are also the time-honored games of counting cars of certain colors and watching for landmarks."

TAKE BREAKS.
Frequent stops and run-around breaks can also be very helpful. Parents who plan ahead and time their trips to fit in some breaks can greatly prevent problems.

START WITH THE CHILD'S INTERESTS.
Rather than trying to force the child to settle down, it is often more effective to move with the child, starting from the child's interests and building outward from there. Once the child's attention is captured the child may become very focussed.

TAKE ACCOUNT OF OTHER TEMPERAMENT TRAITS AND CHARACTERISTICS.
Highly active toddlers and preschoolers may spiral out-of-control quickly, especially if other temperament traits such as low sensory threshold, high intensity or high distractibility are present. The context in which they become overexcited or overwhelmed often provides clues as to which trait or cluster is coming into conflict with the environment: "With two-and-a-half year old Melissa, there was a law of nature. We could tell by the number of adults in a room whether she would 'lose it' or not. Lissy's limit was two adults talking. Beyond that, she turned into a little wild cat." Melissa was an intense, active child with a low sensory threshold.

PREVENTION IS THE KEY.
Prevention is always preferable to dealing with an overexcited or overwhelmed child. At times, the child's distractibility can serve as an asset in these situations, especially with toddlers. Being carried over to look at something captivating may calm the child quickly simply because the child is so distractible.

BE CREATIVE!
Many parents have found water a valuable medium for calming down an excited or overwhelmed youngster: "Magic water works like magic with active Nima, when he is all wound-up. I fill up the bath-tub, put some drops food coloring in the water and he plays happily while I sit and watch, polishing silver (which we never get to use) or mending his pants (which always seem to be needing knee-patches)."





WHEN SHORT ATTENTION SPAN AND LOW PERSISTENCE BECOME RISK FACTORS.


Children whose attention spans are even shorter than the average young child's can appear demanding because they do not get absorbed in activities very long and frequently turn to caretakers for stimulation. Others may become restless and get into things they shouldn't. Others simply rampage through their toys and may create a lot of mess. Although people often think of 'attentional problems' as surfacing in classrooms and other places where the demands for concentration are great, there are many day-to-day tasks in the home that do require attention and persistence: getting dressed, getting through morning and evening routines such as brushing teeth, washing face, and eating meals. Other tasks such as listening to bed-time stories and doing small chores such as picking up toys can also be affected. Although this topic has not received adequate research, it is easy to see how development can be affected if a child is not able to become fully engaged in these normal tasks of childhood. A favorite video or cassette-story can often help even a young child settle. With some children this will be more successful if the adult holds them or at least sits close to them, especially at the beginning.

STRUCTURE AND ROUTINES.
Structure and routines can be helpful to children who are very active with a high activity levels, short attention span and low persistence. Such youngsters may be able to complete a day-to-day task such as getting ready for school if parents break the job into steps and praise the child for each completed step.

CHANNELLING.
Parents and teachers can often channel an inattentive and restless child by giving the child a task that requires activity, such as taking out a waste-basket and carrying it out to the garbage cans by the back gate. If the task can be broken up into several trips, and the child rewarded with stickers or a treat, then there is often a great sense of satisfaction for both parent and child that energy has been channelled in such a constructive fashion.

USE A STRONGER OR MORE APPEALING STIMULUS.
When the normal approaches to obtaining the child's attention don't work, parents and teachers can experiment with making the stimulus stronger or more appealing to the child in question. For example, parents can try using a much louder voice or a resounding clap, a whistle or a bell to gain the child's attention. Tasks, such as puzzles, may gain the child's attention for a long time if they are brightly colored than if they are drab. Because novelty is often a factor in maintaining attention with such children, the particular stimulus may need to be changed frequently.

PAIR WITH A PEER WHO COMPENSATES
A compatible but more focussed playmate offers a most valuable type of compensation. Indeed, the benefits of such a social 'curriculum' are so great that this type of peer-mediated compensation should be explored further in school contexts. Some youngsters will play for exceptionally long periods with another child who fits well with them because they can tolerate the frequent shifts in focus and even make suggestions to help the child stay engaged.
Scott was a child who was low in persistence, very distractible and who had a very negative mood. His mother found that he whined and pestered her constantly. However, in the company of a very familiar and very patient neighbor who was a year older, Scott could play contentedly for hours. When his mother observed the boys to find out the secret, she noticed that Scott's friend followed her son's lead but also made suggestions for making the game more elaborate. This held Scott's attention. These boys played pirate games up and down the stairs, rushing off to bring in a new prop from time to time, or turning their ship into a flying-ship when they got bored with fighting off sharks. The play proceeded at an astonishingly rapid pace and Scott's mother got worn out from just watching them. However, she was eternally grateful to her little neighbor for the rich friendship he offered her son.

COPING.
Channelling the behavior of children who also have short attention spans and low persistence is not as easy as steering the highly energetic, active child into physical play. Even climbing a Jungle Gym requires some ability to stay on task. One form of channelling which can be used at times is watching a video or playing a video-game. These fast-paced activities often do captivate the attention of such youngsters. There is concern that engaging too long in such activities trains a short attention span, so caution needs to be exercised here. However, there are times when parents need to be able to settle their child. Often a non-violent video or educational video-game is the only way to accomplish this. Parents have many tasks to balance. They should not be criticized for resorting to such methods for legitimate purposes, such as paying attention to another child in the family or taking a quick shower. However, it's a good idea for parents to document the amount of time they are using these methods so that the situation can be monitored and excessive video or television-viewing dealt with.

BE CREATIVE!
With ingenuity, parents can help to compensate for temperament where it may be creating developmental risk. "We always read to our daughter, even when she was a baby. She became a bright, articulate early reader and we know that the early reading helped. When our son arrived, we expected the same experience. But Nicky was an active child with a short attention span and low persistence. Reading Nicky stories was a struggle, even at age three. He would start off on our laps, quite interested. But once we started to read, he would play with the page and change the subject. He would turn the book upside down and laugh. Sometimes he would just wriggle off our laps and leave. We didn't want to give up this valuable activity so we asked our day care teacher for some help. Together we developed an inventory of Nicky's interests. We made our own books for Nicky, about the things he liked. Every page had something for him to do. For instance, he loved trains. We made a book about trains. One page had a real whistle taped into it. Another page had some removable tracks. And so on. The implicit rule was: 'First Nicky listens, then Nicky plays'. Slowly we weaned him over to regular books, making sure that there was something he could do when we were reading those, too. (We selected them carefully.) Nicky is nine now. He's still active and still has a short attention span but he's a terrific reader, as long as the books are on subjects that interest him".

HIGH PERSISTENCE.
A child who is highly persistent may get 'stuck in' to activities and, especially when young, may tantrum if forced to disengage. This trait often causes conflict with parents especially when the trait is combined with other 'difficult' ones, such as low sensory threshold, negative mood, high intensity and poor adaptability. Then the child may go on and on about something which seems quite trivial to parents: "Carolyn gets really bothered by the way her pony-tails feel. She insists on wearing pony-tails, but whatever way I do them, they feel 'wrong'. I spend half an hour every morning, redoing them and redoing them, listening to her complain and complain. I have come very close to hitting the child with the hairbrush. What's wrong with her? Why is she so constantly dissatisfied?"

AVOID POWER STRUGGLES
High persistence is the opposite of distractibility. Even when parents offer a treat or remove the child from the situation, the child may persist in wanting something he or she cannot have, or may not give up complaining about something that happened earlier in the day. Because high persistence causes such intense and frequent conflict, parents and teachers need to learn to disengage early and firmly from the issue. Very persistent children, especially when very young, cannot be reasoned or bargained with. They need help disengaging. The best way to help is not to get involved in any way with the substance of the issue. Even comments such as "No, I did not promise ice cream" or "I don't think your teacher was being mean" tend to just add fuel to the fire. If the parent becomes emotionally or intellectually involved in the issue, then the power-struggle will intensify greatly. This tends to make the child even more persistent.

BRING YOUR INVOLVEMENT TO AN END FAST
The most useful thing a parent can do is recognize early when a child is "stuck in" is to hand the control of the situation over to the child: "You're stuck into whining. I'll be listening again when you stop. Now I am not listening any more." When parents bring any negotiating to an end quickly and firmly, the child is greatly assisted in getting 'unstuck'. However, because this behavior is rooted in temperament, the child may be unable to disengage for a long time, and may cry and fuss. This should be ignored. One parent made a rather startling analogy:"We have an older child with epilepsy. We now see his younger brother's 'getting stuck' behavior as a lot like a seizure, even though we know from the pediatrician that this time it's temperament and not a neurological problem. But making the comparison helps us with our expectations. We don't expect to be able to talk him out of 'being stuck' any more than we can talk Randy out of a seizure."




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