Advanced Pediatric Therapies

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Self Regulation 101

 Here is an article I wrote for kidsmoveandtalk.com about self regulation:

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Self regulation is the current buzz term in parent and developmental literature.  We’ve all heard of the famous “marshmallow study” where a marshmallow was placed in front of a child by an adult who also told them not to eat it, then left the room.  In the study, the kids who were able to control their impulses (and thereby earn a second treat) were followed up years later and found to have generally done well in life (think: good SAT scores and a lower body mass index).  The marshmallow study, originally done in the early 1960’s by Walter Mischel, has been called into question for it’s methodology, but it is still often quoted and referenced.  Mischel even recently wrote a follow up book about the study.  But the basic principle holds true through years of research: A child who is able to monitor and control their own behavior builds lifelong skills such as persistence in the face of challenge, ability to deal with anxiety and problem solve in an increasingly complicated world.

In a behavioral context,  self regulation refers to the ability to act in a long term context consistent with your deepest values (Psychology Today).  What does this mean for a child who is still developing a moral compass?  Primarily that they value the power of adults and morally want to please them.  It may also mean that they deeply value candy!  In either case, the child shows a resolute decision to forego the immediate pleasure to attain a greater reward.  In an emotional context, self regulation refers to the ability to calm yourself when upset or even keep yourself from getting upset in a the first place when some sort of trigger arises.  Kids do not have the full cognitive ability to self regulate at all times, their brains simply are not developed enough to do so.  Hence, tantrums occur.  Learning self regulation is a lengthy process that occurs throughout development and can still be learned into adulthood.

Developmentally, even newborns turn their heads away from things they perceive as noxious such as, loud noises or bright lights.  By about age 12 to 18 months, children are able to change their behaviors upon request, if not all the time.  They respond to social and verbal cues from their parents such as “blow kisses”. By about age two, if a known caregiver is not present, they are able to transfer these skills with people they don’t know as well.  From age 3 to 11, these skills continue to grow.  Kids are beginning to learn that they need to wait until mom is off the phone until they can receive that snack they want.  Of course, they are still not able to completely resist impulses at this age, as any parent of a young child will attest!

Older kids and adolescents, while better at self regulating than younger children, may still have problems curbing impulses.  As their brains develop, though,  they are better able to know what works for them and what doesn’t (parents also are learning these things about their own children).  For example, a child may decide to go outside and play when they are angry with a sibling simply because they internally know it will distract them from the upsetting incident.  Similarly, an adolescent may use that same intuition to reach out to a friend to help them calm their nerves before a tough test at school.

What might keep a child from being able to comply with requests or calm themselves down?  Many factors as it turns out.  A child who doesn’t want to play with a certain toy is more likely to help put it away.  Other factors such as fatigue or hunger can affect all of us in being able to keep our emotions in check.  Whatever the situation, kids who buy into the request have an easier time complying than those who don’t agree.  For this reason, it’s recommended to give the request a positive spin rather than a negative.  For example, instead of saying, “You can’t have candy for breakfast!’, say, “How about some delicious eggs for breakfast?” It’s always a good idea to help your child see, in as few words as possible, the positive aspects of a given choice.

The following are also great ways to help your child self regulate as they grow from infants to adolescence: (Gillespie, 2006)

  • Observe:  A baby will tell you she’s hungry by fussing or crying.  But an older child is harder to read.  They may come home from school out of sorts.  You may need to help them to regulate themselves by offering a snack or sitting down to talk with them.  You can also help identify their personal triggers such as crowded spaces or noisy areas.
  • Respond:  Be aware of your child’s particular needs.  Do they need some time and space?  Or do they need tighter routines and order? In the above example, a child may need to move their body to help them reorganize themselves after a busy day or a fight with a friend.
  • Provide structure and predictability:  Let your child know if things may change.  Give them an idea of what’s happening that day or week.  Keep a family calendar.
  • Keep it developmentally appropriate:  You can’t expect a toddler to sit quietly in a waiting room for half an hour.  Bring toys or games to keep them occupied.  For older kids, ask them if they need some space.  Let them know you are there when they need you.
  • Set age appropriate limits:  For younger kids, for example, they need to stay in line so the teacher knows where they are. Explain why teachers have the expectations that they do.  For older kids, develop contracts or agreements to let them know you respect their safety and their space.
  • Show empathy and caring:  For all kids, no matter their age, it’s vitally important that we as parents respect their needs and treat them as people of value.  In the long run, this is what helps them handle strong emotions.
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Parenting the Highly Sensitive Child

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We have lots of kids who come through our doors that parents describe as “sensitive.”  What does this mean?  The book The Highly Sensitive Child written by Elaine Aron, defines a sensitive child as… (from website)

A highly sensitive child is one of the fifteen to twenty percent of children born with a nervous system that is highly aware and quick to react to everything. This makes them quick to grasp subtle changes, prefer to reflect deeply before acting, and generally behave conscientiously. They are also easily overwhelmed by high levels of stimulation, sudden changes, and the emotional distress of others. Because children are a blend of a number of temperament traits, some HSCs are fairly difficult–active, emotionally intense, demanding, and persistent–while others are calm, turned inward, and almost too easy to raise except when they are expected to join a group of children they do not know. But outspoken and fussy or reserved and obedient, all HSCs are sensitive to their emotional and physical environment.

Sensitive kids require extra attention and modification from their families.  The best route to effective intervention is to accept them where they are and not try to change them.  You can try to change your approach to your child in some different ways, though, to keep things calmer at home and provide some much needed predictability.  Sensitive kids tend to get “triggered” more easily.  They are more emotional and struggle to not become overwhelmed.

For parents needing some peer support, this series of articles on the blog Scary Mommy is really helpful.  Raising a Sensitive Child and My Imperfect Child give perspective on what it’s like to raise a sensitive kid.  Some additional reading is a book that has been recommended by parents is by Ted Zeff called The Highly Sensitive Boy.

In any event, parents often confront a difficult issue with these sensitive (or “emotional” or “difficult” as frequently labeled) is how exactly to discipline them so as not to break their fragile spirits.  From the book and this article in Creative Child magazine, we have some ideas.

Firstly, there are discipline techniques that should definitely be avoided.  Shaming, by way of name calling and “why can’t you get this?” type of correcting are perceived very negatively by your sensitive child and be potentially very detrimental.  Teasing a sensitive child is bound to provoke their intense emotions and likely will not be felt in the playful nature that was intended.  Best to be direct.  Physical discipline is also devastating to sensitive kids and most childhood developmental specialists warn against using it with any kids.  Time outs likely will be perceived as being sent away by sensitive kids and can take an additional emotional toll.  Finally, being too permissive in an attempt to avoid tears or meltdowns is to be avoided as well.  Loving correction is best.

Discipline Techniques That Work Well:

  • Be careful of your tone.  Loud does not mean you will be listened to any better, and to a sensitive child can be even more harmful.
  • Connect first.  Remind your child you love them and gently tell them what your concerns are.  You don’t want to be perceived as threatening.
  • No time outs.  Instead, take your child someplace that will help them to calm down and peacefully explain what went wrong and what should happen next time.
  • Consequences should be mild.  Most sensitive kids will adjust their behavior based on their ability to see it displeases you and is not acceptable within the family.  Consequences that make them stand out are shaming and to be avoided.
  • Follow up.  Have play time, and use positive language after the discipline has occurred.  This restores connection.

Hope these are useful to you and your family.

Ask any of our OT’s if you have questions or ask about our lending library for resources on sensitive kids.

 

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