I Hope This Isn’t ADD!

If your child has authentically diagnosed ADD or ADHD, please do not read any further! This is only for moms with ADD-wannabes =)

So my second son, at 6yrs old now, has many of the classic symptoms.  He is distracted by everything.  He has sensory issues, so he hears, smells, and feels everything whether it is the heat coming on, a truck backing up on the interstate, or even the smell of the oven.  This doesn’t help.

But even when I get him “focused” and working, he is very distractable.  He’s an artistic type, so he gets derailed into doodling on his workbook pages, or writing little notes to me on them when he comes to a difficult problem.  He can write a whole misspelled paragraph to me about a one-word blank.  He also likes fonts, so he starts decorating his “Ts” and “Fs” with little serifs or italic/bold-faced type.  Then his pencil needs sharpening, so he spends about 10 minutes doing that only to have it snap off when he gets back to his spot.  He starts that process over.  I homeschool him, and he can easily take from 9am to 12noon just doing two or three tasks.

But he’s extremely intelligent.  So I try not to harp.

It’s hard though.  His ADD spills over into other areas too, like getting dressed, tying shoes, brushing teeth.  It is very frustrating.  And yet, I realize it is partly developmental.  As you know, boys are over-diagnosed with ADD or ADHD.  Sometimes husbands and grandfathers hear about it and believe they’ve suffered with it their entire lives.  If it is maladaptive, maybe they do.  But it could just be part of the male brain.  Male brains are like “waffles,” as one celebrated author says, and topics are compartmentalized–in the brain, each subject has its own box separate from the others, and men jump from box to box, subject to subject.  Little boys do this too, which is how they get so far off track.  Things are just INTERESTING to them, so they think about it, cutting off what they were originally doing.  My girl doesn’t seem to have this problem, but I am sure there are many girls who do, especially creative and  free-thinking ones!

There are many blog posts and books on this subject, so I won’t belabor it here.  The real reason I am writing this post is because it dawned on me just today that there is something  redeeming about ADD wannabes.

Other than the gender component, I had thought that perhaps ADD was personality-related in the sense of learning style.  My second son is very analytical–obviously if he’s into fonts!  But something about this hypothesis wasn’t accurate because my first son is also analytical and has no attention problems at all. He has laser-like focus.  Then this morning I was teaching my third son Language Arts (he’s five) and I saw some of the same ADD symptoms beginning to crop up on him as he worked.  “Oh no!!!” I thought to myself.  “I have to stop this from happening so it doesn’t consume him like my second boy!”

Then it hit me.

He THINKS about his work as he does it.  My third son is not analytical at all.  Not even a little–it took him forever to learn his letters because A and B all looked the same to him.  (My other two sons picked them up before they were 2yrs old).  My third guy isn’t picky about anything, is very independent, talks in general statements, and picks up concepts easily.  But as he was working on his vocabulary and spelling, he was actually trying to think about what the words meant.  He wasn’t interested in just reading them (“cast”… “task”… “track”), he was asking me questions about them.  Then as I would explain them, we would get off track as that led to more questions.  Sometimes we got off for 5 minutes talking about something six degrees away from “cast.”  And I’d have to steer us back to the page at hand.

That’s when I realized that my second son does the same thing.  He tries to really understand things on a heart level.  He is very artistic, very scientific, and has a high IQ.  His vocabulary–especially for a young boy–is excellent.  So he ponders his work and goes slowly, thinking about things as he goes through.  This causes the distraction and “six degrees” problem.

My first son, however, who is 8 and has no attention problems, is analytical but doesn’t think AT ALL when he does his work.  He breezes through it as quickly as possible.  We have trained him to try to get the right answers, so he does know how to slow down and rethink a question with prompting.  But I can tell when I talk to him that he doesn’t like to think!  He is a type A personality and does things by the book, as perfectly as he can and gets good grades for it.  But he’s the type of  boy who can read an entire book and know very little of what he read.  Or misread the directions on a page and complete the entire page according to a rule without it dawning on him that his answers don’t make sense.  Or look up a word in the dictionary and read the definition four times and still have no mental picture.  He’s got a great memory and devours books, but has a terrible vocabulary and makes few connections on his own.  (i.e. he’s a history buff but asked me the other day whether July 4 was an American holiday.)  He just has a superficial understanding of most things and doesn’t know what he doesn’t know.  Terrible commentary on how getting straight A’s doesn’t correlate to comprehension!

So maybe this is just the way it works: quick and brief, or slow and comprehensive.  If you have a child with attention problems too, you can be grateful that s/he’s probably a thinker.  They might grow up to be one of those kids who are terrible test takers but, if they took it correctly, would score extra high.  After all, it’s only if you think about what you’re doing, can you can think enough to get distracted!

I’m not trying to make light of attention problems.  I definitely think the kindergarten age is the optimal moment to teach this study skill– if you can teach your child to sit still and focus when they’re five-six, they will have a huge advantage.  But I have more grace on my boys now.   My kindergartner is clearly building his vocabulary and knowledge base, even though it seems like we labor over getting one page completed.  It’s developmental and important not to skip.

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The Autistic Child (NOT)

Does this describe your child?

  • 2.5-3.5yrs old
  • probably male, probably firstborn
  • delayed language; doesn’t put words together yet
  • doesn’t use Yes/No correctly– can cry/temper tantrum easily
  • doesn’t call for help
  • doesn’t use Mommy/Daddy/own name well
  • very detail-oriented
  • walks on tiptoes
  • walks in circles, sometimes jabbering to self or no-one
  • spins car wheels, pokes blocks off, or otherwise repetitive play behavior
  • repeats your questions/statements
  • repeats sounds or scripts ad nauseum
  • easily distracted
  • bad eye contact
  • can’t answer comprehension questions
  • no gestures or pointing
  • few independent skills
  • doesn’t understand taking turns or people skills well
  • won’t drink milk, eat fruit, etc.
  • constipated all the time
  • difficult sleeper

Congratulations!  You have a fine, well-adjusted NON-AUTISTIC child!  No, I mean it.  Your child is likely a finicky, driven, bored and distracted little boy.  He doesn’t care about language, isn’t able to pick it up easily, and is therefore a tough cookie who is behind in some areas that he wouldn’t be if he had better language skills.  But for now, you have to suffer in the world of preschool, playgrounds, and other life adventures that really do require more English and social skills than your child has.  And guess what?  This is totally normal!  Stop worrying that he is on THE SPECTRUM because life doesn’t seem to fit his developmental timetable, and just hang in there until he’s 5.  Get a lot of structure and routine that works for you, adopt a rigid discipline ethic if necessary, and have faith that once the language kicks in, he will make up for lost time pretty much right away.  His behavior will also become less erratic.

How about this child?

  • 1-4 yrs old
  • picky eater
  • messy, clumsy, can’t dress self well
  • cries easily
  • strange phobias– water, vacuum, dirt
  • anxious behavior
  • taps or scratches self, has repetitive stimulatory behaviors (i.e. may still suck thumb, fidget with socks, etc)
  • seems lost in a group, or plays alone
  • deep, focused play skills; strange attention at times
  • doesn’t like to engage others
  • avoids conflict, checks out
  • can talk but doesn’t initiate or sustain conversation; people might not even know how well they speak
  • may speak to privileged individuals, in-depth about their favorite subject/question
  • unusual talents, or way ahead in an adult area
  • retreats to specific activities; self-soothing repetitive play
  • takes things apart to study
  • handles toys or household objects in peculiar (non-functional) ways
  • sensitive to smells, sounds, touch
  • “freak out” or “shut down” behavior
  • low muscle tone
  • allergies or inadequate nutrition

Congratulations!  You too have a sensitive, fearful, NON-AUTISTIC child!   Most people would like to diagnose your little guy with Asberger’s or Autism Spectrum, but more likely you have a misunderstood, sensory-sensitive little person.  This profile is less commonly complained about than the very first profile I outlined, but it definitely represents a portion of toddlers who are very quickly seen as at-risk for autism and usually packed right off to a specialist for a neuropsychological exam.  Whereas the first  profile I listed above is likely to see the child put in special preschool, perhaps with an ADD-type medication, this second profile is more likely to be medicated for childhood depression, anxiety, OCD, or reactive detachment disorder.  But kids come in all colors!  There is no need to panic because your little person isn’t the extraverted, sensible preschooler.  He/She may be an “old soul” or grumpy type who doesn’t fit in with the flashy world around them.  He/She probably needs a little extra nurture and coddling, as well as some occupational therapy or one-on-one play/floortime with a loved one.  Resist THE SPECTRUM curse!

** Note: Of course I am not against true autism diagnosis.  And I am not against checking out whatever symptoms worry you about your child.  I am just making light of the fact that “normal” is a wide range, and MUCH wider than we are told it is.  Usually we are told to worry, from experts, parents, or friends, because of the developmental scare climate out there.  Yet there is no reason to push the Panic Button just because your toddler or preschooler has some delayed or anti-social behavior.  Attention and special education might be necessary…as it always has been, in the case of small children who have individual tendencies and weaknesses.  But usually these are things you can do on your own or with limited intervention.  There is no need to put small children under a microscope and ship them off for multiple diagnoses so they can receive services from the state until they’re 21 because we’re afraid they’re all high-functioning autistic.**

How about this?

Does Your Boy Develop Unevenly?

After hundreds of comments from moms dealing with their speech-delayed boys who walk on tiptoes or have other such idiosyncrasies, it occurred to me to write another post on the boy/autism thing.  This time, with a focus on the developmental timetable.

I have another post on how boys develop differently than girls, but to recap an important point: boys often do not follow the timetables.  In fact, they are spotty.  They grow unevenly.  At times, they will hit the developmental mark right on the money.  Other times, they will be way off.  And often, they will have some abilities way ahead for their age—while at the same time, they will have glaring weaknesses way behind for their age.

For example, when my firstborn son was 2 going on 3, he could do 100 piece puzzles from memory.  No box, no pausing.  Just snap, snap, piece after piece together.  Like a robot actually.  He even found out, by doing the puzzles on top of each other, that some of them used the same template!  For a toddler who didn’t talk yet or even say “Mommy” or “Daddy,” this was strange to us. Then when combined with some of his habits like walking on tiptoe, spinning and crashing cars (but not really playing with them), memorizing long scripts from video, repeating himself, and not pointing or gesturing, we started realizing he had some of the autism signs.

In fact, when we read down the lists of symptoms, he had lots of them.  He had language delays, some social and emotional issues, and some of the sensory signs.  He seemed to have no imagination or interest in crayons or action figures.  But he seemed way ahead in spatial skills, knew all his letters and numbers etc., had great focus, loved to be cuddled, and generally seemed bright and charming.  His motor skills were great, and any non-verbal tests he got, he passed with flying colors.  Or things that needed one-word answers he could do.  He was way ahead in some cognitive areas and way behind in others.

Then my second son came along and was the mirror image of my firstborn.  Extremely verbal, very early, artistic and creative, but way behind in motor skills.  Emotionally unstable and very anxious, he had almost all the sensory problems common to autistic children, including choking issues, hatred of socks and tags, inability to cross the midline, and freaking out sometimes.  He didn’t bond well to others (except Mom) and couldn’t do puzzles or visual tracking activities.  So even though he was talking, imaginative, and sociable enough in his own way, HE was all over the charts.  And thus possibly autistic.

Then my third boy came along.  You know the story by now.  He hit some milestones right on time (i.e. walking), hit some way early (i.e. sentences by 19months old), and some way behind (i.e. toileting issues until his fourth birthday).  And he had some strange issues (i.e. severe fear of water).  By this time, however, we had trashed the charts.  We figured he was fine!  He didn’t have to love everything 3 year olds loved, he didn’t have to talk like 3 year olds talked, and he didn’t have to fit in some “autistic Spectrum” bucket because he had some emotional immaturity. And now that he’s nearly five, we’re SURE he’s not autistic!  (or any of our other boys either).

So this is my encouragement to you if your boys are geniuses at some things but embarrassingly behind at other things.  Do you know that book, “Men are Like Waffles and Women are Like Spaghetti”?    That book effectively describes how my little boys think.  Their brains are like waffles, with separate compartments for each kind of skill or knowledge.  They can dive in real deep within any one box, but the knowledge doesn’t seem to transfer over into other boxes or compartments.  The connections aren’t there, and there isn’t much infrastructure to help them build up their weaknesses. So they grow very unevenly.  It can be worrisome for a time because their strengths get stronger but their weaknesses seem to get weaker, especially when you start comparing them to other kids.  3 year olds tend to be the most diverse.  Sometimes therapy doesn’t even seem to make a difference, at least not right away.  Little boys just plunge ahead with their strengths (what they naturally get) and prefer to stay there, enjoying it and totally oblivious to your concerns that they aren’t “normal” all around.

Consequently it is now no longer surprising to me that my six year old son currently can take apart radios and electric circuits, but doesn’t understand that if he stands close to the stairs, he might fall down them.  My almost 5 year old son can talk to me about heaven and dying, and what he wants to be when he grows up, but still hates even the tiniest drop of water on him or will change his underwear or socks if they get a speck of dirt on them.  My seven year old son currently can pass second and third grade English and Math tests, on paper, but has a five year old’s vocabulary, says “What?” a lot, and uses awkward phrases all the time.  They are just not even developers.  Some things way ahead and some things behind.  Some normal habits and some strange idiosyncrasies.

In comparison to my girl, who is precocious socially and emotionally, and has met every deadline on time, there is just no similarity.  My conclusion: It’s ok for boys to be uneven and worrisome.  That’s just often how it goes.

The Shy Child

I am entitling this the “shy” child, although one of my sons who prompted me to write this is perhaps not the typical “shy” child as much as the cautious or worried one.  I have been studying this behavior a lot recently and, now that he is turning six, looking for appropriate ways to help him conquer fear and anxiety, especially socially.  He has basically had this problem since he was little.

Looking back, I can see that he was even a “shy” baby.  He was small and weak, clingy but happy.  He was easy—didn’t cry a lot, napped all the time, yet sometimes wouldn’t hang onto a feeding enough to get the full amount.  He gave up easily, grew up behind his physical milestones, fearful of trying to walk, and screaming his head off when I walked away from him, starting at about 8months old and ending I’m not sure when.  Probably at 16 months when he finally tried walking, and found out he could do it perfectly by then.  Toilet training was a nightmare, separation anxiety was terrible, and he sucked his thumb for a long time.  (He still does, only at night though).  We found out he had a barrage of sensory and motor issues, got him occupational therapy for that, and would stutter when he didn’t get enough sensory input that day.  He generally liked people though, he was exceptionally bright and talkative at an early age, and taught himself to read.  I never had any real concerns.

This may or may not describe your child, but the point is that the shyness and fearfulness began at an early age and it has been tricky to help him grow out of it.  We have only just gotten to the place where he was ok enough to do kiddie gymnastics at the YMCA.  He breaks down and cries so easily that most classes are a nightmare.  And most teachers don’t have enough patience!  Let’s face it… I don’t always.  I have a unique empathy for what he’s going through, as his mother, but sometimes I can’t handle an avid crier.  I  just can’t understand why games are not fun, competitions are so threatening, and most stuff he won’t even try.  And I don’t mean like trying out for the soccer team.  I mean, like he won’t try to throw a nerf ball through the Little Steps basketball hoop.  Or use a friend’s kiddie tramp in the yard.  Little things, you know?

Well, now that he’s older (6yrs) and so precocious, I have been able to have some good conversations about it with him.  And I’ve been reading up on the subject.  And here are some things I have learned, which might help you deal with your clingy and fearful one.  (I can tell this is going to be a long post, sorry!)

1.  Shyness is not a crisis. Don’t panic!  (Maybe I should have said, “shyness isn’t autism” =)  Even though it seems that everything for little kids in America is geared towards sanguine, extroverted children, eventually the more reserved ones will fit in.  For kids who are wary of excitement, the world can be a tough place.  As parents who want to see our kids happy so much, we just have to accept this.  There are melancholy types, and we may have one.  My second son is a stereotypical Eeyore, Gloomy Gus, or whatever and it has been a little difficult for me to accept this.  Yet I see the wonderful things God has placed within him which are going to make him successful when he’s older.  I see his empathy, thoughtfulness, gentleness, carefulness, and discernment.  He is analytical, scientific, extremely emotionally aware, and will probably end up in a counselor, teacher, therapist, doctor, or otherwise helpful role when he’s an adult.  I don’t want to squelch this even though I get frustrated that he won’t join in the Uno game or kiddie pool =)

2.  Share the positive things with the child. Whereas my other three kids are blissfully unaware of their strengths and weaknesses, and charmingly prideful about everything, my shy child is painfully self-conscious.  This makes it all the more important to start teaching shy children about themselves.  They are ready to hear it, actually, since they are already thinking about it.  And if I don’t interrupt the “bad tape” that my son is playing inside his own head (“I can’t do this.  I’m too short.  I’m not good enough…”) then it will take over.  I have to replace that bad tape with a “good tape.”  So I do this by sharing those good things I see… how neat it will be to see what he’s going to do when he grows up.  Even at 5yrs old, he was thinking about it and whether we have an accurate vision is not the point as much as it is that there is a purpose for his personality.  (Always approve of any idea they have, about what they want to be when they grow up, even if it is ridiculous or a bad fit.)  Subconsciously, I want to shift my child’s perception of himself from “my problems are my identity” to “I’m destined for great things, so I can overcome the challenges.”  Sort of like talking to the average 13 yr old who feels inadequate!

One way to help a little child who’s insecure is to draw a picture of a big bucket and put their name on it.  Then talk about what good things go in that bucket, like “kind” or “thinker” etc.  You can list these things and draw arrows into the bucket, and then put the picture somewhere they will see it a lot, like on the frig, or over a desk.  For non-readers, draw a small picture next to each word, like a heart next to “kind” or a thinking face next to “thinker.”  They will soon come to know these words as they see it daily, and you can bring it out when you have your talks.

3.  Teach positive thinking. This is kind of the same as #2 except more practical.  I actually teach my son to narrate what he’s doing, sometimes, instead of playing his “bad tape.”  The ol’ standby of “I think I can, I think I can” is ok, but my son is such a realist that “I’m putting this lace around this one, and then I’m pulling through” is better for him.  It replaces “I can’t do this, It’s too hard” while he’s practicing tying his shoes.

Also related to this is watching your language.  Shy is not a bad word, nor is sensitive, and the reserved child needs a vocabulary to talk about the issue as they grow.  Yet the shy child already feels like everything they do is under a microscope.  They feel that the problems they have are huge, but their strengths are insignificant.  If you’re careful how you speak, it can reverse this kind of thinking.  Obviously try not to scold or criticize, but more practically, try to give instruction instead of correction whenever possible.  And when appropriate, sandwich the instruction within two loving statements like, “I know you’re trying really hard to do that right, which is great.  I think you have to hold the bow in one hand while you loop with the other.  Then it will be easier.”  Pretending like everything is NO BIG DEAL is key.

4.  One-on-One time is huge. The shy child tends to appreciate the one-on-one time the most.  All kids need it, but the more tender or reserved child often doesn’t get it because they aren’t around as much, or are gentler, or whatever.  So make time and go get them if they won’t acknowledge the need to come to you.  And beware of leaving the child who plays alone in the corner, alone.  They probably don’t want to bother people, or have conflict, but direct eye contact and engagement goes a long way in warding off problems.  In particular, it keeps them from developing passive aggressive behavior later on, when they realize they need things but don’t know how to communicate or get what they need the right way.  Connect, connect.

One of the best ways to do this is create a personal ritual.  It can become very valuable to them, even if it’s just a bedtime story, or a weekly Saturday breakfast out, or whatever.  Even a non-demanding two year old is able to pick up on a ritual like this, and enjoy munching a bagel with you at Panera.  It tells them “I love you, and I like being with you.”  This will counter that negative tape they play and make them happier inside.

5.  Reward and Celebrate courage. The shy child is reluctant to engage social activities often because they have performance anxiety.  They may not know what to say, or to do, and so they are afraid of getting in the game.  And they may feel pressure to get things right the first time, do a good job, etc.  Knowing what “should” happen or what going to kindergarten “should” feel like causes them great cognitive dissonance as things “actually” happen or they experience what they “actually” feel.  Then they feel guilty or ashamed.  It is a very adult-like trap, really.  It takes some undoing.

Part of the undoing is to obviously teach as many skills as possible.  Shy children in particular need to learn eye contact, hand shaking, phone skills, manners, and what to say when they don’t understand or don’t know.   Many cannot turn off the fear or waterworks once they start, and they shouldn’t feel ashamed for it or convinced out of it until they’re ready.  Time-outs are often helpful.  They also need to practice with non-threatening people or contexts (even stuffed animals!) if actual performance is involved.  But once teaching and practice are done, then the key to reward and celebrate when they step out.  For another child, starting a conversation is not worthy of praise, but for the shy child, it is.  Speaking up, telling someone what they need, asking for help, trying something new, going to a party, singing in circle time at nursery school, offering help, etc…. all these things should be taught and then heavily rewarded no matter what the results are.  I’m not against giving shy kids candy for rewards.  It is a very tangible and non-consuming way to tell a 4yr old, “Great job.  I’m happy with your effort.”  Now with my shy child, giving him the incentive of an M&M to do something is different… it doesn’t work because then he feels all this pressure to perform to get that M&M.  This actually shuts him down and makes him cry.  So do negative consequences being threatened, obviously.  But an incentive is different from a reward.  His face does light up when I catch something good and reward him for it, probably because there was no pressure or expectation involved.  Find a balance, but reward based on the effort not the outcome.

6.  Get sensory and motor issues checked out. For my son, some occupational therapy (and now kiddie gym) has gone a long way in helping him deal with his anxiety.  Not every shy child has sensory issues, but probably more do than we know.  When a child actually feels everything too loud, too fast, too bright, etc., the world is an overstimulating and scary place.  Getting some occupational or physical therapy can raise their tolerance levels, as well as give them non-threatening one on one attention in the areas they need strength.  When I first sought testing for my son (then just 3yrs), everyone was so worried because of his fears and crying during the exams.  They thought he was depressed, had generalized anxiety disorder, and needed a neuropsychological exam.  I feared that only medication was down that path, so I persisted in my quest to take the more physical route.  I truly believed strength and self-confidence was at the root of the anxiety, so I insisted we try that first.  What do you know, it worked!  So if your child is afraid of parties, gyms, playgrounds, malls, etc, it is definitely worth checking this out.  My son not only hears the lowest sounds on the hearing machine, and sense all touches and smells more than anyone else, but he has bad visual discrimination skills so he can’t spot things well.  He can’t see me in a crowd, see Daddy coming back to the car, sense where he is when he turns a corner in the library, or get to the trash can and back in a restaurant without getting confused.  This of course contributes to startling and anxiety but is, thankfully, one of the easiest things to work on at home through worksheets, I Spy/Where’s Waldo, puzzles, and other visual tracking activities (try “Slow and Steady, Get Me Ready” by J. Oberlander for preschooler ideas.)   In my opinion, if there are sensory/motor issues behind social anxiety, you’ll never get the shyness to abate just by tackling them psychologically.  They need skills and desensitization too.

Play Therapy

What is play therapy, and how do I do it?

If your child is on THE SPECTRUM or delayed in other ways, you’ve probably heard of “play therapy” by now.  Play therapy became popular in the 80s and 90s as professionals found out that getting down on the carpet with their autistic-type 2yr olds, and engaging them, actually made progress.  You’d think this would be obvious, but it wasn’t something that the professional community had necessarily thought of before—at least, not given at regular doses like “therapy.”  Before that, professionals were… well, professional.  They sat in chairs and had nice offices with toys, but they administered tests, tried verbal exercises, and had children do activities mostly in chairs and desks.  Not exactly the comfort and freedom a child is used to.

Early Intervention is essentially “play therapy,” often mixed with speech therapy.  A trained special ed person comes to your house and plays with your little guy for about an hour.  She has a bag of toys with her and knows what’s she’s doing, but it is essentially play to engage your child with his or her weaknesses right where s/he’s most comfortable… on the living room carpet. Genius, right!

Well, the good news is you can do play therapy yourself too.  If you suspect your child is having developmental problems, if you know they do, or if they don’t but you’re just looking for some more educational time with them, play therapy is a great option.

For the bible on the subject, check out Stanley Greenspan’s book (http://www.amazon.com/Engaging-Autism-Floortime-Approach-Communicate/dp/0738210943/ref=sr_1_1?ie=UTF8&s=books&qid=1250945781&sr=1-1 ).   But if you don’t have time for that kind of thing, here’s basically what you need to do. (For ages 0-5).

1) Pick a space and time to do it.  Mostly for you so you’ll stick with it, but also because the routine will minister to your child if they are hostile to the idea at first.  Most kids love one-on-one time, but some don’t!   Make sure it’s a nice comfortable place with space to play.  Also make sure it’s not a naturally grumpy time for your child.

2) Set aside some special toys for the time. You don’t have to spend a fortune at Toys R Us, but do consider getting some things that will make the playtime special and familiar.   And imaginative since that is usually an area most playtime kids have trouble with.  Sometimes this means just some props that you think of using a dozen different ways (i.e. a paper towel tube).  Sometimes this is a favorite toy that a child will love going back to (i.e. a little Bob the Builder set or Dora figures).   There is merit in some of those toy companies like Imaginarium and Alex that make educational toys for kids, but use your own judgment.  (Try not to pick anything too complicated or messy, which will discourage you or your child from wanting to do it again!)

Also, check out a book like Jane Oberlander’s “Slow and Steady, Get Me Ready” (http://www.amazon.com/Slow-Steady-Get-Me-Ready/dp/159160236X/ref=sr_1_1?ie=UTF8&s=books&qid=1250945678&sr=8-1 ) Her book is based on daily different activities you can do with ordinary household items.  You can incorporate a couple of these into your routine and change them out as necessary.  Love it, love it.

3)  Start with about 10 minutes for a reluctant child and work up to about an hour.  Start a couple times per week (i.e. MWF) and work up to every day (or even twice a day) depending on the severity of your child’s diagnosis.  Think of it like little doses of preschool.  It is the concentrated attention regularly that constitutes “therapy” just like at a real therapist’s office.

4)  Ok, just start playing with your child. Bring out one toy and set them in front of it, to see what they’ll do.  This is child-guided play where you facilitate.  Don’t jump in with your whole script and ideas.  You’re “peering” here.  And you’re building off what your child does.

It helps to have some goals in mind before you start, so know whether your focus is going to be physical, emotional/social, imaginative, language, memory, etc.  Your child may have a combination of goals, but try to target no more than two in a session.  When your child gets frustrated with a toy or can’t use it, then try another.  Don’t go through your props like you’re trying to please the child’s whims, but don’t exasperate them either.  You’re going to eventually spend time with everything you’ve got, so do some stretching.

5)  Engage their attention. Play therapy is especially good for children with social, emotional, attention, and empathy problems.  They may not recognize or want you there in their space, and that’s fine.  That’s part of the therapy.  What you want to do is engage them, or sometimes gently confront them, especially if they are autism spectrum.  If they jump their little horse up and down, you jump yours up and down near them.  If they get stuck spinning wheels, you crash your little car into them (gently) saying “Vroom vroom!”  Try to get them out of their world and into yours.  If they’re verbal but hostile to you, or turn away, aim for the gentle but stubborn approach.  It helps to do this in a room where you can close the door so they can’t run away.  Make sure you hide other toys too, so they can focus on you and the props you have chosen.

6) Use toys vicariously, to get them to verbalize their experience. If they don’t talk, this might be one of your main goals: to get them to “talk” with their pieces. There are some ways to play with toys if your child is having trouble with language or imagination that I have listed in other posts on speech.  This is the first level of play therapy, to get them to be verbal. (i.e. please keep in mind that age-appropriate speech varies widely, and you shouldn’t be making speech a huge goal if your child is under two.)

The second level of play therapy occurs when your child becomes (or is already) verbal.  Now you want to use their toys as “counselors” or “mouthpieces.”  Don’t talk to them directly, use your piece.  Get them to talk back with their piece.  Kids will tell you all kinds of things if you let them talk through their pieces, about all kinds of things that upset them.  You can also teach all kinds of things through your pieces that they wouldn’t listen to you, their mom, about.  Now the playtime isn’t a teaching time, it’s an understanding time.  But a good therapist DOES use toy “mouthpieces” therapeutically, say to discuss the toilet or a source of a bad dream, etc.  Use your imagination.  Keep it pretend and in the realm of playing a game.   And if you’re going to teach or talk about something, stick to one theme per session so the child doesn’t feel lectured.

Hooray!  You’re a play therapist!

Oppositional Defiant Disorder (ODD)

With the exception of branding our preschool boys autistic, nothing makes me madder than a diagnosis of Oppositional Defiant Disorder.  This is one of those retroactive “syndromes” that describes a child’s problem rather than lists a cause.  Getting a diagnosis does little more than relieve you that a professional thinks your child is as bad as YOU think s/he is.

I don’t say this because ODD isn’t real.  It is real.  I have seen the videos where clinical psychologists interview bunches of young children and diagnose some of them with this disorder.  The children are generally younger than you’d think (i.e. 4, 5, 6), violent, swearing, and have a fascination with things that they shouldn’t.  They are precocious, smart-aleck, psychologically astute.   They generally cannot stay seated in the psychologist’s chair, they may spit or verbally attack the professional, and they often make physical motions or get too close for comfort with their caretaker (like getting in their face, literally).

So it’s real.

That said, it’s an awful diagnosis—not worth getting, if you’re wondering.  Now i”m not talking about older children, like teens adopted out of the foster care system, etc.  I am talking about your unhandleable preschooler or kindergartner.  Now regular kids of this age can stretch you to your limits, so be careful how sensitive you are to this!  ODD is an extreme form of disobedient repertoire, and one that an overtaxed parent or teacher might not understand.  But if your child is suspected to have ODD, remember that for the most part, ODD at a young age is something that is created, not there at birth.  Now you may very well remember your baby being difficult from birth!  I am not saying that they weren’t a grumpy baby, or a colicky one, or hostile to affection, etc.  But children do come out of the womb grumpy.  They don’t come out ODD.

A really great book for those experiencing mild ODD with their young child is The Pampered Child Syndrome by Maggie Mamen.  http://www.amazon.com/Pampered-Child-Syndrome-Recognize-Professionals/dp/1843104075/ref=sr_1_1?ie=UTF8&s=books&qid=1250600538&sr=8-1 .  This book outlines a lot of ODD behavior but without the label and stigma.    Basically what it comes down to is that a permissive parenting style (mixed with your child’s unique temperament) can create a pampered, bratty child who is characterized by a lack of response to authority—the same major criterion of ODD.  We’re not just talking about the bratty children on Jo Frost’s Supernanny show… these children mainly suffer from a lack of childtraining.  But we’re talking about the next level of difficulty… children who actually don’t seem to recognize authority for what it is.  An ODD or ODD-leaning cihld is not very different from an autistic or Asberger’s child in that they have to be taught to recognize the context of structure, authority, obedience, etc.  They won’t pick it up on their own.  Although here is the good part—they are ABLE to pick it up, it is just that they choose not to.

So that is where you, as the parent, come in.  Your job is to take back the job that was stolen from you.  If your child is 6 or under, you’re lucky because it can be done.  You can use small child behavior modification  tactics that will help a lot.  (Get a season of Supernanny on DVD anyway, just for tips and impartation).  But the main thing you need to do is not enforce time-outs per se, or adopt some parenting trick.  What you need to do is examine yourself.  Examine your sense of boundaries and consider if you have codependent attitudes.  While a spouse might withstand codepedency, a child relationship will not.  Consider why it is hard for you to say no, disappoint someone, let someone not be rescued.  Consider if and how much you draw life from making others happy, or if you overesteem your own relationships in general (i.e. Do you idolize being a mother, wife, etc?).  If any of these kinds of characteristics typify you, as they do in some degree for all mothers, then seek help for yourself first.  Otherwise it will break your heart to do what you need to, in order to rescue your ODD child.

The main problem with the ODD child is the invisible dynamics in the household.  It is the subtext, the unspoken.  This atmosphere is mainly made up by your feelings and beliefs about yourself as a person and parent.  They have to change in order for your child to change.  That is why the kids on the Supernanny show mouth off to their parents but they never mouth off to Jo.  It is because of the spirit of conviction and authority that comes with her.  This is what is right, and what you need to develop.  If you can’t stand that idea, or you think that it’s wrong to be an authoritative (not authoritarian) parent, then this is where Step One begins.   Step One is over when you realize that the results you’re getting in your ODD child is the logical extension of your emotions and beliefs.  It’s not random and you’re not a victim. You have a lot of power in this relationship, power to influence your child for good.  And you’re going to have to use it!

When you finally finish Step One, you’re ready to start boundaries in your home.  You’re ready to stop the welfare state—where you do all the work and the kids just receive.  The sense of entitlement your ODD child has is partially what’s making him or her bitter at authority.  They have to get rid of that entitlement feeling in order to respect authority, limits, work, or whatever thing they hate.  When the bitterness is out, a lot of the anger will go with it.  And so will any depression or anxiety they likely also have.

I’m sorry, but development charts are for girls

I have been waiting for the right time to write this post. In the back of my mind, for the last year or so, I have had this feeling that baby development charts are for girls rather than for boys… and now, as my little girl turns two, I am more convinced than ever.

For the record, let me state that I have three boys, right in a row (5, 4, 3yrs), who are all very intelligent. They are very different from each other, too, and some developed ahead in areas where their siblings were behind, and vice versa. This is post is not about stereotyping or maligning boys. I love them, and they are very, very special.

But when my little girl arrived on the scene (last), I began to notice that observing her development was a different experience entirely than my boys’. Even my husband noticed, and he normally has no eye for these types of things. We mainly noticed that she needed hardly any “education” that our boys needed… just magically, she developed on her own, usually right on or before the standard developmental landmarks. Mere exposure seemed enough to teach her things.  And she picked up vocabulary easily, like with one use of the word. We didn’t have to have little lessons with her, or teach her to talk, teach her to use her imagination, or teach her social/independent skills like how to come get Mommy when there was a problem. With little siblings to watch, she just picked them right up. Her language comprehension seemed way ahead, and she was able to follow one -step then two-step directions very early. She was even ahead (by months) in the physical timetable, walking by 10months etc. We didn’t have one worry about her development, and every time we checked in with her doctor, or we consulted a book, she was right on time.

This was just not the case with my boys, whom we worried over continually, at least in isolated areas. Even with my third son who had siblings to watch, there were still things to teach, to make sure he got, to clarify. Each boy had areas where we felt like we were constantly trying to make sure didn’t decline when we weren’t looking: with one boy, it was language; with another it was gross motor skills; with another, it was independence.  And the charts, with their icons like “two words put together at two years old, three words put together at three…” were absolutely no help; I never saw that with anyone.  We were very diligent about making sure we had educational toys, videos, and ways of interacting. And it wasn’t all for naught, nor was it bad! It was just different: my little girl needed almost nothing to thrive.

Now that my little boys are slightly older, and stronger in their initially-weak areas, I realize that the developmental charts caused more panic than necessary.Their development, as male, was simply different than female. My girl was essentially learning through relationship, imitation, communication, and observation.  And she learns while multi-tasking (i.e. wants to sit in your lap, hug a bear, read a book, and have a movie on, talk to you, all at the same time).  My boys essentially learn individualistically, through personal practice, by analysis, and order/sequence/rules.  They process one thing at a time, not unlike my husband who can’t talk with the radio on, and do well with systems, routines, structures.   My boys, even at 1 and 2yrs, had all kinds of skills not on the charts, especially in their strong areas, but were spotty in all kinds of areas for their first four years.  And their verbal development is very different in nature than my girl’s, even though I had one early talking boy who is still very insightful verbally.  I can see why it was harder for them to excel in some areas because they are more “in their own little worlds” than my girl is. They are also more singularly-talented instead of well-rounded, and personality-typed/consistent.  Socially, they have higher walls to climb, and more carefully constructed inroads, than my little girl.

In fact, when reading special needs literature, I realized there was a careful (but important) boundary in describing the qualities of special needs children from just boys in general!! Many of the descriptions, especially in the areas of language and social skills, sounded like my boys at times; never about my girl. I believe this is why boys are so much more likely to be classified as autism spectrum or developmentally delayed. I am certain this is why so many boys end up in special ed preschool, compared to girls.   They are more likely to be one-sided in development, harder to engage, and/or harder to teach.

So my conclusion, after six years of raising three little boys, and two years of raising my girl, is that we have to be careful not to pathologize our boys. They may be slower to mature than girls (at least, comprehensively) or in some way more delicate, more susceptible to autism and other disorders. But this should call us to perhaps reverse the de-genderizing trend of the world and re-discuss any patterns that are inherent to male development, versus female. Of course we don’t want to confuse personality, gifting, or birth order with gender. We don’t want to say girls can’t be aggressive or boys can’t be verbal.  They can be!  But the human world observes gender differences that the Academy seems adversed to.  I  would be interested in seeing if there is correlation of gender to learning style or processing style. And seeing if there are timetables that are more relevant to boys as opposed to girls, just as height and weight charts have long documented. Perhaps there will not be, and I will be proven wrong. But perhaps there will be, and the mothers of boys in future generations can be spared much anxiety as they have charts and milestones that accurately represent their sons.