Behavioural & Other Questions.
This is a list of the 'Other' questions and suggestions from our Principal Clinical Psychologist. If you would like to submit a question please visit our Facebook Page: https://www.facebook.com/GroupworxPsychology. Simply submit your question to the Facebook Message Inbox and your question will be anonymously posted on our page for other parents to post their advice and comments. Advice from Principal Clinical Psychologist, Stefanie Schwartz will also be provided to EVERY question asked within 24 hours. Her advice will be posted on this page.
We have a 3 and 1/2 year old who refuses to poo on the toilet. We have tried rewards, peer led training at daycare, gentle encouragement. Nothing.
While we don't want to force the issue and have her become anxious and shameful about it we also would really like her to use the toilet. We're stumped for ideas. Have I inadvertently done something to make her fearful or shamed?
What you are describing is very common. Children often master 'weeing' in the toilet before they feel comfortable 'pooing' in the toilet. It sounds like you are doing a great job, here are a few tips that may help you out:
1. She may be uncomfortable; a child needs to be more confortable to poo on the toilet than to wee. Make sure any potty cover for the toilet is the right size. A step to get up to the toilet and for her to prop her feet up on may be helpful.
2. She may feel embarrassed; sometimes we inadvertantly connect 'yuck' & 'ew' with the idea of poo and children pick up on this. If you do find that she soils herself or doesn't poo in the toilet, try to focus on cleaning her up in the bathroom and still flushing the poo down the toilet with a big cheer! If she does manage to go in the toilet - big celebrations all round and a small reward may be in order (although it sounds like you are already onto that!). Even if she sits on the toilet without going, praise her effort. Positive reinforcement is always the most effective tool for change.
3. She may be scared; Children can find a lot about going to the toilet scary. Try to make your bathroom as comfortable as possible. Let her have a few books in there, anything to increase her comfort level. A great resource is Sneaky Poo. If you haven't heard about it have a look here: http://www.dulwichcentre.com.[removed]au/beating-sneaky-poo-2.pdf
4. With every psychological issue I tell parents that modelling to their child the behaviour they want is the best assistance they can provide. This is no different (although slightly less appealling) - Take your child to the bathroom with you to show them that there is nothing to worry about.
5. PERSISTENCE IS THE KEY. We often try something once and if it doesn't work immediately we are quick to move onto the next idea (I am just as guilty of this as the next person!). But children thrive on reliability and consistency. Keep trying the same technique for a number of days before determining whether it is effective for your child or not.
Good Luck! Your effort will pay off in the end!
Tantrum Management Question
My nearly 2 yr old girl has just started having tantrums. Just wondering if anyone has advice on a good book to read or someone to contact for strategies to deal with these? They have only just started and are already a nightmare! I'd like to learn quickly how to minimize them!
While it may not help with the frustration around tantrums, it may be helpful to know that your little girl is 'right on track'! 1.5-2 years is PRIME testing the limits phase for little ones. At this age, they don't understand other people's points of view and are wanting to be more independent.
Reasoning with her is a good start, but because of limited understanding of these issues at two, behavioural strategies are your best bet at this point.
1) Some things to prevent tantrums (avoid boredom, reward positive behaviours, lots of positive interactions with you, give her as much control as possible over little things, establish a good routine).
2) To manage the actual behavior you can use: planned ignoring (If it's not worth the argument and it's a minor behavior you can ignore the negative behavior and often children will stop) or implement logical consequences for more difficult, unacceptable behavior (time out, take something away etc.) Its very important with consequences to never threaten something you can't carry out. For example, don't say 'You won't have your birthday party if you keep that up" if you don't intend on cancelling her bday - that will only teach her that you don't follow through.
3) Process behaviours with her when things have calmed down - even though she's little, have a quick calm discussion about her behaviours (good and bad) about what you liked and didn't like. As her vocabulary develops, she will begin to understand more of what you like/dislike.
Triple P is an amazing program for parents and they have great books and DVDs on how to manage children's behavior. There's a lot of research on about how effective the program is too! http://triplep.triplep-staypositive.net/.
Good Luck! Sounds like you're doing an awesome job!
My 5yo boy has just been diagnosed with ADHD & commenced on Ritalin. I'm finding good progress with his medication yet as time goes on its like his body is getting used to it & come afternoon time they don't work as well. His last dose is 3.30pm but almost seems like it doesn't work. It's not until around 7pm he really settles down back to my beautiful little man. Then we have routine of 7.30pm bedtime & do reading in bed for 20mins. am wondering if there is more to his behaviour; He has a lot of texture aversions, he has trouble sitting at the table as the day goes on, He also is a licker, He doesn't have good balance & still wets bed. I guess what I'm asking is could he be on the Autism spectrum? Could this be possible or perhaps the medication not working/ dosage not right? Hmmm. What do u think?
It sounds like there are a number of different elements that you're describing about your son. So I will try to address each of them.
1. Commencement on Ritalin - It's great that you're noticing positive results since commencing Ritalin. It's impotant to know that when commencing Ritalin, your Paediatrician will go through a trial-and-error process in an attempt to find the lowest dose at which the best response is achieved. Your son may still be in this phase of trial and error (where the optimum dose has not yet been achieved). So, what you're doing of noting down when the medication appears to not be working is very helpful information to take to your Paediatrician. Also, a Child & Adolescent Psychiatrist would be able to offer you additional information on the best Ritalin dosages.
2. You mention many sensory behavioural issues; many children with ADHD have sensory issues and some also have a joint diagnosis of sensory processing disorder which can translate into difficult behaviors at school and home. An Occupational Therapist would be able to assess and clarify this further for you. Perhaps discuss an Occupational Therapy referral with your Paediatrician.
3. Finally, you wondered whether your son is on the Autism Spectrum. Recent research suggests that 1/3 of children with Autism Spectrum Disorders also meet criteria for ADHD. In the past, diagnostic guidelines did not allow joint diagnoses of Autism and ADHD, but this has recently been changed. A formal diagnosis of an Autism Spectrum Disorder is quite rigorous (and can be costly), but can translate into additional funding for you and your child, and again may be something to discuss further with you Paediatrician.
4. You discussed a bedtime routine that you do with your son, and it sounds perfect. For children, routine is calming. Routines for wake up, getting ready, meal times etc are also extremely helpful. Behaviour charting (sticker charts, reward charts) are also beneficial for children with both symptoms of ADHD and/or Autism. I've attached a simple sticker chart here to download.
Good Luck - you're doing a fabulous job of noticing your son's difficulties and discussing them with relevant specialists.