This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Monday, June 23, 2014

PRESCHOOL BEHAVIOR MGMT Chap 5 DISCIPLINE & GUIDANCE

PRESCHOOL BEHAVIOR MGMT
CHAPTER 5

DISCIPLINE and GUIDANCE - A to Z

Disclaimer:  Most of this information is not my own, a lot is from my favorite attachment guru Katharine Leslie.  This particular chapter mostly comes from the preschool teacher trainings I gave while working as a director at a large private preschool.

DISCIPLINE and GUIDANCE
a.    Definition of discipline     
       - Stress/ HALT     
       - Perceived safety
b.    Distraction/ Re-direction
c.     Praise appropriate behavior
d.  Concise communication
e. "Because I said so"
f.  Broken Record Technique
g.  Encourage use of language
f.    Ignore negative behavior
g.   Timeouts         
       - Time-ins
h.   Bedtime
i.  Physical Affection
j.   Shadowing
k.    “4 Foot Rule”
l.      Fight/ Flight/ Freeze
m.      Teachable Moments
n.   “This is where you say________”
o.      “No” practice
p.    "Overreacting" 
q.   Prescribing
          r.    Rewarding "bad" behavior
s.    “hmm… how are you going to handle that?”
t.    Behavior charts/ star charts
u.     The five Ps
v.    Age-Appropriate activities
w.     Waiting time/ Transition time
x.    Environments
y.    "Off Limit" Areas
z.   "Off Limit" Activities
aa.    “Off Limit” People
          bb. Avoiding "No" 




Discipline

Definition of discipline- the act of teaching children what is expected of them.


b.  Distraction/ Re-direction is an important tool with little ones.  Find a different activity or something to focus on that distracts from the event that is causing STRESS.


Redirection- three steps
1. State the rule (positively)
2. Redirect ( give choices)
3. Praise appropriate behavior.


  • Jump the Track - Often our kids get in to a habit or a "rut" when it comes to tantrums/ meltdowns. Our goal at this point would be to distract and redirect the child to prevent the meltdown that we can feel coming.  One friend with a child who loves candy, would toss pieces of candy at him when he starts a tantrum. He'd be so busy searching for where the candy went that he forgets that he forgets about the tantrum.
  • Outcrazy the Crazy -  Our kids get "stuck." Stuck in their hurt. Stuck in their big feelings.  Sometimes it's obvious that there are in for the fight, this argument is just going to keep going and the meltdown is about to start... that's when the best way to react is to act ridiculous! Take the focus off what's going on and change it up. Get all excited about the flying turtle you just saw out the window, get up and dance, grab your shoes and head outside to look for your "silly" (take your time looking for it. Get all excited when you find "it" - a pebble, a piece of trash, whatever). The point is not what you found or saw or did, but that you had a positive experience with your child or if not, then at least you got a break. Christine Moer's awesome video about outcrazying the crazy! ~~Christine Moers - an amazing therapeutic parent who also offers parenting coaching. 

c.  Praise- praising appropriate behavior reinforces the behavior.  Be specific in your praise. Avoid the terms “good girl” and “bad girl” – young children internalize these terms (and often start thinking of themselves as “bad.”).  Praise the behaviors as specifically as possible.  Be aware that some children of trauma cannot handle praise.  “I like the way that you cleaned up the blocks, Missy.  They look nice and neat.”

d. Concise communication – long lectures, long timeouts, and public reprimands don’t work - kids tune you out (think how adults sound on Charlie Brown movies).  One word per age of the child is usually appropriate (ex. 3yo.  “Use walking feet.”  “Use your words.”)

e. "Because I said so" - I often find myself arguing and getting in to power struggles with my child. I get sucked in to trying to rationally explain things as though if I say just the right thing, the child will come around to my way of thinking. I give my child all the logical reasons behind my decisions, opening myself up to their (mostly irrational) arguments. Sometimes the answer has to be, "Because I said so."

f.  Broken Record Technique - The broken record technique quite effectively helps you avoid getting sucked into mostly irrational arguments and power struggles. It is simple too, rather than feeling like you have to come up with a new argument every time, you just repeat the same thing over and over again--calmly, sympathetically, kindly and without sarcasm. I tend to say things like, "We've already had this conversation." "Let me know when you're ready." "I'm sorry this makes you sad." "I know. This does stink." "This is a hard thing to handle, but I know you can do it."

e. Encourage use of language – frequently young children act out because they don’t have the words to express their feelings.  Identify their emotions for them, give them the words they need, and encourage them to use them.  “I can see it made you sad and mad when your friend took your toy.  Can you tell him what you want him to do?” (Pause to allow child to try on their own)  “Hmm… maybe you could try telling him, ‘John, please give me back my toy.’”  As children get older they can “work it out for themselves,” but they have to be taught the right way first or they can quickly become victims/bullies.

f.  Ignore negative behavior when it is an attention seeking behavior and it is safe to do so, especially when it occurs during a meltdown/ tantrum.

g.  Timeouts are often ineffective.  Use sparingly and only with children 2.5 years and older.  These should be short.  Usually 1 minute per year of child (ex.  3 minutes for a 3 year old).
     - Time-ins work better for children of trauma.  Most children of trauma are not able to regulate their own emotions.  They need parents to help them.  The biggest calming technique I have is to stay calm myself (if I can't then I switch out with another adult who can).  Speak to the child in a quiet, calm voice and breathe loudly, slowly and deeply (sometimes wish I had a Darth Vader mask!) – this helps the child slow their heart rate and calm down, regulating emotions.  Sometimes it’s better not to interact with the child if this is escalating the dysregulation – in this case I often sit nearby, not looking at or talking to the child and just breathe loudly and deeply – trying not to engage.

h.  Bedtime
       - Establish a bedtime routine -
Ex. Bath, sit next to her bed and read her a story, lights out, sing one bedtime song while I rub her back, then you leave. Super Nanny Stay in Bed Technique. Yes, it may be hell, but so is the alternative.
      - Early bedtime - We discovered that our kids needed a lot more sleep than most kids, but an early bedtime seemed like a punishment.  I decided to move the kids' bedtime earlier by adding some special  mommy time.  I sang to them and told them stories I made up using things they got to choose.
     - Special bedtime stories - I typically set an amount of things they could put in their story.  It became super challenging if 2 or more children were telling me what they wanted in one story!  The kids picked things like who would be in the story ("me, Bob and my cousin") and anything else they could think of "a unicorn", "Snuggles" (our cat), "a flying carpet," "the Indy 500"... Mostly I loosely based the stories on fairy tales or kid movies, and I always tried to incorporate a moral lesson into the story.  It was fun and the kids really liked them.
   
i.   Physical Affection - Both my children rejected hugs, cuddles and kisses.  They NEEDED that time, but were unable to ask for it appropriately.  Sometimes that meant they would rage so I would have to hold/restrain them.  Sometimes they would tease or taunt me (Nyah!  Nyah!  You can't catch me!) so I would chase them and hug or tickle them.  For a brief time we had a requirement that everyone got one hug per year of age (as an old person I needed every one of their hugs, plus some from Hubby to get enough).  It was HARD work and we finally let it drop.  We've tried the Attachment Challenge, but soon found it was overwhelming for Kitty.  After talking to Kitty's therapist, we came up with some other alternatives.

j.   Shadowing – Have the child stay close to you and follow what you do or you stay close to them.  It is not a punishment- it’s an opportunity to help the child regulate safely.  To get compliance, it can even be presented to the child as a reward.  “You can be my special helper and help me pass out snack.”

k.   “4 Foot Rule” – used when the child is dysregulated, threatening harm to themselves or others, being intimidating and/or aggressive… The "4 Foot Rule" means the child must be within (approximately) 4 feet of a caregiver at all times (usually just means line of sight).  If I know she can't hurt herself (like if she's holding the door shut so can't hurt herself without moving away from the door), I might sit outside the door.

l.   Fight/ Flight/ Freeze mode – Avoid trying to talk to discipline a child who is dysregulated and/or in fight/ flight/ freeze mode – they won’t hear you anyway.  You need to get them regulated first.  A child in fight/flight/ freeze mode is “thinking” with the reptilian part of the brain (survival!).  The rational part of the brain just isn't online!  Holding a child responsible for what happens in the middle of rages is pointless- it’s better to just move on after it's over and try to figure out what triggered it so you can avoid it in the future.

m.   “Teachable moments” – in the moment opportunities to guide the child rather than out of the blue lectures.

n.   “This is where you say'________'” - Giving our children the words they need to get what they want. I try to give them the words they'll need to use in the future.  I know they won't learn it from one repetition, but they will at least learn to use words like "Please" "Thank You" "Yes, Ma'am"   Ex.  If my child is begging for a toy and won't stop, then I might say, “This is where you say'Someday I would like to have that stuffed  animal.”  No, it doesn't stop the whining, but eventually it helps.

o.   “No" Practice -  "No practice" is used when a child has a meltdown at being told no or is constantly asking for things they know they can't have in order to pick a fight.  We have "No" practice, which I explain to the child is to get them used to hearing the word "No."  At a time that is convenient for me (and usually inconvenient for the child), I feed the child outrageous demands ("Ask me for the moon."  "Tell me you want me to let you have a pet tiger."  "Ask me if you can drive my car to France."), and I tell them, "No."  Having the requests be silly makes the child more likely to listen instead of shut down.

        - Variations - For example, if the child has been making rude or inappropriate comments, I might start by letting the child know what they are missing because of this issue (a trip to the movies, eating out, a birthday party she's requested to attend, playing with neighborhood children - even if some of these are not areas where she has had issues).  I empathetically (NOT sarcastically) let my child know that it's very sad that they can't do "whatever activity" right now, but all she/he needs to do is show me that she/ he is working to change this rude behavior before it become a habit.  This usually involves lots of practice, at my convenience, in boring places (like the grocery store), before declaring the child ready for public "fun" events.

Here's how the practice might look:
You can have your child give you compliments and even outrageous flattery.  ("Mom, you are so beautiful that you should be a movie star!"  "Mom, you make the best food I've ever tasted.  You make brussel sprouts taste better than dessert!")  Yes, tell them what to say.  Explain that you're teaching them how to talk to people.  That it will make other people want to be around them.  Explain that they are learning an important skill and you want them to practice it a lot so that it becomes a good habit.  Let them know that they will practice with you, then other family members, and then maybe strangers at the grocery store, and when you're sure they are ready, they can start to use their new skills at more fun events.

p.   “Overreacting"  Sometimes when we have a child who cries wolf a LOT, it works best to try to ignore the behavior.  Every now and then I like to switch it up and overreact!  For example, if you have a child with a new behavior like repeatedly bellowing for you from another room (This scene from Family Guy runs through my head - https://www.youtube.com/watch?v=cNkp4QF3we8), then you could try assuming she's really as hurt as her repetitive bellow would imply. *Obvously* if anything were actually wrong, she would get up and walk into your room like she normally does.

I would rush into her room, acting all frantic and check her over annoyingly, and very hands on (my kids hate to be touched when it's not on their own terms), with a lot of "Oh my goodness, are you OK?!! Where are you hurt?! Can you walk?! Why can't you walk?!! What's wrong, Baby?!!!" Give them a few minutes to get frustrated with the fact that you're not being quiet long enough to let them you tell them they're fine. Then when you finally let them talk (while still hugging and patting them), say something like, "Oh, you scared me! I was so worried about you, Baby, because I know you normally are so considerate and come get me if you need something. We can talk more about this in the morning, but why don't we both start thinking about other ways you can let me know that you need more hugging and mommy time."

This way you're letting her know that 1) this new behavior is not giving her the results she wanted, 2) you're showing her that you care about her (ignoring the behavior can sometimes trigger abandonment issues) and 3) subtly warning her that if she does this again, then she'll have to deal with the "threat" of you loving and caring about her! (My kids found hugging and "mommy time" to be a threat).

q.   Prescribing - This is an especially great technique for children that tend toward oppositional behavior.  Sometimes when we know a meltdown is coming or a nasty reaction or fight, we can "prescribe" the behavior and head it off.
"Ok, Honey, I need to tell you something that I know you're going to have trouble handling.  Do you want to throw a fit now or wait until after I tell you?"
"Hey, Tweetie, it's bedtime now.  I've allotted 3 minutes for fit throwing, so... go!"
"I've seen you throw some pretty awesome fits when I ask you to do this.  I think you can do better than that.  Try again."  or "That was a pretty wimpy temper tantrum.  I think you can do better... why don't you try again."

It sounds crazy, but telling the child to have a meltdown can actually prevent it or shorten it's duration! Plus it give YOU some of the control back. It can be easier to be empathetic and take it less personally when you acknowledge the meltdown is because of the event/ trigger and not your (or your child's) "fault."

r.    Rewarding "bad" behavior - It may feel wrong to reward "bad" behavior, but it can "hiccup" their brain and distract them from escalating behaviors. Pick one behavior and one thing that you know they love - it has to small enough to carry around in your pocket. Some examples, used baseball cards, stickers, bubbles.., When they start to do that behavior(ex. screaming at you) tell them they can do that behavior, or they can have a sticker, baseball card, etc. It can't be used for every bad behavior because then they won't do anything unless they get a sticker, but just for the one thing. Eventually, the child will pretty much stop the behavior. Have a little break and pick a new behavior to "reward."

 s. “hmm… how are you going to handle that?" - A lot of times it feels like we take on the responsibilities and blame for our children's behaviors and things that happen, especially from our child's point of view. (How many times have you heard, "It's not my fault"?!). Sometimes we need to step back and let the child know that it's not our problem, it's theirs. We can be sincerely empathetic. ("Wow, that really sucks! So what are you going to do now?"), but you have to be super careful not to be sarcastic. Kids sense that and shut down.

t. Behavior charts/ star charts – do not work with children of trauma.  The reward is usually too far away to be connected with good behavior and many children will sabotage good behavior to give themselves control of what they feel is inevitable failure.  Plus many children have significant impulse control issues.



Proper Planning Prevents Poor Performance!
u.  The five Ps.  Flying by the seat of your pants can lead to disaster and meltdowns.  Try to be aware of whether or not the child feels hungry, tired, ill, unsafe, or stressed!). Have a tool box full of planned activities, little songs, games... doesn’t have to be snacks, art projects or toys to keep them busy (but those are good to have too!).

v.  Age- Appropriate activities – This refers to developmental age, not just number of years they’ve been alive.  Be sure that the individual differences, interests and abilities of each child are taken into account.  Each child has a different personality – get to know your child and learn to recognize “warning signs/triggers” - you will be able to avoid many undesired behaviors this way.

w.   Waiting time/Transition Time – Children become bored, restless and mischievous if expected to sit or stand with nothing to do. A child can only wait 15-30 seconds!  Have a little plan in your head of things to do.  Use transition games or songs for each activity change.
You must be enthusiastic or these won’t work!  
Suggestions:

  • Teach them finger alphabet or signs.
  • Do fingerplays, nursery rhymes or actions songs (try making them fast or silly!)
  • Play Simon Says.
  • Talk to them!  Tell them silly things about your day.

x.  Environments- Change the environment to meet your child’s needs. Set things up so you aren’t constantly saying “No,” or “Don’t touch!”  Watch for areas and activities that frequently cause problems like crowded or out of sight places.  If a child is splashing in the sink (or toilet!), add a water table or extra bath time to your environment.  If your child is throwing toys, take them outside to play with a ball.  Temporarily remove frequently fought over toys if multiples are not available.  If the child is overwhelmed in loud, noisy environments.  Try setting up individual play dates instead of attending big parties and whenever possible, leave the child at home when you need to go shopping.

y,  "Off Limit" Areas – If you are by yourself or feel unable to supervise your children safely, feel free to close down/ make off limits parts of the house, backyard, playground… (sand boxes, bedrooms, play room, etc.).

z.  "Off Limit" Activities – If certain activities cause a child to get overstimulated and act out (shopping, playgrounds, meals…), try to figure out what the trigger is and avoid it!

aa.  “Off Limit” People - Siblings and other children can be off limits too!  When our children were having trouble keeping their hands to themselves, we established a rule that kids could not be within touching distance of each other.  If a child had difficulty with this rule then that child needed line of sight supervision at all times.

bb. Avoiding "No" - A lot of times upon hearing the word no, our kids shut down and don't hear the rest.  – Provide lots of structure from the beginning.  Set up the child’s environment so that he/she doesn't hear a lot of "No"s.  There just shouldn't be an option of doing things that need a “no.”  Think of it like childproofing.

Try rewording what you're saying. In response to a request for candy, instead of, "No, but you can have an apple." Try skipping, the "No," and going straight to "You can have an apple."

Variation - "As Soon As" My preference is to give a "Yes" whenever possible.
Examples
In response to a request for candy, "Sure. As soon as dinner is over, you can have one piece of candy or whatever fruit you want."
In response to a demand for a ride to the mall. "Sure. As soon as you're out of the FAIR Club/ your chores are done/ I have time to go with you/ you get me a list of the names and numbers of the people you're meeting there and their parents contact info....




Reasons Children “Misbehave”
Stress/Anxiety
Fear
Fatigue
Hunger
Loneliness
Illness
Frustration
Cause and Effect
Learned Behavior
Teething
Exploration
Mimicry
Self-Assertion

Guidance

Changing things after they're established. 
Try to catch the child in a calm moment and let him/her know that things will be changing. I would probably apologize for not letting her be the kid and me be the "in-control" mama, and let her know that from now on, "I've got this." It's my job to help her feel safe.

Some casual things to drop into conversations:
"Mamas have room in their hearts for way more than one person.
I love __________(family member: grandma, Hubby...) and I love you. 
It's not OK to treat me this way, but I still love you."
"When I go out, I always come back."
"You are my little girl, and you always will be."
"I know you're scared, and that's OK. I will love us enough for both of us, until you're ready."


Real Life Example (Details changed):
My 2 year old is throwing things, jumping on me, hitting me, and hitting the dog. I've tried redirection, telling him to be gentle, even time outs... nothing works. 

Unfortunately, this is pretty common among neurotypical two-year-olds, especially younger ones who aren't very verbal. They express themselves physically instead of using their words, and they don't have empathy for others yet, so they don't understand that their actions hurt others. That's why "biting a biter back" or "hitting the child for hitting so they can see how it feels," doesn't work. 

Add in any trauma or developmental delays, and you've got a child who is at a much younger emotional age, in a bigger kids body. Basically, your son is probably emotionally an infant or young toddler, who you wouldn't really expect to understand that he just clobbered you with a flailing fist. You also can't expect them to have any impulse control yet (I know adults that punch and throw things too! :( ).

So what do you do about it?!

You parent him like you would a much younger child.
  • Look at what might be triggering his hitting. Is it when he gets overstimulated, when you're transitioning to a new activity, when he's Hungry, Anxious, Lonely, Tired (HALT)...
  • Lots of child proofing -remove things that overstimulate him or that he can throw or get into, 
  • Redirection, 
  • Teach him to "use his words" and identify his feelings for him - "You look mad because it's time for a nap. You want to say 'No' to naps."), 
  • Transitions - Let him know what's going to happen, before it happens. This often includes a running commentary on what you're doing. "It's almost time to change your diaper! Let's finish what we're doing and then we're going to go. We're going to have lunch as soon as we finish this diaper change."his might include a running commentary on what you're doing
  • Use simple, positive directions. I try to keep this to one word per age of the child and avoid the word "Don't" Instead of "No Running!" or "Don't climb on the chair!" try "Walking Feet" and "Chairs are for bottoms" - or better yet, redirect him to a place he can climb safely - like a slide or play structure.
  • Lots of big sensory activities - like running, jumping, dancing, swinging...he's probably still working on his proprioception (where he is in space, so things like wrestling help with that, but try not to get him too worked up, you don't want him to get out of hand). 
  • Protect pets - For now, he needs to be kept away from the dog. Unfortunately, that may mean keeping the dog in another room or on the other side of baby gates.


CHAPTER 6 - ABUSE

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