1) Identify the key issues. Stand back for a moment when the child is not around and really think. Give this some real, considered time. Is it constant meltdowns, crying about what seems like nothing, being hurtful to siblings/others, not engaging with anyone, hating school, refusing to help out even a little at home, destroying property of their own or others, not eating, not sleeping well, making little or very slow progress in reading or learning in general......etc? Be specific with what you have noticed, not simply as a one off insistence, but ongoing behaviours that are affecting the wellbeing of your child.
If possible include the child's other parent in this step (and all steps) so you are both on the same page. Stay away from blame and arguing. Remember that you are trying to move forward together. If there are issues with one parent's actions, it will become hopefully clear to that parent by going through these sequence of steps. If not, speak calmly providing suggestions and listen carefully to responses. At times the professional help may be needed for a parent in one of the later steps.
If possible include the child's other parent in this step (and all steps) so you are both on the same page. Stay away from blame and arguing. Remember that you are trying to move forward together. If there are issues with one parent's actions, it will become hopefully clear to that parent by going through these sequence of steps. If not, speak calmly providing suggestions and listen carefully to responses. At times the professional help may be needed for a parent in one of the later steps.
2) Consider first the obvious things that we often think are too simple to be the answer: food, water, sleep, comfort, level of activity/rest, time with others vs time to themselves, time at home vs time outside of the home. The following barely skims the surface of the affects that the above mentioned can have. If you recognise that one of these areas is the cause of other issues, professionals in the remaining steps can give you further guidance.
Food
Food can have a huge impact on every part of a child's life. The problem is that many families believe they are eating reasonably heathy food, because it is their normal. Really take a good look at what the child is actually eating. Especially consider additives to the food. Is there a balance of protein, good fats, fibre, carbohydrates? Refined/highly processed foods can be a big trigger for many types of negative behaviour patterns, especially when it is found with high doses of sugar. Juice and other things high in sugar can give children all the calories they need for the day very quickly, leaving them not wanting food, but lacking in the protein and fibre they need to get through the day happily.
If the problem is a child not eating meals, has food over the entire day been considered? Children, especially young children, don't eat beyond the calories necessary for the day, so make them count. Is food given at routine times? For many things routine isn't entirely necessary for all children, but when it comes to food it is very important. As adults, we can feel hungry based on our general eating times and have a good hour or so to satisfy that hunger. Children have about 20 minutes. Set reasonable times for snacks and meals and try to stick to 20 minutes either side as much as possible. Also consider thirst and boredom if a child is constantly claiming to be hungry, but then refuses to eat meals.
If there is negative behaviour surrounding meal times for both children and adults take a breath and try not to engage. Making wise decisions about food and eating is a life skill, and one that can not be forced. Clearing a plate isn't necessarily the best for every person, especially if there are underlying issues that may need to be addressed. Instead serve up reasonable portions of heathy food and offer no substitutes or bribes. Dessert really isn't needed. If given time to adjust to the changes, the child still refuses to eat, gather information in the form of a food diary and go to step 3.
Sleep
Note down how much sleep the child is having. Is bedtime regular? Is the child waking happily of their own accord? Is there anything that could be interfering with their sleep? Is the room they are sleeping in hot (cold with blankets is preferable to too hot)? Is the room they sleep in uncluttered and clean? Dust and dust mites can really affect the quality of sleep, especially for those with allergies. Are they scared about something in their room? Is the child lonely? If they like being with lots of people in the day, being alone at night can be horrible. Have you really listened to what they think they need to sleep or their frustrations? Have you considered that they may not need as much sleep as the norm? Is the child active enough physically and mentally throughout the day?
If lack of sleep or wakefulness through the night is a problem, try some of the following. Take excess toys, books, furniture out of the room for a time, and give it a good clean. Think simply sleep when choosing what to put back (few to no toys other than stuffed animals and books). Make sure sheets are cleaned weekly. Wash all stuffed toys and hang them in the sun to dry. Move the bed to a different location in the room. Check for hidden mould. Wash curtains, or consider getting block outs. Wash or replace pillows. Try different bedding (thinner blankets, different type of quilt.) Set a realistic bed time. Change bedtime to lightly earlier or later. Read stories at bedtime. If child showers before bed, change to a bath, or the opposite. Try different bath/shower products that intended to be less irritating. Shower child close to bed time (not too hot as it energises) as going to a cooler bedroom after warming up signals the body that it is time to rest (slowing essential metabolic functions).
Every child is different, so what helps one child may not help another. I personally have one who needs to create her own 'nest' from her teddies, one who has to read for at least half an hour and needs lots of activity throughout the day, one who likes me to tell him the story of me always choosing him with many reassuring hugs in the last half hour before bed, one who struggles sometimes (still working through this with her, although things have improved) and one who needs a blankie, a baby doll and Cinderella to sleep. But then I have to write in my journal before I can sleep, yet Craig can fall asleep sitting just about anywhere! Take away your expectations about sleep and find something that works and go with it. Once there is some sleep, the how it happens can be more easily changed (slowly over time).
Consider what has happened in the past six months as even exciting things can be unsettling for children, and it takes time to feel safe and secure after changes. As much as we would like to rush things, sometimes just being there and going to them every time they are worried is actually the quickest and best solution. Remember parenting is a 24 hr job and they are learning how to treat people all the time, even at night.
Every child is different, so what helps one child may not help another. I personally have one who needs to create her own 'nest' from her teddies, one who has to read for at least half an hour and needs lots of activity throughout the day, one who likes me to tell him the story of me always choosing him with many reassuring hugs in the last half hour before bed, one who struggles sometimes (still working through this with her, although things have improved) and one who needs a blankie, a baby doll and Cinderella to sleep. But then I have to write in my journal before I can sleep, yet Craig can fall asleep sitting just about anywhere! Take away your expectations about sleep and find something that works and go with it. Once there is some sleep, the how it happens can be more easily changed (slowly over time).
Consider what has happened in the past six months as even exciting things can be unsettling for children, and it takes time to feel safe and secure after changes. As much as we would like to rush things, sometimes just being there and going to them every time they are worried is actually the quickest and best solution. Remember parenting is a 24 hr job and they are learning how to treat people all the time, even at night.
Comfort and activity levels
Everyone has a different level of need when it comes to comfort. What provides comfort for us all is different too, so talking to the child helps most here. What makes them feel calm? What makes them feel happy? When do they feel they can actually rest during the day/week? Do they feel rushed too often? Do they struggle to find things to do? Does everything feel too confusing or too structured? Do they feel they can relax and just be themselves?
Is the child feeling overwhelmed with everything on during their week? Do they wish they had more time to be with other people? Are they spending enough time participating in unstructured free play? Is the rhythm of the day not fitting with their natural rhythm? Do they need to go outside to play before school? Do they need time alone before school? Do they need more free time? Does the child have a creative outlet? Are there enough opportunities to run around or play sports?
Some of these questions or others may lead you to realising that the child needs more alone time, more time with others, needs more guidance to find suitable activities to account for energy levels, needs a place set up in which to have needs met such as a place to be alone for a time, needs help finding a place/way to calm down when feeling anxious/angry/irritated etc. Make a plan and help them.
Once you have addressed any problems within these areas, check for change or improvement. If you see improvement, continue with the changes you have made and monitor. If there is no improvement given a reasonable amount of time and commitment to change, you will by now have probably noticed other behaviours due to monitoring. Write everything down. Keep hugging your child and move forward.
3) Gather information from others who have contact with your child. Teachers, preschool director/teacher, grandparents, uncles and aunts. They may have noticed something you haven't, or may have noticed the exact same behaviour/s as you have. Make notes, and especially approach any meeting at this point with an attitude of taking it all in, rather than trying to explain behaviour (this may need to come later if further professional help is needed). Listen to any suggestions made and consider implementing changes. Give each plan/idea time to note any positive changes. If there is some, continue with the plan, if none, move to step 4.
4) See your child's doctor (GP). It's important that this doctor is one your child sees regularly. If this doctor doesn't take your concerns seriously or brushes off your concerns as 'poor parenting' see someone else. By all means, if the doctor makes parenting suggestions that may be helpful, take them on board, but chances are that if you have reached this stage you have probably tried many parenting strategies already. Medically there are many things that can affect behaviour. Certain deficiencies can cause a whole host of problems, and allergies and intolerances can certainly affect eating patterns, sleep and behaviour too. Don't just take your child off certain foods to see how it goes, without medical help. It is better done in a controlled way with the guidance of a doctor or dietitian. For certain testing to be accurate it needs to be done BEFORE a child is taken off the suspected food, because otherwise the test results can be inaccurate.
The doctor may advise tests or specialists that may be able to help further. Follow through with advice given and keep records that may be requested. Make sure you go back for any recommended follow ups, and go back if more information or clarification is needed.
5) Make contact with other professionals. If you have reached this step, decide which other professionals may be able to provide you with help. Paediatricians are a great place to start. Behavioural optometrists, speech pathologists, psychologists, dieticians, occupational therapists, audiologists, hospital sleep clinics, are just a few of those out there ready and happy to be consulted. Don't be afraid to contact them for advice, as that is what they are there for. There may be a long wait with some professionals, so make an appointment as soon as you feel it may be necessary. Parents don't need to wait until an issue becomes huge and unmanageable before making an appointment. Seeking professional advice with concerns early can mean many negative outcomes can be avoided.
All children - all PEOPLE - are different. Differences are great. They enable us to function as a society, with each of us holding special gifts to be used as part of a greater whole. Understanding, patience and kindness are needed. Just remember that sometimes help is needed too. Not all behaviours can be overlooked or ignored because they impact on a child's relationships with others and their life in general. Professionals are available to help give guidance, knowledge, and understanding in many areas. Everyone who is given the gift of this understanding and guidance can better cater for the needs of the child, and with everyone moving in the same direction, outcomes improve.
Some issues may not require all these steps. Some investigations may vary in steps, for example a child with constant headaches, seeing an optometrist would be the best place to start.
At every point take a moment to breathe. Stop and think about your child and ask yourself if the action you are faced with will be a step forward.
It may seem like an overwhelming process, but it is much better moving forward than sitting still worrying.
This has been a brief overview of the process. There is much more that can help make this process work for you and your family, when searching for solutions. I will be writing more about this in the future, so if you have questions or part you would like more information about or further elaboration, please comment and I'll see what I can do.
Jen.x
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