Early Intervention Support

Ask A Therapist: Other Concerns

Early Childhood Intervention

This website is a place for families who are facing challenges pertaining to their child's development and growth.

It is a place to find answers and practical suggestions. That's what Early Intervention Support is all about.

Whether a family has a child with a challenging behavior, a disability or developmental issue, childhood is short - it should be savored and enjoyed.

Learn More:

Ask a Therapist

Group of Therapists

We understand developmental milestones and the challenges of Special Needs children.  We spend a great deal of time with families understanding the inner workings of childhood routines and interactions.  Ask us about your child today!
 
Ask a Therapist

Contact Information

Mother & Baby 

Find Early Intervention Support contacts in your State.  If you have a question or comment for us, please visit our Contact page.

Behavioral Concerns

 

Listed below are a few previous questions from our Ask The Therapist form relating to speech and language.  You may also want to review:

 

 
My 3-year old son has been dismissed from a second daycare because of hitting and throwing chairs and I am at my wits end. I am a single mother and his dad has never been in his life because he's incarcerated. He's had timeouts (don't work), had his toys taken away along with tv (he's ok with this) and i've just reached out to his father's mom for help. She said that the dad was difficult as a child and I am scared that my son will end up in prison like his father.

This sounds like it is really frustrating and frightening for you. Has your son ever been evaluated by early intervention for behavioral or other developmental issues? It is hard for many child care centers to handle behaviors in young children such as hitting, biting, throwing, etc. and sadly we often hear of young children being excluded for these behaviors instead of trying to help the family & child seek professional help and support to minimize these behaviors. Since your son is over 3, he is too old for the 0-3 early intervention services in your county, however, he should still be able to be evaluated at the preschool 3-5 level. You might try calling someone at this website to obtain information on developmental/behavioral testing for your son in Brooklyn.

more » « less

The first step is finding out what is behind your sons hitting and throwing behaviors: when they occur, what happens directly before they occur, who they occur with and where they occur and what are the consequences afterwards. For every behavior there is a reason behind it. Young children lash out by hitting, biting & throwing for a variety of reasons (and this list doesn't cover them all): A) they can't express verbally that they are angry, upset or frustrated B) they are imitating behaviors they see other children or adults do in real life or on TV C) they don't like someone being too close to them or in their "personal space" D) they are overly tired or hungry E) they want attention and have learned this is a way to get it (even if it is negative attention) F) Hitting, throwing, kicking and biting are fulfilling a sensory need for the child (a child may have a sensory processing disorder).

The keys to changing a behavior are consistency and for young children positive reinforcement is a big key as well. When a behavior occurs, everyone needs to be responding to it in the same way, at home, day care, grandmas, etc. For example, when Jack throws his car across the room, he is told to go pick it up. If he does not pick it up he is told matter of factly and in a calm tone by the adult "Jack, you need to go pick up your truck or I will help you to go pick it up". If he picks it up he is then told that "cars are not for throwing, they are for driving on the floor" and "if you throw the car again Jack, it will be put away". If he did not pick it up, the adult can walk him over to the toy and assist him in picking it up and then repeat "cars are not for throwing, they are for driving on the floor" and "if you throw the car again Jack, it will be put away". If he does throw it again, it is taken away for the rest of the day. But, keep in mind if he throws something at home and is allowed to get away with it, and then throws something at day care and simply gets yelled at and told "no throwing" and he throws something at grandma's and gets a smack on the bottom, this behavior may never change since it is being dealt with in an inconsistent manner by all the people involved.

Many young children get into a pattern of acting out for attention because over time they have learned that the only time adults are paying attention to them and responding to them is when they are hitting or throwing. They soon don't care if someone is yelling at them, scolding them, smacking them, etc. they only know that it is adult attention and that is what they are seeking. To change that pattern we need to "catch children being good" and lavish the praise on them whenever they are doing something positive or doing what we want them to do. They need to learn that attention comes from doing things well and listening and following rules, not for breaking rules or misbehaving. Many preschoolers are still in the "no" stage and can be defiant and this is not abnormal or unusual. But, if behaviors begin to disrupt learning or classroom routines, then this can be a problem.

Consequences for behaviors should match the behavior, so taking TV away in the evening because he hit another boy at day care would serve no purpose since the behavior occured hours earlier and there is no association with the actual behavior that occured. When he hits (or any behavior that hurts someone) it does need to be dealt with firmly, calmly and immediately and not with lengthy words or explanations or hitting him back. So he is told "no hitting, hitting hurts, you made Bobby cry" and he is removed from the situation immediately, while all the attention should be lavished on the child who got hit, not on the hitter himself. Time out is effective if used properly and consistently for hurting behaviors. No more than 3 minutes since he is 3 years old. When 3 minutes are up he is told again why he was in time out "You hit Bobby and made him cry. Hitting hurts. We use nice touches with our friends. Show me a nice touch". You can even use dolls or stuffed animals and act out scenarios with toys to encourage him to express feelings and learn it is ok to be mad, we all get mad, but it is not ok to hit people when he is mad. When he is angry teach him to use words "I am mad" and if he has a need to lash out, let him take out his anger or frustration by punching some pillows, etc. Some kids have a need to do this, so it's a matter of letting them get it out in a more socially appropriate way. Some child care centers have even created "quiet corners" full of pillows and maybe a tent like structure where kids can go when they need to be alone or need to kick and hit and burn off steam...this can be more positive than going to "time-out" and being told to sit in a corner in a chair. For some kids it's a matter of recognizing their early anger or frustration brewing and asking "do you need to go to the quiet corner?" and some kids will go willingly because they need that break and that time to release their frustration.

We have a lot of information on our web page about dealing with behaviors in young children, and some of these links may be helpful to you: behavior management, changing behavior, negative feelings, positive reinforcement, and self-regulation. I would also suggest calling 718-522-7300 (All About Kids NY) for more information and then setting up a meeting with your son's day care staff and asking them to write up a formal "behavior plan" detailing how their staff and your family will be dealing with specific behaviors, and let them know that you want to actively work on helping him learn to dimish these behaviors and that you need them to meet you at least half way and help you work on the behaviors through their teaching at day care and your teaching at home.

 

My child turned 3 in Feb. She is the youngest in her preschool class. The other kids are turning 4. The problem is there is a new teacher in her class and my child has picked up a very aggressive behavior toward her friends. I don't know what to do. She does great at school but she is just agressive. My husband think she has A.D.D.

My first suggestion would be to schedule a sit down meeting with her new teacher to discuss your concerns regarding your daughter's aggressive behavior. There is always a reason behind a behavior and together you need to figure out why she is being aggressive towards her friends. Is she on target with her speech and language skills and social skills? Sometimes children with delays in speech or social skills will use hitting or other aggressive behaviors to get attention or to get their point across if they don't have the other necessary skills in place. Is she overly tired? Does she get a lot of attention when she acts out in the classroom? Preschoolers without delays are still prone to temper tantrums, aggression and fighting over toys and this is not out of the ordinary. Preschoolers in group settings are even more prone to these behaviors.

more » « less

What you need to establish for your daughter is whether this is typical for her age or if you think it's something more. Also, your child's teacher needs to have skills in behavior management in the classroom. If you are seeing these behaviors at home and school you and your child's teacher need to establish a behavior plan so that you can all be consistent in managing these behaviors and eventually diminishing them. For most acting out behaviors, the smartest thing parents & teachers can do is to be consistent, and to anticipate times when problems may occur. You have to be proactive, and head off situations in which there are likely to be meltdowns, aggression or tantrums. Parents and teachers can divert attention, for example, offering one child a different toy when two children are fighting over something. Offer choices when appropriate, explain things on the child's level, and enlist the child's cooperation as a helper in the classroom. Ignore what can be ignored, pick your battles and always lavish on praise when your child is behaving appropriately. Let them learn that they receive attention for behaving, rather than for misbehaving. Behavior sometimes escalates with changes, so a new teacher can be one reason she may be acting out, especially if she was attached to her other teacher. Basically at age 3 most children are still learning to self-regulate and most behaviors, although bothersome and worrisome at the time they occur (biting, hitting, etc) do not usually continue long term and by the time children are 4 they are much better at self regulation. So if your daughter was 4 going on 5 and still demonstrating these behaviors, I would say it would be a bigger concern. If you have concerns that your daughter's behavior is escalating or not improving over time, you could seek an early intervention evaluation with your local 3-5 service provider. But, I would definitely start with meeting with your child's teacher. For more information on behavior and self regulation you can check out these links on our web page: self-regulation, changing behavior, behavior management.

 

I need to know how to handle my two year old when she is biting at day care. The owner of the center is threatening to remove her if this problem continues.

Biting is a very common behavior in toddlers and really, among developmentalists is considered a "typical" though challenging behavior or stage that some (not all) children go through. We do often hear of children being pulled from day cares, sometimes due to the pressure of the parents of the children who were bitten. But, a good developmental day care, should know how to deal with the behavior (as challenging as it can be in a group setting) and help remedy it, along with the parent of the child who is doing the biting. These are links to two articles (biting and why bite) that is already appear our web page related to biting and how to handle it.

more � � less

I would suggest reading the above articles and then planning a time to sit down with your child's day care teachers and discuss yours and their concerns so that you can both get on the same page regarding this behavior. You and your day care staff need to figure out when and why the biting is occurring: Is she tired, is she frustrated, is she angry another child took a toy away, is she upset someone is too close to her? Is this behavior only occurring at day care? Is it happening only in the presence of a certain caregiver? Are there certain children being bitten or is it random? There IS a reason behind a bite that most children cannot verbally communicate. Many day care centers do not have adequate staff to always "shadow" a biting child, however, if for a few weeks they are able to have a worker "shadow" your child and intervene BEFORE a bite occurs, this can be helpful. You need to all be dealing with biting in the same way and the second article tells you ways to do this. One thing you never ever do is bite the child back to teach them a lesson.

If your child is age appropriate in receptive and expressive language, you may want to give her something to carry with her when she feels that need/urge to bite, like a soft rubber toy or chew tube ( the chew tube is a therapy tool used by speech/OT) and tell her things like "It is ok to be mad, but you may NOT bite people" or "You may bite on this, you may not bite your friends/Susie/Mommy). Some children actually have an oral need or fixation to bite or chew things, but this is a special circumstance and my not at all apply to your child.

 

I have a 12 yr old (soon to be 13) boy with Down Syndrome who has never been potty trained. He has been in my care for 2 months. I spent the first week teaching him not to be afraid of the toilet. He will potty in the tub, shower, floor, pullups... if he's sitting on the toilet and feels he has to go, he wants to pull up his pullups so he can go in them! I am at a tremendous loss as to what to do. He would rather wear the potty than go in the pot! I would appreciate any help you can give me.

It sounds like you are doing the right thing by starting with the basics of teaching him to not be afraid of the toilet. Most children with Down Syndrome are able to be potty trained by age 5, so it's very sad to hear that no one before you seemed to have worked very hard at helping this boy. Certainly since he's been going elsewhere, not necessarily in his pants, for the past almost 13 years, it's going to be a challenge and hard habit to break. He may also just be confused since he is new to your house, and much like with a toddler, starting toilet training immediately after a major life event (such as a move) can be hard. I would say persistence, a strict schedule & routine, and lots of positive reinforcement and praise will be the keys.

more � � less

You might also start with some teaching outside the bathroom, such as reading toddler books to him on toileting and playing games involving the concept of "wet & dry" since the key to going elsewhere is to feel the discomfort in his soiled diaper. You can start by teaching hand washing and face washing skills and reinforcing when his hands/face are wet and dry. I would start with a schedule much like you would with a toddler of checking his diaper every 30-40 min and for a few days establishing what his elimination pattern is...this will help you know when to learn to encourage him to sit on the potty. Take him to bathroom after snacks and meals and upon waking. If he sits and does not go, praise him anyway for sitting and let him know you'll try again in an hour, etc. When he does go in the potty have a HUGE celebration with hugs, kisses and lots of verbal praise. I would suggest making him a sticker chart for the bathroom as well to help reinforce going to the potty and then reward him with something special if he collects a certain number of stickers (you can start out slow & then build up). I don�t suggest rewarding with food, since children with Down Syndrome can be prone to weight problems. You can read our article on special needs toilet training for more ideas.

 

My son is 10+ years old and in 5th grade. He started having seizures when he was one and half years old. After six months he would get attacks (Generalized epilepsy). He was put on Tagretol. While taking his medicine, he got attacks once more. After one year his dose was increased and continued for another 3 years. His medicine was stopped by the doctors slowly in August 2006. My son is shy, quiet and an anxious kind of child. Sometimes he has odd behaviors but no complaints from school. But from the last 5-6 months, he started crying excessively, clingy and his odd behavior has increased. His physical tests like EEG, MRI and thyroid tests were normal. He is more difficult to handle. I want to know to how much extent we should be strict with him. He is taking Cilentra as advised by the doctor. What do you think about his problem? Sometimes he says he wants to be the last in line if someone comes behind him. In the car he wants to sit down but not on the seat. We are handling him strictly yes for yes and no for no. He doesn't want to study at all. He attends school but is not doing his class work. I want to love him but his behavior or habits don't allow me to do that all the time.  I am feeing very distressed.

I am glad that you have taken your son back to the doctor for the EEG, MRI and thyroid tests to make sure that he is not currently experiencing seizures or other medical problems. I was not familiar with the drug Cilentra that you mention, but upon looking it up on WebMD, I have found that it is the Asian brand name for the drug called Escitalopram, which is commonly used to treat depression. I am not a physician, only a therapist, and my specialty is birth to age three, not school age children such as your son. However, in the USA, many physicians are very careful these days when prescribing certain drugs for depression in children and young adults under the age of 25 because sometimes these drugs can make symptoms worse, rather than better in these youngsters. Here is what WebMD says regarding the drug your son is taking:

more > < less

Escitalopram Oral (Cilentra): Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition. Tell the doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.         From what you have described it does sound like your son is very anxious, having perhaps panic attacks and         being impulsive by fighting with other children if someone is standing behind him, as well as being very         restless-not being able to sit in the car. These could all be side effects of the drug itself, unless         these exact same behaviors were occurring before he started the medication. I also read that seizures can         be a side effect of this drug, so perhaps you also want to be careful using this drug given your son's         past history of seizures.

I would definitely suggest discussing your son's behaviors again with your doctor and asking him         if his symptoms could have actually increased DUE to taking the new medication. You may also want         to take your son to a child psychologist or psychiatrist, who may be more familiar with disorders of         mood and behavior in young children. There are many other diagnoses that affect a young child's         behavior, such as attention deficit disorder (ADD), but these all need to be diagnosed by a doctor and         medication alone is not the answer. Children with diagnoses affecting mood and/or behavior need therapy,         family training, schedules and routines for home and school life, as well as sometimes medication to help         their conditions. Make a list of what behaviors you saw BEFORE your son started the Cilentra and then         make a list of what behaviors you saw AFTER he started the medication and let your doctor know if there         are new behaviors or if any certain behaviors have become worse since starting his medication. If you         son's behavior originally was not due to depression or a diagnosed mood disorder, than perhaps this         medication is not right for him? But these are all things you will need to learn directly from a physician,         psychologist/psychiatrist. I would also suggest talking to your son's teacher and school counselor if         there is one, and address your concerns with them as well. Ask them to document his behaviors in the         classroom, so that you can let the doctor know about the behaviors both in school and at home and how they differ, if at all.

 

My 9 year old son has Fragile X syndrome. On a scale of 1 to 10, he is only a 5 so he is not full blown Fragile X, but also shows signs of autism, ADHD and also has sensory problems as well. When he was younger, I could never get him to wear certain clothes. He would never wear jeans, turtle necks, and socks had to be a certain type. I always had to cut the tags out of everything. With the new medicine the doctor has put him on he is now wearing normal clothes. But he still has one thing that I am afraid that is going to get him made fun of in school soon. He is constantly picking a wedge out of his pants. He is doing this literally every time he makes a different body movement. Can you help me understand why he is doing this and maybe a way to help him stop this?

Has your son received or is he currently receiving occupational therapy for any sensory related issues? From what you described with his previous issues with clothing, these would all seem to be related to his sensory sensitivity, including his current problem with his underwear. These are all indicators that he is hypersensitive to touch, especially with types of clothing that make him uncomfortable. An occupational therapist could help your son work through these issues. Here are some examples of hypersensitivity:

more > < less

Examples of Hypersensitivity include: Feeling pain from clothing rubbing against skin, an inability to tolerate normal lighting in a room, a dislike of being touched (especially light touch), discomfort when one looks directly into the eyes of another person. You can find more info regarding the services of an occupational therapist and how sensory integration dysfunction is treated at these links from the Fragile X Foundation. Since we do not know your son we cannot give you specifics for therapy for him, but would recommend that you consult with an occupational therapist through your son's school or a local hospital or clinic.

 

I am a second grade teacher. I find everyone is quick to diagnose children with ADHD. Is there a "normal rule of thumb" for attention span? How long should a typical 7-8 year old be able to concentrate? I find teachers are lengthy in their lessons and explanations. How long should the child be expected to pay attention? Sometimes I feel children are diagnosed with ADHD because teachers do not change-up their teaching style...so energetic kids become fidgety and conversational. Teachers are competing with iphones, Wii, and ridiculous technology...shouldn't they provide concise, and entertaining ideas in their lesson plans? Everyone is quick to label ADHD...when the teaching methodology needs to improve.

ADHD is a diagnosis that should not be made quickly. There are many parents and teachers who often wonder if a child is restless in the classroom or does not pay attention if they might have ADHD, however, this is a specific diagnosis which should be made by a trained professional with careful testing, observation and parent/teacher interviewing over time. Medication alone is not the simple answer for these children who truly have this diagnosis. You can read a little more about ADHD at our Parenting Tips link.

more > < less

Young children do have relatively short attention spans and generally do best when alternating activities which require sitting still and focusing with those that allow for physical movement. This is one reason there are so many proponents of keeping activities like recess and gym class a part of children's daily schedules. Creative teachers will find ways to make lessons stimulating and can even incorporate movement into lesson plans to hold attention. Therapy catalogs even sell toys called fidgets to help children maintain focus in the classroom, and this is something you can talk to an occupational therapist about if you have children in your classroom who might need such an outlet to help them maintain focus for longer periods during classroom lessons. Here is a link to some "silent classroom fidgets".

You are also correct that teachers today have to compete with the technology that kids use at home, but often technology is also a part of classrooms today, so again, creative lessons involving computers or music can also help to hold young children's interest. We recently answered a question similar to yours posed by an elementary teacher who wanted to know the attention span of children in kindergarten and first grade which I copied below. You can expect that your second graders will be able to pay attention for a bit longer, but the reply below should give you a general starting point:

Children ages 5-6 years old typically can attend to one activity that is of interest to them for         around 10-15 minutes at a time and should generally be able to filter out small distractions occurring         simultaneously in the environment. They may only be able to attend to an assigned classroom activity         for only 5-10 minutes particularly if they find it uninteresting or difficult for them and do not         have adult guidance to stay on task. As a guideline some research suggests using a child's age as a         general starting point for the number of minutes a child can attend to a single assigned task...so 5         minutes for a 5 year old, 7 minutes for a 7 year old, etc. Small groups of children may be able to play         together for 15 minutes or up to a 1/2 hour if they are engaged in novel, interesting play activities.         Children ages 6-7 years may be able to sustain attention to one interesting or novel task for as long a         30 minutes. Typically in kindergarten and 1st grade getting kids motivated, interested and engaged in the         lesson is the key way of holding their attention. It also helps to keep lessons shorter and intersperse         movement activities in between your lessons that require sitting and focusing behaviors. Another key to         success in sustaining attention with young children is to have a teacher or aide in the classroom who is         always able to help with new, difficult or frustrating tasks and who can intervene and provide cues to         stay on task before a child loses interest.

 

My son is 19 months old and enjoys being around people for a short period of time. After about 45 minutes, he has had enough. Even if I am around this happens. I am a Sunday school teacher and I find it hard to leave him for longer than 45 minutes. He also does this when we have people over our home. He is not like this with his siblings or when we are alone. My house is generally very quite. He loves spending time alone and with people. Is this normal? What can I do to help him out with this issue? I need to attend a meeting twice a week and they are 1.5 hours long.

It is difficult for me to give you a definitive answer without knowing more about your son or being able to observe his social/interactional skills directly. I am wondering how your son begins to react differently after 45 minutes to indicate to you he doesn't want to be around other people? Do you feel it is the other people he is reacting to specifically or the situation itself or is it just that he has had enough and wants to go home? Does he start to cry, scream, tantrum, act out, etc.? You describe that he reacts to the social situations after 45 minutes whether or not you are present, so it would not seem that separation anxiety would necessarily be the cause, but perhaps just general over stimulation or a desire to go back home or to be left alone period. Since you mention your house is always quiet and he does not do this around his siblings or you at home, it sounds like home is his comfort zone (which it should be) and when he goes out or others come in it causes some social anxiety for him.

Overtime his reactions in outside settings after 45 minutes could have become a learned behavior or could have increased because they were unknowingly rewarded. I am wondering if when he first started to show his desire to be away from the other people if he was always taken home or removed from the situation which was what he wanted, thus unknowingly rewarding him in some way? Since you need to attend your twice weekly meetings, I would certainly suggest meeting with his day care provider and implementing a plan to work him through his anxiety (if it is indeed anxiety). You could perhaps make him a photo book to take with him while you are gone showing the sequence of his day in photos. At his age he cannot understand the time concept, however, reviewing a photo book showing him eating breakfast, then going in the car, then arrival at child care, playing at child care, pictures of you working at your meeting, then pictures of you picking him up and finally pictures of going home could help. Review this with him at home and let him take it with him to review at child care while you are gone. Even though he doesn't understand time, you could still take a picture of the clock and if your meeting is done at 2:00, show him that when the clock in the room matches his picture it will be time to go home, since matching identical pictures is something he is ready to do at his age.

more > < less

If it is the overstimulation that you feel is affecting him (too noisy in the room, too many kids), perhaps they can create a quiet corner for him in the room where he can go inside a little tent made with blankets and pillows when he needs to be alone and calm himself and listen to quiet music in headphones or read books away from the other caregivers and children, but he may not leave the room to see you or go home early just because he wants to or gets upset. Some child care centers are starting to make quiet corners, so that children can go there to be alone or to pull themselves together emotionally if need be and this has proven quite successful since there are always times when we all want to be left alone. Young children lack the self-regulation and coping skills to do this on their own, so we need to create ways to help them self-regulate and cope in situations they may find difficult. Try to gradually build up his tolerance time, for example, if he indeed makes it a full 45 minutes before becoming upset, set an alarm clock to go off in 5 minutes from that time and say "when the bell rings we can go home" and then reward him for sticking it out another 5 minutes. If he can do 50 minutes, then increase to 55 so that hopefully he can eventually tolerate the full 1.5 hour period.

It would help if you could practice this with the staff on non-meeting days and be prepared for him to act up more when first beginning, as with trying to change any behavior it usually gets a bit worse before it gets better and it does take time and patience. Do not become upset yourself, and have the staff remain calm, firm and positive. Also, when allowing him to leave the situation, be sure to do it when he has calmed himself and stopped crying or fussing, so that you are rewarding the desired behavior and make a big deal of how he made it through the hour. The staff may also want to do something very special for him once he makes it through the 1.5 hours on his own. If you are getting the feeling that his issues seem to be more sensory based, related to overstimulation from being around too many people, loud noises or different environments outside the home, you could also seek an early intervention evaluation from an occupational therapist to look at his ability to handle sensory input (sight, sound, touch, taste, smell) and a developmental evaluation to assess his current social skills. This is a link to the free early intervention services in your area: http://www.aacps.org/infants/itp.asp

 

My granddaughter was a preemie; she had gastricschisiosis and was taken a month early (in May 2009). She repeatedly rocks herself back and forth while in an upright position... otherwise she exhibits normal behavior and milestones. I'm wondering though, if the rocking back and forth is a red flag?

I am not familiar with a condition with the exact spelling as you mentioned, however, I wondered if she perhaps had "gastroschisis" which is when the abdominal wall fails to close and the intestines protrude through it?

more > < less

This is typically surgically repaired and babies usually do very well. I would not think the rocking would be related directly to gastroschisis or to her being a preemie. In infancy, assuming your granddaughter is between 6-7 months old, I wouldn't see rocking back and forth necessarily as a red flag. At this age babies are learning important motor milestones such as how to sit with balance, crawl and eventually pull to stand. She may be simply experimenting with movement, she may get into sitting and start rocking in an effort to find her sitting balance or she may get on her on hands and knees and rock back and forth in an effort to figure out how to crawl, or she may rock back and forth when held in a standing position simply because it's fun. Some babies and young children rock as a self-soothing or self-calming measure when they are tired or upset. If you can easily re-direct your granddaughter from rocking and engage her in age appropriate play with you, I wouldn't be too concerned at this age, especially since you mention that your granddaughter is meeting all her other milestones at this time. Repetitive rocking in toddlers and older children can be a red flag for autism, but typically these older children are not meeting all their social and communication milestones and cannot be easily distracted from rocking by an adult. If you continue to be concerned I would mention it to her pediatrician at her next well child visit so he can observe the behavior and give you further advice.

 

My 4 yr old daughter likes to ignore my husband and I when we    talk to her or ask her with help in a specific task? What do we need    to change to try and stop this behavior?

There is an excellent article already written on this topic called    "How to get your Preschoolers to Listen & Respect You" at this link: http://www.scribd.com/doc/13484/How-To-Get-Your-Preschoolers-To-Listen-To-Respect-You

The author's bottom line is that you are the parent, and if you    want your child to do something than you need to calmly direct your    child to follow through or else use appropriate consequences so she    learns that you are serious and will not give in or bribe her in    order to get the results you desire.

more > < less

By preschool age you can also use incentives for listening and    positive behaviors by making a chart & using stickers. For example if    you want your daughter to pick up her toys before bedtime, write that    as a chore on her chart, if she does it without complaint 7 days per    week you can reward her with something small at the end of the week.    You may also choose to take away special privileges for not complying    with rules or for not listening. For example, if you have planned to    go to the park and your daughter is not listening or following    through with your directives than she stays home from the park as a    consequence for not listening.

Remember, preschoolers will assert their independence and test    your rules and limits, however, it is up to you to stick to your guns    and calmly, but firmly teach them about listening or help them to    learn the consequences for not listening.

You can find more information on positive reinforcement and    behavior on our Early Intervention Support website at this link: http://www.earlyinterventionsupport.com/parentingtips/behavior/positvereinforcement.aspx

 

I have a 9 year old son who has pdd. I also have a 1 year old    daughter who is his 1/2 sister and he is great with her. He plays    with her, and attends to her, makes her laugh. On 2 separate    occasions he got aggressive with her. The first time he pushed her    head and said it was because she kept dropping her bottle after he    kept giving it to her, and the second time he kicked her and said it    was an accident. My question is, how can I differentiate if he is    telling what happened or how or should I hold him accountable for his    actions?

Let me preface this reply by telling you that I am not an expert    in PDD, and my expertise in working with children on the autistic    spectrum is centered on the 0-3 population. I have read on various    parenting forums for families of older children with PDD or autistic    spectrum disorders that male children sometimes become more    aggressive around the age of 9 as they near puberty and are producing    more testosterone.

more > < less

Some families have addressed concerns with aggression and    outbursts with the child's teachers and have asked for more    behavioral therapy to work on specific issues, or visited a    psychologist to assess whether any other disorders are contributing    to their child's aggression (ADD/ADHD, Conduct Disorder, Oppositional    Defiant Disorder). Some families have chosen to try medication to    control aggression and have found success. I would definitely address    these concerns first and foremost with your son's teaching team at    school and see if perhaps goals can be built into his IEP to address    these issues, then if that is not successful you may want to move    onto one of the other above mentioned steps. You asked about his    accountability, and I do not believe a child's diagnosis or    disability excuses him from his actions, so his aggression with his    younger sibling should be addressed in a manor that is suitable to    his intellectual level.

This is the only way he will begin to  learn that his actions were not appropriate in that situation. If he is  hurting his sister it cannot be ignored and must be dealt with in the  moment when it happens, but you would deal with it based on his  cognitive level, whether it be a time out, loss of privilege or a  demonstration of how he could have acted differently and more  appropriately. It sounds like your son may need to be in close  supervision with an adult when he is around your younger child, and  should not be left alone with her. Many parents do acknowledge that  their children with PDD can be extremely loving, caring and sweet, but  that often little things may set them off...and your son can probably  not yet understand that the behaviors of a one year old (dropping her  bottle is a game to her, but to him it was just plain annoying or  distracting) are not intentional and intended to annoy him and so he  may deal with her as if another 9 year old were to continuously throw  or drop a toy.

Children with PDD also often have language and social interaction difficulties, so instead of your son being able to say "Knock it off sis" or "Mom, she is bothering me", or being able to understand the social cues of a baby, he acted out toward his sister to stop her actions from bothering him. You may be able to do some role modeling and positive reinforcement with your son at home to work on specific situations which may occur with his little sister...for example, when she is dropping her bottle from the high chair, you keep picking it up and making it a fun game, demonstrating to your son a positive way to interact to this situation and rewarding him for his appropriate play with your daughter. Lastly, you might want to look into sensory issues with your son, if this isn't being addressed, for example an oversensitivity to sounds (the sound of the bottle hitting the floor), could be enough to cause an outburst. An occupational therapist at your son's school should be able to explain sensory therapy. I have also found a link that describes aggression associated with PDD: http://www.selfgrowth.com/articles/Baldwin3.html

 

I have a 4 yr old little girl and she throws violent uncontrollable temper tantrums. I've taken her to her PCP and she says every kid does it. It will start over anything even the smallest thing. She lost her red color, she doesn't want to wear that, she wants to eat something else, her TV show ended. Anyway, these tantrums last at least 2 hours and usually only end by her  passing out. When they start the screams, whines, she won't talk at all, she bites, she kicks, she scratches, she throws things.

Basically she will do anything possible to hurt you , herself, and everything and everyone around her. Nothing I say or do can ever calm her down and I'm scared for her to hurt herself or anyone else so I basically have to hold her down to protect everyone. Help me I don't know what to do anymore. Where do I go and what do I do. I love my daughter and apparently she needs some kind of help.

Your daughter's frequency and severity of tantrums at age 4 are very concerning. Is your PCP a pediatrician or a developmental pediatrician? If not, I would definitely seek a second opinion with a doctor who is more familiar with preschool aged children and their behavior. While it is true that most children do have tantrums and children as old as 4 & 5 will still have them, the fact that your daughter is engaging in self injurious behavior, as well as trying to hurt others, coupled with the fact that she cannot calm herself and passes out often after 2 hours of screaming makes her case atypical. If you can't get a second opinion from a developmental pediatrician in your area, then I would find a local child psychologist/psychiatrist who would evaluate your daughter. You can also seek an Early Intervention Evaluation (3-5 preschool services) for behavior through your local school district.

more �> � less

To help you in getting help for your daughter I would suggest starting to keep a log of her tantrums that includes when they occur (date & time of day), what triggered the tantrum, what she does during the tantrum (scream, hit, bite, etc), how long they last, and what happens directly afterwards. Also, do these tantrums occur only at home or do they also occur in other environments and with other caregivers besides yourself? Keeping strict documentation of your child's behaviors will often make a doctor take a closer look. Also, has she been having these tantrums since she was a toddler or did they start or increase in intensity just recently? Pay attention to any changes in your or her life that can increase tantrums (i.e., did you recently move, did she recently start school, did you recently get a divorce or new partner, did you recently have a baby).

Typical tantrums in children ages 18 months to age 5 last around 3 minutes, and tantrums lasting longer than 5 minutes, while they may occur sometimes, would not typically occur on a regular basis. Younger children tend to lash out more physically because they don't have the words to express anger or frustration yet, however, by age 4, most children can express anger with words and can also self-calm when upset, something that it sounds like your daughter is having difficulty doing.

I don't want to alarm you, nor can I make a diagnosis, but violent tantrums in ages 3-5 can be associated with mood disorders such as depression or other disruptive disorders of early childhood. I would definitely seek a second opinion and/or schedule an evaluation with a child psychologist as soon as possible to get you and your daughter the help you need.

 

I am very concerned about my 2-year-old child. She is very hyperactive, she doesn't respond to toys or other children, and she would rather be by herself. She only repeats what she hears, and doesn't ask for what she wants. She can't eat without assistance. She screams and hits. She is very unbalanced - falling a lot and running into things without trying to stop herself from becoming hurt. When she gets hurt, she doesn't cry. She constantly has bumps and bruises from where she has fallen or run into something. Please give me any information you can so I can know what is going on with my child.

It sounds as though your little girl keeps you very busy! You mentioned a lot of concerns about your daughter. The most important concern is her safety. If she is running into objects or falling frequently, try to remove any items from the room where she is playing that could harm her. She is under-responsive to pain, meaning she does not register a response to what just happened.

more > < less

It sounds like she has a strong need to move. This may be vestibular dysfunction, which is a type of Sensory Processing Disorder, meaning that she has trouble processing information from her movement ' gravity, balance and space. She is always "on the go" because she is seeking out information and she doesn't get enough movement. She is bumping and crashing into things because she has a strong need for intense movement sensation. Her brain, and particularly her central nervous system, is craving more information from her body.

Different types of movement may have a "calming effect." Use the playground swings, sit 'n'spin toys, an office or dining room chair that spins; sing and spin to "ring around the rosy"; or use a blanket or sheet to make a hammock, while you and another person swing your daughter as she lies inside. Help her to have safe movement opportunities. If you can, make a "crash corner" in your home using a beanbag chair and pillows where she can safely crash and flop herself. If you set this up, she will use it!

ou are very observant of your daughter's behaviors and should have your concerns addressed. Seek out an evaluation or screening from an Occupational Therapist who specializes in Sensory Integration. You can contact the Infant/Toddler Alliance in your area for a free evaluation - you do not need a referral from your pediatrician. Early Intervention services are provided in your home. Services are free and are provided by your state to all children from birth to age 3 who qualify. (Find early intervention contacts in your state.)Ask for an Occupational Therapy evaluation and report on all the behaviors you have shared.

 

My daughter is 33 months and I have a few concerns about her social behavior. She seems to have a lot of issues playing with other children her age. I think it's more of a possessive thing, but she refuses to share her toys with other children who come over for play dates at our house. She will rip toys out of any other kid's hands and becomes very aggressive, and has even hit other kids before for taking her toys (even when they ask her permission). It is to the point now where if I take her to our local playground, she will get agitated if another child comes to play in the same area as her. She even will not allow myself or my husband to "play" with her toys and will tell us "no" and take the toy away from us. I feel like a broken record because I am constantly trying to address the concept of sharing with her, but she is not seeming to get it.

Her interactions with other children other than toys is fine. While I do think she is a little shy, she will run and play and even hug other kids, as long as it does not involve any type of sharing of a book or toy. I've also noticed that she seems to do better with kids who are a few years older than her. She does not have any siblings so sharing is a concept that is very difficult for her it seems. She is not aggressive at all in any other way except in these situations, and it usually only happens with items that she feels are "hers". From what I understand she does fine in our church nursery when it comes to sharing those toys. I'm not sure how "normal" this behavior is because it seems to me that most children her age can at least cope with sharing for a few seconds.

My other concern is her speech. She says many words and can talk in complete sentences, and is able to comprehend a lot. My concern is it seems that the only people who understand what she is saying are my husband and I. Anyone else who she talks to always has to ask her to repeat what she is saying. She is definitely saying words, it's not gibberish, but she's just very hard to understand and it seems as though the words get garbled. Her pronunciation seems to get better and better as the months go by, but I feel as though I'm listening to her through a filter since no one else seems to be able to understand her.

I'm wondering if she should get evaluated for her social and articulation problems, or if these are common and she will eventually "get over it". I'm most concerned with her social skills with other children because she gets very agitated when it comes to interacting with other kids her age.
 

Sharing for most toddlers is still a foreign concept, and although your daughter is nearing age three it is not atypical for her to still be refusing to share toys (particularly at her own house) with same age peers. She is exerting her toddler independence and believe it or not, defiance is a typical toddler social milestone. Most young children do not play reciprocally with peers until they have well passed their third birthday, and the majority of two year olds will play side by side within a peer group, but you won't see sharing and the kind of reciprocal play you might see with preschool aged children.

more > < less

It is typical for 2 year olds to snatch toys from one another and to even hit other children to obtain toys for retaliation if another child takes their toy. Many children at this age just don't have the social, cognitive or language skills at this age to be able to share. You may have seen the popular Toddler's Creed:

If I want it, it's mine.
If I give it to you and change my mind later, it's mine.
If I can take it away from you, it's mine.
If I had it a little while ago, it's mine.
If it's mine, it will never belong to anybody else, no matter what.
If we are building something together, all the pieces are mine.
If it looks just like mine, it is mine.

This is why in Toddler rooms in child care centers you will often see 10 of the same toy, because everytime one child picks up the toy phone, all the other children want it.

Having said that, it is great that you are having play dates since she is an only child and exposing her to same age peers to encourage sharing and turn taking. Toddlers learn to share by having the behavior modeled for them by adults and older peers. Implementing some turn-taking games at home, first with you and your husband and later with her playmates, might be a good start. You can start turn-taking with things that don't involve toys, such as "I am sharing a bite of my sandwich with you...will you share a bite with me?" or "I am stirring the soup, now it's your turn" or "I am sharing my phone with Daddy" and emphasize when you are sharing with her or your husband. Praise her for all attempts at sharing with you and try to ignore her if she says "no" or resists. You want to use positive reinforcement as much as possible. For your play dates you could tell your daughter to pick three of her favorite toys that she can put in her bedroom and doesn't have to share with her peers, but when the friends come over, the toys that she didn't hide in her bedroom will be used for sharing and turn-taking. You can even set a timer for 3-5 minutes (most 2 year olds don't play with one toy longer than this) and when the timer goes off, all the kids will be asked to pass their toy onto a friend, making it into a game.

Also let her see you praise the other children for sharing. You can use a reward system with stickers or anything your child (or for her friends too) finds reinforcing and every time she shares she can get a star, etc. When she collects 5 or 10 stars, whatever you decide, she can then get some special reward like a treat, etc. If sharing the toys is especially difficult to start with during play dates, you can instead do something such as a craft or Playdough and build in turn-taking/sharing with "Can you pass the blue paint to Susie?", or "Can Joey use some of your red Playdoh?". Again, praise all attempts verbally and call her attention to other playmates who shared "Did you see Susie shared her doll with Amy? That was such nice sharing!".

As for speech and language skills, if your daughter currently has a vocabulary of at least 50 words and will imitate new words and seems to be picking up new words weekly and if she is putting 2-3 words together, then she is within normal limits. It sounds like you are more concerned about the clarity of her speech. We do not become concerned about clarity of speech (articulation) until a child reaches age 3. If after age 3 your child is not intelligible at least 75% of the time by people other than her immediate family you may want to have her evaluated. Many children work on pronouncing specific sounds of speech until around age 8, so some sounds we would not expect a 2-3 year old to pronounce clearly. However, if you are still concerned about clarity/articulation after age 3, a Speech Language Pathologist will be able to let you know if your daughter is eligible for speech therapy services.

 

My son is 2 and a half. He wont listen to me unless I threaten to punish him. I have tried everything from time-outs to taking away his toys. He makes me lose my patients and sometimes I don't know what to do. He's extremely energetic and very fidgety. Is there something wrong with him or am I doing something wrong?

Thank you for your question. Developmentally, children at age two and a half are not typically billed as "good listeners". Children this age have very short attention spans (around 3-5 minutes per toy/activity) and often need directions or questions repeated several times before they are able to follow through. Some children may need physical guidance and verbal and gestural cues to be able to follow through with requests. It is developmentally appropriate for children of this age to be very self-involved, and to have what I like to call "selective hearing". This means, for example, if you tell a 2 year old to "pick up your toys" or "it's time to come inside" or "share with your sister", they may indeed understand the command, but will simply choose not to obey it or will even pretend they didn't hear it. They typically aren't doing this on purpose to annoy you, it's just developmentally what 2 year olds do.

more > < less

Most children by age 2 1/2 can follow simple one and two step commands such as "Go get your shoes" or "Get your cup and put it on the table". Two year olds are typically active and busy as well, so this is not unusual. It helps to give young children directions/commands or to ask questions by first gaining their attention. Many active two year olds are so involved in play that sometimes they just are not attending to what you are asking them. When you want your son to do something, get down on your son's level so he sees you, encourage him to make eye contact with you so he sees and hears what your saying, and keep directions or questions simple and to the point. For example, if he is running around in the yard or driving trucks on the floor, slow him down so he's facing you or get down on the floor with him and say "It is time to eat dinner, you can play for a few more minutes and then I will help you clean up your trucks". You can even set an egg timer to signal the "end" of playtime to ease the transition into dinner, bath, bedtime, etc. For example "When the timer bell rings, it will be time to take your bath".

I would not advise getting into a pattern of threatening and punishment to make your son listen to you. Time out should generally only be used for "hurting behaviors" such as hitting, kicking, biting, etc and should be no more than two minutes long (one minute per a child's age). Use natural and logical consequences for behavior when possible, more information on behavior can be found here: Behavioral Tips for Parents

Many two year olds are rebellious by nature, so it is best for you to remain calm, say your directive in a calm, firm voice using simple words "Tommy, you need to put your pajamas on"...wait a few minutes and then repeat your same request. If he does not respond, then you may need to physically get your son (kicking and screaming or not) and restate what you asked him to do, but then guide him into doing the task telling him you gave him a chance to do it on his own and now Mommy will need to help him do it. Most two year olds are in a struggle for independence and are only asserting themselves by refusing to do certain tasks. Ignore temper tantrums.

Choices are also very helpful with 2 year olds. Try to offer them when possible, although there will be times when choices are not appropriate. At lunch time, ask "Do you want a sandwich or macaroni and cheese?". But when it is time to leave the playground, it is indeed time to leave whether he likes it or not. Pick your battles at this age, ask yourself, "is this something worth the struggle?". For example, if he wants to wear one red sock and one blue sock and he will have a meltdown if you make him wear both socks the same color, the battle may not be worth it-yes, he'll have 2 different socks, but so what? But, if it is time to go pick up a friend and he does not want to get into the car, you will have to put up with the tantrum and tears in order to get him in the car, it's not a choice at that point.

It may help you and your son to make a picture chart of your daily routine that you can hang on your frig, as having a consistent daily schedule is very important for toddlers. You can cut pictures out of magazines or use a real camera to take photos of his daily routine. For example 7am-wake up & get dressed, 7:30am eat breakfast, 8am playtime, etc through his whole day. This will help him learn what is coming up next, as advance warning for transitions to new activities are particularly helpful for toddlers.

Aside from the above suggestions, if you son has had a lot of ear infections, I would recommend scheduling a hearing evaluation by your doctor or local hospital to rule out any hearing concerns contributing to your son not listening. We want to make sure first and foremost that he is hearing you clearly and children with chronic ear infections sometimes are not. Secondly, if your son is not consistently following one step commands (get the ball) and two step commands (get your shoes and give them to Dad), you want to make sure he is not having a problem processing or understanding language. This can be determined by having him evaluated by a speech and language pathologist through your local Early Intervention Program (birth-3 program). A full team early intervention evaluation would also look at your son's overall development such as his behavior, attention and play skills to make sure that he is on target for his age.

Also be sure to look over our page on Speech Skills for 24-36 months and note the red flags to the right side of the page which would mean a need for evaluation: Speech Skills for 24-36 Months

Here is a list for early intervention contact information by state so you can find referral information if you need it: Early Intervention Contacts for Your State

Return to Top