Executive Functioning - for parents and children

Executive Function: Parents and Children

By Patience Domowski, LCSW

What is “executive functioning”? It’s a fancy term used to describe certain skills that are usually lacking in a child’s performance, often in school. These skills are the basic skills used to function in everyday life like memory, (remembering homework assignments and the routine), organization (keeping things together and knowing where things are in their backpack, desk, or at home), figuring out how and when to get things done at home and school (planning projects for example), and self-control to regulate their emotional reactions (getting easily frustrated).

Kids with executive functioning impairments are often diagnosed with ADHD or sometimes other disorders as well, or may just struggling with executive functioning regardless of another disorder. If a person has ADHD they struggle with executive functioning, however a child or adult can struggle with executive functioning without having ADHD. Executive Functioning disorder or impairment is often diagnosed by a school psychologist. If your child has this skill deficit they will likely be given some accommodations and adjustments at school to help them learn these skills such as with a 504 or IEP.

If a parent is also struggling with their own executive functioning and is trying to help their child learn these skills, it can be extraordinarily harder than for a more organized parent. The parents should ask for help from the school as well as other friends and family members if needed to learn to put some strategies in place to keep themselves and the child on track. If necessary a behavioral therapist can help as well.

Some basic strategies for parents to use themselves, and then teach their child include:

Organization:

• Set up and label containers, shelves, etc to organize where items go in the house. Do the same with school work papers. Put old school papers in a basket or box to save, or throw them out. Put current school papers in folders in child’s backpack and label what goes where. Practice with child organizing their own papers, so child learns to do the skill too. Parents can use the same strategy with other important household and work papers using a filing system or even scanning and saving on the computer instead of on paper.

Memory and Planning:

• Use a paper calendar on the wall at home, and a travel calendar to take with you (unless you use your phone calendar). Have your child use an agenda for school assignments. Write down appointments, reminders, homework, bills due etc.
• Use sticky notes as reminders. Put them up around the house.
• Use a checklist for routines and chores at home.
• Write out a plan for each day including time frames to get the things done. (Example: 4pm homework, 5pm play outside, 6pm chores. Etc, or more specifically: 3:30- math homework, 3:45 reading, 4:00 writing essay, etc)
• Use timers/alarms to keep you and your child on track for getting things completed. Maybe even make a competition- who can get ready in the morning the quickest, or who can stay on task to finish a chore first.

Self-Control/Self-Regulation:

• Recognize when you are starting to get upset and frustrated, before it gets worse, stop and take a breath and figure out how to relax or solve the problem. Start teaching your child the same strategy by pointing it out to them (“I see you’re starting to get frustrated with math. How about we take a little break?”, or “Mom is sure getting upset over this recipe not working out. I think I’m going to just try a different thing to make for dinner, instead of getting upset.”)
• Play games to work on impulse control and feelings management like running through a routine at another time to see if can improve on your timing or efficiency, or role playing how to handle a frustrating situation that might come up (at a time when nothing bad is happening).
• Come up with strategies for handling problems for both parent and child (can be separate lists) and write them up and hang them in the home where you can see them and use them. You can remind each other to use a strategy.

If needing help with motivation to use any skill or strategy, add in a motivating reward! Such as if you finish your routine in time, without reminders, you get a little piece of candy, or if you calm down quickly you get to play a game on your device for a few minutes. You can make it a fun and friendly competition with your child on who can keep on task the longest, finish their work quicker, or use more coping skills in a week instead of getting upset. Your child will enjoy calling you out when you’re off which will be a good reminder for parents, but also you can help your child recognize and correct their own struggles in a fun way.

Remember to ask for help as needed and not expect yourself or your child to be perfect. These skills take a while to learn but are learn-able, you just need more external assistants like calendars and timers. You can do it- and so can your child!

References and Links:

https://developingchild.harvard.edu/science/key-concepts/executive-function/

Helpful info on how to get helps at school for your child on this website:

https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/3-areas-of-executive-function

This tip sheet list also includes a free printable handout:

https://www.growinghandsonkids.com/executive-functioning-skills.html

Teaching kids to be grateful/Have a gratitude attitude!

Teaching Kids Gratitude

By Patience Domowski, LCSW

In today’s day and age it's hard to raise grateful kids because they are used to getting everything they want and right away. We live in an instant coffee and on demand world. Also the parenting culture today is to provide everything for the kids as soon as possible to make them be happy. As nice as it is to get things right away and provide things for your kids that they want, the problem is that they can get too used to it and not really appreciate what they are given. My advice would be to sometimes give them things they want- like birthday presents, and vacations, but not giving them things constantly or as soon as they ask for it. Have them work for things they want instead- doing extra chores at home or for neighbors to earn money to buy something they want to save up for can teach them the value of things and they will appreciate the things they worked for much more. Encouraging kids to say ‘Thank you’ regularly to everyone even for small things like the waitress handing you a drink, or a cashier giving you a sticker, or even thanking a doctor after a visit. Having kids involved in some volunteer work can be extremely helpful as well- not only do they get a sense of others in need out there but they get a nice feeling of helping others which can help instill some gratitude for what they already have.

Here’s a list of some practical suggestions for teaching kids to be grateful.

• Don’t give them everything they want! It's okay to say ‘No’ or ‘Wait’, or ‘Work for it’.

• Have them work for some things/earn money to buy things they want (it’s okay if it takes a long time to save up for something big!)

• Model gratitude and saying thank you yourself as a parent

• Occasionally go around the dinner table and say something you are grateful for- if creative, make a poster list and keep adding to it so kids can see all the things they have and should be grateful for on a regular basis

• Volunteer- find a program in the community or at church that allows children to help, or start your own project collecting winter coats, school backpacks, or food to donate

• Go to a third world country- doing missions/volunteering, not tourism to see how others without live

• Make them say ‘Thank you’ to others, soon it will become ingrained in their heads

• Have them send ‘Thank you’ notes/cards for gifts they received for birthdays, holidays,

• Have the children help go through old items in the home like clothes or toys they don’t need anymore and give to a charity- have the kids be a part of this. A good time is before Christmas or before a season change.

Don't touch that! It's Mine! Sibling issues

Don’t touch that! That’s mine!

Dealing with siblings messing with each other’s things

By Patience Domowski, LCSW

Do your kiddos fight over who is allowed to touch what item and what toy belongs to which kid? Do your kids get super upset and overprotective of their stuff to the point of fighting frequently over it? Do you have a younger child who loves to torment their older sibling just for the fun of it? Well, here’s some help!

Let’s look at the Why this happens, What to do about it, and How to prevent it strategies.

First, Why does this happen? Why are siblings always getting into each other’s rooms, toys, clothes, etc? Often it's for a reaction or attention. So when Sibling A touches Sibling B’s toy and Sibling B gets mad, Sibling A loves to see that reaction! Sometimes it's because they want to play with the toy or are jealous they don’t have the same item. Some kids want to play with it just because it's not theirs even if they have the same thing! Often younger kids want to be like their older siblings and want to do what they do, so they get into things because of that. Some kids are just curious and get into things out of curiosity and exploration. If you can figure out WHY it will help. Often it can be a combination of these reasons.

• To get a reaction/make sibling mad/get adult’s attention

• For attention/wants to play with the sibling

• Wants to play with the toy because don't have one, or because they just want to play with something different, jealous they don’t have the same thing

• Want to be like an older sibling

• Out of curiosity/exploring (usually very young kids)

• Other reasons...

Next, What can we do about it? We want to look at how to shape the behavior of both the sibling that’s getting into things and the sibling that owns the things because both reactions and behaviors are important to address.

Let’s call the sibling that’s getting into the things “JJ”, and assume he’s younger, and the sibling that owns the things “Johnny”, and he’s a little older than JJ.

Here’s the scenario: JJ sneaks into Johnny’s room and starts messing with his lego creations. Johnny comes home and goes in his room and discovers this. He screams and yells and maybe even hits JJ. Mom comes in and finds everyone is crying. Now what? Let’s assume the reason JJ did this is just out of curiosity and wanting to play with Johnny’s toys, not that he was trying to infuriate him.

My suggestion: Talk to both about their behaviors.

-First try to calm everyone down. If they are out of control, send to separate rooms for some alone time until everyone is calm.

-Then talk to JJ about how he needs to ask before going into brother’s room, and also touching his things. He needs to respect Johnny’s space and toys. He should ask Johnny first if he can touch and play with his legos.

-Talk to Johnny about his reaction. Explain that JJ was just curious and wanting to check the toys out because he’s too little to build things that cool, so he likes to look at them. Suggest that next time Johnny ask JJ nicely to not touch his toys, and suggest another activity or toy that JJ can play with instead, or show him nicely how to build things with some other legos, possibly. If JJ doesn't listen, then ask mom or dad to step in.

-If possible have the siblings act this out again. Have JJ pretend to go into Johnny’s room, Johnny comes in, and practices saying nicely “Please don't touch my legos. Let’s play with your blocks downstairs”. Have JJ ask “Can I please see your airplane you built? It’s so cool!” etc… Praise the children for acting this out appropriately.

(Acting out/role-playing appropriate behavior is a more effective way of teaching good behavior, than just talking/discussing what to do next time, as the act of doing the right behavior builds ‘muscle memory’ instead of just a lecture).

Another situation. Let’s say little brother Bobby loves to make older sister Haley mad. Here’s the scenario: Haley is playing nicely with her dolls in the living room. Bobby runs in, snatches the doll and pulls its hair, throws it down, and runs out of the room. Haley starts screaming and crying. Bobby laughs. Haley chases him down, intent on bodily damage. Mom/Dad comes in and starts yelling at everyone to stop.

Suggestion: Ask everyone to calm down. Have them sit down to discuss when calm. Address Bobby first. Ask what did he do wrong and what would’ve been a better idea. Bobby: “I grabbed her doll. I probably shouldn't touch it”. If he’s able to discuss why see if he can explain (some young children are unable to answer Why questions just yet). Bobby: “ I wanted to make her upset.” Or “Dolls are stupid.” Mom can say something like “Okay, that’s not very nice, let’s think of a better way to interact with your sister”. Bobby: “I could ask her to play with me.” “I could ignore her”. Parents may need to prompt some appropriate responses, such as suggest if he wants a reaction maybe tell her a funny joke, or story, or ask her to play something together. Then talk to Haley. What could she have done differently or better? Haley: “I should’ve told mom/dad instead of chasing him and screaming”. Parents; “Right, when you scream and chase him- that’s what he wants! He’s trying to make you upset. While it's not right what he’s doing, a good way to make him stop is to just ignore him, ask him nicely to please stop, and then tell mom/dad if he isn't listening/continuing. If you keep screaming when he does these things, it makes him happy, which makes him keep doing that. I know it's really hard, because its infuriating when someone hurts your toys or grabs something from you, but if you are calm, he won’t get the reaction he wants.” Haley: “He should be grounded for a year!” …

Then have kids re-do the scenario in a better way. Haley pretends to play with doll. Bobby comes in, thinks ‘I want attention!’. He can say ‘Hey Haley, did you hear this funny joke?’ Haley can say ‘What joke?’. Then have Bobby touch her doll. Haley can say ‘Please don’t touch my doll, Bobby. It makes me upset when you touch my things.’ Praise the kids for making better choices.

Key strategies:

-Teach the one that is messing with the things to ask and respect property and space

-Teach the over-reactor child to ask the sibling to please not touch, ask first, and react calmly. Get parents to help if sibling isn't listening

-Role-play/Act out how to make better choices next time

-If behaviors continue- give out consequences to the child who touches the stuff, and if needed, the child who overreacted (if severe reaction like hitting/etc)

How to prevent this: Talk to all the children about the importance of respecting each other’s space and stuff. Gather them all together and ask them why they don’t want people touching their things, and how they feel when someone messes up their toys. Have them share with each other why it bothers them and what they would prefer. If the children are struggling to share, discuss how this makes others feel, and emphasize why it's important to share sometimes, and sometimes it's okay to keep things to yourself. Ask them how they feel when they are getting into someone’s things, and why they do it. Have the children calmly tell each other why it’s not a good idea and why it upsets them. Have the children figure out what toys/spaces are shareable- maybe the playroom and the blocks are for everyone, but the bedrooms and stuffed animals are individually owned, for example.

Remember- its okay for kids to have some items or space that is just theirs. It is good for them to have some ownership over things and it helps them feel secure to know “this is mine”. However it's just as important to learn to share spaces and toys and knowing which is which and how to respect boundaries is important for children to learn as they are growing up.

Key points: If someone asks you to stop or not touch, you need to listen. If it doesn't belong to you you need to ask for permission before touching or using it.

Books flyer

Books for Sale, downloadable flyer to share

Link to Amazon. 

Appropriate Sexual Development and Behavior in Children

Appropriate Sexual Development in Children

Patience Domowski, LCSW

Often parents wonder if their child’s curiosity about their body parts, or other people’s body parts is normal or a concern. What sexual exploration is normal, and what is a major red flag? Certainly some curiosity and comparison is normal in young children, but how much is too far? Also what should parents do about it? Sexual development occurs from infancy on up, however what is normal or appropriate varies by age.

It is normal for toddlers and preschoolers (ages 2-5) to want to be naked, check their genitals out, and ask about them. They may be curious about their parents body parts and want to touch their mother’s breasts, or check out their sibling’s different genitals. It is typical for children at this age to explore their bodies and want to see others, or play ‘doctor’ and examine each other. It is not normal or okay for any aggressiveness in this play, or having toys act out sexual acts at this age. It would not be normal for them to want to show their body parts to a much older peer, or talk about sex specifically.

At this age parents should teach the proper body parts names- slang terms are fine but it’s also good for the child to know the real names for their body parts. Teaching children when it’s okay to be naked (bath time) and when not (in public) is a good idea at this age. Teaching appropriate personal space as well and proper boundaries is important. Parents should point out that it’s not polite to grab someone’s bottom, or put their hand up someone’s shirt for example. Parents shouldn't try to shame or upset their children as they are naturally exploring and testing boundaries. Parents should just teach appropriate touching and boundaries calmly. Teaching children that hugs and kisses are for close family, and if they don't want to, that’s okay. It's not usually a good idea to force a child to hug or kiss anyone (such as an extended relative they don't know).

By elementary school age (ages 6-10) however children should be aware it's not okay to be naked publicly, they usually have some sense of wanting privacy when using the bathroom and changing. At this age they may want to touch and explore their own body parts. Boys are more likely to fondle their genitals than girls. It should be taught to children at this age that if they want to touch themselves to do so in the bathroom, or the privacy of their bedroom. Children should not have their hands down their pants in public, and it's not okay to be scratching body parts very visibly. Parents should respect and encourage privacy of children and start to have different gendered siblings dress in separate spaces. Children may be curious and want to peek at people changing or see naked pictures and think its funny.

At this age children can be taught “Good touch/Bad touch” and that no one should touch their private area unless helping them stay safe or healthy. For example ‘staying safe and healthy’ means that parents may need to help them bathe, (though at this age they should be starting to be able to bathe themselves with some minor supervision), and doctors may need to check out their bodies to make sure they are healthy, or an emergency responder may have to touch them in certain cases (car accident, for example) to help them if they are hurt. However no one else should be touching you anywhere on your body that a bathing suit covers. Children should be taught that if anyone tries to touch them in a way that make them uncomfortable they should tell their parents right away.

Children should also be taught at this age that is not typically appropriate to hug and kiss peers at school. They may hug close friends and family, but should not be holding hands or hugging all their classmates, and should not be kissing anyone outside the family at this age (some exceptions may apply). Parents should answer any questions children have about sex and body development as age appropriately as possible giving some a basic understanding but not too many details.

Many parents teach their children about ‘stranger danger’, however statistically children are more likely to be abused by someone they know, so it’s important to teach appropriate boundaries for themselves regardless if they know the person or not. Just because someone is a close adult friend, neighbor, uncle, or staff at their daycare, doesn't mean they should allow the person to touch them in a way that is uncomfortable or in the ‘bathing suit zone’. Children can be told to tell the person who tries to touch them to please stop they don't like that, and then try to get away from the person immediately, and tell their parents or a trusted person at their school. It is usually not recommended for children to sleep in same bed with an opposite gendered person, especially if they are much older.

It would be a cause for concern, and not normal if an elementary school child was touching peer’s genitals at school, or showing off their body to someone much older than them (if it occurs normally it would be same age), or showing fear and excessive shyness around their genitals during bath and changing. It would not be normal for sexual acting out or language, or to be caught watching porn at this age.

In the middle school/preteen years (ages 9-13) children will likely want to know more about sex and their bodies. At this age parents should teach their kids about puberty and more about their body. Both boys and girls can be given information on periods, sex, and healthy relationships. It is important to teach children the family’s values and beliefs around sexual expression. Preteens may be interested in dating and relationships. Parents should set up what is expected for appropriate boundaries- though these boundaries and relationship values vary widely between families. Some parents are open to their child having sexual relationships at this age, though most are not. Some parents are fine with their child dating at a young age, but some would rather them wait. It is important to discuss values and the pros/cons of sexual involvement at this age, and not just rely on the school to provide the basics in sexual education.

Generally children at this age should be taught not to masturbate in public, not to touch anyone in a private area on their body, and not to allow anyone to touch them in a private area. They should learn ways to resist peer pressure and decide in advance how to handle any sexual advances by peers. Sex should be discussed such as how far to go (hand holding, hugging, kissing, touching, etc…) and when to give oneself sexually to someone else and how to make that decision. Parents should also teach some basics of contraception information, even if they are encouraging abstinence.

Sexual development and changes in genitalia usually occurs during preteen and teen years during puberty. Some children will develop earlier or faster than others and some children will be more interested in it than others. Encourage children to talk to parents or a trusted teacher about their questions and concerns. Keep the conversation dialog open throughout the teen years to help them navigate through difficult decision making and peer pressures and desires as they grow older.

At any age children will ask questions and be curious. It is helpful to answer questions as truthfully but appropriately as possible. While you probably don’t want to explain exactly where babies come from to your 5 yr old you can say that babies grow in mommy’s tummy for example, which is truthful versus ‘you came from the hospital’ or a ‘stork delivers babies’, or even brushing it off ‘I’ll tell you when you’re older’, ‘Ask your mother’, etc. There are plenty of books available written for children, especially preteens, to explain puberty, sex, and other questions that parents can provide to their child to read and discuss. Parents may feel uncomfortable answering questions but it is better for children to find out the truth from their parents than to get an incorrect answer from their peers on the school bus.

To keep children safe go over how to establish boundaries (not allowing others to touch them in their private areas) and avoid dangerous situations (don’t walk alone at night, for one example). It’s okay to ask your child if they have ever been touched in a way that was not comfortable or appropriate. To keep your child safe have child abuse clearances run on any babysitters, review appropriate boundaries before child has a sleepover, meet the families of children your child is friends with, don’t allow sleepovers without supervision, don’t allow children in the bathroom with other people that you don’t know and trust, and rely on your gut if anything seems off with the other person or your child’s reaction to others has changed. If your child is suddenly upset and afraid to visit someone that they normally love to see, that is something to explore. If a toddler/preschooler doesn't let mom help him wash in the bathtub, not due to being independent but is afraid and upset to have someone touch them, or seems fearful when diaper changed, that is a cause for concern.

If a child shows any inappropriate sexual behaviors ask your child about it in a calm way such as where they learned about that, and what they are doing. Sometimes it's a misunderstanding (example: they drew a large walking stick, not a penis, in front of grandpa, or: they meant to grab their friend’s leg to stop them from running and they pulled off thier pants by accident), and sometimes it’s a cause for alarm. Try to be calm so the child opens up and doesn't shut down or feel ashamed.

If parents have any concerns about their child’s behavior not seeming to be developmentally appropriate, the child has more knowledge of sexual things than what parents have taught them, or any changes in child's behavior that seems to indicate something suspicious having happened, parents should have their child evaluated by a professional such as the child’s doctor, a therapist, or guidance counselor. If the child has been sexually abused, or even if there is suspicion parents should report it to the appropriate authorities to investigate.

Other helpful resources:

http://www.nsvrc.org/sites/default/files/saam_2013_an-overview-of-healthy-childhood-sexual-development.pdf

http://kidshealth.org/en/parents/development.html#

http://nctsn.org/nctsn_assets/pdfs/caring/sexualdevelopmentandbehavior.pdf

Aggression in Children and How to Handle it

Aggression- how to decrease behaviors

By Patience Domowski, LCSW

Aggression in children is really difficult. From yelling to hitting, its very disruptive and sometimes even dangerous. Especially as the child gets older it becomes more of a safety concern. A 3 yr old hitting a parent is not that big of a problem, but a 13 yr old could really hurt someone.

To solve this problem we need to figure out why it is happening. Here are some possible causes:

-Child cannot manage their emotions (needs coping strategies), gets easily angry, anxious, frustrated, etc

-Child cannot effectively communicate (hasn't developed full speech due to age or speech delay, or autism)

-Child has a mental health diagnosis (autism, bipolar, ODD, …)

-Child has observed and copied aggression from older siblings, parents, violent TV

-Child is very impulsive (can’t stop and control themselves)

-Child has discovered that this gets them what they want from others  (example: if they hit then people leave them alone, if they yell then dad gives in, etc)

-Child gets attention from their behavior (even though it is negative, some children still want this attention).

-Other reasons…

For some children there may be a combination of reasons. Sometimes the reason is easy to discover but other times it may be more complicated. Collecting data (writing down the behaviors and what happened before and after) and doing an FBA (Functional Behavior Analysis) can be helpful. Ask your child’s teacher or behavioral therapist about how to do one if it is difficult to figure out the ‘why’ for the behaviors.

To correct the behavior we want to teach the child a combination of better coping strategies and a more effective way to get what they want.

For example: if they get angry easily when their sibling takes their toy we want to teach them to calm down, and also the skill of asking for the toy nicely, or asking a parent for help. If the child wants attention then teaching the child a more appropriate way such as saying “Mom, play with me!” instead of hitting would be helpful. Also the parent should ignore the inappropriate behavior until the child does the expected response.

If the child is copying others aggressive behavior- whether in person or on TV shows/games/ etc it is important to limit this exposure. If the parents are showing aggression such as yelling and hitting children, then it's likely the child will copy this as well. If the parents can try to be more patient and handle their frustrations in a more appropriate coping way, this can greatly help the child. Parents may want to seek therapy on their own, or try anger management groups, or even medication to help, if they are really struggling with depression for example. If older siblings are exhibiting aggression it is helpful to try to get them some more help and teaching the younger child to not copy those behaviors. If the child is watching violent TV shows, movies, video games, eliminate or at least reduce the frequency the child is exposed to that. If the child resists, explain that if they reduce their aggression they can slowly return to those games/shows etc. Pay attention to the ratings on games and shows however and the child’s age.

For cursing- if it’s in conjunction with anger and aggression, use same strategies already listed to teaching better coping behaviors, but besides that mostly ignore it, or teach a silly replacement word “peanut butter jelly sticks!” The more attention you give the curse word, the more powerful they become. You can tell them not to say that word and maybe even why, and if necessary punish for it, but if you make a huge deal about it (such as yelling and lecturing) it will likely make it worse. Also make sure parents and older siblings are refraining from using those words completely. Even if parents tell child not to say a word, if they are saying it themselves, the child will still learn it and repeat it. With any behavior, parents need to model good behavior and not to do anything they would not want their child to do (for the most part). Sometimes an old fashioned ‘swear jar’ is helpful. The person that says the bad word is ‘fined’ and has to pay real money into the jar.When the jar is full some families will use it for a fun activity, sometimes the money would go to the non-swearing person, or maybe the family would donate it to a charity.

Make sure the child’s aggressive behavior is not getting them what they want. If they are hitting their sibling to get them to leave them alone, and its effective, that is going to maintain the behavior. Try to teach the sibling to respond better and quicker and teach the aggressive child to request space in a better way. If the aggressive behavior is getting them the attention or item they want from parents, parents need to try hard to not give in. Even though it makes the screaming stop now, it will just make the behavior worse the next time if you give in.

If the child has not developed appropriate speech, due to age or delays, it maybe be helpful to teach a simple hand gesture/sign language to use to communicate. Maybe a clap means ‘Can I have it?’ or a hand tap means ‘I need help’. Ask your child’s speech therapist for some ideas to figure out what will work best for your child’s speech needs.

For kids who don’t have good coping strategies have them write up a list (or draw) several things they can do when they are angry and then hang the list in a well-trafficked area in the home (living room or kitchen is usually good). The list should be visible because when someone is angry they are not going to go searching for a paper in a drawer to figure out what to do. The strategies can include deep breathing, walking away/ignoring, asking parents for help, doing something fun to distract yourself, and remembering to ask nicely for things. There are many coping strategy lists that can be found online. The key is to find which ones work best for your child and to have your child identify these as well. The more the child is involved in identifying the strategies the more likely the child will use them.  Also have the child act out the appropriate coping strategy when they are in a good mood, as a role play, or after they made a poor choice to reenact making a better choice.

Try giving a reward to the child for using a strategy. For example if the child takes a deep breath instead of hitting mom, or stops screaming by deciding to go chill out in their room, give them a piece of candy, access to a special toy, or extra ipad time for making a good choice. Praise your child for calming down, whether it took 10 seconds or 1 hour, immediately praise them when they are calm so they associate positive attention with calming down.

Try behavioral charts. Children are often not motivated to make a better choice internally - it’s easier for them, or not big deal for them to yell and hit versus breathe and ask nicely. But if you sweeten the deal by offering candy, toys, extra time, other privileges then they are more likely to make the better choice. Some kids will need the reinforcement reward immediately and some can wait until the end of the day or week. Think about your child’s needs and personality to figure out the immediacy of rewards. If you aren't sure how to do this seek out a behavioral therapist who is experienced in this and can help you. Once your child learns the strategies to handle their feelings more appropriately they are likely to reduce aggression and you can fade out the behavior chart, or use the rewards to target another behavior.

Sometimes if the child is so out of control and aggressive they have to be restrained. Parents can learn appropriate ways to restrain their children (ask the school, doctor, or a therapist). If the child is in danger to themselves or others it is okay to restrain them until they are calm and in control again. The police and mental health crisis workers can also be helpful in these situations. If aggression is a regular occurrence, behavioral interventions are not effective, and the behaviors are fairly severe, medication may be necessary. Talk to your child’s doctor or seek a child psychiatrist for help.

Helpful Links:

Swear Jar: https://en.wikipedia.org/wiki/Swear_jar

Child Restraining: https://www.k-state.edu/wwparent/courses/rd/toolbox/rdtool-37.html

Causes of Aggression:

https://childmind.org/article/aggression-in-children-causes/

Handling aggressive behavior:

https://www.empoweringparents.com/article/how-to-manage-aggressive-child-behavior/

Taming Aggression and Coping for parents:

http://www.parentingscience.com/aggression-in-children.html

Anger Strategies (Other helpful blog articles)

Sibling of a Child with Special Needs

If you have a 'typical' child that is struggling to handle having a sibling with behavioral issues/disability/special needs, I made a worksheet to help them process their feelings and thoughts about this. If it seems to be a major concern for the child, they may need some therapy to handle their siblings issues. Its hard to notice the other children as needing therapy versus the one with the special needs, who is likely already getting alot of attention and services, but sometimes siblings feel forgotten or resentful and may need some extra support. 

Worksheet

Mom tribe

Why you need a “tribe”: for moms
Patience Domowski, LCSW

Women are social creatures. We need friends to talk to, significant others to vent to, grandparents to support us, and therapists to guide us. We need people. Moms, especially new mothers, and mothers of children with special needs, often struggle to make friends. They are so caught up in caring for their new child/children, organizing their children’s activities and appointments, keeping their spouse (moderately) happy, and (maybe) keeping the house clean, that they don’t have time or don’t focus on making other mom friends. But it’s really necessary!

Moms need someone they can  go to to ask those questions like “am I crazy or…” as well as “is my kid normal, he does…” and get some feedback from other women in the trenches as well. Moms need someone to hang out with, call to chat, and someone to help out when you just need a break.

Whether your social supports are your family, your spouse’s family, your neighborhood group, friends, or people in your church program, you need supports, you need friendship, you need a “Tribe”. Other women who can help you, listen to you, laugh with you, cry with you, and just be there for you.

Ways to find mom friends could be connecting with others via online forums like Facebook, blogs, etc, meeting moms at the local playground, parents of your children’s friends at school or daycare, coworkers, others in your church group, etc. Try to think of where you could be more intentional, what you could get more involved in, or whom you could try to start up a conversation with. The other person doesn’t have to be a mom. The other person doesn’t have to be a woman (though that might make your husband jealous!). The other person just has to be someone who cares, someone who is there, someone you can call and talk to, hang out with (virtually or in real life!), and is supportive of you and your family.

Getting on the Same Page, even if you're not in the same book!

The Same Page: Helping Parents Agree on Discipline
by Patience Domowski, LCSW

Many parents struggle to be on the “same page” with parenting. This is totally normal because both mom and dad have their own different personalities, upbringing, thoughts, and ideas that they bring into the relationship. But it can be so frustrating when the parents cannot agree on the same strategies or level of enforcement for discipline at home. Some parents are not only not on the same page, they aren’t even in the same book! Mom might be really strict with the kids because she’s home all day and needs them to listen to her, and dad feels bad he’s not around much so gives in all the time. Or maybe mom’s the nice soft pushover and dad’s the strict one the kids know they can’t get away with anything around him. There does not have to be a “strict parent” and a “fun parent” or a “good cop”/”bad cop” in a parenting couple- there can be the a balance for each parent. It’s really important to try to figure this out so that there is less arguing between the parents, a more cohesive family, and the children aren’t playing parents against each other.

Here are some ways to try to get on the same page with your spouse or co-parent.

1)     Agree on something!  Try to find even something small you agree on – even if it’s just the outcome like you want your children to be “good people” for example. (Then later define what that means and how to get there!)

2)      Decide on an outcome. Do we want our children to be happy, balanced, independent, highly educated, etc. Then work on what’s the most important to focus on for our family (Such as school/education, life skills (like learning how to cook, do chores, etc), sports/activities , being social, being creative, future independence, just being “happy”, spiritual/faith based, being healthy, etc) Do the kids need to work on improving their grades? Or are we worried they will live with parents forever because they won’t do chores and get a job? Do we just want them to be happy, we don’t care what they do for the most part?

Parents should decide what they’d like to see in the future so they know what they are working towards. It doesn’t have to be super specific like “my child will be a doctor” or “my kid will never eat red meat” or “I really want them to be married or they won’t be happy”. Outcomes can be more general like “I want my child to be independent” or “I want my child to be as healthy as possible” (if child has health concerns, this might be a goal, for example).

3)     Discuss both parents’ backgrounds and where they come from. Where her parents strict and his super passive? Was she a “child of the ‘60s”, and he from a super conservative family? Discuss child rearing of the parents, how did the grandparents discipline them, what do you want to do the same and what do you want to do differently. Even discuss where they grew up (urban, rural), cultural backgrounds, even socioeconomic status, etc. (Especially if you don’t already know this, or it wasn’t covered in your pre-marital counseling- for married parents).

4)     Try to find a compromise somewhere. The plan doesn’t have to be all mom’s way or all dad’s way. In fact- it really shouldn’t be that one sided. (Because then the other parent will be upset, or one will undermine the other).

5)     Eachparent make a list of what is important to you- then compare and see which things are the same/almost the same.

6)     Decide which behaviors we’re going to “let go” and which we will make a big deal about. Not everyone will agree on what needs to be focused on and that’s okay. [If you can’t decide, see my other article on hierarchy of behavior for my suggestions.]

7)     Even if parents are split and kids go between homes it would be better to still be on same page at both homes for consistency for the children (if this is possible).

8)     Make a plan! Specific behaviors to target, discipline techniques, etc. Write it down and even post it in the house so everyone knows and remembers what to follow. Look online for templates or ideas for making House Rules, chore charts, behavior charts, etc.

9)     Consult with a therapist if needed. A couples/marriage counselor can help get parents to be on the same page, and a child behavioral therapist can help parents come up with specific behavior interventions for their children.

10)Try to get grandparents, babysitters, etc on the same page with the parents for consistency. If the kids know grandma will say yes if mom says no, or the babysitter allows kid to do this and dad would not, it’s going to be difficult to maintain the level of control and discipline you may want in the home. So try to get everyone on board, if possible.

College Choices

When your kid picks a college/career choice you don’t approve of…
by Patience Domowski, LCSW

So your kiddo is all grown up. And now they are ready to spread their wings. But you aren’t quite ready to let them leave the nest yet. You’re really struggling to accept their choices perhaps, or you just want to slam down the hammer and tell them they have to listen to you. You want to protect them, you want the best for them, and you know more than they do too. But it often causes a lot of arguing and upset between parents and emerging young adult and makes the distance between you even farther apart.

Let’s think about their point of view. We all value our freedom and ability to make choices. Children have very limited choices and very limited freedom. Most kids can’t pick their school, teacher, class, etc as a child…until college. Now they suddenly have a lot of choices and a lot more freedom. They can pick their major, future career choice, college location, etc. They want to make their own choices, and parents also want to help them make their best choices too.

Often parents will be firm and tell their kids which college they have to attend or just give them a short list to pick from whether its about where the college is located (close/far from home, suburbs or urban), type of school (private, religious, public, etc), as well as what to major in, where to live (on campus/dorm, in an apartment, or at home with family), etc.

The problem is when your child disagrees and parent stands firm opposite them it will just drive a large wedge between you and really mess up the relationship. In order to continue to have a good relationship with your child you should try to hear their side/viewpoint, don’t just argue but really listen. You should present your reasons factually, not emotionally. And in the end let your young adult child make their own choice, because now they are becoming an adult and need to make their own choices and learn from them.

Maybe they will fail and come back to you crying that they learned their lesson. Maybe they will do great and surprise you. Either way it’s a good learning experience. While college and major is important it’s not going to ‘ruin’ their life to pick the ‘wrong’ one. Sometimes kids have to come home or switch schools after first semester/freshman year. And that’s okay. Try not to gloat if you were right, but lovingly welcome them back and help them figure out what to do next. 

Divorced Co Parenting Tips (and Worksheet for Kids)

Divorce tips to co-parent better - because it’s really all about the kids
by Patience Domowski, LCSW

1)Don’t try to ‘get back’ at your ex via the kids such as trying to take the kids away, limit visits, get the kids to not like them, etc

2) Try not to always have your way or the control. It’s about what’s best for the kids, not you. If you and your ex both think your opposing ways are the best for the child and you can’t agree- meet with a mediator or therapist.

3) Don’t use your kids as “spies” asking what their other parent is doing or who they are dating (there’s social media for that)

4) Don’t let your kids get stuck in the middle. They shouldn’t have to hear both sides and make a choice whom to believe. Don’t make them feel like they have to take sides.

5) Don’t bad mouth your ex to the children. Even if its completely true. Try to find something nice to say or don’t say anything.

6) Don’t try to get your child to not like your ex or their new stepparent (if applicable). It’s okay for them to love mom, dad, stepmom, stepdad, new sibs, etc all at once.

7) If the kids ask why the divorce occurred and it’s a complicated or “adult” reason, don’t tell the children exactly what happened, instead explain that ‘mom and dad just couldn’t work things out’ reassure the child you still love them and that won’t change and that the child is not at fault at all. Be careful about saying you don’t love the ex anymore because sometimes children worry that because parents don’t love each other anymore they might not love their children anymore at some point too.

8) If you have to argue with your ex, try not to let the children hear. Use a professional or unofficial mediator if needed. Try not to respond in anger to texts, emails, etc. Wait until you’ve cooled off before replying.

9) Spend quality time together, especially if you don’t have a lot of time together. Do fun things together, talk, bond. Sometimes do things one on one with the kids (without your new spouse or other children if possible) so they get some alone time. Encourage them to talk by being open and not judging or criticizing.

10) Allow your child to take favorite toys and comforting transitional objects, and call their other parent if they miss them. It doesn’t mean they don’t like you because they miss their other parent or ask for them. Try to help ease the transitions.

11) If your child seems distressed about the divorce, arrangement, etc have them go to therapy. If parents aren’t handling it well go to therapy and handle your stress yourself, don’t dump/vent to the kids. 

Printable version of this article

Worksheet for your child to fill out to see how they feel about the divorce

Attention Seeking Behaviors

Attention Seeking Behaviors ~ by Patience Domowski, LCSW

If your child is a little “Attention Whore” constantly craving attention and trying to get attention even if they are given plenty of positive attention from parents, etc, parents might need to try some strategies to teach appropriate attention seeking behavior.

·        Teach your child it’s okay to play alone

-have them go play for a few minutes at a time, slowly increasing the time spent alone, and then give them a lot of one on one attention after those few successful minutes

-give your child some toys they can only play with/have when mom/dad is too busy to engage with them (like while driving, on the phone, in a conversation, etc).

·        Make a list with your child of things they can do alone, such as…

-play with toys

-color/draw

-read a book

·        Teach your child how to ask for attention appropriately

[instead of hitting/yelling/etc]

-such as by saying “excuse me” and waiting until good time to talk

-start a conversation

-asking a question

-ask someone to play nicely

-ask for a hug

-ask for attention “Mom, can I have some attention!”

·        Ignore your child if they are asking for attention at the wrong time or in the wrong way.

-Remind them to ask appropriately and wait for them to do so.

- Then immediately provide social reinforcement such as praise when they do so appropriately.

-Provide attention when it’s appropriate time and they ask correctly

[Note: If you are giving your child attention such as answering their questions/doing what they request/ etc when they are asking for attention inappropriately (such as hitting/interrupting/etc) then they will continue that behavior. Instead have them wait or ask appropriately for what they need and then parent should give attention at that time. ]

"If I have to tell you one more time!"

“If I have to tell you one more time!”

Reducing frequency of prompting

An Explanation of 123 Magic and Supernanny’s “warnings” techniques

by Patience Domowski, LCSW

Do you find yourself telling your child to do something (or stop doing something) a million times and they don’t listen? Do they ignore you until you really start to lose it and scream at them? Do you find yourself threatening things but nothing seems to work? Or are you always arguing with your child? Well here’s the secret solution!

To reduce telling children a “million” times to do something you need to have a specific consequence tied in as a result for not listening. So if the child isn’t doing what you’ve asked right away they learn they get something taken away and then they start learning to listen right away. The power is in the consequence. They might not care that you are frustrated, but they sure do care when you take away that ipad!

You may have heard of 123 Magic but don’t have time to read the book. I thought I’d summarize the strategy here. (Okay I’ll admit I haven’t read the book either, but I know the strategy!). Remember the “Magic” is in the consequence, not the words!

To use 123 Magic you give the direction and say “That’s One” to the child to let them know you told them what to do once. Wait a few seconds/minutes and if the child doesn’t comply you give the directive again and add “That’s Two”. After a minute if the child still refuses to comply then you say “That’s Three” and give them a consequence. Important note- 123 Magic is NOT counting to three. So it’s not “Pick up that toy, 1. 2. 3. Okay you’re in trouble now,” but rather giving the direction 3 times after 3 occasions of refusals.

Now before you start this you should prepare your child by explaining how it works (during a calm time, not in a moment of noncompliance). You should also have a go-to ideas of consequences in your head that you can use. It doesn’t always have to be the same consequence but it needs to be something the child cares about, and something that you are able to enforce/follow through with. Also don’t use a consequence that will punish yourself. Like taking away TV time when you know that’s the only time you can actually shower, for example!

Here’s how you can explain the new program to your child “Mom and Dad are tired of telling you MANY times to do things. It’s frustrating for us and then we yell at scream at you. I'm sure you don’t like when that happens either. So we’re going to use a new strategy. It’s called “123 Magic”. Isn’t that a cool name? Basically we will only tell you THREE times to do something and then you get a consequence. The consequence will be ____ (examples: lose a toy/go to room/loss of privilege/etc). So when we ask you to do something we will tell you “That’s one” so you know we told you the first time. If you don’t listen right away then we’ll remind you “that’s two” so you know this is the second time we asked you to do something. If we get to the third time we will see “that’s three” and you will have the consequence right away. You still have to do what we told you to do but you also get a consequence. If you do it before we get the Three then you don’t get the consequence.” Then practice it with something easy like throwing trash in the trash can or putting a toy in a box so the child gets in the habit of listening right away and understands how it works during a calm time/teaching time, not just waiting for a problem time.

After you’ve used this strategy a few times the child learns that they do not want to get to Three. They know you MEAN IT and you don’t have to scream at them. You just have to say “That’s three. Now you’ve lost ipad time tonight” in a calm tone. [Ignore any resulting screaming/crying and still insist the child completes the direction you gave them].

When you FIRST start using 123 Magic you might want to remind them of what they are going to lose. Here is an example for when you FIRST start using this system with a child who is refusing to follow directions.

Example “Pick up your jacket and hang it up. That’s one.” (wait a few seconds). “Remember if we get to 3 you don’t get to go out for ice cream with us tonight.” (wait a few seconds). “Pick up your jacket and hang it up. That’s two. If we get to three, you lose ice cream tonight.” (wait for compliance). “Okay this is 3. You lose ice cream tonight. You still need to pick up your jacket.”

After that there should be no more explanations. No more pleading. Nothing else. Just “That’s one” “That’s Two” “That’s Three”. You should NOT be saying “If I have to tell you again…” or “I’ve already told you x times” or explain why they need to listen, etc. Just give a simple direction with the numbers. Because they will know what the consequence is. Then take away the privilege or whatever the consequence is calmly and quietly.

Supernanny has a similar system where she calls it “Warnings”. It’s really the same thing. You can do it that way too. For example “Stop hitting your sister. That’s the First warning”. (behavior continues) “Stop hitting your sister. This is the 2nd warning.” (behavior continues). “This is the 3rd warning.” (wait briefly, if behavior continues then) “Okay that was 3 warnings- now no more computer time tonight.”

The “magic” is that there is no more arguing and parents don’t have to repeat themselves many times. Children soon learn to comply within 1-2 prompts instead of 20!

Check out the 123 Magic books program and read some articles by Supernanny as there are some great strategies there. Links are below. 

Also see my "resources" page for links to more articles. 

Reference:

http://www.123magic.com/1-2-3-magic 

http://csgreeley.org/sites/default/files/files/1-2-3-magic.pdf 

http://www.supernanny.co.uk/Advice/-/Parenting-Skills/-/Routine-and-Teamwork/Parent-child-power-struggles.aspx

http://www.supernanny.co.uk/Advice/-/Parenting-Skills/-/Discipline-and-Reward/Punishment-or-positive-discipline.aspx

You're job as mom (or dad)- for stay at home parents

Your job as mom

So you’re a stay at home mom. It’s your “job” to clean the house, do the laundry, cook meals, etc, right? Well yes… but it’s even more important to teach your child how to do these things and teach them responsibility or they won’t be successfully independent. Your job as mom (and dad!) is not to make your kids dependent on you- it should be to work yourself out of a job (not that your kids will never need you! Even as adults we still need our parents, right?!). “Working yourself out of a job” means you train your children to do the things they need to learn as life skills so they can be on their own one day. It’s more than just teaching your daughter how to use the washing machine or your son how to vacuum, but also requiring and expecting them to help out around the house, do their chores, and care for their things. When they go to college or move out they might be shocked there’s no magical mom-fairy that picks up their stuff, washes their laundry, etc! They need to learn these things now as children so they will be ready for their future. Start as young as possible, and expect more as they grow up. Older teens should be able to do pretty much everything around the house that the parents can do. Younger children may need help but can do more than you might think! It’s definitely harder to teach than to just do it for them but in the long run its better for your child, and it’s less work for you as they can start taking over more responsibility as they get older and there’s less for you to do. Life skills are sometimes even more important than academic skills as everyone needs these for daily living in any future living situation they may find themselves in. So remember don’t do everything for your child but teach them out to do for themselves! 

[see also article on chores by age] 

What if the baby isn't healthy?

What if the baby isn’t healthy?

By Patience Domowski, LCSW

When you find out you’re having a baby, you are usually scared and excited all at once! Whether the baby is expected or not it’s scary but exciting to become a new mom/dad. You start to think about what that child will be like as a baby, growing up, and even what their future might be like when they are an adult. Sometimes you really want a girl or a boy but often people say “I don’t care if it’s a boy or a girl, I just want it to be healthy!” Sometimes they are lying- they secretly want a boy. Or a girl. But usually they really do mean they want the baby to be healthy. No one wants an unhealthy child. But what if the child is “unhealthy”? What if the child is not “normal”? Then what?

Often parents don’t find out their child has special needs until months or year after he or she is born. Sometimes parents find out while pregnant, however, such as if the baby’s condition shows up on a test or ultrasound. Sometime parents find out when the baby is born with some defect right away. Whenever you find out about a “difference” about your child you were probably not expecting it. Whether you find out there is something “different” about your child sooner rather than later, it’s still usually surprising, and often devastating. New parents aren’t expecting any problems usually, and when they find out their precious new baby is going to not be healthy or normal, they are usually very disappointed. Which makes sense, considering it’s not the ideal and it’s usually quite unexpected.

However, many people might not expect to go through all the stages of grief and loss like you would if you lost a baby to miscarriage or stillbirth, or infant due to SIDS, etc, however often the reactions and feelings are quite similar to someone’s who lost a child. Parents might be shocked and confused why they are feeling such loss when their baby didn’t pass away, and they might feel bad knowing other people have lost their children but they at least have one even if the child has special needs. You might feel guilty because you know you love your child, yet by being upset about their condition you feel like you are denying him/her to an extent. Parents go through grief because the loss is not of a child, but of an expectation. They feel their child may never live up to the parent’s expectation of their potential that they had hoped for, and that is why they must grieve. Grieving is important, so we can get to Acceptance and Hope.

The Kubler-Ross stages of grief and loss, so often noted for bereavement, can be applied to this situation as well. The stages include Denial and Isolation, Anger, Bargaining, Depression, and finally Acceptance. Often parents don’t believe the child’s condition- whether it be mental health, cognitive, developmental delays, medical fragility, sickness, deformity, genetic conditions, etc to be real at first. They might want to see several doctors, they might try to get all the information they can online or from specialists to try to explain it away or find a way to change the situation. Parents often isolate themselves, feeling no one understands my child or what I’m going through, or it’s too hard to explain why my child looks or acts different. They might feel shame that their baby is not “beautiful” in the expected ways of the world or that their child is not “normal”. Parents might feel jealous and upset seeing everyone else’s “perfect” children and so keep themselves isolated so as not to feel that way by seeing other babies. Often parents will be angry- perhaps at God- why did you do this to me?, to my baby? Or at the doctors- why didn’t they tell me? Or why didn’t they do anything? Or even at themselves- I should’ve taken more prenatal vitamins, I shouldn’t’ve rode that roller coaster while pregnant, etc.

The Bargaining stage might look like parents going after every kind of intervention and help their child can get such as taking the child to every doctor, specialist, early interventionist, treatment clinic, etc to try to make whatever is “abnormal” about the child go away.

Parents are often grieving which can cause some depression, and postpartum depression can play into this as well, and when they feel they should NOT be grieving, or that they are “bad parents” in some way, or blame themselves for situation, it just causes depression to worsen.

What we want is to get to Acceptance. And Hope. Whether child lives or dies, is healthy or unhealthy, is not up to the parents for most part. Parents can, and should, get as much help as possible for themselves such as mental health therapy, support groups, reaching out to family and friends. Parents should get help for their child as well such as Doctors, Early intervention, etc. too, however it’s important to not worry so much about getting that child to “normal” in comparison to peers, but rather to get that child to be as healthy or as functional as possible for him or her. Develop a “New Normal” or Adapted Expectations. What that will be for your baby will vary greatly from child to child. Everyone is different and everyone develops in their own pace. Some people develop faster and further than others. Children, especially babies, have so many milestones to reach, but instead of focusing on what they “should” be doing or what their peers are doing, if you have a special needs baby, just focus on being happy that you have that child, that you were blessed with someone who needs some extra love and help from you, and embrace the special needs parents identity and community that comes along with it. You will find that you will feel less grief and depression, but rather much hope and acceptance, and even get to the point where you will celebrate difference perhaps. Your child will be happier for it, and you will too. 

[this article was written for MainLineDoulas. Patience provides some postpartum doula services through Main Line Doulas]