HELP! My Child Has Tantrums

By Gopi K. Patel MSE.d, Special Educator

“My child often has tantrums 3-4 times a day—Help me—I can’t take these tantrums anymore,” is often a statement I hear from parents. Tantrums are part of growing up for every child; it is how we deal with them as parents that will determine how long they will continue.

The truth is tantrums are a LEARNED behavior. Even if it just happens once the child learns that when I cry, scream, throw myself on the floor—kicking and arms in every direction, “I WILL GET MY WAY”.

Tantrums usually occur when a child wants something and is frustrated because she can’t have it right away. When this happens parents usually give into the tantrum because they feel helpless. The problem is that as time goes by, with each episode the tantrums often get worse in their intensity, duration, and frequency.

To rid our world of tantrums, we as parents need not only learn how to deal with them once they occur, but identify a potential tantrum before it has begun.

Before the tantrum: The tell-tale signs of an on-coming tantrum are often whining, talking in a baby voice, repeating phrases over and over again, all with the intention to get his or her way. When the signs first appear say to your child (in business like voice),“use your big boy/girl voice and then I can talk to you”. If your child then asks for the same thing simply state, “you cannot have that right now. We are done talking about this now.” Repeat this as many times as necessary. Do not give in to them.

The tantrum has begun: Once a tantrum has begun walk out of the room or area you are in and ignore your child (if at home it often helps to go in a room where she cannot join you such as the bathroom/bedroom). If your child grabs on to you simply ignore them and go on with your task. If the tantrum starts getting severe in intensity where the child could hurt herself, others, or the environment— immediately remove her to a safe time out area. Then, simply state to her, “when you are quiet and ready to be with me I will come get you”. (It should be noted that a child should always know what your time out procedure is, before this is attempted).

Never give in because you feel your child has been in the time out too long. You are not a horrible parent if you let your child tantrum for a long period of time. Your child, just like you, is learning a new way of dealing with behaviors and consequences.

After the tantrum: once your child has been quiet for a couple minutes go to her and say “I am glad you are ready”/”I am glad to see you happy again”. At this point parents often get caught up in talking about the episode that triggered the tantrum, instead of dwelling on this, move on to the next activity or task. If she begins to cry and tantrum again—simply start the process all over again.

Here are some suggestions that have helped many of the families that I have worked with. It should be noted that the parents who were most successful in preventing tantrums dealt with these events in the most CONSISTENT manner. Every family is different, and unique, but every child needs LOVE, CONSISTENCY, and a POSITIVE ENVIRONMENT to grow in to his/her fullest potential.

Helpful Hints for Dealing with Tantrums:

• Before doing a time a time out have a clear procedure for this place. Make sure it is in a safe place.


• Parents should be in control of the situation, not their child
  
  Both parents should work together to achieve results faster. (No good cop bad cop.)


• Do not start talking about the tantrum as soon as it has ended — talk about it at a later, if you must.


• State things a little bit differently—rather than stating what your child should NOT be doing, state what they can be doing (a child running around—instead of: “STOP running” say: “Use your walking feet”)


• Tell your children before the task or activity what the rules are, what you expect from him or her.


• Be calm and in control of yourself — these situations can at times get intense.


• The best way to eliminate tantrums before they even begin is to positively reinforce your children. Tell them as often as you can what a great job they are doing—even if the task is simple.
  
  PRAISE! PRAISE! PRAISE

Five Major Milestones for Early Physical Development

By Deanie Barth, MSPT


The first year of a child’s life is its busiest and most important developmentally. It is at this time when they develop the muscle strength and control that will help them to hold their body up and move against gravity, to initiate purposeful movement and complete simple tasks. The acquisition of these simple skills will allow them to jump, run, play baseball, do gymnastics and clean their rooms when they get older.



There are many milestones over this first year that involve gross motor development, so to keep this piece short I tried to remember five major ones where parents called or emailed me so excited to share the good news. Or when I consoled a mother who missed the first time their child demonstrated acquisition of a milestone. It was hard to pick just five, but here goes in Letterman Style:


Gross Motor Milestone #5 -- Rolling Over

At around 2-3 months, if a child is placed on his side, he should be able to roll on to his back from his sides. At around 4-5 months, he will start to roll from his back all the way to his stomach. At this time and in these positions, his abdominals, back and neck strength are starting to increase to prepare him for...

Gross Motor Milestone #4 -- Sitting Independently

Around 6 months, your child should be able to sit independently without support. This is not to say you should place them on a stool and leave them – they are still pretty shaky at this time and may even still need a little help getting to this position. Give them a nice, padded environment to practice balancing, so if they topple over they will not get frustrated. You need to build that confidence up to get to…

Gross Motor Milestone #3 -- Crawling (technically known as creeping)

Once they are getting in and out of sitting positions independently, your curious little one will not be satisfied to stay in one place. Once they discover they can get on to all fours and actually move forward a bit to grab and destroy your cell phone or remote control, they will soon be racking up the miles on their hands and knees. Did you ever wonder why it doesn’t hurt their knees to crawl on them all day long? Here’s a little tip – it’s not because they’re so resilient at that age or because their adorable little legs are so pudgy, it’s because their knee caps don’t develop until they are toddlers! Isn’t that convenient? In any event, the reciprocal movement of their legs and arms prepare them for yet another milestone, which will come later. But first, on to…

Gross Motor Milestone #2 -- Standing up

Around 9 months, your child will start to pull to stand and then start cruising using furniture. This constant up and down, up and down to retrieve objects you would rather they not will help strengthen their legs. It’s the equivalent of squats at the gym for adults, but far more fun and adventurous. Pretty soon, they will be standing up without support of another object and at that point they are ready for the milestone of all milestones…

Gross Motor Milestone # 1 -- Walking!!!!!

Usually somewhere between 9 and 15 months of age, your little one will stand up and take a step or two. At first, they walk with their legs spread wide apart and their hands way up in the air. This helps to increase their base of support and assist their balance. As their muscles get stronger and their balance improves, you will see a narrower base of support and their arms lower until they are swinging appropriately at their sides. At this time, prepare to be on high alert because with walking comes increased curiosity and an intense need to explore their environment without boundaries. Good luck!

Please keep in mind these time frames are guidelines and not absolutes. If you have concerns that your child may not be achieving milestones at an appropriate age, consult your pediatrician.

Eye-Hand Coordination — A Team That Works Together To Get The Job Done

By Barbara Greenspan OT, pediatric occupational therapist

Many of us think eye-hand coordination is something the ‘big-kids’ need to play team sports like baseball and tennis. But actually, eye-hand coordination begins developing in early infancy. In order to achieve proper coordination, the hands and eyes must work together in smooth and efficient patterns. This is achieved through effective control of the head and neck, which enables the eyes to monitor the work of the hands.

The Eyes: Nature has it set up so that controlled eye movements developmentally precede controlled hand movements. That is why babies use their eyes before they master the use of their hands. As infants, eyes develop in a clear developmental sequence as follows:

• From birth to 3 months is something called ‘localization’ –where infants locate a visual target like mom or a toy


• At four months is ‘Fixation’ where the baby can maintain a stationary gaze (stare at an object)


• At five months is ‘Ocular Pursuit’ typically starts. Where the baby can smoothly track an object with the eyes (follow a toy as it moves, watch mom move around the room)


• At six months ‘Gaze Shifting’ begins. This is when the child quickly and accurately shifts her gaze, moving independently from the head (watch a moving toy while keeping the head still)

The Hands: Just like the eyes develop in a sequence designed for function, so do the hands.

• First the baby learns to grasp an object.


• Next they grasp and release objects (think of dropping food from the high chair).


• The baby then learns to move an object within the hand (in-hand manipulation) and then use two hands together to play or hold an object (bilateral hand skills).


• All this hand development is done through playing with objects and toys.

Mastery of reaching for objects requires good postural control of the head, neck, trunk and upper arms. These areas must be strong before good hand manipulation occurs. Think of a tree-the trunk must be strong in order to support the branches (so much goes in to this eye-hand coordination!).

The first “tool” for eye-hand: When the hands are developing they progress from a simple grasp-release pattern through using tools and objects. The first real “tool” introduced to the hand is the spoon for self-feeding. The hand holds it and the eyes watch the spoon to direct it from the food on the plate to the mouth. As the child grows, they use more refined tools like crayons (use small, broken ones to fit the little hands!) and the eyes are watching as the hand moves the crayon. As the child gets older, he or she can begin to follow mazes and use the eyes to lead the hand in the right direction. In pre-school at 3 or 4 years old, he or she begin to cut with scissors and use the eyes to direct their hands.

Ways to work on eye-hand:

• Playing ball is a great way to work on eye-hand coordination. Start rolling a ball to your baby and watch his or her eyes follow the ball.


• Playing with a balloon (filled with air) is a great way to get the eyes to follow a moving object because a balloon moves so slowly, it is easy to follow.


• As your child grows you can work on throwing and catching with a playground ball and progress to a smaller ball. Tennis balls are great fun to catch and throw for 4 and 5 year olds. Warm these kids up with a big ball and progress to a smaller ball when they are successful.


• Dribbling is also a great activity to develop eye-hand coordination. Four, five and six year olds feel so good about themselves when they can dribble with one hand and then progress to alternating hands!

Eye-hand coordination is something that begins to develop at birth and continues throughout childhood. It is a skill children use daily in their occupations as students and athletes - and for just plain fun! So enjoy, and notice how much you use your eyes to direct your hands! You will be amazed!

Potty Training 101 - Get ready, get set, GO!

by Gopi K. Patel MSE.d

Parents often call me saying “HELP — I can’t get my 3 year old near the potty”. Becoming potty trained is a huge milestone for children and their thankful parents and both will find the most joy and a sense of accomplishment when this goal is met together.

There are some important things I would like to say about the process of being potty trained before getting started. Do not compare your children to their siblings or peers because each child will learn this at his or her own pace. Potty training is a learned behavior thus some children pick this up as early as 18 months, while others take as long as 5 years. In addition, boys often take longer than girls to become potty trained. Please note that if a child has developmental delays the ages can vary as well.

In my experience I think 2 1/2 years of age is a good time to get started. If you have been CONSISTENTLY potty training your child and find that he or she is having difficulty learning this skill, as a precautionary measure, please have your physician examine your child.

SO LET’S GET STARTED…

The three most important things to remember when potty training your child are CONSISTENCY, CONSISTENCY, CONSISTENCY!

PREPARATION

1. Take your child into the bathroom and show them how to use the toilet while telling your child what you are doing. He or she can even help out by flushing the toilet, waving bye to ____,____!!! Some children are scared of the flush — so being with them is a great way to assuage their fear before they actually have to do it for themselves.


2. Make sure to have either a training toilet seat, which goes on the toilet itself or a miniature potty in the bathroom. When your child is comfortable ask your little one if they would like to sit. Do not force your child to do this and immediately praise him or her for doing so.

3. Take your child to the store with you and have them pick out their “big boy” or “big girl” underwear and tell everyone you can this, so your child will know that it’s something to be proud of. Let your child know when you are ready to get started that “today you are going to wear your “big boy” or “big girl” underwear.

The Waiting

Remind your child to tell you when he or she has to go potty. If that doesn’t work, I recommend that parents start off taking their children to the potty every 20-30 minutes. Try to keep track of how long he or she stays dry and take them to the potty accordingly. Once the pattern has been established you may find that they do not need regular reminders to use the potty. Children should sit on the potty for 2-3 minutes each time they use it. Do NOT get upset with your child for having accidents!!! Do not question them —“why didn’t you tell me”, and do not look at them with anger or frustration.

Remember to start potty training when you know you can be consistent — diapers/pull ups one day and underwear the next will only confuse your child.

Positive Reinforcement

Go to the store and buys special potty treats and toys and have them in a box in the bathroom where he or she can see, but not reach them. Tell your little one that he or she can pick one out every time he makes on the potty. Do NOT give in by giving he or she these items at other times.

As soon as your child starts getting more successful on the potty create a sticker chart 5 stickers earns you a toy or treat. Hang the chart right in the bathroom where it can be seen.

Praise your child for sitting and eventually urinating/having a bowel movement, show your excitement with your facial expressions as well as your words.

Other Tips

• It helps some children to have the faucet water on when they are sitting on the potty.


• Some parents find it helpful to give more liquids during the training period.


• It may help to read to your child while he/she is sitting on the potty.


• Your child will learn to urinate first and then have bowel movements.


• Night time potty training should be done after day time training is mastered.


• Some parents let their little ones sit in the wet underwear few minutes longer for them to understand/feel how uncomfortable they are before changing into dry clothes.


• Use pretend play skills to have a favorite stuffed animal/doll go on the potty. Have your child put on a pair of underwear on the doll or stuffed animal. Read potty books.

Follow these tips and should be well on your way and remember CONSISTENCY, CONSISTENCY, CONSISTENCY!!!!

It's All About the Core

By Deanie Barth, MSPT Physical Therapist As an adult, you’re used to hearing how important it is to keep your core (trunk and abdominals) strong. The same is true for your infant and toddler. As a matter of fact, a strong core is the foundation towards achieving very important milestones such as crawling, standing and walking. And it all begins as soon as your child is born. As soon as your child enters this world, curiosity will get the best of him. From birth to 3 months of age, your child will actually begin to work on his core strength. First, you will notice his attempts to lift his head when you hold him over your shoulder. It will begin with clumsy head bobbing, but sooner than you think he will begin to hold it upright to explore the world around him. He will also start to rotate his head in response to sounds. Next, you will find if you place him on his stomach, he will attempt to lift his head up. Between 3 and 6 months, tummy time gets a little more serious. Your child’s neck strength will continue to develop and he will be able to hold his head up without bobbing and will take weight through his forearms. As his upper back and arms get stronger, you’ll see him attempt to push up on to extended arms. Pretty soon, he’ll be shifting his weight back and forth from one arm to the other and if you entice him with entertaining objects, he may even reach out for one while bearing all of his weight through only one arm. If he likes tummy time, you may find that when placed on his back, he will roll onto his stomach. This should be encouraged because it helps to strengthen abdominal muscles as well as back muscles. Once your child reaches 6 months, he’ll really start moving. You’ll find if he doesn’t like tummy time, he’ll just flip himself right back onto his back. Although this can be frustrating for a parent who is trying to encourage tummy time, just remember that these repeated motions help to further strengthen his trunk. Around this time, your child will also start to sit without your support. It is recommended that you make his environment as soft as possible so that if he topples over he won’t be afraid to do it again. His balance will not be up to par and this is because of still inadequate trunk strength. However, the more he is able to recover from a loss of balance, the stronger he will become. A common mistake I see parents make is constantly holding their children at this time or allowing them to lean on them for support whenever they are sitting. While you don’t want to frustrate your child who may seek support, it is important to allow specified times of the day for your child to learn how to gain control over their body and this comes with trial and error. You can further strengthen your child’s upper back and abdominals by encouraging them to pull on your fingers to achieve sitting. You can start with your child lying on an incline for the beginner and then gradually reduce the incline and offer less support as your child becomes stronger. As your child approaches 9 months, his trunk strength is developed well enough to get ready for locomotion. You will find that when he is placed on his stomach, he will start to push himself up onto all fours. He will also spend more time bearing weight through only one arm while playing with objects with the other. If you place one of his favorite toys just out of reach, the next thing you know, he’ll be crawling forward just slightly to retrieve it. Crawling not only will further strengthen his core and arms, but it also encourages reciprocal (alternating) movement of the lower extremities, which is necessary for walking. Between 9 and 12 months your child will be crawling all over your home, but he will soon realize that the only way to truly get into mischief is to not only crawl over to the desired target, but to be able to reach it as well. He will begin attempting to pull to stand to objects and cruising along objects. At first, he will stand with his legs wide apart and if he does let go of the stabilizing object, he will hold his arms high in the air. Once again, this is because of inadequate trunk strength and he requires this positioning to maintain his balance. As his strength improves, so will his balance and with that you will see his base of support become more narrow and his arms drop lower and lower. Once your child is able to maintain his balance in standing unsupported, he will begin what most people believe to be the most important gross motor milestone of all – walking. There are so many ways you can play with your child to strengthen their trunk and thereby achieve these very important milestones. Here are a few of my favorites… For tummy time, I love... Kick and Play Playground Taggies Look At Me Mirror For encouraging upright sitting while reaching with arms to retrieve objects... Big Top Sounds Stacking Toy and Ball Game Follow me Fred is the perfect incentive for a child to crawl. Follow me Fred Together Tunes Cube is a great toy to work on standing. Together Tunes Cube My all time favorite for the child who is about to walk on their own is the Chomp and Clack. Chomp and Clack Remember, to safely achieve goals, your child should be supervised at all times and assisted when necessary. Also, keep in mind that the about mentioned time frames should serve as guidelines, not absolutes. However, if you feel your child is significantly behind these time frames, we recommend you consult your pediatrician.

Preventing Family Headaches

Using The Three “R’s” (Rules, Rituals, and Rewards) In Parenting
by Andy Eig PhD.
Clinical Psychologist


Since my last article, you all have become experts in giving time-outs. For some of you, it has worked out wonderfully – for others, well, not so much. You have been doling time-outs so frequently that you feel more like a hockey referee giving penalties than a parent. So, let us discuss how to prevent time-outs and cranky behavior in your 3 to 5 year old.

Before we go any further, I want to throw out a word of caution. We are not out to sculpt perfectly behaved children. All children need time be grumpy, defiant, and even unruly at times. Challenging parents and sticking up for themselves builds strength of character in your children. That being said, all children need sensible rules and limits in order to feel safe and to grow into productive members of society. They also need to feel a sense of empowerment and enjoyment when they are behaving well. In order to keep the parental headaches of nasty disruptive children away, we need to use the three “R’s” of parenting: rules, rituals and rewards.

Rules: We all need rules. You and I need rules and so do your kids. Exactly what the rules are in each household will depend on the parents own values. As a guideline, you want family rules to help keep children safe and to help them know, understand and follow the conventions of society. Rules in the household need to be sensible and clear to your three to five year old. Perhaps more important than what the actual rules are, each parent must agree on them and enforce them consistently. I call this the united front of parenthood.

Rituals: Kids do well with a structured day. They need to have daily rituals and know what is going to happen next. For instance, kids need to have a wake up time, stimulating play time, a bed time, bath time, meal and snack time. Most days this should follow the same predictable progression.

Rewards: How do you get your kids to follow the rewards and rituals I just have talked about? Take one guess. Rewards. Most kids (if not all) listen and behave better when positively motivated. Most of the current child behavioral research concurs that kids feel much better about themselves earning rewards rather than avoiding punishments. Set up a reward system for your child if they are having difficulty following the guidelines of the day. One great way is to have a reward chart that your child helps design. For each task of the day, your child gets a sticker or a very small reward if he or she does it well. Brushing teeth gets a sticker. Going to sleep and not coming out of your room once “Good Night” is said deserves another sticker. At the end of the week, your child can get a small toy if they earn enough stickers. E-beanstalk has so many inexpensive developmentally appropriate toys to choose from that you and your child can order on line.

By using rules, rituals, and rewards, your family can have more time to enjoy each other. Try it out. Using rewards rather than punishments will go a long way in motivating your child and building positive self-esteem.