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Archive for August, 2009

In my last post, I shared a question from goodfountain, who writes a wonderful blog about life with her two girls, the older of whom has a diagnosis of Asperger’s Disorder.  I shared some of my favorite strategies that caregivers (including parents, babysitters, grandparents, and teachers) can use to help ease transitions and prepare children for challenges in their day.

Today I’d like to share a few ideas that might help 5-year old Charlotte with the handling of her overwhelming emotions:

In the moment you described (not wanting to take off her Princess gown to go to Target) when your daughter lost her temper and tried to bite you, she was mostly likely feeling very dysregulated and scared/threatened.  It helps to think about it in those terms, rather than viewing this type of reaction as “negative behavior” – it makes it a lot easier to feel empathetic and is, I think, accurate. She felt really good in that dress and the idea of taking it off was probably very upsetting (and even threatening) to her, so when you added the idea of you and her sister going to the car without her, it increased her anxiety to the point where her fight or flight response was activated – and she chose fight.  In addition to giving you more strategies to help her prepare for such challenges, we want her to start to recognize her internal signals of anger and frustration and learn to manage them before she gets to that point.  As you said so beautifully: “It’s not that I want to STOP her from being angry, but that I want her to not lose control when she IS angry.”

It is critical that we allow our children to own their feelings.  Our job is not to keep them from experiencing negative emotions, but rather to help them identify their emotions, gauge how intense they are, and choose a coping strategy that matches the intensity.

To that end, it is useful to pause often and model this for kids; in other words, let them know how we are feeling. For example, “I am feeling pretty frustrated right now.  The woman in that store wasn’t listening to me at all.  I am going to sit quietly for a minute and take some deep breaths before we go home.”  Similarly, pause in your day to check in with your daughter.  You might find a way to talk about negative emotions that works for her level.  Making a weather analogy is often helpful; we can identify that we’re feeling “sunny”, “partly cloudy”, and be aware that it’s time to come up with strategies when we start to feel “stormy”.  Help her to talk about how she’s feeling and become more aware of the natural changes that occur throughout the day.

We have a great visual aid that I believe I was first introduced to at a SCERTS workshop.  On a small square piece of paper we write on one side: “When I feel angry…” and on the other side it says, “I can…” and then we list 2-4 strategies to help the child calm down, e.g., talk to someone, take a break/quiet space, say “I’m mad,” go get a drink of water, etc.  The child chooses the strategies.  This is laminated and we put a key ring through it and hang a few of them in easy to reach places (they’d be easy to keep in Charlotte’s pocket, looped to a backpack, or in your purse) so when a meltdown starts, we can quietly hand it to the child and they can choose what they want to do to get under control (become more emotionally regulated) without a lot of verbal negotiation.  We generate these strategies with the child him/herself in a quiet moment so that they are meaningful.  It is impossible to reason with an angry or frustrated child in the moment, it really has to happen at a different time.  For a non-reader, picture images can be used just as effectively as words.  In my experience, we don’t usually need to use this external strategy for very long before the child internalizes her own calming strategies and is able to access them without the adult’s help.

Another great strategy for your daughter would be to do some work with The Feelings Book, which is a dry erase book that has pages depicting a wide range of positive and negative emotions.  The child can write down what makes her feel a particular emotion (e.g., angry) on one side, and then generate strategies on the opposite page (When I feel angry, I can…).  She can write it herself if she is older, or dictate to an adult.  This leads to some wonderful conversations about emotions and coping strategies.

I also love that there is a 1-5 scale at the top of each emotion page where the child can think about degrees of emotion, e.g., “Having to turn off the TV makes me a little angry – that’s a ‘2’” but “Taking off my princess gown makes me very angry – that’s a ‘5’!” and you can discuss strategies that work for mild anger versus extreme anger with an older child.  It could be great to use this book together and then use the strategies to create the little portable card described above.  You can order The Feelings Book directly from my colleague who is one of its creators, Emily Rubin, MS, CCC/SLP.  It’s available on her website.  Take a look at it, it’s really great!  We have many copies of this at the clinic and kids of all ages love it and have greatly benefited from it.

What we ultimately want to do is help a child learn strategies to self-regulate (learn to self-soothe, e.g., move away from a stressful situation, go hit a pillow, get a piece of gum) and also be sure they have good mutual regulation skills (e.g., asking for help, asking for a hug, labeling their emotions for someone else).  To be healthy, we all need a balance of self- and mutual-regulation skills.

I’m happy to elaborate or go more deeply into any of this if you would like me to.  Emotional processing is one of my absolute favorite things to work on – it’s so critical to successful relationships throughout the lifespan!

The next post will include a follow-up from Charlotte’s mom, sharing which of these strategies she’s tried and what has worked.

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Question:  I have a question about how to help my 5-year old daughter express and process her anger. (Submitted by the author of the blog goodfountain, who writes beautifully about parenting her two young daughters, one of whom has a diagnosis of Asperger’s Disorder)

Here’s an example of what happened today. My daughter Charlotte was wearing her Belle dress. As I usually do, I gave her a plan: we’re going to eat breakfast, play with toys, watch show, get dressed, go to Target. However, when we got to the ‘get dressed’ part of our morning, she said, “Not now, I’m still playing.”  This went on all morning. I even rearranged the plan to give her more time and wrote the plan down; we read it together and she agreed to it.  Still no deal.  Charlotte would not get dressed. Not arguing with me, just ignoring me.  She told me she didn’t want to go to Target because she didn’t want to get dressed; I knew it was because she didn’t want to take off the Belle dress.

While going to Target was not a life-or-death situation, I don’t feel I should let Charlotte dictate what we do, and I don’t want her wearing her princess dresses in public all the time. Finally, out of frustration, I suggested that her sister and I were ready to leave and it was up to her whether to join us. At that point she had a major tantrum (she even tried to bite me!) but when she saw I meant it, she got ready to go.

This kind of anger and expression of anger is popping up more often.  It’s not that I want to STOP her from being angry, but that I want her to not lose control when she IS angry.

Any tips are appreciated!!

Answer: First of all, you did such a great job of writing out the plan for your day, I love that you use that strategy with her.  You were also very flexible with Charlotte in making adjustments to the plan along the way, which was fantastic.  Your statement “It’s not that I want to STOP her from being angry, but that I want her to not lose control when she IS angry” is so well-said.  That’s always my goal, too.

I have some strategies in mind that may help you and your daughter prepare for and cope with making transitions and handle challenging emotions in the future.  In this post I’ll share ideas about some things you can do that might help; in my next post I’ll provide suggestions that can help Charlotte more directly.

In terms of that particular situation, I would recommend sitting down with Charlotte later on (when you’re both relaxed) and making a list together: in one column, list places/times she can wear a princess dress, in the other column, write down the types of places/times she cannot. Make it really concrete and put it in writing so it’s “official”. (Kids tend to respect almost anything you put in writing, especially a good reader like your daughter!)  I’d also make a point of suggesting the dress to Charlotte when you see a time coming up when it would be okay to wear one (“Hey, this would be a great time for a princess dress!  Do you want me to help you put one on?”), so that she feels extra supported in her desire to wear one, but you are reinforcing the concept of an appropriate time.  Obviously, this strategy is situation-specific but is applicable to transitions from all sorts of preferred activities.

Also regarding the dress (or any preferred activity she is involved in that you think will be hard to transition away from when it’s time for something else) — I would be open about discussing it with her before the actual transition and I’d also try giving her some sense of control in the situation.  I always recommend the Time Timers that so many therapists and teachers use.  They’ve worked wonders for me (at home and school) because kids can see how much time they have left – it’s very concrete.  I would say something like this: “I see that you’re wearing your beautiful Belle dress!  You really love that dress and it makes you feel so good to wear it.  I know you remember that ‘going to the store’ is one of those times when we wear our regular clothes, and so pretty soon you’ll need to get changed.  You can decide how many minutes are left before you change, as long as it’s in the next half hour – let’s set the timer so we can see how much time you have left to wear it, and when the red is all gone I’ll help you change.” Or:  “I’m sure you remember that we can’t wear a Belle dress to Target but I don’t mind if you wear one piece of  your princess jewelry to the store as long as you take really good care of it.”

A strategy that works well for my own 5-year old is to let him take something in the car that he doesn’t want to part with – he’s been surprisingly good about leaving an object in the car so it won’t get lost as long as he knows he can hold it when we get back to the car after our errand or visit.  I’d also consider letting a child wear a backpack that contains a favorite dress or toy if it’s small enough.  At work I have a Polaroid camera and when a child doesn’t want to leave something behind when it’s time to go home, I take an instant photo of it for them to carry out with them.

It really comes down to finding a way to show your respect for what they are feeling while making your limits really clear: we don’t wear the dress in Target.

[Stay tuned!  The next post will focus on strategies Charlotte's mom can employ to help her daughter learn to regulate her emotions better when she does become upset.]

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Have a Question?

Over the years I have found that there are many “universal” questions about communication development and strategies to help children grow in positive ways.  Therefore, I would like to start a series of “Q & A” posts on this blog this year, in which a reader sends me a question that relates to communication and I answer it publicly, in hopes that others with the same question will benefit from some new ideas.  You can be anonymous if you’d prefer.

If you have a question regarding your child’s communication that you’d like to see answered (either via email or on the blog), please feel free to email it to me at:  jordan@communicationtherapy.net.

The first one will be posted soon!

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thislovelylifeBack in early 2007 I was preparing to give a talk at the clinic here in Chicago on the topic of “Non-verbal Communication”.  As it happened, just a week before my talk I somehow came across the writing of Ms. Vicki Forman, who wrote the Special Needs Mama column at the Literary Mama website.  And one of the excellent posts I came across, titled “Between the Lines”, was about her experience mothering a child classified by professionals as a non-verbal communicator.  Her son, Evan, 6-years old at the time, was in fact multiply-disabled, having been born at 23-weeks of age, weighing only a pound, and surviving by the skin of his teeth as a newborn.

I immediately sent an email to Vicki, explaining what I was doing and asking her permission to print out the “Between the Lines” essay for the parents I would be speaking to, and she replied immediately: “The short answer is YES, absolutely.”

The long answer turned out to be a wonderful friendship.  I have had the privilege of meeting Vicki and her family in person and have followed her life and writing these past two-and-a-half years. One of the best days of 2009 for me so far was when my pre-ordered copy of her incredible, award-winning memoir, “This Lovely Life” arrived in the mail and was finally in my hands. The book chronicles, with incredible honesty and bravery, the first couple of years of Vicki’s life with Evan after he and his twin sister, Ellie, were born.  It is a magnificent piece of work.  Please read one of many excellent reviews of this book.  This week, Vicki is a Bakeless Fellow in Residence at the prestigious Bread Loaf Writer’s Conference in Vermont.

Earlier this month, I was fortunate enough to be able to fly across the country to be in the audience at Book Passage in Corte Madera, CA for the book reading and signing that Vicki did there.  I loved every minute of it, and in my excitement bought an extra copy of “This Lovely Life” and had her sign it for me so that I could give it away to a reader on this blog.

If you are interested in winning this book giveaway, please leave a comment on this post to be entered in the drawing.  Along with your name, please also share with us one book, website, or workshop you have experienced that brought you new insight or changed your perspective on communication, if possible (not required).  I will choose a random winner on September 1 and announce the winner here.  I’m happy to mail the book anywhere in the world.

For those of you in the Chicago area, Vicki Forman is scheduled to do a reading at Women & Children First Bookstore here in Andersonville in late September.  Details to be announced!

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