Monday 05/04/2008 Mayhem and Meltdowns

I have probably mentioned before that M was a happy, placid, smiley baby. There wasn't a lot that fazed him and he was happy to point things out and share every new discovery. We knew that he was behind on his speech, but hadn't suspected a developmental delay of any kind. M was rather late reaching some of the major milestones, crawling at eleven months, walking at fourteen months and he still wasn't feeding himself with a spoon at twenty four months.

I enrolled him at the local preschool and the first couple of terms were uneventful. We were really shocked when M's behaviour started to deteriorate at three and a half. M suddenly became very anxious and clingy. Worryingly, he began to throw toys, hit and push other children and even kick out at staff. On the one hand I have to say that this was the wrong preschool for M, as they did not have a special needs policy in place at that time. The preschool leader, was concerned that M wandered around and wouldn't cooperate at carpet sessions. In retrospect, this was hardly surprising, since M would have understood very little, of what was being said.

M was fretful and very scared at night. He'd would wake on average five to six times a night, in the grip of awful night terrors. We took him to see a cranial osteopath, which helped an awful lot with the night times, but we still experienced terrible rages during the day.

I'd like to be able say, T' Da! this is the solution, but we are novice parents on a steep learning curve. These are some of the strategies that have helped.

I Cues :- We keep language simple, direct and in the correct order. 'I'd like you to sit down and eat your diner.' 'I need you to stop at the road and wait'. 'I feel sad when you hit me, please stop now'.

Social stories/ visual time table:- M needs a order to his day, especially if we are doing something out of the ordinary. I draw a series of small pictures (these can be stick men) to illustrate what we will be doing. I also draw scenarios to show Matty how to/how not to interact with his friends. These could include sharing, turn taking, saying please and thank you or hello/goodbye.

Time Out:- This is a tough one, it takes patience. We take M to the quiet step and he has an egg timer to allow him the time calm down. We sometimes have to repeatedly lead him back there.

Sensory Box:- We have a box with laminated foot and hand prints which can be used as deep pressure points to push or stamp on. We also have a dog/silent whistle he can blow and an unbreakable mirror to help M tune into his Emotions. There is also a flannel to wipe off the sad/angry face. http://specialchildren.about.com/od/sensorystrategies/a/sensorybag.htm

Reward scheme:- We have a jar with a happy face, each time M does something good, he receives a marble. Ten marbles equals a reward.(positive reinforcement.)M responds very well to praise and encouragement.

Empathy:- There are times when M's rage has reached such a level that none of the above would be appropriate. on these occasions, I use the same phrases over and over to soothe him, 'I can see you are very cross/sad' 'I'm sorry that you are feeling angry' 'I can see that the boy wasn't being fair' We talk about the bad behaviour once he has a grip on things again.

I'd love to hear what works for other parents, we are also awaiting a PCAMHS referral, so I'm sure I'll have some more tips to pass on at a later date.