Wednesday, December 29, 2010

Making Mornings Manageable

Making sure that your child's morning routine goes smoothly will help set him up for a good day at school.

If mornings are chaotic and disorganized in your house, what can you do to make them less stressful?  

Here are some ideas that to consider:

Make sure that your child is getting enough sleep at night.  Small children need 11 to 12 hours of sleep.  Even 11 year olds need nine to ten hours.  Teenagers, it seems to me, are always short of sleep.  Because they are growing and changing so much, they require much more sleep than we think.  {If your teenager wants to sleep until noon on the weekends, perhaps you should let him.  He probably needs it.}

Chronic sleep deprivation can cause short attention span, hyperactivity, and irritability.  If your children are habitually waking up groggy, cranky, and slow to get moving, or they require an alarm clock instead of waking up naturally, they may be needing more sleep than they are getting.  Set an age appropriate bedtime, and stick to  it.  Smaller children respond to a set ritual: bath, story, song, hug and kiss, lights out.  Try a drop or two of essential oil in the bath water; according to my colleague, Catherine Traiforou Vlasto, CSW, who utilizes aroma therapy in her practice, it's also helpful to place a few drops on the child's pillow or on the soles of the feet.  Good oils for relaxation and sleep include lavender, bergamot, and geranium.

 A handful of epsom salts in the bath water draws out toxins.

If your child has a hard time transitioning to bed:

Strictly limit computer or interactive video games during the school week.  They are highly stimulating to the brain, which makes it difficult to relax and drift off directly after playing with them.  I would suggest that screen time end a minimum of two hours before bedtime.

Remove all electronic games, computers, and televisions from the child's bedroom.

Reduce the amount of clutter and visual distractions in the child's room.

Turn out lights completely.

If your child has respiration problems, snores at night, or is chronically stuffy, this is probably interfering with his ability to sleep deeply enough.  An air purifier, allergy testing, or a consult with an ENT may be in order.  Make sure there is fresh air in the child's room.  Pajamas and bedding should be made from natural fabrics.

Make certain that your child has plenty of exercise and time outside every single day.  Don't you sleep better when you've had a good work out, or have spent the day outside doing chores in the garden?  So will your child.  Unless you live in Alaska or norther Minnesota and the weather is ridiculously cold, so cold that breathing the air will damage his lungs, your child needs to be outside for a good amount of time every single day.   I grew up in the Midwest, where it was plenty cold and snowy.  Starting in kindergarten, unless there was a tornado or an ice storm, I walked half a mile to school and back,  plus home for lunch and back, and went outside for recess twice a day as well.  

If your child's school has a policy of keeping the children indoors at the first sign of cold or drizzle, what can you do to change it?

To alleviate the morning rush and reduce stress, try to organize as much as possible the night before.

 Choose clothing the night before and lay it out.  {Have your child do this, or do it together, so that he can't complain that he doesn't like your choices.}

Make lunches the night before.

Gather together homework and any special items needed for the  next day and put them together the night before.

Have high protein, nutritious, but easy options for available for breakfast, like nut butter on whole grain toast with sliced bananas, string cheese with whole grain crackers, hard boiled eggs, a handful of dried or fresh fruit and a handful of walnuts or almonds, yogurt with almonds or walnuts mixed in,  mochi, or steel cut oats that you have made the night before and can heat up.  {Note that most of the options listed above are also easy to grab and go.}

One little boy I treated, whose parents were at their wits' end because he would honestly forget that he was supposed to be hurrying to get ready in the mornings and would lie in the bathtub and start dreaming, did better when he switched to showers.  He also initiated a schedule for the mornings, and managed to stick to it.

If your older child won't take responsibility for organizing his things or being on time, perhaps it's time to stop enabling him and to allow him to suffer the consequences of being late or for not having his work or his gym attire.  A few humiliating run ins with his teachers or his principal will teach him to be more on top of his game.

Remember that your child will carry whatever happens in the mornings to school along with him.  If he's had a calm morning, he will have a better chance at staying calm at school.  If he's had a hectic, stressful morning, with his parents losing their tempers and yelling, that's what he will be taking with him for the day.

Wednesday, December 22, 2010

Great Day in the Morning

Children with sensory issues can be stubborn, inflexible, rigid, and altogether infuriating.  The temptation to scream at them when they are pushing your buttons can be overwhelming.  Mornings are the worst.  Schedules are tight, everyone has to get out the door, the school bus will be there any minute... and there is your child, still in his pajamas, video game in hand, saying he has no idea where he left his homework and refusing to eat his breakfast.  


  I used to work with a little boy who was a total delight when we were alone in the clinic but had a great deal of difficulty comporting himself in the classroom.  At one point, he was put on a behavioral program by his teacher.  She listed his problem behaviors on a sheet of paper, such as talking out of turn and being disorganized, and then in the next column, she identified the target behaviors she wanted, such as raising his hand to be called on, speaking kindly to his classmates, finishing his work on time, and keeping his desk tidy.  She made copies and sent one home every day, assigning points when he hit his targets.  When he arrived for his therapy sessions, his nanny would let me know his scores for the week, which could range from perfect to almost zero.

For a variety of reasons, I had secretly begun to keep track of what the rest of the child's life was like and how it was reflected in his behavior in the classroom.  My conclusion:  although he did indeed demonstrate issues that were interfering with his academic functioning, much of what was driving his inability to behave at school was not sensory.

Unfortunately, this little boy and his mother had an extremely tense relationship.  She kept him on a short leash, had him scheduled for extracurricular activities and therapies seven days a week, and, although she worked long hours and didn't spend much time with her children, relegating much of their
care to nannies, she expected and demanded a great deal.

 He, in turn, loved to push her buttons, especially in the morning, which was a hectic time of day: four children under the age of seven and two stressed out adults all needing to get bathed, dressed, breakfasted, their belongings together, and out the door, on time for their various buses and trains, before 7:30 am.

 If his clothing was laid out the night before, my little friend would reject every garment out of hand and insist on choosing others, standing in front of his closet endlessly, unable and unwilling to decide what to wear.  If his nanny offered to help him get dressed, he would refuse, claiming his mother would do it instead.  His mother, however, was busy with three other small children and her own complicated morning routine.

My friend's mother was a very beautiful woman with a high profile, high stress career in Manhattan, and had to behave and appear accordingly.  If my friend spilled his milk or accidentally flicked a bit of toothpaste on her clothing, she responded by blowing up at him.   The nanny reported that his mornings  were routinely a disaster, with a great deal of yelling, screaming and blaming on the part of the grownups, and a great deal of crying, acting out, and aggression towards his siblings and the family dog on the part of my little friend.

There didn't seem to be any understanding on the part of  the adults, all of whom were desperate for this child to improve his behavior at school, that there was a direct correlation between the sturm und drang he experienced at home in the mornings, and his lack of ability, especially on the days that started with a screamfest, to pay attention, apply himself, and treat his classmates with patience and respect.

From my perspective, this child was trying to assert some control where he had none, and to get some attention from his ambitious, highly strung, distracted mother.  His clumsy attempts to connect with her continually backfired on him because of her inability to restrain her temper when she was under so much pressure. Consequently, she habitually sent him off to school miserable and out of sorts before his day had even begun.

If you are a therapist or a teacher working with a difficult child, do you know what is happening in the child's life when he is not with you?  If you are a parent of a child who can't behave at school, what is your child's morning like?  If you  send your child off to school after a morning of fighting and yelling, it will certainly show up in his ability to function there.

In my next post, I'll discuss some strategies for making mornings easier.

Wednesday, December 15, 2010

Gift Giving: a Guide for the Perplexed

Toys that promise to make your child smarter are probably going to do just the opposite.  Remember  those Baby Einstein videos?  The promise that they would turn your child into a genius, just by watching?  Um, no.  Sitting passively in front of a video screen does not make a child smart.  Moving his body, coordinating his hands and eyes, solving problems, and using his imagination, on the other hand, will.

In the waiting room of the sensory gym where I practice, there is a little wooden castle, complete with moat and drawbridge.  There are princesses to be rescued, kings and queens whose honor need defending, horses outfitted with chain mail and colorful banners, and knights in shining armor to ride them.    The children become so absorbed in the little world contained therein  that they often have a hard time dragging themselves away from it.

What's a good toy for a child?  Being an old fashioned curmudgeon, I firmly believe that the job of a toy is to help a child develop his skills {coordination, imagination, memory, problem solving, socialization, spatial awareness} in some way.  The more a toy challenges and engages him, the better.  And the simpler and more open ended it is, the more likely it is to do that.

Does your child have the basics?  I recently read  Stones Into Schools, the sequel to the life changing Three Cups of Tea.  {If you haven't read them, I urge you to do so.  They are about the work of Greg Mortenson, who travels the villages of rural Pakistan, building schools for the children in the remotest, most impoverished villages, on the condition that the girls in the villages be educated, and that the education be secular.} His daughter scolded him for not thinking about the children's bodies and their need for fun during recess, and challenged him to supply all of the schools with a jump rope for every child.  He promptly did, and was thrilled to see the children in those poor villages forget their problems for a while, laughing and playing in the schoolyard.

  Does you child have a selection of balls, a jump rope, roller skates, a Hula Hoop, and a bicycle?  {You would be amazed at how few of the children I evaluate in NYC can bounce or catch a ball.}

Games are a wonderful way to teach social skills like turn taking and being a gracious winner or loser.  How about checkers, cribbage, Jenga, Operation, Connect Four, Guess Who, Tier auf Tier, Memory, and Monopoly?  Or for the older child, nothing beats Scrabble.

I would seriously consider putting a few craft activities on the list this year.  People need to make things!  It's in our DNA.  Until quite recently, we needed crafts {weaving, sewing, leather, pottery, woodwork} in order to survive.  No one ever just sat with idle hands.  After the main chores were done, there was handwork to do: repairing saddles and tack,  spinning, weaving baskets, quilting, making candles and clothing.  When those tasks were completed, hands were turned to decorative arts like carving, leather tooling,  embroidery, and needlepoint.

It's always so  gratifying to me in the clinic when I am working on a craft project with a child and he arrives for his session champing at the bit to get at it.  And the pride and pleasure the child takes in his work is always a thrill.  I was moved beyond words once when I visited the home of a child whom I normally saw at my office, and there was a whole shelf dedicated to his projects in the living room, beautifully and artfully arranged by his father, who is a professional artist.

I confess that although I come from a family where the men can {and do} make or repair anything, I never was much of a crafter myself  -- in fact I practically failed my woodworking class in OT school.  Recently, however, I learned to crochet, and have become so obsessed with it that I haven't picked up a book or magazine in weeks.  The possibilities are endless,  the supplies can be as inexpensive or as costly as you like, and the results are beautiful and useful.  The man who cuts my hair begged me to teach him, because he thought it would help him with his free floating anxiety.  I think it most likely would.  Making things is soothing, grounding, calming, and organizing.  If you have an anxious child, supplying him with an activity that is slightly challenging but requires automatic, repetitive movement, like stitching leather, crocheting, or weaving, can be a huge stress buster.  And nothing motivates a child who tends to give up too easily like success!

If you have a Michael's in the vicinity, you're in luck.  They have a huge selection of structured craft activities as well as the raw materials for things like scrapbooking, cake decorating, painting, drawing, and clay.  I like Perler beads, Loom Loopers, {use a metal loom, the plastic ones are too flimsy} wooden models that you glue together and paint, and the Creatology 3D wooden puzzles that you crack out and put together.  Something all the children like to do is sew a felt stuffed animal from kits and stitch together leather pieces to make a coin purse.

Most small children love art supplies.  How about some gorgeous colored pencils, a supply of stickers, some modeling clay, a collection of fun pattern edged scissors, rubber stamps, glitter, origami paper, a little bag of colored feathers, beads, or a box of watercolors?  I hesitate to recommend markers, unless your child has already developed a good tripod grasp.  If he's still struggling, a chalkboard easel and a supply of colored chalk, which you break into small pieces, would be a big help.  I often play games and do silly drawings on the chalkboard with the children, which strengthens up their arms and hands for writing, and they really enjoy it.

I have to say, looking back, that the gifts that made the biggest impression on me were books.  I would like to thank the woman, whose name I no longer remember, who casually pressed a copy of The Enchanted Castle into my hands one evening as we were leaving her house after dinner.  I must have been about ten years old, and it was not my birthday, so she must have just wanted the pleasure of giving it to me.  I don't know if I ever got the chance to tell her how many times I reread it, how I sought out and read all of E. Nesbit's other books, and how now, as an adult, I still hand out copies to every child who crosses my path.

Buy your child your favorite books when you were his age, and read them together.  Make reading a book together before the child goes to sleep a nightly routine.  Books really are the gift that keeps on giving.  Developing a love of reading will open up the world to a child like nothing else can.

Wednesday, December 8, 2010

Things I Wish all Parents Knew

Children NEED and WANT the grownups to be in charge.  It makes them feel safe, which gives them the confidence they require to go and explore the world.  They will feel less safe if they know that they can push you around and bend you to their will.  I highly recommend forgetting about winning popularity contests with children.  It's far better to assume an authoritative role {authority with empathy and respect} and be, ultimately, s/he who must be obeyed.  

Be the alpha dog in your home.  You can be empathic and respectful of your children's feelings while still standing your ground.  If they are trying to wear you down, you can choose not to engage.  Just be mindful about what you do and do not respond to when you are talking to your child. 

 You won't win any popularity contests by being overly permissive or letting yourself be a pushover; you will only confuse your children by handing them over your authority. They won't respect you, and will continue to act out in an attempt to get you to set limits.  If you allow them to believe that obeying adults is optional, they won't listen to you or to anyone, and you will be setting them up for all kinds of behavioral problems at school.  I have treated many children whose parents don't know how to be the grownups, habitually  allowing their children to misbehave without attempting to contain or correct them, and I have to spend an inordinate amount of time establishing my authority when I should be working on their neurological delays.  Children whose parents are clearly in charge accept my authority instantly, are able to develop a good therapeutic relationship with me in a short period of time, and get right down to work.

Never ask a child if he wants to do something when he doesn't actually have a choice.  In order to avoid an argument or power struggle, a child does much better with a command.  "It's time to put on your coat,"  is going to get the job done a lot more efficiently than, "Do you want to put on your coat?"  If he says no,  which you have empowered him to do by inviting him to make a choice about it, you're in for a fight.  Think you don't do this?   I recently heard a father ask his son, "Would you like to come here for therapy?"  Why on earth would a parent ask a developmentally delayed eight year old boy if he wanted therapy?  It's not his decision to make. It's too confusing and unsettling for children when the adults invite them to make important decisions about their welfare.  It sends them the message, "We don't know what's best for you."

Don't use a lot of words with very young children, and don't negotiate with them.  They don't understand you.  Keep your sentences short, and don't try to reason with them.  Remember that the ability for abstract thought doesn't come into play until the age of about six, so carefully constructed arguments are basically wasted on them before then.  Just say no, and then divert them.

Children will try to wind you up for various reasons.  If you frequently lose your temper when your child acts out, you are telling the child that he is in control of your behavior.  This sets him up to believe that he is responsible for the reactions and emotions of others.   If your consistent response to him is irritation, you are sending him the message that he is irritating, and he will become so.  Conversely, if you are consistently patient and respectful, he will automatically extend that courtesy to others.

Choose to take the high road and avoid shaming, hostility or sarcasm when your child is making you crazy. 

Try not to end every sentence with "Okay?".  Every time you say this, you undermine your authority. You should not be asking the child's permission to be the grownup.  Whether you realize it or not, the child is taking this to mean, "Is this OK with you?"  We are supposed to call the shots, and should not be checking in to see if it's all right with them.

Wednesday, December 1, 2010

Feeding the Special Needs Child {Confessions of a Zealot}

 Children with sensory issues often have undetected food sensitivities, especially to preservatives, flavorings, and dyes, and don't let anyone tell you any different.  Artificial sweeteners, especially aspartame, should be strictly avoided.  They are so far removed from anything occurring in nature that the body has absolutely no ability to deal with them.

The Feingold diet is a good place to start if you want more information about how diet affects attention.

  There is a correlation between ADHD and pesticides,  so if your child has attentional issues, the more organic foods you can provision, the better.   Or try to buy the organic versions of the worst offenders. There are many foods that don't contain a high concentration of pesticides, so you can buy the conventionally grown ones if money is an issue.  Speaking of which, can we prioritize a bit here?  What luxuries can you reduce or eliminate so that you can increase your food expenditures and buy more high quality food?  Many people in other countries are accustomed to spending a far higher percentage of their disposable income on food.

Microwave ovens are bad news.  I have never owned one and won't let anyone heat my food in one.   Not only do they change the internal structure of the food, doing heaven knows what to the nutrition,  nuking things in plastic containers leeches toxins into food.  Do you want your children eating that?  I didn't think so. Replace your microwave with a good convection/toaster oven, and get used to waiting an extra minute or two for your food to heat.

 Get rid of your non stick cookware, which flakes toxins into your food as it ages.  Use cast iron instead.  A Lodge preseasoned cast iron skillet costs less than thirty dollars, and it will last forever.  Your great great grandchildren will be able to cook with it.  Cast iron is not very hard to take care of, and is completely non stick if washed and dried correctly.  Cast iron pans do a much, much better job of cooking things that you would normally associate with non stick cookware, like eggs and fish,  which in turn makes you a better cook. Instead of toxins, they add iron to food, which among other things is what allows the body to absorb and retain calcium.  They're reactive, but the only things you really can't cook in them are high acid foods like tomatoes and wine based sauces.

 Industrially raised cows, pigs, and chickens, and farmed fish, are pumped full of antibiotics and hormones, which we ingest when we eat them.   They live horrendous lives, are fed diets that nature did not design them to digest, which makes them ill,  and they die violently.  The {often undocumented} workers who process them, which is a polite way of saying kill and eviscerate, are treated almost as badly.   Don't believe me?  Watch Food, Inc.  or read Johnathan Safran Foer's  Eating Animals.

Restaurant food, especially fast food, tastes good because it has a very high percentage of sodium and fat.  We don't need to be eating it every day.  Take out and eating in restaurants should be reserved for special occasions, and should not be the default option.

  Something I don't consider real food:  Soy.  {I once heard a well known pediatrician say to a group of parents that he wouldn't feed soy to his own children, and that was good enough for me.}  Most soy is genetically modified.  This may or may not be harmful to humans, but genetically modified crops cause harm to insects,  This in turn disrupts the food chain, which eventually will be devastating to all living beings.  We are in danger right now of losing the ability to grow our own food here in the US, because our bees, who pollinate the crops, are dying off.  If we have to import all of our food in order to survive, that leaves us incredibly vulnerable.

Back to soy.  Even Asians, who have been consuming soy for generations, don't depend on it for the bulk of their protein, and neither should we.  They use soy as a condiment, such as a few cubes of tofu in a bowl of miso soup.  Soy milk and soy yogurt are a relatively new phenomenon.  Soy based  hot dogs, sausages and burgers are highly processed and contain tons of sodium and additives.   It's not a good idea to rely on these things, even if you're attempting to eat less meat.   Have some edamame once in a while as a special treat, or have some delicious homemade tofu at a Japanese restaurant, but I don't recommend consuming soy every day.   Which, in fact, if you rely on any processed foods at all, you already do.   Soy shows up in all kinds of places where you wouldn't expect it.  Kashi cereal, many granola and energy bars, breads, crackers,  mayonnaise, even canned tuna fish contain soy, like soy oil or soy protein, in some form.

Many fruits and  vegetables that we could never dream of buying even as a treat are now readily available at supermarkets.  Have you discovered fennel, lacinato kale, chayote, pomegranates, loquats, passion fruit, or ripe plaintains?

Is there a greenmarket near you?  Discover the joys of seasonal produce and watch the the seasons go by in rhythm with the market:  ramps, spring garlic, cherries, berries, apricots, tomatoes, apples, eggplant, peppers, tatsoi, kale, turnips, corn.  Take your children with you and discover these things together.  Or take a trip to your local Chinatown and discover green things and fruits you never knew existed.

Instead of white rice or spaghetti, try farro, quinoa, kamut, and wild rice.  They are delicious, easy to cook, and highly nutritious.

Remember: we are what we eat.  Do you want your children to be eating bad food?

Wednesday, November 24, 2010

Toxic Free Zone: Rewriting the Script, Part Six

Try taking a step back if  your child is constantly failing to meet expectations.

There is such a wide, wide range of human behavior and abilities.  If your child does not behave exactly like his classmates, it's not necessarily a pathology.  These days we expect all children to have all the same abilities, be successful in only one basic type of environment, and develop along the same time continuum.  How realistic is that?  
In previous generations, only a small percentage of children went to school for hours and hours every day, and the rest learned a trade, or farmed or worked alongside their parents.  Frankly, not every person is suited for sitting for hours and hours in school every day all day, and it pains and saddens me that we think that there is something wrong with people who are obviously not cut out for it.

 Not all three and four year olds are emotionally or physically ready to sit still for long periods every day, to tolerate a great deal of noise and chaos, and to be forced into doing fine motor activities before they have developed the physical and cognitive skills necessary to support complex eye hand tasks.  And wouldn't it be wonderful if schools would be more able to accommodate the needs of individual students, instead of trying to cramp everyone into one homogenous mold.

Learn to pick your battles. Children are messy, unpredictable, stubborn, disorganized, and quixotic, and are not necessarily interested in doing exactly what the adults want and expect of them a hundred percent of the time.

 Be realistic about what you can and can't expect from your child.  In Manhattan, I see so many children whose behavioral problems, which stem from their sensory issues, are severely exacerbated by parents who have no concept about what constitutes normal behavior for their child's age and gender. 

 Children need lots of unstructured play time, preferably out of doors, and in Manhattan they rarely get it.  Their behavior and health suffers as a result.  Children also don't do well when their after school hours and weekends are crammed with activities {with more adults making more demands on them} in addition to too much homework.

Wednesday, November 17, 2010

Toxic Free Zone: Rewriting the Script, Part Five

In a previous post, I mentioned a friend whose husband used to use her as his emotional punching bag by picking fights with her after a stressful day at work.  Do you ever get the feeling that your child needs to let off a little steam by having a temper tantrum and is inventing an excuse to duke it out with you? 

There have been so many times I have seen children come into the clinic spoiling for a fight, which I'm not interested in having.  I have come up with some ways to avert this, as follows.  Consider the following two exchanges, both of which have actually taken place, with a three year old boy I treated a few years ago.

Old script:

Child:  I want my sister to play with me!

Me:  But she's in school today, so she can't.

Child:  I want my sister!

Me:  But she's not here!  She's at school!


Me:  Honey, she's not here.  Do you want an obstacle course?

Child:  WAHHHHH!!!  I WANT LAURA!!!!!

Me: {Frantically casting about the clinic looking for some way to divert him}  Should I put up the purple swing?  We can play wiggle waggle!


Me:  {Flummoxed and mortified} Let's go find your nanny.  You can sit on her lap until you feel better.

About 20 minutes of a 45 minute session wasted.

New Script:

Child:  I want my sister to play with me!

Me:  I want Laura to play with us, too!

Child:  I want my sister!!!

Me:  I do, too! I love it when Laura plays with us.   That was a lot of fun when she was here during her school vacation last week!  Too bad she had to go back to school!

Child:  Yeah!

Me:  We'll have to tell your mom to make sure Laura comes to play with us the very next time she can.  I like it when you both are here to play with me!  Do  you want an obstacle course or wiggle waggle on the purple swing?

Child:  Wiggle waggle!

{When this exchange took place, I could see the befuddlement and disappointment register when the little boy realized that I had managed to derail his tantrum.  But he was a good sport about it and went on to play and have a nice session.  I just hope he didn't take it out on his nanny or his mother later in the day.}

Or consider this scenario, as described by a friend with a two and a half year old.  She asked for a rewrite.

Old Script:

Mom:  We're going to the corner to get a taxi.

Child:  I don't want to take a taxi!!  I want to go on the bus!

Mom:  But we can't.  We don't have time.


Mom:  But the bus takes too long.  We're late.  We have to take a taxi.


Endless loop of argument ensues.  Mother wonders for the zillionth time what she did in a previous life to deserve this.

New Script:

Mom:  We're going to the corner to get a taxi.

Child: I don't want to take a taxi!   I want to go on the bus!

Mom:  I like the bus, too!  The bus is more fun, isn't it?

Child:  Yeah!

Mom:  What do you like better about the bus?

Child:  I don't know.

Mom:  I like looking out the window from way high up.  Do you?

Child:  Yeah.

Mom:  What else do you like?

Child:  I don't know.

Mom:  Hm... Let's see...  I like pushing the button for our stop, do you like that?

Child:  Yeah.

Mom:  And we can take the bus tomorrow, if you like. And today Daddy is waiting for us, and we have to hurry.  I'm looking forward to seeing Daddy, aren't you?  And then we are going to have dinner.  We're having pizza!  Do you like pizza?

Child:  Yeah.

Mom:  Me, too.  I love pizza. Which do you like better on top of your pizza, armadillos or dinosaurs?

Child:  What?  Mommy, you're silly!

Mom:  Let's sing the bus song while we wait.  Can you help me wave so he'll see us and stop?

They sing "The Wheels on the Bus Go Round and Round."

Strategies Employed:  Mom acknowledged the child's feelings, and aligned herself with him by telling him she felt the same way.  She stated the plan without asking for his input {in other words, she did NOT say, "We're going to take a cab, OK?} She used AND instead of BUT.  She gave him something enjoyable to think about, and then diverted his attention to an activity and treat to which he could look forward.

I was talking to a psychoanalyst colleague about my ideas for these pieces, and she brought up a very good point:  what if you secretly would rather have the fight than avert it?  She treats so many families who are stuck in an endless cycle of toxic interchanges.  If you find yourself irresistibly drawn to fighting and having hostile interactions with your children, it's possible that you are trying to work something out with your own parents and are using your relationship with your children to heal your own childhood wounds.  If you suspect this is the case, I strongly recommend speaking to a professional so you can break the cycle and offer your children a better model.  Cleaning up your own interactions with them ensures that you're not setting them up to interact with the other people in their lives in a dysfunctional way.

 I also heartily recommend that any parent read these books by Daniel Siegel.

Wednesday, November 10, 2010

Toxic Free Zone: Rewriting the Script, Part Four

Last week I discussed the joys of never having to say "How would you feel if someone did that to you?" 

Here are two more phrases that I have happily quit using, because they never seemed to get me anywhere:  "You need to..."  and "I need you to..."

"Oh, really?"  I can just hear the child thinking when I say he needs to calm down.  "Oh, no, I don't!"  

"I need you to" is equally as ineffective.

 For example, consider the difference between my telling you "I want you to come home by six o'clock," versus "I need you to come home on time."  The first one establishes my authority and is emotionally clean and clear.  The second one indicates that it's really all about me, and that I am needy.

 Life is so much easier since I started substituting "It's time to...".

"It's time to sit at the table" makes it sound as if an authority from high has designated the next piece of business, and leaves no loophole for discussion. 

Old script:

Me:  I need you to come out of the gym and sit at the table.

Child:  Ignores me, and continues to play on the suspended equipment.

Me:  You need to come out of the gym and sit at the table!

Child:  I want to play one more game!  You said!

Me: No, I didn't! I need you to do your handwriting now.

Child:  NO!!!  

Power struggle ensues. I start fantasizing about going back to my old job as a bank teller.

New Script:

Me:  It's time to come out of the gym and sit at the table.

Child:  I don't wanna!

Me: It's hard to leave the gym when you've had such fun.  And now it's time to sit at the table.

Child: NO!

Me: {Taking down suspended equipment and putting things away as I'm speaking}  It's hard to shift gears, isn't it.  And we had a lot of fun in the gym, didn't we?  And we can do it all again next time, and now it's time to sit at the table.  I can't wait to see how well you're doing this week!  Let's get you a drink of water, and would you like a lollypop or a piece of gum while you're writing?

Child:  Lollypop.  I get to pick which one!  {Runs out of the gym to the cabinet where the lollypops are kept.}

Here are a few more tricks embedded in the second exchange:  I used what my social worker friend refers to as the "broken record" technique: I kept repeating what I wanted to happen in the same tone of voice, over and over.  

I did not say BUT.  I used AND.  AND is a far better choice here.  AND smoothes the way forward, while BUT stops the flow and feels negative.  I also helped the child transition by giving him several things to look forward to when he reached the table, and by inviting him to make a choice about the treat he would get once he got there.  {I give the child something to chew or suck on when he is writing because it helps focus him, and because sucking pulls the muscles of the eyes in close, which is helpful for reading and writing.}

And AT NO TIME during any of this did I say "OK?" to the child.  Don't ASK.  TELL.  If you want your child to obey you, don't say, "Put your shoes, on, OK?"  Don't say, "Do you want to put your shoes on?"  Say, "It's time to put your shoes on."

I absolutely guarantee less heartache, less argument, and less stress this way.  The clearer you are in your expectations and demands, the more the child is able to live up to them.

Wednesday, November 3, 2010

Toxic Free Zone: Rewriting the Script, Part Three

A couple of years ago, I read the very smart and funny book, "Why Men Marry Bitches."  The author maintains that men think that women are too emotional.  Consequently, they tend to shut them out during arguments or negotiations. A woman sounds less than rational to a man when she starts talking about her feelings when trying to reach consensus.  She suggests that a better way to get what you want when negotiating with a man is to jettison the feeling words, and use terms like strategy, analyze, sensible, logical, and objective instead.

"How would you feel if someone did that to you?"

I used to just dread hearing that when I was a kid.  If I even thought a grownup was going to head in that direction, I would leave my body so quickly you could see the skid marks.

So when I started working with children and heard that exact same phrase coming out of my mouth, I knew I needed to call for a rewrite, stat.

Do grown men know how they really feel?  In my experience, often they don't.  Do I know how I really feel? Much of the time, not until I have had the chance to mull it over.  Preferably in private.

So how can we expect four year old boys to be able to pinpoint just how they would really feel, especially when we are being hypothetical?   How many emotions can you name off the top of your head?  Mad, bad, sad, glad. That's about it.  I was once at a school observation where a kindergarten teacher was trying to get twenty restless children to sit still and think of some examples of how people feel.  "Hungry?" one boy asked, uncertainly.  The other kids knew this wasn't right, but couldn't come up with much else.  I had to restrain myself from suggesting that she give it up as a bad job and let the poor kids go to recess, which they were obviously dying to do.

I have come to realize, however, that a large part of my responsibility to the children I treat is to help to socialize them.  It's unfortunately true that most children do not come into this world with a fully developed sense of empathy and must be taught to think of others.  I have to do my part, along with the rest of the adults in the child's orbit.

In order to not have to utter the dreaded phrase, I have taken to substituting, "I wonder what you would think of me if I...?"  By asking the child what he would think of me, the onus is off the child, and is now on me for my bad behavior, which the child thinks is hilarious.  It's a more teachable moment when the child is not feeling attacked, shamed, or intruded on.

Here is my old script:  

I am working with a child at home, sitting at a table in his bedroom.  I pull out a bag of therapy supplies.  Child grabs it out of my hand and starts rummaging through it, exclaiming, "What's in here?"

Me: {Outraged, judgmental voice} How would you feel if I did that to you?

Child:  Shrugs and pouts.  

Connection between us is broken.  Now I have to work extra hard to  reestablish our rapport and get him interested in the project I was about to introduce.

New script:

Me: Now, I wonder what you would think of me if I started going through the drawers in your dresser?  You would probably think to yourself, "Wow, that lady is really nosy!  She should learn how to keep her hands to herself!  Who does she think she is, coming in my room in my house and going through my things?  What's in my dresser is none of her business."

Child:  Giggles and hands back the bag.  We hunker down and get to work.  Later in the session, he starts to grab something out of my hand, then stops himself.

Another young boy that I see has problems with body awareness and pragmatic social skills, like turn taking.  When I first met him, he barreled through doors ahead of others who were in front of him, often pushing others aside to get through the door before them, and he did not understand the concept of turn taking during games or sports activities.  Along with the usual sensory integration techniques for improving his body scheme, I  asked him what he would think of me if I shoved him aside every time we walked through a door together so I could go ahead of him.  "You're not nice!" he said promptly.  "Right!"  I said.  "What else?"

  "I was there first!"

"What else would you think of me?"

"Don't push me, I don't like it!"

The beauty of this is that he immediately understood what I was driving at and never did it again.  He did better at turn taking, too, after I asked him what he would think of me if I grabbed all of the cards out of his hand and knocked his hand away from the game board.

If you try these techniques, let me know how it turns out.

Wednesday, October 27, 2010

Creating a Toxic Free Zone: Rewriting the Script, Part Two

In my previous post, I talked about strategies to circumvent having to overtly correct or discipline the children I treat, using incompatible behaviors.

The other idea from this article that has been very useful in creating a toxic free zone is the LRS, or least reinforcing syndrome. This is employed by animal trainers to shape behaviors, by ignoring what they don't want and only responding to and rewarding behaviors that they want to encourage.

In the clinic, there are so many reasons why a child won't be able or willing to comply with the demands I set for him.  Sometimes it's something simple, like his blood sugar has dropped, he needs a drink of water, or he has to go to the bathroom.  Sometimes it's because it's a busy time in the clinic, there's noise and confusion, and he can't concentrate with all of the chaos swirling around, so he shuts down and tunes out.  Sometimes he's just scared of the equipment, or can't figure out how to get started, and doesn't know how to tell me.

And sometimes, the child just wants to wind me up or to see who's really in charge.  

When I sense that this is the case, I don't argue or scold.  I do nothing. 

If he is not endangering himself or anyone else, I remove myself, go sit in a corner, and gaze off into space.  When the child realizes that he has lost me,  and that I am not responding to what he is doing, he stops the behavior.  What he really wants, more than anything else, is my undivided attention, so if he's doing something that causes me to withdraw it, there is no incentive for him to continue.

I have learned over the years that withdrawing my attention from an unwanted behavior and simply waiting for the child to notice that I'm not engaging with him works far better than any amount of talking.  Any energy or attention that the behavior generates from me is enough positive reinforcement for the child to continue, but if his behavior is eliciting nothing from me, then there is no further incentive to go on.  If he wants my attention, he has to do something that will engage it.

{Ever read The Rules?  The best way to create the desire in another person to move towards you and reconnect in a relationship is to withdraw slightly.}

Another way I use the LRS is to be mindful of what I choose to respond to and what I don't.  When a child starts telling me he doesn't want to do something {usually in reference to handwriting} I don't answer.  It's so easy to get sidetracked into a power struggle and get nothing accomplished.  I just ignore the "I don't want to" and continue to patiently refocus the child's attention on what we are supposed to be doing.  Eventually he has to give up, because he is getting no response.

 LRS also works well with adults.  For example, I have a friend whose husband has a high pressure job and doesn't handle it very well.   He had the unfortunate tendency of coming home after work, full of frustrated aggression, and picking a fight with her.   She responded by trying to defend herself against his nitpicking and accusations.  Inevitably, she would be drawn against her will into an exchange that climaxed with him screaming obscenities at her.  She didn't want to divorce him,  but she didn't want to continue to live with him on those terms.

I suggested that when he arrived home and began to behave that way, she practice an LRS: give him a blank look, go back to cooking dinner or whatever else she was doing, and say nothing at all.   No eye contact, no response of any kind.  She could even quietly leave the room, without so much as a backwards glance.  If he followed her, she was to say, "I'll talk to you later, when you're feeling better."  Pretty soon he stopped doing it, because it wasn't getting him anywhere.

If you try an LRS, or implement incompatible behaviors, let me know how it goes for you in the comments section.

Wednesday, October 13, 2010

Handwriting in the Digital Age

I found this article to be beyond disturbing, but not for the obvious reasons.   Digital apps for handwriting are fun, but they are not a substitute for real teaching.

The reason the four year old in the article didn't want to write is because four year olds should not be writing!!!

Writing should not be introduced before the age of six, despite what anyone tells you.  Most children simply do not have the physical, visual or cognitive perceptual ability to do such fine, precise work.  Forcing them to do so before the necessary subskills are in place sets them up for a lifetime of bad habits, including slumping, using too much tension in their hands and arms to make up for the fact that they don't have fine motor control in their fingers, and dysfunctional grasps on their pencils.

All of these things make the act of writing physically uncomfortable and therefore unpleasant for the child.  Why not wait until he's ready to tackle such an important, complex task?

When I emailed the author of the article to tell her so, she countered with the idea that these days, with all of the digital options out there precluding the need to write by hand, if one waits until the child is at the advanced age of six, it may never happen.

Oh really?  What grammar school does not require its children to write in class by hand, all day, every day?  In New York, where I practice, all of them.  So why aren't they teaching the children how to do it correctly???

People, please.  Stop the madness!!!

Wednesday, October 6, 2010

Auditory Defensiveness

How do you know if your child is auditory defensive?

If your very young child is acting up or being consistently disorganized in a noisy classroom {or trying to escape by hyperfocusing on books or otherwise tuning out and refusing to participate in class} the chances are very good that he is sensitive to noise and is seeking a way to escape.

Auditory defensiveness is a clinical condition in which the child is highly sensitive to sound.  This means that sounds, noises, and voices that would not register at all, or would not be perceived as irritating to a normally functioning nervous system, are perceived as too loud, too high pitched, or otherwise difficult to tolerate, and so he must defend himself against them.  The child will do this by tuning out,  hyperfocusing on something else, holding his hands over his ears, attempting to escape the situation in which he finds himself by running away, or by acting out in such a way that the adults are left no choice but to remove him.

 Or the child might have such sensitive hearing that his nervous system will not only hear, but then alert him to things that other people don't notice.  These are the children who are constantly asking, "Did you hear that?  What's that noise?  Who's talking?" when you don't hear anything at all.  They are pulled out of their ability to attend by the sounds we hear but don't really register, such as traffic, people walking in the hallway, sirens, a telephone ringing in the next apartment, the sounds of plumbing, or the refrigerator fan.  Their ears simply do not habituate to any of it.  They are alerted again and again to noises that a normally functioning nervous system would recognize as irrelevant and filter out, and responding to them as if those things were a cause for alarm.  In the clinic where I treat, if one of my colleagues turns on the answering machine to listen to her messages or returns a phone call at her desk, all activity at the table will often come to a complete halt as the child becomes unable to focus due to the new, distracting stimulus.  Or when the reception area gets noisy, as it will in the afternoon,  an auditory defensive  child  will suddenly become completely disorganized, running around aimlessly or even wandering off altogether instead of participating in the game we have been playing.

I once had a child in my practice who was so sensitive to sound that if someone rang the doorbell while he was working on the suspended equipment, it would cause him to startle so intensely that he would lose his balance and fall.

It's tough to navigate school when your hearing is so sensitive.  The sounds of the bells and buzzers, lockers slamming, children shouting, the echoing noise of the bathrooms and the gym, the chaos of the playground and the cafeteria  -- all these things are experienced as an assault, and will put a child whose hearing is ultra sensitive on high alert and force him to stay there.  This limits his availability to learn, socialize, explore, and develop.   Unfortunately, one of the most common types of auditory defensiveness is sensitivity to high pitched sound.  In a primary school, that's all you hear all day long: the sound of women's and children's voices.  The problem can be so extreme that the child's receptive language is delayed as a result of tuning out voices all the time.

Another feature of auditory defensiveness is the inability to filter out background noise and concentrate on what is relevant.  An adult client who recently came for help told me that he habitually avoids restaurants, parties, and other social situations because his ears simply can't separate out voices from the background noise, and it's too difficult to hold a conversation.  The only time he can socialize comfortably is when he is interacting one on one in a quiet room.

There are a number of possible reasons for auditory defensiveness.  If the child has a history of ear infections, it could be that the infections have compromised the workings of the bones in the middle ear by leaving behind a sticky residue of pus.  These bones vibrate in response to sound and regulate the pressure in the inner ear.  If they are not responding appropriately, pressure in the ear builds up and it becomes painful.

In some cases, the muscles in the ears, which are responsible for dampening sound, are not doing their job properly.  Children who have low oral motor tone {which manifests itself as mushy, lisping speech or problems chewing food} often have this problem.

In the sensory gym, we treat auditory defensiveness in several different ways: directly, through the treatments we offer, and indirectly, by teaching the child and his caretakers strategies to compensate for his inability to filter and dampen sound.

When the child participates in high intensity vestibular activities, such as spinning, it works on the structure of the inner ear, which helps to normalize the way the child takes in sound.  So does the specially filtered music that many therapists have been trained to prescribe.  The vibrations through the bones in the skull and ear that are transmitted by the headphones can actually loosen up the internal structures that have become immobile due to ear infections.

Chewing can help a child dampen sound.  Gum is very good, if your child's teeth permit.  I would strongly advise you not to supply gum with artificial sweeteners.  Stick with regular, or use xylitol sweetened gum.  {Check those labels  -- I no longer chew Juicy Fruit or Bubblicious or give them to the children in the clinic, since even though they are not marketed as sugarless, they now contain aspartame.  Peelu and Glee gum are both Feingold approved.}

You can also give him non food things, which probably his teachers would prefer for classroom use.  I use clear plastic fish tank tubing from the pet store, which is very discreet, or you can buy small dog chew toys, which are designed to withstand merciless chewing.  There are therapy chew toys, of course, but they are expensive.

If the problem is extreme, you can try a set of inexpensive earplugs, which dampen sound but allow voices to come through.  I buy them in packs of several dozen for about three dollars and wear them on the New York subways and in movie theaters, which are always too loud for my liking.  Your child may like to  use these at family gatherings or other noisy venues.  If your child is historically difficult at these types of events, talk to his occupational therapist for strategies to help him manage, or limit your time to what he can tolerate.

Sometimes manual therapy can be exceedingly helpful in helping a child with sensory processing issues. If you are lucky enough to live in a city with a Canadian or British trained osteopath, who specializes in cranial osteopathy, you may want to give it a try.  Here in New York, I refer many of the children I treat to a Canadian trained osteopath, and she has been a tremendous help to almost all of them.  For a wonderful introduction to the powers of osteopathy, and a lovely portrait of the late osteopathic practitioner Robert Fulford, I recommend Andrew Weil's book Spontaneous Healing.

Wednesday, September 29, 2010

Making Handwriting an Automatic Skill

In my last post, I talked about some of the reasons why a child who is bright and articulate can't commit his thoughts to paper in a way that reflects his true abilities.  Today  we'll look at ways to work with children to make writing completely automatic so that that their minds and bodies are free to think more deeply and write more fluently.

 The more completely automatic the child's knowledge of letter formation, the more his mind is able to think about what he wants to say, instead of being stuck in the mechanics of how to write it down.  If your child is still thinking to himself, "Which way does the hook turn on the J?  How do I remember which one is b and which is d?  How does that Q go again?" He's not going to be able to let his thoughts flow through his fingers and onto the paper.  He has to attend instead to the problem of  just getting those marks down, and there is little room left in there for creativity. 

 This is even more the case if he has a dysfunctional pencil grasp and has a difficult time controlling the pencil successfully or suffers hand pain after writing for more than a few moments.

Unfortunately, most schools don't teach the mechanics of handwriting these days.  Teachers are not taught how to teach handwriting during their training, and I have had more than one teacher, who required that their children write every day, tell me that there was no room in the curriculum to teach handwriting!  

What happens instead these days is that the teachers pass out the workbooks and the children are expected to fill them out on their own and then turn them in. 

As no one is actively modeling and monitoring how the child is writing, he will most likely come up with some eccentric habits in how he forms letters.  Generally what I see in the clinic is that the child starts many of his  letters from the bottom, he takes several strokes to write a letter that just requires one or two, he mixes up capitals and lower case, he can't remember which of the lower case letters are taller and so will make an l the same size as an i, or an h the same size as an n.   He will have to stop and think about how to write some of the less common letters, and in which direction to turn the asymmetrical ones like J and P.  He will have a hard time leaving enough space in between the words.   He will ignore the lines on the writing paper and his words and numbers will float all over the place with very little organization.

If the child writes very slowly, concentrating on the act of writing instead of thinking about what he wants to say, he can keep his work legible, but when he starts to speed up, it all falls apart.

The only solution to this is to reteach the child the alphabet, emphasizing correct habits of placement, spacing and letter formation.  This means starting every letter and number from the top; making capitals, numbers and tall letters all the same height; writing letters with tails that go below the line, etc.

  The only way to reteach the child to write correctly is to drill, drill, drill.  Like learning to play a musical instrument, the only way to improve is to practice every day.  Short, mindful sessions are the key.  Especially for a very young child, practice sessions should not exceed five minutes.   Always precede the session with some movement {jumping jacks, a jog around the block, a trip to the park, a spin in an office chair} and a drink of water.  This will help the child focus.  So will a lollypop or a piece of gum.

If you are undertaking this at home, buy yourself some Handwriting Without Tears materials {instruction books, handwriting texts, slate, and double lined paper} and follow the instructions.  It's all there for you.

 If you live in an area with a good selection of pediatric occupational therapists, you may want to hire someone to work with your child.  Make sure that the therapist has taken the HWT training and shows you how to practice with your child at home in between sessions.

Make sure the child is sitting at a table where there is good lighting, he can sit with his feet flat on the floor, and the table is low enough so that there is free movement for his arms.  He may do better with a slant board.

I suggest starting with the capital letters and going on from there only after the child has mastered them completely. I won't go into the specifics of how I teach each letter because it's all laid out in the Handwriting Without Tears books.  Just follow the instructions.

When you see that he can write the capital letters of the alphabet automatically, with no hesitation or mistakes,  starting all of the letters at the top, have him copy some words that you have written and see if he is still hesitating before writing or starting some letters from the bottom.  If he is, he needs to drill further.   It is still not completely automatic.   Drop him back to just writing the alphabet.

 When he is able to copy the words you have written with no hesitation or mistakes, try spelling some three and four letter words for him and see how he does.  If he is still struggling, drop him back to copying words you have written and try again in a day or two.

It's easier to wait until all of the capitals are mastered before you move on to lower case.  The capitals are all the same size and all start at the top, which is less confusing.  {Two lower case letters, d and e, start from the middle.}

You can be creative in teaching the letters.  Have him write them by dragging a forefinger through shaving cream, confectioner's sugar, hair gel, chocolate pudding, etc.  Roll them in  Play-Do.  Buy a pack of foam letters and float them in the bathtub.  I strongly recommend the Handwriting Without Tears wooden pieces for preschoolers.

When he can write the words you spell with no mistakes,  have him write words that you dictate without spelling them.  When he is successful at that,  try writing a little story together and have him record what you both say.  Or you can play a game of Hangman or Mad Libs.   And thank goodness for Harry Potter  -- most of the older children I treat will happily write Harry Potter words for hours.  One little girl loved to write Harry Potter fan fic with me; we would spin endless silly yarns about Hagrid losing control of his Blast Ended Skrewts and all of the havoc they would create in the forest around Hogwarts, or we would make up stories about Tom Riddle and James Potter as schoolboys.  She learned to write as fast as she could think in short order.

If your seven or eight year old is struggling with print, you may want to switch him to cursive.  Many children do much, much better with cursive than they do with print, since the "flow" of cursive suits their hands and eyes better.   Handwriting Without Tears also has has a first rate cursive program.   It uses vertical cursive, which is much easier to write and read, there are no superfluous loops or ornamentations, which makes it easier to learn, and all of the connections are carefully taught.

If your child has trouble holding a pencil, I recommend making sure that he does craft activities and plays with toys that emphasize pinch between the thumb and forefinger.  Lite Bright, Operation, Jenga, and pop beads are good.  So are beading activities, weaving potholders on a little loom, leather lacing, and sewing.  Get rid of big markers and fat crayons and only have small nubs of chalk and bits of crayon, which will force the fingers to hold them in a strong pinch.

Or check out these adaptive grips.  {I don't require a child to change his grip unless I see that he really can't control the pencil very well, or he complains of hand pain.}

Wednesday, September 22, 2010

Why Can't My Child Express Himself in Writing?

Very often, when a child is referred to me for handwriting problems, the parent tells me that the child is very bright and articulate and has lots of ideas, but simply cannot get his thoughts down on paper:  "He will write a sentence or two when the rest of the class has written three or four paragraphs."

In order for a child to be able to write well, the act of writing itself must be completely automatic.  If it isn't,  the child will not be able to compose fluently, even though he has great ideas and can articulate them perfectly.  The cognitive, perceptual, and physical underpinnings {eye/hand coordination, visual acuity for close work, trunk and shoulder stability, fine motor control, attention span, visual memory and discrimination, and knowledge of letter formation} must be firmly in place in order for the child to be able to express himself to the best of his ability in writing.

What does it mean for the child's writing to be an automatic skill?

For those of you who remember what it's like to learn to drive a car, when you were first starting out, it was a stressful, exhausting task.  There were a million details to keep in mind every moment you were behind the wheel.  You had to focus continually on the coordination of your hands and your feet to steer, signal, shift gears, accelerate, and brake.   You had to remember to look in the rearview mirror every few moments and take into account all of the other cars on the road before you could turn, change lanes, or park.  You had to plan how you were going to to respond to traffic, make split second decisions, and remember all of the specific traffic laws.  Holding a conversation or thinking of something other than what you were supposed to be doing while trying to keep track of all of that would have been impossible, because doing it took every ounce of your concentration.

After a few sessions of practice, though, your body took over the details, and braking, shifting, signaling, accelerating, and steering became automatic.  You no longer had to think about it.  Suddenly, without any conscious effort on your part, your body was smoothly coordinating the gas, the brake, the steering wheel,  and the turn signals.  Your eyes began to automatically check the rear view mirrors.   You and the car were one, the car was responding to your commands, and it wasn't terrifying and exhausting anymore.  You didn't have to think about it!

  How did this happen?

 Repetition coupled with conscious thought eventually sent the skills you were practicing down to the lower lobe of your brain, the cerebellum.  This is the part that is responsible for automatic tasks, so when it took over, you didn't have to think about all of those things anymore behind the wheel.  Your conscious brain was freed from having to work at coordinating your body while driving, and then it was easy to have conversations, or to think about other things.

Any physical task we undertake to learn is mastered in the same exact way.  The forefront of our brains, the grey matter, is initially responsible for  coordinating our thoughts with our actions.  The more the task is repeated, the further it is sent to the lower parts, which eventually take over, and the task becomes automatic.  Any impairments in the above mentioned underpinnings {for instance, poor eye hand coordination, delays in visual perception or fine motor planning} will stand as an obstacle in allowing the cerebellum to take over completely.

For a child to whom writing has not become a completely automatic skill, the part of his brain that should be free to think about what he wants to say is caught up in trying to remember how to form the letters or is busy trying to coordinate the work of his hands and eyes.  I see this quite often. I ask the child, "write a capital letter A," and his pencil will hover uncertainly over the paper for a few moments before he begins.    If he can't remember how to write the letters, and must focus his attention on just that part, there's not a whole lot of grey matter available for him to come up with an organized, articulate, cohesive essay.  {Or for that matter, to solve the problems in his math homework. } The activity itself is such an arduous task that order to comply with the adults' demand that he write something, he's going to get the minimum quantity down,  just to get it over with, then breathe a sigh of relief.  He doesn't have the energy or ability as yet to be free to focus on the quality.

  Sometimes poor handwriting is one symptom in a whole constellation of problems. Other times, it's just poor pedagogy {schools are just not doing a good job of teaching handwriting these days} and can be resolved with some extra work on the basics and short, concentrated daily practice sessions.

If your child is doing well in all other aspects of school and life but has bad handwriting, he just may need to learn correct habits of letter formation and do some work on spacing, sizing, and organization to bring him up to speed.  If you suspect that this is the problem, you can try purchasing some Handwriting Without Tears materials, go over how to form the letters correctly, and work on drilling your child until his habits of letter formation are completely automatic.  {If you are putting a disproportional amount of time and effort into it, and it's not getting better, I suggest an evaluation by an OT specializing in sensory integration, and a visit to the neurobehavioral optometrist.  What this suggests is that those underpinnings need some work.}

What if a child is exceptionally resistant to writing?  If a child really has a difficult time of it, it's quite possible that he has a convergence issue with his eyes and can't see what he's doing very well.  He could be struggling just to focus on the paper.  Again, he's using up the part of the brain that should be functioning to formulate and express his thoughts in order to control his eyes and hands.  If the child rests his head on his non dominant hand and turns his head to one side while writing, this is a signal that his eyes are not functioning together properly.  A visit to neurobehavioral optometrist is in order.

Another reason a child won't want to write is a dysfunctional grip.  Many children these days who didn't get enough tummy time as infants, or who spent time in walkers in strollers instead of crawling, didn't develop sufficient shoulder stability or trunk strength to support the fine motor control in their fingers.  They hold their pencils in such a way that their entire hand and arm must be involved in the formation of letters.  This is awkward and often painful, so the child will have quite a limited ability to tolerate the activity.

In my next post, I'll talk about some of the kinds of things I do to help kids practice until they attain fluency.