Monday, May 24, 2010

Lower Your Expectations

A few weeks ago I wrote a post I called Great Expectations, about how children love it when the adults in charge have high standards for them.  This post is about examining our expectations for very young children, and whether they are realistic.

Recently I got a call from a mother who was concerned about her four year old son, who was having tantrums and being oppositional much of the time.  He had OT services at school, but not sensory integration therapy.  She had heard that I was a sensory integration specialist and was hoping I would be able to help him with his behavioral issues.

I asked her about his schedule, mostly to figure out a treatment time, but as she elaborated, his problems became clear to me.  He went to school five days a week from nine in the morning until three thirty in the afternoon.  The ride in the schoolbus took an hour there and an hour back, so he was leaving home at eight and coming back at 4:30.  This meant that last winter, he was coming home at dusk or in the dark.

At school, he was participating in twice weekly sessions, 45 minutes each, of OT, PT, speech, and play therapy.  His mother had enrolled him in a couple of after school activities as well, thinking he could use the extra push. Gymnastics was one of them, and I forget the other.  I asked her how he liked his gymnastics class.  "He hates it!"  was her prompt response.

I said that it seemed like quite a long day, especially with the addition of two hours on the school bus. {I told her: I have to commute two hours every day on the subway and it's annoying and exhausting, even though I use the time to read or do paperwork, so I can only imagine how he feels.  He has to sit still for all that time, with nothing to occupy him, since he can't read  yet.}  I told her that I thought that all of those therapies and extracurricular activities added up to a lot of time for a four year old, especially a child with low tone and sensory issues, to have to be "on."  There was a long silence, and she said, "It's way too much, isn't it?"  

I said that I thought that it probably was, and asked if his time at school could be reduced.  She immediately answered that she was going to take him to school herself instead of putting him on the bus, decrease his time at school by a few hours every day, and cut back to four days a week.  She also said she would cancel all of his after school activities and give him more down time. 

I said that it sounded like an excellent plan, and that adding OT might be too much for him right now, so we should wait and see how he did with the new schedule.  I made some suggestions for things to do at home with him, including a strong recommendation that he be taken to the park every day to play on the swings, which he loved. We decided that we would not schedule OT for him until we saw how the new schedule was impacting his behavior.

I didn't hear anything after that, so I called her a couple of weeks later to ask how he was doing.  She said that a few days after she had decided to reduce his school time, instead of lying awake for a long time after he had been put down, he began to go right to sleep.  He was sleeping in his own bed for a solid ten hours a night, without waking up and crawling in with his parents.   He was getting up in the morning on his own, instead of having to be awakened, happy and refreshed, instead of cranky.  He had mostly stopped complaining about not wanting to go to school.

His mother had decided to use all of his new free time to take him to the park and on walks every day, and do fun things together, just the two of them, and as a family on the weekends.  She reported that his tantrums had stopped, and that she no longer needed any help for managing his behavior.

I wonder if this heavy scheduling and high expectations for such young children is limited only to large cosmopolitan cities, like Manhattan, where I live and practice, or if everyone is forgetting what is realistic for small children to be able to handle.

Since everyone is entitled to my opinion, if it were up to me, most three year olds would not be in school.  Many children, especially boys, don't have the emotional maturity to do well in a school setting at that age, and are not getting the movement opportunities there that they need for optimal development.  Everything a child knows about the world, until he is about six years old, comes from his physical relationship to it, so every time a child is required to sit still instead of moving his body and exploring, he is prevented from developing his strength, coordination, and visual skills, which are what support the ability to sit for long periods and attend, to write, and to solve problems.  Preferably after the age of six!

If your very young child, who spends much of his day in a highly structured environment, being expected to sit still much of the time and follow an elaborate set of rules, is being oppositional, seems anxious and stressed out, has a hard time sleeping, has uncontrollable tantrums, and just can't get it together, is it because too much is being expected of him at his young age?

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