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Archive for the ‘
Early Childhood Development ’ Category
By Bette Freedson, LICSW, LCSW, CGP
Introduction
"If Only I knew then…….." How often do working mothers, or any mothers, say that to themselves as they think back on the toddler ages of their kids?
Toddlerhood comes on with a fury of needs and activities that keep mom's reflexes responding and her head spinning. There is barely time to meet every need and deal expertly with every situation whether the mother is working inside or outside the home—or, as is often the case– both. Realizations of what could have been done differently, and lessons learned, are often revealed in reflections of the past.
What some of the older moms have learned through experience might be helpful to some of the younger moms now in that wild, wooly and wonderfully sweet period called Toddler.
Twelve Tips
Here is what I learned then– that I know now–and wish I had known then…
- Believe in the unconditional love of your toddler for you.
- Set realistic and reasonable limits.
- Stay consistent in your reactions and responses as much as possible.
- Keep disciplinary measures short and to the point.
- Depersonalize your child's reactions to discipline, limits, and you.
- Keep in mind that children of toddler ages are concrete thinkers, and are not born with innate understanding of concepts grownups may take for granted.
- Know that curiosity is normal. Give answers that are short and make sense. Toddlers do better without tons of detail.
- Inform yourself about normal emotional development.
- Trust you have no need to fear their fears. Know that it is okay for them to need reassurance and a sense of security.
- "Me" time is important. No need for guilt.
- Adopt the motto: This too shall pass. —Second motto: Chaos will not make me crazy.
- Know you deserve to have support.
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Bio:
Bette J. Freedson, LICSW, LCSW, CGP is the author of the "Relax and Learn Seminars: Skills For All Seasons," a repertoire of workshops based on the principles of effective stress management. In her work Ms. Freedson emphasizes the power of the mind/body connection to improve decision-making, increase effective coping, reduce time wasted in conflict, boost morale and productivity at work, and create greater harmony in relationships.
Ms. Freedson practices clinical social work at The Listening Place in Lynn, Massachusetts. Besides maintaining an additional private practice in South Berwick, Maine, Bette is Social Work consultant to Maine School Administrative District #35.
Tags: Bette Freedson, Early Childhood Development Tips
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Introduction
Ms. Tara Moser specializes in working with children, adolescents, and families. She has a Master’s Degree in Social Work from the University of Central Florida and is a Licensed Clinical Social Worker in the State of Florida . Ms. Moser also specializes in Play Therapy with children 3 -18 years old, as well as incorporates pet therapy into some of her clinical work utilizing her two dogs Abbey and Bode. She is one of the founding members of the Southwest Florida/Naples Play Therapy Chapter, after serving as an officer on the Central Florida Chapter of the Florida Association of Play Therapy.
Ms. Moser has worked in a variety of therapeutic roles including foster care, non-profit family counseling, non-profit individual counseling, elementary school based counseling programs, adolescent drug prevention/intervention, behavioral therapy with autism, domestic violence counseling, and supervised visitation, in addition to her private practice.
Q. How do I help my child identify their anger?
Teaching children to identify their anger involves teaching them how to identify all feelings that they have. It is important to be sure your child can understand the difference in feeling happy, sad, worried, scared, angry, and many other feelings we all experience throughout our lives. It is also important to let your child know that all those feelings are natural to experience as long as they know what they feel and show it appropriately. If your child learns to show their anger properly and in a controlled manner, it can be a good way for them to express something that has upset them. If they do not learn this, they can hurt themselves or others both physically or emotionally.
A good way to find out your child's ability to identify feelings is ask them to think of a time they were angry and describe what their body was doing. Did their face turn red? Did their breathing change? Did their muscles tighten? Did they want to cry? Scream? Run? By being aware of their physical reactions, it can help them to connect the feeling.
Q. What can I teach my child to help soothe their anger?
Teaching different types of anger management techniques to your child will help you and your child best identify what means are most helpful for them to release their anger. Some ideas would be to teach them to walk away from the trigger, use words instead of fists or feet, go for a run, take deep breaths, punch their pillow, use an angry ball, turn music up loud and sing along loudly, or count to 10. There are fun ways to prepare a child who has trouble with their anger to control it prior to an anger episode. Creating angry balls can be fun for families to do and all you need are inflatable balloons and then the filling of dry rice, dry beans, or sand. You then fill the balloon so it is slightly expanded and tie it off. The angry ball can be squeezed, thrown on the floor, mashed between palms or under foot. A fun way to teach deep breathing is through bubble blowing. By showing your child that you have to blow out slowly to create the best bubbles instead of quick blowing shows them that when they are angry they need to be aware of their breaths.
Q. Why does one of my children react one way to anger and the other react completely different?
Every person reacts differently to their feelings and anger is one of those feelings that this difference can be seen more prominently. It is important to teach each of your children different techniques so that they may decide what works best. It is recommended that you are aware of each child's unique processing of anger to know what they may need. If you notice they become so out of focus from their anger, it is important you be able to calmly provide them those options.
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To find a social worker in your area who can help you with issues like these, please click here.
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Everyone has a gender identity. Gender identity is our internal sense of being male or female. For most people, our basic awareness that we are male or female matches our physical body. When we're born, people decide if we're male or female based on our genitals. But for children and adults who are transgender, their basic sense of being male or female – their gender identity – does not match their body. So a transgender person may have a male body, but feel inside that they are female. Or a transgender person may have a female body, but feel inside that they are truly male.
Children and adolescents can be transgender, just like adults. In fact, a small percentage of all children are transgender. Children understand gender differences from a very early age. And transgender children strongly identify with the other gender, often from age two or three. Because we don't talk about transgender people with children, adolescents or even adults, children who are transgender lack basic information about who they are, and struggle with feeling like they were born in the wrong body. And adults typically react as if there were something wrong with these children, as well.
In truth, there is nothing wrong with these children. But since very few people understand that it is natural for a small percentage of the population to be transgender, people don't know that you can have male genitals and still be female or have female genitals and be male.
Transgender children who express their "real" gender identity can become extremely unhappy and depressed when adults try to prevent them being their true selves. Being transgender is not the cause of their distress. Instead, not being understood and feeling like there is something wrong with them causes them to suffer. And pressure to change their core sense of who they are causes emotional suffering, as well.
Many parents are concerned that something they did made their child become transgender. This is not true. Nothing that a parent or anyone else does can change a child's gender identity. Being transgender is not caused by divorce, neglect, wishing you had given birth to the other sex, using fertility drugs to conceive, encouraging your child to play sports too often or not enough, or other parental thoughts, behaviors or experiences. We don't know exactly why some people are transgender. But science is showing that transgender children are most likely born that way, right from the start. Even before children can verbalize their sense of gender, they start to tell us who they are through their play and choices for clothing, hair styles, and toys. Once they are old enough to talk, transgender children strongly insist that they are "really" a boy, or "really" a girl.
Transgender children and adults have always existed throughout history in a wide range of cultures. In our society, until recently, few parents spoke openly about having children with gender identity "problems."
In the past, parents with transgender children tried to force their children to conform with their expectations of what is "appropriate" behavior for males and females. From very early ages, these parents would try to make their children behave according to their child's biological gender. Although these parents were trying to help their children fit in with their peers and with social norms, their transgender children were severely traumatized by being forced to deny and change their true nature.
Over time, medical and mental health providers have learned how best to support transgender children and their families. Parenting approaches have changed, and more parents and doctors understand how to support children with special needs. We now understand that all children need the love and support of their families and the adults in their lives to thrive.
Research shows how parents and caregivers should respond to having a transgender child. The most important thing parents can do to promote their child's well-being and to reduce their risk is to love and accept them. This means allowing them to live in ways that make them happy — just as you would with any child. For example, let your transgender child play with the toys they enjoy. Let your transgender child dress and wear their hair in the way that is most comfortable for them.
Supporting your child's transgender behavior is not easy. But research shows that by loving and accepting your children as they are, you can help them lead happier, healthier lives – and literally save their lives.
In families where parents highly pressured their children to conform to gender expectations, young people were five times more likely to report symptoms of depression, nearly four times as likely to attempt suicide and to use illegal drugs, and twice as likely to be at high risk for HIV infection, compared with those who parents did not pressure them to conform.
Most people have a sense of their gender identity between ages two and four. If your child expresses a transgender identity since early childhood, it is unlikely they will change their mind as they age. Their sense of themselves will only deepen. For example, a 12-year old child who has consistently stated that he is a girl since age three will most likely remain transgender throughout life.
Parents and family members of transgender children need information and support to raise a child in a way that others don't always understand. However, you are not alone. There are thousands of families doing the same thing and facing the same challenges as your family. Here are some resources to help you get started.
- Gender Specturm Education and Training: Education, resources and training to create a more gender sensitive and supportive environment for all children.
- Gender Odyssey Conference: National conference for families with gender variant and transgender children.
- Family Acceptance Project: Research on LGBT adolescents and young adults and their families. Developing family education materials, and assessment and intervention materials for providers.
- To see social worker Caitlin Ryan’s interview for the ABC Television News Program 20/20 story on transgender children broadcast in April 2007, click here.
- To see the entire ABC News 20/20 story on transgender children entitled Facing Rejection, click here.
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Tags: Caitlin Ryan, How do I know if my child is transgender?, social work and transgender, Stephanie Brill, trangender child, transgender, transgender kid
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Introduction
Most women don't know that by having one drink while they are pregnant exposes their child to the leading cause of mental retardation: Fetal Alcohol Spectrum Disorders (FASD). FASD is an umbrella term that describes the range of effects that can result from prenatal alcohol exposure. These effects may include physical, mental, behavioral, and learning disabilities that continue into adulthood.
Fetal Alcohol Syndrome (FAS), the most severe FASD, is characterized by irregular facial features, growth deficiencies, and brain damage. Children diagnosed with FAS may also have associated behavioral and cognitive problems that include mental retardation, learning disabilities, attention deficits, hyperactivity, poor impulse control, and social, language, and memory deficits. FASD are 100 percent preventable, yet they constitute the leading cause of mental retardation in the United States.
The only way to prevent FASD is to avoid drinking alcohol during pregnancy. However, more than one in five women report using alcohol in the first trimester, while one in fourteen report use in the second trimester, and one in twenty report use in the third trimester. Binge drinking, which is known to increase the chance of an FASD, is reported by one in nine women during the first trimester, while one in thirty pregnant women report high-risk drinking.
A diagnosis of FASD can be very challenging for both the child and family. Caring for a person with an FASD over the course of their life can cost as much as $5 million, and require concentrated attention to their immediate and long-term educational, emotional and physical needs. However, an increased understanding of the difficulties a child faces and adaptation to these needs can lead to a very rewarding relationship. Here are some tips for parenting a child with an FASD:
If you are parenting a child with FASD:
- Don't expect them to act like other children. They aren't like children who do not have brain damage.
- Catch them being good and overdo the praise. Praise them several times for every correction.
- Understand that they may need more time to complete tasks that you give them.
- Give one instruction at a time, and be sure to get their eye contact when you are talking to them.
- Don't try to change multiple behaviors at one time. Focus on one or two things at a time. Let the rest go for now.
- Try to find activities that you can enjoy together. Having fun, laughing, and sharing positive experiences will be good for both of you.
- Take good care of yourself so you can take good care of them.
Obtaining an early diagnosis of FASD is important for several reasons, including the increased risks for:
- Poor bonding, and a failure to thrive
- Increased risk of abuse and neglect
- Early removal from home, with multiple placements
- Fewer resources to address cognitive and behavioral problems
- Early school failure due to inadequate recognition of cognitive and behavioral difficulties
- Social and emotional isolation of the child
- Delinquent behavior and involvement in the criminal justice system
However, early intervention can help:
- A person receive appropriate services
- The family adjust and improve parenting by increasing self-awareness and understanding
- Facilitate intervention into multiple social environments (school, extracurricular activities, home)
- Facilitate an understanding of the child's challenges, and a focus on their individual strengths and interests
(Adapted from Diane B. Malbin, FAS Resource Coalition)
Only trained professionals can diagnose FASD. If you think your child has the following, you should consider getting an assessment:
- Sleeping, breathing or feeding problems
- Small head or facial or dental anomalies
- Heart defects or other organ dysfunction
- Deformities of the joints, limbs and fingers
- Slow physical growth before or after birth
- Vision or hearing problems
- Mental retardation or delayed development
- Behavioral problems
- Known maternal alcohol use
To obtain an assessment for FASD, you can go to a developmental pediatrician, an FASD clinic, a genetics clinic, or another specialist. The National Organization on Fetal Alcohol Syndrome (NOFAS) has a website directory of available FASD services at www.nofas.org/resource/directory.aspx.
Once children with an FASD reach school age, they are likely to face several challenges in this new environment. If you are parenting a school-aged child with FASD, you will want to watch for and seek help for:
- Visual and auditory processing problems
- Difficulty with reading comprehension
- Memory problems
- Attention deficits
- Problems with social skills
- Problems following multiple directions or rules
- Difficulty with math or abstract reasoning
- Inability to understand cause and effect
- Difficulty organizing tasks and material
If a parent is contacted by their child's teacher who suspects any of the above behavior or learning problems, they are urged to request psychoeducational testing, which can assist in the identification of central nervous system dysfunction and appropriate diagnosis.
For children who are already identified as having an FASD, several tips have been identified when working with these children:
- Do not use metaphors, similes and words with double meanings or slang
- Be consistent in your oral directions
- Repeat instructions several times if needed
- Follow a routine and provide consistent structure
- Keep it simple and minimize distractions
- Be specific and give instructions one step at a time
- Supervise closely (they are more apt to be naïve, trusting and lack social skills)
FASD is 100 percent preventable if women do not drink while they are pregnant. However, everyone can play a role in preventing an alcohol-exposed pregnancy. The U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration (SAHMSA) suggests that:
- Physicians advise patients to abstain from drinking during pregnancy.
- Spouses, partners, friends and family members support pregnant women who choose not to drink.
- Alcohol treatment programs give priority to pregnant women.
- Schools teach young people about the dangers of drinking while pregnant as a part of underage drinking prevention efforts.
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Introduction
Congenital heart defects are the most common form of birth defect. Heart defects are three times more common than muscular dystrophy, five times more common than childhood cancer, and thirty times more common than cystic fibrosis. More infants die of heart defects than any other birth defect. Approximately one in every 100 to 120 babies is born with a congenital heart defect. Eight in 1,000 kids or about 25,000 children are born with a heart defect every year; yet others report that this number is closer to 30,000 babies to 40,000 babies. With today's advances in medical technology and early diagnosis, most congenital heart defects can be corrected. There are about 800,000 children and one million adults in the United States who are survivors of congenital heart defects.
It is a structural abnormality in the heart due to a malformation in utero that is present at birth. The defect(s) involves the walls of the heart, and/or the valves of the heart, and/or arteries or veins near the heart. These abnormalities disrupt the normal flow of blood through the heart such that the blood flow slows down, and/or blood goes in the wrong direction/wrong place, and/or passage of blood is blocked completely.
Signs/Symptoms in INFANTS:
The Congenital Heart Information Network (CHIN) reports the following signs and symptoms in infants and Children. Please call your child’s doctor, if you child experiences any symptoms.
- Tires easily during feeding (i.e. falls asleep before feeding finishes)
- Sweating around the head, especially during feeding
- Fast breathing when at rest or sleeping
- Pale or bluish skin color (cyanosis)
- Poor weight gain
- Sleeps a lot–not playful or curious for any length of time
- Puffy face, hands, and/or feet
- Often irritable, difficult to console
Signs and symptoms in CHILDREN:
- Gets out of breath during play
- Difficulty "keeping up" with playmates
- Tires easily/sleeps a lot, change in color during active play or sports (looks pale or has bluish tint around mouth and nose)
- Frequent colds and respiratory illnesses
- Slow growth and weight gain/poor appetite
- Complains of chest pain and/or heart pounding
Causes of Congenital Heart Defects
Most children who have a congenital heart defect do NOT have a family history or any risk factors. It is thought to be an unknown random occurrence. Researchers continue to study the role of genetic and environmental factors.
Congenital heart defects are found in 40 percent of people with Down Syndrome and 20-40 percent of those with Turner's Syndrome. Researchers have found links between some types of birth defects and the mother's exposure to particular drugs, diseases, or chemicals during pregnancy. Researchers have also found that there is a higher risk of a congenital heart defect if two or more family members have a congenital heart defect. Discuss your child's particular heart defect with your doctor or genetic counselor.
Treatment options vary and will depend on the specific situation because there are 35-40 different types of congenital heart problems. For example, some problems will need to be watched, some will need medication, and some will need surgery such as cardiac catherization or open-heart surgery. Please discuss treatment options with your doctor.
- Lots of research is being done about children who have experienced congenital heart surgery and risk for developmental delays.
- Recovery depends on the particular type of congenital heart defect, pre-operative status, operative, and post-operative complications.
- Those who have surgery may have physical and/or emotional scars to deal with
- All survivors of congenital heart defect surgery are at increased risk of additional heart problems as they age and need regular cardiac check-ups.
- Most survivors of congenital heart surgery will require antibiotic medications be taken before most dental procedures (ex. cleanings, extractions) to prevent an infection spread by the blood to the heart that is called "endocarditis."
Please discuss your child’s particular condition with your doctor.
Diagnosis may happen at during pregnancy, at birth, or sometime later on. There are 35-40 different types of heart defects and different treatment options.
- Shock is usually among the initial feelings, i.e., ”Is it really true?” The shock to parents is often greater when they have no family history of congenital heart defects, a routine prenatal sonogram that was normal, and was told she was having a ”healthy” baby.
- Denial is usually among the initial feelings. There may be a feeling that the doctors are wrong.
- Guilt is a also common reaction. Did the parents contribute to this problem in any way?
- Shame may be felt about whom to tell or not tell about the child’s medical history.
- Confusion about treatment options and/or what the future will be.
- Parents may be overwhelmed by new medical vocabulary and large number of medical staff.
- Parents may experience a sense of hopelessness about the child's condition and future.
- Parents may blame themselves or their partner. However, they should keep in mind that that the cause of most congenital heart defects is unknown and thought to be random.
- Parents may isolate themselves because they do not know anyone else with a child with this problem.
- Sadness about the loss of the "perfect" or "ideal" child is a common reaction.
- There may be a fear of death of the child, a "real" or “legitimate” fear with some diagnoses.
- Parents may be angry at God, their partner, and/or the doctors about why this happened to this family.
- Bargaining for a better diagnosis by getting other expert opinions, if there is time.
- Stigma about what this means to the family and the child's future
- Uncertainty about this child's future and about having future children who have a congenital heart defect.
- Changes in family routines/schedules/medical appointments
- Stress that turns into parent headaches, stomach upsets, unable to eat/sleep
- New caregiving roles for certain family members
- Possible delays in caregiver returning to work due to medical appointments
- Concerns about possible financial impact, if family doesn't have health insurance
- Concern about financial impact, if primary caregiver delays returning to work
- Gathering information about the diagnosis and running to other doctors trying to get a better diagnosis
- Stress about any symptoms and when and when not to call the doctor
- A focus on the "sick" child at the expense of paying attention to other children
- A process similar to grieving in some ways but not time-limited and the immediate care of the sick child is important
- Cyclical or recurrent feelings over time
- More complex than any book/article can describe
- Individualized, due to the variety of disabilities and the family
- Affected by cultural and/or religion standards about mourning or grieving
- Recurrent, especially at developmental milestones (ex.school entry, graduation)
- Recurrent, especially if there is another child
- "Bonding" or connecting with others who have had similar experiences
- Speaking in public/telling stories in counseling or support groups or in families
- Assuming leadership positions in support groups or volunteering at organizations
- Caring for the child appropriately so that you can enjoy his/her steps of progress
Provide Counseling to Couples, Parents, and Families:
- For individuals, couples, and/or families to discuss feelings about the diagnosis, options, stress of caring, and future issues.
- To discuss parent concerns about children's developmental milestones.
- To discuss couples’ concerns about having more children with congenital heart defects
Provide Counsel to Siblings of Children with Congenital Heart Defects:
- About breaking the news to them about their sibling's health condition
- To explain their sibling’s diagnosis and treatment
- To convey that it is no one's fault that it happened, no one caused it.
Provide Counseling to Older Children (when applicable):
- About a planned hospitalization by encouraging visits, books, and bringing personal items from home
- About dealing with fears and concerns before and after surgery
- About absences from school for medical reasons
- About teasing from peers about their scars or physical restrictions
- About following restrictions on physical activity in gym class
- About the importance of taking medications
- About issues of "disclosure" of their medical history to friends, others
- About issues of feelings of isolation or "differentness"
- About the importance of keeping regular cardiac check-ups throughout life even when one is feeling well.
- To increase self-esteem, socialization, and independence
- About a healthy lifestyle, diet, exercise, no smoking
- Suggest that the child bring his or her favorite music and headphones to the hospital as music therapy has been used with hospitalized children. Music is soothing and the goal is to increase the child’s comfort and relaxation. Also, suggest the child bring art supplies, like crayons, etc.
Encourage Families:
- To discuss child's developmental concerns with pediatrician
- To take their children to cardiologists regularly because children with surgery for congenital heart defects are at risk of future issues.
- To find out from the cardiologist if their child’s particular heart condition requires antibiotics for dental work.
- To speak with genetic counselors to find out if their child’s particular heart condition is genetically linked.
Assist Families:
- Find support groups for families and/or siblings, consisting of people dealing with similar congenital heart defect issues
- With referrals for services (ex. Early Intervention) with permission
- Of children (birth-age18) with severe medical problems, and limited income and resources, with referrals to Social Security to apply for SSI
- With referrals to genetic counselors to discuss risks for future children
Advocate for Legislation:
- Requiring all infants to be screened for congenital heart disease before being discharged from the hospital. If this is not possible, hospitals should at least test those babies who have been found to have “heart murmurs.”
- Requiring all children be tested for congenital heart disease before they enter school.
- For patient education about congenital heart defects at hospitals via courses for expectant parents in Lamaze, newborn care, CPR/First Aid.
How to Find a Pediatrician and/or Check on “Board Certification” Specialty Status:
Organizations
Many provide information, membership, newsletters, resources, events, and support groups.
- Adult Congenital Heart Association (ACHA), 6757 Greene St., Suite 335, Philadelphia, PA 19119. Phone # 888-921-ACHA www.achaheart.org
- American Heart Association (AHA), 7272 Greenville Avenue, Dallas, TX. Phone # 1-800-242-8721 www.americanheart.org
- Art with Heart, P.O. Box 94402, Seattle, WA 98124, 206-362-4047)
www.artwithheart.org (has activities and art for hospitalized children)
- Birth Defect Research for Children, Inc. (BDRC), 800 Celebration Avenue, Suite 225, Celebration, FL 34747, Phone# (407) 566-8304, Website: www.birthdefects.org
- Children's Heart Foundation P.O. Box 244, Lincolnshire, IL 60069-0244 Phone # 847-634-6474 www.childrensheartfoundation.org
- The Children's Heart Fund at Mount Sinai Hospital, One Gustave Levy Place, Box 1201, New York, NY 10029. Phone # 212-241-7456 www.childrensheartfund.net
- Circle of Hearts, P.O. Box 662, Kenmore, NY 14217. www.cohearts.org
- Congenital Heart Disease Information Network (CHIN), 600 North 3rd St., 1st fl., Philadelphia, PA 19123. Phone# 215-627-4034 www.tchin.org
- Helping Hearts, Inc., 601 Elmwood Avenue, P.O. Box 631, Rochester, NY 14642. Phone # 716-275-6108 www.helpinghearts.org
- Kids with Heart: (NACHD) National Association for Children's Heart Disorders P.O. Box 12504, Green Bay, WI 54307 Phone# 800-538-5390 www.kidswithheart.org
- Little Hearts, Inc., P.O. Box 171, Cromwell, CT 06416. Phone # 866-435-HOPE www.littlehearts.org
- March of Dimes, 1275 Mamaroneck Avenue, White Plains, NY 10605. Phone # 1-888-MOD-IMES www.marchofdimes.com
- The National Family Caregivers Association (NFCA). 10400 Connecticut Ave., Suite 500, Kensington, MD 20895, Phone # 800-896-3650 http://www.thefamilycaregiver.org
- (NHLBI) National Heart, Lung, and Blood Institute of the US Dept. of Health and Human Services/National Institutes of Health: www.nhlbi.nih.gov (go to A-Z Index, then Congenital Heart Disease)
- NYU Medical Center, Pediatric Cardiology, Mend-A-Heart Support Group NYU School of Medicine, 530 First Ave., New York, NY 10016 (212) 263-5940 Dana Connolly, N.P., www.med.nyu.edu (search: Mend-A-Heart).
- Parent to Parent USA: This is a national organization with chapters in almost every state. Matches parents to other parents who have children with similar special needs. http://www.p2pusa.org (click on state info. to find the local chapter nearest to where you live.)
Online Support for Caregivers
Children's Hospitals
National Association of Children's Hospitals and related institutions: www.childrenshospitals.net (Click on Hospital search to locate one in your area). Most "children's hospitals" have details on their website about congenital heart conditions and treatment options, research, etc. Boston and Philadelphia, in particular, have lots of published research in medical journals on pediatric cardiac conditions.
Online Medical Journals
Free e-mail notifications about new articles in your area of interest when you sign up. While most provide free abstracts, there is usually a fee for complete articles. Contact the author of the article directly, if possible, if you want the entire article and can't afford the fee; the author might be able to send you a free copy.
Online Health Encyclopedias
- American Academy of Family Physicians: www.familydoctor.org
- Congenital heart defects: www.congenitalheartdefects.com
- Discovery Health: www.health.discovery.com/ (type directly to your browser)
- General Pediatrician’s View of the Internet: www.generalpediatrics.com (Cardiology)
- Health A to Z: www.healthatoz.com
- iVillage: www.ivillage.com or go directly to: www.parentsplace.com (newborn, health)
- Kids Health: www.kidshealth.org (Parents, then medical problems, heart&blood vessels, CHD)
- Mayo Clinic: www.mayo.edu (click on Health Info., Heart Disease,Congenital Heart)
- Medical Student: www.medicalstudent.com (Click on Pediatric)
- Merck Manual of Diagnosis & Therapy: www.merck.com (see Pediatrics section)
- National Center for Biotechnology Information: http://www.geneticalliance.org
Genetic Alliance-advocacy, education, empowerment. (Lots of information on the website about all genetic conditions, including heart defects)
- Pedi Heart: www.pediheart.org
- http://www.physorg.com (Research news on Health & Medicine-free daily e-mails)
- Rx List/The Internet Drug Index: www.rxlist.com
- Web MD/eMedicine; www.emedicine.com (Pediatric Medicine, then Cardiology)
OR www.emedicine.com/ped/contents.htm (Cardiology)
Parent-Friendly Articles
- Coping with Congenital Heart Disease in Your Baby. (1999, April 1st). American Family
Physician, 59 (7). American Academy of Family Physicians. Available at: http://www.aafp.org/afp/990401ap/990401d.html
- DeGroat, J. (2007, June 1st). Parenting a special needs child. The Jewish Press Magazine, p. F4.
- Experts offer parents guidance on avoiding congenital heart defects. (2007, June 8th)
HealthDay News. Available at:
http://heart.health.ivillage.com/newsstories/expertsofferparentsguidanceonavoiding.cfm?general=NL_HEART
- Graham, E. (2007, Spring). Cliffhanger: For the first time patients with severe congenital heart disease can live to see middle age… Dream: The magazine of possibilities (Children's Hospital Boston), p. 16-19.
- Griener, G. (2007, March). Easing hospital anxiety. Parenting, p. 35.
- Helliker, K. (2005, Dec. 20th). A baby's heart: The case for screening newborns for
congenital heart defects. The Wall Street Journal, p. D1.
- Jenkins, L. (2006, February 14th). With White's triumph in the halfpipe, snowboarding
finally gains an icon. The New York Times. (www.nytimes.com)
*This Olympic winner had a heart surgery as a baby.
- Ouelette, E.M. (2006, Aug.). Bringing home a special-needs baby. Babytalk, p. 24.
Also available at: www.babytalk.com (click on Search, type in article title)
- Sanghavi, D. (2005, June). "Broken Hearts." Parents, p. 85-88. Available at: www.parents.com (Click on: Kids, Health, Newborns)
- Schaff, R.V. (2006, Feb.). Healing broken hearts: Kids born with heart defects can lead
normal lives, thanks to modern surgical practices. American Baby, p. 29-32.
Also available at: www.Americanbaby.com
- Scribman, D. (2007, Feb. 20th). From the ‘dark ages' of heart surgery, a lesson for today.
Available at: http://www.nytimes.com
- Seidman, E. (2007, July). Lessons from Max…Having a son with special needs has taught me to stop obsessing about how my child doesn't measure up to other kids his age. It's something all parents should learn…. Parents, 60-65.
- Smith, L. (2003, May). Music ideas for hospital stays. Available at: http://www.tchin.org/resource_room/c_art03.htm
- Smith, P.M. (1984, March). You are not alone: For parents when they learn that their
child has a handicap. NICHCY Newsletter: National Information Center for
Handicapped Children and Youth. Washington, DC. *Note: This organization was renamed NICHY, the National Dissemination Center for Children with Disabilities: www.nichcy.org
- Steele, R. (2007). Heart murmur in a newborn. Available at: www.ivillage.com
- Wernovsky, G. (2005). The emerging recognition of school and behavior problems in children with congenital heart defects. Available at: http://www.tchin.org/resource_room/CHDSchool.htm
- Whiteman, N.J., & Roan-Yager, L. (2007, June). Having your own life, despite caring for your special needs child. PARENTGUIDE, p. 18. Available at: www.parentguide.com
Book List for Parents
- Note: Books may be available at www.amazon.com or www.barnesandnoble.com
- Baby Hearts Press: http://www.babyheartspress.com/ (This publisher specializes in parent-friendly and parent-written books about experiences with CHD)
- There is an extensive list of book reviews at: www.tchin.org (The Congenital Heart Disease Information Network) (click on book reviews) AND www.achaheart.org (The Adult Congenital Heart Association) (click on store).
- Kramer, G.F. & Maurer, S. (2001). The parent's guide to children's congenital heart defects: What they are, how to treat them, how to cope with them. Three Rivers Press: New York. (www.randomhouse.com) (ISBN: 0-609-80775-7) If looking on the library shelves: (RJ 426.C64 K73 2001 OR 618.92'12-dc21))
- Neill, C. A., Clark, E.B., & Clark, C. (2001). The heart of a child: What families need to know about heart disorders in children (2nd Ed.). Baltimore, Maryland: John Hopkins Press. To order: (www.press.jhu.edu) (ISBN# 0-8018-6636-7) If looking in library shelves: (RJ 426.C64 N45 2001) OR (618.92'12043-dc21)
- Wild, C. J. (1999). Heart defects in children: What every parent should know. New York: Wiley. To order: (ISBN: 0-471-34735-3)
Early Intervention Resources for Parents of Children with Developmental Delays
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Introduction
Tantrums or "acting-out" behaviors are natural during early childhood development. During a tantrum a child may kick, scream, hold his breath, or behave badly in other ways. Unfortunately, this is often a child's response to not being allowed to do something or have something he wants.
Tantrums in the two to three-year-old are fairly common and start to decline by age four. They are the child's way of protesting and signaling to us they really want to get their own way.
During this stage, children are just coming into their own and do not like to be thwarted. They are driven by inquisitiveness and strutting new skills. They have mastered walking and are ever increasing their motor skills. They are ready for exploration, but haven't yet internalized rules, so they think everything is fair game. And while we may think these young children can totally understand us, in truth, this is still a year and more away. How parents respond is critical to tantrum management.
So it is not enough that we tell them what to do, we must also show them and physically direct their play and areas for exploration. When young children get involved in things they shouldn't, it is important to simply re-direct them to approved activities and areas of play. You may find yourself doing this dozens upon dozens of times per day! Once will never be enough at this age and this is why parenting two-year-old can be such a demanding time.
While redirection is the key for managing behavior at age two, if tantrums persist at age three, ignoring such behavior is the next strategy parents should try. Ignoring tantrums teaches the child that this behavior doesn't work and so they often stop. Ignoring really means withholding attention for misbehavior, but, and very importantly, it is also a must that parents do provide attention for appropriate behavior. This is usually in the form of verbal feedback, praise, hugs and kisses.
If ignoring the tantrums isn't working at age three, you can start to use “time-out” as a consequence. Time-out means time away from anything reinforcing or otherwise pleasurable – like sitting on the stairs or in the corner, or quietly on a chair.
While the general rule is one minute of time-out per age of child, time-outs that are much briefer and a matter of seconds, say 5 to 15 seconds are often MORE effective than longer time-outs. In the life of a three-year-old, 5 to 15 seconds is a long time, but it is not so long that they forget why they were sent to time-out in the first place. The key to effectively using this strategy is to apply a brief time-out each time the behavior occurs. It is better a brief time-out follows at each instance of a tantrum, than only long time-out.
If tantrums persist even with the use of time-out, ask yourself if there are other stresses in the home. Issues of illness, marital violence or discord, alcohol or drug abuse in caregivers all can affect parenting and child behavior.
You may also want to check your child's hearing. Many children at this age have had a number of recurring ear infections (otitis media). With each re-occurrence of an ear infection, fluid remains in the ear and diminishes hearing capacity. They will grow out of it, but in the meantime, your child may actually be hard of hearing and as a result, language delayed. Therefore even though a little older, they may not hear you or understand your verbal commands. This is something you should check out with your pediatrician.
If all the above fails, fear not, but do ask for help. Call a local parenting center, a counselor or social worker or even your family doctor. Odds are something is going on that probably because you are so close to the problem, you do not see. If ever you feel like spanking your child, then give yourself a break to stop yourself. Have a cup of herbal tea, warm milk, a hot bath, or go for a walk. Do anything that works to give you a little distance and a chance to collect your thoughts. Just be sure your child is appropriately supervised while you grab a moment alone. Sometimes this "parental pause" is just the ticket to regain composure and reenter more effectively.
Tantrums? Follow these steps:
- Redirection
- Ignore
- Time-out
- Check for other stresses
- Check hearing
- Ask for help
- Take a break
- Learn to deal with your own anger or frustration.
Lastly, you can’t offer too much praise, love and affection to a child. Give generously throughout the day!
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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Tags: development, hearing, ignoring, redirection, social worker, stress, take a break, tantrums, time out
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