Crying in therapy

By Natan Gendelman - http://www.enabledkids.ca

For many parents, family members and therapists, crying can be a big obstacle to overcome when teaching and working with a young child. While it may be difficult to manage this sort of behaviour, it is important to understand why a child is upset as well as the things you can do in order to see his way of thinking. In my opinion, the key to handling this issue is to try to figure out where the child is coming from and be willing to view things from his perspective. In doing so, you will be able to tell the difference between when he is simply protesting something new or if he is hurt and needs you to stop and assist him in his function.

Seeing from a child’s perspective

For this reason, it’s good to take a step back and observe your child. We often believe that since we are older and “wiser,” our primary goal is to teach a child the things that we know and understand. However, every child is different, and each has his own dreams, wishes and fears. In this respect our first response should be to learn as much from him as he learns from us. The ability to understand a child becomes really important especially when you are working with him to improve his function. In response to unfamiliar situations or tasks, a child will often cry because he does not want to do them. This makes it important to know the difference between crying as a response to new experiences or in response to actual injury. If he is really hurt, you will need to stop and find out what is happening. However, if this is not the case it is important to persist and continue with treatment.

Why is this the case, you may ask? If a child is only protesting, explaining things to him will be much more effective than stopping treatment every time he begins to cry. If you stop, he will automatically assume that crying will be the solution to stop you from making him do certain things. It is a self-defense mechanism, which is why you need to explain what, how and why he needs to do something in order for him to be able to understand. In this way, he will come to comprehend what is being taught and you will be able to continue with his treatment.

The effect of this approach

To demonstrate how effective approach this is, I’ll tell you about one of my experiences with a young girl that had cerebral palsy. As I worked with her, I made sure to explain every function and its purpose to her for each new activity we did together. During the girl’s treatment, her mother told me, “You are the first therapist that she didn’t cry with.” My question to her was: did anyone talk to the girl and explain what she was supposed to do? When the mom said no, it was easy to understand the differences she saw in her child’s learning and behaviour.

Whenever I encounter these situations, I ask myself: why do we have to assume things about a child and try to make him follow them, when we can simply ask a child what’s wrong and then explain what we are going to do? If a child is not willing to do the things which he should, then the approach to take is to explain, follow up, and repeat it again and again and again. This is how a child is able to learn and eventually follow. When we do everything for a child however, instead of simply assisting him as he learns to do things for himself, he starts to assume that everything can be done for him. If this were the case, then why should he have to follow instructions and strive to accomplish more? Without being given a reason for doing things, a child will continue to protest and cry whenever he comes across new situations.

So my final advice to parents, therapists and caregivers alike is this: communicate with your child. Explain why he has to perform certain functions and show him how to do them. It is important to be patient, persistent and understanding, for you are the one who will teach him what’s wrong, what’s right, what’s true and what’s false. As you help to introduce him to the world, remember: your child is bright, and it’s up to you to support and guide him as he continues along the path of development.

If you have any questions or comments, feel free to leave a comment down below or email me at natan@enabledkids.ca. Thanks everyone!

Don't wait to treat your child

Elaine, the grandmother of 3-month-old Debbie, called me regarding her granddaughter’s condition. Concerned, she described to me that Debbie was not turning her head to the right side. She did not grab things with her right hand, and did not move her right leg. In addition, when picked up by her hands, she was pulling herself back, and did not try to hold her head in an upright position.
Her daughter-in-law consulted a paediatrician, and was promptly told, “There is nothing to worry about.” But Elaine, who grew up raising four children, knew that there was something wrong.
When the child was brought to me, I saw what Elaine had been talking about: Debbie had a “clenched fist” on her right side. She disregarded her right side as a whole: she did not want to turn her head, or move her right leg or arm. When she was pulled upwards from a lying down position, she did not tip her head forward.
All these are the first signs of cerebral palsy. Unfortunately not every paediatrician or physician is able to recognize them in their early stages. Thankfully for Elaine, she discovered it in time and we were able to reverse the effects of her granddaughter’s condition.
Development isn’t something that starts after a certain age. A child develops physically and mentally starting from pregnancy. This is why it is really important to talk to your child, and make him feel that he is a part of your life even before birth. Fresh foods (preferable organic fruits and vegetables) and fresh air are the best friends of your child. Remember that he deserves the best of what you can give him.
Once the child is born he begins to discover the world. His mental development is inseparable from his physical exploration. If a child moves—he learns. His discovery comes through touch (sensory development), speech and communication, and his daily function.
But if a child does not move, or is having difficulty reaching for an object, usually his parents are the first ones to do it for him. As a result of our “help,” he does not learn to do new things. In a way, we are discovering the world in his place, when it has to be opposite: he has to discover the world for himself, and by himself. We are here just to guide and assist his learning. This way we can teach a child to make his own decisions, and to discover the world on his own.
Life takes your child through the stages of development in a certain order with one goal in mind: to prepare him for the steps ahead. If you can see that your child is having difficulties achieving these milestones, this should ring an alarm for you.
Do not rely on the opinion of others. You are the ONLY person who really knows your child. Consult multiple child experts, and conduct as much research as possible. Look for a second or even third opinion. In some cases, look into therapies and additional services that may help your child.
The earlier you start up treatment, the easier it is to deal with the difficulties your child is facing. Stay positive. As a parent, you make all the difference in his development.

For more articles like this, visit www.enabledkids.ca.

Having the first signs of cerebral palsy doesn’t set your child’s future in stone

One morning, I received a call from a woman named Elena who wanted to ask us some questions regarding her two month old granddaughter, Debbie. Elena had noticed that when Debbie’s back was touched, she would arch her back and throw her head backwards as well. Her right arm was always clenched in a fist, and she did not move very much. Elena told us that she had already gone to a pediatrician, but had been told that these were not signs of anything serious. As a mother with three kids herself however, she knew that there was something wrong. Considering the signs she had described, I knew that we had to bring Debbie in for some treatment. Once the girl was brought in, I could see why Elena was concerned. Debbie’s right leg did not move as much as her left, and her right hand was always clenched. Her body was stiff and tense, and when we tried lifting her off the ground, she would not tilt her head forward like a child would usually do.

These may be the first signs of cerebral palsy. If a child does not follow an object with his or her eyes, or does not want to turn his or her head to one side or the other, this may also indicate that something is wrong. The same can be said if a child does not grab for things with his or her hands, or if he or she is delayed in rolling, crawling and sitting. Should this be the case, it is best to start your child’s treatment as early as possible.

In the first few months of life, a child starts going through the normal stages of development. He or she learns how to roll, sit up, crawl, and move his or her arms and legs. If a child misses one of these milestones however, it will have a snowballing effect on the rest of his or her progress. For example, if he or she is not learning to get up and sit, it will impair his or her trunk mobility. As a result, the head or legs will not be used as much and the child will be unable to crawl properly. If we address these issues before they hinder a child’s growth and progress, we can minimize the effect of the condition in his or her daily life to a point where it is undetectable. That is why today, Debbie is completely cured, running and playing just like any child.

In many situations, both the medical and therapy community use a child’s diagnosis as a label accompanied by the claim of “permanent disability.” Yet, I have seen individuals with cerebral palsy who are able to lead independent, fulfilling lives. As a parent, it is up to you to teach your child about the world and to guide him or her through any difficulties he or she may come across.

So, if you see any behavior that seems atypical for your child, take initiative. Don’t be afraid to ask questions, and gather as much information as possible. Go to more than one physician, and make sure to consult experts who deal with neurological disorders more often than your general pediatrician. Also, even if your child does get diagnosed, don’t let yourself doubt his ability to develop and become the best he can be. You must believe in your child’s abilities, and focus on making realistic goals and teaching him or her how to achieve them.

My philosophy is that there is no treatment, only life. That is why as a therapist, I believe that there are no exercises to learn, only function. When I have a patient, I only guide him or her during the function so that he or she will learn to do it independently. I also request parents to continue working with their child at home so that there is no disruption in the teaching and learning process. As a parent, don’t let anyone set your child’s future in stone, and remember: your child is capable of things no one can predict.

For more articles, visit http://www.enabledkids.ca