Friday, February 1, 2008

Grandparent in Hospital

Dear Dr. Hackney,

My four year old has a very close relationship with my parents. Recently, my mother has been hospitalized and has a poor prognosis. What do we tell our son about my mother’s situation and about my father being sad and preoccupied during our visits? Is it okay for him to visit grandma in the hospital?

Sincerely,
Hillary
Mother of one, age four years


Dear Hillary,

I am sorry to hear of your mother’s prognosis. The idea is to be as honest as you can with your son without overwhelming him. You might let him know that “Grandma is very sick. She is going into the hospital, and the doctors are trying to make her well.” You might follow this by giving him ample time to ask questions. Try to answer any questions he has without giving too much information. If you avoid answering questions, children often come up with their own answers which can be worse than the truth. If you give too much information, it can add to their worries.

If it is okay with your parents and the hospital, it is fine to take your son to visit. You would do well to fully explain beforehand what he can expect during the visit. Let him know about IVs and other machinery in grandma’s room. Let him know that the nurses check on grandma every once in a while and about the other adults if she shares a room.

It is also fine to let your son know that “Grandpa is sad a lot these days. He really misses grandma not being at home and wants her to get well.” It might be helpful for your child to be able to take some action to help others in this situation. You might ask him if he would like to draw pictures for grandma and grandpa or take flowers to the hospital.

Sincerely,
Rene Hackney, PhD.
Parenting Playgroups, Inc.

Thursday, January 31, 2008

Recognizes Letters

Dear Dr. Hackney,

My four year old son recognizes all of his upper and lower case letters. What is the next step?

Sincerely,
Karen
Mother of two, ages four and three years


Dear Karen,

That is great he recognizes his letters. The next step, if he is interested, is to pair the letter shapes with their sounds. This means when he finds an “A” you say, “Yes, that is an ‘A;’ the ‘A’ makes the ‘Aaaa’ sound like ‘aaaapple’ or the ‘Eeh’ sound like ‘aaaacorn’” Then, you might think of all the words you know that start like apple or acorn. Strive to make this learning fun. You might go for a letter hunt in the grocery store by finding all the things you can that start with the B sound, and then really stress the B sound when you say, “Yes that is a BUHnana.”

To reinforce the shapes and pairings, you might also play some upper and lower case matching games such as Memory or Go Fish with pairs.

Sincerely,
Rene Hackney, PhD.
Parenting Playgroups, Inc.

Tuesday, January 29, 2008

Missing Preschool Days

Dear Dr. Hackney,

My four year old son, Nathan, is a very picky eater. I have read and tried all sorts of different tactics... unsuccessfully. I'm sure some (possibly much) is control related, but I'm not sure some of the issue isn't sensory.

I learned of a Picky Eater Group through a local private practice. They claim this class is geared exactly for kids like Nathan, and I'm ready to try anything. However, they have changed the times of the class, and it is now offered during Nathan's class time at preschool. He is in four half-days a week and would miss one day of school each week for the eight weeks that the class runs. I would like your opinion on whether you think I should enroll in the Picky Eater Group. Would that be too disruptive missing school? His eating issues have not impacted his health, and the pediatrician is convinced it is all a control thing. But it impacts my life greatly because he can't sit down to a regular meal. My goal is to get him eating the same food as the rest of the family. I hope to learn as much from the group as he does.

Sincerely,
Elaine
Mother of two, ages 1 and 4 years old

Dear Elaine,

Take the specialized class! It is preschool, and missing one day a week for eight weeks will be fine. The potential benefits far outweigh the extra day in preschool. I wouldn't try to make it back for that one hour a day - no need to wear everyone out for one hour, and he and you both may need time to relax following the group.

I also wouldn't make the fact that he is missing school for a day each week to do this a big deal with him. If the group isn't fun, then he has another point to his argument for not going - that he is missing preschool. Just put it on the calendar as the plan for the day rather than thinking there is a debate to be had over attendance.
Good Luck with this!

Sincerely,
Rene Hackney, PhD.
Parenting Playgroups, Inc.

Monday, January 28, 2008

starting school

Dear Dr. Hackney,

I need your help!!! My six year old daughter Amy is having some anxiety related to starting school soon. She has been having difficulty going to bed at night; this seems to be the only time it manifests itself. As soon as I move to leave the room, she starts fidgeting and says she needs to go to the bathroom. When we return to her room, she says she has to go again. Last night, we stopped the whole process and talked to her about what will happen the first day of school and also explained we are meeting her teacher next week. Is it too much to expect to have her get on the bus the first day? I worry that if she doesn't do it the first day I'm setting her up to depend on me everyday. She has a very good friend who will be riding the bus with her, but I'm not sure that will be enough to motivate her. We are thinking we may look into therapy to help her deal with anxieties.

Thanks, Samantha
Mother of two, ages 3 and 6 years


Dear Samantha,

I am sorry to hear this has been hard already. My older daughter had very similar nights (and mornings) when she was a bit younger. I'm going to write about the global things first, then more practical.

Between now and the time school starts, think lots of downtime and empathy. Downtime is unscheduled, low key playtime. It is fine to have friends over and to go out, but I wouldn't run everyone ragged in the last few days. When children are tired, their worries seem overwhelming. Downtime also lends itself to more open conversation. I would talk about school with her when she brings it up or when she seems particularly anxious – just like you did the other night - stopping everything and talking about her first day.

The empathy component is to remember that her worries are hers and they are real, and the reasoning, reassuring and logic do little to actually help. Empathy (labeling emotions, talking her through and suggesting ways to cope) allows her to own those feeling and validate them so you and she are on the same page. Empathy helps children to calm because they feel understood. So, first approach with empathy before the fix.

Prepare her as best you can, which you are already doing. Talk her through the daily schedule, and answer questions whenever needed. You might go play on the school playground or have playdates with other kids going to the same school. When you meet the teacher, you might ask if you can take a picture of her and the teacher together, and then get it printed that day, so she can have it to hold onto until school starts. You might also use the picture to make a craft project - a poster for her room or a card to give the teacher on the first day, etc. or do both with copies.

Before you meet the teacher next week, you might sit with Amy to find out if she has anything she wants the teacher to know or wants you to ask the teacher. If it were me, I'd tell her tomorrow to think about those things and then talk about it over the few days before meeting the teacher. This gives Amy a sense of control of the meeting. She has her questions answered.

Talk to her about the bus idea and how fun you remember the bus to be and games/songs you remember while riding with your friends. If another good friend rides the bus with her, maybe you all could meet 10 minutes before and board together. Maybe you could assure her that you will step on to be sure she sits with someone she knows. It is best if she can face it and get on the bus the first day but don't be defeated if not. It may be that she takes and few days to feel confident about school and then can better face the bus. If the bus doesn't happen the first day, I would plan a goal date that it will, such as the second day or Monday of the second week. Something realistic so it doesn't turn into a year. Getting on with a friend might be the thing - especially if you make a date out of it.

Remember too that your attitude goes a long way, and she is reading you more than you know. If you are apprehensive and worried, the morning won't go well; she gets that, at least to some extent. So, put on your brave face and smile through her upset. You want to send the message that the bus and school are safe and fun places, it is where she should be, and that you have no doubt she will enjoy herself and want to ride the bus everyday. If you can start to anticipate that it will all go WELL, it will go all the better.

You might check out Helping Your Anxious Child: A Step by Step Guide for Parents by Wignall, Spence, Cobham and Rapee.

Sincerely,
Rene Hackney, PhD.
Parenting Playgroups, Inc.