Sunday, October 04, 2009

October 4th- Sinking in

We're only on day 4 of October and Down syndrome awareness month, and already I'm posting to ask for advice rather than to just give some informational stuff about Ds or life with kids that have it.

I had a post all planned out for today. It was about communication- or lack there of. One day this month you'll get to read it. But for today it plays only a small role in the difficulty we're having. Because even if there was available language, there must also be comprehension. And that's what we're missing.

I've written before that Emma was being aggressive toward Lynae, but now it's lessened a lot and we're doing much better with the two of them being within arm's reach and still both safe. Unfortunately, this aggression hasn't gone completely away though.

Emma's always been one we had to watch around younger kids. She has a tendency to go up to a friend's twins that are less than 2 years old and petite for their ages and to just knock them right over. No reason about it. She'll pull Micah and Brianna down if they're in her way or if she wants something they have. She'll throw a book or toy when she's done with it with no regard for who or what may be around or what damage may be done. Basically, she just has no understanding that what she does may cause someone else to get hurt.

Realistically, this may be in part due to the fact that her own response to pain is sorely lacking. She will fall on the tile with a hard smack to her head and not react. She'll scratch herself, pop joints out of the socket, and flick at the skin on her thumbs when she's frustrated. She laughs when her hair is pulled. She doesn't cry as a response to pain unless it's something really major. She's cut her head open when falling down and hitting the stucco on the outside of the house and not even blinked twice as she sat back up and scooted away. Pain doesn't phase her like it does others, and when it does, her reaction isn't 'typical'.

So brings the question-- how do you teach a child that doesn't understand pain not to inflict it on others? How do you teach her the social graces of not steamrolling people that are smaller than her or knocking down people that are in her way? How do you drill in that throwing large hard objects isn't ok and that books and frisbees are indeed different items?

Tonight as we drove in the car Emma was sitting next to Lynae. We had her carseat sun shade down so Emma couldn't reach her, but we heard her fuss. I quickly turned to see Emma had 'snuck' the shade up (it clicks but she'd done it so we wouldn't hear it... the previous 2x she did it we heard it and stopped her!) and had reached in to the carseat. She can only reach Lynae's hand, but she was messing with the sleeping baby and yes, I was concerned that she might hurt her. Emma was reprimanded, but as I told Mike, having Lynae next to Emma is like putting a musical toy on the seat next to her and telling her she can't have it. She really wants to mess with it, but she's not allowed. Over and over again she loooooooooks. Then she reaches. Then she touches. And eventually she grabs and hopes she gets away with it because her self-control is used up. When she gets in trouble she then pouts and fusses and the process starts again because she really wants it!

That wasn't the end to the day today, though. This evening after the kids were in pajamas I was in the guest room setting out clothes for the week for all the kids. Emma and Micah were playing with Mike nearby and I heard a quick short reprimand to Emma and Mike run to get to her. She had Micah pinned down and was playing with his feet. Yep, he's big enough to hold his own, but it's still not a good idea. Emma was reprimanded, moved away from him, and she pouted a minute, seeming to understand that she was in trouble. Then she did it again.

So what's the answer?? How does this work?? Though of course we're very careful about keeping each of our kids safe and we supervise them and separate them as necessary, it's still something that there's no way to completely avoid without keeping Emma out of play with the other kids all together. And that's NOT an option by any means.

The hard part is, they're seeing this at school too. This week I got a note home from her teacher saying she was hitting, kicking, and pushing another child in her class. Now, she's in a wheelchair or other 'device' much of the day, so the child likely got into "her space" to have been reached, but this is still inappropriate behavior. And who knows, Emma's pretty flexible with long arms and legs... the kid could have been 2' away and Emma just finaggled her way over there to do it.

Tomorrow afternoon I'm meeting with Emma's teacher- a sweet and caring Christian woman who I'm GLAD to corroborate with on Emma's learning and I hope she may have some ideas for curbing this behavior. In the mean time (or after!) I've come to my greatest resource for learning about these lovely difficulties... parents who have been there! :)

How do you get it to sink in???


  1. I will be curious to read the replies to this myself Meredith. My twins get aggressive towards each other. They push, pull hair, bite, and have head butted before. We just constantly tell them No Biting, No Pinching, No whatever... We have actually put together a story book that their TSS reads to them daily explaining that pinching and biting hurt and people do not like that.

    I'm not sure what it is that sets them off but watch out when they do. Well like you when it happens at home its bad enough but when it happens at school it gets a little embarrassing. I think that repetition of telling them NO will have to sink in eventually and redirecting, redirecting, redirecting. Good Luck to you!!

  2. We had some similar problems with Wes when Casey was an infant. Our doc had us put Casey in a pack n play to keep him safe, as there was just no explaining to Wes at the time about hurting. I also used an infant sling or baby carrier strapped on me A LOT so I knew the baby was safe. I'd suggest swapping car seats if possible so maybe K is near the baby instead. Have you tried short time outs with Emma? Those seem to work well for Wes, but I'm not sure given Emma's history if that would be appropriate.

    I've got boys who get rowdy, you know, and I'm not sure if I allow more physical contact than most. But I think they are sort of self managing at this point. They seem to learn, oh yeah, I don't like being tackled/hit/scratched/kicked and the behavior has decreased. So maybe there is hope for the future? I choose a line to draw (like no pushing or hands in faces) and deal with those lines only, and reprimand for those. Does that make sense? There is a beauty to learning from siblings. I think they are the best teachers.

  3. I'd look into applied behavioral analysis or ABA. Its usually recommended for children with autism- and is very effective for this population. However, Ive heard that it isn effective also for children with other cognitive and behavioral challenges (which are after all often part of autism). For a child with significant processing issues feedback from the world seems confusing, overwhelming, and haphazard- so they dont know HOW to learn. ABA is a highly structured teaching method that breaks a targeted skill down into its smallest components and teaches in this very simple repetitive cause and effect manner. Once one component is learned, you move to the next. Ideally, the child learns how to learn. An ABA specialist would help to develop targeted skills (like placing toys in a basket instead of throwing when she's done), break them down (ex, she places one toy in the basket before she's given another), and implements the program.

  4. I am posting this as a mother, not neccessarily one of SN. My 15 year old son has DSI, and exhibits many of what I would call autistic behaviors.

    Meredith, I have read a couple of books by Temple Grandin. She has autism and the books are fascinating to me.

    Anyway, as I read your post the thought that kept rolling through my mind is teach an alternative. No bite to a child that has trouble comprehending doesn't give an alternative. To us what seems obvious, to a toddler or a child with a toddler comprehension, is impossible.

    What she might need is something else, something that is always allowed INSTEAD of biting... as in NO BITE, we touch hands. Or No Pushing, we clap or we say "MOVE". She needs to have something to replace what is a learned behavior to her. This is also esp. true of any child that has yet to learn all the words they want to know.

    That is one of the benefits of teaching a child sign language before they can talk. They WANt to communicate, but can't and that can cause major frustration.

    As an example, when my 4th child turned 2 he started biting his siblings. If you would have watched the scenario unfold, you would see that he bit out of pure frustration at having toys taken away. That is when we developed a trading system. I left off of sharing as the focus and instead did trades. It worked and teh biting stopped.

    Anyway, just my 2 cents. It sounds like a frustrating situation. Emma is a darling girl, and I love to hear about your family! .

  5. I don't have much advice to help Emma stop these behaviors, but I do have something that might help Emma re-organize her sensory input to recognize varieties of touch. Have you tried deep pressure? It's when you squeeze firmly, not hard enough to actually hurt, but almost. Work your way down each extremity, ending with giving each finger or toe a squeeze. Other sensory processing exercises might help her become more aware of her own body's sensations. A neurodevelopmentalist or an ND trained OT or PT would be really great at setting up a program for Emma that you (or someone!) could do at home.

  6. Wish I had some input, unfortunately I have two that have high pain tolerances and don't realize how rough they are with others. All I do is repeat, repeat, repeat, if you figure anything else out, post it and I'll do it to. ;o)

  7. Our sp needs son is the same way.He shows no emotion to pain at all.He also hits pinches and smacks his siter.Everytime he does it i grab his hands and hold them look right at him and say NO THAT HURTS.I have to be repetative but he is finally getting it.He smacked her then stopped realized and said that hurt i sorry.This has taken many many months of looking in his face and holding his hands to get him to stop.Its hard when they really dont understand what they are doing is wrong.

  8. Hi Meredith,
    Looks like you have some very good advice to sort through here. Our son has DS also, and when he is unable to understand a concept I refer back to something he can understand. I have him look at my face and say "That makes mommy sad" or whatever is appropriate for the situation. I show the emotion on my face and even though he doesn't understand "why" I feel that way - he does understand that I do feel that way. It has worked for our little guy.
    Good luck with it all. You are doing such a wonderful job!!
    ~Lauri St.Pierre

  9. We were at a b'day party just Sunday and a 3 yr. old DS girl who is tall and a bit aggressive was trying to push my dd who is 2 and small and has a new prosthesis foot . My first reaction was to rescue my dd but then I watched for a few seconds and saw that my dd was not complaining or fearful and then I saw the DS girl try to push again and I saw my dd spread her feet and plant herself I did not interfere and thought to myself .....this is a good experience for her to learn how to balance herself and learn how to deal with other children. Because surely it will happen again somewhere sometime and I may not be there to help. The little girl walked off after seeing that she could not just push her down. Good lesson for them both. Had my dd cried or seemed fearful I would have intervened....but for that moment it seemed wise to do nothing and just watch. All our little ones are still learning and we need to give grace for the moment in their little lives.