Parenting a Child with Special N

Parenting a Child with Special Needs | What does BiPolar Disorder Look Like in Children?
Treatment of BiPolar Disorder for Children and Teens | Welcome Nancy Peterson Walz | Groups
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Volume 2, Issue 1 - Fall 2004

Parenting a Child with Special Needs
by Mark Myers

Raising a child has many joys as well as responsibilities and, at times, challenges. When a special needs child misbehaves, we are faced with the question: is this child misbehaving because of the disability, or to test limits as most children do? Is this behavior centered around “I can’t” or “I won’t? Sometimes children genuinely are unable to consistently do what they are asked to do. To appropriately understand and intervene in their behavior, we may need to look a little more closely at the behavior.

Look for Patterns
It is helpful to look for patterns in behaviors. Most behaviors serve a purpose. A function of negative behavior could be attention getting, avoidance of an activity, or even a reaction to stressors at school, home, or in the community.

If patterns do exist, interventions may take different forms. An example would be a father working many hours. His child may be rude to him or behave angrily for no apparent reason. Examining the patterns in this case reveals that the child is seeking the father’s attention even if it is negative attention. In this case, it would be more helpful to try to spend extra time with your child than to focus on consequences. Simple changes can make a huge impact on the child’s behavior.

You may also want to talk with school teachers and counselors to see if they notice any patterns. The more people involved, the more insight you gain. Children cannot always communicate what they need or want. It is often easier for them to express themselves behaviorally then verbally. This is especially true of the special needs child.

Consequences are a Necessity
We need to understand that consequences happen all of the time and we as adults certainly experience them. Allowing our children to experience some of the inevitable consequences of their own behavior is a necessary teaching tool. These are called natural consequences.

If there are no obvious natural consequences, choosing consequences that relate to the offense are helpful. For example, a teen violating curfew may lose the privilege to go out for a weekend or may have to demonstrate responsible behavior by maintaining an earlier curfew for several weeks.

Try to make your consequences as immediate as possible. Delays in presenting consequences could confuse the child, and render the consequence ineffective. A child may lose insight into why something was taken away and this is important when we are using consequences as a learning experience.

Be Positive
Offer positive reinforcement as much as possible. Children with special needs tend to be exquisitely sensitive to criticism. As such, negative reinforcement may often backfire resulting in a lack of confidence. Praise success and positive behavior as much as possible. If at all possible “catch them being good.” Target the behavior you want to see and offer positives such as praise, hugs, and so forth. Kids will frequently repeat “good” behaviors to experience these rewards again and again.

Parenting is a Team Effort
When it comes to presenting rules, the first step is to get on the same page with your child’s other parent. Children figure their parents out pretty early in life. Even infants are able to get mom and dad to react by crying. In divorce situations, it is especially important to coordinate your efforts. As long as parents are divided, there will be less focus on the child’s behavior.

Consistency is Key
Make sure expectations are presented in a way the child understands. Most children are visual learners. Posting rules would be helpful in several ways. It offers children the clarity of expectations and parents the structure and consistency they may need to enforce rules. This does not allow any wiggle room for children to back out of expectations. For children who do not read, picture cues can be helpful.

Keep it Simple
As parents, we oftentimes, try to present so many expectations, the child gives up trying to comply. Children with special needs have difficulties with organizing and problem-solving. Too many rules could be overwhelming.

Prioritize
Prioritize what you want and what you expect from your child. Ross Greene, PhD in his excellent book, The Explosive Child, suggests conceptualizing three baskets for behaviors.

Focus on Solutions
We need to send the message to kids, “I love you, but you can not behave this way.” Instead of trying to discuss the issue at the time when the child’s problem-solving ability is impaired, discuss and brainstorm alternatives when the child is emotionally available to discuss the issue in a rational manner.

Focus on “What can we do to solve this problem the next time it happens?” Plan the adults’ response and come up with a non-threatening code word or phrase to signify that everyone needs to take a break before the situation gets out of hand.

“Why ask Why?”
Parents often focus on values. They come into therapy concerned that their children do not have the values they would like them to have. A parent reports frustration that the child is not chipping in for household work, or getting a job to save money, or helping out when needed. When a child is not meeting the value criteria that is set for them by the parents, this could lead to lecturing, reminding, and preaching. Most kids learn to tune this out at an early age. It would be more useful to focus on behavior.

The reason why they are doing dishes is not as important as having the child complete the task as directed by the parent. Values may or may not be internalized by a child until later in life. How many adults can say that when they were kids they thanked their parents for rules such as curfew? It is later in life that we appreciate the rules our parents gallantly enforced.

Resources:
Greene, Ross. The Explosive Child. Harper Collins, 2001.
Heininger, Janet. From Chaos to Calm. Perigree Trade, 2001.
Severe, Sal. How to Behave So Your Children will Too. Penguin, 2003.

What does BiPolar Disorder Look Like in Children?
by Janet Myers

Diagnosing BiPolar Disorder in children and teens can be complex, at best. In children, the symptoms can include mood swings, destructive behavior, physical outbursts or temper tantrums, immature behavior, sleep problems, oppositional behavior, risky behavior, early sexual behavior, and distorted thinking. It has also been noted by Papolos and Papolos that children with BiPolar disorder tended to exhibit difficulties in infancy, precociousness, separation anxiety, night terrors, fear of death and annihilation, raging, oppositional behavior, sensitivity to stimuli, problems with peers, cravings for carbohydrates and sweets, bedwetting and soiling, hallucinations, and suicidal ideas. A child exhibiting such a varied array of symptoms would benefit from an evaluation to properly diagnose the illness.

Many of the symptoms of BiPolar Disorder in children and teens are very similar to other disorders which makes diagnosis very difficult for example, oppositional defiant disorder (ODD), conduct disorder (CD), attention deficit disorder with hyperactivity (ADHD), obsessive compulsive disorder (OCD), and so forth. Disorders can also occur simultaneously which further complicates the picture. As such, it is important to work with a child psychiatrist and therapist to help sort out and appropriately intervene with the illness.

Parents often feel very helpless when dealing with the BiPolar child. They describe feeling as if they are at the mercy of moods of the BiPolar person. Help is available! There are a variety of therapists, professionals, and resources available to assist families.

Treatment of BiPolar Disorder for Children and Teens
by Janet Myers

Understanding the illness
Educating the child, adolescent, family, and school personnel about BiPolar Disorder make living with this mental illness a much more manageable experience. Understanding BiPolar Diorder enables the family and school to respond to the child or adolescent in a productive fashion. Children and teens who understand the impact of their disorder on others make better choices for their health. They are also more likely to respond to interventions when they are feeling out of control.

Perception vs. Reality
Children with BiPolar Disorder view the world through the lens of their illness. This impacts their relationships with others. They often misunderstand social situations or interactions between people. As such, they will tend to see others as “the enemy” and adults as “forcing” them to do things they do not want to do. They need to learn to “check out” their perceptions before reacting.

Medication
The reality of BiPolar disorder dictates that medication will be an essential component of treatment. One of the greatest challenges that BiPolar clients and family members face is remaining convinced of the need for medication when things are going well. For more about medication and BiPolar Disorder see the resources at the end of this article.

Keep a Record
Understanding your child’s moods and recognizing signs that he or she is beginning to cycle (ie. Characteristic mood swings associated with BiPolar Disorder). There are several good ways to record this information. There are several charts available for order through the books listed at the end of this article. These can be somewhat complicated, at first, but once you’ve put in the effort, you will better understand the course of your child’s illness and how best to manage it.

Identify Triggers and Plan Responses
Charting will enable the family to identify triggers for mood changes which allows the child and parents to plan responses to predictable behaviors. The plan will vary from family to family, but will allow parents to intervene in challenging behaviors. For example, when the child has an explosive outburst, “Our best response is to remove the audience, let her calm down on her own, and re-approach discussion at a later time.”

Choose Your Battles
There are many times that parents report feeling out of control of their child or adolescent. This is never more true than in the case of a child with BiPolar Disorder. As out of control as the parent may feel, the child experiences that ever more acutely. Parents need to be on the same page, as much as possible, to be able to decide when and where to take a stand with their BiPolar child or teen.

It is very helpful for parents to decide in advance what are situations which they are willing to ignore, situations where they are willing to compromise, and situations where full-compliance is expected and not up for negotiation. Some negotiation allows these out of control children to exert control in acceptable ways, however, this can go too far. It is necessary to keep a balance that enables parents and child to have their needs met, for the family to run smoothly, and for the child to learn how to function in the world.

Resources:
Miklowitz, David. The BiPolar Disorder Survival Guide. New York: The Guilford Press, 2002.
Papolos, Demitri and Janice Papolos. The BiPolar Child. New York: Broadway Books, 1999.
Singer, Cindy and Sheryl Gurrentz. If Your Child is BiPolar.
www.bipolarworld.com
www.nami.org

Welcome Nancy Peterson Walz

Myers Counseling Group is pleased to announce the addition of Nancy Peterson Walz, LCSW, ACSW to our Staff. Ms. Walz has extensive experience working with individuals, couples, families, and groups. She works with individuals who range in age from 7-70 with diverse clinical diagnoses, ethnic, religious, and developmental disabilities. She especially enjoys working with parents whose children have special needs. For more information about Ms. Walz and her services, see our about us page.

Anger Management Groups are available for a variety of ages from children to adults.

FOCUS Group provides information and education on substance use/abuse concerns to teens and family.

Women’s Group is for women who are experiencing conflict in major life areas; depression, anxiety, stress, relationship problems, divorce/separation, loneliness, and/or lack of confidence.

Coping with Chronic Illness is an 8-week group designed to help newly diagnosed individuals deal with the challenges of living with chronic illness.

Postpartum Depression Group is an 8-week group which focuses on providing support and education to women experiencing postpartum depression.

Surviving Divorce Group is a 10-week group for adults that addresses many issues regarding divorce or the end of a committed relationship. This group helps those who have been divorced for years, going through a divorce, or contemplating ending a relationship.

Girls Support Group is an eight week group designed to provide support, information, guidance, and feedback for teenage girls dealing with a variety of issues.

Children’s Therapy Group is available for children ages 4-7, 8-10, and 11-13 with ADHD, behavioral, emotional, developmental, or situational challenges. It is an 8-week group focusing on improving social skills, coping strategies, and problem-solving skills.

Step Forward Group is designed to provide a reality check for adolescents and/or young adults who do not realistically view their future plans beyond high school. Includes engaging activities and “real world” experiences.

Please contact Mark Myers (847)263-1269 x10 to reserve your place in any of our groups.

Groups are now forming for fall and will begin during the week of October 1, 2004. Groups are $35/session. A deposit is required to hold your place. We will submit to your insurance upon request and subject to the limitations of your health plan.

In the next issue:
Addressing teenage substance abuse
Assessing your substance abuse problem
Tools for making changes with drug/alcohol problems
Helping children cope with their parent’s drug or alcohol problem
The Spouse’s experience of living with an alcoholic or drug addict