Parenting a Child at

Risk
Using Psychology in Parenting
David Holland
Essential Words
 Being “at risk” - A child who is “at risk” is a
child who is exposed to one or more risk
factors for development.
 For example a mother who smokes heavily
during her pregnancy. Being at risk does
NOT mean the child will definitely have
problems but it does mean they are more
likely to.
Essential Words
 Prenatal care – Pre-natal care is what a
mother does while the fetus is still growing
inside her to make sure she has a health
baby, it may include doctor’s visits, taking
vitamins, exercise, special dieting and
abstaining from ATODs.
 Postnatal care – The care that a parent
gives to a child after it is born.
 ATOD – Alcohol, Tobacco, and other Drugs
Mistakes and Misconceptions
 Accepting the worst case
as representative of the
whole problem
 Ignoring other pre-natal
risk factors besides ATOD
 Underestimating the
importance of post-natal
environment
 Accounting for sampling
errors and sample attrition
Risk Factors
 Limited prenatal care
 Inadequate prenatal nutrition

 Poor maternal health

 Poly-drug abuse
Post Natal Risk Factors
 Continued use of ATOD in the home
 Dysfunctional family histories

 Abuse and/or neglect

 Poverty

 Inner city violence

Neurobehavior of high risk
infants
 Fragile,disorganized
 Low Threshold for over-stimulation

 Areas of Difficulty
 Regulation of states of arousal
 Constantly in unavailable states such as sleeping or
crying.
 Interactive capabilities
Caretaker Response to High
Risk Infants
 Overwhelm the lethargic/unresponsive infant
 Avoidance of the irritable/hypersensitive
infant.

 Statistically
the strongest indicated of risk for
an abused child is the condition of the child
and caretakers failure to know how to
respond.
Being at your best
 Everyone is at their best when they are calm
and alert and can concentrate. Babies are
the same way, but their world of sensation is
very different, and at risk babies often have
low thresholds.
 The best thing you can do for infant
development is to get your baby to this state.
External Structuring/Soothing
Techniques for Infants
 Swaddling – restricting the movement of the
arms and legs – pressure releases dopamine
calms system
 Vertical Rocking – stimulation of
proprioception and vestibular senses (works
for short time if baby has other needs like
being fed)
 Pacifier – especially good to train for eye to
eye contact.
Techniques
 Adjusting stimulus intensity
 Adjusting lighting
 Adjusting volume
 Adjusting amount of color input etc.
 Amount of face time (faces are very complex)

Growth comes from manageable stress

and challenge.
Infant Distress Signals
 Gaze Aversion (don’t try to force it)
 Yawns (during normal playtime)
 Sneezes
 Hiccoughs
 Color Changes
 Rapid Breathing
 Jerky Motor Activity
 Crying
 Less well organized children will give less cues!
Fetal Alcohol Syndrome
 Alcohol is actually the worst proven risk factor
for a child.
 Pre- and postnatal growth deficiencies
 Shorter, smaller head size, slowed growth
measured by head circumference.
 Distinct pattern of facial abnormalities
 Central nervous system dysfunction
Central Nervous System
effects of FAS
 Mental retardation
 Memory and Learning Deficits

 Sensory Processing Deficits

 ADHD

 Self-Regulatory Disorders
 Can’t organize their own behavior
 Can’t learn from mistakes
Interventions for FAS
 Early screening, diagnosis, and intervention
 Structured, predictable environments

 Minimize sensory overload

 Teach compensatory learning strategies

 Teach behavioral self-regulatory strategies

Developmental Problems from
prenatal exposure to ATOD
 Disorganization

 Language delays
 Language is one of the most complex things
children have to learn. Damage to any part of the
brain often affects language development in some
way.
 Speech therapy, tutoring, learning to read
Why do Children do what they
Do? – Testing the world
 DON’T TAKE IT PERSONALLY

 Sense of achievement
 Sense of security (need for predictability) looking for
consistency – if they can’t get it for positive
reinforcement they will resort to negative actions to get
it.
 Direct Rewards
 Communication (example: low threshold outburst)
 Attention
 Self-regulation
 Bad behavior serves a purpose for children, if you want to get
rid of it you have to REPLACE it with another behavior
Self Regulatory Behaviors
 Adults learn self regulatory behaviors – kids
don’t have these strategies yet.
 Sensory seeking behaviors
 ADHD children actually are sensory deprived so
their hyperactivity is due to their seeking more
sensation. This is why stimulant meds work for
them.
 Movement is a very good way of stimulation.
Often if you allow a short time of activity a child
will be able to calm down for a time to be at their
best.
Self-Regulatory Behaviors
 Avoidance Behaviors “no” most popular
 Controlling behaviors – “if I can’t avoid it I
want to control it”
 Self directed behaviors – video games
 Oppositional behaviors
 Discharge Behaviors
 Aggressive behavior
 Emotional outbursts
 Tantrums
 Heavy Work
Improving Behavior at Home
 Setting aside regularly scheduled time to
engage in positive interactions with your child
(relieves stress of filling needs)
 “Attend” to good behavior
Two Most Important Things

Knowing what to do.

Being at a place where
you can do it.
Knowing what to do:
If you don’t make a plan – your
child will!
 Organized routines and physical environment
 Consistent rules and discipline

 Use calendar or schedule to ILLUSTRATE

daily and weekly routines
 Create SPECIFIC routines for difficult
transitions
 Create structure for and talk children through
“difficult experiences”
Being able to do it
 Providing appropriate sensory activities as
needed
 Helping children to internalize sensory
strategies

 Activities (photocopies available)

Strategies for School
 Reduce auditory and visual distractions
 Break tasks down into steps

 Use multi-modal instruction

 Consider placement of child within the

classroom
 Provide organizing activities

 Provide safe havens