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