Child Refuses to Go to Doctor

Children learn quite young (within the first moments of life, actually!) that doctors can cause pain. The astute infant and toddler knows that a visit to the pediatrician can mean that someone will be prodding, poking, touching sore spots and giving injections – ouch! The whole ordeal is sometimes followed by having to swallow some nasty tasting medical concoction for a week or longer. Moreover, many children are not fooled by the doctor’s friendly banter or even “prizes” that might be forthcoming – they want no part of it. These kids can become medical protestors, refusing to cooperate when it’s time to go to the doctor or receive their treatment.

If your child has issues with doctors or medical treatment, consider the following tips:

Some Children are More Sensitive to Pain
Avoid discounting your child’s reactions to medical examinations and interventions. Try not to to tell him that “it’s not so bad” or “it doesn’t hurt that much” or “you’re making a big deal out of nothing” or anything similar. Instead, use Emotional Coaching (see Raise Your Kids without Raising Your Voice) to acknowledge your child’s feelings. For instance, say things like, “I know you don’t like it,” or “I know it hurts you,” or “I know it’s uncomfortable.” Acknowledging the child’s pain does NOT mean that he doesn’t have to go see the doctor or take his medicine! The child will have to do that anyway. It simply means that you understand his predicament. You understand his reaction. You’re sympathetic to it. You accept it as true for him. Again, all this doesn’t change the reality that he has to go to the doctor. However, it lessens his resistance somewhat and it even helps to release some of his upset (you know how much better YOU feel when someone understands you!). When using Emotional Coaching, remember to name your child’s feelings in one sentence (i.e. “I know you hate the taste of the medicine”) and give him the facts of the matter in a completely new sentence (i.e. “It’s unfortunate that they can’t make it taste better.” or “You have to have one dose now and another before bed.” or “After you have it, you can have your cookie.”). The important thing is NOT to join these two aspects (feelings and facts) using the word BUT as in “I know you hate the taste, but after you have it you can have your cookie.” The reason we don’t use the “but” word is that “but” discounts the acknowledgment of feelings that you just offered. It’s as if you’re saying, “I know you feel upset, but I don’t care!”

Reward Compliance When at the Doctor’s Office
Once you’ve arrived at the doctor’s office (however you managed to get there), try to make the experience as positive and rewarding as possible. For instance, bring food treats, games or books for your child to enjoy while waiting, and similar treats and/or activities for the way home “for being brave.” Read stories to your child while waiting to be seen. If your baby, toddle or older child is nervous, rub his or her back or – better still – offer a little hand-reflexology (detailed massage of the hand and fingers). Reflexology not only feels pleasant but actually calms the nervous system, reducing fear and anxiety. If the doctor’s office doesn’t provide prizes, stickers and the like, buy your own to give your toddler or young child on the way out of the examining room. The more you can pair fun, comforting and pleasant experiences with the painful and scary experience of visiting the doctor, the less resistance your child will have on future visits.

Some Children are Very Fearful
If your child suffers from anticipatory fear (worrying excessively about what’s going to happen) or if he has an actual phobia (like a needle phobia), you can offer him fear-reducing techniques according to his age level. You can also consult a mental health professional who can teach you the techniques to teach your child or who can treat your child directly. Some tools for reducing fear and worry include learning to make positive pictures instead of scary ones (visualization), learning how to slow down the breath to foster deep feelings of calm and relaxation, learning how to use acupressure techniques like EFT (Emotional Freedom Technique) to calm or even remove the fear or phobia, learning how to use distraction and other mental tools effectively and so on.

Some Children are Very Strong-willed
Some kids just don’t like going to the doctor. In this group are those who don’t do what they don’t like to do – at least not without a battle. Gaining cooperation can involve using techniques like the CLeaR Method of positive reinforcement and the 2X-Rule for discipline (see Raise Your Kids without Raising Your Voice for details of both approaches). Discipline, for instance, might look like this: if your child refuses to cooperate with his medical treatment (taking medicine, therapy or injections), you can explain why it’s important for him. If he continues to balk, you can explain it a second time and add a warning such as “…and if you don’t cooperate with your treatment here at home, then (name a consequence such as the following) we will have to take you to the doctor so she can treat you in the office, because one way or another, you must have that treatment.”

Foster Cooperation with Grandma’s Rule
In Grandma’s Rule, the parent does not give an option to the child. Avoid telling your youngster “If you go to the doctor you’ll get a candy.” The word “if” structures a bribe strategy that is unhealthy. Instead you can say “When we get back from the doctor you can have a candy.” or “As soon as you’ve taken your medicine you can play on the computer.” Grandma’s Rule put the parent in charge rather than the child, which is as it should be.

Find Ways to Help your Child be More Involved
Have your child be as involved and in charge of his treatment as possible. If he needs to take medicine in the evening, let him decide what time in the evening he will take it each day. If he needs to get cast or a bandage, let him select the type and color of it. When your child feels less like a victim, he’ll may cooperate more and be happier.  

Consider Bach Flower Therapy to Help Reduce Fear
Bach Flower Therapy is a harmless water-based naturopathic treatment that can ease emotional distress and even prevent it from occurring in the future.  Every health food store carries Bach Remedies, and especially the pre-mixed one called “Rescue Remedy.” Rescue Remedy is a potent mix of a few different flower remedies, useful for times of panic, injury or hysteria. You can give your child Rescue Remedy as you leave home for the doctor’s office, as well as right after he or she receives any uncomfortable or painful medical intervention. To help prevent anxiety and stress related to future doctor’s visits, you can provide regular Bach Flower Therapy. This involves selecting a few remedies that your child might benefit from and mixing them together in a one-ounce Bach Mixing Bottle. You give this mixture to your child daily until doctor-related distress has diminished totally. Some useful remedies for this purpose include the following: Mimulus, which helps all fears and phobias, Rock Rose which helps feelings of panic, and Cherry Plum, which is used for loss of control (as when your child has a meltdown). Consider the remedy Vine if your child is very strong willed and refuses to cooperate with the medical visit. The flower remedy White Chestnut is useful for those children who worry obsessively in advance of the visit, especially those who lose sleep due to an overanxious mind. To mix your selected remedies together in one treatment bottle, fill the Bach Mixing Bottle with water (a mixing bottle is an empty bottle with a glass dropper, sold in health food stores along with Bach Flower Remedies). Next, add two drops of each remedy that you want to use. Finally, add one teaspoon of brandy. The bottle is now ready to use. Give your child 4 drops of the mixture in any liquid (juice, water, milk, tea, etc.) four times a day (morning, mid-day, afternoon and evening). Remedies can be taken with or without food. Continue this treatment until the fear has dissipated. Start treatment again, if the fear returns. Over time, Bach Flower Therapy can help the fear diminish completely.

Consult a Mental Health Professional
If you’ve tried all of the above suggestions and your child is still suffering intensely from fears of doctors or medical treatments, consult a mental health professional. Ask your pediatrician for a referral. Mental health professionals may be able to give you added strategies to try at home and they can also treat your child directly, using specialized interventions that can help the child overcome anxious feelings. Often, a child only requires a short course of treatment for a specific phobic reaction like fear of doctors or medical treatment.

Out-of-Control Teens

Some teenagers are model citizens. This article is not about them. This article is about those teens who are acting out – the ones who talk back to their parents, dosage swear at them, act aggressively when upset, have no respect for rules or curfews, do what they want when they want, engage in addictive, destructive, illegal or immoral behavior and otherwise distress their well-meaning parents terribly. It is also about those teens who are “acting in” – those with depression, eating disorders, cutting behaviors and other self-destructive patterns. All of these children frighten, worry and dismay their parents. Why do they behave this way? What can parents do about it?

Out-of-Control Parents
Many out-of-control teens trigger out-of-control behavior in their parents. Because of their intense fear, hurt and helplessness, many parents of out-of-control teens become enraged and display their own version of temper tantrum behavior. In an effort to regain control, some dole out irrational negative consequences like “life-long” loss of privileges or “life-long” grounding. Even if they manage to use more reasonable consequences, many use too many or make them too intense for the crime. The result is a very negative relationship in which the adolescent loses all motivation to please the parent or cooperate in any way. The troubled relationship actually fuels more adolescent pain and more troubled behaviors. The last thing a struggling adolescent needs is an out-of-control parent.

How to Help Troubled Teens
The first step for parents it to maintain total control over THEMSELVES. Parents should let their adolescents know that they are starting a SELF-improvement program: no more yelling, tantrumming, insulting or other disrespectful behaviors. The parent will remove all behaviors from his or her own repetoire that would be unacceptable if the teen engaged in that behavior. For instance, if the parents want the teen to stop yelling, the parent will work on removing yelling from his or her own behavior (the same applies for any other similar behavior such as, unpleasant tone of voice, nasty facial expressions, unkind words, stomping & slamming, etc.). After a month of working on his or her own behavior, the parent can begin to help the teen make similar changes using a similar technique. The teen may be inspired by the model of the parnts. The parents have shown their own willingness to help make things better and they have shown that they can be successful. The teen may be more willing to get with the program when the parents have led the way.

The self-improvement program works like this: the parents promise themselves and their child that each unacceptable parental outburst will be followed by a parental consequence. For instance, when a parent yells, he or she can immediately sit down to write a page of lines to the effect of “I can control myself even if I feel upset.” or “I speak respectfully at all times even when I am upset” and so on. After the first week or two of this consequence, the parent increases his or her lines to two sides (one full page, both sides) and after three or four weeks, to three sides, continuing to make increases until all unacceptable parental behavior stops. If it starts up again at a later date, even months or years later, the parent begins the consequence system again.

Another equally important strategy for parents is to lay the foundation for adolescent change. They can do this by practicing the 90-10 Rule. This rule states that 9 out of 10 parental communications need to feel pleasant to the child. Pleasant feeling communications include things like smiles, compliments, weather reports, gifts, treats, jokes, gentle touch (if wanted), interesting neutral conversation, acknowledgement, good quality listening, naming feelings, having pleasant interactions with other family members within earshot of the teen and so on. One out of 10 communications can be “business-oriented” such as giving instructions, making requests, setting a boundary (using discipline if necessary). When the 90-10 Rule is followed, teenagers automatically become calmer and more cooperative, less rebellious and more interested in pleasing. Their own emotional difficulties settle down a bit. They even cooperate more with discipline when it is required.

More Help for Out-of-Control Teens
Parents can be empathetic toward teens without accepting their abusive behavior. Once parents have brought their own behavior under control, they must insist that their teens work on theirs as well. They will live by the rule “I only give and accept respectful communication” (“I do not give nor do I accept disrespectful communication.”) Using quiet, respectful discipline, the parent can invite the teen to create appropriate consequences for behaving in disrespectful ways.

Troubled teens may really benefit from and appreciate other interventions. Bach Flower Therapy is a harmless treatment that can reduce anger, stress, anxiety, hurt, loneliness, despair, depression and all other painful emotions. Both parents and teens can use this form of treatment to help clear and heal the troubled feelings that prompt out-of-control behaviors. You can find more information on Bach Flower Therapy online and throughout this site.

Professional help can be of tremendous benefit to both parents and teens as well. Even if the adolescent refuses to go to therapy, parents will find that the support and strategies offered by a mental health professional can make a huge difference in their family life.

These are some of the ways we can begin to help our hurting kids. Remember that you are the adult – you must show the way. Patience and love will help a lot. Keep envisioning your troubled teen moving through and beyond these years to a very positive outcome. This optimistic picture wilil help you survive the turbulent times and do your best when it is hardest. It will counteract the anxiety that causes you to over-react or “forget” good parenting skills. The truth is that most kids turn around at some point and become very pleasant, well-adjusted adults – just like you!

Rudeness and Disrespect

It once was that children feared their parents; nowadays, it’s more likely to be the other way around. Parents are often afraid of their own kids. Modern parents frequently feel helpless with their children and all the more so with their bigger kids. While they try to set up rules, set limits and run a tight ship, they find that their kids ignore the rules, break the boundaries and do whatever they want. Their disregard for parental authority applies to both action and words. It is no longer uncommon for children ten years old and up (old enough to know better) to impulsively blurt out whatever they want to, however they want to. If they want to holler, they will. If they want to hurl insults, they will. They’ll swear, threaten, get physical and do whatever else they feel like doing when they are displeased, upset or outraged. Disgruntled teens talk back.

Naturally, if a parent responds negatively to a child’s request, the youngster will feel at least displeased, possibly upset and on occasion, outraged. Feelings happen. However, many young people don’t seem to know how to express negative feelings in a way that preserves their dignity, preserves the dignity of others and maintains healthy, loving relationships. Mouthy teenagers do not only harm their parents; they harm themselves as well. Out-of-control teens (adolescents who are not thinking of the long-term consequences of their words or actions) experience more daily pain than their in-control counterparts. When teenagers know how to express their upset with sensitivity to the feelings of others (in this case, parents), they will enjoy all the benefits that good communication skills bring: peace in the home, emotional well-being, emotional love and support, mental stability and even, improved physical health.

Insisting on Respect
Parents will actually do their kids the favor of a lifetime if they are willing to insist on respectful communication. Parents who let their adolescents talk back disrespectfully actually help these children build strong brain pathways for verbal abuse. When these young people get married, those pathways will be solid as rock. Consequently, when feelings of frustration, anger and disappointment are triggered by their new spouses, their abusive brain pathways will light up and BAM: out will spew rude and hurtful words that will burn a deep whole in the new relationship. Rude teenagers grow up to be rude spouses. Rude teens can even grow up to be rude parents! Maturity does not bring respect. Education and training does.

By insisting on respect, parents can help their children build strong brain pathways for self-control. While adrenalin is running, triggered by intense feelings of upset, the self-control pathways will light up. Although the young person may feel like slamming a door, screaming or ranting, he or she will quietly utter a statement instead. “I’m not happy about this” or “I want to talk with you about this again later” or “Is there any way you might reconsider?” or “Would it help if I did such & such?” and so on.

Let’s take an example. Suppose 13 year-old Suzy asks Mom if she can go to a party that 17 year-old Joey is making Saturday night. Mom feels that Suzy is too young for this kind of party and says, “I know you’d really like to go Sweetheart. Unfortunately, I feel Joey and his friends are too old for you. I don’t want you to go.”

Suzy is more than upset. She is hysterical. So she answers back: “I’M NOT LISTENING TO ANYTHING YOU SAY. I’M GOING AND THAT’S IT. THERE’S NO WAY YOU CAN STOP ME!”

Mom has two choices: either ignore the disrespect or address it. If Mom ignores the disrespect she has two choices: she can pretend nothing happened and simply respond to Suzy’s words (i.e. answering fairly calmly, “We’ll see about that.”) or she can actually join in the disrespect by shouting or insulting back (i.e. “TRY IT YOUNG LADY AND YOU’LL SEE WHAT HAPPENS TO YOU!). Either way, ignoring the disrespect ensures that more disrespect will be coming in the future. Ignoring allows the teen to build up the disrespect neural pathway in the brain. Failure to deal with disrespect is actually a form of parental neglect because when the child goes on to have trouble in other significant relationships, it will be due to the fact that no one ever taught her how to express displeasure sensitively. (In fact, if Mom actually screams back, she is actually modeling the dysfunctional communication strategy of yelling when upset).

So let’s hope that Mom decides to address the disrespect. If she does, she has two choices: either she can stop the conversation then and there and deal with the disrespect immediately, or she can wait until things are calmer later on and deal with the disrespect at that time. In this case, it is good to follow the concept of the “teaching moment” as described in the book Raising Your Kids without Raising Your Voice by Sarah Chana Radcliffe. A true “teaching moment” is one in which both the parent and the child are calm and relaxed. Since the child in this example is currently hysterical, the period cannot be called a “teaching moment.” Mom decides to wait until later to teach her daughter  how to express displeasure sensitively.

The Relationship Rule
If a child has been taught The Relationship Rule while very young, it is extremely unlikely that he or she will be rude to a parent in adolescence. Indeed, the younger the child is when self-control is taught, the less likely it is that the child will ever talk back, insult or otherwise hurt a parent’s feelings or diminish a parent’s stature. However, The Relationship Rule can certainly be taught to teenagers (or even spouses!). Some patience will be required, however, to allow time for new brain pathways to form and for this new mode of communication to become the fall-back position during moments of emotional stress.

The Relationship Rule can be put in two ways – the positive and the negative forms:

  • I only give and I only accept respectful communication.
  • I do not give, nor do I accept, disrespectful communication.

A parent teaches The Relationship Rule in 5 simple steps (see Raise Your Kids without Raising Your Voice for complete details). Step One involves teaching the actual rule by providing the rationale for the rule (especially for older children and teens) and by giving numerous examples, role-plays and re-enactments in order to see how this rule is applied under stressful conditions. After providing education and examples, the parent tests the teen. The parent asks, for instance, what is the wrong way for a son to respond to a parent who has refused to buy an MP3 player for him? What is the right way?

Step Five, the last step of the training program, employs negative consequences. Before this step, no punishments are used for disrespectful speech because all steps before this last one are designed to actually train the child’s brain to be respectful. The intervening steps allow the parent to be empathic and responsive to the child’s feelings. The last step is employed only to prevent regressing back to the old brain pattern.

Teaching The Relationship Rule means both teaching it through instruction and guidance, and also modeling it. Obviously parents themselves must have the self-control to continue to be sensitive to the feelings of others even when they themselves are intensely upset. Many parents will be challenged in this area since their own parents didn’t raise them with The Relationship Rule. However, the family that learns together, grows together. It’s fine for parents and kids to improve at the same time. All that is required is sincerity (i.e the parent acknowledges mistakes and actually reduces their frequency over time).

Sometimes, lack of education is not the only culprit in a teenager’s trouble with respect. There can be other issues such as undiagnosed mental health conditions and deeper emotional problems. If, after applying The Relationship Rule, improvement is not forthcoming, do arrange for a consultation for your family with a professional mental health provider.

Morning Routine

What’s it like in your house in the morning? If someone was observing from outside your window, ask what would they see? Laughter and warmth? Irritation and impatience? Conflict, site screaming, viagra 60mg arguing? Or a mixture of everything?

What would you want them to see? Or, more to the point, what do you want your kids to see? Your morning routine sends your kids out the door and into the world, carrying with them the experiences, messages and emotions of the 7a.m. rush. This period, for school age kids, is one of the two main “quality time” parenting periods of their school years – the other being the “after school crunch.”

Teaching Life Lessons
From the time kids wake up till the time they walk out the door, parents are teaching valuable life lessons. Parents are teaching kids how to manage time. Do you get out of bed early enough to get it all done in the morning? Do you teach your kids how to do the same? Parents are demonstrating how to handle pressure – the deadline of the morning rush. Do you dissolve under pressure, becoming nasty, irritable, panicked or otherwise unpleasant? Or do you model self-control and restraint when your blood is boiling and the clock is ticking? Parents teach kids how to convey love – from the first gentle wake-up tickle of the toes to the tender kiss good-bye. Compliments and jokes and other forms of friendly banter show the kids that they are loved. Do you have the patience and good humor it takes to be loving at 7:30 in the morning? Or is it all about “hurry up, hurry up, carpool is coming!”

Morning Challenges
Children can be morning-challenged in a variety of ways. Let’s look at some typical challenges of the kindergarten to sixth grade set.

  • Dawdlers: This group of slow pokes can really unravel a rushing Mom. It’s important to avoid labeling them as “dawdlers” since you don’t want to reinforce this self-concept. It’s also important to avoid nagging them – that is, employing repetitive requests that will ultimately lead to parental anger. Instead, reinforce quicker behavior by using the CLeaR Method (comment on appropriate speed, label it as “quick moving”, reward it with a kiss or a treat). Also, use the 2X-Rule for limits. For instance, you can say “If you haven’t finished brushing your hair by 7:40, I’ll have to finish brushing it for you.” “If you haven’t finished eating by 8:05, I’ll have to remove your plate.” (You can find more information on the CLeaR Method and the 2X-Rule in Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe.)
  • Distracted Kids: these kids have trouble staying on task at home or at school. Supplementing their diet with Essential Fatty Acids can sometimes help improve their concentration. In addition, use the CLeaR Method to give positive attention whenever on-task behavior is occurring and use the 2X-Rule to set consequences for failing to have certain tasks performed by certain deadlines.
  • Sensory Issue Kids: These kids struggle with the way things feel to them. Clothes that you pick out may not feel “right” causing a delay around getting dressed. Try picking out the clothes the night before, with the child’s involvement. If the child wants to wear the same thing over and over, let her – it’s not dangerous and not worth fighting about every day. Try washing the clothes after she takes them off at night. When it’s impossible to get her the clothes she wants, use Emotional Coaching – naming and accepting her feelings sympathetically. Lectures and criticism are unhelpful and destructive so don’t go there!
  • Non-Compliant Kids: These kids simply don’t listen. They may be strong-willed or just plain uncooperative. They complain about their clothes, the weather, the breakfast and the lunch snacks. They are irritable and demanding. They may benefit from Essential Fatty Acids, Bach Flower Therapy or other alternative interventions as well as Emotional Coaching. Try offering this kind of child choices about clothing and food, preferably the night before. The challenge is not to get “hooked” – these kids are not happy campers. They don’t need your anger to top it all off.
  • Others: Some kids are disorganized and need lots of extra help and structure from the parent. This is a brain challenge – not “bad” behavior. Therefore, patience and assistance are in order. Some kids can’t wake up easily and require modification of their bedtime and help with their wake-up routine. And some MOMS are disorganized and have trouble getting it altogether. However, sitting down and thinking about each child’s morning style, your own style and some small interventions may be all that is necessary to ensure that you have consistently good mornings in your household!

Always Says No

Toddlers just have to say “no.” “Do you want an ice cream cone?” “No.” “Do you want your Teddy Bear now?” “No.” No matter how much the child believes, “yes” at two years old he just has to say “No!” Why is that?

Toddlers are just moving out of the symbiotic stage – the stage in which the child and Mommy blur into one. During infancy, infants and mothers live in the same rhythm almost seeming to share one body. This helps the mother sense when her baby is hungry, when she needs to be changed, when she is tired and all the rest. The baby has no words and everything must be communicated non-verbally. Mother tunes into the baby’s body language and little sounds to read her unspoken message. The better Mom can do this, the more successfully the baby’s needs will be met. Therefore, it is advantageous for mother and baby to share a oneness – a relationship that needs no language.

However, toddlers are beginning to speak. This marks the beginning of their independent existence. Now that they can articulate, they can offer an opinion, express a wish, or give positive or negative feedback. Now the child want to express himself or herself – the child needs to discover the “self” to express.

I am Not YOU
The child finds him or herself by distinguishing it from other selves. I know that something is warm only by comparing it to something that is cool. One thing is blue only if it is not any of the other colors. Differences define unique properties of things and people. Therefore, the toddler finds himself by distinguishing himself from his previously symbiotic partner – Mom.

If Mom wants the toddler to do something, the toddler finds herself by saying “No.” “No, I don’t want to do it whereas YOU want me to do it therefore clearly I am not you. I am me.” (The toddler, of course, doesn’t articulate the whole sentence – just the “no” part!)

Managing the Negativistic Toddler
As wonderful as this developmental stage is for the baby’s development, it can present a formidable parenting challenge. It seems that everything has become an argument. The child is no more Mr. Nice Guy. Now, everything is “no!” What’s a parent to do?

First of all, it can be very helpful to encourage the child’s independence. Instead of butting heads with a toddler (“I said, do it!”), a parent can acknowledge the child’s unique view. “Oh, YOU don’t want to do it. You want to sit here and suck your thumb. You are Joey.” This kind of response actually calms the child a bit, since you clearly understand his agenda and appreciate it properly. Sometimes, after hearing such a sentence, the toddler will end the battle and simply comply with the parent’s wishes. But don’t count on it.

Sometimes, the parent will have to insist – for safety reasons or other practical reasons, the toddler may have no real choice in a matter. However, even in such cases, the parent can first acknowledge the child’s opinion and then ease her into the correct spot. “I know you don’t want to get your shoes on now. That’s O.K. Mommy will come back in a few minutes and put them on you because we have to go soon.”

Giving a toddler some choices can help reduce the amount of nay-saying. “Do you want Cereal A or B?” can be less confrontational than “Mommy has some nice cereal B for you today.” Let the child pick out foods, clothes, toys and even some activities. This way the child can develop her sense of self without having to say “no” to your suggestions.

Most of all, just relax. This stage passes. Although children always need plenty of space in order to become themselves, the toddler’s dramatic negativity will eventually give way to a more moderate amount of dispute (until the teens years, that is). The more you can let your child make personal decisions at every stage of life, the better. Acknowledging his point of view, taking him seriously and showing consideration for his thoughts and feelings can go a long way toward preventing real rebellion later on. Help each child develop according to his or her unique needs and characteristics starting in toddlerhood: say “Yes!” to independent thinking!

Toddler Doesn’t Listen

Toddlers – kids who are between 15 months and 3 years of age – are an adorable group of people! They are just beginning to develop their speech and motor skills which essentially means they are beginning to develop their power. Instead of lying immobile in a parent’s arms, a car seat or a stroller, this group of small people can now do damage! They can hurt an infant, dive into the toilet bowl, rummage through garbage cans and even run out of the house. From their point of view they are only doing what comes naturally: exploring the amazing world around them. However, from the parents’ point of view they are doing what they shouldn’t be doing: engaging in activities that are dangerous, messy, destructive, inappropriate or otherwise undesirable. If an older child were to be similarly occupied, he or she would be disciplined. The trouble with toddlers is that they are too young to be disciplined in the traditional manner. What’s a parent to do?

Teaching Toddlers to Behave
Here’s the good news: toddlers can be educated! The primary way of providing this education is through the judicious application of attention (at the right moments). Keep in mind the main, guiding principle: all attention reinforces behavior. This means that if you ever give any attention of any kind to a toddler, that child will do more of what you have been attending to. For instance, if you smile at a toddler who is gently stroking the new baby, then the toddler will tend to gently stroke the new baby more often. Also, if you yell at a toddler who is squeezing the baby too hard, then the toddler will tend to squeeze the baby too hard more often. ALL attention reinforces behavior – not just pleasant attention.

Now, using this knowledge, you can cleverly shape the behavior of your toddler. Do you want the toddler to say “please?” Then after the youngster says “please” give praise and/or concrete rewards. Do you want him to clean up his toys? Then, after he puts a toy away, show excitement and pleasure verbally and or physically (give a big hug or a pat on the head). Do you want the child to play quietly while you’re on the phone with a business call? Then make sure to give her some special cookies and milk when she manages to do so.

Notice that you are purposefully using attention to increase your toddler’s desirable behaviors. To do so you have to ask yourself “what behavior do I want to see more of?” However, what if you see a behavior that you want to see LESS of? What do you do then?

Again, keep in mind the over-riding attention principle described above. If your child is doing something you don’t want him to be doing, refrain from giving him attention! Instead, figure out what the opposite or desirable behavior is, get him to do that behavior (or wait for it to happen spontaneously) and use positive attention to reinforce the desirable behavior. For example, if the toddler enjoys dipping his hand in the toilet, ask yourself what you want him to be doing instead of playing in the toilet. Let’s say that you WANT him to play with his toys near his toy chest. Then, when you find him at the toilet bowl, gently lift him up and put him in front of his toy chest and give him LOTS of attention for playing in the right spot. Refrain from shrieking at him as he sticks his hand in the toilet bowl. If you get red in the face and start sounding hysterical when he’s near the toilet, he’ll be thrilled! It’s fun to see you go nuts! He’ll just love all that attention. He’ll definitely spend every free minute running to that bowl just to see your reaction. However, if you act absolutely bored by his bathroom escapades, and simultaneously absolutely THRILLED when he’s near his toybox, then he’ll veer toward that toybox more and more often.

Consequences for Toddlers
Older toddlers and very smart younger ones can sometimes be punished for inappropriate behavior. However, if you give a toddler a consequence on three different occasions, you must make sure that it is having a positive effect. Many people put a toddler in his crib or room for hurting a baby or hitting an adult. That’s fine if it “works” – that is, if it reduces the hurting hitting behavior. But if you’ve been disciplining your toddler in this way for months on end with no improvement in his behavior, then STOP using that consequence immediately! Always check after a few times to see whether a consequence has changed the child’s behavior and if it hasn’t, then change the consequence! Some toddlers will willing sit on a “thinking chair” when asked to. Again, that’s great – as long as the sitting leads to a positive change in behavior. If you are ready to try using negative consequences with your toddler, be sure to use the 2X-Rule (see Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe for details). This structured form of discipline will help keep you calm and prevent emotional damage to your child. Always warn your child before giving a consequence. Always use a consequence you’re willing to carry out. Minimize the amount of attention you give your toddler when you’re giving a negative consequence because – as you now know – the attention itself can encourage more inappropriate behavior.

Child Won’t Eat

Why won’t your child eat? It’s simple. He’s not hungry. The real question then is why isn’t your child hungry? And what you might really mean is why isn’t he hungry at meal time when I set his food in front of him? Here are some possible reasons.

He Has Filled Himself Up Before the Meal
It can be that your child has recently eaten and is simply not hungry. As long as he recently ate healthy food, this isn’t a serious problem. Some school-age children come home from school “starving.” They consume cheese, milk, crackers, peanut butter, some vegetables and fruit. If dinner is served only an hour or two later, these kids may not be hungry. However, if their “snack” – really a light dinner itself—was full of nutritious food, they should be encouraged to listen to their bodies. Parents should not ask them to eat the “real” meal just because it is meal time. This can cause kids to loose the vital connection between the ability to feel real hunger and the act of eating. Instead of training your kids to eat when the environmental cues invite eating (like, seeing food on the table, seeing other people eating, seeing that the clock is at 6p.m. and so on), it is best to train them to check inside their stomachs and see if they are very hungry, a little hungry, not hungry, full or stuffed. When kids can do this, they will have a much easier time maintaining a lifelong healthy weight and healthy relationship with food.

If you want an official “dinner table” around which the family gathers for companionship, learning and discussion, then help your children be “very hungry” around the time that you want this dinner table experience to occur. Do this by allowing low protein, low fat and low sugar snacks when the child comes home from school (or serve the family dinner at that time!). Healthy snacks that will leave your child hungry within the next hour or so include sliced cucumbers, salad with a minute amount of dressing (or a more generous amount of fat-free dressing), egg whites, a fruit eaten without any other food and plain whole grain crackers with a half a glass of milk.

He Has Eaten Snacks That are High Glycemic Index Foods
High glycemic index foods are foods that turn to sugar quickly in the body. Some examples are cookies, soda crackers, juice, soft drinks, potatoes, French fries, bagels, instant rice, rice & corn based breakfast cereals, candy. If your child likes it, it’s probably high glycemic index!  These tend to destroy the appetite for low glycemic index foods (like steamed fish, baked chicken, whole grains and so on). When children consumer “junk food” for snacks, they actually lose their appetite for real food. Once a person has been away from sugary foods for a little while, real foods with their natural sugars start to taste good again.

Some parents who are worried about their kids’ skimpy appetites try to make food more appealing by putting more sugar into it or onto it. A child may eat his dinner as long as it’s smothered in ketchup, so Mom smothers it in ketchup. Unfortunately, ketchup is a high glycemic index food that will ensure your child will continue to have eating problems. Some people add chocolate chips, raisins or syrup to everything they serve. Again, this strategy will only prolong the eating disorder. Ditto for making the child calorie-filling drinks and snacks just to keep the weight on. This strategy may put on some weight but leaves the child deprived of nutrients and prolongs the eating problem. You need to drastically reduce the amount of high glycemic index foods in your child’s diet in order to solve the eating problem once and for all. After some days, or in extreme cases, after a week or two, your child will be hungry for the food that is being served in his meal! Obviously, you need to be able to be firm and consistent with your child. You don’t want to get into arguments with him about food. Remind yourself that you are “depriving” your child because you don’t want to deprive him of health! Strategies for remaining positive but firm and for avoiding arguments can be found in Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe.

Your Child Has a Heightened Sensitivity to Smell and Taste
Some children are born with acute sensitivity in one or more of the five senses. Many children with Asperger’s Syndrome and Autistic Spectrum Syndromes have this characteristic. However many “regular” kids have it as well. Some will outgrow it but some will not. The result of this heightened sensitivity is that food often doesn’t taste “right” or smell “right.” There is nothing a parent can do to make the food more appealing. However, ensuring that the child is offered only a selection of nutritious foods increases the likelihood of the child eating nutritious food!

Your Child Has Food Sensitivities or Intolerances
Food sensitivities and intolerances can sometimes be ignored by adults. Grownups can eat a food, feel bloated, tired, headachy, gassy or otherwise unwell after eating it, and then have it again tomorrow and the next day and the next. Even if adults have diarrhea, constipation, migraines or arthritis, they will usually continue to eat the foods that irritate their bodies without making the connection between the food and the distress. However, young children are often still sensitive enough to their bodies that they can make the connection between eating and not feeling well. In this way, they respond more like adults who have actually eaten and then vomited. Even adults will stop eating a food that preceded a vomiting episode — even if the vomiting was caused by a case of the flu and had nothing at all to do with the “offending” food! Young children who don’t feel well after eating just don’t want to eat. Or, they discover certain foods that don’t give them that uncomfortable feeling and only want to eat those.

If your child is a “picky eater” and the food he is picking isn’t only junk food, then you might take him to a naturopath who can test for food intolerance or you can try a detection diet with the child yourself (see www.foodintol.com for assistance). Creating meals that make your child feel good may be the key to increase his appetite.

Your Child Has an Eating Disorder
Sometimes children don’t eat because they are troubled. They also feel invisible in some way, either in the sense that they cannot make themselves heard or seen (they can’t express their issues to their parents) or in the sense that they feel controlled (their parents or teachers or bullies trod over them). They then show their emotional distress by withdrawing from food. This almost always gets their parents’ attention. Now everyone is listening and watching! Although this isn’t what the child really needs, it seems it will have to do until the eating behavior becomes so threatening to health and well-being that the parents finally take the child to a psychologist who finally will listen to the child’s real concerns.

Although parents do not cause children’s eating disorders, there is much they can do to create a preventative and healing environment. Whenever a child demonstrates (verbally or with facial or body language) an emotion, name that feeling. The skill of “emotional coaching” is very similar to the skill professional listeners (like mental health professionals) use to help heal their clients. Emotional coaching is explained in detail in Raise Your Kids without Raising Your Voice. Also, tuning into your child’s needs is very important. Pay attention instead of brushing the child off or telling him what he really feels or needs or doing only what works best for you. The more your child feels that he can be appropriately heard and responded to, the less risk he is at for developing eating disorders. If your child is refusing to eat even though you are not serving lots of junk food at the wrong times, then take the child sooner rather than later to a mental health professional. Nipping problems in the bud is always easier than fixing entrenched problems.

General Strategies That Help Reduce Picky Eating Syndrome
In all cases, keep your home pleasant and calm and particularly, keep meal time relaxed and fun. Removing struggle and tension helps everyone’s appetite. Never fight over food with your kids. Don’t show them that it bothers you in any way. However, use quiet, reasonable mealtime structure. Here are some ideas you can implement. Use whatever you and your child’s doctor feel is reasonable for your household: for children over six years old, you can make a rule that everyone has to have at least two bites of the dinner that is being served. Of course, only serve food that you know is not repulsive to the child. It doesn’t have to be the child’s favorite food; it must simply not be disgusting to him. Use appropriate discipline with this—never irritation, impatience or anger (see Raise Your Kids without Raising Your Voice). No one has to eat more than their two bites. They will be hungrier at the next meal. Children under six who are not hungry, do not have to eat at all (unless your doctor has advised you otherwise). They will be hungry at the next meal (even if that next meal is breakfast). Do not operate an all-night kitchen! After a reasonable time (for example, 7p.m.) dinner is no longer served. People who don’t eat dinner can still have a glass of milk or equivalent real food as a bed-time snack. Do not serve high glycemic alternatives before or during mealtime to anyone in the house. DO NOT FEED your child who knows how to eat with a fork. Do not follow your child around offering him or her bits of food. Food should be served on plates at a table (unless you are out on a picnic!). Enlist the help of a professional if necessary. Psychologists, dieticians, nutritionists and naturopaths are some people who may be of assistance. And keep in mind that you are in good company: most children have some kind of eating issue and most of them grow out of it by adulthood. Do what you can about it but don’t obsess about it. Ask your pediatrician about any health concerns you have and then follow his/her advice. Good luck!