Children with “Challenges”
By Jody McVittie/>, M.D., CPDA

As a parent educator and as a physician I hear lots of questions about whether Positive Discipline works for children with “special needs” and children with “challenges.”  The simple answer is, “Yes, absolutely!” 
     It is helpful to think about these “challenges” in a broader perspective. All children (and their families) have challenges…and they are very different.  All of us and our children are unique and that uniqueness creates rough spots when we try to live together and work things out. In the uniqueness are also many gifts that can be overlooked when struggling with challenges. There is a huge spectrum of “challenges” that parents and teachers see in children. Here are a few: 

• a temperament that is extremely sensitive or shy or boisterous, 
• a fragile medical condition like diabetes, sickle cell anemia, cystic fibrosis, or muscular dystrophy

• brain problems that interfere with cognitive and / or emotional function that were present from birth or caused by an accident or illness.

• subtle brain differences that can result in difficulty learning and/or relating to others like ADHD, forms of autism, dyslexia. (There is increasing evidence that the ways neurons hook up and develop in the brain is partly caused by genetics and partly by how a child interacts with his environment. There is also evidence that the connections in some parts of the brain can change significantly over time.)

• loss of a sensory system like blindness or deafness

• inability to use full motor function from cerebral palsy, birth injury, illness or accident.

• trauma caused by war, abuse (of the child or others) at home, poverty, significant losses in childhood or frequent moves.

We are all unique individuals.  We each have unique genetic makeup and we all respond uniquely (and creatively) to our environments.  Adlerian theory (upon which Positive Discipline is based) holds that our behaviors (responses and actions) are all directed toward getting a feeling of belonging and significance in our own lives. (This assumes basic needs like food, sleep, enough air to breath and physical safety needs are met). It is true for children and for adults. What children actually do in a given situation depends on their belief about how to get belonging and significance and the “tools” that are available to the child.    

The tools: Typical children have many tools to use. As they grow they gradually develop and are taught communication skills (which include language and how to engage with others) and problem solving skills. These skills help children make socially useful “connections” with others. They also gradually develop increasing skill in self regulation. As they grow, they learn how to calm themselves or “pull themselves together” under unexpected and or adverse conditions.  It might be helpful to think of a two year old having a tantrum. Most two year olds do not have very flexible self regulation.  When they “lose it” it gets pretty dramatic, but as their brains develop and as they learn that tantrums provide no other special benefit, they “grow out of” tantrums. It is helpful to think of the ability to “self regulate” as the ability to connect to yourself.  Children who have difficulty in self regulation (connecting with themselves), or in communication (connecting with others) will naturally have more difficulty getting the feeling that they “belong” or fit in.  They will easily be discouraged in gaining the sense of “belonging and significance.”

The beliefs: How a child responds in a specific situation depends on his belief about how to get belonging and significance.  Those beliefs can be “mistaken” and the child’s behavior may look like “mis” behavior.  For example, if a child believes that, “I belong when I’m the boss” his behavior may look very defiant or passive aggressive.  If his belief is “I belong when I’m keeping people busy with me,” it is likely that he will appear more incapable than he really is.  The decisions about how to get more belonging are not in the child’s awareness.  Though the behavior is very much toward a purpose (belonging) it is not “on purpose,” in the sense that the child is consciously making the choices.
        When a child does not have the “tools” to get the belonging and significance that she needs, we say she becomes “discouraged.”  The more discouraged children are (the more they don’t feel belonging and significance) the more difficult their behavior can be (ranging from withdrawing and totally giving up to hurtful and dangerous behavior.)    Two common causes of discouragement for children with extra challenges are: specific difficulty in connecting because of a problem (either inherent or learned) with self regulation or communication and the belief that “I belong when I’m keeping people busy with me.”

There are several tools that are very helpful for parents and teachers.

1.       Take a look at the big picture. We are social beings. All children (adults to) need to have their basic needs met and feel like they have a “place” – a sense of belonging and significance in the social setting of their lives.  When working with children it is helpful to use the child’s strengths to support the child in gaining a sense of belonging.  David was wheel chair bound and could only communicate using eye motion and a word pad. One of his tasks was often to wait patiently. Even though it was sometimes hard, he did it well. His (very skilled) family communicated how his contribution (of waiting patiently during hectic times) was important and that helped David gain a sense of belonging. They also actively involved him in almost every family activity.

2.       Two important building blocks for interacting socially are the ability to communicate (connect with others) and to self – regulate (connect with yourself).

·         Children who cannot communicate easily can get easily frustrated and discouraged. Breaking the needed skills down into small pieces and teaching them piece by piece (sometimes over and over) may make progress seem more achievable.

·         When children have difficulty self regulating, it impairs their ability to function in any situation. Even situations that they could normally handle.  Teaching your child to recognize “clues” that they need to step back and “re-gather” before the disorganization escalates is another helpful area to focus. It is not helpful to talk much when a child has already “lost it.” Verbal auditory information will not be processed well. Physical touch, soothing sounds (not words) and if necessary removing the child from the stimulus can be helpful.

·         It is important to remember that children usually want to do well, but may not be able to organize the communication or self regulation to get from one situation to another the way they wish they could. Taking small steps is essential.

3.       Choosing when and how to “help” your child is made much more difficult when he or she has more than the “typical” challenges of growing up. It is very easy for children who have had lots of help to begin to believe that they are not capable and that they only belong when someone is helping them directly.   But many children really do need more assistance because of their physical, mental, medical or sensory challenges.  Choosing when to help out and when to let your child struggle through problems is much more difficult when your child has clearly identified special needs.

• Spend some thoughtful time choosing what behaviors (and in what situations) to focus on with the goal of enhancing independence and responsibility.  When you set clear goals in specific areas it is easier not to “over do” for children with challenges.  This is not a process that is done just once. It gets repeated again and again.

• Remember to ask yourself, “Is this something that my child might be able to do (if given some training and practice)?”

• Remember that giving your child opportunities to contribute in many ways (big and small) will be encouraging.

• Focus on strengths when meeting new challenges.

• If “doing things for” your child is one of the main tools to express your love, widen your repertoire.  Instead of doing things for your child, give of your interest, your listening and your time. Enjoy her, do things with her, not for her.

  4.       Avoid labels whenever possible. Labels are terms that lump many different unique individuals together and can be extremely discouraging to children. One of my favorite books on the subject is "One Mind at a Time" by Mel Levine.  What Dr. Levine notices is that mostly labeled kids aren't what the label claims.  That doesn't mean that they function easily in our world...often they have a significant brain wiring "difference" that creates specific challenges for them.  For example, when a child has difficulty processing a sequence of directions (and most of the class doesn't) he begins to feel different and "not as good as" the other kids.  Without recognizing that it is really only a very narrow problem, this sense of being "not as good as" gets generalized....and occupies more and more of his brain space...and makes it more difficult to do some of the other processing/learning activities. This means he can't do other things well either...even though he could if he weren't so distracted/discouraged.  It creates a vicious cycle.  Dr. Levine's experience is that when kids are taught about their own brains, and a more narrow "diagnosis" is made, that they are relieved.  They are eager to work on the small and specific tasks that help them build a bridge over their challenging spot.  With the new found sense that they are more capable than they had thought and can “fit” in, behavior can improve dramatically and so can academic achievement.  Working with kids specifically around their challenges and teaching them compensatory skills can make such a huge difference.  It is particularly true if the rest of the message is that you are a fine person...you just have a few challenges...and you are skilled enough to be able to work around those by learning a few new tools.
  5.       Be kind and firm at the same time. Appropriate limits are necessary for all children. But be firm with out being mean.  Punishment does not work well in the long run for any child. Instead it invites resentment, revenge, rebellion and or retreat.
  6.       Know and have faith in your child. It is the biggest gift you can give them. Linda had trouble with her son, Jacob (7th grade).  He "couldn't" even get himself out of bed, was doing poorly in school, couldn't focus, was bothering other kids etc. He was diagnosed as having ADHD.  The big turning point in Linda’s family was when she got consistent about giving Jacob the responsibility for getting himself out of bed in the morning and began to express her faith in him that he was capable.  She also engaged him in chores around the house and made an effort to spend special time with him.  Within 2 weeks she said she was "pinching herself".  She almost did not recognize her son as the same person.  She confided privately, "He is really doing better in school too."  I asked Linda what she thought made the difference.  Her response: "I think he finally feels like he has a place at home now."  Linda’s story is not unique. I usually have one or two parents in each parenting class who have a child diagnosed as “ADHD” or with other challenges. When these parents learn some new parenting tools, get their children involved in problem-solving (finding solutions) more, stop doing things for them that they can do for themselves, the parents come to me with delighted and shocked at how much more fun it is to be with their child. My experience is that in trying to do "well for children" the most common mistake is that parents do too much. Most of the successes happen when parents (who are afraid for their kids) take a step toward believing that their child is capable and having faith in their child. They take a baby step toward realizing that their child can learn from mistakes...if the child is not shamed in the process.
          A word of caution, I am NOT saying that kid behavior is the "parent's fault."  What I am saying is that the each child with their own combination of gifts and challenges makes decisions about how to belong.  Helping a child use their gifts to make bridges over their challenges AND working together to create an environment in which our kids get the message that they are capable, we have faith in them, they have a place to belong and that they make a valuable contribution is the best thing we can do for kids.  Each of us has something to contribute, something to teach and it is up to the rest of us to find that piece and create situations that allow it to blossom. 
         One last thought. Parenting is always a challenge.  It is important to take care of yourself.  Be kind to yourself and make sure you have time to restore yourself. The ideas above are just that: ideas. Use the ideas where they make sense to you. Follow your heart.