Wednesday, July 31, 2013

Overcoming Behavior Issues: Causes

It's important to note that the behavior described in my last post wasn't just occasional, or typical of the "terrible twos". The screaming, hitting and throwing was an every day thing, occurring for the most part of the day. It was affecting his daily life, as he was unable to use his time for playing, learning and socializing, hence increasing his global developmental delay. It's also important to mention that the concern raised because of the environment provided to Patrick: A home with two loving and caring parents, with access to a healthy an age-appropriate fun lifestyle.

When all this "sudden" change of attitude happened, we were already receiving services from the Infant and Toddler Connection, and his therapists were very helpful in dealing with this issue. They insisted on asking me why did I think he was behaving one way or another. Understanding why Patrick behaved the way he did, was the key to help him improve his playing and learning process.

The first step in figuring out why was Patrick constantly throwing, hitting and screaming, was to become extremely observant. Every time he would scream, I needed to find out what was upsetting him. But it goes beyond simply knowing what he wants. You see, when he wanted to go outside, sometimes he would come, grab my hand and take me to the door. Other times, he would throw something at me for the same reason. So, we have the same kid, the same desire, but two different scenarios. What would make him act peacefully one time, but aggressively other times? To find that out, I had to observe what was going in his environment every single time he showed a bad behavior. Every time he hit someone, I needed to pay attention to the whole situation: What was he doing right before he hit? What was I doing? What is he throwing? What time of the day was more likely to do it? In which places? Around which people? Has he been sleeping well? Eating well? Any significant routine changes? Same for screaming. Same for hitting. Being able to answer all those questions, led me to answer the big question, why.

Four main reasons surfaced:
  • Patrick is trying to communicate. Patrick's ability to understand is superior to his ability to execute and speak. This causes frustration. Loads of it. If he wanted to play with a child, he didn't know how to tell him, so he would hit him. If Patrick wanted to get my attention, he would come and throw something at me. If he was tired, or bored, he would scream. 
  • Patrick's nutrition. Patrick has been dealing with constipation issues which caused a lack of appetite in him. He started to lose weight, to the point that he gained only one pound in six months, and lost that pound the following two months. We don't operate the same way when we are too hungry, or stomach sick, compared to when we have a satisfied belly, right?
  • Patrick has sensory integration issues. Sensory Integration is the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment. Patrick doesn't necessarily have Sensory Integration Disorder to the full extent, but, he does process a few sensations a little different from most kids. 
  • Patrick's medical condition. Patrick's cerebellum is slightly smaller and a bit disorganized as shown in his MRI. The cerebellum plays an important role in motor coordination, attention, language and regulates fear and pleasure. Patrick's behavior issues are not only limited to bad behavior, but also to "odd" behaviors, such as panicking when feeling fear, and feeling fear to random things such as small pets, or stuffed animals. 
Each one of these reasons deserves its own detailed explanation so expect a post about each bullet point in the upcoming weeks. In the meantime, if your child is dealing with behavior issues, start observing closely what is causing such behavior. Become a critical observant of your child just like I did, you may be surprised with the answers you will find.

Monday, July 22, 2013

Overcoming Behavior Issues: Patrick's behavior.

Patrick has improved so much in the past month. It's like someone took Patrick away and brought him back to me a year later, more mature, healthier, happier. But it all happened in one month, and it happened right here at home.

A little bit of background, Patrick was a super good and happy baby (read hypotonia = happines) up until last winter, when he became a very difficult child. I assumed that because he had learnt to walk, he would be all happy running everywhere, playing at the playground, making friends and learning a lot. There was a lot of running, yes, but paired with hitting, screaming and throwing, every single day, most of the day. 

Patrick's play was very immature, too. At 2 years of age, he didn't know what to do with puzzles other than banging and chewing on them. And that was the case for all of his toys, like cars, blocks, musical toys, learning toys... you name it. Patrick liked looking at books, but he didn't like hearing the stories. His favorite books were the ones with no stories, the ones that are meant to teach children a new vocabulary filled with just pictures of a theme: animals, body parts, baby things... no stories. He didn't like any of the kids TV shows (I didn't see anything wrong with that -until I realized it was because he couldn't comprehend and follow what was going on on TV) and he would still place in his mouth about anything that came across, just like a baby would do when trying to explore. When other kids were around, he wasn't able to join them in their play, rather he would just step back and watch them, or do his very own thing. Now that he was free to move on his own at the playground, instead of going up and down the slide with the other kids, he would just run, run, run... and wouldn't engage.

Patrick isn't a shy kid. He likes people and he is very charming at public places, always saying "bye" with a huge smile to anyone that walks by. So why he won't play with other kids? Why he won't even play with his toys? He would get frustrated VERY OFTEN when he couldn't do something, and the anger would be expressed by screaming, hitting and throwing things at others and me, a 7, 8, 9 months pregnant woman. It was very difficult to deal with this new situation and I just couldn't figure out why was Patrick acting like that.

I began to think about the mean kids from my childhood, that used to hit and bully other kids, that used to get bad grades at school, getting in trouble all the time, and that because of their attitude, other kids feared them, so they almost never had friends. I could picture Patrick becoming one of those mean kids. You somehow think that they are that way because their parents don't pay them attention, or because there are problems in their homes, or maybe, they are just so spoiled that they turn into real brats. But now we were raising one, and I couldn't understand what we were doing wrong.

Just few months before, I was concerned about Patrick being bullied at school because of his developmental delays and his Oculomotor Apraxia, and now it seemed like Patrick would actually turn out to be the bully, which, of course, isn't a better scenario. Where all this violent spirit came from? There is no violence at our home, so where does he learn these things? Are time-outs really not enough for some children? But how can I spank him to show him that hitting is wrong? How can I punish him by not watching TV or playing with X toy, when he doesn't like nor care about TV and has no favorite toy? Giving him the talk of why he should behave well was like giving the talk to a 5 month old. 

I was running out of ideas and patience, but luckily we were already working with the Infant and Toddler Connection, and his therapists had experience working with children like Patrick. They gave me great ideas, we figured out other ones, and all will be talked about in my next post.  

Monday, July 15, 2013

January-April Recap

When I wrote the recap for May and June, I realized I hadn't written one since the beginning of the year. So here it is:

March:

Ha! I don't even remember what happened on January and February, other than being sleep deprived thanks to the newborn/toddler combo.

So, March:
The first week of March, we drove to Northwest Indiana to visit Tim's parents, and then drove to St. Louis to visit Tim's sister and the extended family. Patrick has a memorable picture with Tim, his dad, and his grandfather, making it a 4 generations of Williamson men. Now that Robbie has joined the family, we had to get the 4-generations picture again.

4 generations!
Patrick being silly with Great Grandpa Williamson

We took our dog Lobo on the road trip with us, and he was surprisingly very well behaved. It was also the first snow experience for Robbie, here is a video.


The kids with daddy and Nana

Patrick enjoyed eating the delicious desserts that grandma "nana" baked for us. We all put a few pounds on.



Tim was a best man at a friend's wedding, who also happened to be the best man at our wedding. The wedding was in Indianapolis and we had a really good time. The kids stayed at the hotel with the grandparents and their aunt.

The bride and groom
Tim giving the toast -the speech was great!

Tim with our friend Aric and the groom.
 April:

I grew up in a small town called Lagunas, in the state of Oaxaca in Mexico. Lagunas is one of those cities that are built after a company settles there. The cement factory Cruz Azul settled there in the 1940s, and since then began to build a city for its employees. Houses, schools, churches, stores, recreational areas... about 95% of what Lagunas is today, was built by Cruz Azul. My family works for the cement company (as does about everyone who lives there) so I was born and raised there. Cruz Azul has a soccer team. Soccer is big in Mexico, and Cruz Azul happens to be one of the big teams there, often making it to the finals. I mention all this because I used to play soccer (middle school through university) and I miss it so much I can't wait for my kids to be old enough to play with me. In the meantime, we are content to just watch the matches every now and then. Cruz Azul was in a couple of tournaments this year, winning one in April, which was the perfect excuse for everyone in the house to wear their jerseys!

Team Cruz Azul!
Other than that, we were pretty much at home busy with the 2 kiddos, and every now and then with 3, as I have been babysitting a friend's baby. He (yes, another boy!) is just 3 weeks younger than Robbie, which is perfect because they play together, and Patrick loves having him around, too. We get to see him once or twice a month, so at least every month we get our baby Sam dose.

Planning a strike?

--
If you are here for the developmental delays info and such, stay tuned for my next post, this is my last family-related story in a little while.

Thursday, July 11, 2013

May Recap (Baptism, Disney and family visit)

Here is the family Recap for May:

We celebrated Robbie's Baptism. The Ceremony was held at St. Louis Catholic Church, and the reception was held at the Stone Mansion. It was a good time. We were specially happy to have my parents and brother (coming from Mexico) and Tim's parents and sister (coming from the Midwest) joining us for the celebration.
Robbie in his Christening gown
The proud grandmothers!
Have I ever mentioned that the first time I came to the U.S. was as an Au pair? It was almost 7 years ago, right after I finished college. As an Au pair, I had the blessing of taking care of two adorable children. They and their parents are truly wonderful people, and despite that I only lived with them for 1 year, they treat me and mines as their family, so to make it more "official" we asked the mom, Melanie, to be Robbie's Godmother*. From Tim's side, we chose the Godfather*, Mike, who is one of Tim's best friends. I have probably mentioned him and his nice family a number of times on my posts, when I refer to "our friends from New Jersey" (also Patrick's Godparents are our friends from NJ). Robbie's Godfather and his family will soon become "our friends from PA" as they are moving to a beautiful house there in the next few weeks.

The Priest, Tim, Melanie, Mike and Robbie.
After the Baptism, we drove to Orlando with my parents and brother. They wanted to go to Disney and we couldn't say no, of course. I've been wanting to go to Universal Studios to check out the Harry Potter castle and all, so the first day of park visits, that's where we went. There was nothing for Patrick and Robbie to enjoy there, because they are too young, so it was more of a park visit for Tim and I than for the kids. We will make sure to take them back to the Disney parks when they are at least 6 years old.

Mommy and Patrick about to get eaten

We stayed at the Orange Lake Resort (a good friend of us had time share there and was kind enough to let us use it). The cabana was spacious and the hotel was huge, but the best part was the lazy river, where Tim, the kiddos and I spent the second day (while my family was at Epcot -Tim and I have been there before), with breaks to eat and rest at the hammocks. I know, I want to go back like... tomorrow -today is not a possibility since I still would need to pack everyone's suitcases.

Robbie is underneath the white hat!
My kiddos chilling... Jeez, I can't believe I have two boys!

The third day we went to visit some family members in Tampa, while my parents were at Magic Kingdom (of all parks, they said this was the best by far, so now I can't wait to visit) while we were in Tampa, we ate at Columbia, a Spanish restaurant that claims to be Florida's oldest Restaurant. The food was great!

Robbie with his third cousin, Carolyn
Patrick is a people's person (specially if they are blond)

Having both sets of grandparents in town during the Baptism weekend, we decided to get some professional photos by Peter Stepanek at the Glenview Mansion. It was a good time and we got many cute pictures, here are a couple of them.

The whole family!
Auntie Cath with the kids
My boys
It sure was a busy end of the month!

*For Church purposes, we can only select one Godfather, and one Godmother. Traditionally, someone chooses one from the mom's side, and the other one from the dad's side. However, we consider both sets of couples as Robbie's godparents (so for us, he has two Godfathers and two Godmothers) we did the same with Patrick.

Tuesday, July 9, 2013

Happy (belated) Father's day (and June Recap)

Hi there!

Sorry for the loooong silence. The end of May was busy, and June had a broken laptop, but now I have a number of posts on the work that will be all posted on July. I will make up for my June absence, I promise.

So, happy father's day, dear daddies. We often praise (yet not enough!) the hard work of mommies, but hardly ever talk about the amazing job that daddies are doing around the globe.  I'm not talking about working and bringing the money to the house... that's like praising a mom for cooking and feeding the kids. No, I congratulate the ones that go the extra mile. 


One thing (of the many) that I admire about the American culture is how involved are dads in the raising of kids. When I came to the U.S. for first time, I was quite shocked to see that many men here loved making the family meals, and gardening, and taking the kids to their extracurricular activities. I married one of them, which is great considering that I kill all plants and if it was left to me, my kids would only eat Mexican food (my menu is not that long either.) So if we invite you to dinner one day, and you think our garden is beautiful and we have shepherds pie and delicious home made bread pudding, you will have to thank my husband for it.

But going back to children-dads relationship, about everywhere we go with the kids, there are dads with their kids. Unless is during the day, during the week (when dads are usually working) children's places are filled with dads. It's not rare that we will take Patrick to the soft room at the RECenter, and there will be more dads than moms. It was not a coincidence that Patrick's first swimming class had more dads than moms. The pediatrician office is often outnumbered by dads. When we go to museums or playgrounds, I notice that moms usually step back to take care of the babies, while the dads are hands on, running around and playing with the older kids. Having a family where both mom and dad are involved in their children's development and education, is the best we can do for society.

Patrick's first swimming class

So let's talk about the dad of my children. Have I said that I'm overjoyed to have a son that loves me more than anything? Robbie loves me more than anything on this world. That's right, Patrick loves his daddy more than he loves me*. But, thinking about it, how couldn't he? Daddy is in the backyard working which means Patrick gets to run around in the yard; Daddy is fixing something in the house, which means Patrick gets access to a whole world of super cool tools that mommy has no idea how to use; Daddy likes to play Rock Band, which means Patrick gets to play Rock Band (please don't tell him his guitar is not on) and most importantly, Daddy is not home all day long. This is important, because when is nap time, daddy isn't there to fight the battle, when is crazy throwing things time, daddy isn't there to fight the battle, and when is hitting the baby bro time, daddy isn't there to fight the battle neither. 

So Patrick loves his dad more than he does mommy. But, Daddy made this possible, too, by being a great dad. I do have to harass him every now and then about spending some quality time with the kids, but I believe this is quite common. The important thing is that he does respond to that harassment, and doesn't complain one bit. I take it as if he just has to be reminded that sometimes we have to put work aside to enjoy the kids. He loves his children as much as I do, and that is all I want for my kids. He is a great example to them and I know Patrick wants to be just like him, because he imitates him on EVERYTHING he does, and I'm not even exaggerating (good thing he quit smoking awhile ago!)


Tim has been on board in all the things I have tried (from therapies to vitamins, to toys and family outings) to help Patrick in his developmental delays. He has even suggested to try a few new things to help Patrick, which have been a great asset and which I will talk more about in a future post. That support is the one that makes this journey easier, and for that, we thank you! 


Oh, and nothing much happened in June to write about, other than Patrick's new gig as a Rock Star. He has this new desire to play the guitar (and every now and then, the drums) and sing songs for us. 

He isn't shy to play the instruments in front of other people
He got a beautiful singer to join the band
It's absolutely cute, and this is one more thing he is imitating daddy on (no, Tim is not an actual Rock Star, unless he is playing Rock Band) so here is a video we made for him on Father's Day.


*UPDATE: After reading this post, Tim said that Patrick doesn't love him more than he loves me. I do have to admit that when Patrick gets scared, is sick or gets a boo boo, I'm the only person that can bring him comfort. So I guess that counts for something. But the other 80% of the time, he prefers his daddy. 

Tuesday, July 2, 2013

Overcoming Low Muscle Tone: Parents

To close the series on Overcoming Low Muscle Tone, I wanted to write a post about the indispensable role that the primary caregivers of the child play.

I'm not an expert on Low Muscle Tone. I'm not even a therapist, or a special teacher and actually I had never heard of Low Muscle Tone until the day I read the term online, when I was looking for answers to why Patrick wasn't crawling, rolling or pulling up. Being just shy of 4,000 hits on this blog, it makes me so happy to see that most of those hits are from Google searches on low muscle tone, hypotonia blog, oculomotor apraxia, afos for kids and so forth. This means, parents out there are looking for answers to their questions, and looking for ways to help their children, just like I'm. This is the very first step and most important one on helping your children. If the primary caregivers are determined to help the child overcome the obstacles, then he/she will overcome the obstacles.

I realize that in this series I missed out on mentioning so many toys that are specifically designed to help kids with low muscle tone. There are many exercises to do at home that I didn't list, and perhaps some specialists that are there to help hypotonic kids that I have never heard of. But the thing is, I'm writing our experience, I'm here to tell what we have done, and what has worked for us. Patrick's hypotonia wasn't severe, but it was still stopping him from developing at his friends' speed. Every single thing posted here, we did it, and that is why Patrick is now walking and running and jumping. So, you see, it's not about the doctor, or the therapist, or the toy, or the exercise, it is about all the things combined, that you, as parents, will do for your child.

My mother would say that ultimately Patrick's improvements are possible because of all the prayers. And she is probably right. Rather than praying for a miracle that one day Patrick will just wake up and will be capable of doing all the things kids his age do, we actually pray that God gives me and my husband the wisdom to know how to better help Patrick. We pray that we have easy access to the tools (doctors, recreational areas) that will help us help him. We pray for our patience, and our perseverance, and to never let our hope die, that one day, not long from now, Patrick will be able to close that gap of capabilities between him and kids his age.

As much as the Pediatrician loves children, or the special ed loves children, or the therapist loves children, no one loves your children more than you do. So nobody has the desire and love to help your child more than you do. One hour a week of physical therapy won't make the difference. Hypotonia is not a rare disorder, there is a lot of information out there, on websites, books, online groups... you don't need to spend too much time trying to figure out how to help your child. It's all at your fingertips. Reach out to services provided by your county, ask your doctor. Take your child to the playground and other outdoor activities. Host play dates, go to play dates. Make your partner involved. 

But, don't feel bad if you don't work with your child every single day. We have other things to do besides working with our hypotonic child. We have other children too, and a house to take care of, meals to make, and perhaps a job. And we get tired, too. So we need to rest. And we need to go out and have adult conversations with adults outside our jobs. And trust me, taking care of all that helps the hypotonic child as well. Because if you, the primary caregiver are fulfilling your needs and desires, your overall attitude is so positive, energetic and stress-free that therefore your are more able to fulfill your child's needs. Trust me, I know.

Take a break but don't lose sight of goal. That's what I'm trying to say here. Work with your child short, but often periods of time a week. Your consistency will make the difference, you will make the difference. Be your child's best advocate.