I have mentioned in passing to a couple of friends about Max’s occupational therapist when they ask us what we’re doing for the day and I forgot to just say “we’re seeing the doctor” instead of using the doctors official title. And I’ve taken pictures inside of the therapist’s clinic before, but I’ve always been nervous to publicly talk about it, as if it’s something that we need to be ashamed of or that Max and us would be judged for. Looking back on it now, that feels incredibly silly. Max seeing an occupational therapist (OT) isn’t embarrassing or shame worthy. It has been life changing. It is a weekly appointment that both he and I greatly look forward to. His therapist hasn’t been someone who has been in our lives for long, but she is someone who is making more of an impact than I think any of us realized.
To cut everything short, Max has what is called executive function disorder, or EFD. EFD is a very broad term for a variety of things that basically means his brain is functioning at a higher level than most two-year-old’s (yay!), but when something comes in and causes him to become frustrated or angry, his frontal lobe “shuts down” and he loses the ability to control his outward behavior (not yay). I totally get that this sounds like most two-year old’s, and even most three-year old’s when they want something or are told no. All hell can break loose. Tantrums ensue wherever you are (toddlers have no shame in throwing down in the middle of aisle seven at the grocery store) and no amount of negotiating or calm speaking will bring an end to the tantrum. But EFD is a little bit different. Tantrums and meltdowns are still the same, but the duration is abnormal. A 10 minute tantrum, although overwhelming for parents, can be pretty normal. But a 35 minute tantrum with no end in sight? Not so normal. And EFD affects behavior towards others as well. Max repeats the same kind of phrases whenever we go somewhere with a lot of other kids; “I don’t hit people,” “I don’t smack anyone,” “we want to make people happy!” He gets it. But when he’s upset, he just simply cannot control himself. All memory of proper behavior sometimes flies out the window. For example, I was upstairs washing dishes when I heard my five-year-old screaming bloody murder downstairs in the playroom. When I flew down there, I saw my two-year-old pulling his sisters hair with such force that his arms were literally shaking. He was pulling so hard that he had not one ounce of strength left in him to pull, but he was trying. After I pulled him off of her, all while yelling and trying to comfort his sister, he began fighting me. Ripping my glasses off, scratching my face, kicking my stomach – the works.
I felt like a failure crying in the pediatrician’s office, explaining to him that being Max’s mom sometimes feels like it is too difficult for me, like I am one more endless tantrum away from ending up on Snapped. Luckily, his pediatrician was literally sent from the Gods and knew right away that what I was describing was atypical and that Max needed to be seen by someone who was specialized in behavioral issues. Going to OT has been unbelievably helpful. There are nine million new things I could tell you about Max, but there’s a few things I have learned that I think any parent of littles, even those who are completely typical, can utilize in their day-to-day parenting life to make things a little easier, for both you and your child.
- Understanding a Sensory Diet
When most of us hear “diet,” our brains immediately think “food.” Because duh. But as much as our bodies need to be fed the right things to fuel us properly, so do our senses, especially young kids. Max can get overstimulated simply because everything around him looks like a toy. The couch to him can become a mountain that needs to be climbed. The bathtub can be an ocean that needs to be explored (and that needs to be splashed all over the bathroom floor). This is where proprioception comes in to play. Proprioception is just a very fun word that essentially means “heavy work.” Having toddlers perform something that requires almost every muscle in their body to be working can ultimately result in a very tired and very calm child. I’m sorry, I think I hear angels singing. Some examples of whole body proprioception include pushing a box full of toys, climbing up a slide, pulling wet clothes from a washer (bonus points if they help load the dryer), or jumping on a trampoline. The latter has been the most helpful for us. By simply letting Max jump on his trampoline for 15 minutes before bed, we have cut our nighttime routine by half. He’s just too exhausted to fight sleep. Toddlers are the opposite of us adults. While we need to relax and unwind before bed, kids need to exercise and increase their heart rate. All of that pent up energy has got to go.
2. The Development of Self Regulation
Self regulation is something that comes in three “orders.” The first order are automatic functions, or things that we cannot typically control. Things like body temperature, immune system functions, sleep/wake cycles. The second order are things we learn in infancy, such as vocalization in patterns (“mama,” “dada,” etc.), sucking, and adaptive movement. The third order is where our children find themselves struggling quite often. It deals with things like sustained attention, planning, execution of strategies, and problem solving. While our children are learning at a rapid pace, the third order primarily takes place in the frontal lobe, which takes an immense amount of time to grow and mature. This is when we have to take a breath and understand that this “third order” takes a LOT of time to develop, and even when they’re at their worst, our kids are trying their damndest to figure it all out. And there’s a good chance they’re just as frustrated as we are.
3. Planning Ahead
Planning ahead has sometimes been the key for us to avoid meltdowns in a public place, or to ease Max’s mind when things don’t go exactly according to plan. Meltdowns still happen, but the frequency and intensity has become much more minute. When we’re going somewhere that Max needs to sit and stay calm for a while, having him do something to move his body around, like throwing a squishy ball in the house or chasing each other around the kitchen, can calm him down and get his body ready for rest. Alternatively, when we’re going to be taking him somewhere loud and chaotic or with a lot of other kids, creating a calm environment at home seems to keep him from being overstimulated once we’re out. Turning off the TV, closing all the curtains and turning the lights down, speaking lower and softer. All the things that would keep a body and mind calm help to ease his transition into a more loud and bright setting.
Another option for planning ahead is to get your toddler’s olfactory senses engaged. Something as simple as drawing at the table with scented markers has been known to have calming effects in children’s behavior. We aren’t a family who does (and we seem to be the only one these days), but a lot of OT’s, ours included, encourage the use of calming and relaxing essential oils about 30 minutes prior to leaving the house. If you are an oil diffusing family, I would love to hear if this works for you!
All two-year-olds are several years away from fully understanding empathy. When another child takes their toy away and they smack them as a result, they aren’t trying to cause pain or sadness to that child. They’re simply frustrated and need a release. Here are where visual cues can help. Listening to adults explaining emotions usually results in a child who is only half understanding what is being told to them. But showing your child pictures of people being sad, angry, happy, frustrated – anything– will help them understand and remember what each emotion looks like and how it can be evoked. Not only pictures, but simply talking to your child about the people around them can give them a better understanding. Max and I were sitting outside of a plaza eating froyo when a little girl, who was sobbing, walked by with her mother. Max pointed out that she was sad and I said, “yes she is. Maybe somebody hit her or pulled her hair.” He immediately followed it up with, “that’s not nice! That’s bad!” It was a nice reminder that these small changes we are doing are working for him.
5. Give Yourself a Break
Children are exhausting. Even kids who don’t have any sort of behavior abnormalities can still be taxing and frustrating and overwhelming. Sometimes our kids can just be real assholes. But you’re doing a great job. The fact that you’re there every day, without fault, is good enough. Some days you will be at the top of your parenting game, even when your child is having a nightmarish day, and you’ll handle each issue as perfectly as possible. Other days you’re going to cry while stuffing your face full of chips and watching The Real Housewivesas your child breaks something else out of anger. And it’s all okay. Even now, after having a much greater understanding of how Max functions internally, I still sometimes find myself crying in the bathroom, going over all the reasons why I am a terrible mother. But I’m not. I’m really good and also really human. I’m allowed to mentally need a break and not feel bad about it. You can’t expect to properly take care of someone else’s needs when you’re neglecting your own, which are just as valid and just as important.
Max won’t have these behavioral issues his entire life just like most children his age. And for that, I’m grateful. But if you find yourself struggling through some of these tantrums and meltdowns, I can personally promise you that implementing some of these tools can garner a positive response. And it may even allow you to end the day feeling not as exhausted as before. Know that when parenthood has brought you to your lowest point, you’re not alone. It just takes a village. A very large and very understanding village that also has wine readily available.