Toilet Training Your Child is a Big Deal – For Both of You!

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Toilet Training Your Child is a Big Deal – For Both of You!

Toilet training your young child is a major event in the life of your child – not to mention in your own life as well. After two or more years of changing diapers and waiting for the big day to arrive when your youngster begins to notify you that she has to go – and she actually does use the potty successfully – is like a day of liberation. It’s one less concern in the daily care of your child.

However, getting to that day can be a real challenge – both for you and your child.

For instance, here is what one parent said recently:

“My son has been somewhat slow in parts of his development, such as his speech. However, physically he has always seemed to be on schedule, but one thing that hasn’t happened yet is his use of the potty. I’ve been encouraging him to use the potty for a year, but even though he just turned three he seems to have no interest in using it. He just prefers to wet his pants. Am I doing something wrong?”

Another parent said: “My daughter seems to be afraid of the potty chair. She cries if I put her on it. I’ve tried praise and rewards, but nothing seems to make any difference. She is two-and-a-half years old, and I thought she would be using the potty at this stage of her life.”

Most children are ready to begin toilet training by somewhere between the ages of two and three. The average age is about two years and eight months. Many parents, however, think that they can have their child trained by age two, but many children are just not physically mature enough prior to age two to control their urination or bowel movements.

You may think that it is just a matter of will or of compliance, but children first have to be aware of the sensation of a full bladder. That usually doesn’t come about until later in the year between ages one and two. However, in addition to recognizing the signs of a full bladder, then they have to have a certain amount of control over the muscles controlling urination so that they can postpone urination until they get to a toilet or potty. Again, that control may not appear before age two.

The same process is true of bowel movements. First the youngster has to recognize the fullness of the lower bowel and then has to be able to indicate that need. And that, too, doesn’t come about until between ages two and three. Not only do they have to recognize their readiness to go to the toilet, but they have to be able to get to the potty in time to eliminate there. As it turns out, both nighttime bladder and bowel control comes before daytime bladder and bowel control.

That’s the physical part, what about the temperamental part?

You usually need to take your cues from your child in order to decide the right time to begin toilet training. Starting too early can create problems as some children become oppositional about using the potty when they feel pressured and this may delay the overall accomplishment of successful toilet training. However, most children, if you are fairly relaxed about the start of toileting training will give you the major signs as to when they are ready.

Those signs include their staying dry all night and waking up dry after a nap, having bowel movements on a fairly predictable schedule, showing that they don’t like being wet or having a soiled diaper, and having an understanding of the words that you will use in toilet training – such as “wet,”  “dry,” and “potty.”

What is the best way to teach toileting behaviors?

There are a wide variety of approaches and both your family background and your cultural expectations will play a part in how you think you should teach your child to use the potty. But, the use of a potty chair often works well because it is easier for a child to use and might not be as intimidating as the regular toilet.

If you have come to recognize your child’s patterns of urination and defecation, you can call attention to what is happening (for instance, where your child is grunting at a regular time after a meal) and then associate this with using the potty (“When you feel like you have to poop, then I can help you use the potty”).

Bedtime Routines and Rituals Make for Good Sleep Habits in Children

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Bedtime Routines and Rituals Make for Good Sleep Habits in Children

When children have bedtime and sleep problems at ages three, four, and five, those problems can often be traced back to the development of poor sleep habits at younger ages.

For instance, Tracey, age 4, whined and complained about going to bed at night. She found excuses to try to stay up later, and when she ran out of excuses she would cry and leave her bedroom.

And Reid, age 3, had temper tantrums at bedtime and insisted one of his parents stay in his room and sleep beside him. If his mother or father tried to leave the room before Reid was sound asleep, he would cry and fuss until they lay back down beside him.

Many such sleep and bedtime problems can be avoided by establishing bedtime routines between six and 12 months of age. Children do much better at bedtime if they know what to expect at the end of each day. In other words, if you create a predictable sequence of events that you follow consistently every evening, your child will feel secure and will be ready to go to sleep by the end of the routine.

Once established during the second six months of life, the basics of your child’s bedtime routine will be established and although some aspects of it might change somewhat, the basics routine will stay the same.

A predictable sequence of events prior to your child going to sleep may involve some or all of the following:

  • Washing or taking a bath
  • Putting on pajamas
  • Brushing teeth
  • Having a story read
  • A final goodnight kiss and hug

This routine should not be lengthy, but it should be consistently followed. However, no matter how you tweak this kind of bedtime ritual, it works best if it is preceded by about an hour of quiet time or winding down activity. Engaging in roughhousing with your child — wrestling, watching stimulating videos, or running around — are not conducive to what is needed for good sleep; and that is a peaceful and quiet transition period.

There are other helpful elements that can ease bedtime, but some that work well for many parents include:

  • Specific bedtime. Children function best when there is a predictable routine. A good place to start is by setting a bedtime and not deviating from this time.
  • Advance warnings. Your child may be far too young to tell time or know how long 15 minutes is. But by announcing that it is almost time for a bath or for putting on pajamas helps her to begin to associate certain events with the approaching bedtime. For example, saying “It’s almost seven o’clock and time for bed,” won’t be much help, but saying, “I’m going to start your bath” and then turning on the water in the bathtub will be a signal that she will learn to associate with getting ready to go to sleep.
  • Snack. A light snack of foods that include protein and carbohydrates will tend to help induce sleep. Protein will keep his blood sugar level on an even keel until breakfast the next morning, while carbohydrates will make him sleepy.
  • Warm bath. A warm bath will be relaxing and by raising your child’s body temperature slightly, she will be more likely to fall asleep easily.
  • Story. Reading a story is also relaxing and comforting. Not only are you teaching your child about reading and language, but you are providing a comfortable experience that will, in time, be associated with sleep. As your child develops favorite stories and loved books, she will ask to be read the same ones over and over. By reading her favorite books, she will feel secure and be more relaxed and ready to go to sleep.

Finally, always make a final kiss and hug fairly brief. Prolonged goodbyes may signal your anxiety and may lead to your child crying or being anxious when you try to leave. Anxiety often results in crying – rather than a final goodnight and gentle sleep.

Teens often Assert their Independence by Refusing to take Prescribed Medication

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Teens often Assert their Independence by Refusing to take Prescribed Medication

A friend’s 18-year-old son recently decided he didn’t want to take his ADHD medication anymore.

“I don’t think I need it anymore, because I’m doing so well,” he told his parents.

Three weeks later, his parents found out he was in danger of failing a class he needed to get into the college he selected.

“Don’t worry,” he assured his parents. “The college doesn’t care about your grades during your last semester in high school.”

But, of course, his parents were worried.

“He’s going off to college in September and how is going to be able to do well if he is not able to concentrate and do his work,” his father asked. “It is really evident that he needs his medication, even if he doesn’t see the necessity of it any longer.”

Over the years, I worked with many adolescents and their families. Some of the teens took medication for the symptoms of ADHD; others were prescribed medications for other medical conditions, such as diabetes or seizure disorders. But there was a pattern that I began to recognize.

As teenagers reached their middle and late adolescent years, there was an increasing need to be self-sufficient, independent, and autonomous. They wanted to be grown up and to be their own person. For many of them this meant that they no longer wanted to be dependent on a drug or a medication. They needed to prove to themselves and others that they were an adult and that they were capable of handling their problems and symptoms without the aid of a medication. For some, it was like taking a medication meant weaknesses or a crippling dependency. It frequently reminded me of the toddler who proclaims “Me do it!” whenever an adult tries to assist them.

One adolescent I saw for counseling during his junior and senior years in high school, credited his success in high school to the medication he took to deal with his short attention span. In his second semester in college, he came back to see me during a spring break.

“I did really well my first semester in college,” he said. “But things really went downhill this term.”

When we talked about why this might have happened, he admitted he wasn’t taking his medication. “I thought I could do it on my own,” he said. “But I’ve been taking Ritalin for years and I’m tired of it. I just want to be normal.”

He did, however, agree to start taking his medication again, and as I anticipated, his grades went up.

Taking drugs, for many teens, becomes one more battleground in the adolescent power struggle and the need to assert greater personal autonomy. In other words, rebelling against the taking of medication – even when it is important for maintaining good health – is a way teenagers can feel more in control of their own lives.

For example, Diana resents every pill she puts in her mouth to manage her seizure disorder.

“I don’t want someone else telling me what I need to do,” Diana has said, “especially a grown-up.”

At 16, Diana was still living at home and going to high school. She had frequently had seizures in school, which resulted in her being taken by ambulance to an ER. She knew the medication prevented seizures, but still she resented taking the medication. As a compromise with her parents, she said that she would not stop taking her medication until she was 17.

“Then, I’ll stop taking it for a while and see if I can get along without it,” Diana said. “But if the seizures return, then I’ll go back on the medication.”

It is probably very clear to you that your adolescent might not be able to function adequately when not taking their medication. However, it is likely that your child has other issues – such as the need for independence, autonomy, and personal power – that may overshadow their judgment and commonsense.

Although your teenager may resent you telling them they need to continue taking their medication, a doctor, who is not their parent, is more likely to be listened to as an authority. If the doctor’s authority doesn’t work, you may have to stand by while your teen tests out their ability to function without their medication. Although this might be difficult for you, you may be able to be supportive and help them make a healthy decision once they have figured out that they can’t control a medical condition without medication. If you have been engaging in a conflict with your teen over the use of their medication, they just might hide their condition from you so that they don’t have to admit they were wrong or made a poor choice.

It’s Tough being a Stepparent

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               It’s Tough being a Stepparent

A woman recently confessed she didn’t like her 10-year-old stepdaughter.

“When I first met Jennifer,” Samantha said, “we seemed to hit it off and I thought we would become good friends. She and I seemed to have a lot in common —  including love for her father.”

However, once Samantha was married, she and Jennifer no longer seemed to have so much in common. Jennifer seemed to change. She acted resentful of Samantha, was demanding, ungrateful, and jealous of her father’s attention.

“Her behavior was so obnoxious,” Samantha said, “that I began resenting having her around. And she acted like I was in the way, too.”

Mark, a stepparent to 13-year-old Thomas, also saw problems once Mark married Thomas’ mother.

Thomas became disrespectful towards both Mark and his mother. He seemed angry most of the time and didn’t want to be around either Mark or his own mother.

“We got along great in the beginning,” Mark said recently. “He seemed to need a man in his life and I thought we would have this relationship where he and I could hang out together.”

Mark went on to say that he and Thomas’ mother have a exceptional relationship and they are still deeply in love. However, Thomas’ behavior has put a damper on the marriage and family togetherness.

“I wonder sometimes if I should leave,” Mark said. “Thomas doesn’t like me and I don’t see how we can have the kind of marriage I want when Thomas seems to hate me so much.”

A great many remarried couples have problems related to a stepchild’s behavior. Contrary to what many stepparents and biological parents think, it is older children —  particularly teenagers — who have the most difficulty adjusting to a stepparent entering the family.

There are various reasons for this, but often the older child or teen has great difficulty accepting that their parent has remarried and that there is a stepparent in their life. Younger children may be grateful for the love and kindness of a stepparent, but an older child’s adjustment is frequently complicated by feelings of being disloyal to the other parent of they like, or even love, the new stepparent.

Furthermore, adolescents who are dealing with their own sexuality are often forced to deal with the sexuality of their parent who has remarried. When their parent is dating, they may be able to deny their mother or father is having a sexual relationship. When their mother or father gets married, though, and they see more of the love and affection between them, they can no longer deny the sexuality and the feelings they’re struggling with inside themselves.

Furthermore, frequently both biological parents and stepparents have expectations that once they get married, the children will love the stepparent as much as the biological parent loves that person. And both may expect that they will all just become a happy, blended family.

But, it may take years for an older stepchild to come to accept a stepparent. All of the typical feelings stepchildren have need to be resolved at the very same time these kids are trying to cope with all of the aspects of adolescence.

Stepparents usually need very tough skin in order to deal with some of the adjustment problems teens have. If a stepparent holds on to the romantic notion that the stepchild is going to respect and love them  right away, that makes it more difficult for that stepparent to detach and not take things personally.

And that relates to one of the first recommendations for stepparents: Don’t take your stepchild’s adjustment problems personally. It’s not your fault they can’t accept you. Frequently they will act like they hate you and that has to be kept in perspective. It’s not you; it would be the same no matter who their stepparent was.

Sometimes it helps for the family to be involved in counseling. Of course, it may be the stepchild who might need this most in order to learn to adjust to the new family arrangement. But, both biological parents and stepparents often need to be talking to someone who knows and understands the child in order to learn how to better cope with the child’s feelings and behavior.

Know Your Toddler’s Limits – and Plan Accordingly

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Know Your Toddler’s Limits – and Plan Accordingly

I was watching a young parent in a mall recently. This father had stopped to talk to a friend. However, he had his two-year-old child with him. And it was very clear that his toddler was very quickly bored and wanted to move away from his dad to do some exploring on his own.

This father wanted his child to stand by him and be patient. But as his son kept trying to get away, the father became progressively more upset and angry as his young son did not want to stand quietly near him.

This dad hadn’t planned very well. He should have had some toys or objects to distract his son just in case he stopped to talk to a friend or decided to go to lunch.

Despite what some parents might think, toddlers aren’t evil little creatures constantly looking for chances to frustrate their parents. They’re just trying to grow and learn about the environment and how best to operate within their world. And a lot of times, they are not going such a good job – mostly because they have a short attention span. Neither yelling nor stern commands from parents will change that. They will still have a short attention span.

In living with a toddler, there will be many situations – say when you’re talking to a friend, traveling in the car, or having lunch in a restaurant – which require the use of distractions.

Distraction can be a fine art when thoughtfully used with a toddler. By simply drawing your child’s attention from an unwanted action or behavior to something more interesting, you can solve some immediate behavior problem or prevent a temper tantrum.

It is always best to know the abilities of your toddler – and to bring along some supplies which will suit his abilities.

The 12- to 18-Month-Old Toddler

At this age, distraction is most likely to be used in a very deliberate way. But it’s important to know the attention span of the normal child from 12 to 18 months. Their attention span ranges from a few seconds to about three minutes.

Children of this age can look at pictures in a book for a few seconds and may spend a few concentrated minutes exploring an unfamiliar object or toy. But they have a hard time dealing with confinement, so they will get restless and squirmy fairly quickly, which may mean one possible distraction is to get them moving.

Your best bet for distraction at this age is to bring along a new toy or one your child hasn’t seen for a while. More complex toys – with texture, sounds, and colors – will keep a toddler busy longer. You can also use snacks that are eaten one little piece at a time as a distraction.

The 18- to 24-Month-Old Toddler

At this age, the child’s attention span will range from about one minute to seven minutes. Since this slightly older toddler has a better ability to concentrate, she may sit quietly for several minutes with a book, toy, or video.

The best bet for distraction at this age is to use toys that inspire her to use her imagination. Dressing and undressing a doll, coloring on a sheet of paper, putting different shapes in a form board, or playing with simple puzzles can work well.

The 24- to 30-Month-Old Toddler

The older toddler’s attention span has increased from about five minutes to 15 minutes. Two-year-olds are continually gaining in concentration abilities, but remain highly distractible and move quickly from one activity to another.

The best ways to provide distraction now are to fill up a bag with surprises for your child to discover one at a time. Or let him choose several toys to bring along. But you should have that bag handy with several toys and other distractions. Other good distractions for children of this age include beads to be strung, stickers to be placed in a book, coloring books, and audiotapes with headphones which include a book that goes with the audiotape.

Have distractions available and you’ll never have to try to enforce patience or compliance with a stern voice.

Dealing with a Challenging Teen is a Daunting Task

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Dealing with a Challenging Teen is a Daunting Task

Thirteen-year-old Brock is a difficult youngster. He doesn’t come home from school on time, he talks back to his teachers, and he refuses to obey many requests or orders from his mother and stepfather. He’s also been in trouble for stealing. He’s generally angry at his teachers and his parents, and he says he wishes they would “just stop yelling at me.”

When his parents try to restrict him, Brock tells them it’s unfair. He says that being grounded or restricted to the house doesn’t do any good.  “It just makes me hyper and I get into more trouble,” Brock contends.

His parents have tried other punishments to attempt to get him to conform to the rules and to their expectations. They’ve taken away his bike, the use of a phone, his privilege of watching TV, and his iPod. Brock says he has to be good “for a little while” and then he gets back whatever was taken away. He adds, “My stepfather softens up after a while no matter how long he says he’s going to keep my stuff. My mom just can’t handle it when I give her a hard time, so my stepdad lets me off the punishment so my mom isn’t upset.”

Brock has learned to work the system in his home without really changing any of his behavior. All he has to do is yell at his mother, destroy something in the home, or just make life miserable for his parents, and they tell him to leave because “they can’t stand me anymore.”

When children who have been stubborn, oppositional, or defiant for several years get to be in their early teenage years, and their parents lack the training or skills to deal with them, they may be similar to Brock. Given Brock’s problems at home and at school, and given his consistent anger, along with his ability “to work the system,” it is very likely that he will continue to get into trouble and he could well end up in the juvenile justice system.

For some parents, having a teen like Brock end up in the justice system may be a welcome relief. They may feel like they’ve exhausted their ability to handle their adolescent. However, the reality is that a juvenile court or a family court can only offer some support and structure, and a court is unlikely to be able to undo everything that has led a young person like Brock to be what he is at this stage in his life.

There are, of course, other alternatives. Seeking professional help and having the teen attend a therapy group may be useful. Even more useful, though, might be family therapy. Family therapy can be particularly important in opening up lines of communication, changing reinforcement patterns in the family, and decreasing negative and critical interactions.

When an older child or adolescent, like Brock, is presenting serious and persistent oppositional and acting-out problems, parents must examine their own role in the development of the problem. It is often necessary for parents to accept that they will have to make some changes.

If a child, like Brock, has reached the adolescent years and is as out of control as Brock is, then it very likely means that there have been too many ongoing conflicts and battles within the family, and too little parental understanding of children and how they express negativism and independence. Of course, it almost never is exclusively the fault of a parent that a boy like Brock develops. However, it might well be the case that parents have likely mishandled at least some aspects of discipline.

But what can you do at this point?

A good place to start is to understand that there is no magical solution to getting a teen under control. It usually requires patience, perseverance, strength, and determination to bring about changes. In addition, there will have to be work to set clear limits and rules. Rules and expectations will have to be communicated clearly. Parents will have to learn to be consistent and firm in enforcing rules. And they will have to offer close monitoring and supervision.

But with all of that, outside help is usually required because the task of bringing about changes in a stubborn and defiant teen is daunting.