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Making Sense of Instructions

Sunday, August 1st, 2010

As a patient, I ask a lot of questions.  I may take up more than my allotted 3 minutes with the doctor, but I need to understand why a medication is being prescribed for me, what the test results mean for me (not the fictitious normal person), and the reasoning behind what the doctor is suggesting that I do.  It is very important for parents to do the same thing.  Otherwise they end up doing things that they partially understand or following a doctor’s instructions blindly.

Let me give you an easy example.  Let’s say I am a new parent leaving the hospital with a 9-pound infant.  This is my first baby, so I don’t know how much or how often to feed her, so I ask the doctor.  The doctor tells me to feed her 3 ounces of formula every 4 hours.  If I didn’t ask any more questions, I would take my baby home and feed her 3 ounces of formula every 4 hours.  I would try to make sure that she took the entire 3 ounces, just like the doctor said.  I would wait 4 hours between feedings and make sure to set my alarm clock at night so she got fed on time.

If I had asked the doctor why I needed to feed the baby exactly 3 ounces every 4 hours, the doctor would have told me that feeding a baby is not an exact science, the same as feeding children and adults.  Some days we are hungrier than others, so some feedings the baby will take 2 ounces and some feedings the baby will take 5 ounces.  Some feedings the baby will space 2 hours apart and some feedings the baby will space 5 hours apart. So basically, follow the baby’s lead when it comes to feeding.  She will let you know when she wants to be fed and how much.

For new and not so new parents, when you are told by a doctor to do something, stop and think about the instruction for a minute.  Make sure you understand why you are doing what you are doing and the actual instructions.  Then and only then will it make sense to you!  It you can explain it to someone else, then you know you understood the directions.

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When is a Grandmother not a Grandmother?

Tuesday, May 18th, 2010

As you may or may not know, I will become a first time grandmother in July.  Actually I will be a step-grandmother.  This is an interesting predicament to be in.  I am very excited to be a grandmother yet; I’m not really a grandmother.  My stepson and his wife are sweet enough to include me as a grandmother but I know in my heart that I’m not a true grandmother or am I?  I’m concerned about stepping on the toes of the “real” grandmothers.  I don’t want to cause any problems for the new parents who will already have their hands full with the baby.  So I have been pondering my place as a step-grandmother.

So what is a grandmother?  Grandmother is a noun

1. The mother of one’s father or mother

2. A female ancestor

I will be neither of those to this new baby, yet I am the wife of the baby’s grandfather, so I will be a part of its life, and I hope a decent sized part.  I think a grandmother can be a lot more than the above definition.  A grandmother provides history for the child and can be a friend, confidante and so much more.  A grandparent has wisdom beyond the parents, and can help the parent raise the child when advice is asked for or needed, not to mention must-needed respite in the form of babysitting.

I like to talk to people and read articles to see what experts say and other people who have been there.  It seems that there is really no “correct” way to be a step-grandparent.  The best advice I got is to follow the lead of the parents of the baby as it grows up.  They will determine how much involvement they want from all their parents as they learn to be parents themselves.  However I was also told that grandparenthood is fairly fluid in our society.  You will often find older adults serving as “surrogate” grandparents to children in schools, who might not have grandparents, or as readers in a library.  I believe if they act like a grandparent, then that’s what they are.

I have to be honest here.  Waiting is not one of my virtues. I know first impressions can last a lifetime, so in order to have an authentic relationship with the baby, I will need to sit back and wait to see what the new parents need and want from me.  This won’t be easy, but I will do it for the future relationship with the baby, the parents and all the other grandparents.  I know it is not a competition. The more loving people in the child’s life, the better for the child!!

If you have been in this situation as a new parent, step parent or “real” grandparent, I look forward to your advice and stories.

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Early Intervention, What Doctors Should Know but Don’t!

Monday, February 1st, 2010

I recently had a parent in desperation ask me what she should do.  She had taken her daughter to the doctor several times.  She knew in her heart that her daughter who was born at 32 weeks and was not developing as her peers at 3 had some sort of a disability, probably Autism, yet her doctor told the mother to wait a little longer to let her daughter catch up.

This is not an unusual scenario.  It is played out many times daily in Pediatricians offices across the country.  Since this child was born prematurely, in many states she would have automatically received early intervention at birth.  I will explain early intervention in a minute.  As a Child Development Specialist with a Masters Degree and over 17 years experience working in Early Intervention and Preschool with children with Special needs and their families. I gave her the following advice;  First, parents know their children better than anyone else.  If you suspect something is wrong, there usually is.  Second, your child needs to be assessed.  Find out who in your state’s State Interagency Coordinating Council (SICC).  In California our SICC is the Regional Center.  Call your local Elementary school and ask them if they know who your state’s SICC is.  If they don’t know, have them refer you to the District’s Special Education Department, they will know.

Once you have found the SICC, you will want to tell them what you have seen, and then ask for an assessment of your child.  The earlier you get this done, the better.  The assessment by the SICC will be free, but you may wait up to 4 months to get it done.  You can also have an assessment done by a Developmental Pediatrician, Occupational Therapist, Child Development Specialist or Child Psychologist.  In California, the preferred assessment by our SICC is the Bayley III. You will have to pay for this.

So, what is Early Intervention you ask.  The definition from the Early Intervention Dictionary is:  “Specialized services provided to infants and toddlers who are at–risk for or are showing signs of developmental delay.  Services emphasize the continued development of basic skills through planned interaction that will minimize the effects of the baby’s condition.  Several types of qualified professionals may plan and implement early intervention services, provided in conformity with an individualized family service plan.  These professionals include case managers, infant educators (who use developmental play activities to promote the infant’s acquisition of basic skills), physical or occupational therapists, speech and language therapists, audiologists, social workers, or individuals who rare trained to help infants and young children with acquiring new skills and behaviors, or to provide other services such as family training, screening, assessment, or health care.  Early intervention services are provided under public supervision and at no cost (except where federal or state law provides for a system of payment by families.”

Early intervention was established in 1986 as part IDEA (Individuals with Disabilities Education Act) and established the Part C (Early Intervention) program.  It was reauthorized in 2004 when President Bush signed legislation reauthorizing IDEA. The current IDEA 2004 Statute (P.L. 108-446) for Part C .

Part of Idea is Child Find.  In the scenario above, the doctor should have referred mother and baby at birth to the state’s SICC because the baby was premature and at risk for a disability.  If the state’s law’s didn’t include at risk children, at the very least, he should have been watching for signs that the baby wasn’t keeping up developmentally.  The problem here is that Pediatrician’s are not educated in what developmental milestones are for children.  They know what correct height and weight is, but now how many words a child should have at 9 months or when they should turn over or reach for things.  That is a Child Development Specialists role.  So many, many children fall through the cracks until they enter Kindergarten.  Fortunately the CDC, Center for Disease Control has stepped in with a program to educate Doctors and the public with their “Learn Signs, Act Early” Campaign.   .  On their website, you can view or download the various materials for the “Learn the Signs. Act Early.” Campaign designed for parents and health care professionals to learn some developmental milestones, and to ask questions should a delay appear.

If your child qualifies for your state’s SICC services, you will be assigned to a Service Coordinator.  Your Service Coordinator will meet with you and write up an IFSP, Individual Family Service Plan.  The IFSP contains information about the services necessary to facilitate a child’s development and enhance the family’s capacity to facilitate the child’s development. Through the IFSP process, family members and service providers work as a team to plan, implement, and evaluate services specific to the family’s concerns, priorities, and available resources. This plan is about the entire family and what they need in order to help the infant/toddler to reach their potential.  You may need respite care (skilled care giving service which allows the parents time away from the house) along with Occupational Therapy and other early intervention for your child.

While you are taking this journey into early intervention, you, the parent will have a lot of feelings to deal with including, denial, grief and being overwhelmed.  Please look into support groups in your area where you can talk to other parents who have been through what you are going through, and came out the other side still standing and with an in-tact family.  There are also many online groups for every disability.  Please build a support group for yourself.  We all need one whether we have a child with a disability or not.

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Early Warning signs for Autism and Developmental Disabilities

Sunday, December 13th, 2009

Last weekend I went to a great conference sponsored by Zero to Three.  One of the most important sessions that I went to among others was about a new program out of the Center for Disease Control.  Now we tend to think of illness when we think about the CDC, but this is a prevention program for young children.

The name of the program is Learn the Signs, Act Early.  The purpose of the program is to teach Pediatricians and parents about child development so that they don’t miss early warning signs that children may not be developing correctly or on time.  This is important because the prevalence of Autism Spectrum Disorders has risen from 1 in 2,000 in 1990 to 1 in 100 today.   Why this is happening, the researchers don’t know yet.  But what we do know is that the sooner a child has intervention, the sooner he will be able to reach his full potential.

In two reports done by Autism and Developmental Disabilities Monitoring (ADDM) Network and the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) the majority of children identified with an Autism Spectrum Disorder had documented concerns by a parent or professional before the age of three.  These concerns were about the child’s language, social, or play development, but the median age of diagnosis was 4 ½ to 5 ½ years.

As a Child Development Specialist, I have been concerned for years that parents and Physicians have been missing early warning signs and have missed the benefits that early action could have provided these young children.  This program will increase the dialogue on the topic of developmental milestones and increase early action on childhood developmental disorders.

It’s Aparent will be dissemination Learn the Signs, Act Early in the San Fernando Valley, Calabasas and Agoura  We will be Sharing information with Pediatricians, preschools and day care sites.  We will also share the information with parents at local community sites such as Churches, Synagogues, Community Groups and other places where parents get together.  Please let us know if you would like us to distribute information to your doctor or preschool or if you would like us to speak to your group. It’s Aparent is happy to be able to share this vital information with the community.

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Learn The Signs, Act EarlyVisit the “Learn the Signs. Act Early.” website for information about childhood developmental milestones and delays. You’ll be able to track the developmental milestones your child should be reaching and download fact sheets on developmental milestones for children from 3 months to 5 years.

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Children Learn Gratitude From Watching

Saturday, November 28th, 2009

My mother always said that little pictures had big ears.  She was right that children hear everything that we say whether we want them to or not. What she didn’t know was that children also notice everything that we do whether good or bad.

Your child will notice when you drive too fast just as your child will notice when you help an elderly person at the market with an item they can’t reach .  Your child sees you giving bringing canned goods for a food drive to feed the less fortunate.  She sees you bringing food to your neighbor who just had surgery and can’t cook for her family too.  Your offers to take your parents to the doctor or to take care of a neighbor’s cat while your neighbor is on vacation do not go un-noticed by your child either.

A child of 3 years can start with small acts of kindness for others such as helping you to get the mail for a neighbor or feeding her cat.  Your 4 year old can help you bake cookies or brownies for a friend who has just lost a family member.  The seven year old can help serve food at a homeless shelter with you and your family.  All children can go through their closet yearly to give the things that they don’t wear or use to others who can use them more.

When you and your child do these things together or with the rest of the family, you are teaching your child to be grateful for what they have, to be empathetic and to be charitable toward others. These things can’t be taught by talking or from a book, but only by example, and by doing them together. In this way, you teach your child the value of being charitable, empathetic towards others and gratitude for what they have that others may not.  These lessons will last a lifetime because they were taught not only by watching, but by doing with you.  Some of the best memories are made this way.

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A Must Read Story

Monday, July 13th, 2009

I just heard a story that I want to share with you.  A young family was on their way home from a morning shopping trip when they were in a serious car accident.  Horribly, one child was thrown from the car and later died in the hospital.  Sadly, this kind of thing happens all the time.  What sets this story apart from others like it is that the father was driving drunk.  He was driving drunk in the morning after shopping with his wife and four children.

So, I ask myself the following questions:   What part did the mother play in the accident?   Did she know that the father was drunk then knowingly risk her life and her children’s lives by getting into the car?

I found out a couple of days after hearing the story that this was the second time that this family was in a car accident under the same circumstances.  The father is being held in jail for involuntary manslaughter and the mother is being held for child endangerment.  With both parents in jail, this leaves three little girls in the foster care system, at one of the most vulnerable times of their lives, after the death of their brother.  I can’t tell you how badly I feel for those children right now.

We all make hundreds of decisions every day.  If we are parents, we not only make decisions for ourselves, but we make decisions for our children.  Most of the time, our decisions don’t seem to have any effect on our children, so we don’t think of our kids very often when we make decisions for ourselves.  This mother’s decision to put her children in the car with their father cost one of her children his life, and will affect the other children’s lives for the rest of theirs.

Please do what is best for your children regardless of what you think other people think.   You hold your child’s life in your hands.  And don’t forget that when you have children, you must have a Will and a Guardian for your children.  It is an absolute MUST.

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Growth and Change

Sunday, May 17th, 2009

Growth and Change
May 17, 2009
I just read a blog from a friend of mine, Dawn.  In her blog, she talks about her three year old son’s first rebellion regarding taking a nap.  Her son says, “No nap, I’m MAD.”  Dawn replied to him, “You’re mad because you have to take a nap?” He says, “No nap, I’m MAD.”  This is his first attempt to exert his limited authority.
Dawn understood that this was a powerful step for him to admit that he was mad and that he didn’t need her to do anything about it, to understand it or to try to solve the problem for him.  He just needed to be mad for a while.
As parents, we need to know which problems we own and should get involved with and which we don’t.  Dawn doesn’t own her son’s problem in this case.  Her son needs to experience this emotion and what it feels like.  She should not step in to tell him not to be mad etc.  Even at three years old, this is his issue to deal with, feel and experience.  Watch what happens.  Dawn allows her son to be “mad.”  (She actually gets out the video camera and tapes his first mad incident for posterity while he works this out for himself).  Dawn tells her son, “I see you are mad and that is OK, but it is still nap time,” Meanwhile she is collecting his naptime collection of two blankies and a pacifier.  While Dawn is doing this her son is saying, “No nap, I’m MAD.”  When they arrive at the bed, she says, “Tell mommy nite nite,” which he does and gives her a hug and kiss on his own and goes to sleep.
Our children need to learn from their experiences, good or bad.  If we wrap them in bubble wrap so that they never get hurt or never experience a negative feeling, they will never grow as human beings.  If a person never feels unhappy, how do they know when they are happy? Therefore we should be there to support our children while they learn these lessons in life.  In the above example Dawn says to her son, “I see you are mad and that is OK, but it is still nap time.”   Dawn tells her son what they are going to do, and then proceeds to do it, letting her son know that even if he isn’t in control right now, he can feel comforted knowing that she is.  This gives her son the sense of structure that all children crave while they are learning about their world.
Dawn is a seasoned mother of three who believes that:   “Emotions are healthy.  Unlike hiding a toy, jewelry or cash, emotions are not something you should be embarrassed about experiencing.  You need to be able to explain to them what they’re feeling and help your children work through them if they need help.”
If you have difficulty with negative emotions such as anger and fear, you own that problem, your child does not.  You will want to work out those emotions on your own or with a professional so your child doesn’t end up with the same difficulty you have.  Remember that children from what you do not what you say.
As your child grows, you will face many stages and changes in your life and theirs.  Be prepared for the changes with a sense of humor, and a basic structure from which you make parenting decision.   Be ready to face sudden rebellions and emotional upheavals with a tool box full of parenting tools and a calm rational mind.
To read more of Dawn’s blogs which are very insightful visit http://www.toibocks.com/wp/

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How Kids Learn Respect

Tuesday, May 5th, 2009

Tomorrow, my son, my youngest child, will close escrow on his first house.  He asked for my help all along this very scary and important road.  I have never filled out escrow or loan documents on my own before, but he trusted me to help him, so I did.  I read the papers and guided him as did his real estate agent.

Trust between a parent and a child starts with respect.  Respect must be earned and it starts when the child is an infant.  My son learned to respect me because I fed him when he was hungry, changed him when he was wet, and understood the cues he gave me that told me he was tired and needed to be put down or needed to be held.

Parenting is a very scary job.  I never knew if I was doing a good job or if my kids were going to turn out OK.  I had to do what I thought was best and hope that I knew what I was doing was right.  I was lucky because I had my parents beside me to help me and guide me through my childrearing years.  When I was tired and needed a break, they were always there to help.  They taught me that I would love my children with all of my heart for the rest of my life and that parenting is a job that will last a lifetime.  Parenting lasted a lifetime for my father.  My sisters and I relied on him for help and guidance until he died last October.  We all learned to respect him when we were infants, just like my children learned to respect me, and hopefully their children will learn to respect them.

Your comments are always welcome.

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