Tourette

There have been many parent posts online regarding the general and persistent negative behaviour patterns of their children.  “Why is my child mean?”  They describe their children as being “mean” on a regular basis.  It’s not uncommon to see this default behaviour in children who have neurological challenges.   In my presentations, I call this the “Awfulizer Syndrome“.  To these children, everything is awful.  They always seem annoyed or angry.  They are routinely mean or insulting.  They often engage in name calling and typically communicate in an unkind or angry tone of voice.  Generally negative in most aspects of their daily life, they are most often disagreeable.  Without intervention and support, it is difficult to correct these behaviours.  From personal experience, as a person who has overcome this challenge and a parent who has dealt with it, I can tell you it takes a great deal of effort to overcome this neurological affect.

Step One:  Identify your child’s behaviours and the responses of your family members

Identify and address when your child is mean through his/her words, voice or actions.  Be sure to do this when your child is in a calm and receptive state of mind.  Session need to be frequent and on-going.  Share your feelings with your child.  Explain how their words/tone/behaviours make you feel, and how it affects your thinking about them (e.g. “Although I love you, your tone of voice makes me feel mad and I don’t want to be around you when you are mean to me”).  This response is a natural consequence – people don’t want to be around people who are mean or unkind.

You need to make your child recognize and understand their behaviours before you can begin to change them. At times, it may be necessary to actually reflect behaviours back to your child by demonstrating them in a kind way.  There was a time in my stepsons “awareness training” where I actually showed him what he looked like by putting him in front of a mirror to show him how threatening he looked.  I showed him his angry face and clenched fists, and clearly stated that he was not allowed to be near us when he presented in this threatening way.  Prior to this moment, he had no idea how he looked or sounded.  It was not an easy process to embark.  He was enraged by us showing him what he looked like.  In the end, it was worth it.  We convinced him that showing him explicitly how he appeared was something we were doing for him and not to him.  It was not punishment but a step necessary for self-insight.  I am not sure he could have learned as much about himself and how he appears to others without this step.

Step Two:  Show and Teach

Do not assume your child knows how to be kind, even though you are kind in all you do to model appropriately for your child.  Many children with these disorders do not learn by watching.  They miss most body language and social cues (facial expressions and tone of voice).  As a result, they must be explicitly taught.  You will need to teach them appropriate words and actions, and explain when and how to use them (e.g. “When you upset someone, you must say “I’m sorry I hurt your feelings.  I didn’t mean to”).

As a parent of neurologically challenged children, I admit it’s not always easy to for me to maintain my composure.  In times such as this, it is also important to apologize to your child.  As the grown-up it is our responsibility to model how to demonstrate how to keep calm and be in control.  In addition to repairing any possible damage to your relationship with your child, you will be also teaching your child how to apologize.

Step Three:  In the moment

When my stepson engages in mean behaviour, we politely remind him with positive language, “You need to use a friendly and caring tone of voice”, “Please use kind words” , “You need to try again, with a friendly (or caring) face”.

(See Neurologically Gifted’s article:  Using Positive Language for Success)

If he continues with unkind behaviour we then issue a choice for him to self-correct, “You need to use a friendly voice”, or “You need to go somewhere else (give a choice) because we don’t like your behaviour right now and don’t want to be around you”.  (such feelings are normal, and are the result of the child’s behaviour.  This is a true-life natural consequence that your child needs to be aware of for understanding social norms.  If he can’t make a positive choice independently then we would help by making the decision for him

(see Neurologically Gifted’s article Taking On Rage 4: Prepare a Plan)

While teaching my stepson, there were good days and bad days.  I was not disheartened when he seemed to “slip back” a few steps.  We focused on his progress, when he applied his new learning, and we built on those moments.  Always quick to give him praise for making a good choice, we built his confidence and his emotional investment in the members of our family.  Once distant and unconnected to his family, he now knows he is loved, and he not only cares about us, he is quick to admit when he has made a mistake, and asks for help when he needs it.

We all do, in our family.

Emotional Dysregulation – Just like Regular Kids but “Only More So!

A very dear friend and expert special educator insists that kids who have neurological disorder are just like regular kids – “only more-so!”

Let me explain what that confusing statement means…

Kids who have neurological disorders have feelings just like everyone else, except their feelings are so much more intense. They feel so much more of everything. They experience more joy when happy, (hence their hyperactivity), they feel more pain when injured (we think they’re over-reacting), more anger when frustrated or disappointed (leading to rage) and more sadness (also misinterpreted as over-reacting).

This evening, my stepson erupted into a fit of screaming and pounding the floor in a rage over homework, then back to a total recovery and calm. Soon after, he collapsed into a heap of tears as he suddenly recalled the death of his grandmother from the previous year. The intense grief lasted about 2 minutes, and he recovered once again, to join his friends in playing basketball.

I shouldn’t be surprised by his behaviour tonight. He was bound to fall from perfection at some point. He’s been stable and even tempered for months – and it’s due to consistency at home and at school.

Kids with neurological disorders are incredibly susceptible to change, as we all are – “only more so!”

Change has an effect on us all, to varying degrees. Some people abhor surprises, which is just another name for change. Kids with neurological disorders often fall apart in these circumstances that arise from change.

Emotional dysregulation can be observed as intense or extreme emotional responses to a situation, aggression, impulsivity, avoiding behaviours, difficulty calming themselves and difficulty knowing what emotion they are actually feeling and especially, drastic changes in mood.

My stepson’s chemistry and subsequent emotional state is totally dysregulated today for any number of reasons. From my own personal Tourette experience, I know he could be unconsciously reacting to the onset of the Canadian winter – with a reduction of daylight hours and cold temperatures. This always messed me up. It still does, sometimes. When his chemistry is thrown into flux like this, Nathan’s behaviour is erratic and (almost) manic. He can swing from one extreme mood to another. As well, he is dealing with another ill family member. Although he seems calm, he is very prone to experiencing a quick thought of concern, then bursting into tears from a memory of his late grandmother.

By keeping Nathan’s life consistent, we greatly reduce the occurrence of mood swings and emotional dysregulation. At times of change, it is important to stay connected to any consistency and predictability you can find. For example, on a trip during the holidays, we can expect Nathan to be extremely dysregulated and prone to mood swings.

His normal routine of waking, going to school, coming home and going to bed ceases.

In these cases, we keep eating and bed times consistent. We maintain sleep hygiene so he can slowly unwind and fall asleep at a reasonable time using his normal bedtime routine.

We give him ample warning of the plan of each day with frequent recaps and updates to give him time to process the upcoming schedule and reduce over reaction when the changes happen.  Rules must be kept consistent, as well.  There are no exceptions such as, “just this one time”, or “it’s the holiday”.  There is no “flying by the seat of our pants” with our Nathan.

Keeping Calm

Meltdowns from emotional dysregulation can be minimized by maintaining routines, maximizing predictability, planning ahead, advanced warning of change and consistent rules.

For the times when dysregulation occurs, (and it will), it is helpful to keep in mind that kids with neurological differences actually do feel more, and they will respond more.  They are just like regular kids – “Only More So!”

Coprolalia Part 3: Taking Action on Coprolalia

Coprolalia can be a particularly distressing symptom and a lifelong struggle for an individual with Tourette Syndrome.  Stigmatization, shame and isolation must be reduced by the efforts of the individual, their families, their community and society.  Strategies to manage coprolalia will target improving the acceptance and understanding of this difficult symptom which will in turn reduce the frequency and the intensity of it’s expression.

Understanding the nature of coprolalia is essential to understanding strategies for the management of coprolalia.  (Please see Coprolalia Part 1:  The Nature of Coprolalia and Coprolalia Part 2:  Coping With Coprolalia)

Here are some strategies that take action on coprolalia to reduce it’s impact on well-being.

Use positive language

Planned ignoring of coprolalia is not just ignoring the symptom altogether especially if the behaviour is having a negative or harmful impact on the individual or other members of the family.  Be sure to define what negative or harmful impact means for your family.  An individual can contribute to the family’s well being whilst consistently ticcing “F**k, f**k”.  It is not harmful just because you or someone else does not  particularly want to hear it.  In fact, a tic as harmless as this example may actually be helpful in directing the individual’s attention away from more harmful forms of coprolalia.  When helping to redirect behaviours that are harmful or have  negative impact, use positive language at all times.  (See Neurologically Gifted’s article:  Using Positive Language for Success – coming soon).  If coprolalia is loud enough or involves another person you can use positive language to help modify the behaviour or make it less hurtful.  For example, “You may say “F**k” but you need to increase the distance from your brother’s ear when you say it”.  If coprolalia hurts another person’s feelings you can use positive language to teach responsibility.  For example, “You looked at your brother and called him a name.  You didn’t mean to, but you hurt your brother’s feelings.  You should apologize and ask if  he is okay.”  Note:  this is not apologizing for having Tourette Syndrome and for having tics, it is an apology for having potentially hurt someone’s feelings (a natural consequence).

Use substitution words

Substitution words are words or phrases that can be strategically placed to modify coprolalia.  The important aspect of this technique is that the child must be involved in its development and the word or phrase must satisfy the tic.  The individual using this technique must also be highly motivated to attempt to modify the behaviour.  If they are not invested, this strategy  will not work.  Always investigate motivation and the ability to invest mental energy into this task.  A child who suppresses tics all day and is mentally exhausted will not benefit from mom or dad saying, “Now Johnny, say Fruit Cake, not F***.” Willingness and readiness is essential and it is okay to put this task aside indefinitely if necessary.  If there is enough motivation and investment from the individual, involve them  with coming up with words that are similar enough to satisfy the tic but may be less offensive.  For example, “Shitake” or “Fruit cake”.   If the tic is not satisfied the individual is essentially suppressing the tic, causing more focus on the actual tic and increasing stress.  Increasing stress on the individual is counter-productive to managing coprolalia.

Here is an example of my son substituting counting from 1-10, (his own idea) to prevent coprolalia from recurring.  Caution:  Clip contains Coprolalia.

Be Accountable and Responsible

At first glance, being accountable and responsible for your own or your child’s symptom,  coprolalia, may seem harsh.  Coprolalia is an uncontrollable symptom of a neurological disorder.  This is true.  They can’t help it and it is not their fault.  However consider that being accountable and responsible does not involve finding fault or laying blame.  For example –  you step on someone’s toe while waiting in line.  It was an accident, the other person will assume it was an accident and it wasn’t done on purpose.  You would naturally apologize and ask if the other person was okay.  You take responsibility and you are accountable for the action however unintended and unwanted.  If you sneeze, you may apologize or excuse yourself, if you trip and bump someone you would apologize, if you were startled and screamed and scared someone else you would apologize and or explain.  The same should apply to tics and coprolalia which have an impact on others.  It does not imply that the individual is willfully or maliciously doing the act.  For example, my son has a screaming tic and when his screaming tic and his coprolalia occur together he is screaming profanities.  Everyone in our home knows that it is unintentional and an uncontrollable symptom of his Tourette Syndrome.  However, sometimes it hurts!  It can hurt our ears, it can startle us, it can shock our neighbours and it can hurt our feelings.  As a mom with a young son who has a “f***ing b**** a**hole” tic, being barraged daily with these words, I can say that it hurts, it wears me down, and it sometimes makes me sad.  No harm is intended and no blame is laid but if he apologizes, it does a few positive things for us all.

Being responsible and accountable for his neurological symptoms gives him power!

• He can teach others about his symptoms and his disorder and promote understanding.  “Sorry,  I didn’t mean to scare you.  I have Tourette Syndrome and that was something I can’t control.  I can tell you more about it if you would like.”
• He can control the effects of his symptoms on others.  He can change how others feel and think about him.  “Sorry, that was an accident.  I have Tourette Syndrome.  I sometimes do things I don’t mean to do.  I didn’t mean to do that”
• He will become a powerful social thinker!  He learns to care about what others see of his actions and how they feel about him.  Being accountable and responsible means “I know I did something that may have affected you negatively, I care, I am sorry and I did not mean to do that to you”.  He will grow to be a caring and kind adult.

Being responsible and accountable for his neurological symptoms makes others feel better!

• Just like stepping on my toe, my sonsaying sorry to me for saying “F**k you” makes me feel better.  I know he can’t help it but by apologizing I also know he didn’t mean it and that he cares about my feelings.
• Apologizing or acknowledging the coprolalia alsoenlightens others, makes them smarter and more tolerant of others.  They probably didn’t know it was unintended until there was the apology and explanation.  How could they?

For the complete documentary see:  Neurologically Gifted’s article,  Learning From Kids with Challenging Behaviour:  The First Day (coming soon)

Be sure to see our other articles about coprolalia

Coprolalia Myths Demystified

There are several common coprolalia myths one may encounter when learning about Tourette Syndrome.  The first big myth is that most people with Tourette Syndrome have coprolalia.  This is what is known as TV Tourette…  In reality, only 10-15% of people with Tourette have coprolalia and even then it waxes and wanes as do all Tourette Tics.  Here are some other Coprolalia Myths…

Coprolalia Myths #1:

Children with coprolalia come from homes where they are exposed to obscene language and/or inappropriate material.   False!

Children who have neurological differences with the symptom of coprolalia have brains that work atypically.  Despite often being diagnosed with Attention Deficit Disorder, children with ADD or ADHD are not lacking in attention ability but their attention works differently than a typical child.  A typical child’s attention manages their environment by attending to what is important, (or what they are directed to), in the particular immediate situation.  A child with ADD/ADHD has attention but it most often easily drawn outside the immediate situation and the child is said to be highly distractible.  It is not an attention deficit at all but rather the inability to focus that attention where it should be.  Often attention is drawn to and captured by what is brightest, what is loudest and what is most inappropriate.  There attention flickers through all the available stimuli and if it settles it will do so on language, actions and social situations that are most different, most exciting and socially taboo or inappropriate.

Actually the diagnosis Attention Deficit Disorder is misleading.  Ask any parent who’s ADHD child can play video games or watch TV for hours but can’t attend long enough to brush their teeth properly.  This phenomena is called hyper focusing and very common in ADHD children.  To further add to this, it is easy to focus on things that are interesting, exciting or unusual to us.  It takes mental maturity, skill and focused attention to attend to things that we find boring.

So, the stage is set.  Their brilliant minds are primed to pick up the most unusual and inappropriate data their roaming focus can find.

By walking through stores, to and from school, around the mall, and every where else, a child with ADHD or TS has their attention pulled to any inappropriate language, visual material and actions of others they find different or interesting.  They notice the teens huddled in the corner smoking, using bad language, or spitting on the ground.  They notice how they dress, how they look at each other and how others look at them dissatisfied with their behaviour.  They notice reference to sexual behaviour and materials and how society tries to shield them from it.  They often get adult sarcasm, hints and inferences.  They quickly learn what is inappropriate from all these cues and because of the hyper focus and attention to the behaviours, they stick in the child’s mind like glue.  My son from a very young age was particularly drawn to teen behaviour.  Walking through a mall with him was a struggle.  It took a great deal of effort to keep him on task and with me and I could tell instantly when there was some alternate social teen behaviour happening around us.  Suddenly he would be still and silent, watching and listening and soaking it all in.  He would then recount aloud what he had heard or saw repeatedly and he never forgot his observations.  And he was never reluctant to share them with others.

As an example:  (Caution:  Contains Coprolalia)

 These cases are not bad parenting, or abuse or access to adult material that could be prevented.  It is simply a hyper attentive mind doing what it does most easily and effectively…finding and perpetuating that which is most exciting and most instigating.

Coprolalia Myths #2:

 Children with coprolalia need firmer and more consistent discipline.  False!

Children with coprolalia know what they are saying (or doing in the case of copropraxia) is socially unacceptable.  That is how they were drawn to learn it.  As a matter of fact, the more they understand the behaviour is unacceptable and the more unacceptable it is, the more they will be driven to do it.  Simply stated, the worst possible thing to say or do becomes the hardest thing not to say or do.  Ask any child if they know what they are saying is wrong or inappropriate and they will tell you, yes.  Often they are embarrassed and ashamed by their own uncomfortable symptoms.

Correcting the child or punishing the child is counterproductive and can dramatically increase the chance of it’s occurrence.  It creates a dialogue in the child’s head that tells them not to say “@!”, because they will be punished.  Don’t say “@!”.  My dad really hates when I say “@!”.  It’s wrong to say “@!”.  I will be sent to my room if I say “@!”.  The child ends up consumed with thinking “@!” reinforcing the tic’s neurobiological pathway and making it that much more difficult to prevent its expression.  This process of negatively reinforcing the coprolalia adds to the child’s stress level which ultimately makes tics, including coprolalia worse.

The child already knows it is wrong and is usually already punishing themselves internally, creating a negative impact on their self esteem and self worth.  Imagine the feeling of being obsessed with doing something you know causes a negative reaction from everyone you care about.  The time spent obsessing and worrying about coprolalia leaves the individual less able to manage everything else.  Ideally, understanding and knowledge about coprolalia, for the child and adult, helps create a caring environment where the child can grow.

Educate yourself and avoid coprolalia myths.

SCHOOL MEETINGS: HOW TO MAKE THEM EASIER

***THIS ONE HAS LOTS OF LINKS AT THE BOTTOM !!!!

How to Make The Most of School Meetings

School meetings are most often difficult for the parent but so important for your child.  Your child is special, requires special accommodations, your child’s behaviour doesn’t follow the normal or expected behaviour or your child isn’t learning as well as he or she could.  Perhaps it’s not your first meeting or perhaps the strategies being implemented aren’t working.  Perhaps your child’s teacher or school administration doesn’t understand your child’s difficulties and differences or are unable to offer help.  In any case, it usually provides for a stressful time for the parent….trying to make things better for your child.

I have attended countless school meetings.  My son, having Tourette Syndrome, Attention Deficit Disorder, Obsessive Compulsive Disorder and Oppositional Defiance Disorder, provides an unending barrage of challenges for the adults who help to shape his life.  Some of these school meetings have gone well, some have been a complete disaster.  I have survived them, dreaded them and finally, I now feel blessed that the adults in my child’s school understand his differences, see his challenges and strengths, listen to him and help to guide him and teach him.

In the past, have been at school meetings because my child was suspended for behaviour that was out of his control.  I have been to school meetings where I have been face to face with an adult who told my son he was faking and didn’t have Tourette Syndrome or coprolalia.  I have been to school meetings where I have been asked to keep my child home for all or part of school days.  I have been to school meetings where administration has asked my child’s psychiatrist how they can “turn a blind eye to his behaviour and just let him get away with it?”  It has been a very heartbreaking and difficult road.

I have not always been able to follow these tips that I will share, but I do know that even the really, really bad school meetings would have been a little better if I had been able to remember:

Tips for School Meetings

1. Keep an open mind and always assume that the players are acting with the common goal of helping your child. They are your team and you need to have a good working relationship.  Unless you are going to up and leave the school you must work with them.  Give them the benefit of the doubt that they do want to make things better for your child just like you do.  If you are considering them as an opponent, your focus should be getting them on your team.
2. Keep an ongoing record and bring it to all your appointments. As you probably know, you will often encounter the same questions from numerous players on the team.  Keep dates of diagnoses, medical professionals you’ve consulted, medications you’ve tried and what the outcomes were.  Ask for copies of consultations to keep in your medical file. Keep a record of your school meetings, who was present, what the discussion covered, what strategies were to be implemented and what the next steps will be and when they will occur.  If you have items that need to be covered in the meeting, prepare an agenda and give it to the school ahead of time.  In the school meeting jot down notes to keep for your school file.

3. Know your rights and your child’s rights. Read about the process of getting your child identified, having accommodations implemented or changing placement in your school board.  It is a legal process and prompting “okay, so this should be reviewed by this date…etc”, lets them know that you have expectations about the process and will follow up.  Be sure to allow the players time to respond to whatever issue is on the table before trumping them with a higher upper.  Everyone deserves a chance to do their part on the team.
4. Provide resources as a helpful gesture if you think there is an understanding gap. Use information and resources that you are familiar with and have been helpful to you and your child.  Make the resource as specific to the situation and to your child as possible so it doesn’t seem overwhelming or intimidating.  Be selective and specific about resources you provide.
5. Bring someone with you. A friend or family member who is familiar with your child and his or her differences can be a big support.  It can be intimidating to walk alone into a room with many unfamiliar faces.  Moral support it great, a second set of ears is always helpful and if you begin to stumble or get off track they can prompt you back to the discussion.
6. Be kind and respectful. Share your wishes, what works for you at home, what you think might work better at school.  Emotions tend to surface but try to keep cool.  People in general are more willing to listen to you and take value from what you say if you are kind and present your ideas nicely.  Everyone tends to shut down when being told what to do.

Good luck!

Make school meetings a positive experience.

Remember that you are a very important member of your child’s school team!

Here are some links to help out at home and at school with understanding and strategies:

For Education:

Learning From Kids With Challenging Behaviour:  The First Day

Tourette Syndrome Plus Class Presentation

Where Tics and Compulsions Meet:  TS Plus OCD

Coprolalia Part 1:  The Nature of Coprolalia

For Strategies:

Instructional Tools From Social Thinking:  Teacher’s Review

Support Your Child’s Learning at Home

Using Positive Language for Success

Coprolalia Part 2:  Coping With Coprolalia

USING POSITIVE LANGUAGE FOR SUCCESS

One of the first words we learn as children is “No”.

We learn the meaning of “No”  early in our development.  It’s a quick and easy instruction.  “No” is simple and used regularly – especially with toddlers because it is immediately effective at that age.  A stern “No”, and an action to stop the child quickly ends the behaviour that we don’t want.

The effectiveness of this strategy usually backfires for us when our child learns to parrot “No” back to us.  Often called the “terrible twos”, children start to assert their self-determination.  They learn that if “No” works on them it should work on everyone else.  From childhood, we become accustomed to hearing and giving instructions that start with “Don’t” and “Stop”.  We learn that “Don’t hit” or “Stop talking” is quick, clear and easy to comply with – but is it really?  In the long run, the “No” strategy often ends up creating more problems for us than solutions.

As parents, we often become frustrated and angry with our children because when we tell them what not to do, they quickly find something else to do that is equally undesirable.  “Stop talking” becomes singing or whispering, “Don’t hit” becomes poking or kicking.

Without clear instruction, children are often frustrated as well.   They  have followed your instruction, but now they’re in trouble for doing something else!  They have a multitude of other behaviours to choose from and feel overwhelmed, (or fearful), at the potential of further failure.  Children often prefer clear direction so that they can be successful.

In children challenged by Oppositional Defiance Disorder (ODD), negative language usually ensures the child will do exactly what you told them not to do.  In our home, telling our child with Oppositional Defiance Disorder to not something prompts him to do it.  Then he will quickly apologize because he was compelled to do it, and in the end, everyone feels bad.

Consider this simple example of positive and negative language for instruction.

Positive language instruction:

Think of a green monkey.

What happened?  Did you comply with the request?  You probably did and even if you didn’t, I would bet that you didn’t think of a pink elephant which is exactly what I didn’t want you to do.

Now…

Negative language instruction:

Don’t think of a pink elephant.

What happened?  In order for you to NOT think of a pink elephant you were forced to think of a pink elephant.  This is called priming and prompts the child to do something.  Unfortunately for everyone, what they end up doing is what you didn’t want to happen.

What is Positive Language?

Positive language is a strategy that can be used to direct children and works especially well with children who have oppositional tendencies.  The opposition could stem from hyperactivity and attentional challenges, Tourette Syndrome or Oppositional Defiance Disorder.  Positive Language is the use of direct language that states what you want the child to do, increasing the chance that the child will be successful.

Positive Language tells the child what they can do.  Be as specific as necessary for the child to be successful.  An example that comes to mind is the direction, “relax” – positive language but difficult to do especially if the problem is that you are not relaxed.  A more simple positive language instruction than “relax” would be “take a deep breath”, “close your eyes”, or “think of a happy moment”.

Positive Language increases the chance of a child complying with your request without providing the idea of doing what you don’t want them to do.  Instead of telling them what not to do and forcing them to hear and think about it, clearly state what you want them to do.  Remember the pink elephant example.  We don’t want to prime the child and set them up to fail.

Positive Language reinforces desired behaviours by verbalizing exactly what is desired.  Undesired behaviour is prevented and not verbalized which would inadvertently give it undue attention.  Don’t focus on the behaviour that you want the child to stop.  By giving direction about what they can do or should do, the attention stays on the desired behaviour.  Children prefer positive attention so be sure to positively reinforce their compliance with your request with praise.

Using Positive Language

Positive language instruction may be kept very simple.  It may be a clear direction stating specifically what you want the child to do.  For example, “put your pencil down”.  With negative language you would say “stop tapping your pencil” which may be met with the child breaking it or chewing on it.  In my home, with a child with Oppositional Defiance Disorder, “stop tapping your pencil” would turn into a drum solo!  “Don’t do that!”, using positive language, becomes “Please eat your dinner” or whatever else you want them to focus on.  Talking in class would be met with “Mouths closed, please.”  To regain the attention of my class, I would say “Knees under your desk, mouths closed with your eyes on me, please”.  To address running in the school hallway, I would say, “Everybody walking with your hands by your side, with one person in front of you and one behind you, please”.  Make your request as direct and simple as you need depending on the child.

Positive language instruction may be more complex.  The child may have options but is directed away from what you don’t want them to do.  For example, “you can stay in this room if you are being respectful to everyone”.  The child may choose to leave and do something else.  Be confident that the child is likely to make a good choice with what he goes on to do.  If the choice is likely to be a different undesired behaviour somewhere else, you may want to stick to a more simple use of positive language instruction.  In this example, using negative language you would have said, “stop hitting your brother” which may be met with the child then poking or making faces at his brother.  To address this behaviour using simple positive language you might say “Keep your hands to yourself, please”.  Occasionally, with challenging children I may have to make the request clearer, stating, “Please keep all your body parts to yourself”.  Fair enough – just keep it positive.

Positive Language:  Neurologically Gifted

Take some time to self-reflect on how you direct your child or students and try to add more positive language in your instruction.  We are often very pleasantly surprised by the positive responses we receive.

For information about using positive language as a strategy for coprolalia see:  Coprolalia Part 3:  Taking Action on Coprolalia

Oxytocin and Attachment

Oxytocin and Attachment

A couple years ago, I began researching bonding, attachment and oxytocin.  My son was a bundle of nerves, so hypersensitive to my touch it appeared painful.

Oxytocin is a powerful hormone that is necessary for bonding and attachment.  It is often called the “love” molecule.  My son with tactile sensory sensitivity as well as TS Plus was not getting any oxytocin and it worried me.  When Nathan was a baby he pushed his body away from mine and cried louder when I tried to soothe him.  It was a painful phenomenon not being able to comfort or soothe your child with cuddling, contact and kisses.  Every time he pulled away or reacted with anger or violence to intimate touching was painful for everyone and it is hard not to just stop reaching out due to how uncomfortable he obviously was with touch.  I wondered what I should do.

When we hug or kiss a loved one, oxytocin levels drive up. It also acts as a neurotransmitter in the brain. In fact, the hormone plays a huge role in pair bonding. In Nathan’s case I had to restrain myself from doing what seemed natural because of his hypersensitivities.  If Nathan fell off his bike, I learned not to go and see if he was okay because his distress would amplify by my presence, I would end up physically hurt and not have been able to comfort him in any way in the process.  By age 7 or 8 his combined disorders made it difficult to tell if he would notice if I was suddenly not there.  I wondered if he had a bond with me.  I had a difficult time answering the question at that point and I didn’t like that at all.

We put together an experiment.  We needed a plan to get his body to make some oxytocin and hopefully in the process, bring us closer together.  Plans work better when we make them together so I talked to Nathan.  I told him about oxytocin, what it does and how we could potentially get more.  We came up with “cuddle time”.  We did have to implement a minimum time as it was very difficult and sometimes painful for Nathan with his disorders and sensitivities.

“Cuddle time” would happen at bedtime, when he was finishing a last game on his Ipod, I could read to him, I could scratch or rub his back…anything, even tickles.  The only rule was that it had to have skin on skin contact.

The proposed benefits:

Helping us create a greater sense of intimacy and bonding

Induced feelings of optimism, self-esteem and building trust

Reduced feelings of depression and anxiety

Increased empathy and generosity

For Nathan, the results of “cuddle time” have been astounding.  He is more likely to offer cuddle time spontaneously.  He may even ask for cuddle time, or a back rub at times.  He may still react negatively to touch that he is not expecting but will apologize for his reaction.  He will hug and kiss freely when appropriate.  I no longer wonder if there is a bond between us, there is and it is much stronger.  And we no longer need to plan cuddle time as we have many spontaneous opportunities throughout the day.  We hug and kiss and there are many “I love you”s going around our house.  I know as he grows older we may have to reinstate our planned “cuddle time” and we will and we know why it is important.

At the Tourette Syndrome Foundation of Canada National Conference of Tourette Syndrome Plus this past weekend I was reminded of this regimen I implemented and was validated as it is an intervention being taught to parents.  Jennifer Kolari did an informative and engaging presentation about her method, Connected Parenting.  Included in the therapeutic technique…baby time!

Here is a little bit about Jennifer and Connected Parenting.

Connected Parenting shares techniques that therapists use to help parents soothe their child as well as enhance the parent-child bond and is based on the understanding that correcting and guiding behavior works best when it is preceded by and linked to empathy. At the heart of this parenting model is the CALM Technique which helps parents accurately attune to children’s affect and experience. These empathic interactions release reward chemicals in the brain that stimulate positive emotions and increase order and balance in the nervous system. Reward chemicals, including natural opiates, endorphins, and a powerful hormone called oxytocin, reduce and inhibit stress hormones and bathe the brain in positive emotions that ripple through every cell in the body. The benefits of empathy and compassion have a strong base in science that cannot be underestimated. Simply put, it is brain food, the emotional nutrition all of us need, perhaps our children most of all.

Although many parenting techniques stress the importance of empathy, Connected Parenting will show you how to use it skillfully to repair frayed bonds, deescalate tantrums, contain and correct difficult behaviors and help your child to become more confident and emotionally resilient. We use a collaborative and supportive coaching model and provide inspirational, easy-to-understand techniques grounded in neuroscience and attachment. In the end, your child will be more compliant, more relaxed, and – most importantly – happier. Connected Parenting will bring out the best in you and your child.

I encourage you to check out her website.  It is packed with information, video, a blog and her books are available there.  If you have an opportunity to hear her speak, jump at the chance.  Her session was a highlight of the conference.